Hantavirus: Why is a dangerous infection with a mortality rate of up to 50 percent in the news now?

 Hantavirus: Why is a dangerous infection with a mortality rate of up to 50 percent in the news now?

Hantavirus is not usually transmitted from one person to another. However, in the case of the Andean species of hantavirus found in South America, a few cases of human-to-human transmission have been recorded.

Hantavirus is a very deadly ‘zoonotic’ virus that can become a global health challenge at any time. This virus, which is mainly transmitted to humans from rodents, causes serious damage to the lungs and heart if infected. After its sudden outbreak on a cruise ship operating in the Atlantic Ocean, it has become a topic of renewed discussion and concern among health experts and the general public around the world.

What is Hantavirus?

Hantavirus is a group of viruses belonging to the ‘Bunyaviridae’ family. It is named after the ‘Hantan’ river in South Korea, where it was first identified in 1978.

So far, scientists have discovered more than 20 species of it in different parts of the world, which affect human health in different ways.

Based on their effects and geographical presence, hantaviruses are mainly classified into two categories. The New World hantavirus species, found mainly in the American continent, causes ‘Hantavirus Pulmonary Syndrome’ (HPS) or ‘Hantavirus Cardiopulmonary Syndrome’ (HCPS). This causes serious damage to the human respiratory system and heart function.

Similarly, the Old World hantavirus species, which is more active in Europe, Asia and Africa, causes ‘Hemorrhagic Fever with Renal Syndrome’ (HFRS). This type of infection has a risk of direct and fatal effects on the human kidneys.

Recent Outbreak: Hantavirus Scare on Cruise Ships

The main reason why Hantavirus has recently become the focus of international media attention is the sudden outbreak on the MV Hondius cruise ship operating in the Atlantic Ocean. The ship, operated by the Dutch Oceanwide Expeditions company, departed Argentina on April 1. The health crisis on the ship, which is on a tour of remote islands such as Antarctica, South Georgia and Tristan da Cunha, has caught the attention of the world.

According to the latest report from the World Health Organization, seven of the 147 passengers and crew members on board the ship have been confirmed or suspected to be infected with Hantavirus. Three of the infected have died, while one is still receiving treatment in a serious condition. The other three have shown mild symptoms.

The deceased include a German citizen and a Dutch couple. According to the information received, the husband of the Dutch couple died on the ship on April 11, while the wife died in a hospital in South Africa on April 26. This tragic incident has sparked a new debate about the risk of the virus in closed environments such as cruise ships.

Source of infection and transmission

The main source of infection with Hantavirus is rodents. The virus is mainly transmitted to humans through the urine, feces or saliva of rats. When a person breathes in an area contaminated with rat feces, tiny particles of the virus mixed in the air directly enter the respiratory system. This is the most common and major route of infection. In addition, the virus can also enter the body when a rat bites, eats food contaminated with the virus, or touches a contaminated surface and then touches the eyes, nose or mouth with the same hand.

Hantavirus is not usually transmitted from one person to another. However, limited human-to-human transmission of the Andean hantavirus, a strain found in South America, has been recorded. According to the World Health Organization, such transmission is likely to occur through very close and prolonged physical contact.

The current outbreak on the MV Hondius cruise ship is also suspected to have involved human-to-human transmission. Dr. Maria Van Kerkhove, WHO’s director of pandemic preparedness and response, said that the possibility of human-to-human transmission cannot be completely ruled out, as some of the infected people appeared to have had very close contact. However, she urged people not to be overly concerned, saying that the virus is not as easily airborne as flu or COVID-19 and that the risk to the general public is not currently high.

Treatment and prevention

There is no specific drug or specific vaccine developed to protect against hantavirus infection. Therefore, supportive care in hospitals remains the only option to save infected people. If the patient's condition is serious, they are placed in the intensive care unit (ICU) and oxygen therapy and ventilators are used to facilitate the respiratory process.

Since this virus is transmitted by rodents, the best way to avoid it is to avoid contact with rats. Proper arrangements should be made to prevent rats from entering your home, workplace or storage rooms.

Special care should be taken when cleaning areas that may have rat droppings. To prevent dust from flying in such areas, instead of sweeping the floor, only damp cleaning should be done using a disinfectant solution or bleach. The mandatory use of masks and gloves during such cleaning can prevent virus particles from entering the body.

In addition, Squirrels should always be kept in a secure container out of the reach of rodents. People who live or work outdoors or near forests need to pay extra attention to the cleanliness of their surroundings. In unusual circumstances, it is wise to maintain personal hygiene and social distancing, while fully following the instructions of health authorities. Since there is no cure for Hantavirus, awareness and caution are the strongest weapons in the fight against this deadly infection.

How at risk is Nepal from the Hanta virus that has swept the world?

 How at risk is Nepal from the Hanta virus that has swept the world?

Since the initial symptoms of many infectious diseases are very similar to each other, laboratory tests are helpful in distinguishing the infection.

According to the World Health Organization, 3 out of 8 people have died from Hanta virus seen on a cruise ship.

Although Hanta virus is transmitted through the feces, urine or saliva of infected rats, it has been confirmed that the 'Andean' species can be transmitted from person to person.

Nepal is at risk of Hanta virus, but even if it has not been confirmed as an outbreak, regular testing and research are necessary.

Recently, the Hanta virus seen on a cruise ship has swept the world. According to the information published by the World Health Organization a few days ago (on May 8), 3 out of 8 people have died.

That is, about 38 percent of the infected have died. This human-to-human transmission is considered very rare, but currently, dozens of cases on cruise ships have become a matter of concern and interest.

At the time of writing, the main source of infection is unknown. Information on the circumstances under which it spread from person to person is yet to be released.

Hantavirus can be transmitted to humans through contact with the feces, urine, or saliva of infected rats. Even if an infected rat does not show symptoms, it can still cause death if it infects humans.

The mortality rate of the Hantavirus strain seen in the Americas is many times higher than that of the Hantavirus strain seen in Europe and Asia, which is about 50 percent. Recently, a cruise ship has seen a mortality rate of about 38 percent. The World Health Organization has reported that the mortality rate of the Hantavirus strain seen in Europe and Asia is up to 15 percent.

Although Hantavirus is said to be transmitted only through the feces, urine, or saliva of infected rats, the ‘Andean’ strain of Hantavirus can be transmitted from person to person to some extent.

The Hantavirus strain currently circulating on cruise ships has also been confirmed by gene sequencing to be ‘Andean’. Hantavirus is mainly divided into two types based on symptoms, which also vary according to geographical location.

First, Hanta pulmonary syndrome and second, hemorrhagic fever with renal syndrome.

