maxwellc

Bodywork: When should you get vaccinated for shingles?

May 12, 2026 by maxwellc

Adam’s Journal

In honor of the NBA playoffs, here’s a question from an Oklahoma Medical Research Foundation co-worker:

I read that Indiana Pacers’ star — and 2025 Thunder championship nemesis — Tyrese Haliburton has been struggling for several months with a case of the shingles on his face. He’s only 26.

I thought shingles was more of a concern for older people, especially because vaccination recommendations start at age 50. Can and should you be vaccinated for shingles if you are younger than 50?

Jenny Lee

Dr. Scofield Prescribes

This weakening of immune control typically begins to happen as people age, which is why standard recommendations for Shingrix, the shingles vaccine, begin at 50. However, younger adults can get shingles, and in recent years we’ve seen an uptick in cases in people in their 20s, 30s and 40s.

Although we’re not sure why, the rise of shingles in younger populations is probably due to a number of factors, with stress and sleep deprivation suspected as contributors. The chicken pox vaccine may also impact shingles trends, although that effect is complicated.

By reducing childhood chickenpox, the vaccine has cut adults’ periodic exposures to the virus. Some experts believe those periodic exposures help boost immunity against shingles.

Meanwhile, those vaccinated people are less likely to carry the strain of the virus that most often reactivates as shingles. As a result, studies indicate their future shingles risk is lower than those who were infected naturally.

Unless a person is immunocompromised — such as individuals with HIV, those undergoing chemotherapy, or those receiving treatment for autoimmune disease — vaccination for those under 50 isn’t routinely recommended.

That’s because the absolute risk for disease remains low. Plus, immunity from the previous shingles vaccine (Zostavax) waned over time, and this may happen with Shingrix, too. So, vaccinating too early might leave less protection later in life, which is when risk is highest.

Still, physicians can legally give the vaccine “off label” to younger adults in certain circumstances. Some doctors might consider vaccination for younger patients who have experienced recurrent shingles or an unusually severe case of the virus, especially if it involved the face or eye.

In such cases, insurance likely would not cover the shots.

So, can you be vaccinated under 50? Yes. But should you consider it? Generally, no, unless you’re immunocompromised or have had a significant prior case of shingles.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Should we all be taking creatine?

May 5, 2026 by maxwellc

Adam’s Journal

So, I’m going to pose a question that an audience member asked when you traveled around the state as part of the Oklahoma Medical Research Foundation’s “Spotlight Conversations” series:

Should we all be taking creatine?

Dr. Scofield Prescribes

The supplement creatine has long been a favorite of athletes and bodybuilders for boosting muscle mass and athletic performance. But these days, its use has expanded.

Our livers, kidneys and pancreas produce creatine. We also get it in our diet from animal products like red meat and fish.

Our muscles use a product derived from creatine to generate energy, especially during high-intensity activities like lifting weights or sprinting. Most of us get sufficient creatine (about two grams) from a combination of diet and what our bodies generate.

The idea behind creatine supplementation is that it helps the body rapidly regenerate adenosine triphosphate (ATP), which is the primary source of energy used during short bursts of high-intensity exercise. This enables the body to work harder for longer, which both enhances performance and promotes muscle growth.

In addition to bodybuilders and other athletes, some vegetarians — whose only source of the compound is their own bodies — have taken creatine supplements. In healthy people, the supplements have generally been shown to be safe.

Clinical trials and other studies have found that athletes who take creatine can generate 5–15% more strength or force during repeated short bursts of activity. An analysis of dozens of clinical trials also showed that people who took creatine while resistance training increased their lean body mass by an average of more than two pounds.

Creatine also pulls water into muscle cells, causing them to swell. This can lead to some weight gain, which is most often temporary.

People with kidney disease should consult their doctors before taking creatine, as it could further strain their kidneys. Other potential drawbacks, while usually mild, include gas, bloating and an upset stomach.

Beyond what we see in the mirror, the relatively minor gains that creatine supplementation provides during intense workouts may be invisible to most of us. But as we age and lose muscle mass, the supplement could help counter age-related muscle loss.

It’s important to emphasize that creatine supplementation alone is insufficient to provide benefits. Those gains only come in combination with a regular strength training regimen.

