What's Trending, What's Helpful, What's Harmful

Pretty Doesn't Always Mean Safe:

What Parents and Teens Should Know About Artificial Nails

This summer we've seen a few patients who had very traumatic experiences with artificial fingernails. We want you to be aware of the risks and have conversations with your kids and teens about them.

Long acrylic, gel, and press-on nails may be trendy, but they can also increase the risk of injury, especially during sports, dance, cheer, and other activities where fingers are likely to get bumped. A forceful hit can cause the artificial nail to catch and partially or completely tear off the natural nail underneath, which is extremely painful and may require medical treatment.

Artificial nails can also trap moisture and bacteria, increasing the risk of nail infections. They are known to weaken or damage the natural nail with repeated application and removal. They can sometimes cause allergic reactions from the nail glues or gel/acrylic ingredients, which can lead to a painful rash around the nails or even on the face and eyelids.

Safer choices:

• Keep nails short, whether natural or artificial.
• Consider short press-on nails for special occasions rather than wearing long nails continuously.
• Remove artificial nails before sports or activities where finger injuries are common.
• Stop using nail products if redness, swelling, itching, or pain develops.

Healthy nails are always in style. If your child wants to express themselves through nail art, choosing shorter nails and taking breaks between applications can help keep their natural nails healthy while reducing the risk of painful injuries.

Allergy Management: A Guide for Parents and Families

Allergies happen when the immune system overreacts to normally harmless substances like pollen, dust mites, pet dander, or mold. This guide will help you understand the best ways to manage allergy symptoms for children, teens, and adults in your family.

Reduce Your Exposure —

Simple Habits That Make a Big Difference

The most important first step in allergy treatment is reducing contact with the things that trigger symptoms. Here are practical steps your family can take:

• Remove shoes at the door. Shoes track in pollen, mold spores, and outdoor allergens throughout your home.
• Shower and wash hair before bed. Pollen and allergens collect in hair and on eyelashes throughout the day. If you don't wash them off, you transfer allergens to your pillow and breathe them in all night. At minimum, wash your face and eyelashes before bed.
• Sleeping cap tip: On nights when hair washing isn't possible (especially for young children), a smooth cotton or silk sleeping cap can help reduce pollen transfer from hair to the pillow. The cap should be washed frequently. This is a helpful backup, but washing hair remains the best option.
• Change clothes after spending time outdoors during allergy season.
• Keep windows closed during high pollen days. Use air conditioning instead.
• Use HEPA filters. Place high-efficiency particulate air (HEPA) filter air purifiers in bedrooms and main living areas. Use a vacuum with a HEPA filter. These devices remove pollen, pet dander, dust mite particles, and mold spores from the air.
• Cover mattresses and pillows with dust mite–proof encasements.
• Wash bedding weekly in hot water.
• Keep pets out of bedrooms if anyone in the family is allergic to pet dander.
• Keep indoor humidity between 30% and 50% to discourage dust mites and mold.
• Check local pollen counts (websites like pollen.com) and limit outdoor time when counts are high.

Kansas City Pollen Calendar —

Know Your Allergy Seasons

In the Kansas City area, outdoor allergy season runs from about March through October. There are three main pollen waves, plus mold:

Tree Pollen (Spring)

• When: Late February through early May
• Peak: April
• Common trees: Oak, elm, maple, cedar
• Tip: If you are allergic to tree pollen, start your nasal spray and antihistamine by mid-February — before symptoms begin

Grass Pollen (Late Spring – Summer)

• When: Late May through July
• Peak: June
• Tip: Limit time outdoors on windy days during this period; mow the lawn when pollen counts are lower or wear a mask while mowing

Ragweed Pollen (Late Summer – Fall)

• When: Mid-August through the first frost (usually mid- to late October)
• Peak: Late August to early September
• Tip: Ragweed pollen is highest around midday (not early morning, as many people think). If you are ragweed-allergic, start your medications by early August
• Fun fact: A single ragweed plant can produce up to one billion pollen grains per season

Mold Spores (Spring – Fall)

• When: Present throughout warm months, worst in late summer and fall
• Worse after rain and in humid conditions
• Tip: Keep indoor humidity below 50% and clean damp areas regularly

Important note: Allergy seasons are getting longer. Over the past 30 years, pollen season in the U.S. has lengthened by about 20 days and pollen levels have increased by 21%, largely due to climate change. This means symptoms may start earlier and last longer than they used to.

When to start medications

The best approach is to begin daily nasal corticosteroid sprays and antihistamines 2 to 4 weeks BEFORE your expected allergy season starts. This gives the medications time to build up their protective effect.

