• A breakdown product of excess niacin was linked to a higher risk of cardiovascular events such as heart attack and stroke.
• Niacin, or vitamin B3, is needed for a healthy nervous system. Most people get enough in their diet.
• Breads, flours and other foods are fortified with niacin. However, researchers say this may need to be reconsidered, given the new findings.

For decades, the food industry in the United States has added niacin — also known as vitamin B3 — to bread, flour and corn products to prevent pellagra, a disease caused by a deficiency of this nutrient. 

The program was so successful that today pellagra is virtually unknown in the country, except among certain populations with extreme food insecurity.

While preventing deficiency is a good thing, a new study published February 19 in Nature Medicine suggests that excess niacin in the diet may have a downside — increasing the risk of cardiovascular disease.

In the study, researchers looked specifically at a metabolic byproduct of excess niacin known as 4PY.

Researchers did not set out to examine the role of niacin in cardiovascular disease. Instead, they were trying to identify why when people are treated for other risk factors — such as diabetes and high cholesterol — some still have cardiovascular events.

In their initial research, 4PY, whose full name is N1-methyl-4-pyridone-3-carboxamide, showed up as a possible marker in the blood for cardiovascular risk. Researchers then traced this compound back to excess niacin.

They found that participants in the highest quarter of 4PY levels had about a twofold increased risk of major adverse cardiovascular events such as a heart attack or stroke, compared to those in the lowest quarter.

To put it another way: “one in four people in our cohorts had high levels of 4PY, and are at significantly higher risk for adverse cardiovascular events,” study author Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at Cleveland Clinic’s Lerner Research Institute in Ohio, told Healthline.

Researchers argue that 4PY increases cardiovascular risk through inflammation in the blood vessels, known as vascular inflammation.

Mixed effects of niacin on heart

Niacin’s ability to lower low-density lipoprotein (LDL or “bad”) cholesterol and triglycerides, and raise high-density lipoprotein (HDL, or “good”) cholesterol led to it being used as a treatment for preventing cardiovascular disease prior to the development of cholesterol-lowering statins.

Some research, though, shows that taking niacin doesn’t reduce the risk of cardiovascular disease events, or offers no extra benefit when used alongside statins. One study even found that use of niacin may slightly increase the risk of dying early.

Adding to this, the findings of the new study suggest that excess niacin may counteract some of the benefits of smaller amounts of niacin, such as supporting the nervous system.

“While niacin was previously prescribed as a cholesterol-lowering medication, its use has fallen out of favor, as multiple studies did not find as much benefit to cardiovascular health as initially thought,” said Dr. Cheng-Han Chen, interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, Calif.

Chen was not involved in the study.

“This [new] study will put another nail in the coffin for the use of niacin in heart disease,” he told Healthline.

However, Chen cautions that more research is needed to understand the relationship between different amounts of excess niacin and cardiovascular disease, especially in people taking niacin supplements.

How much niacin is too much?

To avoid a deficiency, adults need 14 to 18 milligrams of niacin per day. This can be found in 6 ounces of tuna or 4 ounces of peanuts, among other foods, including those that are fortified with niacin.

In comparison, therapeutic levels of niacin — such as amounts used in clinical trials for lowering cholesterol — are along the lines of 1,500 to 2,500 milligrams per day, the researchers write.

People taking prescription or over-the-counter niacin products were excluded from the analysis, said Hazen. So that leaves the diet as the main source of niacin for participants.

Researchers did not have data on how much niacin participants were getting in their diet. However, Hazen pointed out that ingestion of excess amounts of niacin — or related compounds such as nicotinamide adenine dinucleotide, nicotinic acid, and nicotinamide riboside — have all been shown previously to increase the level of 4PY, as well as another breakdown product, 2PY.

In this study, 2PY, also known as N1-methyl-2-pyridone-5-carboxamide, was not linked to inflammation or a higher risk of cardiovascular disease events.

