corticosteroid

You may have heard of anabolic steroids, which can have harmful effects. But there's another type of steroid - sometimes called a corticosteroid - that treats a variety of problems. These steroids are similar to hormones that your adrenal glands make to fight stress associated with illnesses and injuries. They reduce inflammation and affect the immune system.

You may need to take corticosteroids to treat:

• Arthritis
• Asthma
• Autoimmune diseases such as lupus and multiple sclerosis
• Skin conditions such as eczema and rashes
• Some kinds of cancer

Steroids are strong medicines, and they can have side effects, including weakened bones and cataracts. Because of this, you usually take them for as short a time as possible.

An allergy is a reaction by your immune system to something that does not bother most other people. People who have allergies often are sensitive to more than one thing. Substances that often cause reactions are:

• Pollen
• Dust mites
• Mold spores
• Pet dander
• Food
• Insect stings
• Medicines

Normally, your immune system fights germs. It is your body's defense system. In most allergic reactions, however, it is responding to a false alarm. Genes and the environment probably both play a role.

Allergies can cause a variety of symptoms such as a runny nose, sneezing, itching, rashes, swelling, or asthma. Allergies can range from minor to severe. Anaphylaxis is a severe reaction that can be life-threatening. Doctors use skin and blood tests to diagnose allergies. Treatments include medicines, allergy shots, and avoiding the substances that cause the reactions.

Asthma is a chronic (long-term) lung disease. It affects your airways, the tubes that carry air in and out of your lungs. When you have asthma, your airways can become inflamed and narrowed. This can cause wheezing, coughing, and tightness in your chest. When these symptoms get worse than usual, it is called an asthma attack or flare-up.

The exact cause of asthma is unknown. Genetics and your environment likely play a role in who gets asthma.

An asthma attack can happen when you are exposed to an asthma trigger. An asthma trigger is something that can set off or worsen your asthma symptoms. Different triggers can cause different types of asthma:

• Allergic asthma is caused by allergens. Allergens are substances that cause an allergic reaction. They can include
  • Dust mites
  • Mold
  • Pets
  • Pollen from grass, trees, and weeds
  • Waste from pests such as cockroaches and mice
• Nonallergic asthma is caused by triggers that are not allergens, such as
  • Breathing in cold air
  • Certain medicines
  • Household chemicals
  • Infections such as colds and the flu
  • Outdoor air pollution
  • Tobacco smoke
• Occupational asthma is caused by breathing in chemicals or industrial dusts at work
• Exercise-induced asthma happens during physical exercise, especially when the air is dry

Asthma triggers may be different for each person and can change over time.

Asthma affects people of all ages, but it often starts during childhood. Certain factors can raise your risk of having asthma:

• Being exposed to secondhand smoke when your mother is pregnant with you or when you are a small child
• Being exposed to certain substances at work, such as chemical irritants or industrial dusts
• Genetics and family history. You are more likely to have asthma if one of your parents has it, especially if it's your mother.
• Race or ethnicity. Black and African Americans and Puerto Ricans are at higher risk of asthma than people of other races or ethnicities.
• Having other diseases or conditions such as obesity and allergies
• Often having viral respiratory infections as a young child
• Sex. In children, asthma is more common in boys. In teens and adults, it is more common in women.

The symptoms of asthma include:

• Chest tightness
• Coughing, especially at night or early morning
• Shortness of breath
• Wheezing, which causes a whistling sound when you breathe out

These symptoms can range from mild to severe. You may have them every day or only once in a while.

When you are having an asthma attack, your symptoms get much worse. The attacks may come on gradually or suddenly. Sometimes they can be life-threatening. They are more common in people who have severe asthma. If you are having asthma attacks, you may need a change in your treatment.

Your health care provider may use many tools to diagnose asthma:

• Physical exam
• Medical history
• Lung function tests, including spirometry, to test how well your lungs work
• Tests to measure how your airways react to specific exposures. During this test, you inhale different concentrations of allergens or medicines that may tighten the muscles in your airways. Spirometry is done before and after the test.
• Peak expiratory flow (PEF) tests to measure how fast you can blow air out using maximum effort
• Fractional exhaled nitric oxide (FeNO) tests to measure levels of nitric oxide in your breath when you breathe out. High levels of nitric oxide may mean that your lungs are inflamed.
• Allergy skin or blood tests, if you have a history of allergies. These tests check which allergens cause a reaction from your immune system.

If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include:

• Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
• Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
• Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.

If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.

Your provider may adjust your treatment until asthma symptoms are controlled.

Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway's ability to tighten and allows you to breathe more easily. The procedure has some risks, so it's important to discuss them with your provider.

