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Asthma is a chronic lung condition in which the airways narrow and become inflamed, which leads to wheezing, coughing, and chest tightness. Extrinsic asthma and intrinsic asthma are subtypes of asthma.

The symptoms of these subtypes are the same, but they have different triggers:

  • Extrinsic asthma symptoms occur in response to allergens, such as dust mites, pollen, and mold. It is also called allergic asthma and is the most common form of asthma.
  • Intrinsic asthma has a range of triggers, including weather conditions, exercise, infections, and stress. People may call it nonallergic asthma.

In this article, we discuss the causes, symptoms, and treatment of intrinsic and extrinsic asthma.

Intrinsic vs. extrinsic asthma

Intrinsic and extrinsic asthma are two subtypes of asthma, which people more commonly refer to as allergic and nonallergic asthma.

Both types cause the same symptoms. The difference between the two subtypes is what causes and triggers asthma symptoms. The treatments are similar for each type, although the prevention strategies differ.

Triggers

Woman taking inhaler for asthma whilst playing football. Intrinsic and extrinsic asthma have the same symptoms but different triggers
Intrinsic and extrinsic asthma have the same symptoms but different triggers.

In people with extrinsic asthma, allergens trigger the respiratory symptoms. Common triggers for extrinsic asthma include:

  • pollen
  • mold
  • dust mites
  • pet dander
  • cockroaches
  • rodents

In some cases, a person is allergic to more than one substance, and several allergens trigger asthma symptoms.

In people with intrinsic asthma, allergies are not responsible for the symptoms. Instead, the following triggers cause symptoms:

  • cold
  • humidity
  • stress
  • exercise
  • pollution
  • irritants in the air, such as smoke
  • respiratory infections, such as colds, the flu, and sinus infections

In some cases, intrinsic asthma can occur with no known cause.

Prevalence

Extrinsic or allergic asthma is the most common form of the disease. According to the Asthma and Allergy Foundation of America, about 60% of people with asthma have allergic asthma.

Less commonly, intrinsic or nonallergic asthma occurs. Research in The Journal of Allergy and Clinical Immunologyindicates that intrinsic asthma occurs in anywhere from 10% to 33% of people with asthma.

It occurs more often in females than males and typically develops later in life than extrinsic asthma.

Causes

In all types of asthma, a person has overly sensitive airways and airway inflammation, which produces asthma symptoms.

Inflammation causes swelling in the airways that narrows the tubes and makes breathing difficult. The body also produces excess mucus, which further impairs breathing. These factors decrease the amount of air that can get into the lungs.

The inflammatory processes are similar in extrinsic and intrinsic asthma. In both, the immune system releases cells called T-helper cells and mast cells.

Research has found that there may be more similarities between the two types of asthma than researchers previously thought. Both types of asthma involve the production of IgE locally at the airways in response to the relevant triggers:

  • Extrinsic asthma occurs when the immune system overreacts to a harmless substance, such as pollen or dust. The body releases an antibody called immunoglobin E (IgE). The release of this antibody leads to inflammation and asthma symptoms.
  • Intrinsic asthma occurs when something other than allergens triggers an immune system response. People are not always able to identify the trigger.

Symptoms

The symptoms of extrinsic and intrinsic asthma are the same and may include:

  • wheezing
  • chest tightness
  • shortness of breath
  • coughing
  • increased mucus production
  • trouble breathing

Symptoms can vary in severity and may develop suddenly. Ignoring the signs and symptoms of an asthma attack can lead to a life-threatening situation. Recognizing symptoms as soon as possible and following an asthma action plan can help decrease the severity of an attack and reduce complications.

Treatments

The treatment options for intrinsic and extrinsic asthma are similar and include medications, lifestyle changes, and the avoidance of triggers. Since the triggers are different, the prevention strategies may differ.

Reducing triggers

It may be easier to identify the triggers for extrinsic asthma because allergies are the culprit. With both types of asthma, the identification of triggers allows an individual to take steps to reduce exposure and decrease symptoms.

The following steps can help reduce asthma symptoms in people with extrinsic asthma:

  • fixing leaky pipes to prevent mold buildup
  • keeping doors and windows closed when the pollen count is high
  • vacuuming often to reduce dust
  • keeping pets out of the bedroom

Triggers of intrinsic asthma do not involve a specific allergen. Due to the variability of triggers, it can take a little longer to determine the cause of flare-ups. People may find that avoiding humid, dry, or cold weather can prevent symptoms.