Hanta pulmonary syndrome is mainly seen in the Americas, while hemorrhagic fever with renal syndrome and Hantavirus are seen in Europe and Asia.

Hanta pulmonary syndrome is characterized by symptoms such as fever, chills and dizziness, muscle pain, diarrhea, nausea or vomiting, abdominal pain, and low blood pressure. If it becomes complicated, coughing, difficulty breathing, chest tightness, and pneumonia may occur.

These symptoms may appear within one to six weeks of infection.

Hemorrhagic Fever with Renal Syndrome Hanta virus causes chills, stomach pain, headache, nausea, blurred vision, red eyes, and later complications, bleeding, and there is a risk of kidney failure.

These symptoms appear one to two weeks after infection, and sometimes up to 8 weeks. This Hanta virus is seen in Asia, especially in countries like China, Korea, Japan, and Russia. Research articles have also been published that Hanta virus has been seen in neighboring India. But there is no information that it has taken the form of a major outbreak.

Is there a risk of Hanta virus in Nepal?

Hanta virus is transmitted when it comes into contact with rat feces, urine, or saliva. Rats are seen in significant numbers in all villages and cities in Nepal.

The number of people who come to Teku Hospital for treatment of rat bites is also high. Most people with such problems do not come to the hospital. There is a lot of contact between humans and rats in Nepal too.

Hundreds of scrub typhus cases are reported in Nepal every year. The main source of scrub typhus infection is the mite found in rats. This also clearly shows that the risk of any infection that can be spread by rats in Nepal is high.

Hanta virus is no exception. In 2017, a tourist fell ill and was admitted to the ICU immediately after returning to his country after visiting Nepal. A research article was published stating that the person had been diagnosed with hanta virus. This was published in an American medical journal in 2020.

This also indicates that the risk of hanta virus is present in Nepal.

However, as in India, there is no confirmation of an outbreak in Nepal yet. Since this infection is not included in routine laboratory tests, we are unaware of the status of hanta virus in Nepal.

Blood tests of tourists infected with hanta virus in Nepal show a decrease in platelet count and an increase in liver enzymes, which the author has experienced is also widely seen in fever patients in Nepal.

However, the possibility of Hantavirus seems to be overlooked when sending for diagnostic tests for limited infections. Since a large number of fever patients are still not diagnosed in Nepal, there is a need to increase the scope of testing.

In the case of a new infection or a first-time infection, testing for that infection should also be included in routine testing. Since the initial symptoms of many infectious diseases are very similar to each other, laboratory testing is helpful in distinguishing infections. Only if the infection is diagnosed can treatment, prevention, and counseling be correct.

Currently, the World Health Organization has stated that the risk of further spread of this virus is low. However, the number of infections on a cruise ship at the same time is so high. And as the problem becomes more complicated and the mortality rate is higher, it cannot be ruled out that the contagiousness and lethality of this virus has increased compared to the past.

Nepal cannot completely ignore the risk of the virus, given the confirmed research on this virus and the frequent contact with rats, which is considered the source of the virus.

If national guidelines were developed in Nepal, prioritizing research on Hanta virus, it would be useful for health workers in diagnosis, treatment, and prevention.

Selling hydropower to Silicon Valley in the name of data centers may not bring real benefits to Nepal

 Selling hydropower to Silicon Valley in the name of data centers may not bring real benefits to Nepal

A few months ago, a well-intentioned development consultant working in Nepal explained to me why Nepal is a perfect fit for green computing (environmentally friendly data centers). His argument was that the country is ideal because of its abundant hydropower, cool mountainous climate, and its location between two of the world’s largest digital economies. He was right in a way. But he failed to understand what all of this would ultimately lead to.

To put it simply, the proposal is to let a foreign company build a data center here, run it on Nepal’s own hydropower, attract foreign investment, and call it green. It sounds like a win, but personally, I don’t think it’s a win.

In green computing, the word ‘green’ refers almost entirely to the source of electricity. Everything else is left out of the equation. Data centers, in particular, are heavy users of water. Large hyperscale infrastructure can consume up to 10 million liters of water per day for cooling.

Nepal is facing a severe seasonal water crisis, and the rivers that feed the hydroelectric system are the same ones that farming communities have depended on for centuries. No one is talking about this water trade-off. That is, no one is talking about how much water is lost to agriculture and locals when water is used to run data centers, or what Nepal has to lose.

In addition, there is another big problem of embedded carbon (the hidden carbon emitted during the manufacture and transportation of goods). The cement and rods used to build buildings, and the large server machines transported by trucks and ships, are also contributing to pollution. These servers break down every three to five years and have to be replaced.

This leads to a huge amount of electronic waste. There is no effective system in Nepal to recycle and reuse such old machines or hardware. So this electronic waste will eventually end up in some corner of the country, where those foreign investors probably won't even notice. There are many other things that are good in Nepal, but our waste management or recycling system is not good.

If we look deeper into the issue of electricity, this argument also proves to be weak. It is true that Nepal produces more electricity. However, in my experience, this is only during the rainy season. Even today, when the water level in the rivers decreases during the dry season in winter, households and industries have to face electricity shortages.

If Nepal provides electricity to these data centers of foreign companies, that electricity cannot be sold to India at a good price. Similarly, domestic industries that are trying to produce something in the country do not get that electricity either. Nor can that electricity be delivered to the remote homes of Karnali, which are still burning kerosene.

What Nepal should not forget is that this country has spent the past few decades in extreme load shedding. The situation was so miserable that even in Kathmandu, the electricity was out for 16/17 hours a day. At that time, the phrase ‘lights gone out’ was always on people’s lips. I remember, I used to use the ‘lights come’ app myself to know when the electricity would come back. After such a long struggle, ending that dark era and letting the electricity that was barely collected run for our own country and not for our own country is like ‘walking in the opposite direction’.

The argument that these data centers ‘create jobs’ sounds the most tempting. But when you dig deeper, this is also the thing that proves to be the most hollow. In a large data center, barely a few dozen people get permanent jobs, and that too in security guards and general maintenance work. The main technical work that pays well is done by specialists, who are often foreigners.

It is true that they bring in big investments. But that money immediately goes abroad. Because that money could be used to buy server machines from America or other Asian countries and pay for software licenses. The government gives various tax breaks to bring such companies to Nepal, which also results in the loss of revenue that the country is supposed to get.

In the end, what happens is that Nepal gives its land, electricity, political support, and even the transmission line or infrastructure. However, all the profits from this go abroad.

