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H1N1 (Swine Flu): Causes, Symptoms, Treatment, and Prevention 

Introduction

H1N1, also known as swine flu, is a type of influenza A virus that was identified in humans in 2009. It emerged as a result of a mix of genes from flu viruses found in North American swine, North American birds, humans, and Eurasian swine¹.   

H1N1 causes respiratory illness by infecting the nose, throat, and sometimes the lungs. Its symptoms are similar to those of seasonal flu, which includes, fever, cough, sore throat, and body aches. In India, signidicant H1N1 outbreaks were recorded in 2009 and 2015, and the virus continues to circulate as a seasonal flu strain².   

The H1N1 infection can affect both the upper and lower respiratory tract. In severe cases, it may lead to complications such as viral pneumonia and acute respiratory distress syndrome (ARDS), particularly among vulnerable groups such as pregnant women, young children, the elderly, and individuals with compromised immune systems. 

Vaccines that offer protection against the H1N1 virus are widely available and are included in the annual influenza vaccine recommended by global and national health authorities. 

Understanding H1N1 causes, symptoms, treatment, and preventive measures is critical for managing future outbreaks and minimising health impacts. This article provides a comprehensive overview of H1N1 influenza to help increase awareness. 

What Is Swine Flu (H1N1)?

Swine flu, or H1N1 influenza, is a contagious viral infection caused by a subtype of the influenza A virus, primarily affecting the respiratory tract. The H1N1 virus originated from a mix of swine, bird, and human flu viruses and gained global attention during the 2009 pandemic³. 

It is important to note that, although it is called “swine flu,” the virus primarily spreads through inhaling contaminated air (either from an infected person or animal) and not through the consumption of properly cooked pork^3,4.  

Causes of Swine Flu (H1N1)

Swine flu (H1N1) is caused by the influenza A (H1N1) virus³.  

Infection occurs when the virus enters the body through the nose, mouth, or eyes. The most common sources of infection include: 

• Inhalation of respiratory droplets released when an infected person coughs, sneezes, or talks³. 
• Touching contaminated surfaces or objects and then touching the face (especially nose, mouth, or eyes)³. 

While the original H1N1 strain emerged from swine and was occasionally linked to close contact with infected pigs, the 2009 pandemic strain has since adapted to human transmission. In most incidences, it is not spread from pigs to humans. Instead, the virus primarily spreads through droplet transmission and fomite transmission, making person-to-person contact and surface hygiene key areas of prevention. 

Symptoms of Swine Flu (H1N1)

Swine influenza (H1N1) presents symptoms similar to seasonal influenza, ranging from mild to severe. Common H1N1 symptoms include³:

• Fever or chills  
• Sweating 
• Cough 
• Sore throat 
• Runny or stuffy nose 
• Appetite loss 
• Weight loss 
• Body aches or muscle pain 
• Headache 
• Fatigue or weakness 
• Shortness of breath (in some cases) 

Gastrointestinal H1N1 symptoms such as nausea, vomiting, or diarrhoea are more commonly observed in children⁶. 

Risk Factors

While swine influenza (H1N1) can affect anyone, certain individuals are at a higher risk. These risk factors include⁷: 

• Children under 5 years of age 
• Adults over 65 years of age 
• Pregnant women 
• People with chronic health conditions, such as: 
• Asthma 
• Diabetes 
• Heart disease 
• Chronic lung diseases (such as COPD and interstitial lung disease) 
• Individuals with weakened immune systems (e.g., due to cancer, HIV/AIDS, or immunosuppressive therapy) 
• Obese individuals 
• Residents of nursing homes or long-term care facilities 

How Is Swine Flu (H1N1) Diagnosed?

Swine flu (H1N1) is diagnosed by detecting the presence of the H1N1 virus in respiratory specimens that are typically collected using nasopharyngeal swabs, nasal swabs, or nasal aspirates, depending on the type of diagnostic test being used. Throat swabs, while sometimes collected, are generally less sensitive and not preferred for molecular testing methods such as RT-PCR, which is commonly used for confirming H1N1 infection. Early and accurate diagnosis helps guide H1N1 treatment and prevent complications.  

Common diagnostic methods include⁸: 

• Rapid influenza diagnostic tests (RIDTs): Provide quick results by detecting viral antigens, but have limited sensitivity, often ranging from 50–70%, especially in adults and outside peak flu season. RIDTs usually cannot distinguish between influenza types or subtypes (e.g., H1N1 vs. H3N2).  
• Reverse transcription polymerase chain reaction (RT-PCR): Highly accurate and considered the gold standard. It detects the virus’s genetic material (RNA) and can specifically identify the H1N1 strain. 
• Viral culture: Confirms the presence of the virus by growing it in a laboratory. While reliable, it is time-consuming and mainly used for research or confirmation purposes. 

Complications of Swine Flu (H1N1)

While many cases of swine flu (H1N1) are mild, the infection can lead to serious complications, especially in high-risk individuals. These complications may require hospitalisation and can sometimes be life-threatening. Common complications include^3,9: 

• Pneumonia (viral or secondary bacterial) 
• Acute Respiratory Distress Syndrome  
• Otitis media (ear infection)  
• Sinusitis 
• Worsening of chronic medical conditions such as asthma, diabetes, or heart disease 
• Neurological complications, including: 
• Seizures (rare) 
• Encephalopathy 
• Encephalitis 
• Guillain-Barré syndrome 
• Transverse myelitis 
• Sepsis (a life-threatening response to infection) 
• Multi-organ failure (in severe cases) 

Treatment and Management

The H1N1 treatment focuses on reducing the severity of H1N1 symptoms, preventing complications, and stopping the spread of the H1N1 virus. Management strategies include: 

• Antiviral medications: Doctors commonly prescribe oseltamivir, zanamivir, and peramivir for symptom control^3,10.
  • Oseltamivir
  • Zanamivir 
  • Peramivir 
  • Baloxavir marboxil 

Note: They are most effective when started within 48 hours of symptom onset³. Zanamivir is inhaled and not recommended for patients with asthma or COPD due to the risk of bronchospasm. Peramivir is administered intravenously and is usually reserved for hospitalised patients or those unable to take oral medications.

• Supportive care: Adequate rest and hydration are necessary when recovering from swine flu. You may even use fever-reducing medications and other symptom-relieving H1N1 treatments, as needed under medical guidance³. 
• Monitoring for complications: Watch for signs of worsening symptoms such as difficulty breathing, persistent chest pain, or high fever.  

Prevention

Practicing essential H1N1 precautions, such as those mentioned below, can significantly reduce the risk of infection: 

• Annual flu vaccination: The seasonal flu vaccine includes protection against H1N1 and is recommended for everyone over 6 months of age³. 
• Frequent handwashing: Wash hands thoroughly with soap and water (for a minimum of 20 seconds) or use an alcohol-based hand sanitiser¹⁰. 
• Covering coughs and sneezes: Use a tissue (or elbow) to cover your mouth and nose when coughing or sneezing¹⁰. 
• Avoiding close contact with sick individuals/animals: Stay away from people or pigs showing flu-like symptoms^5,10. 
• Staying home when sick: Helps prevent the spread of the virus to others¹⁰. 
• Disinfecting frequently touched surfaces: Clean surfaces like doorknobs, phones, and countertops regularly¹¹. 
• Using a face mask (when necessary): Especially in crowded places or when taking care of someone with flu symptoms¹¹.
• Maintaining healthy habits: Support your immune system by getting enough sleep, staying physically active, managing stress, drinking plenty of fluids, and eating nutritious foods¹¹. 

Living with Swine Flu (H1N1)

If you are diagnosed with swine influenza (H1N1), it’s important to manage your symptoms at home while taking steps to prevent spreading the virus to others. Key guidelines for daily living while ill include: 

• Stay home and self-isolate when ill, preferably in a separate room, until at least 24 hours after the fever has resolved without the use of fever-reducing medications; immunocompromised individuals may require a longer isolation period as per health authority recommendations. 
• Monitor your symptoms daily and seek medical help if you experience worsening symptoms. 
• Get plenty of rest and drink fluids to stay hydrated and support recovery³. 
• Cover your mouth and nose when coughing or sneezing¹⁰. 
• Dispose of used tissues properly and wash hands frequently¹⁰.
• Wear a mask when around people to reduce the risk of transmission¹¹.
• Return to work/school only after you have fully recovered for at least 24 hours without medication¹¹. 

The Role of Vaccination in H1N1 Prevention

Vaccination is one of the most effective ways to prevent H1N1. 

Seasonal influenza vaccines, including quadrivalent vaccines (which also protect against both lineages of influenza B), are designed to provide immunity against the most common flu strains, including H1N1 and H3N2 (both subtypes of influenza A)¹². 

• The vaccine is recommended annually for everyone aged 6 months and older³. 
• It is especially important for high-risk groups such as young children, the elderly, pregnant women, and individuals with chronic medical conditions³.
• Vaccination helps reduce the risk of H1N1 infection, severe illness, hospitalisation, and complications; quadrivalent influenza vaccines protect against H1N1, H3N2 (influenza A subtypes), and two influenza B lineages, Victoria and Yamagata. 

Also Read: Viral Fever: Causes, Symptoms, and Treatment Options

When to See a Doctor

Most cases of swine flu (H1N1) are mild and can be managed at home. However, medical attention should be sought if you experience the following¹⁰: 

• Difficulty breathing or shortness of breath 
• Persistent chest pain or pressure 
• High fever (≥102°F or 39°C) lasting more than 3 days despite the use of antipyretics 
• Severe or worsening cough 
• Confusion or dizziness 
• Bluish lips or face 
• Symptoms that improve but return with worsening fever or cough 

Note: In children, watch for signs like fast breathing, irritability, poor feeding, or lack of responsiveness¹⁰. Additionally, pregnant women, the elderly, and people with underlying health conditions should consult a doctor early, even for mild symptoms.  

Conclusion

Swine flu (H1N1) remains a significant public health concern, particularly for vulnerable populations. The H1N1 (pdm09) strain, which caused the 2009 pandemic, is now part of regular seasonal influenza circulation and no longer classified as a separate pandemic strain. Awareness of symptoms, early detection, and timely medical treatment are essential to reducing the severity and spread of the infection. Annual vaccination remains the most effective preventive measure.  

In addition, following basic H1N1 precautions, such as maintaining hand hygiene, using masks, and avoiding close contact with those who are ill can reduce transmission. Public health campaigns also play a vital role in reinforcing these preventive measures, especially during flu season and among high-risk groups. 

Frequently Asked Questions (FAQs)

References

1. World Health Organization. Influenza A (H1N1) [Internet]. World Health Organization; [cited 2025 Jun 19]. Available from: https://www.who.int/emergencies/situations/influenza-a-(h1n1)-outbreak 

2. Kshatriya RM, Khara NV, Ganjiwale J, Lote SD, Patel SN, Paliwal RP. Lessons learnt from the Indian H1N1 (swine flu) epidemic: Predictors of outcome based on epidemiological and clinical profile. J Family Med Prim Care. 2018 Nov-Dec;7(6):1506-1509. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6293944/ 

3. Jilani TN, Jamil RT, Nguyen AD, Siddiqui AH. H1N1 Influenza [Internet]. StatPearls Publishing; [updated 2024 Mar 4; cited 2025 Jun 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513241/ 

4. Centers for Disease Control and Prevention (CDC). About Influenza in Swine [Internet]. CDC; [cited 2025 Jun 19]. Available from: https://www.cdc.gov/swine-flu/about/influenza-in-swine.html 

5. Centers for Disease Control and Prevention (CDC). What People Who Raise Pigs Need To Know About Influenza (Flu) [Internet]. CDC; [cited 2025 Jun 19]. Available from: https://www.cdc.gov/swine‑flu/media/pork‑producer‑fact‑sheet.pdf 

6. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016 Dec 7;355:i6258. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5141587/ 

7.  Coleman BL, Fadel SA, Fitzpatrick T, Thomas SM. Risk factors for serious outcomes associated with influenza illness in high- versus low- and middle-income countries: Systematic literature review and meta-analysis. Influenza Other Respir Viruses. 2018 Jan;12(1):22-29. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5818335/ 

8. R R, Dalal A, Mohan H, Prasad M, Pundir CS. Detection methods for influenza A H1N1 virus with special reference to biosensors: a review. Biosci Rep. 2020 Feb 28;40(2):BSR20193852. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7000365/ 

9. Gutierrez C, Nazar GA, Torres JP. Otolaryngological complications in patients infected with the influenza A (H1N1) virus. Otolaryngol Head Neck Surg. 2012 Mar;146(3):478-82. Available from: https://pubmed.ncbi.nlm.nih.gov/21998086/ 

10. Department of Health & Family Welfare, Government of Puducherry. Swine Influenza (A H1N1) [Internet]. Puducherry: Government of Puducherry; [cited 2025 Jun 19]. Available from: https://health.py.gov.in/swine-influenzaa-h1n1 

11. Centers for Disease Control and Prevention. Healthy Habits to Prevent Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/prevention/actions-prevent-flu.html 

12. Trombetta CM, Kistner O, Montomoli E, Viviani S, Marchi S. Influenza Viruses and Vaccines: The Role of Vaccine Effectiveness Studies for Evaluation of the Benefits of Influenza Vaccines. Vaccines (Basel). 2022 May 1;10(5):714. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9143275/ 

13. Centre for Food Safety, Hong Kong. When buying and handling pork: food safety advice during swine flu [Internet]. Hong Kong: CFS; [cited 2025 Jun 19]. Available from: https://www.cfs.gov.hk/english/faq/faq_16_Leaflet_on_swine_flu_html.html 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Influenza B: What is It, Causes, Symptoms, Treatment & Prevention 

Introduction

Influenza B is one of the primary types of influenza viruses responsible for seasonal flu outbreaks across the globe¹. Among the estimated 1 billion cases of influenza that occur annually, influenza B contributes significantly, more commonly in children and adolescents, however, it can affect all age groups^1,2. 

Although less prevalent than influenza A, influenza B virus can co-circulate with it and have varying global impact based on season and region³. Therefore, understanding what influenza B is, its symptoms and its management strategies is essential for effective prevention and treatment, especially during peak flu seasons. 

What Causes Influenza B?

Influenza B is caused by the influenza B virus, a member of the Orthomyxoviridae family⁴. This virus is divided into two genetically and antigenically distinct lineages⁴:  

• B/Victoria/2/87-like or the Victoria lineage⁴
• B/Yamagata/16/88-like or the Yamagata lineage (this lineage has not been detected since March 2020 and is expected to go extinct)^4,5 

The influenza B virus spreads easily from person to person through respiratory droplets released when an infected individual coughs or sneezes, making close contact a key factor in transmission. It can also spread by touching contaminated surfaces and then touching your face without washing your hands². 

While influenza B typically leads to mild to moderate respiratory illness, particularly in otherwise healthy children, it can sometimes result in more severe disease. This is especially true for individuals with underlying chronic medical conditions, weakened immune systems, or other health vulnerabilities. In rare cases, it can even be fatal⁴.

Influenza B Symptoms

Influenza B symptoms usually begin within 1 to 4 days after infection and can include^2,6: 

• Sudden onset of high fever 
• Dry, persistent cough (may last 2 weeks or more) 
• Headache 
• Muscle and joint pain 
• Severe fatigue or general feeling of unwellness (malaise) 
• Sore throat 
• Runny or congested nose 

Note: Children (especially those under 5 years of age) may experience vomiting, abdominal pain and diarrhoea. However, these symptoms are not prevalent in adults⁷. 

How Influenza B Differs from Types A and C

Influenza B differs from types A and C in several important ways, including its virus structure, who it primarily affects, and the severity of the illness it causes: 

Virus Strains: 

• Influenza A has many subtypes (e.g., H1N1, H3N2). 
• Influenza B has two main lineages (B/Victoria and B/Yamagata) 
• Influenza C has no subtypes or lineages³. 

Who It Affects: 

• Influenza A infects humans and animals. 
• Influenza B and C infect only humans⁸. 

Severity: 

• Influenza A usually causes more severe illness. 
• Influenza B tends to be milder but can still be serious. 
• Influenza C causes mild, cold-like symptoms². 

Outbreaks: 

• Influenza A (particularly certain strains like A(H1N1)) can cause seasonal epidemics and pandemics.  
• Influenza B causes seasonal flu but not pandemics. 
• Influenza C rarely causes outbreaks².

Who is At Higher Risk of Influenza B

While influenza B can affect anybody, certain groups are at a greater risk of complications. These include: 

• Young children (especially under 5 years): Their immune systems are still developing, making them more susceptible⁹. 
• Older adults (65 years and above): Aging weakens the immune system, reducing the body’s ability to fight off infections². 
• People with chronic conditions: Individuals with asthma, diabetes, heart disease, kidney problems, or lung disorders may face more severe illness^2,9. 
• Those with weakened immune systems: People undergoing treatments like chemotherapy or those living with conditions like HIV/AIDS are at greater risk⁹. 
• Pregnant women: Changes in the immune system during pregnancy increase the risk of flu-related complications^2,9. 
• Healthcare workers and caregivers: Due to frequent contact with infected individuals, they have a higher chance of exposure and transmission, although not a higher risk of complications as such².

Diagnosis of Influenza B

Diagnosing influenza B typically starts with a clinical evaluation, where doctors review the patient’s symptoms and medical history¹⁰. To confirm the infection, several diagnostic tests may be used but the common ones are: 

• Rapid influenza diagnostic tests (RIDTs): These detect flu virus antigens (proteins) from a nose or throat swab. They can easily be done using test kits and give quick results but are less accurate, especially for Influenza B. A negative result doesn’t always mean that you’re flu-free, so further testing may be needed if there is strong clinical suspicion^11,12. 
• Molecular-Based Tests: These tests detect the virus’s genetic material (RNA) and are more accurate than antigen-based tests. They can also distinguish between influenza A and B viruses. Tests like reverse transcription polymerase chain reaction (RT-PCR) are usually done in a laboratory and are considered the most reliable. Moreover, rapid molecular assays are also available that provide quick and accurate results^11,12.
• Viral Culture: The virus is grown in a laboratory for detailed study. Although this is a highly accurate test, due to its slow processing time, this is rarely used for immediate diagnosis¹⁰. 