Your immune system protects you from disease and infection by attacking germs that get into your body, such as viruses and bacteria. Your immune system can tell that the germs aren't part of you, so it destroys them. If you have an autoimmune disease, your immune system attacks the healthy cells of your organs and tissues by mistake.

There are more than 80 types of autoimmune diseases. They can affect almost any part of your body. For example, alopecia areata is an autoimmune disease of the skin that causes hair loss. Autoimmune hepatitis affects the liver. In type 1 diabetes, the immune system attacks the pancreas. And in rheumatoid arthritis, the immune system can attack many parts of the body, including the joints, lungs, and eyes.

No one is sure why autoimmune diseases happen. But you can't catch them from other people.

Autoimmune diseases do tend to run in families, which means that certain genes may make some people more likely to develop a problem. Viruses, certain chemicals, and other things in the environment may trigger an autoimmune disease if you already have the genes for it.

Millions of Americans of all ages have autoimmune diseases. Women develop many types of autoimmune diseases much more often than men. And if you have one autoimmune disease, you are more likely to get another.

The symptoms of an autoimmune disease depend on the part of your body that's affected. Many types of autoimmune diseases cause redness, swelling, heat, and pain, which are the signs and symptoms of inflammation. But other illnesses can cause the same symptoms.

The symptoms of autoimmune diseases can come and go. During a flare-up, your symptoms may get severe for a while. Later on, you may have a remission, which means that your symptoms get better or disappear for a period of time.

Doctors often have a hard time diagnosing autoimmune diseases. There's usually not a specific test to show whether you have a certain autoimmune disease. And the symptoms can be confusing. That's because many autoimmune diseases have similar symptoms. And some symptoms, such as muscle aches, are common in many other illnesses. So it can take a long time and some visits to different types of doctors to get a diagnosis.

To help your doctor find out if an autoimmune disease is causing your symptoms,:

• Learn about the health conditions in your family history. What health problems did your grandparents, aunts, uncles, and cousins have? Write down what you learn and share it with your doctor.
• Keep track of your symptoms, including how long they last and what makes them better or worse. Share your notes with your doctor.
• See a specialist who deals with the symptoms that bother you most. For example, if you have rash, see a dermatologist (skin doctor).

The treatment depends on the disease. In most cases, the goal of treatment is to suppress (slow down) your immune system, and ease swelling, redness, and pain from inflammation. Your doctor may give you corticosteroids or other medicines to help you feel better. For some diseases, you may need treatment for the rest of your life.

Your bones are made of living tissue. To keep them strong, your body breaks down old bone and replaces it with new bone. But when more bone is broken down than replaced, you lose bone density, also called bone mass. Bone density is a measure of the amount of calcium and other minerals in bone. Bones containing more minerals are denser. They tend to be stronger and less likely to fracture (break).

Losing bone density can weaken your bones. In some cases, it can lead to osteoporosis. This is a disease which can make your bones more likely to break. Low bone density that is not low enough to be osteoporosis is sometimes called osteopenia.

Your bones become less dense as you age. Other factors can also make you more likely to lose bone mass, such as:

• A family history of osteoporosis or low bone mass
• Not developing good bone mass when you are young
• Having certain medical conditions, such as:
  • Endocrine diseases
  • Certain digestive diseases
  • Rheumatoid arthritis
  • Certain types of cancer
  • HIV
  • Anorexia nervosa, a type of eating disorder
• Taking certain medicines, such as:
  • Corticosteroids
  • Proton pump inhibitors (which treat GERD)
  • Medicines to treat epilepsy
• Smoking tobacco
• Long-term heavy alcohol use
• Physical inactivity or prolonged periods of bedrest

Not everyone who has low bone mass gets osteoporosis, but they are at higher risk for developing it.

A bone density scan is the best way to measure your bone health. It compares your bone density, or mass, to that of a healthy person who is the same age and sex as you are. It can show:

• Whether you have low bone density
• Whether you have osteoporosis, a disease that makes your bones weak
• Your risk for breaking bones
• Whether your osteoporosis treatment is working

To help keep your bones strong and help prevent osteoporosis, the best thing to do is to eat a healthy diet rich in calcium and vitamin D. Getting regular physical activity, limiting alcohol, and not smoking can also help. In some cases, your health care provider may prescribe medicines to prevent osteoporosis.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. Cholesterol is also found in foods from animal sources, such as egg yolks, meat, and cheese.

If you have too much cholesterol in your blood, it can combine with other substances in the blood to form plaque. Plaque sticks to the walls of your arteries. This buildup of plaque is known as atherosclerosis. It can lead to coronary artery disease, a condition in which your coronary arteries become narrow or even blocked.