My country, Ireland, said ‘yes’ to all these things (offshore data centers and tax breaks). And the situation there over the last 10 years has taught us a valuable lesson. Ireland’s calculations were not entirely wrong. Companies there were only charged 12.5 percent corporate tax (minimum tax). This not only filled the country with data centers, but also large technology companies like Google and Meta opened their European headquarters in the capital, Dublin. This really benefited the Irish economy. However, the story of the data centers is different.

In the 2010s, Ireland became a data center hub in Europe, thanks to its cool Atlantic climate, access to the European market, and low taxes. In 2015, data centers consumed only about 5 percent of the country's total electricity, but by 2023, they were consuming 21 percent. According to AirGrid, the country's national electricity transmission system operator, data centers will consume about a third of the country's electricity by the mid-2030s. .

On the one hand, Ireland has set its own goal of producing 70 percent renewable energy by 2030. But on the other hand, this goal has been undermined by the fact that foreign servers are consuming electricity. The electricity infrastructure there could not cope with this pressure. Due to which, in 2022, the Electricity Authority completely banned the connection of new data centers in the capital Dublin.

The biggest hit has been to the general public. According to the latest statistics (May 2026), the people of Ireland are buying electricity at the most expensive price in the European Union. Citizens there are paying almost 40 percent more than the average price in Europe. Having to pay more than 40 cents per unit, an average household is facing an additional financial burden of about 480 euros (about 82 thousand rupees) per year on its electricity bill alone.

The issue of water has also become another big problem there. Microsoft's data center at Grange Castle (for drawing too much water) has been the subject of so much controversy and scrutiny that when the UN's special representative visited Ireland to assess the state of the clean environment, Microsoft refused to let him enter its data center.

The number of jobs it has provided is no longer a mystery. Even if all the data centers across Ireland were combined, only a few thousand people would be directly employed there. This is an area that alone generates 20 percent (one-fifth) of the country's electricity. Billions have been invested in building transmission lines to deliver electricity to it. These data centers occupy so much land; many homes could be built there for the general public. In comparison, these jobs are a very small and disappointing return.

Ireland had many such facilities that Nepal does not have. Ireland is a member state of the European Union (EU), it has a reliable legal system. On top of that, the first language is English. In addition, the country has decades of experience in making deals with big tech companies. Its tax-free policies have not only brought data centers, but also large offices for companies like Google and Meta. Where tens of thousands of engineers found jobs and a ‘knowledge-based economy’ developed along with server machines.

But that may not be the case in Nepal. Nepal will only get server racks. But people will not get desks to work. Despite such favorable conditions, data centers in Ireland have crippled public infrastructure, caused electricity shortages and provided jobs to only a few people who could not fill a football stadium in the name of employment. In such a situation, Nepal will have to make deals on even weaker ground, the results of which are sure to be worse than Ireland’s.

I have been closely monitoring the actual development of the technology sector here, living in Nepal for more than a decade. As expected, Nepal’s IT services exports will reach $1 billion by 2025, which is more than double in the last three years.

Nepali engineers who studied at world-renowned universities like MIT and Carnegie Mellon in the US are returning home with investments and international networks. Nepal is really building a strong foundation now. This development is not happening by becoming ‘cheap workers’ in the supply chain of foreigners, but by Nepali engineers themselves becoming founders and owners of companies.

However, this so-called ‘green compute’ (foreign data center) plan is nowhere in line with the real progress of the country. It is trying to make Nepal a mere shepherd who provides water and electricity. Where local resources are used, but the real profit is taken by someone else.

Whose law applies to the data of a company kept in Nepal but registered abroad? What if a foreign government exerts legal pressure tomorrow? Such questions are never discussed seriously before an agreement is signed.

Nepal is between two large countries like India and China. Both these countries do not take digital infrastructure (data centers, etc.) built in their neighborhoods for granted. The decision to bring a US company to the Chinese border (Nepal) and set up a data center, or to allow a Chinese company to open a data center at a distance that India considers a security threat, cannot be dismissed for long as ‘it’s just a business decision’. This could quickly become a matter of geopolitical tension.

Once large data center buildings are built here and machines are connected, Nepal’s negotiating position becomes even weaker. Because those machines have to be repaired by foreign experts, and the spare parts needed to keep them running have to be imported from abroad. Thus, Nepal is forced to rely on foreigners structurally.

One argument is always heard in support of this. That is, isn’t it better to run a data center using hydropower in Nepal than to run a data center burning coal (and polluting it) in some other country? However, this is just an illusion created by showing a false alternative. The main question here is not what to use instead of coal. The main question is how Nepal uses the excess electricity it has and how to make good use of this short opportunity to benefit on its own terms.

Sell electricity directly to foreign countries at a good price, open industries in the country and invest in our own infrastructure in a way that benefits Nepalis first. These are the options that bring sustainable development to the country. However, a foreign data center is something that, if it were to arise from here tomorrow, would affect almost all of us. The money will be taken with it.

As I write this article, there is talk of more investment coming in. The first project approved will be called a pilot project. When the second project comes, it will be called momentum. And, when it reaches the third project, it will be given the form of policy.

Nepal has very little time left to decide what kind of economy it wants to build. Nepal must make a clear decision before this opportunity is lost. Otherwise, foreign consultants will move on to another country with favorable conditions.

(The author Jonathan Clark has been living in Nepal since 2015. This article is a translation of his blog. He published a blog titled ‘Who Actually Benefits When Nepal Sells Hydro to Silicon Valley’ on his website on 7 May 2026. He created a software called ‘ConX’ in 2015 and sold it to the American company ‘Houzz’ in 2021. Jonathan currently works as the ‘Director of Engineering’ in the same company. He mostly lives in Lalitpur.)

Why does Google Maps consume so much battery? This is the new power saving mode that saves battery for up to 4 hours

 Why does Google Maps consume so much battery? This is the new power saving mode that saves battery for up to 4 hours

In this era, smartphones are no longer just a means of communication for us, they have also become an integral part of our journey. Whether traveling to unfamiliar places or short distances within the city, we often depend on Google Maps.

But one of the bitter truths of using Maps is that it consumes the phone's battery at a very fast rate. Using Maps while going on a long journey or when there is no charging facility is like pushing the phone to the brink of death.

To solve this serious problem, Google has introduced a new power saving mode in its navigation service. As claimed, this feature can increase the battery life of smartphones by up to four hours.

But as attractive as this feature looks, some of the conditions or limitations that come with it are equally challenging. Today, we are discussing in detail about this new feature of Google Maps, how it works and the impact it has on the user.

Why does Google Maps consume so much battery?

There are many technical reasons behind Google Maps consuming battery. The first and main reason is the constant GPS tracking. Every second, the phone has to constantly communicate with satellites to determine your geographical location. This never lets the phone's processor rest.

