Lurking behind these conditions may be other,
scarier illnesses. Here's what to look out for.
"Shadow diseases" that strike
together
Experts aren't sure why some illnesses travel in
pairs, but knowing your risk will help you stay
safe.
For years, doctors have observed that patients
with one illness may be stricken by another
condition that's seemingly unrelated and
sometimes more serious, known as a "shadow
disease." One of the most well-known is the
connection between migraines and heart attack
or stroke. Now researchers are uncovering even
more linked ailments and zeroing in on why they
appear to travel in pairs.
Studies show that these couplings occur for
different reasons. In some cases, one disease
creates damage that causes the second illness.
In others, troublesome genes or poor health
behaviors, such as smoking or lack of exercise,
trigger one problem, then the other. Being alert to
the following dangerous connections can help
you avoid the shadow disease or get early
diagnosis and treatment, leading to a better
outcome.
1. Migraine
Its shadow: Stroke or heart attack
If you regularly suffer from migraine pain
(especially if you develop auras, which are visual
or sensory phenomena that accompany the
headache), your doctor has probably warned you
about your susceptibility to heart attack or
stroke. Now, thanks to recent findings, experts
better understand which cardiac ailment is more
likely to occur for any given migraine sufferer.
Frequency matters. If you have fewer than one
migraine a month, you're 50% more likely to have
a heart attack than nonsufferers. If migraines
strike at least weekly, you have 3 times the risk
of stroke, compared with those who don't have
this problem, says study coauthor Tobias Kurth,
MD, an assistant professor at Harvard Medical
School.
Protect yourself: Unfortunately, existing research
has not yet found that preventing migraines has
the effect of lowering stroke or heart attack odds.
However, by keeping your cardiovascular system
as healthy as possible, you diminish your chance
of a cardiac event, according to the National
Stroke Association. To do this, control known
hazards, such as high cholesterol and obesity,
via diet and exercise. You should also quit
smoking and limit alcohol intake (no more than
one drink a day for women, according to the
American Heart Association.)
2. Endometriosis
Its shadow: melanoma
In 2007, a huge, 12-year French study confirmed
that women with endometriosis (in which tissue
similar to the uterine lining grows outside the
womb) are 62% more likely to suffer from
melanoma. Researchers are unsure why
endometriosis and the deadly skin cancer
sometimes travel together, but one possibility is
a genetic defect that triggers both conditions.
Protect yourself: If you have endometriosis, ask
your doctor to scan your skin for melanoma,
advises Jeffrey P. Callen, MD, a professor of
dermatology at the University of Louisville School
of Medicine. You can also do a self-check of your
moles. If anything suspicious turns up, be sure to
have it biopsied. Don't panic, though. "When
diagnosed very early, melanoma is nearly 100%
curable," Dr. Callen says.
3. High blood pressure
Its shadow: diabetes
Doctors have long wondered how high blood
pressure and diabetes are related, because the
two often appear together, especially in obese
patients. Now, after following 38,000 midlife
women for 10 years, researchers at Brigham and
Women's Hospital and Harvard Medical School
report that constantly elevated blood pressure, or
hypertension, doubles your risk of developing
diabetes, regardless of your BMI. More
surprising, the risk of diabetes goes up if your
blood pressure increases over time—even if it
stays under the hypertension threshold.
The two problems may have a common cause,
says study author David Conen, MD, a research
fellow at Brigham and Women's Hospital.
Potential culprits include high levels of
inflammation in the body, he says, or a
malfunction in the blood vessels' inner lining,
allowing blood cells to leak into surrounding
tissue and damage it.
Protect yourself: If you have mild hypertension or
are at risk for this problem, get tested for
diabetes. You can help prevent onset of diabetes
with lifestyle changes: Increase your physical
activity, lose excess weight, limit salt, and stub
out those cigarettes for good, suggests Dr.
Conen.
4. Psoriasis
Its shadow: heart attack
The rough, itchy patches of psoriasis are more
than uncomfortable and unsightly: They may
increase your odds of a heart attack, concludes a
study that followed half a million people for 5
years. The risk of a cardiac emergency was
related to the severity of the psoriasis, the
researchers determined; serious cases of the
skin ailment could mean a more than doubled
heart attack risk.
"The out-of-whack immune system that triggers
the psoriasis may also cause inflammation that
infiltrates the arteries of the heart," explains
study author Joel M. Gelfand, MD, an assistant
professor of dermatology at the University of
Pennsylvania.
Protect yourself: Will controlling the skin disease
diminish the inflammation that can cause a heart
attack? The idea makes sense but must be
confirmed with further research, says Gelfand.
You can also consider talking with your doctor
about new psoriasis medications, including
Amevive (generic name alefacept). They're made
from living sources, much as vaccines are. They
may work, even if past treatments failed. In the
meantime, Dr. Gelfand suggests keeping your
heart healthy with diet and exercise.
5. Metabolic syndrome
Its shadow: kidney stones
Metabolic syndrome is a serious health condition
associated with coronary heart attacks, diabetes,
and even early death. You have it if you've got at
least three of these five traits: excess abdominal
fat, high blood triglycerides, low HDL (which is
the good cholesterol), high blood pressure, and
impaired glucose tolerance.
Now research reveals that metabolic syndrome
could also be behind the rising rate of kidney
stones. Your odds of developing them go up by
54% if you have two of the above traits; with
three symptoms, your risk hits 70%, says the
research.
Protect yourself: Obesity is a key player in both
metabolic syndrome and kidney stones, perhaps
because overweight people are likely to consume
excess protein and sodium, which may cause the
painful crystals to develop, says study coauthor
Bradford Lee West, MD. Trimming your waistline
reduces one of the metabolic syndrome traits and
may diminish your chances of getting kidney
stones, he says.
6. Asthma
Its shadow: depression and anxiety disorders
Studies reveal a striking connection between
asthma and psychological problems, including
depression and anxiety. In 2004, the CDC
announced that 18% of patients with asthma
report mental distress. "This link has been
debated by scientists for about 20 years, but in
the last half decade it has become more
accepted," says Bruce G. Bender, PhD, who is a
professor of psychiatry at the University of
Colorado Health Sciences Center.
Research on military veterans with post-
traumatic stress disorder also confirmed the
connection. Veterans with the greatest number of
PTSD symptoms were more than twice as likely
to have asthma as those with the mildest cases,
reports study coauthor Renee D. Goodwin, PhD,
an associate professor of epidemiology at
Columbia University. Speculates Bender: "One
condition may lead to the other. Breathing
difficulties may cause anxiety or even
depression. Or psychological problems may
make asthma worse."
Protect yourself: If you know you have either
asthma or mental health problems and suspect
you have the other, get tested for it. Seek help for
any confirmed illnesses so you don't find
yourself in a downward spiral, with each
condition exacerbating the other one.
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