Medications

People can use the following medications to treat flare-ups of both intrinsic and extrinsic asthma:

Short-acting bronchodilators

Short-acting bronchodilators, also called quick relief medications, reduce symptoms fast. They work by relaxing the muscles of the airways.

Long-acting medications

People take long-acting bronchodilators daily, and they also open up the airways. Long-acting bronchodilators do not treat sudden symptoms as they take longer to work than short-acting bronchodilators.

Corticosteroids

Corticosteroids decrease inflammation in the airways. People take steroids daily to prevent symptoms.

Omalizumab

Omalizumab is an anti-IgE antibody therapy that prevents the release of IgE. Reducing IgE decreases the allergic response and prevents asthma symptoms.

People usually use omalizumab to treat extrinsic asthma, but it may also help with intrinsic asthma.

Lifestyle changes

Lifestyle changes might also help decrease symptoms of both types of asthma.

People with asthma may wish to consider adopting the following lifestyle practices:

  • maintaining a healthy weight
  • quitting smoking
  • avoiding secondhand smoke
  • reducing stress
  • getting a flu vaccine each year
  • washing the hands frequently to decrease the risk of infection

Outlook

Although there is currently no cure for either extrinsic or intrinsic asthma, people can manage the symptoms with medications, prevention methods, and lifestyle changes.

Intrinsic asthma is often harder to control than extrinsic asthma, as identifying its triggers is sometimes difficult. People can work closely with a doctor to determine the causes of asthma symptoms and find an effective treatment.

Dental implants are artificial structures that a dental surgeon inserts into a person’s jawbone. A person may need an implant if they have lost one or more teeth.

Keep reading to learn about the types of implants and associated risks. We also describe what to expect from dental implant surgery and how much the procedure may cost.

What are dental implants?

A dental implant is a structure that replaces a missing tooth. With screw-like devices, the surgeon inserts an implant into the jawbone, and it acts as an anchor for an artificial tooth, called a crown.

A device called an abutment connects the artificial tooth to the dental implant.

The crown is custom-made to fit the person’s mouth and match the color of their teeth. Crowns look, feel, and function like natural teeth.

Implants have several advantages over dentures, which are removable artificial teeth. Implants:

  • are more natural and comfortable
  • have a higher success rate
  • improve chewing function
  • lead to a lower risk of cavities developing in nearby teeth
  • lead to better maintenance of bone at the site of the lost tooth
  • cause decreased sensitivity in nearby teeth
  • do not need to be taken out and cleaned every night

However, dental implants are not suitable for everyone. The implanting devices must bond with the jawbone, so a person’s bones must be healthy before they can undergo implant surgery.

Types

There are two types of dental implant: endosteal and subperiosteal.

Endosteal implants are the most common type. A surgeon embeds them in the jawbone, and each can hold one or more artificial teeth.

A surgeon affixes a subperiosteal implant on top of the jawbone. Dental surgeons choose this option for people who do not have much height to their jawbone.

Safety

According to the American Academy of Implant Dentistry, around 3 million people in the United States have dental implants, and this number increases by about 500,000 every year.

Dental implant surgery is safe when a qualified and experienced surgeon or dentist performs it. It is also the only dental restoration option that maintains the health of the person’s jawbone and stimulates its growth.

Risks

Some people are not eligible for dental implant surgery. It is not safe for dental surgeons to operate on people with:

  • acute illness
  • uncontrollable metabolic disease
  • bone or soft tissue disease or infection

If these issues are resolved, a person can have the surgery.

In some cases, dental surgeons refrain from operating on people with:

  • heavy smoking habits
  • parafunctional habits, such as tooth grinding or clenching
  • behavioral or psychiatric disorders
  • HIV
  • diabetes
  • osteoporosis
  • AIDS

If people with any of the above undergo dental implant surgery, there is a higher risk of the implant failing.

Dental surgeons may also choose not to operate on people undergoing the following treatments, due to an increased risk of implant complications:

  • bisphosphonate drug treatment for bone loss diseases
  • chemotherapy
  • radiation therapy of the head or neck

Potential complications of implant surgery

People who undergo this procedure may experience complications during or afterward. The issues may include:

  • nerve damage, resulting in altered sensation in the surgical area
  • an opening of the incision following surgery
  • movement of the implant
  • exposure of the implant above the gumline
  • infection of the implant

People who experience movement or exposure of the implant may need to undergo additional procedures to improve the health of the bone and gums or remove or replace the implant.