The second reason is real-time data streaming. Maps doesn't just show the route, it also downloads real-time road speeds, accident information, and traffic congestion details based on data from millions of other drivers. Using machine learning, it constantly calculates the estimated time of arrival (ETA) to your destination and alternative routes.

The third and most visible reason is the bright screen. In daylight, the phone's screen needs to be run at full brightness to see the road clearly. Full-color maps, 3D buildings, and constantly changing scenes put a lot of strain on both the phone's processor and display. All these factors together can make even a phone with a large battery die before it can be fully charged.

New Power Saving Mode

This new mode recently introduced by Google is specifically aimed at users who are on long-distance trips and do not have the option of charging their phones. This feature minimizes unnecessary and energy-consuming visuals without removing basic information needed for navigation.

Technically speaking, this mode uses the phone's Always On Display technology. When you turn on this mode and press the phone's power button while navigation is active, the phone's screen turns into a monochrome, i.e. black and white interface, instead of turning off completely. This saves a lot of battery, especially on phones with OLED displays. Because the phone's pixels do not have to light up to display black.

Limited to the Pixel 10 series

One downside for now is that this feature is not available to all Android users. Google has limited this feature to its new models Pixel 10, Pixel 10 Pro, Pixel 10 Pro XL and Pixel 10 Pro Fold for now. These phones use Google's new Tensor G-5 chipset. Which can handle such complex tasks in a way that consumes less energy.

Although this feature has been rolling out since last year, it has not yet reached other older Pixel models or phones from other brands like Samsung and Xiaomi. However, Google is expected to gradually make it widespread.

How to activate this mode?

If you have a Pixel 10 series phone, you will have to adjust this feature from the internal settings of Google Maps. To do this, first open the Google Maps app.

Tap on your profile picture in the upper right corner. Now select the Settings option and go to the Navigation settings.

You will see a toggle button for Power Saving Mode within the Driving options there, turn it on.

Once this setting is turned on, you just have to press the power button when you start your journey. After doing this, the main navigation information will start appearing on your phone's lock screen.

Effects of turning on power saving mode

While this mode is said to save battery, it may not always be useful for everyone. Google has removed many important features of Maps in this mode to save battery. Normally, Maps shows red if there is traffic jam, yellow if there is moderate traffic, and green if there is clear traffic.

However, this color-coded information is not available in power saving mode. You will not get visual alerts about accidents, construction work, or sudden jams on the road.

Similarly, this mode removes 3D buildings, detailed street names, and complex map layers. Only a simple black and white line appears on the screen and an indication of where your next turn is.

Where is the gas station in the middle of a trip? Where is the nearest restaurant or coffee shop? Such details are not visible in this mode. If you want to eat or fill up on gas along the way, you'll have to turn this feature off and return to the normal map.

Many drivers prefer to keep their phones in a horizontal position on the dashboard of their car. However, this power saving mode only works in portrait mode. This makes it difficult for those using the landscape mount. This can be inconvenient for some.

Surprisingly, this feature only works when you are driving. This mode does not work if you are walking, cycling or on public transport. While pedestrians may need more battery life.

In what situations does it work?

This mode seems to be designed by Google as an emergency tool rather than a default setting. Imagine, you are on a long road trip and your car's mobile charger suddenly breaks down.

Your phone has only 10 percent charge left and the destination is still far away. In such a situation, this mode can keep your phone alive for an additional 4 hours. It helps you reach your destination without getting lost. But it does not provide other features on the road.

So, using this mode on short daily trips or when there is a phone charging facility does not make much sense. It keeps you away from the real road conditions, which can sometimes be risky from a safety point of view.

Negative thinking affects the heart

 Negative thinking affects the heart

Stress increases the heart rate, increases blood pressure, and causes long-term heart problems.

According to a 2023 study by the American Heart Association, constant stress increases the risk of heart disease by up to 35 percent.

Doctors recommend 10-15 minutes of meditation, 30 minutes of exercise, and positive thinking daily to reduce stress.

A problem that is not visible on the surface but silently haunts most people on the inside is stress. From the outside, people appear normal, busy with their work. But inside, they are carrying the burden of worry, fear, and pressure. This invisible negative burden gradually weakens the body.

Negative thinking, anxiety, anger, or frustration is not only a problem for the mind, but also a big threat to the heart. Its effect on the heart is even deeper.

When you are constantly stressed, your heart starts beating faster, your blood pressure increases, and your body is forced to be on alert all the time. If this situation persists for a long time, the risk of heart problems increases.

How does stress affect the heart? What is the relationship between the heart and stress?

The relationship is very simple, the mind controls the body. When negative thoughts come, the body goes into 'stress mode'. The heart beats faster, blood pressure increases and the heart has to work harder. If this thought is short-lived, the heart is fine.

But if the pressure of daily work, financial problems, family disputes, comparisons with friends, negative news on social media or past tragic events continue to bother you, negative thoughts take up residence in the mind. This puts a burden on the heart and increases the stress associated with it.

Negative thoughts, especially anger, rage, hatred and malicious thoughts, have a profound effect on the heart because they overactivate the 'sympathetic nervous system'. This system is responsible for the 'fight or flight' response, that is, the body's natural response to immediately fight or flee when it senses danger.

When we get angry or have negative thoughts, the brain immediately sends signals that increase levels of stress hormones such as adrenaline, cortisol, and noradrenaline.

These hormones increase heart rate, raise blood pressure, and constrict blood vessels. Over time, this activation damages the inner lining of the heart’s blood vessels (endothelium). The endothelium loses its ability to dilate blood vessels, which reduces blood flow and accelerates the process of plaque buildup.

If the mind is not healthy, the heart will not be healthy

If the mind is not healthy, the heart will not be healthy either. Studies say so. According to a 2023 study by the American Heart Association, depression, anxiety, and chronic stress increase the risk of heart disease by up to 35 percent. Similarly, a large study by the British Heart Foundation also showed that stress at work or at home increases the risk of heart disease and stroke, albeit slightly.

Studies have shown that even a short bout of anger can reduce the dilation of blood vessels for up to 40 minutes, which reduces the amount of oxygen reaching the heart. Anger and hatred cause blood vessels to constrict through sympathetic activation. This weakens the heart muscle and can lead to heart failure or irregular heartbeat.

What happens in the long term?

If you have persistent negative thoughts, your heart is under constant pressure, which can lead to high blood pressure. Blood vessels gradually narrow, reducing blood flow to the heart and increasing the risk of heart attack or stroke.

High risk with chronic illness if you have negative thoughts

If you already have diabetes, high blood pressure or high cholesterol, the risk doubles if you add negative thoughts. Because these diseases are already weakening the heart, negative thoughts increase stress and put additional 'overload' on the heart. According to the British Heart Foundation, such stress increases the risk of heart disease and worsens the condition of those who already have heart problems.

