Billy Joel, the iconic singer-songwriter, recently revealed that he has been diagnosed with normal pressure hydrocephalus (NPH), a lesser-known but serious brain disorder. Joel explained that the condition has affected his hearing, vision, and balance, leading him to pause his performances to focus on recovery through specialized physical therapy. His candid disclosure has brought much-needed attention to NPH, a condition that can profoundly impact mobility, bladder control, and cognitive function—often in ways that are easily mistaken for other neurological diseases.

Hydrocephalus refers to an abnormal accumulation of cerebrospinal fluid (CSF) in the brain’s ventricles, the four hollow chambers where this fluid is produced. CSF plays a crucial role in cushioning and protecting the brain and spinal cord. Under normal circumstances, CSF flows freely from the ventricles, circulating around the brain and spinal cord before being absorbed into the bloodstream.

However, when this flow is obstructed or disrupted, excess fluid builds up inside the ventricles, causing them to enlarge and potentially leading to brain damage. The result is hydrocephalus, which can occur at any age but presents differently depending on its type.

What Is Normal Pressure Hydrocephalus?

Unlike other forms of hydrocephalus where increased fluid leads to heightened pressure inside the skull, normal pressure hydrocephalus (NPH) is characterized by an accumulation of CSF without a corresponding rise in intracranial pressure. The fluid builds up gradually, often making the condition challenging to detect in its early stages.

NPH typically affects adults over the age of 55, with an increased incidence among those over 60—a demographic that includes Billy Joel, who is 76 years old. While NPH can sometimes follow events such as head trauma, infections, tumors, or complications from brain surgery, many cases develop without any identifiable cause, earning it the classification of idiopathic NPH.

Symptoms Of NPH That Often Goes Undiagnosed

One of the primary challenges with diagnosing NPH is that its symptoms overlap significantly with other neurological disorders, such as Alzheimer’s disease and Parkinson’s disease, and even with normal aging. This overlap often leads to misdiagnosis or delayed diagnosis, impacting timely treatment. Symptoms of NPH include:

Gait disturbances: People with NPH often experience an unsteady, slow, or shuffling walk, with difficulty lifting their feet, making it hard to maintain balance.

Urinary incontinence: Loss of bladder control is a common sign, which can sometimes be mistakenly attributed to aging.

Cognitive impairment: Memory problems, confusion, and mood changes, including depression, can resemble dementia symptoms.

Increased falls and trouble maintaining stability.

Due to these similarities, many patients are first evaluated for dementia or Parkinsonism before NPH is considered.

Diagnosing Normal Pressure Hydrocephalus

When NPH is suspected, a thorough neurological evaluation is essential. Physicians may observe gait and balance abnormalities, cognitive function, and urinary symptoms before ordering brain imaging tests. A CT scan or MRI helps reveal the enlargement of the brain’s ventricles indicative of hydrocephalus.

The diagnostic process often involves ruling out other conditions and may include specialized tests like a lumbar puncture (spinal tap) to measure CSF pressure and assess how symptoms respond to CSF drainage.

Can NPH Be Reversed?

Fortunately, NPH is one of the few causes of dementia-like symptoms that can be treated effectively, especially if caught early. The primary treatment involves surgical placement of a ventriculoperitoneal (VP) shunt. This device consists of a flexible tube with a valve that drains excess CSF from the brain ventricles to another part of the body—usually the abdominal cavity—where it can be absorbed.

The shunt reduces the buildup of fluid, relieving pressure on the brain and often leading to significant improvement in symptoms such as walking difficulties, bladder control, and cognitive decline.

However, surgery carries risks, and not all patients respond equally. Some may require adjustments to the shunt or additional therapies. Recovery often includes physical and occupational therapy, similar to what Billy Joel is currently undergoing, to regain strength and coordination.

Who Is at Risk?

NPH primarily affects older adults, but several factors may increase susceptibility:

• Age over 60
• History of head injury or trauma
• Previous brain infections, such as meningitis
• Brain tumors
• Complications from brain surgery

Awareness of these risk factors is crucial for early diagnosis and intervention.

Importance of Awareness and Early Detection

Billy Joel’s public announcement has cast a spotlight on a condition many people have never heard of despite its potentially devastating effects. NPH can mimic other neurological disorders, leading to confusion and misdiagnosis. Yet, unlike most forms of dementia, NPH symptoms may improve significantly with timely treatment.