The following are some signs and symptoms that an implant placement has been unsuccessful:

  • the implant is excessively mobile
  • pus or other secretions come from the site
  • pain when tapping the implant
  • rapid, progressive bone loss

Procedures

Each person is likely to have a different experience of dental implant surgery. Factors that may influence this include:

  • the number of teeth requiring replacement
  • the location of the implants within the jaw
  • the quality and quantity of bone at the implant site
  • the person’s underlying oral and systemic health

Depending on these factors, additional procedures may be necessary. These can include:

Sinus augmentation

Placing an implant in the upper jawbone is usually difficult because of the location of the sinuses.

The surgeon may need to perform a sinus augmentation — a procedure to lift the floor of the sinuses to allow more bone to develop so that the implantation can be successful.

Ridge modification

Some people have a jawbone abnormality that prevents enough bone for an implant from developing. In such cases, a surgeon may need to perform a ridge modification.

This involves lifting the gum to expose the area of deformed bone. The surgeon will then use a bone or bone substitute to repair and build up the area. This improves the quality of the jawbone in preparation for dental implant surgery.

Maintenance

After a person has undergone dental implant surgery, they must continue to brush and floss their teeth regularly. Artificial teeth require the same care and maintenance as regular teeth.

The surgeon or dentist will also schedule follow-up visits to monitor the implants and make sure that the teeth and gums are healthy. It is important to return to the dentist every 6 months for professional cleanings.

Cost

The cost of dental implant surgery varies, and the following factors can influence it:

  • the number and types of implants required
  • the location of the implants within the jaw
  • whether there is a need for any additional procedures to prepare the mouth for surgery

A dentist or another oral health professional can estimate the cost of dental implant surgery during an initial examination.

Some dental insurance policies cover a larger portion of the cost.

Other tooth replacement options, such as bridges, may be less expensive. However, bridges are harder to keep clean and often require replacement and repair, increasing the overall cost. Dental implants may provide longer-term benefits if a person takes care of them well.

Summary

Dental implants are fixtures in the bone that replace missing teeth. Implants have a high success rate and can provide long-term benefits.

Some people need additional procedures to prepare their mouth for dental implants. These will add to the overall cost. The number and type of implants required can also raise the cost.

Anyone considering dental implant surgery should ask their dentist whether it is right for them.

Insomnia can have a serious impact on a person’s health and well-being. Now, a study of females aged 50 and over has found that some parts of the diet most likely contribute to this sleep disorder.

Insomnia affects many people all over the world. According to the National Sleep Foundation, up to 40% of people in the United States experience some insomnia symptoms each year.

Researchers have taken due note of this, as numerous studies have suggested that insomnia is not just a mild annoyance: It may actually be linked with many other negative health outcomes.

According to the Centers for Disease Control and Prevention (CDC), short sleep duration and sleep disruptions are associated withTrusted Source cardiovascular problems, diabetes, and depression, to name a few.

For this reason, specialists have been looking for ways of preventing or treating insomnia and other sleep disorders — starting by looking for all the possible causes.

Existing research has already called attention to the fact that diet may influence a person’s sleep qualityTrusted Source. Now, a study from Columbia University Vagelos College of Physicians and Surgeons in New York City, NY, suggests that a diet high in refined carbohydrates — particularly added sugars — is linked to a higher risk of insomnia. This, at least, appears to be the case among females aged 50 and over.

The research team reports these findings in a study paper that now appears in The American Journal of Clinical NutritionTrusted Source.

“Insomnia is often treated with cognitive behavioural therapy or medications, but these can be expensive or carry side effects,” explains senior study author James Gangwisch, PhD.

But, he adds, “[b]y identifying other factors that lead to insomnia, we may find straightforward and low cost interventions with fewer potential side effects.”

The possible underlying mechanism

The researchers worked with the data of 53,069 female participants aged 50–79, all of whom had enrolled in the Women’s Health Initiative Observational Study between September 1994 and December 1998.

To understand whether or not there really is a link between dietary choices and the risk of insomnia, the investigators looked for any associations between different diets and sleep disruptions.

Gangwisch and colleagues found a link between a higher risk of insomnia and a diet rich in refined carbohydrates. This includes foods with added sugars, soda, white rice, and white bread.

The researchers caution that it was unclear from their analysis whether the consumption of refined carbohydrates led to insomnia, or that people who experienced insomnia were more likely to consume refined carbs, especially sugary foods.

However, they do note that there is a possible underlying mechanism that might explain added sugars causing sleep disruptions.

“When blood sugar is raised quickly, your body reacts by releasing insulin, and the resulting drop in blood sugar can lead to the release of hormones such as adrenaline and cortisol, which can interfere with sleep,” Gangwisch explains.