Other laboratory tests include immunofluorescence and serological assays to detect virus-specific antigens/antibodies. However, molecular tests have largely replaced these now¹¹. 

Complications

High-risk individuals should be especially vigilant for influenza B complications such as¹³ 

• Pneumonia (viral or bacterial) 
• Sinus and ear infections 
• Myocarditis (heart inflammation) 
• Encephalitis (brain inflammation) 
• Myositis or rhabdomyolysis (muscle inflammation or breakdown) 
• Sepsis (a life-threatening response to infection) 
• Worsening of existing medical conditions 

Influenza B Treatment Options

Most cases of influenza B can be managed at home with supportive care, but antiviral medications may be recommended in some situations, especially for those at high risk of complications. Common influenza B treatment options include: 

1. Antiviral Medications

• Drugs such as the following can help reduce the severity and duration of influenza B symptoms, especially when started within 48 hours of symptom onset.  
  • Oseltamivir 
  • Zanamivir 
  • Peramivir 
  • Baloxavir marboxil 

These drugs are especially recommended for all hospitalised patients, those with severe or progressive illness, and high-risk individuals (e.g., elderly, pregnant women, people with chronic conditions, etc.), regardless of how long symptoms have been present^10,11,12. 

2. Rest

Adequate rest helps the body recover and conserve energy to fight the infection². 

3. Hydration

Drinking plenty of fluids prevents dehydration, especially if fever is present².

4. Over-the-Counter Pain Relievers

Fever and pain-relieving medications, when taken under medical supervision, can help relieve fever, headache, and body aches. Common mediactions include: 

• Acetaminophen (paracetamol)  
• Ibuprofen 
• Aspirin 

Note: Do not give aspirin to children as it has been associated with the risk of Reye’s Syndrome¹⁵. 

Prevention Tips

To protect yourself and those around you, it’s important to follow these effective prevention measures: 

• Get vaccinated annually: The flu vaccine (quadrivalent influenza vaccine offers broader protection by covering both lineages) is the most effective way to reduce your risk of influenza B infection and its complications^2,5. 
• Practice good hand hygiene: Wash your hands regularly with soap and water (for at least 20 seconds) or use an alcohol-based hand sanitiser. 
• Avoid close contact: Stay away from people who are sick, and if you’re unwell, keep your distance to prevent spreading the virus¹⁵. 
• Cover coughs and sneezes: Use a tissue (or your elbow) to cover your mouth and nose when coughing or sneezing. Wearing a mask will also help prevent the spread of infection¹⁵. 
• Clean and disinfect surfaces: Frequently clean high-touch surfaces like door handles, mobile phones, and countertops to lower the risk of contamination¹⁵.
• Maintain a healthy lifestyle: Support your immune system by getting enough sleep, eating a balanced diet, staying hydrated, managing stress, and staying physically active¹⁵.

Also Read: Everything To Know About the Influenza Vaccine & Its Importance 

When to See a Doctor

Most individuals recover from influenza B within 5 to 14 days, though symptoms like cough may persist for longer than 14 days^2,16.  

However, in some cases, symptoms may worsen or lead to serious complications. It’s important to consult a doctor immediately if you experience any of the following¹⁶: 

• Worsening of existing symptoms 
• Difficulty breathing or shortness of breath 
• Chest pain or pressure 
• Sudden dizziness, confusion, or disorientation 
• Persistent high fever that doesn’t improve 
• Bluish lips/face  
• Severe muscle pain, extreme weakness, or trouble walking 
• Little or no urine output 
• Flare-up of chronic health conditions (such as asthma or heart disease) 

Also Read: Influenza A: What is It, Causes, Symptoms, Treatment & Prevention

Conclusion

Understanding and effectively managing influenza B is crucial for reducing the spread of infection and minimising the risk of complications, especially among vulnerable groups like children, elderly, and those with weakened immune systems.  

While often milder than influenza A, influenza B can still lead to a serious illness. Timely diagnosis, appropriate influenza B virus treatment (such as antiviral therapy), preventive measures like vaccination, and awareness of warning signs, all play a vital role in controlling the impact of this seasonal virus. Thus, by staying informed and proactive, individuals and communities can better protect themselves and others during flu season.

Also Read: H1N1 (Swine Flu): Causes, Symptoms, Treatment, and Prevention 

Frequently Asked Questions (FAQs)

References

1. Ashraf MA, Raza MA, Amjad MN, Ud Din G, Yue L, Shen B, Chen L, Dong W, Xu H, Hu Y. A comprehensive review of influenza B virus, its biological and clinical aspects. Front Microbiol. 2024 Sep 4;15:1467029. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11408344/ 
2. World Health Organization. Influenza (seasonal) [Internet]. World Health Organization; [cited 2025 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) 
3. Centers for Disease Control and Prevention. Types of Influenza Viruses [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/about/viruses-types.html 
4. Bhat YR. Influenza B infections in children: A review. World J Clin Pediatr. 2020 Nov 19;9(3):44-52. Available from: https://pubmed.ncbi.nlm.nih.gov/33442534/ 
5. Paget J, Caini S, Del Riccio M, van Waarden W, Meijer A. Has influenza B/Yamagata become extinct and what implications might this have for quadrivalent influenza vaccines? Euro Surveill. 2022 Sep;27(39):2200753. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9524051/ 
6. Boktor SW, Hafner JW. Influenza. StatPearls [Internet]. StatPearls Publishing; 2025 Jan; Available from: https://www.ncbi.nlm.nih.gov/books/NBK459363/ 
7. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016 Dec 7;355:i6258. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5141587/ 
8. Liang Y. Pathogenicity and virulence of influenza. Virulence. 2023 Dec;14(1):2223057. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10283447/ 
9. Coleman BL, Fadel SA, Fitzpatrick T, Thomas SM. Risk factors for serious outcomes associated with influenza illness in high- versus low- and middle-income countries: Systematic literature review and meta-analysis. Influenza Other Respir Viruses. 2018 Jan;12(1):22-29. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5818335/ 
10. Gaitonde DY, Moore FC, Morgan MK. Influenza: Diagnosis and Treatment. Am Fam Physician. 2019 Dec 15;100(12):751-758. Available from: https://pubmed.ncbi.nlm.nih.gov/31845781/ 
11. Vemula SV, Zhao J, Liu J, Wang X, Biswas S, Hewlett I. Current Approaches for Diagnosis of Influenza Virus Infections in Humans. Viruses. 2016 Apr 12;8(4):96. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4848591/ 
12. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016 Dec 7;355:i6258. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5141587/ 
13. Moghadami M. A Narrative Review of Influenza: A Seasonal and Pandemic Disease. Iran J Med Sci. 2017 Jan;42(1):2-13. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5337761/ 
14. InformedHealth.org [Internet]. Cologne (Germany): Institute for Quality and Efficiency in Health Care (IQWiG). Overview: Influenza [updated 2022 Nov 22; cited 2025 Jun 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279459/ 
15. Centers for Disease Control and Prevention. Healthy Habits to Prevent Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/prevention/actions-prevent-flu.html 
16. Centers for Disease Control and Prevention. Signs and Symptoms of Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/signs-symptoms/index.html 
17. Saha S, Chadha M, Shu Y; Group of Asian Researchers on Influenza (GARI). Divergent seasonal patterns of influenza types A and B across latitude gradient in Tropical Asia. Influenza Other Respir Viruses. 2016 May;10(3):176-84. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4814861/ 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Pneumonia Diet: What to Eat & Avoid During Recovery 

Introduction

Good nutrition plays a crucial role in helping the body recover from any illness, and pneumonia is no exception^1,2. Studies^2,3,4 show that undernutrition in children can significantly increase the risk of contracting pneumonia and worsen its outcomes, as a weakened immune system makes them more vulnerable to respiratory infections. 

Pneumonia can spread through droplets, inhalation, or in newborns, through the bloodstream during or just after birth. Although it isn’t always contagious (as its spread depends on the cause), more research is needed to understand the transmission of pneumonia better². 

While precise numbers may vary, evidence consistently demonstrates that good nutrition can play a vital role in supporting pneumonia recovery⁵. In fact, targeted dietary interventions in malnourished older adults led to a 77% reduction in pneumonia-related hospital readmission, highlighting the importance of improved nutrition for recovery, immune function, and long-term management of pneumonia⁶. 

If you’ve been diagnosed with pneumonia, adhering to your prescribed treatment plan, which typically includes antibiotics (for bacterial pneumonia only), and respiratory support is essential for recovery⁷. While it is not the primary treatment, a balanced, nutrient-rich diet can help promote the healing process by strengthening your immune system^5,7. Additionally, monitoring your symptoms and maintaining good hygiene can help prevent the infection from spreading to others.  

Following a nutritionally supportive diet during pneumonia helps ensure your body receives all the essential nutrients needed to fight the infection and recover quickly. In this article, we’ll share valuable tips on what to avoid during pneumonia recovery to help support a faster, safer, and more complete healing process. 

How Diet Affects Pneumonia Recovery

A well-balanced nutritious diet plays a crucial role in recovering from pneumonia. When the body is fighting an infection, it needs extra nutrients to repair tissues, restore energy, and strengthen the immune system. A proper diet can support recovery from pneumonia by: 

• Strengthening the immune system⁸. 
• Promoting tissue repair and minimising muscle loss during illness^8,9. 
• Improving energy levels and providing the energy needed to combat fatigue^8,10. 
• Supporting lung health and healing (with certain anti-inflammatory foods like omega-3 fatty acids)^8,11. 

Foods to Eat During Pneumonia

A balanced diet for pneumonia patients plays a crucial role in speeding up recovery by providing essential nutrients. In individuals with pneumonia, diet that includes the following five types of foods is beneficial: 

• Fruits and Vegetables: Foods like oranges and apples and vegetables like spinach, carrots, and broccoli are rich in vitamins, antioxidants, and fibre and help boost immunity and fight infections^7,8,12. 
• Lean Proteins: Protein-rich foods for pneumonia, such as chicken, eggs, and legumes, help repair body tissues, support muscle strength, and help improve overall health^7,10,12.
• Whole Grains: Brown rice, oats, and whole wheat bread provide long-lasting energy and fibre to support digestive health^7,10,12. 
• Healthy Fats (Monounsaturated and Polyunsaturated Fats): Good fats such as olive oils, walnuts, and avocados support the body’s anti-inflammatory processes and help in cell repair^11,12. 
• Warm Fluids Like Soups, Broths, and Teas: Warm and easily digestible food for pneumonia, such as chicken soup or vegetable broth, herbal teas, and warm water with honey can soothe the throat, help in mucus clearance, and provide the much-needed energy^13,14,15,16. 

Foods to Avoid During Pneumonia

In patients with pneumonia, foods to avoid include certain food products that may increase mucus production. Here’s what to limit or avoid and why: 

• High-Sodium Foods: Processed meats, salty snacks, and canned soups might worsen respiratory distress in patients with compromised lung function due to fluid retention^12,17. 
• Saturated Fats: Fatty meats, butter, full-fat dairy, and fried foods may contribute to inflammation, which can further impair lung function and the immune system in individuals with pneumonia^12,18. 
• Added Sugars: Sugary beverages, desserts, and candy may suppress immune function and promote inflammation^12,18. 
• Highly Processed Foods: Fast food, instant noodles, and ready-made sauces often contain unhealthy fats, excess sodium, and preservatives that might impair recovery¹². 
• Alcohol: Alcohol may interfere with medications, weaken immunity, and slow healing. It’s best to avoid alcohol entirely during recovery¹².

Note: Some people report increased mucus production after consuming dairy, but scientific evidence on this is inconclusive. Thus, the focus should instead be on avoiding foods that may impair immunity or promote inflammation. Always consult a doctor or a registered dietitian for personalised dietary advice, especially during illness. 

Sample Diet Chart for Pneumonia Recovery

The ideal diet for pneumonia patients includes warm fluids, soft foods, and meals high in vitamins A, C, and E to support lung health. You can follow the below-mentioned pneumonia diet chart to help with pneumonia recovery^7,12: 

Tip: Stay hydrated by consuming plenty of water throughout the day. 

Also Read: Walking Pneumonia: What Is It, Causes, Symptoms, Diagnosis & Treatment

Lifestyle Tips Alongside Diet

A pneumonia diet chart helps plan meals that are light, nutritious, and rich in essential vitamins to support better health. Along with dietary guidance, adopting a few lifestyle tips can further speed up the healing process: 

• Practice Deep Breathing: Perform several deep breathing exercises daily to help improve lung function. 
• Prioritise Rest and Sleep: Ensure you get ample sleep to allow your body to strengthen and repair your immune system. 
• Maintain Good Posture: Sit upright to enhance comfort and facilitate easier breathing. 
• Stay Hydrated: Drink plenty of fluids throughout the day to maintain good hydration, which is crucial for recovery. 
• Engage in Light Physical Activity: Gradually incorporate gentle movement into your routine to rebuild strength. However, avoid strenuous activity that causes dizziness or significant shortness of breath; consult your doctor for guidance on appropriate activity levels. 
• Avoid Smoking and Second-hand Smoke: Refrain from smoking and avoid exposure to second-hand smoke (inhaling smoke from being near people who are smoking), as both can worsen pneumonia. 
• Limit Alcohol and Illicit Drug Use: Steer clear of alcohol and illegal drugs, as they can compromise your immune system and increase the risk of complications¹². 

Also Read: Bacterial Pneumonia: What Is It, Causes, Symptoms & Treatment

Conclusion

Choosing the right diet for a pneumonia patient may help reduce inflammation and support lung function. Nutrient-rich foods that may support recovery include warm soups, fruits rich in vitamin C, and leafy green vegetables. Additionally, knowing which foods may hinder recovery or worsen inflammation can help prevent complications and promote faster healing.  

By providing essential nutrients, staying hydrated, getting adequate rest, and avoiding harmful substances like tobacco smoke and alcohol, you can support your immune system and significantly enhance your healing process. Also, staying up to date with vaccines, especially the pneumococcus vaccine and the flu vaccine, can help reduce the risk of developing pneumonia or experiencing severe complications.

Also Read: Pneumococcal Vaccine: Types, Side Effects, and Who Needs It

Frequently Asked Questions (FAQs)

References

1. World Health Organization. Healthy diet [Internet]. World Health Organization; [cited 2025 Jun 10]. Available from: https://www.who.int/initiatives/behealthy/healthy-diet 

2. World Health Organization. Pneumonia in children [Internet]. World Health Organization; 2022 Nov 11 [cited 2025 Jun 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/pneumonia 

3. Srivastava AD, Awasthi S, Jauhari S. Prevalence of persistent pneumonia among severe pneumonia and nutritional status as its associated risk factor: A prospective observational study among under-five children. J Family Med Prim Care. 2024 May;13(5):1911-1916. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11213408/ 

4. Prastika M, Astutik E. THE RELATIONSHIP BETWEEN MALNUTRITION AND SEVERE PNEUMONIA AMONG TODDLERS IN EAST JAVA, INDONESIA: AN ECOLOGICAL STUDY. Journal of Public Health Research and Community Health Development. 2023;6:93-101. Available from: https://www.researchgate.net/publication/369106207_THE_RELATIONSHIP_BETWEEN_MALNUTRITION_AND_SEVERE_PNEUMONIA_AMONG_TODDLERS_IN_EAST_JAVA_INDONESIA_AN_ECOLOGICAL_STUDY 

5. Vu TT, Van Horn L, Achenbach CJ, Rydland KJ, Cornelis MC. Diet and Respiratory Infections: Specific or Generalized Associations? Nutrients. 2022 Mar 11;14(6):1195. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8954090/ 

6. Yang PH, Lin MC, Liu YY, Lee CL, Chang NJ. Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial. Int J Environ Res Public Health. 2019 Nov 27;16(23):4758. Available from : https://pmc.ncbi.nlm.nih.gov/articles/PMC6926802/ 

7. National Heart, Lung, and Blood Institute. Pneumonia Recovery [Internet]. National Heart, Lung, and Blood Institute; [cited 2025 Jun 10]. Available from: https://www.nhlbi.nih.gov/health/pneumonia/recovery 

8. Office of Dietary Supplements. Dietary Supplements for Immune Function and Infectious Diseases – Health Professional Fact Sheet [Internet]. National Institutes of Health; [cited 2025 Jun 10]. Available from: https://ods.od.nih.gov/factsheets/ImmuneFunction-HealthProfessional/ 

9. Katagiri R, Yamaji T, Sawada N, Iwasaki M, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group. Total, animal, and plant protein intake and pneumonia mortality in the Japan Public Health Center-based Prospective Study. Am J Clin Nutr. 2022 Mar 4;115(3):781-789. Available from: https://pubmed.ncbi.nlm.nih.gov/34918031/ 

10. Masters B, Aarabi S, Sidhwa F, Wood F. High-carbohydrate, high-protein, low-fat versus low-carbohydrate, high-protein, high-fat enteral feeds for burns. Cochrane Database Syst Rev. 2012 Jan 18;1(1):CD006122. Available from: https://pubmed.ncbi.nlm.nih.gov/22258965/ 

11. Alperovich M, Neuman MI, Willett WC, Curhan GC. Fatty acid intake and the risk of community-acquired pneumonia in U.S. women. Nutrition. 2007 Mar;23(3):196-202. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2293281/ 

12. National Heart, Lung, and Blood Institute. Heart-Healthy Living – Choose Heart-Healthy Foods [Internet]. National Heart, Lung, and Blood Institute; 2022 Mar 24 [cited 2025 Jun 10]. Available from: https://www.nhlbi.nih.gov/health/heart-healthy-living/healthy-foods 

13. Rennard BO, Ertl RF, Gossman GL, Robbins RA, Rennard SI. Chicken soup inhibits neutrophil chemotaxis in vitro. Chest. 2000 Oct;118(4):1150-7. Available from: https://pubmed.ncbi.nlm.nih.gov/11035691/ 

14. PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. Selected Vegetables/Sun’s Soup (PDQ®): Health Professional Version. 2018 Aug 24. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. [cited 2025 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65862/ 

15. Abuelgasim H, Albury C, Lee J. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evid Based Med. 2021 Apr;26(2):57-64. Available from: https://ebm.bmj.com/lookup/pmidlookup?view=long&pmid=32817011 

16. Hacioglu M, Dosler S, Birteksoz Tan AS, Otuk G. Antimicrobial activities of widely consumed herbal teas, alone or in combination with antibiotics: an in vitro study. PeerJ. 2017 Jul 26;5:e3467. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5533155/ 

17. Brown RB. Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19. Medicina (Kaunas). 2021 Jul 22;57(8):739. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8399536/ 

18. Kiecolt-Glaser JK. Stress, food, and inflammation: psychoneuroimmunology and nutrition at the cutting edge. Psychosom Med. 2010 May;72(4):365-9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2868080/ 

19. Hooper L, Abdelhamid A, Ajabnoor SM, et al. Effects of fluid and drinking on pneumonia mortality in older adults: A systematic review and meta-analysis. Clin Nutr ESPEN. 2022 Feb;47:96-105. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8631606/ 

20. Padhani ZA, Moazzam Z, Ashraf A, et al. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database Syst Rev. 2020 Apr 27;4(4):CD013134. doi: 10.1002/14651858.CD013134.pub2. Update in: Cochrane Database Syst Rev. 2021 Nov 18;11:CD013134. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7192369/ 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

3

What is Hepatitis A? Causes, Symptoms, and How It Spreads 

Introduction 

Hepatitis A is a viral disease that affects the liver¹. It is a significant health concern globally, including in India, where its prevalence has been reported to range between 2.1% and 52.5%². 