Don't wait until you're already miserable!

Saline (Salt Water) Nasal Rinses

Rinsing the nose with salt water is a safe, drug-free way to relieve allergy symptoms for all ages. Saline rinses work by:

• Washing allergens (pollen, dust, dander) out of the nasal passages
• Thinning mucus so it drains more easily
• Soothing swollen, irritated nasal tissue

You can use a squeeze bottle, neti pot, or saline spray. For children, a simple saline spray is often easiest.

Nasopure brand has instructions for use and videos to help kids get comfortable with using a saline rinse.

Safety tip: Always use distilled, sterile, or previously boiled water — never use tap water straight from the faucet, as it can contain harmful organisms.

Saline rinses can be used alone for mild symptoms or alongside allergy medications for added relief.

Choosing the Right Allergy Medication

Nasal corticosteroid sprays — the most effective allergy treatment

For moderate to severe allergy symptoms — especially nasal congestion, which antihistamine pills don't treat well — nasal corticosteroid sprays are the most effective treatment available. Here are the options and the youngest age each is FDA-approved for:

Approved for ages 2 and up:

• Mometasone (Nasonex) — 1 spray per nostril once daily for ages 2–11
• Fluticasone furoate (Veramyst) — 1–2 sprays per nostril once daily for ages 2–11
• Triamcinolone (Nasacort Allergy 24HR) — 1 spray per nostril once daily for ages 2–5

Approved for ages 4 and up:

• Fluticasone propionate (Flonase) — 1 spray per nostril once daily for ages 4–11

Approved for ages 6 and up:

• Budesonide (Rhinocort) — approved for ages 6 and up

These sprays work by reducing inflammation directly inside the nose. They are safe for daily use and many are available over the counter.

Important tips for nasal sprays:

• They work best when used every day during allergy season — they are not "as needed" medications
• It may take several days to a couple of weeks to feel the full benefit
• Aim the spray toward the outside wall of the nose (away from the center wall/septum) to reduce the chance of nosebleeds
• The most common side effect is minor nosebleeds; if this happens, take a short break and restart

We recommend 24-hour antihistamines (and avoid diphenhydramine/Benadryl)

There are two types of antihistamines:

• Older "first-generation" antihistamines like diphenhydramine (Benadryl) and hydroxyzine
• Newer "second-generation" 24-hour antihistamines like cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra), and levocetirizine (Xyzal)

Diphenhydramine (Benadryl) and other older antihistamines cause significant side effects

• Drowsiness and sedation — this can impair school performance in children and driving ability in teens and adults
• Impaired thinking, memory, and coordination — these effects can happen even when a person doesn't feel drowsy
• Dry mouth, blurred vision, constipation, and difficulty urinating
• Rapid heartbeat
• In overdose, they can cause hallucinations, seizures, dangerous heart rhythms, and even death
• They wear off quickly (every 4–6 hours), so symptoms return and doses must be repeated
• The body builds tolerance to the sedating effect within days, but the other side effects remain

The newer 24-hour antihistamines do not cross into the brain the way older ones do, so they cause far less drowsiness and do not impair thinking or coordination. They last all day with a single dose and are available over the counter. They are safe for long-term daily use in children, teens, and adults.

For people with both nasal and eye symptoms, combining a nasal corticosteroid spray with a 24-hour antihistamine often provides the best relief.

When to Consider Allergy Testing and Immunotherapy (Allergy ShotS)

Talk to your doctor about allergy testing if:

• Symptoms are not well controlled despite using the medications above correctly
• Medications cause bothersome side effects
• Symptoms last many months of the year or are getting worse over time
• You want to reduce the need for daily medications
• Your child has allergies along with asthma, recurrent sinus infections, or ear problems

If your child's allergies are not well controlled and you want to consider allergy testing, please schedule a visit to discuss options.

Quick Summary by Age

Children ages 2–3:

• Saline sprays, allergen avoidance, sleeping caps, and HEPA filters are safe starting points
• 24-hour antihistamines (cetirizine, loratadine) in age-appropriate doses
• Nasal corticosteroid sprays: Nasonex, Veramyst, or Nasacort (the three brands approved for age 2+)
• Avoid diphenhydramine (Benadryl) and use 24 hour antihistamines

Children ages 4–5:

• All of the above, plus Flonase becomes an option at age 4

Children ages 6 and up:

• All of the above, plus Rhinocort becomes an option at age 6
• Fexofenadine (Allegra) can be added as an antihistamine option
• Consider allergy testing if symptoms are persistent or poorly controlled

Teens and adults:

• All of the above, plus combination nasal sprays (corticosteroid + antihistamine) for stubborn symptoms
• Immunotherapy for long-term control when medications aren't enough
• Be especially cautious with diphenhydramine — it impairs driving and academic performance

When to schedule a visit

• Allergy symptoms interfere with sleep, school, work, or daily activities
• Over-the-counter treatments aren't providing enough relief
• You notice wheezing, chest tightness, or shortness of breath (these may indicate asthma)
• You have frequent sinus infections or ear infections along with allergies

Supplements Teens See Online:

What Works, What Doesn't, and What's Risky

Start Here: The Big Picture

A well-balanced diet meets nutritional needs for almost every teen and adult. Supplements are typically not required, and no supplement makes up for inadequate sleep, poor nutrition, or an unstructured training plan.

Supplements are not approved by the FDA before they are sold. Companies do not have to prove a product works, and they do not have to prove it is safe before putting it on the shelf. What's on the label isn't always what's in the bottle.

Social media is not a reliable source. Most influencers are paid to promote products, and teens report getting supplement information mainly from friends, coaches, and the internet.

How to Choose a Product If You Decide to Buy One

1. Look for third-party certification. These organizations independently test what's actually in the container:

• NSF Certified for Sport — the strongest option for athletes; also screens for banned substances 
• Informed Sport / Informed Choice — batch-level testing for banned substances
• USP Verified — verifies identity, potency, and purity
• ConsumerLab — independent testing and reviews

2. Purchase single-ingredient products. A tub labeled simply "creatine monohydrate" is far easier to verify than a 22-ingredient blend.

3. Read the full ingredient list. If you can't identify what something is, look it up before taking it.

4. Check the caffeine content in anything labeled pre-workout, energy, or fat burner. Add it to what you already get from coffee, tea, and soda. Be aware that many products have energy boosters that are not included in the caffeine count. More on caffeine.

5. For athletes: Check every ingredient against your league's banned substance list. "I didn't know it was in there" is not an accepted defense, and contaminated supplements are a known cause of failed drug tests.

6. Tell your doctor and pharmacist. Bring the actual bottle or a photo of the label to appointments. Supplements can interact with prescription medications.

Tier 1: Reasonable Evidence, Generally Safe

Creatine Monohydrate

• What it does: Improves strength, power, and lean muscle when combined with resistance training. Helps with short bursts of intense effort — lifting, sprinting, interval work.
• What it doesn't do: It is not a steroid, does not damage kidneys in healthy people, does not cause hair loss, and does not cause dehydration or cramping. It does not help endurance sports.
• Dose: 3–5 g/day. A "loading phase" is not necessary.
• Note: Expect 1–3 lbs of water weight, held inside muscle — not fat.

This has become a very popular supplement for athletes and non-athletes alike. What started as part of this blog grew to be too much to cover. Use the button below to learn more. There is a link to return to this page from the creatine page.

Protein Powder

• What it does: A convenient way to hit daily protein targets, which supports muscle growth alongside training. 
• Reality check: It is food, not magic. Most teens eating a normal diet with meat, dairy, eggs, beans, or soy already get enough. Whole food is cheaper and works just as well. Plus, food usually tastes better.
• Watch out: Testing of protein powders has found low levels of heavy metals like lead, cadmium, and arsenic in some products, more often in plant-based powders. Third-party certification matters most here.

Caffeine

• What it does: Genuinely improves endurance and alertness in adults. One of the few supplements with strong performance evidence.
• The teen problem: Caffeine hits kids and teens harder than adults. The American Academy of Pediatrics recommends that children not have any beverages with caffeine and adolescents never consume energy drinks. High-dose caffeine from energy drinks, powders, and pills has caused abnormal heart rhythms, QT prolongation, high blood pressure, and seizures in teens.
• Sources of caffeine are not just in coffee, tea, sodas, and energy drinks. You might be surprised to learn it's in chocolate and other popular products kids consume. Due to its popularity and surprising sources, I made a separate page with much more information. There is a link to return to this page from the caffeine page.

Tier 2: Modest, Narrow, or Uncertain Benefit

Beta-Alanine

• Small benefit (about 3%) only for efforts lasting longer than 60 seconds. No benefit for short efforts.
• Commonly causes tingling/pins-and-needles in the face and hands — harmless but unpleasant, and often mistaken for the product "working."

Beetroot Juice / Nitric Oxide "Pump" Products

• Results are mixed. Any benefit is small and mostly in endurance events.
• Arginine and citrulline supplements offer little to healthy young athletes already eating enough protein.

