Weight loss drugs like Ozempic and Wegovy are more popular than ever, leading people to seek options that are quicker, cheaper and involve less prying questions than a traditional in-person doctor visit.

But here’s a statistic that should give you pause: Casey Zaring, RPh, PharmD, a clinical pharmacist at OSF HealthCare, says a 2023 audit by the U.S. Food and Drug Administration [FDA] found 95% of online pharmacies were not legitimate. This leads to concerns about getting bilked out of money or taking a counterfeit drug that could bring serious side effects.

“It skips a lot of checks and balances,” Zaring says of the online outlets. For one, he says, these websites typically don’t have a pharmacist check your full medical history to make sure you’re getting the right drug.

Legit or not?

Some red flags to look for when deciding to buy prescription drugs online:

• Is the website based outside the United States?
  
• Do you start on one website and get pushed to another to complete the transaction?
  
• Does the site guarantee you cost savings? Zaring says it may look like a deal up front, but the final price tag might not be so good. Or, you might unintentionally sign up for auto-renewals. Zaring recommends first checking to see if your insurance will cover a medication.
  
• Have other people or agencies flagged the outlet for possible problems? Zaring recommends the websites safe.pharmacy and BeSafeRx to check if the pharmacy is registered with the National Association of Boards of Pharmacies and complying with the law.
  
  “How we know an online pharmacy is legal is they require a prescription by a licensed practitioner. You have a pharmacist review things, and the consumer has access to a pharmacist to ask questions,” Zaring explains. “Look for the outlet to be based in the United States and have a license in your state. Some online pharmacies will provide medications for patients even though they don’t have a license in the patient's state.”

Another law pharmacies have to follow is the Drug Supply Chain Security act. Zaring says this ensures all medications are logged and accounted for as they move from the manufacturer to the distributor. This makes sure all medications in the supply chain are legitimate and safe.

“In December 2025, the Food and Drug Administration warned about fake Ozempic,” Zaring recalls, noting what can go wrong if laws aren’t followed. “It looked almost identical to real Ozempic. It had lot numbers and expiration dates. But what they had done is created a syringe that looked similar and put on fake stickers.

“What pharmacists do then is go through and scan every medication that enters the pharmacy to ensure it’s directly from the manufacturer,” Zaring adds.

Consequences

Zaring says pharmacists’ biggest fear with these websites is someone putting something non-legitimate or harmful in their bodies. Is the syringe sterile? Has the drug expired? Is the dose correct? Is it properly diluted? Is it interacting with my other medications? Ingesting fake medications could lead to infections or other serious side effects.

Speaking on weight loss drugs: “If something is off by a decimal point, it’s a tenfold error. It can cause lack of movement in your gastrointestinal tract, obstructions and gallbladder attacks,” Zaring says. “If a person isn’t aware of the risks and talking to a pharmacist, they can upgrade their dose too quickly and cause more adverse effects like dehydration. Also with some of these online websites, there’s not continuous monitoring by a health care provider. No labs, check-ins or follow ups.

“The cost saving may be up front, but at the back end there may be an overall greater cost of having to see more health care providers because of adverse reactions or infections,” Zaring also warns.

If you’ve done business with an online pharmacy and have concerns, Zaring recommends talking to your primary care provider or a pharmacist at an in-person, well-recognized business. You can even bring the medication for them to inspect. You can also report pharmacies to the FDA at the BeSafeRx website.

Learn more

Read more about how OSF HealthCare pharmacists bring medication to you safely on the OSF HealthCare website. Some OSF HealthCare locations also have retail pharmacies that can be used regardless of whether you’re an OSF patient.

Interview clips

Frequently asked questions

Manufacturers say the items will help consumers relieve anxiety, decrease stress, become relaxed and even fight addiction. However, there’s major concern about the negative side effects these products can have. They can be bought as drinks, like the Feel Free Classic, or in pill form with powder from the kava plant inside.

The California Department of Public Health says kava’s active ingredient, kavalactones, contain sedative and psychoactive (mind-altering) properties.