When should you see a doctor?

If you feel pain or pressure in the chest, difficulty breathing, irregular heartbeat, excessive fatigue, dizziness, cold sweats, or pain in the hands are more common after negative thoughts or stress, this may be a sign of a heart problem.

It is advisable to go to the hospital immediately without delay. In addition, a heart check can be done during regular checkups. ECG, echo, and blood tests also tell about the condition of the heart in a timely manner.

In addition, these problems can be reduced to a large extent by consulting a mental health professional.

How to reduce negative thoughts and stress?

First of all, it is important to establish positive habits in your daily life. Practicing deep breathing or meditation for 10-15 minutes every day calms the mind and reduces stress.

Similarly, walking or doing light exercise for about 30 minutes daily keeps the body active, the mind light, and heart health is also good. If a negative thought comes to your mind, you should not let it develop further. At such times, remind yourself, "This thought may not always be right, I can try."

Such positive thoughts gradually strengthen the mind.

Keeping things bottled up inside can increase stress. Talking to family members or close friends can help you relax and understand your problems and find solutions.

Eating a healthy diet, getting enough sleep, and avoiding social media can also help you feel more at ease. If you still feel stressed and negative thoughts aren't going away after trying these things, talk to a therapist or counselor. 

Food with ‘trans fat’ in abundance in the market, heart and brain are paying the penalty

 Food with ‘trans fat’ in abundance in the market, heart and brain are paying the penalty

Doctors say that the trans fat (very bad fat) hidden in bakery products, noodles, puffs and French fries, which are abundant in the market, is causing serious damage to the heart and nervous system at a young age.

Food with ‘trans fat’ in abundance in the market, heart and brain are paying the penalty

February 15, Kathmandu. ‘What is the worst fat found in?’ This is a question that senior cardiologist Dr. Ommurthy Anil often asks his patients who come to him for check-ups.

Most of those who come to check answer, ‘Red meat, ghee, milk, butter.’

Some add, ‘The fat in oil can be bad.’

He explains, ‘The worst fat in the world is found in foods containing trans fats.’

According to Dr. Anil, eating foods containing trans fats for a long time is fatal to the heart, blood vessels, kidneys, and brain. But we do not find it unusual to eat biscuits with tea in the morning, puffed noodles in the afternoon, and french fries with friends in the evening.

But hidden within this easy and tasty option is ‘trans fat’, i.e. very bad fat (unhealthy fat).

According to the doctor, foods containing trans fats are causing chronic diseases in the body. This is not a ‘normal fat’, but a silent poison that opens the door to chronic diseases.

A monitoring conducted by the Department of Food Technology and Quality Control last November showed this alarming situation. During the monitoring, the ‘croissant’ of Nanglo Bakery and the puff produced by Khajuri Nepal Pvt. Ltd. were found to be harmful to health. After ‘trans fat’ was found to be more than the limit set by the government, the Food Department completely banned the sale and distribution and destroyed them.

Trans fat is considered one of the most harmful fats from a health perspective. According to experts, the reason for the increase in trans fat is unhealthy diet and urban lifestyle. Due to trans fat, heart attacks are increasing at a young age.

‘The trend of heart attacks that we are seeing in patients is directly related to diet,’ says senior cardiologist Dr. Prakash Raj Regmi, ‘Trans fat is an important reason for that.’

What is trans fat?

Trans fat is found from two sources, natural and artificial. It is found in the fat in red meat of animals such as cows, buffaloes, goats, and in dishes made from milk and yogurt. According to doctors, trans fats obtained from natural sources when consumed in small amounts do not have much negative impact on health. However, consuming excessive amounts can have negative impacts.

Industrial trans fats produced in the food industry are extremely harmful to health. They are obtained from artificial sources.

Industrial trans fats are mainly produced by converting vegetable oils into ghee through hydrogenation. In this process, it is produced by heating vegetable oils at high temperatures and adding hydrogen molecules. In this process, the liquid oil is converted into a solid state, i.e. vegetable ghee.

The vegetable ghee produced from this process is used to make various processed foods including bakery products, biscuits, cookies, ready-made noodles, bhujiya, dal moth, potato chips, etc.

Trans fats, which are produced by heating cheap oils in the industry and adding hydrogen, increase the amount of fat. In addition, foods cooked in such very bad fats become tasty and can be stored for many days.

Foods cooked in such oil are mostly used for packaged foods. Foods that look attractive from the outside are very harmful to health. Even if vegetable oil is heated many times, the amount of trans fat increases. Pakodas, samosas, potatoes, and chicken cooked in such oil are delicious to eat.

Another senior cardiologist, Dr. Premraj Vaidya, says, “It is considered good to eat one teaspoon of ghee a day. However, trans fat-rich foods are very dangerous.”

Senior cardiologist, Dr. Ommurthy Anil, says that heart attacks are increasing in people in their 30s and 40s. The main reason for this is a bad lifestyle and eating trans fat-rich foods. He says, “Trans fat-rich foods cause blockage in the blood vessels of a healthy person and lead to heart attacks. It affects everyone from children to senior citizens, pregnant women.

Transfats that poison the blood vessels

Ultra-bad fats (transfats) increase the amount of bad cholesterol in the blood and reduce the amount of good cholesterol. Similarly, they negatively affect the inner part of the arteries and increase the narrowing of the arteries.

'Not only does it narrow the blood vessels, it also causes inflammation (a condition like a swollen wound) in the inner part,' says Dr. Regmi, 'When cholesterol accumulates, blood blockage occurs. Which can lead to a heart attack or stroke.' Not only this, transfats increase the risk of type-2 diabetes.

Due to processed foods prepared for commercial purposes, fat accumulation around the stomach, weight gain and metabolic syndrome are increasing. There is an increasing addiction to junk food among children these days. Obesity, high blood pressure and pre-diabetes are starting to appear at school age, says Dr. Vaidya.

Experts say that excessive trans fat intake by pregnant women can affect fetal development. “There is a possibility that the effects of trans fat can reach the newborn through breastfeeding,” says Dr. Vaidya, “and the risk can last for a generation.” It is not limited. It has a bad effect on the health of the unborn child.

The fried and packaged foods in the market are rich in trans fats. Doctors say that excessive consumption of which leads to fatal diseases at an early age and many people die.

Dr. Regmi claimed that a young woman died after eating Bhujia after watching an advertisement. Recalling an incident a few years ago, he said, "Amitabh Bachchan had promoted Bikaji Bhujia in a very attractive way on Sony TV. A young woman is an Amitabh fan. After consuming Bhujia for a long time, she had reached a state of heart failure."