Hepatitis A is caused by infection with the hepatitis A virus (HAV), which is usually spread through the faecal-oral pathway. Although common in children, with improved sanitation conditions in some parts of India, fewer kids are now getting exposed to hepatitis A at an early stage, making teens and adults more vulnerable to this infection³.   

Hepatitis A disease can range from a mild illness with few or no symptoms to severe cases in some. It is more commonly seen in low- and middle-income countries, such as sub-Saharan Africa, South Asia, Asia, Latin America, Eastern Europe, and the Middle East^1,4. 

In this article, we will understand what hepatitis A is, its symptoms, transmission, management, and prevention. 

What is Hepatitis A?

Hepatitis A is a viral infection that causes inflammation of the liver. Unlike other types of hepatitis (B and C), which may cause chronic disease, cirrhosis, or even hepatocellular carcinoma, hepatitis A does not lead to long-term (chronic) infections. However, hepatitis A infection can still present with mild symptoms to severe illness. In rare situations, it can even lead to acute liver failure (more likely in the elderly with underlying health conditions)⁴. 

It is important to note that there a change in the susceptibility trend of this infection with improving hygiene conditions across the country, affecting more of older children and adults, who often experience severe illness³. 

Causes of Hepatitis A

Is hepatitis A viral disease?  

Yes, hepatitis A is caused by a hepatotropic virus, meaning it mainly targets the liver cells (hepatocytes). It is a small, spherical, non-enveloped virus which is roughly 27 to 32 nanometres in diameter. It contains single-stranded RNA as its genetic material, along with specialised structures that enable it to infect liver cells and replicate within them⁴. 

How Hepatitis A Spreads  

Wondering how is hepatitis A spread? Let us see! 

Hepatitis A is mainly spread through: 

• Faecal-oral route: The most common mode of transmission; occurs when a person consumes food contaminated with faeces (stool) from an infected individual⁵. 
• Close physical contact: The virus can spread through activities like oral-anal sex with an infected person or through close personal care of an infected person^1,4. 
• Poor hygiene during food handling: In households, this often happens when an infected person prepares food without proper handwashing¹. 
• Contaminated water: Waterborne outbreaks (more common in areas with inadequate snatitation) can occur due to sewage-contaminated or improperly treated drinking water¹. 

Note: Everyday interactions or casual contact with an infected person usually do not transmit the virus⁵. 

Signs and Symptoms of Hepatitis A

Hepatitis A infection can lead to a wide spectrum of symptoms, ranging from very mild to quite severe. However, many cases (particularly among children) may have no signs and symptoms of hepatitis A. 

When symptoms do occur, they typically appear 2 to 6 weeks after you have been exposed to the HAV and can include^1,4,5:

• Fatigue 
• Fever 
• Loss of appetite 
• Nausea and vomiting 
• Abdominal pain (especially near the liver) 
• Dark urine (due to reduced bile flow or inability to process bilirubin)  
• Pale stools  
• Jaundice (yellowing of the skin and eyes) 

Recognising the early signs and symptoms of hepatitis A can help in timely diagnosis and treatment. 

At-Risk Groups for Hepatitis A

Certain groups of people are more likely to get infected with hepatitis A or to experience more severe illness. These include: 

• International Travellers: People travelling from low-risk areas to countries where hepatitis A is more common are at high risk, especially if unvaccinated¹. 
• Men Who Have Sex with Men (MSM): HAV can spread through close physical contact, and several outbreaks have occurred in this group due to sexual transmission⁴. 
• People Who Use Drugs: Both injecting and non-injecting drug users are at higher risk due to poor hygiene, shared equipment, and contaminated environments⁶. 
• Individuals Experiencing Homelessness: Limited access to clean water, sanitation, and healthcare increases the risk of infection and severe outcomes⁶. 
• Individuals Living in Close Contact with Infected People: Includes those who live with or care for someone who has hepatitis A, or care for a child recently adopted from a country where the infection is common⁷. 
• People with Chronic Liver Diseases: Those with hepatitis B or C, alcoholic liver disease, or HIV may experience more severe illness or liver failure if infected with HAV⁶. 

Diagnosis and Tests for Hepatitis A

Hepatitis A diagnosis cannot be based on symptoms alone, as it looks similar to other types of viral hepatitis. Laboratory testing methods (mentioned below) are essential for accurate hepatitis A diagnosis: 

• Anti-HAV IgM Test: This is the main test used to detect acute infection. IgM antibodies appear just before the start of symptoms (about 5 to 10 days before) and remain high for about a month. They typically disappear within six months. However, false positives can occur (especially after recent vaccination), so the test should be used only when there is a strong clinical suspicion⁶. 
• Anti-HAV IgG Test: These antibodies appear shortly after IgM and stay in the body for life. Their presence means the person has had a past infection or has been vaccinated⁶. 
• HAV RNA Tests (Nucleic Acid Amplification Tests): These are not commonly used but can detect the virus’s genetic material in blood or stool. They are helpful in confirming infection and tracing the source during outbreaks⁶.
• Liver function tests (LFTs): These are commonly used to assess suspected hepatitis. Elevated levels of alanine transaminase (ALT) and bilirubin, in particular, support the diagnosis and help assess the severity of infection⁸. 

Complications of Hepatitis A

“Is hepatitis A dangerous”? The answer to this is yes, for some it can be dangerous. While hepatitis A is usually self-limiting, it can occasionally cause serious liver complications, particularly in certain high-risk groups.  

Possible hepatitis A complications include: 

• Relapsing hepatitis: Some individuals (occurs in around 10% patients) may feel better, and then experience a return of symptoms (milder than initial illness) after sometime (usually within 6 months)^4,9.  
• Cholestatic hepatitis: A rare condition (occurs in less than 5% patients) where jaundice and itching persist for an extended period (lasts upto 3 months) due to bile duct injury and resolves without any chronic liver damage^4,9. 
• Fulminant hepatitis: A very rare but severe hepatitis A complication leading to sudden liver failure, which can be life-threatening (more likely in elderly patients or those with chronic liver disease)⁴. 
• Death: Rare, but can occur, particularly in people with other liver conditions⁴. 

Thus, understanding when and how hepatitis A is dangerous emphasises the importance of prevention and timely medical care in managing this infection. 

Treatment and Management Options for Hepatitis A

Many people ask, can hepatitis A be cured? The answer is yes; most people recover fully without needing specific antiviral treatment⁵.  

Key aspects in managing hepatitis A infection include: 

• Rest: Fatigue is common, so adequate rest helps the body recover¹. 
• Hydration: Drinking plenty of fluids is important to prevent dehydration, especially if nausea, vomiting, or diarrhoea is present^3,5. 
• Nutrition: Eating light, balanced meals can support healing, even if appetite is reduced¹⁰.
• Supplementation: Supplementation with vitamins such as the following may be beneficial in restoring immune function in patients recovering from viral hepatitis A¹¹. 
  • Vitamin C  
  • B-complex (including B3, B6, and B12)  
• Avoiding painkillers: Medications such as paracetamol (if taken in high doses) can damage the liver further and should be avoided during recovery. Thus, take any pain medications only under medical supervision¹. 
• Regular checkups: Monitoring liver enzymes and bilirubin levels regularly can help indiviuals with symptomatic or prolonged liver illness. 

Note: The typical hepatitis A recovery time can last a few months, although most people begin to feel better within a few weeks¹. The good news is that while the hepatitis A recovery time varies, most individuals fully recover without any long-term liver damage. 

How to Prevent Hepatitis A

Understanding how to prevent hepatitis A can help reduce the spread of the virus in communities, these include: 

• Vaccination: It is the most effective way to protect against hepatitis A. It’s recommended for children, travellers to high-risk areas, and high-risk groups (mentioned above)¹².  
• Safe food and water: Avoid raw or undercooked food and drink only clean or bottled water, especially when travelling⁴. 
• Hand hygiene: Wash hands thoroughly with soap and water after using the toilet, changing diapers, and before preparing or eating food¹. 
• Improved sanitation: Access to clean water and proper sewage systems reduces the risk of outbreaks.¹ 
• Protection during sex: Use condoms and dental dams, especially during oral-anal contact. Additionally, post-exposure prophylaxis with the hepatitis A vaccine or immunoglobulin is recommended for individuals who have had close contact with a confirmed case^1,4. 

Note: Public health campaigns that focus on the prevention of hepatitis A through awareness and immunisation can also be a good strategy. 

When to See a Doctor

You should seek medical attention if you experience any symptoms suggestive of hepatitis A, especially^4,7: 

• Jaundice 
• Dark-coloured urine or pale stools 
• Persistent fatigue or weakness 
• Severe abdominal pain  
• Severe itching or rash 

Note: Symptoms like confusion, drowsiness, or changes in mental status could indicate serious liver complications such as hepatic encephalopathy or liver failure, which are considered as emergency and require immediate medical attention. 

Conclusion

Hepatitis A is an avoidable viral infection that is usually self-limiting and resolves without long-term complications. Awareness of how hepatitis A is spread can reduce the risk since it typically occurs through the ingestion of contaminated substances. Additionally, timely diagnosis and supportive care are essential for managing symptoms and avoiding severe outcomes. Since hepatitis A doesn’t cause long-term infection, the answer to “Can hepatitis A be cured” is reassuring; yes, most people recover completely! 

Rare complications such as fulminant hepatitis might still occur (especially in older adults or those with chronic liver disease). This make vaccination the most effective method for the prevention of hepatitis A, complemented by good hygiene practices and safe food and water consumption. Maintaining these preventive measures along with monitoring complications and identifying high-risk groups is crucial to reduce the spread of infection and safeguard public health. 

Also Read: Everything You Need to Know About the Hepatitis A Vaccine

Frequently Asked Questions (FAQs)

References

1. World Health Organization. Hepatitis A [Internet]. World Health Organization; [cited 2025 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-a 

2. Kumar D, Peter RM, Joseph A, Kosalram K, Kaur H. Prevalence of viral hepatitis infection in India: A systematic review and meta-analysis. J Educ Health Promot. 2023 Mar 31;12:103. Available from: https://pubmed.ncbi.nlm.nih.gov/37288405/ 

3. Mathur P, Arora N. Epidemiological transition of Hepatitis A in India: Issues for vaccination in developing countries. Indian J Med Res. 2009;128:699–704. Available from: https://www.researchgate.net/publication/24044039_Epidemiological_transition_of_Hepatitis_A_in_India_Issues_for_vaccination_in_developing_countries 

4. Girish V, Grant LM, John S. Hepatitis A [Internet]. StatPearls Publishing; [cited 2025 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459290/ 

5. World Health Organization. Hepatitis A [Internet]. World Health Organization India; [cited 2025 May 28]. Available from: https://cdn.who.int/media/docs/default-source/searo/india/health-topic-pdf/factsheet-a-hepatitisday2016.pdf?sfvrsn=e6953225_2 

6. Migueres M, Lhomme S, Izopet J. Hepatitis A: Epidemiology, High-Risk Groups, Prevention and Research on Antiviral Treatment. Viruses. 2021 Sep 22;13(10):1900. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8540458/ 

7. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Hepatitis A [Internet]. National Institutes of Health; [cited 2025 May 28]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a 

8. Lala V, Zubair M, Minter DA. Liver Function Tests [Internet]. StatPearls Publishing. 2025 Jan; [updated 2023 Jul 30; cited 2025 Jun 9]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482489/ 

9. Lai M, Chopra S. Hepatitis A virus infection in adults: epidemiology, clinical manifestations, and diagnosis. UpToDate [Internet]. Waltham, MA: UpToDate; 2024 Dec 12 [cited 2025 Jun 5]. Available from: https://www.uptodate.com/contents/hepatitis-a-virus-infection-in-adults-epidemiology-clinical-manifestations-and-diagnosis 

10. Centers for Disease Control and Prevention. Clinical Care of Hepatitis A [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/hepatitis-a/hcp/clinical-care/index.html 

11. Centers for Disease Control and Prevention. Hepatitis A Prevention and Control [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/hepatitis-a/prevention/index.html 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Influenza A: What is It, Causes, Symptoms, Treatment & Prevention

Introduction

Each year, influenza affects an estimated one billion people worldwide, with 3 to 5 million cases resulting in severe illness and between 290,000 and 650,000 deaths due to respiratory complications (World Health Organization, 2023)¹.  

Influenza is primarily classified into four types (A, B, C, and D). Among them, some influenza A viruses are highly contagious and cause acute respiratory illness, spreading rapidly through populations, particularly during seasonal outbreaks². 

Therefore, understanding the scale, transmission dynamics, and subtypes of influenza A is essential, as it is the only type of influenza virus known to cause global pandemics. This article will explore the influenza A symptoms in adults as well as children, setting the stage for further discussion on its diagnosis, treatment, and prevention strategies. 

Causes of Influenza A

Influenza type A is caused by the influenza A virus, which is a single-stranded RNA virus. It infects the cells lining the respiratory tract and triggers an immune response that leads to the flu².  

Influenza A viruses are classified into subtypes based on the combination of their proteins (hemagglutinin [HA] and neuraminidase [NA]). Currently, the two main influenza A subtypes circulating in humans are A(H1N1) and A(H3N2)^1,2. 

Influenza A is highly contagious. This virus primarily spreads through respiratory droplets released during coughing, sneezing, or talking, and can also be transmitted by touching surfaces that already have been exposed to the virus. One of the key reasons influenza A is so widespread and potentially severe is its ability to undergo frequent genetic changes³: 

• Antigenic drift refers to small and gradual changes in the virus’s surface proteins, allowing it to escape the immune system of humans and cause seasonal outbreaks.  
• Antigenic shift refers to an abrupt and major genetic change that can lead to new viral subtypes with pandemic potential³. 

Common Symptoms of Influenza A

Influenza A typically presents with a sudden onset of symptoms, often making individuals feel acutely unwell within a short period. The most common influenza A symptoms in adults and children include⁴: 

• Chills (during early stage) 
• Sweating 
• High fever 
• Muscle aches (myalgia) 
• Headache 
• Extreme tiredness  
• Dry cough 
• Sore throat 
• Nasal congestion or a runny nose 
• Chest discomfort/shortness of breath (in severe cases) 

In addition to these respiratory symptoms, gastrointestinal symptoms such as nausea, vomiting, and diarrhoea may also occur, especially in children, though they are not always present⁴. 

Note: Although often confused with the common cold, influenza (flu) is generally more severe and comes on more suddenly⁵. Therefore, accurate diagnosis is important for proper management. 

Risk Factors for Influenza A

Certain groups of people are more likely to develop serious complications from influenza A. These include: 

• Older adults (65 years and above): Their immune systems might make it harder to fight off infections¹. 
• Young children (especially under 5 years): Their immune systems are still developing⁶. 
• Pregnant women: Pregnancy can alter the immune system, making expectant mothers more vulnerable to flu-related complications⁶.
• Other illnesses: People with chronic health conditions, such as asthma, diabetes, heart disease, kidney disease, or lung disorders that may experience more severe complications¹. 
• Individuals with weakened immune systems: They may not be able to fight the virus effectively (such as those undergoing chemotherapy or living with HIV/AIDS)⁶.
• Healthcare workers and caregivers: They experience a risk of frequent exposure to sick individuals¹. 

The influenza vaccine shot can easily be taken in the arm, unlike other injections, that typically need to be taken in the buttock region¹².

Dr. Nayana Shetty, MBBS, MD

How Is Influenza A Diagnosed?

The initial diagnosis of influenza A usually begins with a clinical evaluation, where doctors assess the patient’s symptoms and medical history⁷. 

To confirm influenza A, the following diagnostic tests may be used: 

• Rapid Influenza Diagnostic Tests (RIDTs): Detect flu antigens from a nasal or throat swab but have low to moderate sensitivity, especially in adults, increasing the risk of false negatives if done later in the illness⁸.
• Rapid Molecular Assays: These nucleic acid amplification tests (NAATs) detect influenza viral RNA with higher sensitivity and specificity than RIDTs, delivering results faster⁴. 
• Reverse Transcription Polymerase Chain Reaction (RT-PCR): A highly accurate test that can identify and differentiate flu types. It is often used in hospitals but may take a few hours to process⁸. 
• Viral Culture: Grows the virus in a lab for detailed analysis. This test is slow and not used for immediate diagnosis⁷. 

Note: If you test influenza A positive, it means the virus has been detected in your body, and you may need rest, supportive care, or antiviral medications depending on symptom severity. 

Treatment Options for Influenza A

Most healthy people with mild flu symptoms recover with rest, fluids, and fever-reducing medicines. However, treatment may be necessary if influenza A symptoms in adults (and children) worsen or do not improve. 

1. Antiviral Medications

• Common antivirals such as the following may help reduce the duration (or severity) of symptoms (if started within 24 to 48 hours of symptom onset) and under medical supervision⁸. 
  • Oseltamivir 
  • Zanamivir 
  • Peramivir 
  • Baloxavir marboxil 

Note: They are usually not needed for mild cases in healthy people⁷. However, patients with mild cases in high-risk group (e.g., elderly, pregnant, chronic illness) may warrant antivirals. 