For individuals experiencing unexplained gait problems, urinary issues, or cognitive decline—especially those over 60—consulting a neurologist for a comprehensive evaluation can make all the difference. Early detection not only improves quality of life but may also prevent irreversible brain damage.

Normal pressure hydrocephalus is a complex but treatable neurological disorder characterized by the buildup of cerebrospinal fluid without increased pressure. Its symptoms—impaired walking, bladder control, and cognition—often mimic other common age-related diseases, leading to underdiagnosis.

Long seen as the enemy of healthy diets and weight loss plans, the humble potato may be getting a new lease of life, this time, as a key ingredient in fighting obesity. Kolkata researchers have found a way to turn starchy potatoes into a powerful dietary ally. At the Food Technology and Science Institute (FTSI), under TCG CREST, scientists have devised a method to convert potato starch into high-functioning dietary fibre. This fibre is designed to improve gut health and support weight management.

According to the team, the fibre works as a prebiotic, feeding the gut’s existing good bacteria and helping them thrive, an essential part of maintaining digestion, metabolism, and overall wellness.

Challenging the Potato’s Bad Reputation

Potatoes have long been excluded from weight-loss diets, blamed for belly fat and seen as calorie-dense comfort food. But the development out of FTSI challenges this narrative. The innovation arrives at a time when demand for functional foods is booming in India, with consumers increasingly seeking clean-label, plant-based, and gut-friendly options.

“Much of the core fibre ingredients like inulin, FOS, GOS, and glucans are still imported, mainly from China,” said Prof. Parthasarathi Bhattacharya, Head of FTSI. “That has created concerns around pricing, quality control, and long-term supply.”

India’s Potato Surplus Finds New Purpose

India harvested more than 60 million tonnes of potatoes in the 2024–25 crop year, making it the second-largest producer in the world. A significant portion of this crop ends up in surplus.

The key lies in a proprietary enzyme developed by the institute. This enzyme can convert starch from potatoes or other carbohydrate-rich crops into dietary fibre.

“We’re using what India already grows in abundance and giving it a new role,” said Prof. Bhattacharya.

Potatoes as the Future of Functional Snacking

Plans are already underway to integrate this fibre into a range of everyday food products. These include vegan ice creams made from potato “milk”, gummies, protein-rich cones, and high-protein snack bars. Designed to appeal to urban consumers, these products aim to provide indulgent snacking experiences without compromising on health goals.

This trend marks a larger consumer shift, from isolated supplements to functional foods that naturally support wellbeing. Unlike probiotics, which involve introducing live bacteria into the body, prebiotics like potato fibre simply nourish the good microbes already present in the gut, making them easier to incorporate into daily diets.

Beyond potato fibre, the team at FTSI is also working on a range of other innovations such as prebiotic gummies, fungi-based proteins, and preliminary research on postbiotics. The overarching goal remains the same: to create functional food ingredients that are rooted in Indian crops and traditional food practices.

With increasing awareness around health and a growing emphasis on ingredient security, the potato, long vilified in diet culture, could be poised for a comeback. This time, not as a source of guilt, but as a scientifically backed, fibre-rich, gut-friendly food that supports weight control and overall wellness.

Bipolar disorder affects an estimated 5.7 million American adults, or roughly 2.6% of the adult population, according to the National Institute of Mental Health. And while lithium remains one of the most effective treatments, its narrow therapeutic window means monitoring will always be part of the equation. For millions of people living with bipolar disorder, lithium remains one of the most reliable medications available. It’s a cornerstone of treatment—a powerful mood stabilizer capable of managing both manic and depressive episodes. But here’s the problem: lithium has a razor-thin therapeutic window. Too little, and it’s ineffective. Too much, and it can cause serious harm—kidney failure, thyroid damage, or worse. That means patients must routinely monitor blood levels, often through invasive, time-consuming blood draws.

Now, a team of engineers and medical researchers at the University of Southern California (USC) has developed a game-changing solution: a first-of-its-kind wearable lithium sensor that measures drug levels in real-time using sweat. No needles. No lab visits. Just a patch and a smartphone.

Why Lithium Monitoring Has Always Been So Hard?

Lithium, though widely prescribed and highly effective, isn’t a one-size-fits-all drug. Dosage must be tailored for each patient, with careful consideration of body weight, diet, hydration, and other variables. And even after a dose is dialed in, regular lab tests are essential to ensure safety.

For patients, that often means monthly or more frequent blood draws—painful, inconvenient, and for some, a barrier to consistent treatment. Add to that the cost, anxiety, and time involved, and you begin to see why a more user-friendly monitoring method has been a long-standing need in psychiatry.