Americans tend to get more than enough niacin to prevent a deficiency, ingesting 37 milligrams per day of niacin on average, according to the 2017-2020 National Health and Nutrition Examination Surveys (NHANES). In addition, that survey shows that fewer than 4% of adults report consuming less than 15 milligrams per day, the authors point out.

So most Americans get enough niacin in their diet, some of which is coming from fortified foods, which Hazen thinks may need to be reconsidered in light of the new findings.

“The main takeaway is not that we should cut out our entire intake of niacin — that’s not a realistic approach,” he said in a release. “Given these findings, a discussion over whether a continued mandate of flour and cereal fortification with niacin in the U.S. could be warranted.”

Chen cautions against people routinely taking niacin supplements, especially if they have a higher risk of cardiovascular disease. If they are considering taking niacin or related products, they should talk to their doctor first.

“However, it may be more difficult to avoid niacin-fortified foods, given their ubiquity in the food chain,” he said. So “niacin fortification may need to be examined at a higher level as a matter of public policy.”

Takeaway

Researchers found that people with higher amounts of a breakdown product of excess niacin had a higher risk of major adverse cardiovascular events such as heart attack and stroke.

This breakdown product, known as 4PY, acts through inflammation in the blood vessels to increase the cardiovascular risk, researchers say.

More research is needed to understand the link between different levels of excess niacin and the risk of cardiovascular disease events. Researchers call for a re-examination of the fortification of foods with niacin.

For years, chronic fatigue syndrome has been dismissed as being all in the mind. But new research today ruled the illness — also called myalgic encephalomyelitis (ME) — is real. Scientists have found, for the first time, key differences in the brains and immune systems of CFS patients. It suggests the disputed condition’s fatigue, which […]

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• Comedian Amy Schumer took to social media to talk about the symptoms of endometriosis.
• Endometriosis is a common condition, affecting an estimated 1 in 10 women.
• The condition has been given the nickname “the missed disease,” as it is poorly understood and difficult to diagnose. 

Amy Schumer revealed that she has endometriosis, a chronic disease where tissue similar to the tissue that lines the uterus grows outside of the uterus. 

Schumer, 42, was responding to criticism that her face appeared more swollen than usual in recent media appearances.

“I’ve enjoyed feedback and deliberation about my appearance as all women do for almost 20 years. And you’re right it is puffier than normal right now. I have endometriosis an auto immune disease that every woman should read about. There are some medical and hormonal things going on in my world right now but I’m okay,” Schumer posted on Instagram.

Endometriosis is a common condition, affecting an estimated 1 in 10 people with uteruses. 

Despite affecting so many people, the condition, which has been given the nickname “the missed disease,” is poorly understood, frequently dismissed, and difficult to diagnose. 

“Like any chronic disease , things can flare up during menses, with certain physical activities and even related to diet for some patients. The range of symptoms are so vast, it is really dependent on the extent of the disease,” Dr. Sameena Rahman, a board-certified OB/GYN and founder at Center for Gynecology and Cosmetics in Chicago, IL, told Healthline.

How endometriosis can lead to feeling swollen

People with endometriosis often report bleeding in between periods, painful periods, painful intercourse, and pain with urination or defecation. 

“Whole body swelling is not a common symptom, but feeling swollen is a common complaint,” said Dr. Chandrika Rao, a board-certified OB/GYN with Pediatrix Medical Group.

It’s entirely possible to become pregnant with endometriosis, but many people, especially those with late-stage endometriosis, experience issues conceiving. 

In many cases, the condition can be asymptomatic and people only discover they have the condition when being evaluated for infertility. 

The condition occurs in four stages, from one to four, with stage one being the mildest and stage four being the most severe. 

With stage four endometriosis, for example, thick adhesions can be found throughout the pelvic area.

“Endometriosis can be a debilitating disorder, but oftentimes it is an incidental finding. Not everyone who has endometriosis has severe symptoms,” says Rao.

Here’s what causes endometriosis

It’s unclear what causes endometriosis, but it’s thought to be multifactorial.