2. Supportive Care 

• Adequate rest and hydration are helpful¹. 
• Fever and pain-relieving medications such as the following can be taken: 
  • Acetaminophen (paracetamol) 
  • Ibuprofen  
  • Aspirin

Note: Aspirin should be avoided in children due to the risk of Reye’s syndrome⁹. It’s ideal to consult a doctor before. 

• Watching out for warning signs, such as trouble breathing or a high, persistent fever, is important. 

Preventing Influenza A

Being influenza A positive indicates an active infection that can be contagious, so isolation and proper hygiene are important to prevent spreading the virus to others. Here are effective ways to protect yourself and others: 

• Get the Flu Vaccine: Annual vaccination is the best way to safeguard yourself against influenza A infection and its complications¹. 
• Practice Good Hand Hygiene: Wash hands frequently with soap and water or use alcohol-based hand sanitiser. Also, avoid touching your eyes, nose, or mouth, as germs can enter your body this way^1,9. 
• Avoid Close Contact: Try to stay away from people who are sick. Also, if you are sick, keep your distance from others to protect them from getting infected. Physical distancing lowers the risk of spreading respiratory viruses^1,9. 
• Cover Your Mouth/Nose: Make sure to cover your mouth and nose with a tissue when coughing or sneezing to avoid spreading the infection. Also, wearing a mask can further reduce virus spread by blocking infectious droplets, protecting both you and others^1,9. 
• Clean Regularly: Regularly clean commonly touched surfaces like doorknobs, countertops, handrails, and phones to reduce the chance of virus transmission⁹. 
• Improve Air Quality: Increase ventilation by bringing in fresh outdoor air, using air purifiers, or spending time outdoors to reduce airborne virus particles⁹. 
• Maintain Healthy Habits: Support your immune system by getting enough sleep, staying physically active, managing stress, drinking plenty of fluids, and eating nutritious foods⁹. 

Since the influenza virus tends to change and evolve each year, a new batch of vaccines is produced each year. Thus, each year when the vaccine is given, it actually protects against the virus currently spreading infection. It is like a new virus vaccine each year¹¹.

Dr. Nayana Shetty, MBBS, MD

Also Read: Everything To Know About the Influenza Vaccine & Its Importance 

When to See a Doctor

While most people recover from influenza type A within a few days to two weeks, it’s important to seek medical care if symptoms worsen or new complications arise. You should see a doctor as soon as possible if you experience¹⁰: 

• Trouble breathing  
• Chest pain or pressure 
• Sudden dizziness or confusion 
• High fever (≥39°C or 102.2°F) (persisting for more than 3 days or not responding to medication) 
• Bluish lips or face 
• Severe muscle pain, weakness, or difficulty walking 
• Seizures 
• Decreased or no urine output 
• Worsening of chronic conditions (such as asthma) 

Note: If you observe that your symptoms improve for a while but then return with fever and worse cough, it may indicate a secondary bacterial infection. Therefore, it is very important to contact a doctor in such cases. 

High-risk individuals should be especially vigilant and contact a doctor early. Complications to watch for in influenza type A include³: 

• Pneumonia (viral or bacterial) 
• Sinus and ear infections 
• Myocarditis (heart muscle inflammation)  
• Encephalitis (brain inflammation) 
• Myositis or rhabdomyolysis (muscle inflammation or breakdown with severe pain, and risk of kidney damage)  
• Sepsis (a life-threatening response to infection) 
• Worsening of existing medical conditions 

Also Read: What is Influenza (Flu) & Its Types

Conclusion

Understanding and effectively managing influenza A is vital to reducing its impact on individuals and communities. While many cases are mild, the flu can lead to serious complications, especially in high-risk groups. Therefore, timely diagnosis, appropriate treatment, and preventive measures like vaccination, hand hygiene, and staying home when sick can help avoid the spread of the virus significantly.  

Additionally, raising awareness about symptoms, risk factors, and when to seek medical help empowers people to take proactive steps, ensures better health outcomes, and avoids severe illness or death from flu-related complications.

Also Read: H1N1 (Swine Flu): Causes, Symptoms, Treatment, and Prevention 

Frequently Asked Questions (FAQs)

References

1. World Health Organization. Influenza – India [Internet]. World Health Organization; [cited 2025 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) 
2. Belshan MA, Knoop FC, Huggett KN. Influenza A. Reference Module in Biomedical Sciences. 2014:B978-0-12-801238-3.05048-0. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7157457/ 
3. Moghadami M. A Narrative Review of Influenza: A Seasonal and Pandemic Disease. Iran J Med Sci. 2017 Jan;42(1):2-13. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5337761/ 
4. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016 Dec 7;355:i6258. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5141587/ 
5. Centers for Disease Control and Prevention. Cold Versus Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/about/coldflu.html 
6. Coleman BL, Fadel SA, Fitzpatrick T, Thomas SM. Risk factors for serious outcomes associated with influenza illness in high- versus low- and middle-income countries: Systematic literature review and meta-analysis. Influenza Other Respir Viruses. 2018 Jan;12(1):22-29. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5818335/ 
7. Gaitonde DY, Moore FC, Morgan MK. Influenza: Diagnosis and Treatment. Am Fam Physician. 2019 Dec 15;100(12):751-758. Available from: https://pubmed.ncbi.nlm.nih.gov/31845781/ 
8. Vemula SV, Zhao J, Liu J, Wang X, Biswas S, Hewlett I. Current Approaches for Diagnosis of Influenza Virus Infections in Humans. Viruses. 2016 Apr 12;8(4):96. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4848591/ 
9. Centers for Disease Control and Prevention. Healthy Habits to Prevent Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/prevention/actions-prevent-flu.html 
10. Centers for Disease Control and Prevention. Signs and Symptoms of Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/signs-symptoms/index.htm 
11. Mäkelä MJ, Puhakka T, Ruuskanen O, Leinonen M, Saikku P, Kimpimäki M, Blomqvist S, Hyypiä T, Arstila P. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol. 1998 Feb;36(2):539-42. doi: 10.1128/JCM.36.2.539-542.1998. PMID: 9466772; PMCID: PMC104573. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC104573/
12. Panda M. Current Status of Influenza Infection in Pediatric Age-group: Special Focus on Indian Scenario. Available from: https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1451

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

What is Influenza (Flu) & Its Types

Introduction

Influenza, commonly called the flu, is an infectious disease that can lead to mild to severe illness, sometimes resulting in hospitalisation or even death¹.  

Influenza is caused by highly contagious viruses and can lead to seasonal outbreaks worldwide¹. According to the National Centre for Disease Control, India recorded 76,030 cases and 2,172 deaths (2019 to April 2025) from Seasonal Influenza A, with significant outbreaks in 2019 and 2024².  

This article explores what influenza is, its types, its transmission, diagnosis, treatment, and prevention. 

What is Influenza?

Influenza is a common respiratory infection caused by influenza viruses that include types A, B, C, and D, however, types A and B are primarily responsible for seasonal epidemics in humans. These viruses infect both the upper and lower parts of the respiratory system and primarily spread through respiratory droplets when an infected person coughs, sneezes, or talks, but can also be transmitted via surfaces that have already been contaminated³.  

While healthy individuals usually recover within a few days, influenza can lead to serious complications (such as pneumonia and even death) in high-risk groups like young children, the elderly, pregnant women, and those with weakened immune systems^1,3.  

Note: People with the flu are usually contagious 1 day before symptoms appear and remain so for 5 to 7 days after. 

What is the Difference Between Influenza and Common Cold?

Influenza (flu) and the common cold are respiratory infections caused by different viruses, with the flu typically producing more severe symptoms than the common cold. Let’s see the difference: 

• Onset: Influenza virus symptoms usually come on suddenly, while cold symptoms develop gradually^4,5. 
• Fever: A high fever is common with the flu, but rare with a cold^3,4. 
• Fatigue: The flu often causes significant fatigue and weakness, while the fatigue from a cold is typically mild^4,5. 
• Aches: Flu causes more intense body aches and headaches, unlike the mild discomfort seen with a cold⁶. 
• Cough: Both can cause coughing, but flu-related coughs are usually more severe and persistent⁶. 
• Complications: The flu can lead to serious complications like pneumonia, especially in high-risk groups⁶. Colds rarely result in severe health issues. 
• Duration: Cold symptoms often resolve within a few days, while the influenza virus symptoms can last one to two weeks or longer^3,5. 

The culprit for common cold is most often rhinoviruses²⁰.

Dr. Nayana S Shetty, MBBS, MD

Types of Influenza

There are four types of influenza viruses that affect humans to varying degrees: 

1. Influenza A

This type of influenza causes pandemics and epidemics: 

• Infects: Humans, birds, pigs, and other animals⁷ 
• Subtypes: Classified based on two proteins, hemagglutinin (H) and neuraminidase (N), such as, H1N1 and H3N2^8,9 
• Severity: Certain strains can cause the most severe illness⁷ 

2. Influenza B

This type of influenza causes seasonal outbreaks:  

• Infects: Humans⁷
• Lineages: Two major lineages, Victoria and Yamagata⁸
• Severity: Generally milder than A but can still cause significant illness^7,9

3. Influenza C

This causes mild respiratory illness: 

• Infects: Humans (occasionally pigs)⁷
• No subtypes or lineages^7,8 
• Severity: Usually causes mild symptoms like a cold; rarely causes epidemics⁹

4. Influenza D

This does not infect humans (currently): 

• Infects: Cattle and pigs⁷
• No subtypes or lineages^7,8 
• Severity: Not known to cause illness in humans, but should be monitored for possible crossover⁹

Here’s a quick comparison table to help you understand the key differences between the four types of influenza viruses^3,7,9.

Types of Influenza 

How Influenza Spreads

You may be wondering is influenza infectious?  

Yes, influenza is highly infectious. The virus mainly spreads through respiratory droplets expelled when an infected person coughs, sneezes, or talks. These droplets can land in the mouths or noses of nearby people or be inhaled into their lungs. Additionally, the virus can be transmitted by touching surfaces or objects contaminated with it, and then touching the face (particularly the nose, mouth, or eyes)^3,5. Influenza can also spread through tiny airborne particles that linger longer and travel farther, especially indoors. 

Each type of influenza virus (A, B, C, and D) spreads differently: 

• Influenza A: Spreads quickly and extensively, especially during seasonal epidemics. It infects humans and animals and is responsible for major flu pandemics. Contagious from about 1 day before symptoms start to up to 7 days after^4,7. 
• Influenza B: Only affects humans (seals occasionally) and causes seasonal outbreaks, typically less severe than A. Contagious for a similar duration as Influenza A^4,7,9. 
• Influenza C: Causes mild respiratory illness and spreads more slowly. It’s less common and not linked to epidemics, with lower contagiousness than A or B^7,9. 
• Influenza D: Mainly infects cattle and is not known to cause illness in humans. It does not contribute to human flu outbreaks^7,9.

Risk Factors for Influenza

Certain groups of people are at an increased risk of developing severe influenza complications. Key high-risk groups include: 

• Infants and young children (especially under 5 years of age)¹⁰ 
• Elderly adults (above 65 years)⁹
• Pregnant women (during all trimesters and the postpartum period) 
• People with chronic medical conditions (like asthma, diabetes, etc.)^3,9 
• People with weakened immune systems (including those with HIV/AIDS, undergoing cancer chemotherapy, organ transplant recipients, etc.) 

Diagnosis and Tests for Influenza

The diagnosis of influenza usually starts with a clinical assessment based on observable symptoms such as fever, cough, body aches, and fatigue. For confirmation, your doctor may use various diagnostic methods to detect influenza viruses. These may include: 

• Rapid Molecular Assays: These tests detect influenza virus nucleic acids with high sensitivity and deliver results very rapidly¹². 
• RT-PCR and Other Molecular Tests: Considered the gold standard, these tests identify influenza viral RNA and can distinguish between influenza A and B strains, including subtypes¹².
• Rapid Influenza Diagnostic Tests (RIDTs): These antigen detection tests provide results quickly but have variable sensitivity (sometimes lower), although its specificity is usually high. While convenient, negative results may require confirmation with molecular assays during high influenza activity¹².
• Immunofluorescence Assays: Uses a fluorescent microscope to detect influenza A and B antigens¹².
• Viral Culture: Though not useful for immediate clinical decisions due to slow turnaround (1–10 days), viral culture is important for surveillance and strain characterisation¹². 

Note: Nasal swabs or suction samples from the nose are the best for accurate flu testing. 

RT-PCR is the gold standard diagnostic method for confirming influenza virus and its types. Though cost wise it does lean on the higher end¹⁹.

Dr. Nayana S Shetty, MBBS, MD

Treatment and Management of Influenza

Influenza often resolves itself without medical intervention³. However, treatment options are important for those at higher risk of complications or severe illness. 

• Antiviral Medications: Antiviral drugs are the main treatment options for influenza types A and B. They may also help reduce complications, hospitalisations, and mortality in high-risk populations.  Antiviral medications work best when started within 48 hours of symptom onset, reducing illness severity and duration by about a day¹³. Common medications include¹⁴: 
  • Oseltamivir 
  • Zanamivir 
  • Peramivir 
  • Baloxavir marboxil

Note: You should only take this medication if your doctor has prescribed it for your condition.

• Symptomatic Care: Healthy individuals with mild flu symptoms should stay home, rest, and avoid contact with other members of the family (to minimise the risk of transmission)¹³. Fever and pain-relieving medications, when taken under medical supervision, can help relieve fever, headache, and body aches. Options include: 
  • Acetaminophen (paracetamol)  
  • Ibuprofen 
  • Aspirin

Note: Do not give aspirin to children as it has been associated with the risk of Reye’s Syndrome¹⁵. 

If your fever has been gone for at least 24 hours without using fever-reducing medicine and you feel better, it’s a sign of recovery. Isolation should continue for at least 24 hours after the fever ends to help prevent the spreading of the flu¹³.

How to Prevent Influenza

Prevention strategies are essential to reduce flu transmission and protect public health: 

• Flu Vaccination: It is recommended for everyone aged 6 months and older, annually. Additionally, high-dose vaccines are preferred for adults 65 years and older, as the immune response tends to weaken with age. Pregnant women and other high-risk groups are also strongly recommended to get vaccinated. 
• Hand Hygiene: Frequent handwashing with soap and water (for at least 20 seconds) or using alcohol-based hand sanitisers reduces the spread of flu viruses.  
• Avoiding Close Contact with Sick Individuals: Limiting exposure to people who have flu-like symptoms helps prevent infection¹⁴. 
• Disinfecting Surfaces: Regular cleaning of commonly touched surfaces (doorknobs, phones, keyboards) decreases virus transmission¹⁵. 
• Wearing Masks: During flu outbreaks or in crowded settings, wearing masks (especially well fitted surgical or N95 marks) can help reduce respiratory droplet spread.  
• Stay Home When Sick: If flu symptoms develop, staying home minimizes the risk of spreading the virus to others¹³. 

Teaching the 7 steps of hand washing to pre-school and school going kids is beneficial to lower transmission. As seasonal influenza is a common infection seen among paediatric age group²¹.

Dr. Nayana S Shetty, MBBS, MD

Complications of Influenza

While many cases of influenza resolve within a week, the virus can sometimes lead to serious complications, especially in vulnerable populations. Common influenza complications include: 

• Pneumonia³ 
• Sinus infections⁴ 
• Ear infections⁴
• Worsening of chronic conditions (e.g., asthma, diabetes)⁴

Other rare complications occurring only in severe cases include:  

• Myositis (muscle inflammation)  
• Acute Respiratory Distress Syndrome (ARDS occurs especially in patients with compromised immunity or underlying lung disease) 
• Myocarditis (heart muscle inflammation)  
• Encephalitis (brain inflammation)¹⁶ 
• Organ failure (multiple organs)¹⁶

Also Read: Pneumonia: Types, Symptoms, Characteristics & More!

When to See a Doctor

Early medical care can help avoid serious complications. Seek medical attention immediately if you experience¹⁶:

• Symptoms that suddenly worsen, e.g., worsening cough, increased shortness of breath, confusion, or persistent vomiting 
• Difficulty breathing/shortness of breath 
• Persistent high fever (not reduced with medications) 
• Severe weakness or fatigue 
• Lips or face turning blue (indicating cyanosis and hypoxia)  
• Significantly decreased urine output or inability to urinate. 
• Chest pain or pressure (may indicate complications like pneumonia, myocarditis, or cardiac events) 
• Seizures (indicate severe complications like brain damage) 

Also Read: 12 Best Remedies to Say Goodbye to Your Dry Cough

Conclusion

The introduction of influenza as a major public health concern highlights the need for effective prevention and treatment strategies. It is a potentially serious illness that spreads easily and can lead to severe complications if not managed properly. Therefore, recognising symptoms early, seeking timely medical care, and taking preventive measures are key to reducing its impact. While early antiviral treatment (under medical advice) can help reduce the risk of severe outcomes, annual vaccination remains the most effective way to protect against seasonal flu.  

