Headache? Take a painkiller. Joint pain? Take another. For all of us, over-the-counter (OTC) painkillers such as ibuprofen or acetaminophen are as much a part of daily life as a morning cup of coffee. They're fast, efficient, and appear harmless—who needs a prescription, anyway? But what if this blase dependence on painkillers is actually laying the groundwork for a much more devastating health emergency?

If that's your daily mantra, don't worry, you're in good company. In the age of instant gratification, all of us are turning to over-the-counter pain relievers as a quick fix for even mild pain. But what if this ostensibly innocuous habit is silently threatening your kidneys with a major health problem?

Painkillers, or analgesics, are usually a lifeline for individuals with chronic or severe pain. From recovery from surgery and migraines to arthritis and menstrual cramps, these drugs offer relief that ensures our quality of life is not drastically reduced. But beneath the pain relief lies a surprising question: whether the overuse of these drugs may exact too high a price-kidney damage and even kidney cancer.

Dr. Aditya Punamiya, a GI, HPB, and Gynecologic Oncosurgery Consultant, cautions, "The long-term and uncontrolled use of over-the-counter painkillers is emerging as an under-diagnosed but serious risk factor for kidney cancer." Dr Punamiya observations reveal an alarming pattern, numerous patients self-medicate for chronic pains—headaches, joint pains, or back pain—unaware of the additive damage to the kidneys.

Why We Turn to Painkillers So Easily?

Pain is a biological alarm system. Helpful in warning us of injury or sickness, chronic pain can strongly interfere with our functioning on a daily basis. To counter this, painkillers provide a feeling of control and comfort. For acute on-demand pain and chronic inflammatory diseases, drugs like NSAIDs and acetaminophen are not only handy but effective as well.

Sadly, the very ease of use of these drugs has led to their misuse. Painkillers are increasingly being consumed without medical supervision, particularly in nations such as India where OTC availability is prevalent but even within well-regulated economies such as the U.S., long-term use has become an undercurrent of an epidemic.

What Are The Types of Painkillers?

Over-the-Counter (OTC) Medications

Paracetamol (Acetaminophen): Good for fever and light pain, but hepatotoxicity is a serious issue above moderate doses.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Contains ibuprofen, naproxen, and diclofenac. These are useful for pain that is inflammation-related but have gastrointestinal and renal toxicity with long-term use.

Prescription Painkillers

Opioids (Tramadol, Morphine, Oxycodone): For severe pain only but pose the risk of respiratory depression, addiction, and endocrine disruption.

Topical and Alternative Therapies

Topical creams and patches containing drugs such as menthol or capsaicin are localized treatments with fewer systemic hazards.

How Do these Drugs Harm the Kidneys?

How do such drugs damage the kidneys? Dr. Punamiya clarifies, "Drugs such as ibuprofen, diclofenac, and naproxen, if taken in excess, can harm the kidneys in two ways. One, they weaken the kidneys' function to filter blood by cutting off blood supply. Two, they cause chronic interstitial nephritis over time, scarring kidney tissues." This scarring provides a fertile ground for RCC to grow.

The kidneys, essential organs responsible for filtering waste products from the blood, are especially susceptible to chronic exposure to NSAIDs and acetaminophen. Acute kidney injury, chronic kidney disease, and, in severe cases, kidney failure can result from excessive use of these compounds. The transition to kidney cancer is not as sudden but equally alarming, since the cumulative insult changes cellular mechanisms, possibly initiating malignant growth.

A landmark meta-analysis by Toni K Choueiri, Youjin Je, and Eunyoung Cho has again highlighted the relationship between chronic painkiller use and renal cell carcinoma (RCC)—the leading form of kidney cancer.

Non-Aspirin NSAIDs: Chronic use was linked to a 25% enhancement in the risk of RCC. Heavy consumption increased that threat by 56%, long-term consumption for more than 10 years especially concerning for women.

Acetaminophen: Associated with a 21% heightened risk of kidney cancer. Heavy users who took high doses saw their risk rise by 66%.

Aspirin: While most U.S.-based research found no conclusive link, some research from other countries suggested a connection, possibly due to regional variation in formulation or consumption habits.

