Archive for the ‘Hormone Physician’ Category

The Iowa Board of Nursing has suspended the license of a nurse who allegedly had sex with a former psychiatric patient.

At its January meeting, the board voted to suspend the license of Shawn Sandersfeld of Muscatine indefinitely and ordered a mental-health and chemical-dependency evaluation.

Once that evaluation is completed, Sandersfeld must submit to any treatment that is recommended and, after showing proof of 12 months sobriety, may resume practice while serving a 12-month period of probation. Sandersfeld must also complete a three-day course on professional boundaries and ethics and submit to case-manager evaluations pertaining to competency and the ability to interact professionally with co-workers and patients.

The sanctions are tied to allegations by the board Sandersfeld was working as a psychiatric mental health nurse at an unspecified hospital in 2019 and provided nursing services to a particular patient who was discharged in July 2019.

According to the board, from August 2019 through June 2021, the patient lived at Sandersfelds home and the two engaged in a sexual relationship during that time.

According to the Iowa Board of Nursing, these other nurses have recently faced sanctions from the board:

Patrick Jones, Waterloo Jones agreed to immediately relinquish all rights to practice nursing in the state of Iowa and surrendered his license. He can apply for reinstatement in 12 months. According to the board, Jones was employed at a care facility, unspecified by the board, from September 2019 until July 2021.

At some point during his employment, the board alleged, Jones sent electronic communication to staff that created an uncomfortable work environment. According to the board, Jones communicated conversations that were sexual in nature with a patient and he engaged in sexual actions with a patient.

James Dickerson, Neola The board ordered Dickerson to immediately stop providing any treatment to patients with a complex mental health diagnosis until he received certification as a psychiatric nurse practitioner. The board also fined Dickerson $1,000 and ordered him to undergo five hours of consultation with a nurse practitioner. The settlement stemmed from charges that Taylor exceeded his scope of practice and dispensed drugs to individuals whose care was not within his specialized, licensed area of practice.

Miranda Figueroa, Omaha Figueroa agreed to immediately relinquish all rights to practice nursing in the state of Iowa and surrendered her license. She can apply for reinstatement in 12 months. Last October, the board charged her with an inability to safely practice nursing as a result of a physical or mental condition. At that time, the board indicated it had sought provider approval for Figueroa to safely practice nursing and that no provider had given that approval.

Kristine Wikner, McGregor Wikner agreed to undergo 10 hours of educational instruction on nursing documentation. In October, the board alleged she was working at a nursing home in 2020 when a family member was admitted to the facility. Although she was instructed not to access her family members medical records, she allegedly went into her relatives medical chart and changed some of the information entered there by another worker.

Nathan Tucker, Sioux City Tucker agreed to undergo 60 hours of educational instruction on critical thinking and nursing procedures. The board alleged that in October 2020, while working at a hospital emergency department, Tucker administered intravenous medication to patients on three occasions without a physicians order, failed to assess the IV sites, and failed to provide accurate information to a physician.

Terry Seitz, Williamsburg Seitz agreed to immediately relinquish all rights to practice nursing in the state of Iowa and surrendered her license. She can apply for reinstatement in 12 months. In September 2020, she was allegedly working at an unspecified facility when she had to be transported by emergency services to a hospital where she tested positive for amphetamines, marijuana and non-prescription opioids.

Mona Taylor, Rock Island, Ill. Taylor agreed to immediately relinquish all rights to practice nursing in the state of Iowa and she surrendered her license. She can apply for reinstatement in 12 months. The factual circumstances that triggered the action have yet to be made public. The board states that it filed a statement of charges against Taylor in October 2021, but that statement of charges has yet to be published by the board.

Kori March, Sioux City March agreed to undergo 60 hours of educational instruction pertaining to professional ethics and what the board called nurses legal advisor. Last fall, the board alleged that while working at an unspecified long-term care facility between 2018 and 2021, she performed intravenous therapy functions without having the IV-therapy certification required of licensed practical nurses.

Jennifer Mayberry, Waukee Mayberry agreed to have her license placed on probation for 18 months, during which time she must abstain from the use of alcohol and illicit drugs, submit to case-manager evaluations and chemical screening, and undergo mental health counseling. Last summer, the board alleged that during a pre-employment health screening in 2021, Mayberry tested positive for amphetamine and methamphetamine.

Derrick Miller, West Branch Miller agreed to have his license placed on probation for 12 months and to undergo six hours of educational instruction on medication safety. Last fall, the board alleged that in February 2021, while working at an unspecified nursing home, Miller lost the keys to the homes medication cart, left the unlocked cart unattended, and then left medication at a residents bedside without a doctors order to do so.