Why fruit will not impact sleep

The study authors also explain why not all foods that contain sugar will lead to the same effect. Fruits and vegetables — which naturally contain sugar — are unlikely to raise blood sugar levels nearly as quickly as foods containing added sugars.

This is because these natural foods are also high in fiber, which means that the body absorbs the sugar more slowly, preventing a spike in blood sugar levels.

Indeed, the female participants who had diets rich in vegetables and whole fruits — but not fruit juices — did not have an increased risk of insomnia.

“Whole fruits contain sugar, but the fiber in them slow the rate of absorption to help prevent spikes in blood sugar,” says Gangwisch.

“This suggests that the dietary culprit triggering the women’s insomnia was the highly processed foods that contain larger amounts of refined sugars that aren’t found naturally in food.”

James Gangwisch, Ph.D.

The researchers only worked with females aged 50 and over, but they believe that the findings could also apply to males and people of other ages. Going forward, they argue that this idea is worth exploring in more detailed studies.

“Based on our findings, we would need randomized clinical trials to determine if a dietary intervention, focused on increasing the consumption of whole foods and complex carbohydrates, could be used to prevent and treat insomnia,” concludes Gangwisch.

There are various types of headache that can affect people during the night. Certain types of headache only happen at night, while some are far more likely to occur during the night or early hours of the morning.

In this article, we look at the different types of headache that people may experience at night.

We also discuss symptoms and treatment options.

Causes of nighttime headaches

The sections below contain information about different types of headache that are likely to occur at night.

Hypnic headache

Hypnic headaches are rare. According to the Migraine Trust, they occur most often in people over the age of 50, although they can also affect younger people. Hypnic headaches are more common in females than males.

Hypnic headaches only occur during sleep. If a person experiences nighttime headaches more than 10 times per month, they may have hypnic headaches. In some cases, hypnic headaches can occur if people sleep during the day.

Some people call hypnic headaches “the alarm clock headache,” because they cause people to wake up — often at the same time each night. In fact, people may find that a hypnic headache wakes them up between 1 a.m. and 3 a.m.

Symptoms of hypnic headache may include:

  • throbbing pain
  • pain on one or both sides of the head
  • pain that lasts anywhere between 15 minutes and 4 hours but usually lasts for around 30–60 minutes
  • increased sensitivity to light and sound
  • watery eyes or a blocked nose
  • nausea

Some people may have more than one hypnic headache per night.

Cluster headache

People who experience multiple headaches may have a cluster headache. These headache episodes, or clusters, can happen between one and eight times per day and last between 15 minutes and 3 hours. Cluster headaches are also one of the most painful types of headache.

Cluster headaches commonly occur at night and can cause people to wake up 1–2 hours after falling asleep.

Researchers are not sure what causes cluster headaches, but genetics may play a part. They usually occur in people who are over the age of 20. Males and people who smoke heavily are also more likely to experience cluster headaches.

Certain factors may also trigger cluster headaches, including:

  • alcohol intake
  • strong smells, such as paint fumes or solvents
  • exercise
  • overheating

Symptoms of cluster headaches can include:

  • severe stabbing pain on one side of the head, which can include the eye and temple area
  • red, watery eyes
  • runny nose
  • sweating on the side of the head where the headache is
  • restlessness and agitation
  • a headache that stops abruptly

Tension headache

Tension headaches can occur due to stress, tight muscles, or fatigue. People may experience tension headaches at night due to tension building up throughout the day.

Symptoms of a tension headache include:

  • a dull ache or squeezing sensation on both sides of the head
  • pain that feels like a tight band or vice around the head
  • aching muscles in the neck, shoulders, or back
  • tightness in the jaw
  • pain that lasts between 20 minutes and 2 hours

Migraine

Migraine can cause intense head pain and wake people up from sleeping.

According to the American Migraine Foundation, the most common time for people to experience a migraine is the early morning. This is because any pain medication they may be taking to treat the head pain will often stop working after 4–8 hours.

The National Sleep Foundation report that 50% of migraine episodes occur between the hours of 4 a.m. and 9 a.m.

Symptoms of migraine include:

  • moderate-to-severe pain
  • nausea
  • vomiting
  • increased sensitivity to light and sound
  • changes in vision, such as seeing flashing lights or zigzag patterns

Each migraine episode can last 4–72 hours.

Diagnosis

A doctor should be able to diagnose the type of headache a person has by conducting a physical examination, taking their medical history, and looking at any symptoms.

If a person has any other symptoms that suggest an underlying cause to nighttime headaches, a doctor may also carry out:

  • blood tests
  • MRI or CT scans
  • EEG tests, to look at brain wave patterns

Treatment

The following sections list treatment options based on the type of nighttime headache a person may have.