Some researchers suspect the condition is due to “retrograde menstruation, which occurs when menstrual blood flows back up through the fallopian tubes and into the pelvic cavity.

The blood is thought to contain endometrial cells from the uterine lining that stick to other pelvic organs, thicken, and bleed each month during menstruation. 

Other experts believe that endometriosis is caused by genetic factors, hormone dysfunction, past surgeries, and issues within the immune system. 

Risk factors include having a family history, not having a history of pregnancies, early onset of first menstrual cycle, congenital defects of the uterus, low body mass index, obstruction of menstrual flow, and short menstrual cycles lasting less than 27 days, according to Rahman. 

Endometriosis is associated with a greater risk of early menopause.

Endometriosis cannot be prevented, however, there are various strategies, including hormonal birth control, exercise, and dietary modifications, that can impact the amount of estrogen in the body, which influences the thickness of the uterine lining and reduces the risk of developing it.

How endometriosis is diagnosed and treated

A pelvic exam will typically first be conducted in people who are experiencing any of the symptoms linked to endometriosis. 

Depending on the symptoms, imaging tests, such as an ultrasound, may also be ordered to look for abnormal growths or ovarian cysts.

That said, laparoscopy, a type of minimally invasive surgery done to look inside the pelvic area, is the only way a doctor can confirm a diagnosis of endometriosis. 

While endometriosis is rarely cured, the condition — and the painful symptoms it triggers — can be treated with analgesics, hormonal therapy, and surgery.

People often have to experiment with various treatments to find a solution that alleviates their unique set of symptoms.

“You do not need surgery for adequate treatment. It is most often diagnosed clinically due to pelvic pain and managed with medications,” Rao said.

The bottom line:

Amy Schumer revealed that she has endometriosis, a chronic disease where tissue similar to the tissue that lines the uterus grows outside of the uterus. Symptoms vary from person to person but often include pelvic pain during sex, menstruation, and going to the bathroom. The condition is notoriously difficult to diagnose, and while it’s rarely curable, there are treatments to ease the symptoms.

Sorting out my Mum’s financial affairs after her death late last month has been a rollercoaster affair — both emotionally and administratively. At times, it’s required detective work that Sherlock Holmes would have been proud of, hunting down key financial documents. Occasionally, it has brought joy as unknown savings accounts have been discovered — only […]

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• A study has found that the drug abatacept could help prevent rheumatoid arthritis.
• It also appeared to improve pain, inflammation, function, and quality of life.
• It may work for this purpose because it targets immune reactions early in the process.
• Abatacept is currently only used to treat established rheumatoid arthritis.
• Experts say this could change how rheumatoid arthritis is managed.

A new study published in The Lancet indicates that the rheumatoid arthritis drug abatacept (brand name Orencia) could also be useful in preventing the disease.

Francisco Contreras, MD — Director, President, and Chairman of Oasis of Hope Medical Institute, who was not involved in the study — describes rheumatoid arthritis (RA) as being a chronic autoimmune condition with symptoms such as joint inflammation, swelling, pain, and stiffness.

“This inflammatory response, driven by the body’s immune system, can gradually result in damage to the joints and subsequent limitations in mobility and function over time,” he explained.

Abatacept is a biologic medication used to reduce the symptoms of adult rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, and psoriatic arthritis, according to Bristol Meyers Squibb, the manufacturer of Orencia.

The study’s authors note that abatacept is currently used as a second or third-line treatment for established rheumatoid arthritis.

It is administered weekly, either at home via injection or in a hospital via an intravenous drip.

Contreras said that if abatacept can also play a role in preventing rheumatoid arthritis, this could have significant implications.

“While conventional approaches to RA management primarily focus on symptom control,” he stated, “the potential preventive application of abatacept represents a paradigm shift in disease management strategies.”

Abatacept is a promising rheumatoid arthritis preventative

To study the drug’s ability to prevent rheumatoid arthritis, a team of researchers from King’s College London recruited 213 at-risk patients.