HDL, LDL, and VLDL are lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. Different types of lipoproteins have different purposes:

• HDL stands for high-density lipoprotein. It is sometimes called "good" cholesterol because it helps your body get rid of cholesterol. It carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoprotein. It is sometimes called "bad" cholesterol because a high LDL level leads to the buildup of plaque in your arteries.
• VLDL stands for very low-density lipoprotein. Some people also call VLDL a "bad" cholesterol because it too contributes to the buildup of plaque in your arteries. But VLDL and LDL are different; VLDL mainly carries triglycerides and LDL mainly carries cholesterol.

The most common cause of high cholesterol is an unhealthy lifestyle. This can include:

• Unhealthy eating habits, such as eating lots of saturated fats. These fats are found in red meats, full-fat dairy products, chocolate, some baked goods, and many deep-fried and processed foods. Eating too much saturated fat can raise your LDL (bad) cholesterol.
• Lack of physical activity, with lots of sitting and little exercise. This lowers your HDL (good) cholesterol.
• Smoking, which lowers HDL cholesterol, especially in women. It also raises your LDL cholesterol.
• Stress, which may raise levels of certain hormones such as corticosteroids. These can cause your body to make more cholesterol.
• Drinking too much alcohol, which can raise your total cholesterol level.

Genetics may also cause people to have high cholesterol. For example, familial hypercholesterolemia (FH) is an inherited condition that causes very high levels of cholesterol in the blood. Other medical conditions and certain medicines may also raise LDL cholesterol levels or lower HDL cholesterol levels.

A variety of things can raise your risk of high cholesterol:

• Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.
• Sex. Between ages 20 and 39, men have a greater risk of high total cholesterol than women. But after menopause, a woman's risk goes up. This happens because menopause lowers levels of female hormones that may protect against high blood cholesterol.
• Family history. High blood cholesterol can run in families.
• Other health conditions. Conditions such as diabetes, chronic kidney disease, HIV, and lupus can raise your risk of high cholesterol.
• Medicines. Certain medicines can raise your level of LDL cholesterol or lower your level of HDL cholesterol, including:
  • Steroids
  • Some chemotherapy medicines
  • Medicines taken after an organ transplant
  • Medicines for certain heart conditions
  • Certain acne medicines
• Race or ethnicity. People from certain racial or ethnic groups may have an increased risk of high cholesterol. For example, Asian Americans are more likely to have high levels of LDL cholesterol than other groups. And non-Hispanic White people are more likely than other groups to have high levels of total cholesterol.
• Weight. Being overweight or having obesity raises your cholesterol level.

Undiagnosed or untreated high blood cholesterol can lead to serious health problems:

• If you have large deposits of plaque in your arteries, an area of plaque can rupture (break open). This can cause a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow in a coronary artery.
• If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, it can cause angina (chest pain) or a heart attack.
• Plaque also can build up in other arteries in your body, including the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease.

There are usually no signs or symptoms that you have high cholesterol. A blood test can measure your cholesterol levels. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are ages 20 to 65::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

For people over age 65:

• They should be tested every year

You can lower your cholesterol through heart-healthy lifestyle changes. They include a heart-healthy eating plan, weight management, and regular physical activity.

If the lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering medicines available, including statins. If you take medicines to lower your cholesterol, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

NIH: National Heart, Lung, and Blood Institute

Encephalitis is inflammation (swelling) of the brain. It can happen when an infection or medical condition that affects the brain activates your immune system. The inflammation can cause a wide range of symptoms. In extreme cases, it can lead to brain damage, stroke, or even death.

There are different types of encephalitis, based on what the cause is. The two main types are infectious encephalitis and autoimmune encephalitis.

Infectious encephalitis is usually caused by a virus. In fact, viruses are the most common cause of encephalitis. Some of the different viruses that cause it include:

• Herpes viruses, including herpes simplex (HSV), the Epstein-Barr virus (which causes infectious mononucleosis) and the varicella-zoster virus (which causes chickenpox).
• Viruses you can get if you are bitten by an infected tick, such as tick-borne encephalitis (TBE virus) and Powassan virus.
• Viruses you can get if you are bitten by an infected mosquito, such as eastern equine encephalitis virus, West Nile virus, and La Crosse virus.
• Enteroviruses, which are a common group of viruses that mostly cause mild illness or respiratory infection. These infections usually happen in the summer and fall.

Bacteria, fungi, and parasites can also cause infectious encephalitis. But this is not common.