Researchers have begun to look at other potential benefits of creatine supplementation, including cognitive gains, blood sugar control, bone health, and a variety of disease-specific questions. However, the studies so far are limited, and the results have been mixed.

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Bodywork: Are coronary calcium scans for everybody?

April 29, 2026 by maxwellc

Adam’s Journal

I’ve seen low-cost heart scans advertised at local hospitals. I’ve never had one, but should I? Should we all? How useful are they?

Dr. Scofield Prescribes

You’re most likely talking about a coronary artery calcium scan. These quick, noninvasive tests, widely available for as little as $50, use a type of computed tomography (CT) scan to measure calcified plaque in the coronary arteries.

These are the arteries that supply blood to the heart. Plaque buildup in these arteries, known as coronary artery disease, is a leading cause of heart attacks.

For some people, these scans can be quite helpful. They’re most useful in those who don’t have any symptoms of cardiovascular disease (things like chest pain, shortness of breath, and dizziness) but nevertheless have an increased level of risk due to factors like high blood pressure or elevated cholesterol.

For folks in these “gray” areas, especially between the ages of 40 and 75, coronary artery scans can help tip the balance on whether a person should start taking a statin drug. For instance, someone with elevated cholesterol who shows moderate plaque buildup might be advised to begin statins, while someone who shows no detectable calcified plaque might be advised to wait and focus instead on lifestyle changes.

Coronary calcium scans, though, are not a one-size-fits-all solution.

Unless there is some special circumstance, like a strong family history of heart disease, the test is not recommended as routine screening for very low-risk people. And at the other end of the spectrum — those who have established coronary disease, those already known to be at high risk, and those who have experienced symptoms — the scans add little useful information to inform the treatment path.

Plus, these tests do expose you to radiation, and there is no safe dose of radiation. And if every person got one – as some advertising seems to suggest – the cost would run well into the billions.

Still, these inexpensive, noninvasive scans can be useful in borderline cases, helping to determine whether a person needs a cholesterol-lowering medication. If you believe you might fit into this category, talk to your healthcare provider to see if a coronary artery calcium scan makes sense for you.

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Bodywork: Do smelling salts help athletes – or anyone?

April 21, 2026 by maxwellc

Adam’s Journal

Here’s a question from Kate Miller, our ever-curious colleague at the Oklahoma Medical Research Foundation:

The other night, despite a strong start, Texas Rangers pitcher Nathan Eovaldi seemed off his game. When the camera cut to him in the dugout, he was taking a big whiff of smelling salts.

What are smelling salts anyway? And do they really improve athletes’ performance? (I should note that Eovaldi pitched seven scoreless innings that night.)

Dr. Scofield Prescribes

The last time I administered smelling salts was in the 1970s, during my medical training. We typically used them if someone had lost consciousness, hoping the odor would be powerful enough to awaken the person.

Smelling salts are usually made of ammonium carbonate. When exposed to air – most often by the opening of a small capsule – they release ammonia gas.

Ammonia gas is extremely irritating to the mucous membranes in the nose, and that irritation triggers the body to inhale deeply. The salts can also cause a burning sensation in the respiratory tract, watery eyes and coughing.

Many athletes – including, apparently, Mr. Eovaldi – believe the salts give them an edge, jolting them to an enhanced level of consciousness and performance. But research on the topic paints a less convincing picture.

A 2022 study in athletes found that the salts improved alertness and perceived performance. However, when scientists gauged the athletes’ performance, they determined that actual strength and reaction times were unaffected. A 2018 study yielded similar results, with researchers finding no improvements in strength.

So, the short answer seems to be that while smelling salts can provide a psychological boost, they haven’t been shown to enhance actual athletic performance.

The salts, however, can come with some downsides. In football, their use could mask the symptoms of concussions. And if someone has suffered a spinal injury, the involuntary jerk that follows the inhalation of noxious fumes could be dangerous.

Ammonia is a known toxin, and concentrated exposure can lead to burns or even lung injury. While I found no studies examining the effects of repeated exposure to low concentrations of the gas, if there’s no benefit, why risk it?

In any case, I hope no one had to resort to smelling salts to get through this column.

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Bodywork: Does cupping really help athletes?