Erica Dawkins, a clinical dietitian with OSF HealthCare, dives into the additional health concerns that have been widely reported to have a connection to kava.

"We're seeing nausea and vomiting, dizziness, gastrointestinal distress. Some people are having trouble with their vision," Dawkins says. "Because of all these kavalactones, or active ingredients, some of them tend to damage the liver. Because we're seeing some extra liver damage going on, if you're also taking other medicines, supplements, or drinking alcohol, which can also damage the liver, we're seeing an exacerbated effect of that, too." 

In 2002, the U.S. Food & Drug Administration (FDA) issued a consumer advisory about dietary supplements containing kava, saying they might be associated with severe liver injury and hepatoxicity (hepatitis, cirrhosis, liver failure).

Nearly two decades later, the FDA released a memorandum concluding that there’s enough data to suggest that using kava for “recreational” or “relaxation” purposes “is not safe for human consumption.” It lists kava as an unapproved food additive when used as an ingredient in conventional foods.

In addition to the concerning reports released by the FDA, the U.S. Drug Enforcement Agency (DEA) reports that chronic use in large quantities may cause “dry scaly skin or yellow skin discoloration.” This is known as kava dermopathy, as well as causing tremors or other abnormal body movement.

"The safety of these supplements aren't as closely regulated by the FDA,” Dawkins says. "So, I would be very careful and talk to a physician about any alternatives before going down that route."

Kava is native to the South Pacific and is a member of the pepper family, the National Center for Complementary and Integrative Health, a section of the National Institutes of Health (NIH), reports.

Traditionally, kava would be used in ceremonial, social and medical situations. Dawkins says how it’s being produced today offers an added layer of danger.

"Boiled down again, no pun intended, to the way it's being made and manufactured. Back in the traditional sense, a lot of times the root was dried or grounded and then extracted with pure water. Nowadays it’s extracted with alcohol or acetone (colorless, solvent liquid)," Dawkins says. "When it's extracted with those things, you can get a larger amount and an amount that's much more potent and effective than if it were done in the traditional sense."

Dawkins says to speak with your medical provider about speaking with a therapist or counselor. There are other medications out there which can respond more safely and effectively to the issues you're facing, instead of an unregulated product.

Video Interview Clips

We’re approaching the late summer-early fall period when respiratory illnesses begin their annual upswing. The latest news from federal health officials concerns a new variant of COVID-19, NB.1.8.1. Some people impacted have reported severe sore throats, almost like there’s a razor blade in there.

Fred Burke, MD, an emergency medicine physician who sees patients at OSF HealthCare, says illnesses like COVID, RSV and the flu will always be around. It’s just a matter of taking precautions to avoid serious illness. So, what’s the level of concern with this new COVID variant as we begin to make fall plans?

The razor’s edge

Any sore throat is an annoyance. But Dr. Burke says you should monitor severe cases closely.

“You’re less likely to want to eat or drink, which can lead to further dehydration,” he says.

You can manage sore throats at home with Tylenol or ibuprofen, chloraseptic spray, warm tea and throat lozenges. Dr. Burke says if you have trouble keeping food or fluids down, feel lightheaded or dizzy or have trouble breathing, see a health care provider right away.

COVID precautions

Dr. Burke says this new COVID variant isn’t linked to as much severe illness as other variants. But, he says it’s more easily spread.

“The average healthy person might get through it with some [figurative] bumps and bruises and little to no symptoms. For people with comorbidities or who are immunocompromised, the virus might be a little bit more detrimental,” Dr. Burke says.

Getting vaccinated and practicing good hygiene are two big tools to avoid serious illness, he adds. Wash your hands and high touch surfaces, like doorknobs, often, don’t cough or sneeze into the open air and stay home and away from others when you don’t feel well. If you’re in a crowd, especially if you have a comorbidity like diabetes, Dr. Burke says you should consider wearing a mask.