Why Kidney Cancer Is a Silent Threat?

Kidney cancer is especially stealthy since it usually presents late without any symptoms. "Flank pain, hematuria and weight loss are typically late presentations," states Dr. Punamiya. For patients such as Sarah, who might have been taking painkillers for years, these signs may only manifest by the time cancer has metastasized, and so treatment is less effective.

Risk factors such as smoking, hypertension, diabetes, and obesity increase the risk, particularly in individuals with previous long-term analgesic use. Women also have an increased risk with non-aspirin NSAIDs, possibly because of hormonal or metabolic variation, although further work is required to explain this difference. He describes two principal mechanisms:

Decreased Renal Blood Flow: NSAIDs inhibit prostaglandins, decreasing kidney blood flow and compromising kidney filtration capability.

Chronic Interstitial Nephritis: Long-term NSAID use leads to fibrosis and inflammation of kidney tissue, setting the stage for RCC.

"Most patients self-treat for headaches or joint pain without knowing they're gradually driving their kidneys towards failure," he adds.

Why Early Detection Of Kidney Cancer Symptoms is Difficult?

Kidney cancer is infamous for its asymptomatic nature in the early stages. By the time symptoms such as pain in the flank, hematuria (urine containing blood), or unexplained weight loss appear, the disease is usually advanced. Patients with pre-existing risk factors—such as smoking, hypertension, and diabetes—and with a history of analgesic abuse are particularly susceptible.

Dr. Punamiya advises individuals to consult a doctor for ongoing pain rather than resorting to self-medication. "Routine screening and preventive caution are necessary, especially for vulnerable groups," he points out.

What Are Ways You Can Manage Pain Management Smartly?

Not every use of painkillers is risky. "Short-term, doctor-monitored use is generally safe," says Dr. Punamiya. The trick is not entering into uncontrolled, long-term use. Here's how to handle pain more safely:

Consult a Healthcare Provider

For long-term pain, consult a professional to treat the underlying condition, whether arthritis, neuropathy, or migraines. A customized treatment plan can minimize painkiller dependency.

Try Non-Drug Options

Physical therapy, acupuncture, yoga, and cognitive-behavioral therapy can treat chronic pain without medication risks. For sudden pain, ice, heat, or rest may be enough.

Use Painkillers Wisely

Follow instructions on dosing and avoid prolonged use outside of medical guidance. For NSAIDs, eat food when taking to reduce stomach discomfort, and drink enough fluids to aid kidney function.

Take Precautions

Encourage regular health screening for early detection of kidney problems, particularly among high-risk groups. Dr. Punamiya urges "preventive vigilance" with follow-up visits and attention to early signs such as blood in the urine or recurrent flank pain.

Lifestyle Matters

A balanced diet, exercise, and weight control can cut pain from conditions such as arthritis while reducing kidney cancer risk factors such as obesity and high blood pressure.

There may be the temptation to cover up pain instead of comprehending its cause but swallowing a pill with a glass of water can be an instant solution that might come at a price of long-term health. The growing body of evidence linking commonly used painkillers to kidney cancer is a call for informed, cautious use. As more people take their health into their own hands, the importance of education, medical guidance, and moderation cannot be overstated.

Dr. Aditya Punamiya is a Consultant GI, HPB & Gynec Onsosurgery at HCG Cancer Centre, Borivali in India

The air quality in many Indian cities has reached worrying levels, with thick smog and high pollutant concentrations now a part of daily life. In Delhi, the situation has turned severe, with air quality dipping to its lowest point of the season. A dense layer of smog has settled over the city, and temperatures have fallen well below the usual range.

While toxic air is dangerous for everyone, it poses an even greater threat to vulnerable groups, one of them being pregnant women. So, how exactly does pollution affect them? To understand this better, we spoke with Dr. Ashish Saini, Consultant Endocrinologist at Kailash Hospital, Noida, and Sonia Mehta, Nutritionist and Founder of EverBloom, who explained the impact in detail.

How Does Air Pollution Affect Pregnancy?