Eleven months earlier, Miller allegedly gave oxycodone to a resident who had not complained of pain and did not request the medication. In 2014, Millers license was indefinitely suspended pending completion of board-ordered treatment and verification of 12 continuous months of sobriety, followed by 12 months of license probation. The 2014 sanctions stemmed from charges of misappropriation of medications and being involved in the unauthorized manufacture or use of a controlled substance.

Ronda Eick, Waterloo The board issued Eick a warning and ordered her to undergo 34 hours of educational instruction on COVID-19 and medical documentation. Last fall, the board alleged that while Eick was working at an assisted living center in 2021, she received a text message from a co-worker who stated that he or she had COVID-19. Eick did not notify human resources, the facilitys clinical coordinator or the staffs health nurse of that information.

A few days earlier, two residents of the center had tested for COVID-19, with one showing a positive result and the other showing an inconclusive result. According to the board, Eick falsely reported that one of the two residents had tested negative for COVID-19. In 2008, the board ordered Eick to complete 15 hours of educational instruction related to ethics. That sanction stemmed from her pleading guilty to a criminal charge of theft tied to allegations that she stole money collected by colleagues for the benefit of a co-worker.

McKinsey Schurr, LeClaire The board issued Schurr a warning for excessive use of alcohol after it allegedly received information that Schurr had an alcohol-use disorder. The board charged Schurr with excessive use of alcohol that may impair a licensed nurses ability to practice.

Rhonda Adkins, Grinnell Adkins agreed to under 30 hours of educational instruction on professional ethics. Last fall, the board alleged Adkins was employed as a home care nurse in 2021 when she falsified patient records and employee timecards to indicate she was providing care for a patient on dates when she did not actually work.

Jennifer Evins, Rock Island, Ill. Evins agreed to immediately relinquish all rights to practice nursing in the state of Iowa and surrendered her license. She can apply for reinstatement in 12 months. Last fall, the board alleged that in 2020, Evins was convicted of a crime related to the profession of nursing and the theft of patient medications.

As a result of the criminal conviction, Evins license was placed on probation in October 2020 and she was barred from using alcohol while on probation. In June 2021, she allegedly tested positive for alcohol use and later admitted she had been drinking.

Amanda Bendon, Dubuque Bendon agreed to undergo up to 10 hours of educational instruction on ethics and legal liability. The board had alleged that Bendonwas working at an unspecified medical clinic in 2020 when she removed a vial of Pentacel from the clinic, took it home and administered it to her child without a prescription and without permission from the clinic. Pentacel is used as a vaccine for immunization against diphtheria, tetanus and other conditions.

Jennifer Mastin, Walnut Mastin agreed to undergo up to 10 hours of educational instruction on ethics and legal liability and have her license placed on 12 months probation. The board had alleged that on more than one occasion while working at an unspecified care center, Mastin disposed of medication without the required witness; removed two narcotics from the inventory and administered only one dose; and failed to document the administration of narcotics to residents.

Tricia Venzke, Ames Venzke agreed to undergo 30 hours of educational instruction on managing difficult patients. The board had alleged that in 2021, while dealing with a combative hospital patient, Venzke reacted physically inappropriately to the patient.

Miranda Depyer, Graettinger Depyer agreed to undergo seven hours of educational instruction on professional accountability and critical thinking skills. The board had alleged that in April of last year, Depyer responded to an ambulance call for a woman in labor. While en route to a hospital, Depyer allegedly gave the woman a dose of Pitocin a natural hormone sometimes used to induce labor without a physicians order.

Read more here:
Iowa nurses sanctioned for sex with patients, meth use and other violations - Iowa Capital Dispatch

Transcript:

Lori Wirth, MD: Maybe you could describe for us what the typical thyroid cancer diagnosis and brief course of typical treatment is for the garden variety thyroid cancer.

Bryan McIver, MD: Most thyroid cancer presents as a lump in the neck, and that lump is often something that is felt on a routine physical exam. Sometimes its picked up on a scan done for other reasons. For example, if somebody gets their carotid artery scanned and the lump in the thyroid gland is found by accident. Occasionally, of course, the disease is found having already spread, and so sometimes a lump on the side of the neck is found and it turns out to be a lymph node involving that cancer. The typical course of treatment is to diagnose and confirm that it is cancer using a biopsy, typically a fine needle biopsy under ultrasound guidance. That biopsy leads to the diagnosis and that leads to a surgical treatment.