“If you’re going to have a gathering, whether at home or somewhere else, you can also recommend people take a home test to make sure they don’t have COVID prior to going,” Dr. Burke suggests. Those at-home tests can usually be found over the counter at a pharmacy.

For vaccines, recent preliminary guidance from the U.S. Food and Drug Administration recommends the shot this fall for people 65 and up. For others, the shot is recommended for people who have a compromised immune system or a comorbid condition like obesity, heart disease, high blood pressure, lung disease or depression. The website for the U.S. Centers for Disease Control and Prevention, meanwhile, has a broader recommendation. When in doubt, Dr. Burke says to talk to your primary care provider.

Learn more

Explore other resources to keep yourself safe from COVID on the OSF HealthCare website, blog and newsroom.

Interview clips

Spring allergies will be here soon. If you’re suffering from a runny or congested nose, watery or itchy eyes or sneezing, it’s tempting to grab the first medicine that catches your eye at the pharmacy or rifle through the bathroom drawer for some pills you’re hanging on to.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall. She says it’s important to know what to take and when in order to avoid side effects that can be serious.

What to take

Draper says an antihistamine like Astepro, Zyrtec, Allegra or Benadryl is a typical first line of defense.

“There are also decongestants for severe nasal congestion or sinus pain and pressure,” Draper adds. Sudafed is a well-known decongestant.

If a more severe case brings symptoms like face swelling or wheezing, Draper says treatment could be a steroid like Flonase or prednisone.

For more chronic (in other words, long term) allergy cases, the U.S. Food and Drug Administration says a provider may recommend immunotherapy to build up a tolerance. This could be an injection or a tablet under the tongue.

Misuse

It may not seem like over the counter allergy medications are ripe for misuse, but it can happen.

Draper says antihistamines, especially Benadryl, can make you drowsy. If you take too much or take it at the wrong time, you could, for example, find yourself sleepy behind the wheel. Or your attentiveness at work or school could suffer.

On the flip side, Draper says Sudafed can make you jittery, irritable or cause heart palpitations (the feeling of an irregular heartbeat). This could be a big issue, she says, for people with a heart condition.

“We want to avoid nasal sprays for people with nasal trauma. Things like a deviated septum or nasal sores,” Draper adds. “Putting something up the nose could cause further tissue damage.”

Draper says to take medication as directed by your provider. Or if it’s over the counter, follow the label instructions. She says these medications typically take a couple days to start working. So don’t be tempted to take an extra dose if you’re not seeing relief right away.

Think of the children! (and seniors)

Children and seniors may be more impacted by the side effects of allergy medications. An older adult who takes Benadryl, for example, may be drowsy to the point that they fall and suffer a serious injury.

So, Draper says providers will typically start with an antihistamine that doesn’t make you super drowsy. She says Zyrtec is approved for ages six months and up, and that’s often where providers will start.

“Any antihistamine label is going to tell you to consult your provider for use under the age of two,” Draper says. “So you’ll need to be seen by a provider or your pediatrician.” This could be a virtual visit or a message to your provider in your patient portal.

Plan ahead

Draper says knowing your allergy triggers and acting accordingly is key to avoiding unpleasant symptoms. For example, you know grass clippings will cause an allergic reaction, but you have no choice but to mow the lawn.

“Primary care providers and allergists typically recommend starting the medication prior to exposure,” Draper explains. “If you know you’re going to be outside on that windy, dry day to mow, start the antihistamine a couple days prior so it can fully take effect.”

If you can’t get a handle on a known allergy, or if you have unexpected allergy symptoms, Draper says it’s never a bad idea to go to an urgent care.

Or if you find yourself looking for an over the counter medication option: “Just ask the pharmacist,” Draper suggests. “They’ll give you recommendations.

“There’s usually a specific aisle for allergies,” she adds. “Find the right antihistamine. Flonase is another big one we see people use.”