Autoimmune encephalitis happens when your immune system mistakenly attacks healthy brain cells. It can be triggered by conditions such as certain cancers, benign tumors, and infections. Sometimes the cause is not known.

Anyone can get encephalitis, but you are more likely to get it if you:

• Have a weakened immune system, for example from having HIV or taking certain medicines. These could include medicines taken after an organ transplant, certain chemotherapy medicines, and specialized treatments for certain autoimmune diseases.
• Are a young child or older adult.
• Live in areas where there are ticks and mosquitoes that carry viruses that can cause encephalitis.

The symptoms of encephalitis can vary a lot, depending on how severe it is. Many people do not have any symptoms. Others may have mild flu-like symptoms such as fever, fatigue, headache, or body aches. If encephalitis becomes more serious, it can cause:

• Severe headache
• Stiff neck
• Vomiting
• Seizures
• Behavior changes
• Drowsiness
• Muscle weakness
• Partial paralysis in your arms and legs
• Coma

Encephalitis can be dangerous in infants. Their symptoms may include:

• Fever
• Lethargy (weakness or drowsiness)
• Poor feeding
• Vomiting
• Body stiffness
• Unusual irritability or crying
• A full or bulging fontanel (the soft spot on the top of the head)

If you or your child is having symptoms of encephalitis, it's important to get medical care right away.

To find out if you have encephalitis, your health care provider:

• Will do a physical exam
• Will take your medical history, which includes asking about your symptoms
• May do a neurologic exam
• May order imaging tests, such as a brain CT scan or MRI
• May order an EEG (electroencephalography), which use small electric sensors to measure your brain activity
• May order blood and cerebrospinal fluid (CSF) tests

Most people with encephalitis will need treatment in the hospital. Depending on the cause, treatments may include antiviral medicines, antibiotics, corticosteroids, and other medicines.

For some types of encephalitis, there is no medicine to treat it. But rest, nutrition, and fluids can help your body fight the infection and relieve symptoms.

Some people may need physical, speech, and occupational therapy once the illness is under control.

There are steps you can take to help prevent encephalitis that is caused by infections:

• Use good hygiene, including washing your hands often with soap and water.
• Don't share food, drinks, utensils, and glasses with other people.
• Get vaccines for viruses that can cause encephalitis.
• Avoid mosquito and tick bites, for example by:
  • Wearing insect repellent with DEET or another U.S. Environmental Protection Agency (EPA)-registered insect repellent. Make sure to follow the instructions for using the repellant.
  • Wearing clothes that cover your arms, legs and feet.
  • Treating your clothing and gear with products containing 0.5% permethrin before you go in grassy or woody areas.

NIH: National Institute of Neurological Disorders and Stroke

Fatigue is a feeling of weariness, tiredness, or lack of energy. It can interfere with your usual daily activities. Fatigue can be a normal response to physical activity, emotional stress, boredom, or lack of sleep. But sometimes it can be a sign of a mental or physical condition. If you have been feeling tired for weeks, contact your health care provider. They can help you find out what's causing your fatigue and recommend ways to relieve it.

Fatigue itself is not a disease; it's a symptom. It can have many different causes, including pregnancy and various medical problems, treatments, and lifestyle habits such as:

• Medical problems:
  • Chronic (long-lasting) diseases such as diabetes, COPD (chronic obstructive pulmonary disease), and heart, liver, kidney and thyroid diseases
  • Untreated pain and diseases like fibromyalgia
  • Anemia
  • Infections
  • Parkinson's disease
  • Sleep apnea and other sleep disorders
  • Recent stroke
  • Mental disorders such as depression and anxiety
• Treatments:
  • Cancer treatments such as chemotherapy, radiation, and bone marrow transplants
  • Recovering from major surgery
  • Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
• Lifestyle habits:
  • Not getting enough sleep
  • Staying up too late
  • Drinking too much alcohol
  • Substance use
  • Having too much caffeine (which can keep you from getting a good night's sleep)
  • Getting too little or too much exercise

Overwhelming fatigue is part of a disorder called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The fatigue caused by this disorder is different from a tired feeling that goes away after you rest. Instead, the fatigue in ME/CFS lasts a long time, does not get better with rest, and limits your ability to do ordinary daily activities.

If you've had fatigue that does not get better after several weeks, call your provider. They will ask questions about your sleep, daily activities, appetite, and exercise. They will likely do a physical exam and order lab tests. Once they decide on a diagnosis, they can tell you what treatments might help.

You can also make some lifestyle changes to feel less tired:

• Get regular physical activity
• Improve your sleep habits
• Stop smoking (if you smoke), since smoking is linked to many diseases that can cause fatigue
• Manage stress
• Eat a healthy diet and avoid alcohol

It also may be helpful for you to keep a fatigue diary. This can help you find patterns throughout the day, such as when you feel more tired and when you have more energy. It can also help you plan for activities that may give you more energy.