Hypnic headache

To treat hypnic headaches, a person can consume caffeine before going to sleep. For people with hypnic headaches, consuming caffeine at bedtime does not seem to prevent them from sleeping.

In some cases, other treatment options may be more effective.

These include:

  • melatonin
  • flunarizine
  • indomethacin
  • lithium carbonate

People with stomach ulcers should avoid taking indomethacin, however.

Also, people with dehydration who use diuretics or have kidney or thyroid disease should consult their doctor before taking lithium carbonate.

Cluster headache

Although there is currently no cure for cluster headaches, there are treatment options to relieve the pain. Cluster headaches produce intense pain rapidly, so many pain relief medications are not effective enough.

According to the Migraine Trust, effective pain relief treatment for cluster headaches can include:

  • High flow oxygen: People can take in extra oxygen through a cylinder and face mask. Breathing in oxygen at a rate of 7–12 liters per minute may help delay or stop a headache episode. This may take 15–20 minutes to treat cluster headaches.
  • Sumatriptan: People can take this medication as an injection, which may relieve pain in 10 minutes during a cluster headache episode. People can also take sumatriptan as a tablet or nasal spray, but these forms can be slower to treat the pain.
  • Zolmitriptan nasal spray: This may be effective for treating cluster headaches in some people, but it can be slow to take effect.

Using preventive treatments is usually an effective way to stop the cluster headaches before they start. Preventive medications include:

  • verapamil
  • methysergide
  • lithium
  • corticosteroids
  • ergotamine
  • topiramate

Some of these preventive treatments can have side effects, so a doctor may need to monitor people while they are taking them.

Tension headache

If a person experiences tension headaches at night, taking over-the-counter pain relief medication before bedtime may help.

Applying a warm compress to the area or taking a warm bath or shower before bed can also help relax the muscles and relieve any tension.

Migraine

There is currently no cure for migraine, though it is possible to treat the symptoms. People can take medication either to relieve the pain during a migraine episode or to prevent the development of a migraine in the first place.

Managing stress through relaxation techniques and regular exercise may also help prevent the severity or frequency of a migraine episode.

When to see a doctor

A person should see their doctor if they have frequent or severe headaches at night. A doctor will be able to carry out tests to check for any underlying causes and to find out which type of headache the person may be experiencing.

A person should also see their doctor if they notice any unusual symptoms, such as:

  • getting new headaches after the age of 50
  • changes in personality or mental state
  • getting headaches after a knock to the head
  • headaches that stop them doing everyday activities
  • fatigue or muscle weakness

Tips for good sleep

People may be able to prevent or reduce the severity of headaches at night through practicing good sleeping habits.

For example, people may be able to get better sleep by:

  • waking up and going to sleep at the same time every day
  • getting 7–8 hours of sleep each night
  • avoiding caffeine before bedtime, unless using it specifically as a treatment option
  • avoiding alcohol and nicotine, as these can affect sleep
  • unwinding and relaxing before going to sleep

Summary

People may be able to relieve headaches at night with pain relief medication, relaxation techniques, and good sleeping habits.

If a person has severe or persistent headaches at night or notices other symptoms alongside a nighttime headache, they should see their doctor.

Pain under the left armpit can be concerning, and many people associate any pain on the left side of their body with a heart attack. However, most of the time, pain under the left armpit has a less serious cause.

The armpit is a complex meeting point for muscles and connective tissues, lymph nodes, and blood vessels. As such, many issues in this area can lead to pain.

Causes range from pulled muscles and mild allergic reactions to more severe issues, such as an underlying infection.

While many of the causes of left armpit pain are not harmful in the long term, anyone experiencing breathing difficulties and pain in their chest, jaw, or neck should see a doctor immediately.

Causes of left armpit pain include:

A pulled muscle

Many muscles around the shoulder and armpit can cause pain if a person injures them.

People can pull a muscle when reaching for an object, twisting incorrectly, or overstretching.

People who exercise regularly, especially those who do weight training, may be more likely to experience muscle pulls and strains.

In these cases, the pain should go away over time, as long as the individual rests the injured muscle and does gentle stretches.

If the pain does not go away after about a week, it is best to see a doctor.

Allergic reactions

Armpits are a frequent location for allergic reactions, which could cause pain under the left armpit or both armpits.

Most allergic reactions in this area will occur due to chemicals people apply to their bodies or clothes that touch the armpits.