Interview clips

Related stories

Prepare for warm weather and migraines
Phenylephrine or placebo?
Late to the allergy party
First foods: Allergen introduction 101
Allergic rhinitis is a year round concern
Breathe in fresh air

The "PE" comes from the drug’s active ingredient, phenylephrine (phen-uh-leh-frin), marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter products contain this ingredient, including items under the brand names NyQuil, Benadryl, Mucinex, and more.

Jason Scheid, the director of pharmacy services for community and specialty programs at OSF, says the FDA is now seeking public comments on the proposal into 2025. He offers a few other alternatives you can try to lessen congestion.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID, and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There are also nasal steroids and antihistamines—this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Scheid says more natural remedies, like standing in a hot shower or using a cool mist humidifier, can help ease congestion.

Video Version With Chyrons

Video Version Without Chyrons

Sudafed has been a household name for decades, with the drug’s active ingredient pseudoephedrine being around since the 1920s.

Recently, the U.S. Food and Drug Administration (FDA) claimed Sudafed PE, one of Sudafed’s more popular items, is not effective and should be banned from over-the-counter use. The announcement came roughly a year after a panel of advisors to the FDA unanimously said phenylephrine doesn’t work to clear up congestion when taken orally.

The PE in Sudafed PE comes from another active ingredient, phenylephrine, marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter (OTC) combination drugs contain phenylephrine, including some items under the brand names NyQuil, Benadryl and Mucinex.

The FDA advisor panel’s decision led CVS pharmacy to pull common cold and cough medicines from store shelves in October 2023, which list phenylephrine as the main ingredient.

“It is the FDA’s role to ensure that drugs are safe and effective,” said Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”

The FDA points out that while phenylephrine is found in many nasal sprays as well, its recommendation is only related to orally administered phenylephrine.

Entering public comment period

Jason Scheid, the director of Pharmacy Services for Community & Specialty Pharmacy for OSF HealthCare, says the FDA is now seeking public comments on its proposal until May 7, 2025. A final order will be issued after the 180-day comment period.

“At that point (after the 180 days) the FDA will provide the manufacturers with their due warning whether they have to pull the products or reformulate it to find an alternative that meets the labeling requirements,” Scheid says.

Scheid anticipates if drugmakers wanted to reformulate these products, and wanted them to remain as oral decongestants, the companies would have to put pseudoephedrine into the products. This would push more products behind the pharmacy counter, like the original Sudafed.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There’s also nasal steroids and antihistamines, this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

Phenylephrine or Placebo?

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Many medications will claim to offer multiple benefits. For example, Mucinex Sinus-Max® claims to clear sinus congestion and relieve headaches, while thinning and loosening mucus. But the drug also has Acetaminophen and Guaifenesin in it. Scheid says this proposal simply targets the phenylephrine component when considering nasal decongestion, so other benefits might still be possible.

“It might provide you a placebo-type effect. You might just feel better because of the other ingredients in it, but that one (phenylephrine) solely is not meeting the effectiveness criteria to remain over the counter,” Scheid says.

Natural treatment options that can relieve symptoms

“Using that hot shower or cool mist humidifier will add moisture to where you are to help with that congestion,” Scheid says. “Something as simple as saline nasal spray will add some moisture to the nasal cavity and give some relief.”

It’s always important to clean your humidifier after each use to prevent mold and other bacteria from being released in the air.

Don’t overdo it on the nasal sprays

Another reason why it’s important to read labels is the effect nasal sprays can have if they are used longer than their intended use. Most nasal decongestant sprays will recommend using the product for three days or less.

“What happens is a rebound nasal congestion, where you lose the effectiveness of the medication to relieve that pressure, and it causes more pressure if it’s used more than just a couple days,” Scheid says.

If congestion is caused by allergies

About one quarter (25.7%) of American adults have a seasonal allergy, according to the Centers for Disease Control and Prevention (CDC), while nearly one in five (18.9%) children are affected. Scheid says treating nasal congestion for those with allergies is a longer-lasting issue.

“You’re looking at longer-term solutions then. You’re either using a long-term nasal steroid spray or antihistamine spray, or oral antihistamine.”