April 14, 2026 by maxwellc

Adam’s Journal

With my basketball-watching now reaching its annual fever pitch – go Thunder! – I’m increasingly noticing players bearing the telltale signs of “cupping”: round, reddish bruises on their upper backs and shoulders.

Why do athletes have cupping treatments? And do they actually do anything?

Dr. Scofield Prescribes

When you see athletes with the characteristic circular byproducts of cupping on their bodies, they have undergone what is essentially a suction massage. The process involves using cups to create suction on the skin.

The idea is that cupping increases blood flow, speeding muscle recovery and easing soreness. Athletic training staffs commonly incorporate cupping into sports therapy routines alongside massage and physical therapy.

Researchers have conducted quite a few studies of cupping. However, the evidence that cupping aids in athletic recovery remains limited and mixed.

Some of the more comprehensive studies suggest that cupping may help with subjective recovery measures like soreness, perceived exertion, sleep and wellness. But the evidence for meaningful improvements in more objective measures – like athletic performance or physiologic gauges of recovery – is much weaker.

Perhaps the best athlete-specific evidence I found was a 2018 systematic review of randomized controlled trials of cupping in amateur and professional athletes. It reported possible benefits for pain relief and range of motion, as well as a potential reduction in levels of creatine kinase, an enzyme that appears in elevated amounts in the blood with muscle injuries.

Still, the review stopped short of making any explicit recommendations for cupping in athletes, concluding that the evidence base was too small and methodologically weak.

When it comes to musculoskeletal pain – think back or neck pain in the context of sports – the evidence is even weaker. A review of the studies in this area concluded that cupping was often ineffective in treating this type of pain, whether in athletes or the general population.

As a recovery tool, cupping has failed to show that it reliably improves outcomes like performance, strength restoration or return-to-play timelines. Still, I’d view it as an (extremely) optional recovery aid, one that comes with essentially no risk and potential moderate benefits in areas like pain relief and improved sleep.

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Bodywork: Catching a case of the yawns

April 7, 2026 by maxwellc

Adam’s Journal

My cat and I were hanging out and being lazy the other day. At some point, February got up from the sofa and let out a big yawn.

Febs snaps her teeth together at the end of her yawns, which I find adorable. But before I could say, “Awww,” I found myself yawning, too.

How did I catch yawning from my cat?

Dr. Scofield Prescribes

As you have seen, humans are not alone in yawning. All mammals and probably all birds yawn, and even reptiles engage in yawning-like behavior.

We humans start yawning even before we are born, at about 14 weeks of pregnancy. The process is stimulated by chemicals in the brain called neurotransmitters: dopamine, oxytocin and serotonin.

In utero, the yawning is spontaneous. And throughout our lives, spontaneous yawning continues to occur when we are tired or doing repetitive tasks.

Scientists have proposed many theories about why we yawn in these situations. One is that yawning helps regulate brain temperature, using deep inhalations to introduce cool ambient air while also stretching the jaw to increase blood flow.

Other theories center around improving alertness. A new study – yet to be reviewed by scientists unaffiliated with the work – found that yawning caused an increased flow of blood and cerebrospinal fluid away from the brain. The authors speculate that the movement of these fluids out of the head might “cleanse” the brain, which could increase awareness.

In addition to its spontaneous form, yawning can also be contagious. Again, this happens in both humans and animals – and, as you have experienced, from one species to another.

It’s triggered by hearing or seeing another creature yawning. It can be spurred by seeing only the eyes of someone who’s yawning.

Contagious yawning can go beyond visual or auditory cues. Even reading about yawning can spawn the irresistible urge to do so yourself.

I even yawned while writing this column.

People who study yawning have hypothesized that contagious yawning serves as a non-verbal method of social bonding among members of a group. Interestingly, they’ve found that people who score higher for empathy are more likely to be susceptible to contagious yawning.

So, consider it a plus that you caught a yawn from February. It might signal that you’re an empathetic person. Or maybe you just really get cats.

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Bodywork: How Cold Should Drinking Water Be?

March 31, 2026 by maxwellc

Adam’s Journal

Here’s a question from an Oklahoma Medical Research Foundation coworker:

I heard someone say the other day that drinking room-temperature water was better for digestion than ice-cold. Is this true?