The study participants were adult men and women with early disease symptoms, such as joint pain without swelling.

Half of the patients were given treatment with abatacept for a year, while the other half received an inactive placebo.

Drug treatment was then ceased, but monitoring continued for an additional year.

The researchers found that only 6% of people treated with abatecept went on to develop arthritis after one year. This was in comparison to 29% of those given the placebo who developed the disease.

Even at the two-year mark, there was still a significant difference between the two groups, with 25% of drug-treated patients developing RA versus 37% in the placebo group.

It was also found that abatacept improved pain scores, function, and quality of life in people who received it preventatively.

Additionally, these people had lower scores for inflammation in their joint linings.

How abatecept might help prevent rheumatoid arthritis

Ani Rostomyan, PharmD, a clinical pharmacist practicing in the area of Diabetes and Genomics and Functional Medicine, said that consensus guidelines from the American College of Rheumatology and the European Alliance of Associations for Rheumatology currently advise using abatecept in people who already have established rheumatoid arthritis.

The rationale for the study was “if the pre-clinical phase of RA could be accurately defined, targeting therapy to those at highest risk of developing the more severe form of disease would possibly prevent or at least delay the onset of the disease,” Rostomyan explained.

Abatacept was chosen for the study because it can target immune reactions early in the process that can lead to the inflammation associated with rheumatoid arthritis.

This drug “is a fusion protein, composed of the Fc region of the immunoglobulin IgG1 fused to the extracellular domain of cytotoxic T-lymphocyte antigen 4 (CTLA-4),” she explained, adding that “it interrupts interaction between T-cells and antigen-presenting cells, weakening the co-stimulatory signals required for T-cell activation, differentiation, and effector responses, thereby resulting in downstream immunomodulatory effects on other inflammatory cells of the immune system.”

Rostomyan went on to say that using abatacept for this application is promising. However, in her opinion, given the state of healthcare coverage in the United States, it is unlikely to be given approval by health plans as a preventive medication.

She did note, though, that further studies into the drug could alter this assessment.

Takeaway

A new study has found that the rheumatoid arthritis medication abatacept (brand name Orencia) might additionally have applications as a preventive for the disease.

It also appears to help with symptoms such as pain, function, inflammation, and quality of life.

The reason it might work to prevent the development of rheumatoid arthritis is that it can target the immune reactions early in the process.

Abatacept is currently used as a treatment for already-established rheumatoid arthritis.

Experts say these findings could change how rheumatoid arthritis is managed. However, it seems unlikely that insurance companies in the United States will be willing to pay for its use as a preventive.

By Luke Andrews Health Reporter For Dailymail.Com Published: 13:23 EST, 19 February 2024 | Updated: 13:31 EST, 19 February 2024 More than 275million entirely new genetic variants have been discovered in humans — and some of them could reveal a higher risk of cancer. Researchers led by the National Institute of Health (NIH) in Bethesda, […]

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• Cardiovascular disease is the leading cause of death in the United States, accounting for more than 900,000 deaths in 2020.
• The American Heart Association reports that deaths related to irregular heart rhythms may be rising, especially among younger people.
• Experts share answers to the most common questions regarding heart health, including heart arrhythmias.

Heart disease does not discriminate. As the leading cause of death for men, women, and people of most racial and ethnic groups in the United States, heart disease affects almost everyone.

Unsurprisingly, many people take to the internet to learn about heart disease and heart health.

To help ease curiosity and spread awareness, experts answer the following most searched questions about heart health, according to Google Trends. 

What is a heart arrhythmia

Heart arrhythmia occurs when there is an abnormality in the rhythm of the heartbeat.

“This means your heart either beats too fast, a condition known as tachycardia; or too slow, also known as bradycardia; or irregularly,” Dr. Martha Gulati, a cardiologist at Cedars Sinai Heart Institute and president of the American Society of Preventive Cardiology, told Healthline.