Possible allergens include:

  • detergent
  • fabric softener
  • soap
  • deodorant
  • perfume
  • shaving cream
  • moisturizing creams or lotions

These products may contain chemicals or perfumes that irritate the skin. A rash may also form.

Anyone who suspects that their skin is sensitive to a particular allergen should note the products they used that day and report them to a dermatologist.

Allergy testing may help find the irritating product. Avoiding products with any harsh chemicals or other ingredients can also improve symptoms in these cases.

Cosmetic procedures

Simple cosmetic procedures, such as shaving or waxing, can also be to blame for pain under the armpit. These hair removal techniques may lead to other issues, such as ingrown hairs, cysts, or general irritation and chafing in the armpit.

Skin infections

A skin infection under the armpit may cause itching and pain. Bacteria thrive in warm, damp environments such as the armpits.

An overgrowth of bacteria in this area may lead to an infection, which could cause redness, swelling, and pain, among other symptoms.

Other forms of infection, such as fungal infections due to ringworm or yeast, may also cause similar pain and irritation in the area.

Mild skin infections should clear up without treatment if a person keeps the area clean and dry. However, a doctor may recommend antibiotic creams or medications to treat more severe cases.

Hidradenitis

Hidradenitis is a chronic condition that causes similar symptoms to severe acne. Hidradenitis occurs due to clogged hair follicles and glands. It is common in areas such as the armpits, where the skin rubs together.

Hidradenitis can lead to multiple cysts or boils developing in the area. In addition to these breakouts, the person will likely experience pain and tenderness.

Doctors can treat hidradenitis with anti-inflammatory medications. Some cases may require surgery.

Varicella zoster virus

The varicella zoster virus causes chickenpox and shingles. Breakouts of both illnesses are possible under the armpits, although chickenpox usually beginsTrusted Source on the face, back, and chest.

A shingles rash usually developsTrusted Source as a single strip on one side of the face or body, left or right. A person with shingles may also experience:

  • a fever
  • headaches
  • chills
  • an upset stomach

A person may feel pain and tingling in the area before the visible rash develops.

A doctor may prescribe antiviral medications to speed up the healing process, as well as pain medications to help ease symptoms.

Swollen lymph nodes

Lymph nodes are small, bean shaped bundles of tissue that play a vital role in the immune system. Lymph nodes help filter toxins from the lymph and deliver white blood cells to help fight disease.

The armpit houses a large number of lymph nodes. Lymph nodes swell as part of an overall reaction by the immune system, such as to an infection or illness.

Swollen lymph nodes in the armpit may cause:

  • a single or multiple lumps
  • tenderness
  • pain

If the swelling does not go down after an infection, such as the common cold, goes away, or the person is not feeling any other symptoms, they should speak to a doctor.

Psoriasis

Psoriasis is an autoimmune condition that leads to an overgrowth of skin cells. The buildup of skin cells forms patches called plaques. These plaques can cause symptoms such as itching and pain.

Psoriasis plaques can form anywhere, including the armpit. Some forms of psoriasis are more common in this area, including inverse psoriasis.

Psoriasis treatment typically includes both topical and oral medications to control symptoms.

Nerve damage

Nerve damage may also cause pain under the armpit. Nerve damage can be the result of a physical injury, such as one from overuse during sports or from an accident or fall.

Nerve damage can feel like:

  • pain
  • tingling
  • numbness
  • burning

Certain conditions, such as diabetes, may also lead to nerve damage or neuropathy. The National Institute of Diabetes and Digestive and Kidney Diseases note that up to half of people with diabetes have peripheral neuropathy, which is nerve damage.

While peripheral neuropathy typically affects the feet and legs, it may also affect the arms in some individuals. Diabetes treatment may help slow nerve damage progression.

Angina

Angina occurs due to a lack of oxygen-rich blood flow to the heart. This can be because one of the arteries leading to the heart is narrow or blocked.

Angina causes chest pain and discomfort, which is sometimes severe. It may also cause pressure and pain in other areas, including the:

  • armpits
  • shoulders
  • back
  • neck
  • jaw

Some people may also experience a feeling similar to indigestion.

Angina is a symptom of an underlying heart condition, for example, coronary heart disease, which can lead to a heart attack.

There are also many other types of angina. Anyone who suspects they have angina should talk to their doctor.

Cancer

In rare cases, pain under the left armpit that does not go away may be a sign of a cancerous growth, including breast cancer.

Cancer can cause the lymph nodes under the armpit to swell painfully. An individual may notice a lump under their arm or in their armpit that causes persistent pain or discomfort.

Underarm pain may also be the result of a specific cancer treatment, such as lymph node removal or mastectomy.

