When Group Captain Shubhanshu Shukla became the first Indian to board the International Space Station (ISS) as part of the Axiom Mission-4, he carried with him not only national pride but years of medical preparation and personal discipline.

Space travel is as much about the body and mind as it is about engineering and exploration.

Here's a deep dive into how astronauts safeguard their wellbeing before, during, and after their missions — and why every step is critical.

Prep Before Launch

Astronauts begin their journey long before liftoff. Months — sometimes years — ahead of the mission, they are paired with flight surgeons (physicians with specialized training in space medicine) who monitor and manage their health meticulously. In Shukla’s case, the Indian Air Force appointed Dr. Punyashlok Biswal as his designated physician, offering continuity of care throughout his space journey, as reported by NDTV.

The Week.in reports that in the final weeks before launch, astronauts enter a tightly controlled quarantine. According to space analyst Girish Linganna, as was told to the Week.in, this isolation isn't just protocol — it's protection.

Infections like the common cold could threaten an entire mission. The ISS is a sealed environment with limited medical supplies, where even a minor illness can compromise experiments, affect crew performance, or force an early return to Earth.

Physical Conditioning and Mental Fortitude

Training includes intense physical conditioning and simulation drills. Astronauts must meet demanding benchmarks for strength, endurance, agility, and aerobic fitness to ensure they can function in a microgravity environment. Mental preparation is equally crucial. NASA assesses candidates for resilience, adaptability, and communication skills as early as the selection phase. Crew members are also trained in self-care and team dynamics — vital skills when you’re isolated 400 kilometers above Earth.

Monitoring Health in Real-Time

Astronauts like Shukla don’t travel alone — at least not medically. Flight surgeons remain connected throughout the mission, conducting weekly telemedicine check-ins to monitor everything from sleep quality to cardiovascular performance. These physicians act as both doctors and confidants, forming years-long relationships with astronauts. As Dr. Brigitte Godard of the European Space Agency told NDTV, “They are like family physicians.”

Each astronaut's physiological response to microgravity is unique. While Shukla initially experienced space motion sickness — a common side effect in early days of spaceflight — his extensive background as a fighter pilot made him more resilient. With monitoring and proper support, these symptoms are manageable, especially on short-duration missions like Ax-4.

Physical Fitness In Microgravity

Microgravity weakens bones and muscles due to the lack of physical stress normally exerted by gravity. To counteract this, astronauts exercise for approximately 2.5 hours each day. They use devices like the ARED (Advanced Resistive Exercise Device) to simulate weightlifting, a treadmill (T2), and the CEVIS bike for cardiovascular fitness. These workouts help preserve muscle mass, maintain bone density, and support motor coordination — all vital for safe movement and return to Earth.

Ensuring Nutrition

Nutrition in space serves a dual purpose: physiological support and psychological comfort. NASA’s Space Food Systems Laboratory creates meals that are both nutrient-rich and enjoyable. Astronauts also receive care packages and can request familiar foods — a small but significant way to boost morale. Their dietary intake is carefully tracked using digital tools, and samples of blood and urine are analyzed throughout the mission to ensure optimal nutrient levels.

Mental and Emotional Support

Long-term isolation, confined quarters, and the lack of natural stimuli can weigh heavily on astronauts’ mental health. NASA provides behavioral support, including access to psychologists, video conferencing with loved ones, and team-building activities. These efforts are designed to sustain emotional resilience and interpersonal harmony in space.

Postflight Rehabilitation

Once back on Earth, astronauts don’t just walk away from the mission — literally. The effects of weightlessness linger, including muscle weakness, balance issues, and reduced cardiovascular capacity. Recovery begins immediately with medical evaluations and a customized reconditioning program. NASA’s Astronaut Strength and Conditioning Specialists (ASCRs) design plans that rebuild agility, strength, and motor skills.

Each astronaut's recovery timeline is different. While most regain preflight fitness within 45 days, others may need extended rehabilitation. Progress is carefully tracked using pre-mission benchmarks, ensuring each individual returns to full function — and readiness for future missions.