Think of the heart as having an electrical system that serves as the timing mechanism to tell the heart when and how fast to pump, said Dr. Kevin Thomas, electrophysiologist at the Norton Heart & Vascular Institute Heart Rhythm Center.

“An arrhythmia occurs when the electrical system acts irregularly,” he told Healthline.

Arrhythmias can affect people of all ages and can be triggered by genetics, pre-existing heart conditions, as well as lifestyle habits such as smoking, unhealthy diet, and stress.

“The significance of an arrhythmia depends on what type of abnormal rhythm is occurring. Some are serious and could be life threatening if not treated, while others are not worrisome or dangerous,” said Thomas.

The most common type of arrhythmia is atrial fibrillation, also known as AFib.

“AFib is an irregular, and often rapid heart rate, that can increase risk of stroke, heart failure, and other heart-related complications,” Gulati said.

The lifetime risk for AFib is one in four for all men and women over 40, according to a study published in Circulation, a journal by the American Heart Association (AHA).

What are the symptoms of heart arrhythmias?

While different types of arrhythmias can present with a variety of symptoms, Thomas said the most common symptoms of an arrhythmia are:

• Heart palpitations
• Racing heartbeats
• Heart fluttering
• Sensation of skipped beats

Extra beats

• Hard beats

“Some arrhythmias, though, can be ‘silent’ and have no symptoms at all,” he said.

When arrhythmias (including AFib) last long enough to affect how well the heart works, the AHA reports that the following serious symptoms can occur:

• Fatigue or weakness
• Dizziness or lightheadedness
• Fainting or near-fainting spells
• Rapid heartbeat or pounding in the chest
• Shortness of breath and anxiety
• Chest pain or pressure
• Alternating fast and slow heart rate
• Sweating
• Collapse and sudden cardiac arrest in extreme cases

One challenge of arrhythmia symptoms is that they can come and go, said Gulati.

“Sometimes, a patient makes an appointment or comes to the hospital after experiencing a cardiac symptom, and by the time they speak with a doctor, their symptoms have abated,” she said.

When patients are no longer presenting with the symptoms they experienced, it can make it difficult for doctors to treat, and scary for patients who want to understand what is happening.

“One intervention that can help break this cycle is the use of medical-grade personal digital health tools, which allow patients to access accurate, real-time heart data anytime, anywhere,” said Gulati.

She partnered with AliveCor, which offers KardiaMobile, a personal electrocardiogram (ECG) device that allows people to share findings with their doctor digitally.

What are heart palpitations?

Heart palpitations are perceived (felt) abnormalities of the heartbeat that can be characterized by the sensation of fast, irregular, or skipped heartbeats felt in the chest, throat, or neck.

“These can be transient and short-lived, lasting only a few seconds, or they can sustain and last for hours to days,” said Thomas.

Palpitations can be triggered by stress, anxiety, hormonal changes, or stimulants like caffeine.

“That said, heart palpitations on their own aren’t always a cause for alarm,” said Gulati. “However, if you experience heart palpitations coupled with chest pain, fainting, or severe dizziness, it is important to seek immediate medical attention.”

What causes heart arrhythmias?

The causes of heart arrhythmias vary.

“Some are due to abnormal or extra electrical pathways that a patient is born with, while others are caused by damage to the heart and its electrical system as the result of prior heart attack or cardiac surgery,” said Thomas.

Sometimes arrhythmias can be triggered by increased adrenaline levels, which can be seen during infection, surgery, or other illnesses, he added.

Aging can also play a part because as people age, their hearts change.

“These age-related changes, though natural, can affect the way our hearts operate and the way electrical impulses flow through our cardiovascular system,” Gulati said.

Additionally, some arrhythmias, such as AFib, become more common as people get older and can be influenced by other conditions such as hypertension, diabetes, sleep apnea, and obesity, explained Thomas.

While lifestyle choices can influence overall health, managing aging and congenital or genetic factors often requires a multifaceted and personal approach, added Gulati.