Anyone noticing texture changes or lumps in their chest or breast tissue should seek medical attention.

Treatment options for cancer will depend on its stage, which refers to how much it has spread. In general, earlier stages are easier to treat.

When to see a doctor

Anyone noticing the following symptoms along with left armpit pain should seek immediate medical attention:

  • shortness of breath
  • dizziness
  • pain in the chest, jaw, or shoulder

A doctor can also diagnose and treat pain from other issues, such as infections or swollen lymph nodes.

Pain under the left armpit from sources such as a pulled muscle should go away within about a week in most cases. Anyone who experiences symptoms beyond this time frame should see a doctor for a full diagnosis.

Summary

There are many possible causes of pain under the left armpit. The person may have pulled a muscle or may have swollen lymph nodes from an infection.

Other causes can be more serious, such as angina. Anyone concerned about their symptoms should see a doctor for a full diagnosis and treatment.

“I used to be a full-time patient at this facility,” says Michelle Eze, a drug abuse survivor, as she signs her name in the register for a check-up with her psychiatrist at Karu General Hospital in Abuja, Nigeria’s Federal Capital Territory(FCT).

“I’m so glad I sought help in time as I was dependent on drugs and it cost me so much. It negatively affected the relationship with my family and people around me. I was disowned and left to face this harsh world all by myself. Drug abuse is a problem we should all join hands and fight it.”

Michelle is now a full-time ambassador against drug abuse among women.

One out of every four people who uses drugs in Nigeria is a woman, according to a 2018 report by the United Nations Office on Drugs and Crime (UNODC).

Over 300,000 Nigerians are high-risk drug users

Approximately 376 000 people – or about 0.4% of the Nigerian population aged 15-64 – are reckoned to be high-risk drug users, according to the UNODC report. Nearly 90% of these users regularly take opioids – particularly pharmaceutical opioids such as tramadol codeine, or morphine – while the others take cocaine or amphetamines.

Over 20% of the high-risk drug users inject drugs, with women first injecting on average at 20 years old and men first injecting on average at around 21 years old. HIV prevalence among women who inject drugs is almost seven times higher than among men who inject, according to the 2010 National Agency for the Control of AIDS (NACA) Integrated Biological and Behavioural Surveillance survey.

“At Karu hospital, we receive roughly 15 patients every day and usually at least half of them report to be using one drug or another,” says Pius Wabass, a psychiatric nurse on the Karu General Hospital’s psychiatry ward.

“These patients are often so young – under 40 – and, of late, more women are checking into our facility. The misuse of drugs

has serious health repercussions. Medically, opioids are primarily used for pain relief, including anaesthesia, while amphetamines are powerful stimulators of the central nervous system used to treat some medical conditions.”

Efforts to respond to drug use in Nigeria

As countries including Nigeria make efforts to respond to drug use among the population, health experts note that there are some factors that affect women more than men. A lot of factors have been identified as putting women at increased risk, some are psychological, cultural, social and economic aspects of their lives. Another issue is the general perception that drug use is a male issue and women users are often reluctant to seek help. The Federal Ministry of Health (FMOH) is now addressing this.

“The FMoH has taken up this challenge and currently working with all stakeholders to respond to drug use among young people, especially women,” explains Dr Jimoh Salaudeen from the Food and Drug Division, FMOH. As part of the response, a women-specific drug treatment programme has been established at the federal neuropsychiatric hospital in Kware in Sokoto State and the ministry hopes to replicate such centres across the country.”

Dr Salaudeen continues: “There is a strong linkage between opioid use disorders and health conditions such as preterm births, stillbirths, poor foetal growth, maternal death and neonatal abstinence syndrome. This is why the Ministry of Health has prioritized sexual reproductive health, particularly for women, within the context of drug treatment and harm reduction.”

Working assiduously to reduce drug demand and harm in Nigeria

The FMOH, with the support of WHO, established the National Technical Working Group (NTWG) on drug demand and harm reduction in Nigeria in May 2019.

“The NTWG is working under the leadership of the Minister of Health and is actively engaged in implementing a comprehensive public health response to the challenge of drug use in the country,” says Dr Rex Mpazanje, WHO Cluster Coordinator for Communicable and Non Communicable Diseases.Close

“This effort also includes bringing together different stakeholders at the national and state level for a concerted response. This includes advocacy, capacity building and resource mobilization to ensure promotion of evidence-based prevention activities and the availability of drug treatment and harm reduction programmes at community level.”

Target 3.5 of the United Nations 2030 Sustainable Development Goals (SDGs) is to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol. WHO Nigeria will continue to support to the Government of Nigeria in achieving this goal.