Also Read: Home Remedies For Flu By Dr. Rajeev Singh

Frequently Asked Questions (FAQs)

References

1. World Health Organization. Influenza – India [Internet]. World Health Organization; [cited 2025 May 28]. Available from: https://www.who.int/india/health-topics/influenza-seasonal 
2. National Centre for Disease Control. Seasonal Influenza [Internet]. Ministry of Health and Family Welfare, Government of India; [cited 2025 May 28]. Available from: https://ncdc.mohfw.gov.in/seasonal-influenza-2/ 
3. Boktor SW, Hafner JW. Influenza. StatPearls [Internet]. StatPearls Publishing; 2025 Jan; Available from: https://www.ncbi.nlm.nih.gov/books/NBK459363/ 
4. Centers for Disease Control and Prevention. About influenza [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/about/index.html 
5. Centers for Disease Control and Prevention. About common cold [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/common-cold/about/index.html 
6. National Institutes of Health. Cold, flu, or allergy? [Internet]. National Institutes of Health; 2014 Oct [cited 2025 May 28]. Available from: https://newsinhealth.nih.gov/2014/10/cold-flu-or-allergy 
7. Liang Y. Pathogenicity and virulence of influenza. Virulence. 2023 Dec;14(1):2223057. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10283447/ 
8. Centers for Disease Control and Prevention. Types of influenza viruses [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/about/viruses-types.html 
9. World Health Organization. Influenza (seasonal) [Internet]. Geneva: World Health Organization; 2025 Feb 28 [cited 2025 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) 
10. Huang QS, Bandaranayake D, Wood T, et al. Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study. J Infect Dis. 2019 Jan 9;219(3):347-357. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9006182/ 
11. Bhalerao-Gandhi A, Chhabra P, Arya S, Simmerman JM. Influenza and pregnancy: a review of the literature from India. Infect Dis Obstet Gynecol. 2015;2015:867587. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4355110/ 
12. Centers for Disease Control and Prevention. Overview of influenza testing methods [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/hcp/testing-methods/index.html 
13. Centers for Disease Control and Prevention. Treatment of Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/treatment/index.html 
14. Santibañez S, Fiore AE, Merlin TL, Redd S. A primer on strategies for prevention and control of seasonal and pandemic influenza. Am J Public Health. 2009 Oct;99 Suppl 2(Suppl 2):S216-24. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4504386/ 
15. Baek JH, Seo YB, Choi WS, Kee SY, Jeong HW, Lee HY, Eun BW, Choo EJ, Lee J, Kim SR, Kim YK, Song JY, Wie SH, Lee JS, Cheong HJ, Kim WJ; Transgovernmental Enterprise for Pandemic Influenza in Korea. Guideline on the prevention and control of seasonal influenza in healthcare setting. Korean J Intern Med. 2014 Mar;29(2):265-80. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3957004/ 
16. Centers for Disease Control and Prevention. Signs and Symptoms of Flu [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu/signs-symptoms/index.html 
17. Press Information Bureau, Government of India. Update on Seasonal Influenza. [Internet]. Ministry of Health and Family Welfare; [updated 2023 Mar 10; cited 2025 May 28]. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=1905602 
18. Centers for Disease Control and Prevention. About Influenza A in Animals [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/flu-in-animals/about/index.html 
19. Akaishi Y, et al. Evaluation of the rapid influenza detection tests. Journal of Microbiology, Immunology and Infection. 2016;49(6):923-31. doi:10.1016/j.jmii.2016.06.002. Available from: https://www.sciencedirect.com/science/article/pii/S1201971216311857#:~:text=Reverse%20transcriptase%20PCR%20(RT-PCR,rapid%20diagnosis%20of%20influenza%20infection
20. Mäkelä MJ, Puhakka T, Ruuskanen O, Leinonen M, Saikku P, Kimpimäki M, Blomqvist S, Hyypiä T, Arstila P. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol. 1998 Feb;36(2):539-42. PMCID: PMC104573. doi:10.1128/JCM.36.2.539-542.1998. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC104573/
21. Panda M. Current status of influenza infection in pediatric age-group: Special focus on Indian scenario. Pediatr Infect Dis. 2025 Jan 27;7(1):19–21. doi:10.5005/jp-journals-10081-1451. Available from: https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1451

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Best Exercises for Fatty Liver You Should Try 

Introduction

Non-alcoholic fatty liver disease (NAFLD) is often referred to simply as fatty liver. It is one of the most common liver conditions affecting people worldwide¹. This condition involves the buildup of excess fat in the liver that is not caused by the consumption of alcohol².  

In India, adult NAFLD rates have been reported as high as 38.6% in adults and 35.4% in children, and the prevalence is known to increase with age and lifestyle related health issues³. Fatty liver can range in severity from simple fat accumulation (non-alcoholic fatty liver or NAFL) to a more serious form called non-alcoholic steatohepatitis (NASH), which can lead to liver fibrosis, cirrhosis, or even liver cancer if left unaddressed¹. 

The good news is that regular physical activity is one of the most effective ways to manage fatty liver^1,3. In this article, we will explore the causes and symptoms of fatty liver and highlight the most effective exercises you can incorporate into your routine to support liver health and manage this condition. Keep in mind that choosing the best exercise for fatty liver means focusing on activities that improve cardiovascular health as well as promote weight loss. 

How Is Fatty Liver Disease Caused?

Fatty liver develops when there is an abnormal buildup of fat in liver cells, more than 5% of the liver’s weight^2,5. This fat accumulation occurs due to various conditions: 

• Unhealthy Lifestyle:  The most common cause of fatty liver disease is an unhealthy lifestyle. This includes being overweight, not getting enough exercise, and eating too much unhealthy food. These factors can make the body less responsive to insulin (a hormone that controls blood sugar), which leads to insulin sensitivity and more fat being made and stored in the liver^1,6. 

Beyond this, several other conditions and factors can contribute to NAFLD: 

• Medical Conditions: Having conditions like diabetes, kidney disease, or high cholesterol^4,5. 
• Genetic Factors: Diseases such as glycogen storage diseases and Wilson’s disease². 
• Medications: Certain medications such as selective oestrogen receptor modulators, antimetabolites, and antiarrhythmics². 

NAFLD or NASH is now often referred to as Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD), and the most common cause for this is obesity or being overweight^22,23.

Dr. Nayana Shetty, MBBS, MD

Fatty Liver ​​Symptoms

Most people with fatty liver disease (especially in the early stages) may not experience any symptoms¹. However, as the condition progresses, some people might start to notice signs that something isn’t quite right.  

Below, we have mentioned some common symptoms of a fatty liver: 

• Feeling of tiredness/fatigue¹  
• Discomfort or pain in the upper right side of your belly² 
• Unexplained weight gain or difficulty losing weight⁷ 
• Bloating or a feeling of heaviness 
• Feeling thirsty frequently 
• Mild to moderate anxiety 
• Headaches or general discomfort 
• Nausea or reduced appetite 
• Palpitations or a warm sensation in the body⁸ 

It’s important to note that these symptoms are not exclusive to fatty liver disease and may be associated with other health conditions. However, as the condition progresses to NASH and cirrhosis, signs like abdominal/leg swelling, itchy skin, and spider-like veins may appear⁹. That’s why regular health check-ups are crucial, especially if you have risk factors like obesity, diabetes, or high cholesterol. 

If you’re concerned about your liver health, you can get a simple test, such as Liver Function Test (LFT), to check how well your liver is working. This blood test measures levels of liver enzymes and can help detect early signs of liver problems.

Easy Exercises to Reverse Fatty Liver?

One of the most effective ways to improve fatty liver disease is through regular exercise. Are you wondering what the best exercise for fatty liver is? The answer lies in a combination of aerobic activities like walking and strength training for lasting benefits. Studies have shown that both aerobic (cardio) and resistance (strength) training have been proven to reduce fat in the liver^10,11. 

Here are some simple and effective exercises for fatty liver that you can include in your daily routine: 

1. Walking

• Duration: About 30 minutes¹² 
• Frequency: Minimum 5 days in a week¹² 
• Best Time: Morning or evening walks 
• Why it helps: Low impact, improves blood circulation, burns fat¹³ 

2. Cycling (Outdoor or Stationary Bike)

• Duration: Around 40 minutes¹⁴ 
• Frequency: 3 to 5 days in a week¹⁴ 
• Best Time: Morning or evening 
• Why it helps: Great cardiovascular workout, targets belly fat¹⁴ 

3. Resistance Training (Leg Press, Chest Press, Shoulder Press, etc.)

• Duration: 2 to 3 sets of 8 to 12 repetitions (around 40 minutes) 
• Frequency: Minimum 3 days in a week¹⁰ 
• Best Time: Morning or evening 
• Why it helps: Builds muscle, boosts metabolism, reduces liver fat¹⁰ 

4. Yoga or Pilates Routines

• Duration: Around 60 minutes¹⁵ 
• Frequency: Minimum 3 times in a week¹⁵
• Best Time: Morning or evening 
• Why it helps: Reduces stress, supports weight loss, and liver function^15,16 

Note: While exercise and yoga offer certain benefits for fatty liver, it is important to perform activities within your comfort level and under the guidance of fitness and yoga professionals. Additionally, if you have any underlying health conditions, it is important to take medical clearance with the medical practitioner before pursuing any exercise regime. 

There is a growing trend pf NAFLD in children which is closely linked to rising childhood obesity²⁴.

Dr. Nayana Shetty, MBBS, MD

​​​Yoga Postures for Fatty Liver and Overall Liver Health

Yoga is a powerful tool that not only reduces stress but also helps stimulate internal organs like the liver, enhancing detoxification and improving its function¹⁶. Hence, it can be particularly beneficial for individuals with fatty liver disease. Here are some asanas that you can try out: 

1. Kapalbhati Pranayama (Skull Shining Breathing Technique) 

Steps¹⁷: 

• Sit comfortably in any meditative posture with your spine straight. 
• Close your eyes and relax your body completely. 
• Inhale deeply through both nostrils. 
• Slowly let your chest expand fully. 
• Exhale forcefully through the nose by contracting your abdominal muscles. 
• Allow the inhalation to happen passively (do not put effort into breathing in). 
• Repeat this process with active exhalations and passive inhalations. 
• Complete one round by taking 30 rapid and forceful breaths. 
• After completing 30 breaths, take a deep breath in and exhale slowly. 
• This completes one round of Kapalbhati 
• Ensure you do not strain while performing the practice. 

Duration and Frequency^17,18: 

• Start with 3 rounds (will take around 6 minutes). 

Benefits^16,17: 

• Stimulates liver function and aids in detoxification. 
• Supports digestion and reduces belly fat. 

2. Bhujangasana (Cobra Pose)

Steps¹⁹: 

• Lie on your stomach with your legs straight. 
• Keep your palms facing downwards and placed beneath your shoulders. 
• Inhale and slowly lift your chest while keeping your lower ribs on the ground. 
• Keep your elbows close to your body and look upward. 
• Hold the pose for a few breaths. 
• Exhale and gently lower your chest back down. 

Duration and Frequency¹⁸: 

• Hold for a few seconds and do it again for 3 rounds (should take around 6 minutes). 

Benefits^16,19: 

• Strengthens abdominal muscles. 
• Stimulates liver and kidney function. 

3. Dhanurasana (Bow Pose)

Steps¹⁹: 

• Lie on your stomach with your arms at your sides. 
• Bend your knees and try to hold the ankles with your hands. 
• Take a deep breath in and gently lift your chest and legs off the floor, forming a bow shape. 
• Keep breathing normally while holding the pose. 
• Exhale and slowly release. 

Duration and Frequency: 

• Hold for a few seconds and do it again for 3 rounds (should take around 6 minutes). 

Benefits¹⁹: 

• Strengthens back and abdominal muscles. 
• Stimulates the liver and improves digestion. 

4. Śalabhāsana (Locust Pose)

Steps¹⁷: 

• Lie on your stomach with your arms relaxed by your sides. 
• Keep your palms facing upwards. 
• Inhale and lift both legs without bending the knees. 
• Stretch the legs and arms to ease the lift. 
• Exhale and slowly lower the legs. 

Duration and Frequency: 

• Hold for a few seconds. Do it again if you feel comfortable (will take about 6 minutes). 

Benefits¹⁷: 

• Reduces fat on thighs and buttocks. 
• Improves blood flow to the abdominal muscles, enhancing their function. 

5. Pavanamuktasana (Wind Relieving Pose)

Steps¹⁷: 

• Lie on your back (Shavasana). 
• Bend both knees, bringing your thighs to your chest. 
• Clasp your shins below the knees. 
• Exhale and lift your head, trying to touch your knees with your chin. 
• Pause and hold briefly. 
• Lower the head and legs while exhaling. 
• Return to Shavasana. 

Duration and Frequency: 

• Hold for a few seconds and do it again for 3 rounds (will take about 6 minutes). 

Benefits¹⁷: 

• Massages abdominal organs, promoting digestion. 
• Stretches and tones the back and pelvic region. 
• Stimulates liver and intestines, helping with detoxification. 

Note: Always practice yoga for fatty liver with awareness and within your comfort level. If you have any underlying health conditions, recent surgeries, or are pregnant, consult your doctor before starting²⁰. It’s best to learn and perform yoga under the guidance of a certified yoga instructor to ensure proper technique and safety. Ideally, practice yoga in the early morning or at a time when your stomach is empty for better results and comfort¹⁷. 

No particular exercise can specifically target the fat in liver. Generally incorporating any type of physical activity is one of the many lifestyle measures that can be taken to inch towards a healthy liver. When concerning symptoms do show up, consulting your doctor is important.

Dr. Nayana Shetty, MBBS, MD

Also Read: Signs You May Have Liver Stress

Additional Tips to Manage Fatty Liver

In addition to medical guidance and structured treatment, individuals with fatty liver disease can adopt several practical lifestyle measures to support liver health: 

• Adopt a liver-friendly diet: Focus on including fruits, vegetables, whole grains, and healthy fats in your diet. Additionally, limit intake of refined sugars, sugary beverages, trans fats, and saturated fats²¹. 
• Engage in regular physical activity: Aim for at least 150 to 200 minutes of moderate-intensity exercise for fatty liver per week (e.g., brisk walking, cycling, aerobics, strength training)²¹.
• Achieve and maintain a healthy weight: Target gradual weight loss of 7 to 10%, or more if overweight, to significantly improve liver enzymes, inflammation, and fat accumulation²¹. 
• Manage associated health conditions: Control diabetes, obesity, high cholesterol, and hypertension as they may contribute to NAFLD progression².
• Seek professional guidance: Consult with a doctor, nutritionist, or fitness expert for personalised advice and to safely implement lifestyle changes. 

Also Read: Exercises for Hernia. Dos and Don’ts

When to See a Doctor

Fatty liver disease often develops silently, but timely medical consultation is advised when you notice the above-mentioned symptoms to rule out this condition. If the disease progresses, it becomes crucial to seek immediate medical attention. You must visit the doctor if you experience any of the following, as these may indicate that the liver disease has advanced: 

• Worsening of symptoms (discussed above) 
• Itching, spider-like blood vessels, or red palms 
• Yellowing of skin or eyes 
• Swelling/fluid retention, especially in the abdomen or legs 
• Bleeding or bruising easily 
• Memory or concentration issues⁹ 

As NAFLD progresses, it may develop into non-alcoholic steatohepatitis (NASH), a more severe form that includes inflammation and liver cell damage. If left unmanaged, NASH can progress to fibrosis, cirrhosis, or liver cancer². Therefore, regular medical check-ups and early lifestyle interventions such as exercise for fatty liver are key to managing fatty liver disease and avoiding long-term complications. 

Also Read: Safe Stretching Exercises You Can Try If Suffering From Phimosis

Conclusion

Exercise and yoga play a vital role in managing fatty liver disease by promoting weight loss, enhancing insulin sensitivity, reducing liver fat, and improving overall metabolic health. While there is no single best exercise for fatty liver approved solely for NAFLD, consistent physical activity, combined with mindful practices like yoga, can significantly halt the progression of the disease. 

By adopting a healthier lifestyle that includes regular exercise, a balanced diet, stress reduction, and mindful habits such as yoga, individuals can not only manage fatty liver more effectively but also improve their overall well-being. Regular consultation with a doctor with early intervention and sustained lifestyle changes is key to avoiding complications and leading a healthier, more energetic life.

Also Read: 6 Best Yoga Poses & Exercises To Deal With Piles

Frequently Asked Questions (FAQs)

References

1. Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, Yang W, Kassir R, Singhal R, Mahawar K, Ramnarain D. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord. 2022 Mar 14;22(1):63. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8919523/ 

2. Antunes C, Azadfard M, Hoilat GJ, Gupta M. Fatty Liver [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan; [updated 2023 Jan 1; cited 2025 May 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441992/ 

3. Shalimar, Elhence A, Bansal B, Gupta H, Anand A, Singh TP, Goel A. Prevalence of Non-alcoholic Fatty Liver Disease in India: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2022 May-Jun;12(3):818-829. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9168741/ 

4. Zarghamravanbakhsh P, Frenkel M, Poretsky L. Metabolic causes and consequences of nonalcoholic fatty liver disease (NAFLD). Metabol Open. 2021 Nov 16;12:100149. Available from: https://pubmed.ncbi.nlm.nih.gov/34870138/ 

5. Kneeman JM, Misdraji J, Corey KE. Secondary causes of nonalcoholic fatty liver disease. Therap Adv Gastroenterol. 2012 May;5(3):199-207. Available from: https://pmc.ncbi.nlm.nih.gov/articles/pmid/22570680/ 

6. Hallsworth K, Adams LA. Lifestyle modification in NAFLD/NASH: Facts and figures. JHEP Rep. 2019 Nov 5;1(6):468-479. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7005657/ 

7. Wijarnpreecha K, Aby ES, Ahmed A, Kim D. The association of weight gain with nonalcoholic fatty liver disease and fibrosis detected by FibroScan in the United States. Ann Gastroenterol. 2022 Mar-Apr;35(2):194-202. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8922259/ 

8. Khoonsari M, Mohammad Hosseini Azar M, Ghavam R, Hatami K, Asobar M, Gholami A, Rajabi A, Safarnezhad Tameshkel F, Amirkalali B, Sohrabi M. Clinical Manifestations and Diagnosis of Nonalcoholic Fatty Liver Disease. Iran J Pathol. 2017 Spring;12(2):99-105. Epub 2017 Apr 1. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5831064/ 

9. Kudaravalli P, John S. Nonalcoholic Fatty Liver [Internet]. StatPearls Publishing; 2025 Jan; . [Updated 2023 Apr; cited 2025 May 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541033/ 

10. Zelber-Sagi S, Buch A, Yeshua H, Vaisman N, Webb M, Harari G, Kis O, Fliss-Isakov N, Izkhakov E, Halpern Z, Santo E, Oren R, Shibolet O. Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial. World J Gastroenterol. 2014 Apr 21;20(15):4382-92. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3989975/ 

11. Keating SE, Hackett DA, Parker HM, O’Connor HT, Gerofi JA, Sainsbury A, Baker MK, Chuter VH, Caterson ID, George J, Johnson NA. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol. 2015 Jul;63(1):174-82. Available from: https://pubmed.ncbi.nlm.nih.gov/25863524/ 

12. Schweitzer GG, Klein S. Exercise and NAFLD: Is it worth the effort? Hepatology. 2017 Nov;66(5):1691-1694. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6121783/ 