Scheid says if the FDA’s proposal goes through in May, pharmacy shelves will look a whole lot different than they do now.

Another way to clear congestion is to stay hydrated. Drinking water will help thin out mucus discharge from the nose and loosen up any phlegm in the lungs, making it easier to cough up.

Video Interview Clips

Sepsis is a critical health issue worldwide, but the advancements in artificial intelligence are starting to offer a better path forward for early diagnosis and treatment.

OSF HealthCare Saint Francis Medical Center in Peoria, Illinois was one of 10 hospitals taking part in clinical trials that led to the first-ever Federal Food and Drug Administration authorization to market an AI diagnostic tool for sepsis. Chicago-based company Prenosis, which spun out of the University of Illinois in Urbana Campaign (UIUC), created The Sepsis ImmunoScore^TM.

OSF Saint Francis hospitalist Anwaruddin Syed, MD, began working with researchers at UIUC while in residency at a hospital in Champaign. He took that experience to OSF Saint Francis where he was the lead investigator, continuing research in the Prenosis clinical trial. As a hospitalist - a doctor who provides care for patients at a hospital - he wanted to help solve the challenge of a serious and often deadly complication.

“In the US alone, there’s an estimate of 1.7 million American adults who develop sepsis every year out of which 350,000 people die or go into hospice. The numbers are eye opening.” (:19)

Dr. Syed explains sepsis happens when the body tries to fight an infection.

“When you have a really bad infection and your immune system is compromised by that infection, then the infection takes over. That’s why it’s important to identify that infection early on, before that infection can take you over.” (:19)

OSF contributed to the pool of 100,000 blood samples and de-identified patient data to help train algorithms to identify patient vital statistics, such as heart rate and oxygen levels, most associated with developing sepsis. It looks at biomarkers – biological molecules found in blood, tissues and other bodily fluids that lead to disease. The ImmunoScore is based on a total of 22 factors to identify risk, which it then put into one of four categories.

The risk score can be integrated with a patient’s electronic health record. Care team members can see what factors impacted the patient’s risk score. Dr. Syed says it can be an add-on to the protocols and information hospitals already use to help better identify patients at risk and for managing those with a confirmed sepsis diagnosis. In other words, it’s one more tool to help physicians.

According to a 2022 study published in Nature Medicine, in severe cases, the then-UIUC AI model detected sepsis an average of six hours earlier than traditional methods. Dr. Syed says Prenosis will conduct additional studies to demonstrate the tool’s accuracy and impact on clinical decision-making.

In the meantime, Dr. Syed is excited OSF has participated in such important research.

“It honestly feels amazing, knowing that our work and the trust and contributions from our patients here at OSF played a role in developing this first-ever FDA sepsis AI tool. It’s really rewarding. It’s a game-changer in patient care and I’m proud to have been a part of it.”

Other companies have developed sepsis diagnostic tools, but Prenosis wanted the FDA approval before marketing its software. The company worked for 18 months to receive the go-ahead to market and sell The ImmunoScore under a process in which the FDA reviews and regulates artificial intelligence/machine learning software as if it is a medical device.

Dr.  Anwaruddin Syed

B-roll of sepsis patients, treatment

There’s renewed optimism for people with fatty liver disease, sometimes called NASH (non-alcoholic steatohepatitis) or MASH (metabolic associated steatohepatitis). The United States Food and Drug Administration recently approved the first medication, Rezdiffra, that can directly address liver damage as the person makes lifestyle changes.

“This is a gamechanger for anyone who has fatty liver disease with moderate to severe liver scarring,” says Marcie Lindstrom, APRN, a gastroenterology provider at OSF HealthCare. “This can reduce the number of complications that can develop with worsening scarring.”

Fatty liver basics

The liver is an important organ. Experts even call it a miniature factory inside us. The liver detoxifies medication; releases glucose to give you energy; aids digestion and makes cholesterol, proteins and amino acids.