Being able to track these levels continuously over time will improve safety by allowing for medication dose adjustments that avoid side effects and potential medication toxicity.

How Does The Wearable Sensor Work?

Sweat-based sensing is a noninvasive approach that bypasses the needle altogether. While the idea might sound futuristic, the science is sound. Sweat carries many of the same chemical markers as blood, including lithium concentrations, and reflects them in real time.

The newly developed sensor from USC includes a skin-safe iontophoresis system—a gentle electrical current that stimulates localized sweating without requiring the wearer to exercise. In just a few minutes, the patch collects sweat, analyzes it, and sends the lithium level data to a companion smartphone app.

Think of it like a glucose monitor, but for mood stabilization.

At the heart of the wearable device is a breakthrough in electronics: organic electrochemical transistors, or OECTs. These are tiny, low-power sensors that respond to the presence of ions—like lithium—in a liquid medium. But what sets this new device apart is the fact that it’s fully printed, meaning it can be manufactured affordably at scale.

The USC team customized the OECT materials to respond specifically to lithium ions, something traditional sensors weren’t optimized for. This is what allows the device to deliver reliable readings without the need for expensive or bulky lab equipment.

According to Mohammad Shafiqul Islam, lead author of the study and a PhD candidate in the USC Khan Lab, “Our goal was to make lithium tracking as easy and comfortable for patients as checking a daily fitness tracker.”

This isn’t just lab theory. The USC researchers collaborated with psychiatrists and actual patients during early trials. They conducted a pilot study with patients actively taking lithium, comparing the wearable’s readings with those of traditional commercial lithium sensors. The match was successful.

Patients reported that the wearable felt like a huge relief—no more frequent lab visits, no more stress about waiting days for results. One participant even noted how seeing consistent readings around 0.4 millimolar (mM) helped them better understand their own treatment.

“This kind of personalized insight is one of the key benefits of wearable technologies,” said Yasser Khan, lead investigator and director of the USC Khan Lab.

How It Can Transform Bipolar Treatment?

For a mental health condition as complex and lifelong as bipolar disorder, personal agency matters. The new lithium sensor gives patients the power to understand and manage their treatment from anywhere—at home, at work, while traveling. It reduces reliance on clinical infrastructure and gives both patients and doctors more data to guide decision-making.

But the team isn’t stopping there. They’re already working on next-gen versions powered by artificial intelligence. These advanced systems could one day automatically adjust lithium dosage in response to real-time levels, completely closing the loop between monitoring and medication.

“This is a market-ready technology,” Khan noted. “What we need now is broader clinical validation—studies involving hundreds of patients—and partnerships to bring the device into commercial production.”

This new wearable could change that equation completely—making lithium tracking less invasive, more frequent, and far more accessible. That’s not just a tech upgrade. That’s a leap forward in how we care for people with serious mental health conditions.

Just as glucose monitors transformed diabetes care, sweat-based lithium sensors could do the same for bipolar disorder. It’s a shift from episodic to continuous care, from reactive to proactive management—and it’s coming not from a big pharma company, but from an interdisciplinary lab bringing engineers, doctors, and patients together.

As this innovation moves from pilot phase to potential FDA approval and commercial availability, it represents something more than just a sensor. It’s a symbol of how technology and empathy can work together to improve lives.

What started as a promising medical breakthrough is fast turning into a public health dilemma. Weight loss injections like Wegovy and Mounjaro have exploded in popularity, hailed for their effectiveness in reducing obesity and improving metabolic health. But the current demand for these drugs has escalated to a point that pharmacists across the UK and the US are calling it unsustainable.

Far more people want the jabs than are clinically eligible to receive them. And the gap between public perception and medical reality is only growing wider.

According to a poll commissioned by the National Pharmacy Association (NPA), around 21% of adults said they had tried to access weight-loss injections in the past year. Among younger adults aged 16 to 34, that number shot up to 35%. Yet the actual number of people who meet the clinical criteria for these drugs—based on BMI and comorbidities—is significantly smaller.

As pressure mounts on both private and public healthcare systems, experts are urging restraint, better education, and tighter regulations to prevent a brewing crisis: drug shortages, black-market sales, and patients using powerful medications without proper oversight.

What These Drugs Are And Who They’re Really For?