13. Schneider CV, Zandvakili I, Thaiss CA, Schneider KM. Physical activity is associated with reduced risk of liver disease in the prospective UK Biobank cohort. JHEP Rep. 2021 Mar 2;3(3):100263. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8056270/ 

14. Oh S, So R, Shida T, Matsuo T, Kim B, Akiyama K, Isobe T, Okamoto Y, Tanaka K, Shoda J. High-Intensity Aerobic Exercise Improves Both Hepatic Fat Content and Stiffness in Sedentary Obese Men with Nonalcoholic Fatty Liver Disease. Sci Rep. 2017 Feb 22;7:43029. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5320441/ 

15. Liu X, Miller YD, Burton NW, Brown WJ. A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose. Br J Sports Med. 2010 Aug;44(10):704-9. Available from: https://pubmed.ncbi.nlm.nih.gov/18927159/ 

16. Singh AK, Kaur N, Kaushal S, Tyagi R, Mathur D, Sivapuram MS, Metri K, Bammidi S, Podder V, Modgil S, Khosla R, Sharma K, Anand A, Malik N, Boroiah V, Nagarathna R, Nagendra HR, Anand A. Partitioning of radiological, stress and biochemical changes in pre-diabetic women subjected to Diabetic Yoga Protocol. Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2705-2713. Available from: https://pubmed.ncbi.nlm.nih.gov/31405697/ 

17. Ministry of External Affairs, Government of India. Common Yoga Protocol. [Internet]. New Delhi: Ministry of External Affairs; [cited 2025 May 20]. Available from: https://www.mea.gov.in/images/pdf/common-yoga-protocol.pdf 

18. Telles S, Sharma SK, Kala N, Pal S, Gupta RK, Balkrishna A. Twelve Weeks of Yoga or Nutritional Advice for Centrally Obese Adult Females. Front Endocrinol (Lausanne). 2018 Aug 17;9:466. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6107686/ 

19. Ministry of External Affairs, Government of India. Yoga Postures – 17 [Internet]. New Delhi: MEA; [cited 2025 May 20]. Available from: https://www.mea.gov.in/yoga-postures-17.htm 

20. National Center for Complementary and Integrative Health. Yoga: Effectiveness and Safety [Internet]. NCCIH; [cited 2025 May 20]. Available from: https://www.nccih.nih.gov/health/yoga-effectiveness-and-safety 

21. Ahmed IA, Mikail MA, Mustafa MR, Ibrahim M, Othman R. Lifestyle interventions for non-alcoholic fatty liver disease. Saudi J Biol Sci. 2019 Nov;26(7):1519-1524. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6864195/ 

22. Li B, Zhang C, Zhan YT. Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its Epidemiology, Risk Factors, Clinical Presentation, Diagnosis, Management, and Prognosis. Can J Gastroenterol Hepatol. 2018 Jul 2;2018:2784537. doi: 10.1155/2018/2784537. PMID: 30065915; PMCID: PMC6051295.Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6051295/

23. Sharma B, John S. Nonalcoholic Steatohepatitis (NASH) [Updated 2023 Apr 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470243/

24. Zhang X, Wu M, Liu Z, Yuan H, Wu X, Shi T, Chen X, Zhang T. Increasing prevalence of NAFLD/NASH among children, adolescents and young adults from 1990 to 2017: a population-based observational study. BMJ Open. 2021 May 4;11(5):e042843. doi: 10.1136/bmjopen-2020-042843. PMID: 33947727; PMCID: PMC8098935. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8098935/#:~:text=Prevalence%20of%20NAFLD/NASH%20and%20its%20variations%20among%20CADs%20and,SDI%20regions%20(table%201).

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

2

Top Vitamin B12 Foods to Include in Your Diet Today! 

Introduction

Have you been feeling unusually tired, low on energy, mentally unclear or confused? While these symptoms can have many causes, one possibility worth considering is a deficiency in vitamin B12. 

Vitamin B12, also known as cobalamin, is an essential nutrient involved in red blood cell production, nerve function, and DNA synthesis. While it is often overlooked, adequate B12 level is essential for maintaining energy levels and supporting cognitive and neurological health of the body. 

Your body cannot produce B12 on its own, so it must be obtained through foods high in vitamin B12 or supplements. Animal-based foods such as meat, dairy, and eggs are the primary sources of vitamin B12. Thus, if you follow a vegetarian or vegan diet, you may need B12 supplements to meet your daily requirement for the vitamin^1,2. 

In this article, we will explore vitamin B12 rich foods to help you maintain optimal vitamin B12 level and support your overall health, in a way that is both enjoyable and practical. 

Why Is Vitamin B12 Important for Your Health?

Vitamin B12 (also called cobalamin) is a nutrient your body needs to stay healthy². It plays a key role in: 

• Nervous system health: Vitamin B12 helps build and maintain the protective covering (called myelin) around your nerves. Without enough B12, people can experience tingling in their hands and feet, poor balance, memory problems, or mood changes^2,3. 
• Red blood cell formation: Vitamin B12 is needed to produce healthy red blood cells that help carry oxygen throughout your body.² Vitamin B12 deficiency is associated with anaemia, which can cause symptoms like tiredness, weakness, and shortness of breath.^3,4 
• Energy and cell repair: B12 contributes to the production of DNA (the genetic material in your cells), which is essential for the formation of new cells and keeping your tissues healthy². 
• Heart health: B12 helps control levels of a substance in your blood called homocysteine. High levels of homocysteine have been linked to an increased risk of heart disease^2,4. 

The recommended dietary allowance (RDA) of vitamin B12, which is sufficient for the nutrient needs of adults, is approximately 2.4 mcg per day². 

Who is at Risk for Low Vitamin B12 Levels?

Individuals following a vegan or vegetarian diet are at increased risk of having low vitamin B12 levels, as B12 is mostly found in animal foods. 

People with health conditions that interfere with vitamin B12 absorption also may be at risk of deficiency, even if they consume enough through food. Since vitamin B12 absorption is a complex, multi-step process, any disruption can affect how much the body absorbs. 

Vitamin B12 Absorption Process: 

• In the mouth, a protein in the saliva (haptocorrin) binds to B12 from the food you eat. 
• In the stomach, acid and enzymes free the B12 from the food you have eaten, allowing it to bind to intrinsic factor. 
• In the ileum (the last part of the small intestine), B12 is finally absorbed in the body². 

Factors Associated with Vitamin B12 Deficiency: 

You are more likely to have low B12 if you³:

• Are vegetarian or vegan 
• Are over age 50 years (your stomach may not make enough acid to absorb B12) 
• Have pernicious anaemia or digestive issues like Crohn’s disease or celiac disease 
• Have had stomach surgery (like gastric bypass) 
• Take certain medications (like metformin or acid blockers) 

Good to know: Unlike foods high in vitamin B12, B12 from supplements or fortified foods (like some cereals or plant-based milks) does not need to go through all these steps. It is already in a form your body can absorb more easily. Therefore, these alternate options could be helpful for people who have trouble absorbing B12 from food. 

Vitamin B12 Deficiency Symptoms: 

Signs of a vitamin B12 deficiency can appear slowly and may include³:

• Feeling tired or weak 
• Numbness or tingling in your hands and feet 
• Trouble with balance 
• Mood changes, memory problems, or brain fog 
• Pale skin or shortness of breath 

If these sound familiar, talk to your doctor about testing for vitamin B12 levels. 

Predominately vegan and vegetarian consumers are at higher risk of vitamin B12 deficiency. If you are considering supplementation, do so following a thorough examination by your registered medical doctor.

Dr. Nayana Shetty, MBBS, MD

Top Food Sources of Vitamin B12

Vitamin B12 plays a key role in keeping your energy levels up, your nerves healthy, and your blood cells functioning properly². Since your body cannot make it on its own, getting enough from foods high in vitamin B12 (or supplements) is essential. 

Most vitamin B12 comes from animal-based foods, but there are some excellent fortified plant-based options for vegetarians and vegans^2,3. Let’s explore some of the top vitamin B12 rich foods to help you meet your daily needs and stay energised and healthy: 

1. Milk

Milk is an easy and reliable source of B12. It also gives you calcium and vitamin D, which help build strong bones and support your immune system¹.

• One cup of milk (2% fat) provides about 54% of your B12 RDA². 

Tip: For vegans, fortified plant-based options like soy milk can offer up to 45% of your B12 RDA. Check the label to be sure. 

2. Yoghurt

Yoghurt is not just good for your gut; it is a solid B12 source¹.  

• A 170 g (about ¾ cup) serving of plain, fat-free yoghurt provides around 43% of your B12 RDA^1,2.

Tip: Choose low-fat, unsweetened yoghurt to avoid added sugar while still getting protein, calcium, and gut-friendly probiotics. 

3. Cheese

Cheese adds flavour and nutrients to your meals².

• A 43 g slice (about 1.5 ounces) of cheddar cheese offers around 21% of your B12 RDA².

Note: Cheese is nutritious but also high in saturated fat; therefore, enjoy it in moderation. 

4. Eggs

Eggs are packed with high-quality protein, healthy fats, and B vitamins¹. 

• One large, hard-boiled egg gives you about 19% of your B12 RDA². 

Tip: Include eggs a few times a week as a simple, nutrient-rich choice. 

5. Fish (Especially Fatty Fish)

Fish is one of the richest natural sources of vitamin B12. It also provides omega-3 fats for heart and brain health¹.

Here is how much B12 you get from these portions: 

• Sardines (150 g): 554% of your daily RDA¹. 
• Salmon (85 g / 3 oz): 108% of your daily RDA².
• Tuna (85 g / 3 oz): 104% of your daily RDA².

Bonus: A serving of salmon also gives you around 40g of protein, which is great for muscle health. 

6. Chicken and Turkey

Poultry is a lean and healthy protein source that also provides B12¹. 

• A 75 g (about 2.5 oz) serving of roasted chicken or turkey gives you about 14% of your B12 RDA². 

Bonus: It is great for those who prefer lean meats. 

7. Shellfish (Oysters and Clams)

Shellfish are B12 superfoods as they provide high levels of vitamin B12². 

• Clams (85g / 3 oz) provide 708% of B12 RDA². 
• Oysters (85g / 3 oz) provide 621% of B12 RDA². 

Bonus: Even small portions of these superfoods provide way more than your daily need and they are also rich in zinc and iron! 

8. Nutritional Yeast (Fortified)

A favourite among vegans, nutritional yeast has a cheesy flavour and is often fortified with B12¹. 

• About ¼ cup of nutritional yeast can give you between 346% and 1,000% of your B12 RDA, depending on the brand². 

Bonus: Great served on popcorn, in soups, or stirred into sauces. Always check the label to make sure it is fortified. 

9. Fortified Breakfast Cereals

Fortified cereals have vitamin B12 added during processing, making them easy to absorb for vegetarians and vegans¹. 

• Depending on the brand, a single serving may offer 25 to 100% or more of your B12 RDA^1,2. 

Tip: Pair with fortified plant milk for a double B12 boost. Check the nutrition label for specifics. 

10. Beef (Especially Liver)

Beef is a powerful source of B12, especially organ meats like liver².

• Cooked beef liver (85g / 3 oz) offers an incredible 2,944% of your B12 RDA². 
• Ground beef (85g, 85% lean) offers about 100% of your B12 RDA².

Caution: Although liver is a great vitamin-rich option for those who eat it, make sure you cook it in healthy oils. 

If someone is diagnosed to have pernicious anaemia, oral supplementation of vitamin B12 won’t work sufficiently due to lack of intrinsic factor which is needed for the absorption of vitamin B12 that comes from the diet. In these individuals’ usually vitamin B12 injections (IM) are prescribed. But some small studies have hinted that vitamin B12 oral supplements (1000 mcg) may be a fruitful alternative to injections, this is probably due to some passive absorption, but the overall consensus is that it is insufficient¹⁶.

Dr. Nayana Shetty, MBBS, MD

Who Might Need a Vitamin B12 Supplement?

Most people can get enough vitamin B12 from vitamin B12 food sources, especially if they eat animal-based foods like meat, dairy, or eggs. But for some groups, it can be harder to absorb or get enough from food alone. In these cases, a vitamin B12 supplement can be very helpful, and sometimes even necessary. 

Here are some groups who may benefit from B12 supplementation³: 

1. Vegetarians and vegans: 

Since B12 is found mainly in animal products, people on plant-based diets may not get enough from food alone. A daily B12 supplement or fortified foods can help fill the gap. 

2. Adults over 50 years of age: 

As we age, our stomach produces less acid, which can affect how well we absorb B12 from food. Many older adults benefit from B12 in supplement form, which is easier to absorb. 

3. People with digestive or gut issues: 

Conditions like Crohn’s disease, celiac disease, or those who have had intestinal or stomach surgery (including weight-loss surgery) can make it harder to absorb B12 properly. Supplements, sometimes in higher doses or by injection, may be needed for these individuals. 

4. People with pernicious anaemia: 

This is an autoimmune condition that prevents the body from absorbing B12 naturally. If you have this, your doctor may recommend regular B12 shots or high-dose supplements to keep your levels up. 

5. Individuals who have had gastrointestinal (GI) tract surgery: 

GI tract surgery, such as a gastric bypass, can reduce your body’s ability to absorb vitamin B12, increasing the risk of deficiency. 

6. People who take certain medications: 

Medications like metformin or acid blockers can impair the body’s ability to absorb B12 properly, therefore, individuals who take such medicines may need vitamin B12 supplementation. 

Both oral and injectable (IM) vitamin B12 are effective for replacement, but an injection causes more rapid improvement and is considered in severe deficiency or when neurologic symptoms appear¹⁵.

Dr. Nayana Shetty, MBBS, MD

How to Test for Vitamin B12 Deficiency?

Symptoms like fatigue, memory issues, dizziness, numbness or tingling in the hands and feet, and pale skin can indicate a vitamin B12 deficiency. If you have these symptoms, you should visit a doctor.  

Your doctor will ask about your symptoms and may also check your reflexes, balance, and sensation since B12 affects the nerves. To confirm whether you are deficient, your doctor will order some blood tests. These help catch problems early, guide treatment, and prevent serious complications like anaemia and nerve damage. 

Also Read: How To Increase Platelet Count Naturally

Common Tests for Vitamin B12 Deficiency

1. Serum Vitamin B12 Level 

• Measures how much B12 is in your blood. 
• Low levels usually mean deficiency, but sometimes more tests are needed to be sure⁵. 

2. Complete Blood Count (CBC)

• Checks for anaemia and looks at the shape and size of red blood cells⁶. 
• In B12 deficiency, red blood cells may be larger than normal and less effective at carrying oxygen⁷. 

3. Reticulocyte Count

• Reticulocytes are young red blood cells. 
• A low count means your body is not making enough new red cells, which can happen in B12 deficiency⁸. 

4. Lactate Dehydrogenase (LDH) 

• LDH goes up when cells break down too quickly. 
• In B12 deficiency, fragile red blood cells may break apart early, raising LDH levels⁹. 

5. Bilirubin

• This is a pigment released when red blood cells break down. 
• High levels can be another sign that your blood cells are being destroyed too soon⁹. 

6. Methylmalonic Acid (MMA) 

• One of the most sensitive early markers of B12 deficiency. 
• MMA levels go up even before your B12 levels drop below normal. This can be helpful for early detection^{10, 11.} 

7. Homocysteine

• High levels of this amino acid are linked to low B12 (as well as low folate). 
• If untreated, high homocysteine can raise your risk for heart problems and cognitive decline¹². 

8. Anti-Intrinsic Factor Antibodies 

• These are immune system markers that attack intrinsic factor, a protein in your stomach that helps absorb B12. 
• A positive result may indicate pernicious anaemia, a common cause of B12 deficiency¹³. 

9. Anti-Parietal Cell Antibodies 

• Another immune test that looks for antibodies against stomach cells that produce intrinsic factor. 
• Also used to diagnose pernicious anaemia¹⁴. 

Also Read: 11 Healthy Foods That Can Help You to Gain Weight

Additional Tests (Only If Needed)

Sometimes, if the cause of B12 deficiency is unclear, your doctor might recommend further testing: 

1. Upper Endoscopy (EGD)

• A thin camera is used to look at your stomach and small intestine. This helps detect ulcers, damage, or other issues that might affect nutrient absorption. 

2. Bone Marrow Biopsy

• Although a bone marrow biopsy is rarely needed, it can be helpful in complex or unexplained cases of anaemia. 

Testing and treating vitamin B12 deficiency is simple, but crucial. Left untreated, low B12 levels can lead to permanent nerve damage, anaemia, and memory issues. If you are experiencing symptoms or are in a higher-risk group (like older adults, vegans, or people with gut issues) it is important to get checked.

Also Read: 10 Iron Rich Foods to Add to Your Diet 

Conclusion

Making sure you get enough vitamin B12 from vitamin B12 food sources is an important part of staying healthy. This is because it supports your energy levels, nervous system, and red blood cell production. 

Vitamin B12 deficiency often develops slowly, and sometimes the symptoms can be easily overlooked, like fatigue, brain fog, or tingling in the hands and feet. For most people, eating a well-balanced diet that includes animal-based foods like dairy, eggs, fish, or meat is enough to maintain healthy B12 levels. However, if you are vegetarian, vegan, over the age of 50 years, or have a digestive condition that affects nutrient absorption, a quick blood test can give you peace of mind and help you stay ahead of any health issues. 

Taking small steps now, like including vitamin B12-rich foods in your diet, can make a significant difference in your long-term energy, memory, and well-being.