The behavioural medicine unit of the Karu General Hospital, Abuja. Many drug abuse patients are treated here.

The majority of people can donate blood. However, those who use nicotine products, cannabis products, or both may wonder whether or not they can donate blood.

Hospitals and health clinics use donated blood to treat various medical conditions. According to the World Health Organization (WHO), the number of blood donations collected around the world per year exceeds 117.4 millionTrusted Source.

Blood donations can help with:

  • serious injuries
  • surgery
  • anemia
  • cancer
  • chronic illnesses

Read on to learn more about how different ways of using cigarettes, cannabis, and other drugs can affect a person’s ability to donate blood.

Nicotine

If a person smokes cigarettes or vapes, it does not disqualify them from donating blood.

However, both tobacco cigarettes and electronic cigarettes (e-cigarettes) contain harmful chemicals that may affect a person’s blood.

The American Lung Association claim that a burning cigarette produces more than 7,000 chemicals, including carbon monoxide, ammonia, and arsenic. Several of these chemicals are toxic, and 69 of them can cause cancer.

In addition to nicotine, e-cigarettes may contain the following harmful substances:

  • propylene glycol, which is present in paint solvents, antifreeze, and some foods (as an additive)
  • acetaldehyde, which is a toxic product of ethanol alcohol
  • formaldehyde, which is a chemical preservative present in disinfectants, glue, and plywood
  • diacetyl, which is a flavoring agent that tastes like butter
  • heavy metals, including nickel and lead
  • benzene, which is a chemical compound present in car exhaust

Currently, minimal information exists regarding the exact effects of vaping on blood donations. One thing to keep in mind is the fact that both vaping and smoking cigarettes can increase blood pressure.

According to American Red Cross guidelines, people can donate blood as long as their blood pressure is between 90/50 millimeters of mercury (mm Hg) and 80/100 mm Hg.

In one 2018 studyTrusted Source, researchers compared blood donations from people who smoke with donations from people who do not smoke. They concluded that smoking cigarettes does not affect the overall quality of the donated blood.

However, the researchers did note that the donations from the people who smoke had higher concentrations of carboxyhemoglobin (COHb) in the red blood cells. COHb forms when red blood cells come into contact with carbon monoxide, significantly reducing the amount of oxygen that red blood cells can carry.

Based on these findings, the researchers recommend that people avoid smoking for 12 hoursTrusted Source before donating blood.

Cannabis

Like smoking cigarettes and vaping, smoking cannabis does not disqualify a person from donating blood.

Current scientific researchTrusted Source suggests that cannabis use can negatively impact the cardiovascular system by:

  • increasing blood pressure and heart rate
  • narrowing the blood vessels
  • causing inflammation in the vessel walls
  • promoting blood clots

However, these potential adverse health effects should not impact the quality of any donated blood.

That being said, Vitalant — a nonprofit blood service provider — explain that people must not be under the influence of recreational drugs or alcohol at the time of donation.

Other drugs

According to the American Red Cross, people with a history of recreational intravenous drug use are not eligible to donate blood. This requirement helps prevent the spread of HIV and hepatitis.

It is important to note that this is not the case for people who have used drugs in other ways, such as by smoking them or taking them orally. The American Red Cross and other blood donation companies do not specify drug use as an excluding factor.

However, a person does need to make sure that substances such as nicotine and cannabis are not in their system when donating blood.

Excluding factors

To donate blood, the general requirement is that a person should be at least 17 years old. A person can be 16 years old, but they must have a legal guardian’s consent.

Other factors that may disqualify a person from giving blood include:

  • feeling sick or having cold or flu symptoms
  • using intravenous drugs not prescribed by a licensed doctor
  • having an active infection
  • having HIV or testing positive for hepatitis B or C
  • having uncontrolled diabetes
  • having a blood clotting disorder
  • having ever had the Ebola virus
  • having blood cancers, such as leukemia or lymphoma
  • having received a blood transfusion within the past 12 months
  • having a heart rate below 50 beats per minute (BPM) or above 100 BPM
  • having recently traveled to a foreign country
  • being pregnant, or having given birth within the past 6 weeks

Read more about the advantages and disadvantages of donating blood here.

Summary

Although smoking cigarettes, vaping, and using cannabis will not disqualify a person from donating blood, they should refrain from smoking for at least 2 hoursTrusted Source before and after donating blood.

A person may feel lightheaded or weak after giving blood, and smoking can exacerbate these symptoms. It is a good idea to avoid smoking until these symptoms go away.