Obesity, diabetes, high cholesterol and excessive alcohol use can lead to fatty liver disease, which Lindstrom says impacts around one in four people worldwide. Left untreated, scarring from fatty liver disease can progress to cirrhosis, or severe scarring. Complications from cirrhosis can include enlarged blood vessels in the esophagus which can lead to life-threatening bleeding, fluid overload called ascites, liver cancer and liver failure necessitating a transplant.

How we got here, where we’re going

Lindstrom says before Rezdiffra, people with fatty liver disease could only make those lifestyle changes to try to get better: control your blood sugar, cholesterol and weight.

“Strictly on the shoulders of the individual,” Lindstrom reiterates.

“We know that people who lose 5 to 10% of their body weight are able to make improvement with fatty liver disease. It is considered a reversible condition,” she adds.

Now, Rezdiffra is an option for people with moderate to advanced scarring.

“It works on thyroid-B receptors in the liver. We normally think of thyroid receptors in our thyroid gland [in our throat], but we do have thyroid beta receptors elsewhere. A lot of them are in the liver,” Lindstrom explains. “The medication works to release triglycerides from the liver. It improves and may even resolve fatty liver.”

It’s a once-a-day pill, Lindstrom says, and there’s no “one size fits all” for how long you need to be on it. Side effects include nausea and diarrhea, but Lindstrom says studies have shown those get better after three weeks. She also says women who are pregnant, are about to become pregnant or are breastfeeding should not take Rezdiffra. There hasn’t been enough study of the drug to see how it impacts those groups.

The bottom line: you can talk to your health care provider to see if Rezdiffra is right for you. Be sure to mention what other medicines you are taking so your provider can see how Rezdiffra might interact.

“If somebody is taking a statin for cholesterol levels,” for example, Lindstrom says. “It’s not that we want them to go off their statin. There are certain limitations to the dosage.”

Learn more

Learn more about how to avoid fatty liver disease and other gastroenterology care tips on the OSF HealthCare website.

Interview clips

After nearly six decades of research, experiments and testing, the U.S. Food and Drug Administration has officially approved the first RSV vaccine.

Respiratory syncytial virus (RSV) is a common respiratory virus that causes mild, cold-like symptoms. While the virus is normally mild in most people, it can be extremely serious for infants and some higher-risk older adults.

Douglas Kasper, MD, section head of infectious disease at the University Of Illinois College Of Medicine Peoria and an infectious disease specialist for OSF HealthCare, says, currently, the Arexvy vaccine is only approved for individuals 60 and older but the hope is to expand who can receive the RSV vaccine by the end of summer.

“There are ongoing trials looking at vaccinating mothers who are pregnant,” Dr. Kasper says. “This would be for potential protection of unborn children, but that has not been approved yet. There’s expected re-evaluation of that data coming this summer. Hopefully by August we get some updated patient groups.”

Dr. Kasper says if the RSV vaccine is successful in pregnant women, it could provide life-saving antibodies for their babies.

“We’re trying to use the mother’s ability to create an immune response, because the baby cannot do that on their own. So if we can vaccinate during pregnancy, which is the study group we’re awaiting data for, there would be a huge benefit for young children that currently does not exist,” Dr. Kasper says.

Dr. Kasper says this vaccine is much different than the COVID-19 vaccine.

“This is not an MRNA vaccine which is something we talked very commonly with COVID-19,” Dr. Kasper says. “This is more of a traditional vaccine. The person is being exposed to a protein from the virus and then they make an immune response that protects them if they were ever exposed to the virus. It’s much more akin to the influenza vaccine that most people are comfortable with.”

Dr. Kasper says most older adults who get RSV experience mild symptoms. But he says doctors have seen a change in RSV symptoms during the COVID-19 pandemic.

“Particularly those with chronic lung disease, RSV can almost mimic COVID-like illness that brought some people to the hospital,” Dr. Kasper says.

Dr. Kasper adds that the late summer timing would be good to expand the RSV vaccine for other high-risk groups, since most cases are normally seen in the fall through spring.