The most common surgery is to remove either part or all of the thyroid gland and some of the surrounding lymph nodes. Then, for patients with more advanced disease, with more aggressive disease, additional treatment with things like radioactive iodine is commonly used, and then treatment, as well, with thyroid hormone. When I think about cancer, I think about 3 main ways to treat cancer: surgery to remove it, radiation treatment to burn it, and chemotherapy to poison it. We use that same technique in thyroid cancer. We remove it surgically, we use radioactive iodine as our primary radiation therapy, and we use chemotherapy in the form of thyroid hormone. This is done because thyroid hormone in a slightly higher dose than the body expects to see can suppress the growth of thyroid cancer, and actually, in some cases, prevent it from recurring in the future. Its important for us to think about it in those 3 modalities.

Lori Wirth, MD: Then, of course, there is a subset of differentiated thyroid cancer that recurs despite those 3 modalities of treatment, and thats really what the program today is focused on, a more advanced differentiated thyroid cancer. There are some cancers that just have a more aggressive biology that will, despite having surgery, thyrotomy suppression, and radioactive iodine, still come back. Generally, those are considered radioactive iodine-refractory differentiated thyroid cancers. Thats really what were talking about today. Im a medical oncologist. When I think of chemotherapy, I dont think of levothyroxine so much as IV [intravenous] chemotherapy, or oral multikinase targeted therapies, or other cancer drugs that we use. They are gene-specific therapies that have a role in some subset of thyroid cancers. Bryan, of course, you are an endocrinologist, so our specialties are a little bit different. What do you think of in terms of the general role for the endocrinologist in taking care of patients with more advanced radioactive iodine-refractory differentiated thyroid cancer, and the role with the patient, and the role with the other physician team members taking care of those patients?

Bryan McIver, MD: Thats a really important question, Lori, for us to address. When I think about thyroid cancer when I first trained 25 years ago, we didnt have the options for these more advanced targeted kinase inhibitors and other true chemotherapies. We were really restricted to surgery, radioactive iodine, and thyroid hormone. I learned during my career to care for patients from diagnosis all the way through to the end of the journey, and unfortunately sometimes that journey was the end of life because the cancer could actually kill people. Its not a good cancertheres no such thing as good cancerbut certainly thyroid cancer is not always the rosy picture that people paint. A significant minority of our patients do get recurrences that we cant control through these traditional means, or get disease that have spread, and they require more advanced therapy.

The most amazing thing during the last 10 years has been the development of so many new chemotherapy drugs, typically taken by mouth, often very effective at suppressing the cancer growth, sometimes for years and even longer. The endocrinologist has to learn to think like an oncologist and begin to recognize that some patients need systemic therapy, and then either learn how to treat those patients with those systemic therapies, or work in partnership with a medical oncologist who is used to using these drugs. I always think that a medical oncologists skillset is poisoning people without killing them. At the end of the day, we use these poisons, theyre going to have side effects and theyre going to have issues, but they can be highly effective in controlling this disease for which weve otherwise run out of options. My job is to recognize when its time to bring in those other skillsets. I do that with surgeons because I dont operate. I do it with the radiation doctors because I dont administer the radioactive iodine. I do it with medical oncology colleagues because I dont prescribe chemo [chemotherapy]. Some people just say that I dont do anything, which is actually accurate.

Lori Wirth, MD: Bryan, Im curious, when you share a patient with a medical oncologist, what kind of a working relationship do you tend to have with a medical oncologist, as well as with the individual patient?

Bryan McIver, MD: I think the best way to describe the relationship I have with my medical oncology team is one of mutual respect. We both recognize that we have distinct skillsets, and we can bring those skillsets to bare to help manage the patient. I understand the cancer and I understand how to manage the early stages of that journey for this patient. Often by the time theyre coming to need chemotherapy and advanced treatments, Ive known this patient for years, and what I dont do is then abandon them and just send them off to a medical oncologist. We work together in a multidisciplinary clinic where we see the patients together. Once a decision is made to initiate therapy, we involve our pharmacist, who is an important team member to help understand side effect management and dose management. My medical oncology colleague does all of the difficult work of modulating the dose and getting patients to tolerate the drugs effectively, and then we jointly follow that patient in our multidisciplinary setting to review the scans, review the tumor markers, and ensure that thyroid hormone levels are appropriately managed, and thats an ongoing relationship again for the duration of the journey.

Lori Wirth, MD: I really like your answer, because if I had been asked that question, I would have answered it in a very similar way except from the medical oncologist point of view. The other reason I really liked the answer is that I think you captured very nicely how helpful it is to have a really robust multidisciplinary team taking care of patients with advanced iodine-refractory thyroid cancer.