NIH: National Institute on Aging

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

• Nonalcoholic fatty liver disease (NAFLD)
• Alcoholic fatty liver disease, also called alcoholic steatohepatitis

NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

• Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
• Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

The cause of nonalcoholic fatty liver disease (NAFLD) is unknown. Researchers do know that it is more common in people who:

• Have type 2 diabetes and prediabetes
• Have obesity
• Are middle aged or older (although children can also get it)
• Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
• Have high levels of fats in the blood, such as cholesterol and triglycerides
• Have high blood pressure
• Take certain drugs, such as corticosteroids and some cancer drugs
• Have certain metabolic disorders, including metabolic syndrome
• Have rapid weight loss
• Have certain infections, such as hepatitis C
• Have been exposed to some toxins

NAFLD affects about 25% of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use:

• Your medical history
• A physical exam
• Various tests, including blood and imaging tests, and sometimes a biopsy

As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as:

• An enlarged liver
• Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow

You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

If you have any of the types of fatty liver disease, there are some lifestyle changes that can help:

• Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains
• Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.
• Get regular exercise, which can help you lose weight and reduce fat in the liver
• Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

A food allergy is an abnormal immune system reaction to certain foods. Your immune system normally protects you from germs. But if you have a food allergy, your immune system mistakenly reacts to certain foods as if they were harmful. This reaction is usually mild. But in some cases, it can be serious or even life-threatening.

A food intolerance is different than a food allergy. If you have a food intolerance, you also have symptoms when you eat that food. But these are typically just digestive symptoms such as bloating and gas. Also, an intolerance is not an immune system reaction.

Most food allergies are caused by:

• Cow's milk
• Chicken eggs
• Crustacean shellfish, such as shrimp, crab, lobster, and crayfish
• Fish
• Peanuts
• Sesame
• Soy
• Tree nuts, such as almonds, walnuts, pecans
• Wheat

People with a food allergy may be allergic to more than one type of food.

Both children and adults can have food allergies. Some children will outgrow their food allergies. And sometimes people can develop food allergies as adult.

Certain factors can make you more likely to have a food allergy. They include:

• Having eczema, a disease that causes inflammation, redness, and irritation of the skin. Your immune system also plays a role in eczema.
• Having asthma or other allergies, such as hay fever.
• Your genes. Certain genes may influence the development of food allergies. And you are more likely to have food allergies if someone in your family has allergies, asthma, or eczema.

If you are allergic to a food you have eaten, you may have a variety of symptoms. These symptoms are not always the same for every person. And the symptoms that you get each time you eat the food may not always be the same. For example, your symptoms may sometimes depend on how much of the food you ate.

Food allergy symptoms usually start within a few minutes to two hours after you eat that food. They may include:

• Hives
• Flushed skin or rash
• Tingling or itchy sensation in the mouth
• Face, tongue, or lip swelling
• Vomiting and/or diarrhea
• Abdominal (belly) cramps
• Coughing or wheezing
• Dizziness and/or lightheadedness
• Swelling of the throat and vocal cords
• Trouble breathing

In rare cases, a food allergy can cause a life-threatening reaction called anaphylaxis. It may start out with some milder symptoms, but then it becomes more serious. It can lead to:

• Narrowed airways in the lungs
• Severe trouble breathing because of swelling in the throat
• Severe lowering of blood pressure and shock ("anaphylactic shock")
• Loss of consciousness

This is a medical emergency. Call 911 if someone is having the symptoms of anaphylaxis.

To find out if you have a food allergy, your health care provider will

• Ask about your symptoms, family health history, and medical history, including other allergies.
• Likely do a physical exam.
• Do food allergy testing. This could involve skin testing, blood testing, a food elimination diet, and/or an oral food challenge test. An oral food challenge test is the most accurate food allergy test.

There is no cure for food allergies. The only way to prevent a reaction is to avoid eating the food that you are allergic to.

There are medicines for people with food allergies. They include:

• Medicines to reduce food allergy symptoms, including antihistamines and corticosteroids.
• Medicines to reduce allergic reactions, including severe reactions.
• Epinephrine, a medicine to treat anaphylaxis. Your provider may give you a prescription for an epinephrine auto-injector. It is a device used to inject epinephrine when someone is having symptoms of anaphylaxis. If you have been prescribed one, it's important to learn how to use it and to carry it with you at all times.

If you have a food allergy, it's a good idea to have a medical alert bracelet that says what your allergy is.