Video Interview Clips

Mammography remains the gold-standard imaging tool for early detection of breast cancer but some women might need additional screening. That includes women who have dense breasts.

The FDA is now recommending any facility that offers mammograms must tell women if they have dense breasts that could put the at higher risk for breast cancer. The regulation will begin being enforced next year.

Illinois and Michigan are among 38 states in the country that already require imaging centers to disclose if women have dense breasts but rules vary on how much information they require in the notification. The new federal regulation will mandate that notification in all states and standardize what must be disclosed.

Jessica Guingrich, MD, is radiologist and medical director of OSF HealthCare Center for Breast Health in Peoria. She says for women with dense breasts, it can be more difficult to detect cancer with mammography, which relies on contrast to detect cancer. She says dense tissue, which is white, can mask changes in breasts such as a tumor.

“We’re trying to see white findings (tumors) so the denser tissues means there’s more whiteness in the background and it’s harder to see those white findings,” Dr. Guingrich explained.

Having dense breasts not only makes cancer detection more challenging, it can also increase cancer risk, particularly for the roughly 10% of women over 40 that fall into the category of very dense breasts. Dr. Guingrich says a woman can’t determine her own breast density through self-exams or through a clinical exam. Radiologists use national guidelines based on the amount of fibrous tissue within the breasts.

“The density actually has nothing to do with how they feel on physical exam or the breast size. It actually has to do with that appearance on the mammogram.”

Breast density can change over time so a women who earlier was considered for advanced imaging such as a breast ultrasound or MRI might not qualify another time if the density has changed. But, the goal of the notification is to promote a discussion with medical providers about whether advanced imaging is needed to detect cancer earlier and reduce the need for aggressive treatment.

So what are the best options for women who receive the notification? Dr. Guingrich says that will depend on a woman’s risk factors. She stresses having dense breasts is a minor risk factor compared to other considerations such as family history.

“Like if one has a first-degree relative or a pre-menopausal relative diagnosed with breast cancer or if they have a personal history of breast cancer, those women are at higher risk. If a lady is a gene carrier or if a lady has had chest wall radiation.”

The American Cancer Society says breast cancer is the most common cancer diagnosed among U.S. women and is the second leading cause of death from cancer among women after lung cancer. Insurance coverage for advanced breast imaging varies from state to state and the new FDA recommendations don’t address coverage so it’s best to check with your insurance provider.  

Here are the Center for Disease Control and Prevention’s answers to frequently asked questions about dense breasts and implications for additional screening beyond a mammogram.

Video clips-Dr. Jessica Guingrich,  radiologist & medical director, OSF HealthCare Center for Breast Health  

Mammogram B-roll

From Elon Musk to TikTokers, ongoing social media chatter claims drugs like Ozempic, Mounjaro and Wegovy are the magic way to weight loss.

There’s good news, says Aminat Ogun, MD, a family medicine physician at OSF HealthCare in Champaign, Illinois. Those drugs can help you lose weight when prescribed by a doctor under specific circumstances and paired with diet and exercise.

The more important bad news? There’s no magic, one-size-fits-all drug that will by itself cause you to shed pounds. And if someone on social media is claiming so, they’re wrong.

Dr. Ogun says Ozempic, Mounjaro and Wegovy are from the same family of medicine. They are usually prescribed to people with Type 2 diabetes.

“It increases the insulin in the body, which helps bring glucose into the cells,” Dr. Ogun explains.

The medications also slow food leaving your stomach and suppress appetite.

Once the drugs became more well known, Dr. Ogun says people found, not surprisingly, that weight loss was a side effect and began prescribing them for that purpose under specific circumstances. She says the patient should have a body mass index (BMI) greater than 30 or a BMI greater than 27 with a chronic condition like diabetes, hypertension or hyperlipidemia.

But even if you meet those guidelines, Dr. Ogun says you should talk with your doctor about whether a weight loss drug is right for you or whether simply changing habits can get the results you want.

For one, Ozempic, Mounjaro and Wegovy are expensive and may not be covered by insurance.