Also Read: Vegetarian Foods High In Vitamin B12

Frequently Asked Questions (FAQs)

References

1. Food Safety and Standards Authority of India [FSSAI]. Vitamin B12 rich foods: 7 foods that may load you up with energy [Internet]. NDTV Food; [updated 2021 Aug 31; cited 2025 Apr 18]. Available from: https://fssai.gov.in/upload/media/FSSAI_News_Vitamin_NDTVFood_31_08_2021.pdf 

2. National Institutes of Health (NIH) – Office of Dietary Supplements. Vitamin B12 – Health Professional Fact Sheet. [Internet]. NIH; [updated 2024 Mar 26; cited 2025 Apr 18]. Available from: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/ 

3. MedlinePlus. Vitamin B12 – Medical Encyclopedia [Internet]. U.S. National Library of Medicine; [updated 2024 Oct 19; cited 2025 Apr 18]. Available from: https://medlineplus.gov/ency/article/002403.htm 

4. Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy–A Review. Nutrients. 2016 Jan 27;8(2):68. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4772032/ 

5. Better Health Channel. Vitamin B [Internet]. Department of Health; [updated 2024 Jul 24; cited 2025 Apr 18].Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/vitamin-b 

6. MedlinePlus. Vitamin B12 Deficiency Anemia [Internet]. U.S. National Library of Medicine; [updated 2024 Oct 19; cited 2025 Apr 18]. Available from: https://medlineplus.gov/ency/article/000574.htm 

7. Seo IH, Lee YJ. Usefulness of Complete Blood Count (CBC) to Assess Cardiovascular and Metabolic Diseases in Clinical Settings: A Comprehensive Literature Review. Biomedicines. 2022 Oct 25;10(11):2697. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9687310/ 

8. MedlinePlus. Reticulocyte count [Internet]. National Library of Medicine (US); [updated 2024 Mar 11; cited 2024 Mar 11]. Available from: https://medlineplus.gov/ency/article/003637.htm 

9. MedlinePlus. Lactate dehydrogenase (LDH) test [Internet]. National Library of Medicine (US); [updated 2023 Oct 30; cited 2025 Apr 18]. Available from: https://medlineplus.gov/lab-tests/lactate-dehydrogenase-ldh-test/ 

10. Kwak MS, Kim D, Chung GE, Kang SJ, Park MJ, Kim YJ, Yoon JH, Lee HS. Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease. Clin Mol Hepatol. 2012 Dec;18(4):383-90. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3540375/ 

11. Johannsen P, Ostergaard K, Christensen JE, Worm M, Rasmussen K. Methylmalonic acid in serum from patients with neurological symptoms consistent with cobalamin deficiency. Eur J Neurol. 1995 Sep;2(4):357-62. Available from: https://doi.org/10.1111/j.1468-1331.1995.tb00139.x 

12. Zhang J, Li Y, Zhou Y, Zhao Y, Xie H, Duan R, Yao Y, Gong Z, Teng J, Jia Y. Serum Homocysteine Level Is a Predictor of Relapse and Prognosis in Patients With First-Attack Neuromyelitis Optica Spectrum Disorders. Front Neurol. 2021 May 26;12:667651. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8187771/ 

13. Fraile L, Sopena A, Chávez CE, Font-Font M, Esquerda A. Autoantibodies to intrinsic factor can jeopardize pernicious anemia diagnosis: a case report. EJIFCC. 2023 Jul 10;34(2):181-187. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10349311/ 

14. Rusak E, Chobot A, Krzywicka A, Wenzlau J. Anti-parietal cell antibodies – diagnostic significance. Adv Med Sci. 2016 Sep;61(2):175-179. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1896-1126(16)00003-1 

15. Langan RC, Goodbred AJ. Vitamin B12 deficiency: recognition and management. Am Fam Physician. 2017 Sep 15;96(6):384-389. Available from: https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

16. Langan RC, Goodbred AJ. Oral vitamin B12 supplementation in pernicious anemia: a prospective cohort study. Am J Clin Nutr. 2024 Jul;120(1):217-224. Available from: https://pernicious-anaemia-society.org/pernicious-anaemia-society/oral-treatment/

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

1

What Happens if Erythrocyte Sedimentation Rate (ESR) is High? 

Introduction

Your blood can reveal a lot about what’s happening inside your body, and there are several parameters which help detect the same. One such commonly used indicator is the ESR or Erythrocyte Sedimentation Rate, which helps assess the presence of inflammation or infection in the body.  ESR measures how quickly your red blood cells (erythrocytes) settle at the bottom of a test tube. When there is inflammation in the body, the red blood cells tend to clump with each other and settle more quickly, resulting in a higher ESR value. 

In this blog, let’s explore the causes of high ESR, what does high ESR indicates, how it’s diagnosed, and how to reduce ESR. But before that, let’s understand what ESR is, what the normal range looks like, and which values are considered abnormal.  

What is ESR?

ESR is a measure of how quickly your red blood cells settle to the bottom of a test tube, which is related to the presence of inflammation in your body. Inflammation is how your body reacts to injury, infection, or other health issues like immune disorders, certain cancers, or blood problems. 

Normally, red blood cells fall slowly, but when there’s inflammation, they stick together. These clusters are heavier, so they settle more quickly. The speed at which they fall helps doctors assess the level of inflammation. The faster the cells settle, the more inflammation is likely present. However, the ESR values do not reveal the exact cause of the inflammation². 

ESR values along with a detailed history, physical examination and other investigations can help diagnose and monitor conditions that cause inflammation such as infections or autoimmune conditions. It can also help doctors track how well treatment is working². 

Normal ESR Range

ESR is recorded in millimeters per hour (mm/hr). Its normal values are: 

• 0 to 15 mm/hr in men under 50. 
• 0 to 20 mm/hr in women under 50. 
• 0 to 20 mm/hr in men over 50. 
• 0 to 30 mm/hr in women over 50. 
• 0 to 10 mm/hr in children. 

Please note the normal values can differ based on factors like age, sex, overall health, and even the lab conducting the test³. 

Your ESR value gives information about the inflammation in your body. However, a value outside the typical range doesn’t always mean something is wrong. It’s best to talk to your doctor to understand what your results mean for you. 

What Does a High ESR Indicate?

A high ESR may point to several underlying conditions. It can be associated with infections, such as osteomyelitis (bone infection) or septic arthritis (joint infection)_, autoimmune conditions like rheumatoid arthritis_, or Inflammatory disorders, such as systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD). It may also be elevated during flares or relapses of chronic inflammation⁴, and specific conditions like pregnancy, diabetes mellitus, end-stage kidney disease, heart disease, and certain cancers³. 

However, a high ESR is not always due to inflammation. Certain non-inflammatory conditions can also affect it. For example, anaemia (low red blood cell count) makes RBCs clump more easily, which increases ESR⁴. 

While ESR is a helpful clue, it’s a non-specific test, meaning it doesn’t pinpoint the exact cause. Your doctor will consider it along with other tests and symptoms to understand what’s going on in your body. 

Common Symptoms of a High ESR

If your ESR is higher than normal, your body might be telling you something. Below are some common signs and symptoms that may be present along with a raised ESR:

• Headaches: May be seen in infections or inflammatory diseases such as vasculitis (Condition affecting the blood vessels)⁵. 
• Joint swelling or pain: Present in inflammatory diseases like rheumatoid arthritis, gout, lupus, or psoriatic arthritis⁶. 
• Unexplained fever: In case of infections or some inflammatory diseases⁷. 
• Unexplained weight loss: Sometimes seen in autoimmune conditions like rheumatoid arthritis and polymyalgia rheumatica⁸. 
• Neck or shoulder pain: Common in conditions like polymyalgia rheumatica causing pain and stiffness in shoulders, neck, and hips⁹.  
• Anaemia: While this can be caused by many factors such as iron deficiency, chronic disease, or vitamin B12 deficiency, chronic inflammation can contribute to anaemia of chronic disease¹⁰. 
• Fatigue or tiredness: Due to anaemia¹⁰ or chronic inflammatory conditions like rheumatoid arthritis⁶. 
• Skin rashes or lesions:  Sometimes occur in inflammatory diseases such as vasculitis, which affects blood vessels¹¹. 

While the symptoms associated with high ESR may seem non-specific at first, it is always advisable to seek medical help when you experience the earliest symptoms to diagnose your condition.   

Causes of High ESR 

ESR can be influenced by a variety of factors. For instance, women generally have slightly higher ESR values compared to men, and factors like aging and pregnancy can also contribute to an increase. However, certain medical conditions may also cause ESR levels to rise due to increased inflammation in the body. These illnesses may include³: 

• Infections: Serious infections, especially in bones or joints, can raise ESR. 
• Rheumatoid arthritis: Swelling and pain in the joints often cause a higher ESR. 
• Lupus (SLE): An autoimmune disease that attacks your own body, raising ESR levels. 
• Cancer: Certain cancers, particularly blood or bone marrow cancers (e.g., lymphoma, leukaemia, myeloma), can lead to a high ESR. 
• Kidney problems: Long-term kidney disease may increase ESR. 
• Polymyalgia rheumatica & giant cell arteritis: Conditions in older adults that cause muscle pain and headaches, often with very high ESR. 
• Heart disease: Inflammation in the heart or blood vessels may cause a higher ESR. 
• Diabetes: Poorly controlled diabetes can trigger hidden inflammation, which may raise ESR. 
• Thyroid issues: Problems with the thyroid (hypo or hyperthyroidism) can lead to an increased ESR. 
• Bone infection (osteomyelitis): ESR can help diagnose and track treatment for bone infections. 

While an elevated ESR can indicate the presence of underlying conditions, it is not a definitive diagnosis on its own. It is important to look at your full health picture, such as symptoms, history, and other tests to identify the cause of the inflammation. 

Risks of High ESR

If you’re wondering what happens if erythrocyte sedimentation rate is high for long, note that it means there is active inflammation in your body, especially when the underlying cause is undiagnosed and untreated. This can indicate an increased risk of certain medical conditions or higher chances of complications from persistent infections and inflammatory conditions, also possibly having a poorer prognosis (treatment outcome) in some cases. Let’s have a detailed look at these.  

• Multiple organ dysfunction: Chronic high ESR, especially in untreated autoimmune diseases, can reflect advancing inflammation in the body that may start affecting multiple organs¹². 
• Heart disease: High ESR can indicate an increased risk of heart disease and stroke, as it shows the presence of ongoing inflammation which is linked to heart-related issues. Although, there are more specific markers for determining heart disease risk like the C-Reactive Protein¹³. 
• Kidney disease: Elevated ESR levels in certain kidney problems like chronic kidney disease or AAV (ANCA-Associated Vasculitis, which causes inflammation in the small blood vessels of the kidney) can indicate more serious kidney damage and a higher risk of complications, especially in older adults¹³. 
• Cancer: High ESR can also be found in people with certain cancers, like lung cancer, which may help doctors spot potential risks¹⁴. Consistently high ESR values in cancer patients are also related to poorer prognosis in various cancers¹⁵. 
• Permanent Joint Damage: High ESR levels can indicate serious inflammation in conditions like arthritis, and if not treated early, it can cause long-term damage to the joints¹⁶. 
• Fatigue and Pain: High ESR levels in conditions like infections, rheumatoid diseases, or cancers can lead to persistent fatigue and pain due to inflammation affecting the body and nervous system¹⁷. 

It is important to receive timely high ESR treatment to manage the underlying causes and reduce the risks associated with high ESR. 

Adopting lifestyle changes to reduce high ESR is advisable as these are beneficial practices with no harm that is preferable to incorporate even if the ESR is normal. But if you are considering any kind of supplementation to reduce high ESR or prevent rise of ESR like vitamin D or omega-3-fatty acid supplements and OTC anti-inflammatory drugs, don’t do so without the advice of your registered medical doctor.

Dr. Nayana Shetty, MBBS, MD

Diagnosis and Further Evaluation

To measure the sedimentation rate of red blood cells, an ESR test is done. This test makes use of a small sample of your blood which is placed in a test tube and watched for the settling of your red blood cells. There are several methods to perform the ESR test: 

• Westergren method: This is the most widely used and reliable method. Blood is placed in a long (200 mm), thin tube, and the distance the red blood cells fall in one hour is measured. It’s often considered the gold standard for ESR testing due to its accuracy. 
• Wintrobe method: This uses a shorter (100 mm), narrower tube, making it less sensitive compared to the Westergren method but still used in some labs. 
• Micro-ESR and automated ESR analysers: These make use of more advanced techniques that can give quicker and more consistent results.  

While the ESR test helps doctors check if there is inflammation in the body, it doesn’t point to any specific condition. When checking your ESR results, do remember the following: 

• A slightly high ESR isn’t always a reason to worry it can happen due to aging, pregnancy, periods, or even a lab error³. 
• The ESR test alone doesn’t confirm any disease, so it should always be combined with other tests and a proper check-up³. 
• If the ESR is only a little high and there are no other signs of illness, doctors might suggest waiting or doing a few more tests³.
• If someone feels fine, it’s usually okay to repeat the ESR test after a few months instead of going for more tests right away³. 
• A very high ESR (above 100 mm/hr) can sometimes mean a serious issue like an infection, cancer, or inflammatory disease. These require timely high ESR treatment to prevent complications³. 
• If the ESR stays high for a long time, doctors might check further to see if there’s a hidden problem³.

Doctors always look at your ESR result along with your symptoms, physical examination results and other test findings. This helps them decide the right next steps for your care. 

Also Read: High Platelet Count: Causes, Symptoms, Management and More!

Ways to Manage High ESR

If your ESR levels are high, it is important to identify the cause, which could be related to infection, autoimmune disorders, or other medical conditions. If you are wondering how to reduce ESR, here are some tips that can help reduce ESR levels: 

• Eat a healthy diet: Focusing on antioxidant-rich foods like fruits, vegetables, and whole grains can help reduce inflammation in the body and support healthy ESR levels¹⁸.  
• Consume foods rich in Omega-3 fatty acids: Consuming foods rich in this, such as walnuts, flaxseeds, and fish, can help reduce inflammation and lower ESR levels¹⁹. 
• Consume Vitamin D supplements: Consuming Vitamin D supplements can help reduce inflammation and lower ESR levels²⁰. 
• Exercise regularly: Getting active, especially with more intense exercise, can help lower ESR by reducing inflammation in the body²¹. 
• Maintain a healthy weight: Being overweight or having metabolic issues like high blood sugar can increase ESR, so keeping your weight in check is important²¹. 
• Avoid smoking: Smoking can raise ESR levels, so quitting or not smoking helps lower it²¹.
• Avoid drinking alcohol: Drinking too much alcohol can raise ESR levels, so avoiding or minimizing intake helps lower it²¹.
• Understand how age and gender affect ESR: ESR naturally increases with age, and women generally have higher ESR levels than men. It’s important to consider these factors when looking at ESR results²¹.
• Take medications as prescribed: Anti-inflammatory drugs²² or steroids²³ may be recommended by your doctor to address the underlying cause and help lower ESR levels. 

It’s important to talk to your doctor before making lifestyle changes to understand how to reduce high ESR and inflammation in your body. 

Consuming foods high in antioxidants can help fight inflammation over time. This may be helpful in reducing markers of inflammation like ESR. Few such anti-inflammatory foods are yogurt, avocado, berries, broccoli, chia seeds, etc²⁴.

Dr. Nayana Shetty, MBBS, MD

Conclusion

High ESR is an indicator of underlying inflammation in the body. It is linked to conditions like infections, autoimmune diseases, and certain cancers. While ESR is a non-specific tool that cannot be used for diagnosis on its own, it helps doctors detect inflammatory and certain non-inflammatory conditions in the body, as well as monitor the response to ongoing treatments. You can manage your ESR levels through a healthy diet, regular exercise, and lifestyle changes such as quitting smoking and limiting alcohol intake. But remember, if your results show abnormal levels of ESR, it is important to contact your doctor for a proper diagnosis and management plan.  

Also Read: Can You Check Thyroid at Home

Frequently Asked Questions (FAQs)

References

1. Healthdirect [Internet]. Erythrocyte sedimentation rate (ESR) test Canberra (AU): Healthdirect Australia. 2022 [cited 2025 Apr 24]. Available from: https://www.healthdirect.gov.au/erythrocyte-sedimentation-rate-ESR-test 

2. National Library of Medicine (US) [Internet]. Erythrocyte Sedimentation Rate (ESR): MedlinePlus Medical Test Bethesda (MD): National Library of Medicine (US). [updated 2024 Dec 02] [cited 2025 Apr 22]. Available from: https://medlineplus.gov/lab-tests/erythrocyte-sedimentation-rate-esr/​ 

3. Tishkowski K, Zubair M. Erythrocyte Sedimentation Rate [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025 Jan. [updated 2023 Apr 23] [cited 2025 Apr 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557485/ 

4. Batlivala SP. Erythrocyte Sedimentation Rate and the C-reactive Protein Test [Internet]. Pediatrics in Review. 2009 Feb;30(2):72–74. [cited 2025 Apr 22]. Available from: https://renaissance.stonybrookmedicine.edu/sites/default/files/ESR%20and%20CRP.pdf 

5. Younger DS. Systemic vasculitis and headache. Curr Opin Neurol. 2023 Dec 1;36(6):631-646. doi: 10.1097/WCO.0000000000001223. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624412/ 

6. Baker JF, O’Dell JR. Diagnosis and differential diagnosis of rheumatoid arthritis [Internet]. UpToDate. Waltham (MA): UpToDate; [cited 2025 Apr 22]. Available from: https://www.uptodate.com/contents/diagnosis-and-differential-diagnosis-of-rheumatoid-arthritis 

7. Elizabeth C, Hersch, Col, MC, et al. Prolonged Febrile Illness and Fever of Unknown Origin in Adults. Am Fam Physician. 2014;90(2):91-96. Available from: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=136408e2d4746d5a27f2288ba1a5ab77a990a30d  

8. University of Rochester Medical Center [Internet]. Erythrocyte sedimentation rate. Rochester (NY): URMC. [cited 2025 Apr 24]. Available from: https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=167&contentid=erythrocyte_sedimentation_rate 

9. Van Hecke O. Polymyalgia rheumatica – diagnosis and management. Aust Fam Physician. 2011 May;40(5):303–306. Available from: https://www.racgp.org.au/getattachment/fda350a5-7187-4e50-aa81-f02ebdf351ee/Polymyalgia-rheumatica.aspx  

10. Nemeth E, Ganz T. Anemia of inflammation. Hematol Oncol Clin North Am. 2014 Aug;28(4):671–681. doi: 10.1016/j.hoc.2014.04.005. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4115203/ 

11. Chakraborty S, Dimaio D, Vanschooneveld T. Palpable maculopapular rash with elevated ESR: what is your diagnosis? Ups J Med Sci. 2013 Nov;118(4):285-6. doi: 10.3109/03009734.2013. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4190890/  

12. Liang H, Xin M, Zhao L, Wang L, et al. Serum creatinine level and ESR values associated to clinical pathology types and prognosis of patients with renal injury caused by ANCA-associated vasculitis. Exp Ther Med. 2017 Dec;14(6):6059–63. doi:10.3892/etm.2017.5306. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5740565/  

13. Andresdottir MB, Sigfusson N, Sigvaldason H, Gudnason V. Erythrocyte sedimentation rate, an independent predictor of coronary heart disease in men and women: The Reykjavik Study. Am J Epidemiol. 2003 Nov 1;158(9):844–51. doi:10.1093/aje/kwg222. Available from: https://pubmed.ncbi.nlm.nih.gov/14585762/ 

14. Zhang YH, Guo LJ, Kuang TG, Zhu M, et al. Association between the erythrocyte sedimentation rate, serum C-reactive protein and risk of lung cancer. Zhonghua Zhong Liu Za Zhi. 2010 Jan;32(1):48–51. Chinese. Available from: https://pubmed.ncbi.nlm.nih.gov/20211068/ 

15. Tas F, Erturk K. Elevated erythrocyte sedimentation rate is associated with metastatic disease and worse survival in patients with cutaneous malignant melanoma. Mol Clin Oncol. 2017 Dec;7(6):1142-1146. doi: 10.3892/mco.2017.1440. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5740825/#:~:text=A%20number%20of%20studies%20indicated,cancer%20(9)%2C%20had%20a  

16. Poudel P, Lappin SL. Inflammatory Arthritis [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025 Jan. [updated 2023 Apr 17] [cited 2025 Apr 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507704/ 

17. Louati K, Berenbaum F. Fatigue in chronic inflammation – a link to pain pathways. Arthritis Res Ther. 2015;17:254. doi:10.1186/s13075-015-0784-1. Available from: Louati K, Berenbaum F. Fatigue in chronic inflammation – a link to pain pathways. Arthritis Res Ther. 2015;17:254. doi:10.1186/s13075-015-0784-1. 