Behind the Mask: What We Forget About the Doctors in Our Lives

A missed diagnosis. A prescription that showed no improvement. A patient who returns only to say their condition worsened. An important family event missed for a last-minute consultation. These are not just incidents, they are everyday realities for many doctors.

Doctors are trained to heal. To know. To always be in control. But what we forget is that they are human too. They grieve every loss, carry the weight of every failure and constantly walk the tightrope between their duty and personal life.

In a deeply candid conversation, Dr Guru N Reddy, a senior gastroenterologist, shared, “I didn’t spend time with my family when my kids were growing up. My work always came first and then came my family.” That struck a chord. As patients, we expect doctors to answer our calls immediately, respond to texts late at night and be available at all hours. We rarely pause to think who’s waiting for them at home?

And God help you if you have a doctor in the family. Because the rare time they do manage to show up at a gathering, they inevitably turn into the unofficial consultation desk. “Can I quickly show you this report?” “There’s this pain that won’t go, can you suggest something?” Sometimes, it’s not even for them, it’s for a friend, a colleague or someone they barely know.

Most doctors, even the most humble and well-meaning, find it hard to say no. Their instinct is to help. But somewhere in the process, their own boundaries blur. What’s meant to be a relaxing evening becomes a mini OPD. And they smile through it because that’s just who they are. But let’s not pretend that it doesn’t wear them out.

No wonder this year’s Doctors’ Day theme is so fitting - Behind the Mask: Care for the Caregiver. We often forget that doctors, beneath their professional calm are silent sufferers too. They carry the emotional burden of every patient they try to heal. While we blame them for a delayed recovery or a missed diagnosis, we fail to see how much it breaks them from within.

“If doctors could carry a magic wand that ensured perfect diagnoses and flawless treatments every time, they would, without question,” Dr Shuchi Sharma said. But medicine is not magic. It’s a science filled with uncertainties and doctors do their best within those limits.

It takes years to build a reputation as a doctor and just one unexpected outcome to tear it down. That’s what they fear the most, not for their name, but for the trust they lose, for the patients they couldn’t save, shares Dr Reddy.

And for this very reason, we have started Beyond The Stethoscope podcast series where we go past the prescriptions and procedures to bring you inspiring conversations with the minds shaping the future of healthcare.

So today, let’s pause. Let’s honour the ones who put others before themselves every single day. Behind their mask is not just a professional, it’s a person, quietly carrying the weight of hundreds of lives. This Doctor’s Day, let’s offer them what they rarely ask for - understanding, respect and a little care in return.

It’s 2 PM, and despite having slept a full eight hours the night before, you find yourself reaching for that third cup of coffee just to stay awake. The afternoon slump is familiar to many, but what if this persistent tiredness isn’t just a passing phase? What if you feel exhausted all day, no matter how much rest you get? This chronic fatigue can be frustrating and confusing, leaving you wondering why your body won’t recharge even when you’re resting.

Fatigue is more than just feeling sleepy. It’s a complex state that affects both body and mind, often blurring the lines between physical exhaustion and mental weariness. Many people experience occasional tiredness, but when fatigue becomes a constant companion, it signals that something deeper may be at play. Understanding why you’re tired even when you’re resting—and how to address it naturally—can transform your energy levels and overall well-being.

This kind of persistent fatigue—especially when it lingers even after a full night’s rest—has become increasingly common in today’s fast-paced, always-connected lifestyle. And while an “afternoon slump” is a known phenomenon, more and more people are grappling with all-day exhaustion. The big question: Why are so many of us tired all the time?

Tired vs. Fatigued: What’s the Difference?

It’s important to distinguish between simple tiredness and fatigue. Feeling sleepy after a long day or a restless night is expected. That’s sleepiness—a short-term issue that’s usually remedied with adequate rest.