Beth Benefield

Dr. Scofield Prescribes

There’s not a lot of research on this topic. But from what we know, when it comes to the benefits of hydration, the important factor is not the temperature of the water but rather how much we drink.

The best-studied cases involve athletes. From studies, we know — unsurprisingly — that cold water is better for cooling the body during exercise. It helps delay or offset increases in core body temperature.

In addition, we’ve seen that drinking colder water can improve rehydration in hot conditions after exertion. Again, it aligns with most of our experience, but studies show that we consume more in these circumstances if water is chilled.

These benefits also seem to hold true in more generalized heat conditions – cold water cools us more effectively, and we drink more of it.

So, when it comes to hydration, the advantage goes to cold water, at least for exercise and cooling the body.

The idea that warmer water aids digestion is not new; indeed, it’s part of traditional Chinese and Ayurvedic medicine practices. And while there’s a small amount of data suggesting that warm water could help move food through the digestive system, it’s not enough to draw conclusions.

For some people, warmer water may be more comfortable to drink in large amounts. Similarly, certain individuals may find it easier on their stomachs to drink room-temperature water.

However, research does not point to any physiological advantages to drinking room-temperature water for the purpose of aiding digestion.

When it comes to water consumption, the goal is to make sure we get enough. This is especially true as we grow older: It’s been shown that the thirst sensation diminishes with aging.

As a result, older adults are at greater risk for dehydration, especially due to medications and certain illnesses. Dehydration in these circumstances can lead to a wide range of issues, including confusion, falls, urinary tract infections and kidney problems.

In the end, drinking water temperature comes down to individual preference. If you like cold better, drink it. Ditto for warmer water.

Hot, cold or in between, whatever makes you most inclined to hydrate is the “best” one for you.

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Bodywork: The hereditary risk of Parkinson’s disease

March 24, 2026 by maxwellc

Adam’s Journal

Here’s a question from a reader:

My mother-in-law has Parkinson’s disease. Is my wife at greater risk because her mother has it? Over the last couple of years, I’ve noticed my wife, who is 55, has a tremor in her hands that’s more pronounced when she’s holding her phone.

Michael Romero

Edmond

Dr. Scofield Prescribes

Parkinson’s disease is a neurodegenerative disorder characterized by slowness of movement, tremors and stiffness. It usually begins slowly, and over time can affect walking, balance and dexterity. Some patients can also experience cognitive changes as the disease progresses.

As with so many diseases, the single greatest risk factor for Parkinson’s is aging.

The lion’s share of Parkinson’s cases – up to 90% – are “sporadic,” meaning they have no clear inherited cause. But in the remaining 10% or so, genes play a role, most often in the form of a strong family pattern.

That said, even for those with a strong family pattern – such as a parent with the disease – risk increases only moderately. In the general population, a person’s chances of developing Parkinson’s are in the range of 1–2%. If a person’s mother or father has the disease, their lifetime risk for Parkinson’s rises to about 2–3%.

In fact, the symptoms you are describing for your wife – a tremor that’s noticeable when she holds her phone – are actually more typical of a condition known as essential tremor.

In Parkinson’s, tremors are most prominent at rest, like when hands sit in the lap. When hands move or are engaged, the tremor often lessens.

Meanwhile, essential tremors surface when people are trying to put their hands to use, manifesting when people eat, drink, write – or use their phones.

The condition is more common than Parkinson’s, and its prevalence increases significantly with age. At 55, your wife is entering a time of life when essential tremors become more common.

Like Parkinson’s, essential tremors tend to worsen as we grow older, although changes are typically very gradual. While they aren’t dangerous in the way many neurologic diseases are, they can affect daily activities, along with confidence and social engagement.

None of this should be substituted for a visit with your wife’s physician, who can much more thoroughly and accurately assess the situation. But from what you’ve described, your wife’s tremor shouldn’t meaningfully raise concern beyond that modest baseline increase from family history.

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Bodywork: How smallpox inoculation helped America win independence

March 17, 2026 by maxwellc

Adam’s Journal

Before digging out all of our red, white and blue clothing to celebrate America’s 250^th birthday this summer, my wife and I watched Ken Burns’ (excellent) documentary, “The American Revolution.” In the series, I was surprised to find that Burns highlighted smallpox. What role did it play in the colonies’ fight for independence?