Wegovy and Mounjaro belong to a class of medications known as GLP-1 receptor agonists. Originally developed for type 2 diabetes, they’ve since been found to trigger weight loss by reducing appetite and slowing digestion. Clinical trials show patients can lose between 15% to 20% of their body weight over time with these injections—far outperforming older diet drugs.

However, these are not designed for casual use or cosmetic weight loss. Under current UK guidelines—mirroring those in the US—these drugs are only approved for people with a BMI over 30, or over 27 with weight-related conditions like type 2 diabetes, hypertension, or sleep apnea. The NHS has even stricter criteria for its limited rollout: patients must have a BMI over 40 and at least four weight-related comorbidities.

Despite this, the NPA survey shows that public interest is surging. 41% of all adults said they’d opt for these jabs if they were available for free through the NHS. Among those aged 25 to 34, interest jumps to 64%—even though many in this group are unlikely to qualify.

The Supply Chain Is Struggling

The spike in interest isn’t just a theoretical concern. Supply chains are already under strain.

According to the NPA, 1.6 million packs of Wegovy and Mounjaro were purchased in the UK in April alone—a number believed to reflect the actual user base. Meanwhile, some pharmacies have begun limiting access due to shortages, especially for higher dosages of Mounjaro.

This isn’t just a UK problem. In the US, Wegovy shortages have been ongoing since late 2023, leading to months-long waitlists in some areas. Healthcare providers have had to triage who gets treatment, often prioritizing patients with severe obesity or life-threatening complications.

“The demand is spiralling far beyond what is clinically deliverable,” said Olivier Picard, Chair of the National Pharmacy Association. “Weight loss jabs are one of the biggest drug innovations this century—but they need to be reserved for those who truly need them.”

How The Black Market Is Also A BIG Problem?

The concern now is not just about meeting demand—but managing it safely. As access becomes more limited, more people are turning to unregulated online sellers, beauty clinics, or even social media to obtain the injections. The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and the US FDA have both issued warnings about the risks of sourcing these drugs without medical supervision.

Buying Wegovy or Mounjaro online or from non-clinical settings raises the chances of getting counterfeit or improperly stored medication, not to mention bypassing essential medical checks. These drugs are meant to be taken as part of a structured weight management plan, including dietary guidance, lifestyle support, and regular health monitoring.

Without that ecosystem, even legitimate medications can become dangerous. Despite the chaos, pharmacists see an opportunity to play a larger, more regulated role.

Currently, 85% of all weight loss drug prescriptions are issued by community pharmacies. The NPA is now pushing for pharmacies to become more formally integrated into the NHS weight management rollout and to be equipped with clearer protocols, funding, and legal support.

“Pharmacists are experts in medication, and many already have experience delivering these jabs as part of a complete care package,” Picard explained. “If we’re going to scale up access, pharmacies are in the best position to do it safely.”

But he also emphasizes the need for new national regulations—especially for the private market and online prescribing. These should include mandatory two-way consultations and access to comprehensive medical histories before prescriptions are given.

The “Worried Well” vs. Clinical Need

One of the most pressing ethical dilemmas is who gets priority when supply is short.

“There’s a big difference between someone whose life is at risk from obesity-related disease and someone who’s hoping to lose ten pounds before vacation,” said Picard.

This distinction has led to the growing use of the term “the worried well”—people who may have a normal or near-normal BMI, but want to use these drugs for aesthetic reasons or as a quick fix. While everyone has the right to pursue their health goals, many experts argue that this group should not be taking up limited medical resources, especially when there’s no clinical indication.

Health agencies and professional bodies are calling for public education campaigns to clarify the appropriate use of GLP-1 drugs, to manage expectations, and to reduce pressure on already overstretched supply chains.

The UK’s Department of Health has said that up to 220,000 people in England will be offered tirzepatide (the drug in Mounjaro) over the next three years as part of its long-term obesity strategy. In the US, insurers are still grappling with coverage decisions, but pressure is mounting to expand access—particularly for patients in medically underserved communities.

Meanwhile, the pharmaceutical industry is racing to increase production, and new weight loss drugs are on the horizon. But none of this solves the immediate issue: demand already outstrips supply, and most of the people seeking these drugs may not even qualify.

Weight loss injections are not a silver bullet. They’re a tool, not a miracle cure and like any tool, their effectiveness depends on proper use, oversight, and the right person wielding them.

For now, healthcare systems must walk a tightrope expanding access to those in clinical need while holding the line against misuse, misinformation, and unsafe practices. Because when it comes to powerful medicines that affect your metabolism, more isn’t always better.