Fatigue, on the other hand, is deeper and more persistent. According to experts, fatigue is more than just feeling sleepy—it’s a state of constant physical and mental exhaustion that doesn’t resolve with sleep. It can often be a sign of an underlying issue—either lifestyle-related or medical.

“Physical and mental fatigue are different, but they often occur together,” explains Dr. Pooja Singh, Sports & Fitness Specialist. “Chronic tiredness is not something to normalize—it’s your body asking you to pause and reflect.”

Why Are You Always Tired?

A surprisingly large portion of ongoing fatigue can be traced back to everyday habits. According to data, 1 in 3 adults in the U.S. don't get enough sleep, despite the recommended 7–8 hours per night. But even those logging decent sleep hours can feel drained. Sometimes, it’s the well-known “afternoon slump” caused by natural dips in circadian rhythm. Here’s why:

1. Poor Sleep Hygiene

Many people underestimate how profoundly sleep quality affects daily energy. Tossing and turning, late-night screen time, or simply going to bed at inconsistent hours can disrupt sleep cycles.

“Eating real food and supplementing with magnesium and vitamin D—especially through effervescent tablets—can improve sleep quality significantly,” says Dr. Singh. “Small nutritional tweaks go a long way.”

2. Sedentary Lifestyles

We now know that sitting is the new smoking. Modern work and leisure habits often mean we’re sitting for hours without a break, which affects circulation, mental focus, and yes—sleep.

“Start moving in between your day,” Dr. Singh advises. “You don’t need a gym. Basic moves like calf raises, squats, shoulder shrugs every 30–40 minutes can reset your energy levels.”

3. Screen Time Overload

If your bedtime routine includes scrolling social media or watching Netflix in bed, you’re disrupting your circadian rhythm. Screens emit blue light, which tricks the brain into thinking it’s daytime.

“Try meditating or doing deep breathing exercises for 20–30 minutes before bed instead,” Dr. Singh recommends. “This calms your nervous system and improves sleep quality.”

Is There a Medical Reason You’re Always Tired?

Sometimes, the root of constant fatigue runs deeper than lifestyle.

Conditions like anemia, thyroid imbalances, diabetes, chronic fatigue syndrome, and sleep apnea can all manifest as chronic tiredness. Mental health conditions—especially anxiety and depression—are also significant contributors to low energy levels.

“It’s important to note that if basic lifestyle interventions don’t help, consult a doctor,” Dr. Singh emphasizes. “Your fatigue could be a symptom of something more serious.”

Keep a diary of your sleep patterns, energy dips, and emotional states. This can help doctors identify patterns and offer targeted treatments.

Natural Ways To Fix Your Fatigue

Thankfully, there are several science-backed strategies to restore energy—without relying on caffeine or sugar.

Improve Sleep Quality

Good sleep isn’t just about quantity, but consistency. Stick to a sleep schedule, reduce screen time before bed, and create a calming bedtime ritual. Choose natural sleep aids like magnesium and herbal teas if needed.

Move More, Sit Less

Even light movement boosts circulation and releases endorphins. If you can’t squeeze in a gym session, take a brisk walk or stretch for 10 minutes. Exercise increases oxygen flow and mitochondrial efficiency—your cells’ natural energy factories.

Step Into the Sun

Just 10–15 minutes of sun exposure daily can help your body produce vitamin D, a deficiency of which is linked to fatigue. Light exposure also helps reset your circadian rhythm, making you more alert during the day and sleepier at night.

Balance Your Meals

High-carb lunches can spike insulin and lead to energy crashes. Opt for protein- and fiber-rich meals to maintain stable blood sugar and mental clarity throughout the day.

“Supplementing with collagen (type 2) is great for joint-muscle health, especially if fatigue stems from physical pain or weakness,” adds Dr. Singh.

Practice Stress Management

Chronic stress leads to cortisol dysregulation, which drains your body over time. Use meditation, yoga, journaling, or nature walks to bring stress hormones back to balance.

Chew Gum (Yes, Really!)