“The more proactive you are about your heart health, the better. Regular check-ups and monitoring can help identify and manage these factors,” she said.

What are arrhythmia treatments?

While most arrhythmias are not considered dangerous and are often left untreated, your doctor will need to determine if the arrhythmia is cause for concern and requires treatment.

“When it comes to arrhythmias, early detection and intervention can significantly impact the long-term prognosis and reduce the risk of complications, such as stroke or heart failure,” said Gulati.

The AHA states that the goals of treatment are aimed at:

• Preventing blood clots from forming to reduce stroke risk, especially for people with AFib.
• Keeping your heart rate within a relatively normal range.
• Restoring a normal heart rhythm, if possible.
• Treating heart disease or heart conditions that may be causing arrhythmia.
• Reducing other risk factors for heart disease and stroke like coronary artery disease.

Treatments for arrhythmias depend on which type of abnormal heart rhythm is occurring. Thomas broke down which type of treatment is needed for each type of arrhythmia.

• A pacemaker is often needed if the heart is beating abnormally slow.
• Medications designed to suppress abnormal heartbeats/rhythms
• Cardiac ablation, a minimally invasive surgical procedure, can help when the heart is beating too fast or irregular.
• Non-pharmacologic interventions and lifestyle modifications, including weight loss, blood pressure control, maintaining healthy cholesterol levels, eating a heart-healthy diet, exercising, avoiding tobacco smoke and vaping, and treating sleep apnea can help manage arrhythmias.
• A defibrillator may need to be implanted in cases where a dangerous or life threatening arrhythmia is occurring.

By Jo Tweedy For Mailonline Published: 11:36 EST, 18 February 2024 | Updated: 11:53 EST, 18 February 2024 The Prince of Wales has arrived solo on the red carpet of the BAFTA film awards in London  – as his wife the Princess of Wales continues to recover from her abdominal surgery at the family’s home. Prince […]

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• New research shows that self-managed medication abortion offered via telemedicine is safe and effective.
• The study adds to a large body of evidence supporting the safety and efficacy of the telemedicine procedure, which includes virtual visits with a provider who prescribes abortion pills by mail.
• The U.S. Supreme Court will soon decide whether to restrict access to the abortion pill mifepristone.

The U.S. Supreme Court will hear the case against the abortion pill mifepristone on March 26. Their decision could have a major impact on the ability of people to safely and easily access medication abortion.

The hearing follows a 2023 ruling by the U.S. Court of Appeals for the 5th Circuit that challenged the U.S. Food and Drug Administration’s (FDA) authority on the abortion pill, which has been reviewed and evaluated for safety for more than two decades.

If the justices rule against the FDA, it could significantly restrict access to the medication.

Medication abortion accounts for more than half of all abortions. The procedure, which involves taking mifepristone followed by another medication, misoprostol, is safe and effective.

Should mifepristone be restricted, medication abortion can still be done via misoprostol, according to recent studies. However, experts say that this version of medication abortion may be less effective.

Medication abortion is extremely effective and safe

A substantial body of research supports the safety and effectiveness of self-managed medication abortion, whether the procedure is performed in person or remotely via telehealth. 

Now, researchers from the University of California San Francisco have found more evidence supporting telehealth abortion as a safe and effective way to terminate pregnancy.

The national study, published in Nature Medicine on Thursday, has been cited in a brief submitted to the Supreme Court in advance of the hearing. The research is backed by more than 300 reproductive health researchers, according to a news release.  

“We believe this study has huge implications for policy, in particular for the upcoming Supreme Court case on mifepristone (one of two medications used in medication abortion). This research shows that the FDA followed science when it expanded how this medication could be dispensed and that the Supreme Court should follow suit,” lead study author Dr. Ushma Upadhyay, professor of Obstetrics, Gynecology & Reproductive Sciences at UCSF, told Healthline.