Air pollution can directly affect both the mother and her developing baby. According to ScienceDirect, pollutants such as fine particulate matter (PM2.5), nitrogen dioxide, and carbon monoxide enter the lungs and pass into the bloodstream when inhaled. Once in the blood, these harmful particles can reach the placenta—the organ responsible for supplying oxygen and nutrients to the baby.

This exposure may reduce the amount of oxygen available to the foetus and trigger inflammation in the mother’s body, disrupting normal placental function. Over time, such changes can increase the risk of pregnancy-related complications like restricted foetal growth and high blood pressure.

Air Pollution and Pregnancy: Can It Lead to Gestational Diabetes?

Growing research points to a strong link between long-term exposure to polluted air and metabolic problems such as gestational diabetes. Pollutants like PM2.5 and nitrogen dioxide, commonly found in city smog, can cause oxidative stress, hormonal imbalance, and chronic inflammation—all of which can interfere with insulin sensitivity.

Dr. Ashish Saini explained, “These physiological changes can make expectant mothers more prone to glucose intolerance. For those already diagnosed with gestational diabetes, continuous exposure to polluted air may lead to unstable blood sugar levels and raise complications for both mother and baby. As pollution worsens in the winter months, it becomes vital to stay cautious and take preventive measures.”

Why Are Pregnant Women More Vulnerable To Air Pollution?

Polluted air is often described as a silent hazard for women’s health, and pregnancy makes women especially sensitive to its effects. For expecting mothers managing gestational diabetes, breathing in polluted air can worsen oxidative stress, inflammation, and metabolic disruption. This can increase the chances of high blood pressure, early delivery, and other health risks for both mother and child.

Nutritionist Sonia Mehta highlighted the importance of nutrition as a protective factor: “A balanced diet can help reduce these risks. Expectant mothers should include a variety of colourful fruits and vegetables rich in vitamins C and E, add walnuts or flaxseeds for omega-3, opt for whole grains such as oats or brown rice, and include dal, paneer, or eggs for protein.” These nutrients help fight inflammation and support healthy insulin activity.

Precaution Steps for Expecting Mothers During Air Pollution

On days when smog levels are high, it is best to stay indoors, use a good air purifier, and opt for light exercises such as prenatal yoga or simple stretches on the balcony instead of outdoor walks. Small, everyday decisions can go a long way in protecting both mother and baby from the silent harm caused by polluted air, as per Sonia Mehta.

Dr. Saini recommends limiting outdoor exposure during peak pollution hours, ensuring proper ventilation at home, and using well-fitted masks. A diet rich in antioxidants, safe indoor physical activity, staying hydrated, and regular glucose monitoring under medical guidance can further strengthen metabolic health.

Air quality awareness should be an essential part of prenatal care. Taking these steps not only safeguards maternal health today but also shapes a healthier future for the next generation.

A new study published in the Lancet says that feeling sick after eating foods with gluten often has nothing to do with gluten itself. Instead, it’s about a complicated communication problem between your gut and your brain.

Over the years we have seen many people avoiding gluten. According to NYU Langone Health, one-third American avoid gluten due to health concerns, but is gluten really such a big cause of concern for health?

This condition, called Non-Celiac Gluten Sensitivity (NCGS), affects many people around the world, and these new findings will completely change how doctors understand and treat it.

The researchers from the University of Melbourne looked at lots of previous studies to figure out why people who don't have Celiac disease still feel bad after eating gluten. Common complaints are feeling bloated, having stomach pain, or feeling tired. The lead researcher says these results challenge the old ideas we had about what causes the sensitivity.

Is Gluten The Culprit Behind Bread Bloating?

The research reveals that it is not due to gluten. The study found that for most people who think they are gluten sensitive, their symptoms are actually being caused by two main things:

FODMAPs (Fermentable Carbohydrates)

These are types of carbohydrates found in many foods, including wheat, that are hard for some people to digest. They ferment in the gut and cause gas and bloating. The study found that these are often the real cause of discomfort, not the gluten part of the wheat.