According to Dr. Regmi, continuous consumption of Bhujia weakened the heart muscle, increased blood pressure and cholesterol. Due to which the heart could not pump properly.

Heart disease is becoming the leading cause of death in the world. The main risk factors are unhealthy diet, physical inactivity, tobacco and alcohol consumption. A study by the World Health Organization has shown that high intake of trans fats increases the risk of death by 34 percent.

Effects of diet on the brain

Experts say that brain diseases have started increasing among Nepali youth due to changing diets along with modern lifestyle. According to neurologist Dr. Sushil Mohan Bhattarai, serious neurological diseases including stroke, Alzheimer's, Parkinson's and other diseases have started appearing even in young people in their 30s due to trans fat-rich foods and unhealthy lifestyle.

Dr. Bhattarai, who works at a civil hospital, says, 'Earlier, paralysis and brain stroke were considered diseases that occurred after reaching the age of 70. But now it is seen in young people in their 30s.'

According to Dr. Bhattarai, after trans fats enter the body, they go directly to the cell membrane. Cell membranes are very important for maintaining the structure of the body and for communicating from one cell to another.

In order for the brain to implement what the hand thinks, there must be continuous communication between the nerves. But when trans fats start to mix with cell membranes, communication is disrupted and brain functions gradually deteriorate.

According to Dr. Bhattarai, trans fats reduce the amount of serotonin, the ‘happy chemical’ produced in the brain. Due to this, people in the modern era have started to tend to be more sad, negative and depressed. Not only that, but the ability to learn new things and memory decline.

‘Many college-going students come to the clinic with problems with concentration,’ says Dr. Bhattarai.

Similarly, according to Dr. Rajiv Jha, senior neurosurgeon at Bir Hospital, when the amount of fat in the body increases, the blood vessels that carry blood begin to clot. When fat accumulates in the veins, the blood flow is blocked, due to which the amount of oxygen that should reach the brain decreases.

According to Dr. Jha, if blood circulation is blocked in any part of the brain, the risk of stroke is high. ‘When too much fat accumulates, the vessels become narrow or stiff. That leads to brain hemorrhage or stroke,’ says Dr. Jha says.

According to Dr. Bhattarai, smoking is the number one risk factor for stroke in young people. In second place is unhealthy diet and foods high in trans fats.

‘Brain-related diseases are more common in urban youth and they smoke and eat foods high in trans fats from a young age,’ said Dr. Bhattarai.

Regarding the direct link between trans fat intake and stroke, Dr. Jha says, ‘Obesity and high blood pressure are the main problems in many patients who come to the hospital. Patients who have strokes at a young age often have an unhealthy lifestyle, excessive consumption of junk food, and lack of physical activity.’

Trans fat-rich foods in abundance in the market

Data from the Food Department shows that some of the foods produced in the market are very harmful to health. The department had monitored 67 prepared food items and the raw materials used in them in the last one year.

Of these, 16 percent, or 11, were found to contain trans fats exceeding the standard. In which the total fat content of the food item was more than two percent.

Manita Vaidya, Director General of the department, says, ‘During the monitoring, up to 15.5 percent trans fat was found. Which is very harmful to health.’

Eight puffs were tested during the monitoring. Four puffs had trans fat levels exceeding the standard. Four of the six vegetable ghees tested had high trans fat levels. Vaidya claimed that the products found to have trans fat levels exceeding the standard were returned to the market.

Dr. Anil says, ‘Finding 15.5 percent trans fat in food in the market is a poison for health. Eating such foods directly blocks the blood vessels of the heart and causes heart attacks.’

In the race to increase profits, hotels, restaurants and roadside shops are repeatedly using oil to make fast food such as pakodas, samosas, puris, chicken fries, sausages, etc., which produces trans fat. Deep frying destroys all the nutrients in the food and adds harmful fats to it.

“Most of the sweet shops in the market are using vegetable ghee and oil containing trans fats to make sweets. These dishes, which look smooth, shiny and durable, are actually poisonous to the heart and blood vessels,” said Dr. Vaidya.

Dr. Regmi adds, “Repeatedly heating oil is harmful. It is used Not only is it linked to disease, but it is also linked to the risk of cancer. It is advisable to avoid using vegetable ghee as much as possible.

Main causes of death Heart and stroke

The mortality rate from non-communicable diseases is increasing in Nepal. According to statistics, a large part of the total deaths are due to respiratory diseases, heart diseases, and strokes.

According to experts, unhealthy diet and increased consumption of processed foods are one of the main reasons for this.

According to the 2023 data of 'Nepal Burden of Disease', respiratory diseases are the number one cause of death in Nepal, heart disease is the second, and stroke is the third.

Our diet, behavior, and lifestyle have emerged as the main root causes of the spread of non-communicable diseases. Experts say that non-communicable diseases are increasing as a 'dormant' epidemic in developing countries in recent times. The mortality rate is also increasing in proportion to that. According to the latest statistics, 71 percent of deaths in Nepal are due to non-communicable diseases.

Public health expert Dr. Rita Thapa says that the increase in the incidence of non-communicable diseases has become a matter of concern in recent years. According to Thapa, non-communicable diseases are increasing due to luxurious lifestyle and carelessness in eating, high blood pressure, and diabetes.

According to Dr. Thapa, the reasons are in our hands. There are things related to our lifestyle. Our behavior, junk food, lifestyle, use of tobacco products at a young age, and lack of exercise are the result.

‘Children at a young age consume tobacco products, junk food, and alcohol. Parents also give junk food to young children for lunch,’ Dr. Thapa clarified, saying, ‘The burden of non-communicable diseases is increasing due to lack of physical exertion and excessive stress.’

Is it right to call food ‘junk’? – Online Khabar

State silence, consumer health at risk

With the beginning of the 2000s, health agencies in various countries of the world began to implement regulations to control trans fats used in food. Denmark introduced stricter standards in 2003, while Switzerland banned trans fats in 2008.

Within the United States, New York banned trans fats in 2006 and California in 2008. Canada followed suit in 2008. These decisions led to very low trans fat levels in many foods and complete bans on many products.

Then, it was announced that heart attacks, high blood pressure, obesity, and diabetes in young people had decreased. Denmark announced that it had reduced the incidence of diseases in young people by 50 percent. But at the time, many countries found it difficult to believe what Denmark had announced.

The World Health Organization investigated the issue and declared Denmark a “trans fat-free” country.

In the United States and Canada, the amount of trans fat must be stated on the label of packaged foods sold.

The World Health Organization had launched a campaign with the goal of eliminating industrial trans fats from all countries of the world by 2023.