18. Hulander E, Barebring L, Turesson Wadell A, Gjertsson I, et al. Proposed anti-inflammatory diet reduces inflammation in compliant, weight-stable patients with rheumatoid arthritis in a randomized controlled crossover trial. J Nutr. 2021 Dec 3;151(12):3856-3864. doi:10.1093/jn/nxab313. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8643575/ 

19. Sedighiyan M, Abdollahi H, Karimi E, Badeli M, et al. Omega-3 polyunsaturated fatty acids supplementation improve clinical symptoms in patients with Covid-19: A randomised clinical trial. Int J Clin Pract. 2021 Dec;75(12):e14854. doi:10.1111/ijcp.14854. Available from: https://pubmed.ncbi.nlm.nih.gov/34516692/ 

20. Ranjbar M, Rahimlou M, Fallah M, Djafarian K, Mohammadi H. Effects of vitamin D supplementation in patients with rheumatoid arthritis: A systematic review and meta-analysis. Heliyon. 2025 Mar;11(3):e42463. doi:10.1016/j.heliyon.2025.e42463. Available from: https://www.sciencedirect.com/science/article/pii/S2405844025008436  

21. Alende-Castro V, Alonso-Sampedro M, Vazquez-Temprano N, Tuñez C, et al. Factors influencing erythrocyte sedimentation rate in adults: New evidence for an old test. Medicine (Baltimore). 2019 Aug;98(34):e16816. doi: 10.1097/MD.0000000000016816. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6716712/ 

22. Hegg R, Lee AG, Tagg NT, Zimmerman MB. Statin or nonsteroidal anti-inflammatory drug use is associated with lower erythrocyte sedimentation rate in patients with giant cell arteritis. J Neuroophthalmol. 2011 Jun;31(2):135-8. doi: 10.1097/WNO.0b013e31820c4421. Available from: https://pubmed.ncbi.nlm.nih.gov/21358421/  

23. McConkey B, Davies P, Crockson RA, Crockson AP, et al. Effects of gold, dapsone, and prednisone on serum C-reactive protein and haptoglobin and the erythrocyte sedimentation rate in rheumatoid arthritis. Ann Rheum Dis. 1979 Apr;38(2):141-4. doi: 10.1136/ard.38.2.141. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC1000338/  

24. Yu X, Pu H, Voss M. Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. Br J Nutr. 2024 Oct 14;132(7):898-918. doi: 10.1017/S0007114524001405. Epub 2024 Oct 16. PMID: 39411832; PMCID: PMC11576095. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11576095/

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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21

Is It Possible to Increase Penis Size? Myths vs. Medical Facts

Introduction

Penis size is a common concern for many men, but it’s important to understand that size does not necessarily correlate with sexual satisfaction or performance^[3]. While there are no exercises that can significantly increase the size of the penis, some practices can improve blood flow and contribute to better sexual health. It’s essential to approach any claims of penis enlargement with caution, as many are not supported by scientific evidence. Prioritizing general sexual health and fitness is the most reliable way to support sexual function.
What is the average penis size? How to get a bigger penis? If you are trying to find answers for these frequently searched questions- this article can help you with medically correct information.

How to Measure Penis Size?

You need some privacy, a clean ruler, a clean measuring tape or a non-stretchable string (for measuring the girth of penis).

• Prepare for the measurement: Ensure that the penis is fully erect for accurate measurement. You may also measure while flaccid, but results will vary more significantly^[4].
• Measure the length: Place a ruler or measuring tape at the base of the penis, where it meets the pubic bone, and measure along the top side up to the tip of the glans. Make sure the ruler is pressed gently against the skin^[4].
• Measure the girth: Wrap a soft measuring tape around the thickest part of the erect penis shaft, usually at the middle. Record the circumference^[4].
• Repeat for accuracy: Take multiple measurements at different times to account for natural variations in size due to factors like temperature or level of arousal^[4].
• Record your measurements: Write down your measurements to keep track and compare if needed^[4].

Anatomy of the Penis

Main Parts of the Penis:

• Shaft or Body of Penis: The long, cylindrical portion of the penis.
• Glans (Head): The rounded tip of the penis^[5].
• Root: Anchors the penis to the body^[5].

Internal Structure:

• Corpora Cavernosa: Two cylindrical chambers inside the shaft that fill with blood during an erection^[5].
• Corpus Spongiosum: Surrounds the urethra and maintains the penis’s shape during erection. Urethra is the common passage for semen and urine^[5].

Understanding the Growth Of Penis

• The penis is formed during the growth of the baby in the mother’s womb. 
• Penile growth begins during puberty, typically between ages 9 and 14.
• Growth is influenced by hormonal changes, especially testosterone.
• The penis reaches its adult size by the end of puberty, with no further natural growth occurring afterward.

Factors Affecting Penis Size in Men

• Genetics: The primary determinant of penis size is genetics, much like other physical traits such as height or eye color. Your genes play a key role in shaping the size and appearance of your penis.
• Hormonal Levels: Hormones, particularly testosterone, influence penis growth during puberty. Any imbalance in these hormones during this critical period can affect final size^[7].
• Health and Nutrition: Proper nutrition during childhood and adolescence supports overall development, including penis growth. Poor nutrition or chronic illness during these years may impact growth.
• Body Weight: Excessive body fat, especially around the pubic area, can make the penis appear smaller, as fat can obscure part of the shaft. Maintaining a healthy weight can help in accurately assessing size^[6]. 
• Developmental and Endocrine abnormalities: The size and shape of penis can be affected by developmental or hormonal disorders. 

5 Exercises That Claim To Increase Penis Size

Penis stretching exercises have gained popularity over the years. People often search online- how to increase penis size? and start following the remedies and exercises given on the internet. But do not set your expectations high if you are planning to try exercises to make your penis big. Let’s read more about different exercises known to increase penis size and understand the scientific logic behind them-  

1. Massage Exercise

In this type of manual exercise, a safe lubricant is applied to the penis and massaged gently. This exercise is intended to stretch the skin of your penis which may aid in the enlargement of the penis.

Caution: Vigorous massaging can lead to tissue injury.

2. Penis Pump Exercise

This stretching device can be attached to the penis and it tends to create immediate erection. The device creates a vacuum and increases the blood flow to penis with the help of suction^[2],[8].

Steps:

• Firstly, apply lubricant on penis to avoid irritation. 
• Place the tube over your penis. 
• Turn on the pump and it will take a few minutes for an erection to happen. 

Caution: There are limited studies around the long-term effectiveness of such devices. Always consult your doctor before using any such device around your sensitive areas.

3. Jelqing Exercise

This is the most common form of exercise among men. It may help in improving the blood circulation to penis^[1].

Steps:

• Place both hands on the penis and gently move it from top to bottom. 
• Repeat for 5-10 times 
• Stop immediately if you experience any pain or discomfort.

4. Stretching Exercise

There is no scientific evidence that stretching exercises can increase penis size. This exercise is similar to milking a cow. This is a kind of jelqing exercise, but it uses only your thumb and index finger. 

Steps:

• Use your thumb and index finger to slide the skin from top to bottom.
• Do it 5-10 times. (Make sure you do not masturbate). 
• If there is erection, let the penis relax and continue after 5 minutes

5. Kegel Exercise

Kegel exercises help strengthen the pelvic floor muscles and may support performance. Stay focused throughout the exercise^[9].

How To Do?

• Contract your pelvic floor muscles and hold for three seconds
• Relax for three seconds. 
• Repeat this a few times in succession. As your muscles strengthen, try doing Kegel exercises in different positions, such as sitting, standing, or walking

Note: Before implementing any exercise or technique mentioned in this article, it is important to consult a urologist to understand the pros and cons of performing any exercise for penis. Incorrect practices may injure the penis.

Penoscortal rings are devices that may help in keeping an erection for a longer period and create the appearance of a larger penis. These rings fit around the base of the scrotum and penis, helping to keep the blood in the penis, which might make make it look bigger during sexual activities. However, it should be worn cautiously and after consulting a doctor, as it may also cause discomfort and injury.

Dr. Nayana Shetty, MBBS, MD

Can You Increase the Size of Your Penis Naturally?

While many products and techniques claim to increase penis size, there is little scientific evidence supporting their effectiveness. However, maintaining a healthy lifestyle can contribute to better overall sexual health, which might indirectly influence penis function and appearance.

1. Healthy Diet

A balanced diet rich in macro and micro nutrients, such as fresh fruits, vegetables, whole grains, lean proteins, and healthy fats, is essential for overall health, including sexual health^[10]. Proper nutrition supports blood flow and hormone levels, which are crucial for sexual function.

2. Regular Exercise

Regular physical activity improves cardiovascular health, which is vital for maintaining proper blood flow. Exercises like Kegels specifically target the pelvic floor muscles, potentially improving sexual performance and penile function.

3. Weight Management

Maintaining a healthy weight can prevent conditions like obesity and diabetes, which are known to negatively impact sexual health. Excessive body fat can also reduce testosterone levels, leading to potential issues with libido and erectile function^[11].

4. Sufficient Sleep

Adequate sleep is crucial for hormonal balance, including testosterone production. Poor sleep can lead to lower energy levels and reduced sexual desire, affecting overall sexual health.

5. Stress Management

Chronic stress can lead to hormonal imbalances, including reduced testosterone levels, which may impact sexual function. Techniques such as meditation, deep breathing, and yoga can help manage stress, promoting better overall and sexual health^[12].

6. Avoid Smoking and Alcohol Consumption

Smoking^[13] and excessive alcohol intake can impair blood flow and lead to erectile dysfunction. Quitting smoking and moderating alcohol consumption are important steps in maintaining sexual health and overall well-being.

Penis Enlargement Products that Claim to Achieve Bigger Size

Various products are marketed as remedies for increasing penis size naturally. These can be dangerous to your health. Never consume or use anything for penis enlargement without consulting a doctor. Here are some popular examples that you need to be cautious about-

1. Pills

People often ask if Penis enlargement pills increase penis size? Often marketed as natural supplements, these pills claim to increase penis size by boosting blood flow or enhancing hormone levels. However, there is little scientific evidence to support their effectiveness, and some may contain harmful or unregulated ingredients.

2. Creams

These topical products claim to enlarge the penis by improving circulation or stimulating tissue growth. However, there is no reliable proof that they work, and they can sometimes cause skin irritation or serious allergic reactions.

3. Pumps

Vacuum pumps create temporary swelling by drawing blood into the penis, which can make it appear larger temporarily. While they can help temporarily with erectile dysfunction, they do not result in permanent size increase and overuse can lead to tissue damage.

Also Read: Does Masturbating Increase Risk of Prostate Cancer or Vice Versa?

Penis Enlargement Surgery

Penis-enlargement surgery (phalloplasty)^[2] is rarely needed and is usually reserved for cases where the penis doesn’t function properly due to a congenital issue or injury. Some surgeons offer cosmetic procedures to enlarge the penis, but these are controversial and often deemed unnecessary by experts. There is a lack of sufficient research to fully understand the risks and benefits of these procedures.

A penis enlargement surgery can be involve any one of the following : 

• Cutting the suspensory ligament: This surgery makes the penis appear longer by cutting the ligament that attaches it to the pubic bone, but it doesn’t actually increase length and can lead to instability and potential injury during erection.
• Fat injection: Fat is taken from another part of the body and injected into the penis to increase thickness, but results can be uneven, with possible scarring, irregular shape, and issues with sensation.
• Tissue grafting: Skin and fat are grafted onto the penis to increase width or length, but the procedure can cause infections, scarring, and deformation, with no proven safety or effectiveness.
• Penis implants: Material is implanted under the skin to make the penis appear thicker, but risks include infection, scarring, and potential erectile dysfunction, sometimes requiring additional surgery.

To know more about the risks and benefits associated with surgery to increase penis size, consult a urologist and plastic surgeon.

Many people are not aware that filler injections might also help in increasing penis size. Studies have shown that using these fillers may lead to a modest increase in some, especially in the initial months. These injections may also improve erectile dysfunction in the long run. However, more studies are needed to validate these treatments for their effectiveness and safety.

Dr. Nayana Shetty, MBBS, MD

Stop Worrying About Penis Size. Here’s What Experts Have to Say!

Consult a psychiatrist and a urologist first. Many-a-times it’s not the size but the self doubt related to the normal size of penis that creates the entire problem. Consulting an expert can solve the problem. They may help you in understanding the following- 

• Psychological Impact:  Concerns about penis size can affect self-esteem and sexual confidence. However, focusing on mental and emotional well-being can significantly improve your sexual experience and satisfaction.
• Communication with Your Partner: Open communication with your partner about your feelings and concerns can reduce anxiety and strengthen your relationship. Understanding and support from your partner can ease worries about size and improve intimacy.
• Role of Exercise: Regular exercise and maintaining a healthy weight can enhance your overall sexual health, boost confidence, and improve your body image, making you feel better about yourself.

Also Read: Things You Shouldn’t Do Before And After Sex

Conclusion

Worrying about penis size is common, but it’s crucial to remember that size doesn’t determine masculinity or sexual ability. Confidence in and acceptance of your natural size is key to a fulfilling and healthy sexual life. If you are constantly looking for options to increase penis size, if concerns about penis size are affecting your mental health or relationships, consulting a sexologist (MBBS, MD Psychiatry) can help address these issues and provide guidance on managing anxiety and self-esteem.

Also Read: Is Daily Sex Good for Health?

Frequently Asked Questions (FAQs)

References

1. Gold Journal. Penile and Foreskin Stretching Practices Through Time and Culture.[Internet].Available from:https://www.goldjournal.net/article/S0090-4295(23)00183-8/fulltext 
2. The Aesthetic Society.Penis Enlargement.[Internet].Available from:https://www.theaestheticsociety.org/procedures/genital/penis-enlargement 
3. Eisenman R. Penis size: Survey of female perceptions of sexual satisfaction. BMC Womens Health. 2001;1(1):1. doi:10.1186/1472-6874-1-1. PMID: 11415468; PMCID: PMC33342. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC33342/
4. Habous M, Muir G, Soliman T, Farag M, Williamson B, Binsaleh S, et al. Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement. Int J Impot Res. 2018 Feb;30(1):21–6. doi:10.1038/s41443-017-0013-3. Epub 2017 Nov 27. PMID: 29180797; PMCID: PMC8519169. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519169/
5. Sam P, LaGrange CA. Anatomy, Abdomen and Pelvis, Penis. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482236/
6. Hong S, Choi W, Lee KW, Lee YT, Kwon T. Penile length and circumference: are they related to nose size? Transl Androl Urol. 2023 May 31;12(5):708–14. doi:10.21037/tau-22-869. Epub 2023 May 9. PMID: 37305632; PMCID: PMC10251097. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251097/
7. Nerli RB, Guntaka AK, Patne PB, Hiremath MB. Penile growth in response to hormone treatment in children with micropenis. Indian J Urol. 2013 Oct;29(4):288–91. doi:10.4103/0970-1591.120107. PMID: 24235789; PMCID: PMC3822343. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822343/
8. Hoyland K, Vasdev N, Adshead J. The use of vacuum erection devices in erectile dysfunction after radical prostatectomy. Rev Urol. 2013;15(2):67–71. PMID: 24082845; PMCID: PMC3784970. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784970/
9. Huang YC, Chang KV. Kegel Exercises. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555898/
10. Yang H, Breyer BN, Rimm EB, Giovannucci E, Loeb S, Kenfield SA, Bauer SR. Plant-based diet index and erectile dysfunction in the Health Professionals Follow-Up Study. BJU Int. 2022 Oct;130(4):514–21. doi:10.1111/bju.15765. Epub 2022 Jun 9. PMID: 35484829; PMCID: PMC9474604. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9474604/
11. Majzoub A, Elbardisi H, Madani S, Leisegang K, Mahdi M, Agarwal A, et al. Impact of body composition analysis on male sexual function: A metabolic age study. Front Endocrinol (Lausanne). 2023 Jan 4;13:1050441. doi:10.3389/fendo.2022.1050441. PMID: 36686453; PMCID: PMC9846759. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846759/
12. Joshi AM, Arkiath Veettil R, Deshpande S. Role of Yoga in the management of premature ejaculation. World J Mens Health. 2020 Oct;38(4):495–505. doi:10.5534/wjmh.190062. Epub 2019 Sep 3. PMID: 31496152; PMCID: PMC7502310. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502310/
13. Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI. Effects of cigarette smoking on erectile dysfunction. Andrologia. 2015 Dec;47(10):1087–92. doi:10.1111/and.12393. Epub 2014 Dec 29. PMID: 25557907; PMCID: PMC4485976. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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