Psychological Reasons

Researchers found that people’s symptoms were often triggered by what they expected to feel after eating the food. In many tests, people who thought they were reacting to gluten felt just as sick when they were secretly given a placebo, which is a fake, gluten-free substance, as when they were given real gluten. This shows that your brain's expectation plays a huge role.

Is Bread Bloating Only Due to Gluten Sensitivity?

The researchers concluded that we should stop thinking of NCGS as a problem with gluten and start seeing it as a communication breakdown between the gut and the brain. Because the symptoms are so similar, they say NCGS is more like Irritable Bowel Syndrome (IBS), which is a condition where the gut and brain don't communicate properly.

When people who have IBS and think they are sensitive to gluten eat gluten, wheat, or a placebo, they often react the same way to all three. This strongly suggests that how a person anticipates and processes sensations in their gut is heavily influencing their symptoms. This new view will help doctors stop focusing only on gluten and start treating the underlying communication problem.

Doctors now have better information to help patients. Experts say this new knowledge is essential for making better diagnoses and creating personalized treatment plans for each patient.

The study strongly suggests that public messages should stop telling people that gluten is automatically bad for their gut, because the research shows that is often not true. We need to change the public message about gluten.

The researchers suggest that effective treatment for people with NCGS should include not only changing their diet but also psychological support to manage their gut-brain interaction.

It’s also important to make sure people are still getting all the nutrients they need. The authors also want to see better testing tools, stronger guidelines for doctors, more funding for research, and clearer food labels.

Health and Me had previously reported about the findings from an unpublished study that linked the long use of melatonin, a sleep inducing hormone, and often used as a supplement for the same with heart failures. However, experts are now asking the public to not panic. Their message is simple: this early research is not a reason to toss out your melatonin just yet.

The study, based on health records from more than 130,000 adults with chronic insomnia, found that people who took prescription melatonin for over a year had a higher likelihood of heart failure, hospitalization and death over a five year period compared with those who didn’t take the supplement.

However, the experts who are now reviewing the findings say that the research has major gaps and should be seen as an initial sign and not as a definitive warning.

This Is Not A Melatonin Crisis

As reported by the Washington Post, the spokesperson for the American Academy of Sleep Medicine, Dr Muhammad Rishi, who reviewed the research, called the findings "provocative". However, Dr Rishi stressed that electronic health records can’t establish cause and effect. Other cardiologists echoed the sentiment, noting that melatonin has long been considered safe and even potentially beneficial for heart health because of its antioxidant properties.

This study, they say, is the first to suggest the opposite. One study alone is not enough to overturn years of research, especially when it hasn’t yet undergone peer review.

Joyce Oen-Hsiao, a Yale cardiologist, pointed out that people with chronic insomnia often have elevated risks for heart problems even without medication. Poor sleep itself raises heart rate, disrupts blood pressure and increases cardiovascular risk. So it’s entirely possible that insomnia, not melatonin, is the real culprit behind the outcomes seen.

What Did The Study Do In Its Analysis?

Researchers analyzed an international electronic-health-records database, looking at adults diagnosed with insomnia. About half had a record of being prescribed melatonin and reported taking it for at least a year.

Across five years, roughly 3,000 long-term melatonin users developed heart failure for the first time, compared with nearly 1,800 people listed as nonusers. The team matched melatonin users with nonusers to account for age, sex and other health conditions.

But here’s the catch that experts keep flagging: the “nonuser” group probably included plenty of people who did take over-the-counter melatonin but didn’t mention it to their doctors. In the United States, melatonin is sold as a supplement, not a regulated drug, so people often take it without any record in their medical file.

That alone, experts say, could skew the results.

The dose information was also missing, and researchers couldn’t tell whether the prescription melatonin actually improved users’ sleep. If someone continues to struggle with severe insomnia even while taking melatonin, the underlying sleep disorder could be driving heart risks, not the supplement.

Melatonin: To Continue Or Not To Continue

As per experts, you should not discontinue taking your medicines by just basing it off the study. The key is of course to speak to your doctor. However, no one is recommending widespread discontinuation. Experts, instead, are asking people to stay calm, informed, and talk to a doctor if they’ve been using melatonin for a long time, especially at high doses or if they already have heart disease risk factors.