On 24 Magh 2078, the government passed the Multi-Sectoral Action Plan (2021-2025) for the Prevention and Control of Non-Communicable Diseases. Under this plan, there is a policy to keep trans fats below 2 percent of the total fat content of food.

The Department of Food Technology and Quality Control has implemented the standards since 25 Shrawan 2081 after the standards were approved by the Food Standards Committee. However, it has not been adequately monitored.

Consumer rights activists say that the state machinery is still not serious about trans fat-containing foods being sold openly in the market. Consumer rights activist Madhav Timalsina says that the problem will worsen unless the state comes up with a clear and strict policy. According to him, the problem extends from production to regulation.

‘First of all, there should be stricter restrictions on the import of raw materials. Trans fat testing should be made mandatory at customs and quarantine checkpoints. But it does not seem to be happening effectively,' said Timalsina.

Stating that merely setting standards is not enough, he says that strictness is needed in implementation.

'The policy is limited to paper. There is no will to implement it. The terror of trans fats in the market will not stop until a comprehensive awareness campaign is launched among the government, industrialists, importers and consumers,' said Timalsina.

Department spokesperson Bal Kumari Sharma claims that food products have been monitored regularly lately.

'Last November, we recalled the puff produced by Khajuri from the market after it was found to be substandard,' says Sharma. 'We found that it was safe to eat in subsequent monitoring.'

Lax regulation

The Food Hygiene and Quality Act, 2081, clearly provides for mandatory labeling of food and beverages. It is the responsibility of producers and sellers to provide consumers with accurate and clear information about the nature, quality, quantity, expiration date and potential risks of the product.

Similarly, the Consumer Protection Act, 2075 BS, has ensured the right of consumers to be informed about price, quality, results and purity, and has provided a legal basis to protect them from the sale and distribution of products that are harmful to human health.

But the law seems to be limited to paper. Unlabeled food products are found being sold openly in the market. Some products do not even mention the details of ingredients, production and expiry date. Due to this, consumers are directly at risk due to weak state monitoring.

The Advertisement (Regulation) Act, 2076 BS and the Consumer Protection Act, 2075 BS clearly prohibit misleading and false advertisements related to health and nutrition. Who is it? These legal provisions could have been enough to stop the aggressive marketing of unhealthy foods, sugary drinks, and industrial trans-fat products targeting children. But implementation is weak. The Food Technology and Quality Control Department and provincial-level laboratories have cited a lack of manpower as the reason for their inability to conduct effective monitoring.

The argument of limited technical capacity and weak laboratory infrastructure at the food department, provincial laboratories, and local levels has been repeated. The growing market for highly processed foods, the tendency to not follow labeling, and a weak monitoring system have made the situation more complicated. The regulatory mechanism is in disarray, increasing the health risks to consumers.

Health experts say that mandatory mention of trans-fat content on food labels, clear visual warnings, and targeted implementation strategies are necessary to control industrial trans-fat. They suggest that inspection and laboratory capacity should be strengthened by implementing tax policies and strict labeling at the provincial level.

Consumer rights activists in Timalsina say that there should be no delay in making market monitoring effective and banning the sale and promotion of high-trans-fat products in schools and communities.

Preparations to bring a multi-sectoral action plan

The government has said that preparations are underway to bring a new multi-sectoral action plan for the prevention and control of non-communicable diseases. According to Health Secretary at the Ministry of Health, Dr. Bikas Devkota, the action plan implemented from 2021 to 2025 has expired. Now, the process of formulating a new strategy for 2026 to 2030 has been initiated.

Stating that the main causes of non-communicable diseases lie outside the health sector, Dr. Devkota says that multi-sectoral cooperation is indispensable.

‘About 80 percent of the causes of non-communicable diseases are related to factors outside the health sector,’ says Dr. Devkota. ‘They are linked to other ministries and agencies on issues such as environmental pollution, chemical substances, waste management, and pesticides.’

According to him, although the previous action plan tried to include a multi-sectoral concept, sufficient success was not achieved in practical implementation.

‘The health sector alone cannot be held responsible; other sectors should also reduce the causes that negatively affect health through their policies, investments, and practices,’ he emphasized. He also said that a strategy will be prepared so that various ministries and stakeholders can clearly contribute through policies, resources and programs.

‘A plan is being prepared to incorporate the lessons learned from the previous period into a new strategy and address the weaknesses and challenges seen in implementation,’ says Dr. Devkota, adding, ‘A more effective and clear multi-sectoral approach is now needed to control non-communicable diseases.’

Low libido on the rise, is there a way to increase it?

 Low libido on the rise, is there a way to increase it?

Alan Reeves used to perform on stage in the 90s and also appeared in the movie Spice World.

Prescriptions for testosterone replacement therapy in the UK increased by 135 percent from 2021 to 2024.

Testosterone therapy has restored libido in some men, but there are also concerns about its side effects and profiteering.

In the 90s, Alan Reeves regularly performed on stage. As a member of the group ‘The Dreamboys’, he would take off his clothes in front of thousands of people. Due to his increasing demand, he and his friends later appeared in the Spice Girls movie ‘Spice World.’

Reeves, who was 24 at the time, said, ‘I was the poster boy for pin-up fame.’ As Reeves turned 30, he found himself in a different situation. His moods were bad and his sex drive had almost disappeared.

He said, “Nothing felt right to me.”

“My lack of sexual desire had a negative impact on my long-term relationships,” says Reeves, now 52. Reeves, who works as a fitness and lifestyle coach in London, started testosterone replacement therapy (TRT) and it has helped restore his libido.

“I’ve gone from a grumbling old man to a young man again,” he says. “It’s an amazing feeling.”

Sexual desire is steadily declining

Women are also turning to testosterone. Blogger Rachel Mason, 37, says the hormone has been “amazing” for her energy levels, concentration and libido. She recounts her experience after menopause.

There has been a huge increase in testosterone prescriptions. The Care Quality Commission has compiled figures from the NHS Business Authority, which show a 135 per cent increase in its prescriptions between 2021 and 2024.

The increase comes at a time when ‘sex drive’ is seen to be declining across the UK. The National Survey of Sexual Attitudes and Lifestyles (NatSAL) asks more than 10,000 people about this every decade.

In 1990, people aged 16 to 44 said they had sex an average of five times a month. By 2000 this had fallen to four times and by 2010 to three times.

The next set of results is due later this year, and researchers say the downward trend is continuing. However, they do not point to any one reason for the decline.

Against this backdrop, a debate is growing rapidly. Can testosterone really improve libido, or is it just a profit-making hype? The frequency of sex in the UK is falling. The National Survey of Sexual Attitudes and Lifestyles asks about 10,000 people about this every decade.