Dr. Scofield Prescribes

At the time of the American Revolution, smallpox posed one of the most significant health threats to the citizens of the 13 colonies. The highly communicable virus had already become common in the colonies, and densely populated port cities like Boston, Philadelphia and New York periodically saw concentrated outbreaks, usually triggered by the arrival of infected passengers or goods like clothing. Spread mainly through respiratory droplets, smallpox carried a mortality rate of 15–30%. Those who survived often suffered permanent scarring – they were “pockmarked” – and some were left blind. As a result, colonial Americans viewed smallpox with a fear comparable to what we experienced during the Covid-19 pandemic.

Early in the Revolutionary War, smallpox nearly destroyed the Continental Army during the colonies’ invasion of Canada, where outbreaks devastated troops. The virus hit American soldiers much harder than the British, as smallpox was extremely common in Great Britain, especially in cities. So, most British troops had already caught and survived smallpox as children, and those who hadn’t likely had been inoculated, a forerunner to vaccination.

Inoculation (or variolation) involved taking a scab or pus from a person with active smallpox and inserting it into a healthy individual, usually by making a small cut or scratch in the arm. The healthy person would then develop smallpox. But because the virus entered through the bloodstream instead of the lungs, infection was typically milder, and mortality rates (1–2%) were much lower.

Either way, British troops were largely immune to smallpox, as a single infection confers a lifetime of protection.

Meanwhile, the Continental Army was largely composed of men from rural areas, where smallpox was much less common. So, a large percentage of the troops lacked immunity to the virus, and generals were initially reluctant to inoculate them, fearing both the ensuing sickness – which would sideline troops – and potential larger outbreaks that could follow.

However, on the heels of an outbreak during the Canadian invasion and others among colonial troops, George Washington made a bold decision in 1777: he ordered systematic inoculation of the Continental Army.

This proved to be a tremendous logistical undertaking, with soldiers inoculated in controlled waves during winter encampments, when troops were less active. Infected soldiers were isolated during recovery, then returned immune.

Inoculation effectively eliminated smallpox as a threat to American troops, ending outbreaks that had removed large numbers of soldiers from service at critical moments. Washington’s daring choice stabilized the Continental Army and allowed it to keep fighting the war that ultimately led to our independence.

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Bodywork: My sense of taste changed. Should I worry?

March 10, 2026 by maxwellc

Adam’s Journal

On the heels of my last bout of Covid, things that used to taste good tasted bad or, sometimes, like not much at all. I know that loss of taste is a side effect of Covid, but should I worry? Could this signal other health issues?

Dr. Scofield Prescribes

Covid is known to cause changes in taste, and they can linger even after other symptoms have resolved. These changes are known technically as ageusia (loss of taste) and dysgeusia (when foods taste distorted or unpleasant).

While you may think of the sensation as a loss of taste, what’s actually happening involves smell: Much of what we perceive as taste is actually aromas traveling into the nose, where we have about 400 different smell receptors. A 2024 study in the journal Science calculated that we can distinguish 1 trillion different smells.

However, upper respiratory infections – not only Covid, but also flu, colds and sinusitis – can disrupt these receptors. When this happens, foods can taste flat, muted or simply bad.

Happily, for most people, this disruption is only temporary, with normal smell and taste returning within weeks or months. In some, recovery can take longer.

If the issue persists, grows worse or is accompanied by other symptoms – especially neurological ones – you should discuss it with your physician. Although it seems highly unlikely in your situation, there is evidence that a loss of smell can be an early warning sign for dementia.

In a recent study, scientists followed 900 people with a gene called ApoE4, which carries an increased risk of Alzheimer’s, for a decade. They found these people experienced a more rapid decline in smell than those without the gene. (We all lose some ability to smell as we age.) And other studies have found that a loss of the sense of smell can precede many forms of dementia.

A change in or loss of smell or taste can also signal other diseases. Approximately 10% of patients with severe kidney disease will experience a severe or total loss of smell, and roughly half of all others will have smaller changes.

In rare cases, altered senses of taste and smell can even herald an undiagnosed cancer.

For you, I wouldn’t worry. With your recovery from Covid, I expect that – if it hasn’t already – your sense of taste will return to normal. Just give it time.

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