Collagen Peptides

• May modestly help joint pain and tendon-related discomfort; less convincing for muscle building.
• For skin and hair claims, evidence is much weaker than the marketing suggests.
• Not a superior protein source — collagen is a low-quality protein for building muscle.

Melatonin

• Modestly shortens time to fall asleep (roughly 18–30 minutes of improvement) in teens.
• Not a first-line solution. Sleep hygiene and behavioral strategies should come first.
• Over-the-counter melatonin content is often inaccurate compared with the label.
• Long-term safety in children and teens is not established, and there is a theoretical concern about effects on puberty hormones.
• Use short-term only and involve a doctor.
• For more on melatonin and other sleep aids, visit Dr Stuppy's blog.

HMB

• Small strength gains in untrained people; essentially nothing in trained athletes.
• Generally safe short-term but low value for the money.

Ashwagandha

• Popular for stress and sleep, with some supportive studies but inconsistent quality.
• Important safety concern: Multiple documented cases of liver injury, including jaundice, itching, and in rare cases liver failure requiring transplant. Injury has occurred within 2–12 weeks of starting.
• Not recommended for children or teens. Anyone with liver disease should avoid it entirely.

"Greens Powders"

• Marketed as replacing vegetables.
• There is little rigorous evidence they improve health outcomes.
• They are expensive, and eating actual fruits and vegetables is better supported.

Tier 3: Risky — Avoid

Fat Burners / "Thermogenics" / Weight-Loss Supplements

• Among the highest-risk categories. Roughly one-third of users of certain weight-loss products report adverse effects.
• Linked to palpitations, chest pain, fast heart rate, high blood pressure, and emergency room visits — most commonly in people aged 20–34.
• Frequently spiked with undeclared stimulants or banned drugs.

Pre-Workout Powders

• About 1 in 4 users report side effects. Doses of stimulants are often high and poorly disclosed under "proprietary blends."
• Many contain multiple stimulants stacked together. Some have been found to contain unapproved amphetamine-like compounds.

SARMs (Ostarine, RAD-140, LGD-4033, "Enhanced Athlete" products)

• No FDA-approved SARM exists. These are not legal supplements, and they are banned in all levels of organized sport.
• Documented harms: liver injury, suppressed natural testosterone, shrunken testicles, tendon rupture, heart muscle inflammation, and reduced HDL cholesterol.
• Products bought online are frequently contaminated with other undisclosed drugs.
• More than half of users in survey data report significant side effects.

"Testosterone Boosters," Prohormones, and DHEA

• Prohormones had the highest rate of reported side effects of any supplement category (about 35%).
• Often contain hidden anabolic steroids.
• Teens who use legal supplements are significantly more likely to go on to use anabolic steroids, and more than half of all anabolic steroid use begins in high school.

Anabolic Steroids

• In teens there is a premature closure of growth plates (permanently shorter adult height), acne, hair loss, mood swings and aggression, testicular shrinkage, infertility, gynecomastia (breast development) in males, and voice deepening and facial hair in females. Some of these side effects do not reverse.

Turkesterone / Ecdysterone

• Heavily promoted online with almost no quality human evidence.
• Product testing has repeatedly found that many contain little to none of the advertised ingredient.

Weight-Loss Teas, "Detox" Products, and DNP

• No legitimate detox benefit. Laxative-based teas can cause dehydration and electrolyte problems.
• 2,4-dinitrophenol (DNP) is sold illegally for fat loss and has killed users. Never use it.

Red Flags in Supplement Marketing

Be skeptical of any product that:

• Promises dramatic or fast results ("gain 20 lbs of muscle in 8 weeks")
• Uses the words "steroid alternative," "legal steroid," "SARM," or "prohormone"
• Lists a "proprietary blend" without disclosing individual ingredient amounts
• Is sold primarily through influencers with discount codes
• Claims to "cure," "treat," or "reverse" a disease
• Has a name suggesting extremity ("Hardcore," "Extreme," "Ripper," "Shred")
• Is only available from an overseas website or a research-chemical vendor

Bottom Line On Supplements



• Worth considering: creatine monohydrate, protein powder (as food convenience), and correcting a documented vitamin deficiency.
• Overhyped but mostly harmless: collagen, greens powders, BCAAs, nitric oxide boosters, most "recovery" products.
• Genuinely risky: fat burners, high-stimulant pre-workouts, SARMs, prohormones, testosterone boosters, and anything sold as a "legal steroid."
• Always: buy third-party tested, choose simple formulas, and tell your doctor what you're taking.
• Remember: No supplement outperforms consistent training, adequate protein and calories, and 8–10 hours of sleep.

Manage your home with better strategies

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