Studies show chewing gum can improve alertness and cognitive performance. It’s a simple, effective brain boost—especially during work or study sessions.

Nap Smartly

A power nap of 15–30 minutes can recharge your brain. Avoid longer naps which may disrupt your night sleep cycle and leave you groggier.

Fatigue isn't always a sign of laziness or poor time management—it’s often a whisper from your body (or sometimes, a scream) that something needs attention. In a world that praises busyness, acknowledging tiredness as a valid and treatable state is a radical act of self-care.

From smart nutrition and movement to emotional well-being and medical check-ins, fighting fatigue naturally is not just possible—it’s essential. And remember: you don’t need to fix everything overnight. Small, consistent changes create long-lasting energy shifts.

As Dr. Singh puts it, “Your body is incredibly intelligent. The more in sync you are with its signals, the more resilient, vibrant, and rested you’ll feel.”

Dr. Pooja Singh is a Sports & Fitness Specialist at Fast&Up in India

Drinking coffee every morning is a sacred ritual for many people. It gives them the energy to start their day as well as the boost they need through midday etc. Coffee often gets credit for waking us up, but it's also been linked to a lower risk of type 2 diabetes, heart disease, and even a longer life. However, new research suggests that how you drink your coffee might determine whether you actually get these health benefits.

While people have their own preferences of how they like their coffee, new research shows that having it a certain way can make it worse for your health, rather than helping you.

Black Coffee for Better Health

A recent study found that people who drank one to two cups of coffee daily had a 14% lower risk of dying compared to those who didn't drink coffee. But there's a catch: this was only true for individuals who drank their coffee black or with just small amounts of cream, milk, or sweeteners. Adding too many extra ingredients seemed to cancel out coffee's positive effects.

Coffee Habits and Life Expectancy

This study, published in The Journal of Nutrition, followed over 46,000 adults in the U.S. for about 10 years. Researchers wanted to see if there was a connection between how people drank coffee and their risk of death.

At the beginning, participants filled out a survey about their diet for over 24 hours. From this, researchers estimated their usual coffee intake and noted if they added sweeteners or high-fat products. After tracking participants' health (including deaths from cancer, heart disease, and all other causes), the team found:

• Drinking one cup of coffee daily was linked to a 16% lower risk of death from any cause.
• Drinking two or three cups daily cuts this risk by 17%.
• Coffee drinkers also had a significantly lower risk (29–33%) of dying from heart disease.

When looking at additives, people who drank black coffee or coffee with low amounts of added sugar and saturated fat had a 14% lower risk of overall mortality compared to non-coffee drinkers. "Low added sugar" meant less than 2.5 grams (about half a teaspoon) of sugar, syrup, or honey per 8 ounces. "Low saturated fat" meant less than 1 gram (about 5 tablespoons of 2% milk or 1 tablespoon of light cream/half-and-half) per 8 ounces.

Why Additives Might Reduce Benefits

Coffee contains over 100 different molecules, including polyphenols, which are likely responsible for many of its health benefits. Polyphenols are antioxidants that help reduce inflammation and protect cells from damage. This makes the link between coffee and lower mortality "biologically plausible," as coffee is a major source of antioxidants for many.

Adding sugar or saturated fats to your coffee doesn't necessarily destroy these polyphenols. Instead, a high intake of sugar and saturated fats in general is simply linked to worse heart health and a higher risk of death.

Making the Most of Your Coffee

Since this is the first study to specifically look at how coffee additives affect mortality risk, the evidence isn't yet strong enough for strict recommendations. However, a good general rule is to reduce your overall consumption of sugar and saturated fat.

If you enjoy a little cream and sweetener in your coffee, don't worry too much. While black might be better, adding small amounts doesn't necessarily put you at increased risk.

Regardless of additives, moderation is key. The health benefits of coffee tend to decrease after about two cups daily, and drinking too much can even be harmful. High doses of caffeine can cause anxiety, irregular heartbeats, and elevated blood pressure.