Low libido

According to study author Alan Reeves, the experience of low libido is one example of a trend that is becoming more common. “We’ve seen a decline in all age groups in the last few years,” says study director Soezig Clifton. “There are fewer couples living together now than in the 1990s, which could help explain the decline in sexual desire. But when we look specifically at that group (cohabiting couples), there’s also a decline,” she says.

In fact, the fastest decline in sexual frequency has been among older couples or couples who live together.

“It’s hard to say exactly why libido is declining,” says Clifton. “We don’t have any data yet that can tell us with any certainty that libido is not as high as it used to be,” she says. “There have been a number of studies that have tried to understand why. These studies point to the digital world as a big factor, making it harder to turn off screens, and there are so many other options to spend time with.”

General practitioner and sex therapist Dr Ben Davies says our stress levels are generally much higher than they were 30 years ago. This is also a reason, he says. “There’s a lot going on in people’s lives. Obviously there’s technology, but there’s also an increase in stress, depression and loneliness. All of these things contribute to a decrease in libido,” says Dr Ben Davies.

Professor Geoffrey Hackett, a consultant urologist and member of the British Society for Sexual Medicine (BSSM), says that testosterone levels in men are definitely falling.

According to him, the rise in obesity, type 2 diabetes and an increasingly inactive lifestyle all contribute to low testosterone levels. And declining testosterone levels may be one reason for our lack of libido.

Over the past 20 years, studies have measured hormone levels in men, which have shown that testosterone levels have decreased. But Hackett emphasizes that this graph is very subtle.

Low testosterone increases the likelihood of low libido, but that does not mean that every man with low testosterone has a low libido. Despite this complexity, subway stations, bus stops and social media feeds are now filled with ads like, “Low libido? Tired? Time to get a testosterone test!”

So, can testosterone replacement therapy (TRT) really be a cure for low libido?

Testosterone ‘gave me my life back’

Melissa Green has been taking testosterone for about a year. In his words, it gave him "the zest for life." ’ Not only did it bring her back, but it also saved her marriage. Melissa, 43, had been suffering from a low libido that had taken a toll on her relationship.

Her doctor had already prescribed her hormone replacement therapy, which consisted of estrogen and progesterone, due to early menopause symptoms, but Green says, “the doctor was not prepared to test her testosterone levels. They said she didn’t need the extra hormones.”

Women’s bodies produce low levels of this hormone, and according to NHS guidelines, women can only be given testosterone if they have ‘hypoactive sexual desire disorder’. That is, their sex drive is very low or almost non-existent. It can affect women of any age, but it peaks during menopause.

Eventually, Green went to a private clinic, had a blood test, and was told her levels were low. After taking the test report to her doctor, she was given some testosterone from the NHS.

‘It’s given me my life back. I feel like I’m in my 20s again,’ she says.

While some people are enthusiastic about the effects of testosterone on sex drive, others say it has some unpleasant side effects.

Cheryl O’Malley took testosterone for a year, she says, and while it may have helped restore some of the energy lost during the menopause, it also increased her libido and made her feel very angry.

‘I was feeling very horny. I wanted to have sex with my husband, but there were times when you felt like it wasn’t right, it wasn’t me. I felt like everything was out of my control.

Rachel Mason says, “When she posts about TRT, she sees, ‘Many women are very scared to start testosterone, they worry that they’ll look like a man, they’ll grow facial hair, or they’ll lose their identity.’

Mason has also developed hair growth on her arms. But that’s nothing compared to the benefits she gets from the hormone. In addition to body hair growth, TRT can have many other side effects.

In women, excessive hair growth, dandruff, and weight gain can occur. These can be resolved when the dose is reduced or stopped.

In men, side effects can include weight gain, prolonged erections, male-pattern hair loss, and mood swings. It can also reduce sperm production, which can affect fertility. There are treatments available that can help, but medical advice is recommended.

Money-making pot

Some NHS GPs and specialists say private clinics are making a profit by selling testosterone replacement therapy as a quick fix for a complex problem.

NHS consultant in sexual and reproductive health Dr Paula Briggs says it is a way of making money and people are paying huge sums for something they don’t need. “It’s getting out of hand,” she says.

What do you mean, private clinics?

They say they are improving people’s lives by providing a service that the NHS is failing to provide. Jeff Foster, medical director of the multi-million pound clinic Boy, which specialises in men’s health, and an NHS GP, says the private sector is filling a gap that the NHS is failing to provide.

Michael Cox has been providing TRT through his company Balance My Hormones since 2016. He says he has seen a “tremendous” increase in demand for it in recent years.

Some of his patients had been tested on the NHS, but were turned away because their levels were not low. They then went into the private sector. “Even if they are slightly above the NHS limit, TRT can help,” says Cox.

The proportion of people who benefit is small

What constitutes a healthy testosterone level in men depends on which organisation you ask and which studies you read. According to the BSSM guidelines, men with levels below 12 nmol/L should consider TRT, especially if they have symptoms of ‘hypogonadism’, a condition in which the testicles are not producing enough hormones.

NHS guidance can vary by region. But levels below 6 to 8 nmol/L can be considered low testosterone.

In women, testosterone levels start to fall between the ages of 20 and 40 and stabilise at menopause. Low levels are normal, but the question is how much this affects sex drive and overall health.

Tests are available for women but it is difficult to get an accurate reading because the doses needed are so low. There is no licensed treatment for women on the NHS. Dr Briggs is wary of the hype and hype surrounding TRT. . She says ‘Many patients come in complaining of a lack of sexual desire. They say they have done a study, which usually means they have seen someone posting about life-changing effects on social media. ‘Even if it works for a celebrity, it doesn’t work for everyone.’

She has a flood of patients asking for testosterone tests in her area. Some take a prescription and then return after a few months because the effects have diminished. The clinical evidence suggests that TRT is only effective in women who have gone through menopause and have a low libido.

‘The advertising from private clinics has exaggerated everything,’ says Briggs. 

This therapy is not a miracle cure

Cheryl O’Malley has stopped taking testosterone. The intense anger and hypersexuality that came with the treatment have now subsided, and her libido has returned to a comfortable level.

“It’s been a huge relief for me to get off it,” she says. There are many factors that can cause low libido, and testosterone is not the only solution. But Alan Reeves has been on TRT for seven years and his life has improved dramatically.

“My libido has returned, and at first I wanted to have sex for 10 nights straight,” he says. “Now I’m calm and in a better mental and physical state.”

According to her, it’s not a miracle drug, and TRT is meaningless without lifestyle changes. “It’s like putting a Ferrari engine in a junk car,” she says.