Also, the U.S. Food and Drug Administration reports a shortage of Ozempic and Wegovy. So Dr. Ogun says doctors may be less likely to prescribe the drugs for weight loss when diabetics may have a more critical need.

And like any other medication, there is a list of side effects.

“Abdominal pain, nausea, vomiting, diarrhea and constipation are possible,” Dr. Ogun says. “There are also hypersensitivity side effects like angioedema and an anaphylaxis reaction. It’s also been known to cause kidney injury or pancreatitis.”

Lately, the term “Ozempic face” has been trending on social media, describing a hollowed-out appearance due to quick weight loss.

One last piece of advice you’ll hear doctors give over and over: don’t rely on social media for health tips. If you find a tip that might benefit you, talk to your doctor before starting any treatment.

“The good thing about social media is that it allows a lot of people to receive a variety of information all at once,” Dr. Ogun says. “The downside: is it a credible source?”

Find a primary care provider on the OSF HealthCare website.

Interview clips

A brawl is brewing between government regulators and the manufacturer of the best-selling e-cigarettes in the United States. The U.S. Food and Drug Administration (FDA) has agreed to pause its ban on products from vaping company Juul while the government reviews the company's electronic cigarettes. 

The FDA had banned the marketing and sales of all vaping products produced by the company, a decision that was appealed by Juul, yet applauded by health care professionals. 

“Why would we inhale anything in our lungs except good clean air?” remarks Dr. Patrick Whitten, an OSF HealthCare pulmonologist in Peoria, IL. “So it's just yet another step in the right direction to try to get people not to put anything in their lungs this damaging.”

The FDA claims Juul’s application for authorization lacks enough details about the chemical makeup of its vaping formulas, and doesn’t significantly prove that its e-cigarettes help adult smokers quit or reduce their smoking. 

Another concern of government regulators and health care providers alike is the increase in teen and adolescent vaping, and what Juul Labs, which is owned by Altria Group Inc., the maker of Marlboro cigarettes, is doing to prevent it. 

“The cigarette companies realize that it's important for them to get people hooked on these products because cigarettes kill people and if they kill their consumer, they have to replace that consumer or else they don't have a business model,” says Dr. Whitten. “So this despicable business model is to get younger smokers or younger people hooked on their products to continue to use. If they don't replace their consumers that they're killing off, they have no business.”

As the battle between the FDA and Juul continues in the courtroom, Dr. Whitten urges parents to be proactive at home. 

At high doses, nicotine can cause dizziness and vomiting. Users who refill their own cartridges are especially at risk for unsafe levels of the drug. Even more concerning, young children have been poisoned after coming in contact with the nicotine-containing liquid. Teens who use e-cigarettes may become addicted to nicotine, which can harm their developing brain. There’s also concern they may start smoking regular cigarettes. 

According the U.S. Centers for Disease Control and Prevention (CDC), in 2021, about one out of every 35 middle school students and one of every nine high school students reported that they had used electronic cigarettes in the past 30 days.

Dr. Whitten says a parent’s open and honest communication with their kids can help pave the way to a smoke and vape-free future. 

“Education is the key here,” he explains. “We can all learn things from each other, right? So even for our own kids, who we think are not going to be doing things like vaping, information is so important. So why they shouldn’t do things like that. So it's good to have that open dialogue between the parents and the kids.”

When it comes to both vaping and smoking, the top takeaway, according to Dr. Whitten, is to not start. And if you are a smoker to quit. He says it’s never too late – even for life long smokers. 

“It’s never, never too late to quit. When someone quits smoking, even within hours, some of the respiratory cells start to heal themselves a little bit. And you do reduce your risk for lung cancer over time. It's not back to zero, but you do decrease some of that risk if you quit smoking.”

For help quitting smoking, speak with your primary care physician. OSF HealthCare also offers structured programs to help individuals who want to quit. To learn more visit osfhealthcare.org and search “smoking cessation.”

Interview Clips - Dr. Patrick Whitten