Telehealth abortion is as safe and effective as seeing a physician

For the study, researchers looked at medical records for more than 6,000 people prescribed abortion pills from telehealth clinics in 20 states and Washington D.C. from April 2021 to January 2022.

They determined no adverse events were reported 99.8% of the time, and 98% of the time, people who had abortions did not require follow-up care.

These findings present similar success rates to patients who obtained abortions in person at clinics or doctor’s offices, the study authors noted.

Telehealth abortions may involve video visits and secure text messaging with a healthcare provider, who sends prescribed abortion pills by mail and may engage in virtual follow-up visits.

“As with any other medical visit via telehealth, the physician takes a history and relevant physical exam, reviews lab results and ultrasounds, and evaluates for any contraindications to medication abortion before administering the mifepristone pill,” explained Dr. Lydia Prevost, a family medicine physician who provides abortion care via telehealth in Kansas and Fellow with Physicians for Reproductive Health. 

Dr. Sarah W. Prager, a professor in the Department of Obstetrics and Gynecology at the University of Washington School of Medicine, said the UCSF study supports all the previous data and “unequivocally shows that medication abortion is safe and effective.” 

“It doesn’t matter whether the medications are dispensed by a clinician after an in-person visit or through a virtual clinic — mifepristone and misoprostol are safe and effective,” Prager told Healthline.

“These data further underscore the reasons why mifepristone should stay available — without any of the REMS restrictions  — and highlight that all the restrictions (both to mifepristone and to abortion more broadly) are political and serve only to harm pregnant people.” 

Researchers also noted that telehealth abortion makes the procedure more accessible while protecting patient privacy, a growing concern in states with abortion bans and restrictions.

“Telehealth addresses some of the geographic, transportation, and other resource-related barriers that we know have always gotten in the way of patients accessing abortion care, but especially in the months since Dobbs,” Prevost noted, referencing the legal decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade

“Medication abortion using mifepristone and misoprostol is a great option for many people needing abortion care. The education that patients need to be informed about their decision and instructions on how to take the medications can be done just as safely and effectively via telehealth as in person,” she told Healthline.

What happens if the abortion pill is banned?

Abortion has been banned or had additional restrictions added in 21 states following the Supreme Court’s June 2022 decision to overturn Roe v. Wade. Another three states have had restrictions on abortion blocked in courts.

Demand for abortion pills prescribed via telehealth has increased as abortion clinics have closed in states with bans and other restrictions. In states where abortion may be permitted, long wait times at clinics stretch for weeks, some with no availability at all.

If the Supreme Court decides to ban the abortion pill mifepristone, it could severely limit access to the medication. A mifepristone ban would block telehealth prescriptions and shipments of the medication by mail, creating additional barriers in states where people seeking to end a pregnancy already face mounting hurdles.

 “If the Supreme Court rules to reinstate further restrictions to mifepristone, not only would it be ignoring all the credible scientific data available, it would also significantly increase the barriers to accessing abortion, which will increase morbidity and mortality for pregnant people,” Prager said.

While misoprostol alone can work to safely terminate pregnancy, experts have cautioned it may not be as effective as when combined with mifepristone.

“The combination of mifepristone and misoprostol is the current standard of care for medication abortion care,” Prevost said. “While other regimens like misoprostol-only do exist and are also safe, medications with proven safety records like mifepristone should stop being targeted because of political beliefs.”

Takeaway

As the Supreme Court decides whether to ban the abortion pill mifepristone and limit access to telehealth abortion, a large national study has demonstrated the safety and effectiveness of self-managed abortion via telemedicine.

Medication abortion can be safely delivered through telemedicine via video visits, secure text messaging, and mailing prescribed abortion pills.

The new research adds to a substantial body of evidence demonstrating the safety of self-managed medication abortion.

“Telehealth has been growing exponentially in many fields of medicine particularly since the pandemic, and we have good data to show that it is safe and effective,” Prevost said.

At just 17, Taylor was homeless and alone. She’d witnessed her mom’s…

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