Transcript edited for clarity.

Excerpt from:
General Principles of Management of DTC and Role of the Health Care Team - Curetoday.com

This time, I have to wait. The day after my regular screening mammogram, the nightmare begins, quietly. I learn through the patient portal system that I have to go back for diagnostic imaging of the questionable calcifications on the left, and possible architectural distortion on the right. There is a number to call.

I call right away. I cannot have the second mammogram and ultrasound, Im told, until December 13 five weeks away! The system, not a friendly doctor as Id once had, has just told me that I might have cancer or even two different kinds of cancers, one in each breast but I wont find out for at least five weeks because this hospital is fully booked.

Fully booked? I cant believe this wait can be blamed totally on COVID-19. I suspect preexisting, patient-unfriendly hospital bureaucracy as well.

Waiting for anything can be agonizing. For a loved one to call. For a college acceptance. For a needed paycheck. Stressful, but normal. Waiting for medical test results? Excruciating. And, to my mind, at least somewhat avoidable.

Granted, growing cells in culture or analyzing pathology specimens takes time. But when the system chugs along at its own sluggish pace, when doctors or their surrogates dont call back promptly, when online patient portals give only partial information? Thats unforgivable. And would be fixable, if patients, not bureaucracy, always came first.

The basic dictum of medicine is primum non nocere: First, do no harm. But being made to wait for weeks to find out if you have cancer, or any other serious disease for that matter, is harm it evokes fear of the unknown. The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown, is how horror writer H. P. Lovecraft put it. Philosopher and writer Joseph Campbell interpreted the struggle with what he called our greatest fear this way: Many of us would enter a tigers lair before we would enter a dark cave.

As humans, we crave information to help us understand everything that comes at us every day. What underlies the fear of the unknown is the perceived absence of information at any level of consciousness, wrote psychologist R. Nicholas Carleton, who has studied the phenomenon, in a 2016 paper. And unpredictability makes it worse. In experimental settings, people show more stress if there is a 50 percent chance of receiving an electric shock than if there is a 100 percent chance, according to a 2016 study published in Nature Communications journal.

On the surface, this does not make rational sense we should be only half as anxious if theres only half the risk. But thats not how our minds work. With uncertainty, the brain, particularly the fear center, the amygdala, revs up into a state of hypervigilance.

And so, I wait. I meditate. I swim. I do my relaxation tape. I swim some more, 2 miles at a time. I use a meditation app on my phone. I wait.

Some days, I can concentrate on work. Other days, Im imagining a double mastectomy, reconstruction, Stage 4 cancer. I Google madly, pore over reliable websites, print out reams of cancer data. And I fume. Cancer wasnt in my lifes plan. Its not in anybodys. Im stunned by my own anger. Why would I expect to be any luckier than anybody else?

And Im angry at the hospital that did the mammography. Couldnt the mammography center predict how many questionable scans like mine are likely on any given day, then plan to save slots the following day for subsequent tests?

I call my primary care physician who, God bless her, works the system and gets me in for the second round of mammograms sooner, just a week away.

November 11, 2:45 p.m.

Breast imaging at a different top Boston hospital.

Two gentle radiologists do more mammography and ultrasound. We have to do some sampling, says the senior radiologist. Im afraid I have to use a scary word 'mass on the right. The left seemed less worrisome.

I lose it. You mean I could have two different cancers? At least I can ask the doctors in front of me right away.

Its possible, she says.

I ask for my husband. He comes in, strokes my back. Double biopsies are scheduled, 18 days away. We go out to eat. I have a martini and a half. He does, too. The fear is running away with me.

I go home and log onto the hospitals online patient portal. I need more information. I click on the little envelope icon that suggests I might be able to initiate contact with the radiologist whose name appears on the test results. No luck shes not listed as one of my available contacts.

I try calling. No luck. The hospital switchboard has no record of anyone by this name. I ask about the other radiologist, but she also seems to be unknown to the hospital. I persist. I learn that shes gotten married and uses a different last name now, not yet updated in the system. When we finally connect by phone, she repeats the results I already have but doesnt elaborate on them to me thats for another doctor to do.

I wait some more. I meditate. Im up to 2-mile swimming sessions now.

November 29, 10:15 a.m.

Biopsy day finally.

Again, two radiologists. They patiently describe the biopsy procedure to me, step by step, then narrate the procedure as they continue their work. The lab tech stands where I can see her and chats kindly with me throughout. Thanks to lidocaine, the procedures are almost painless.

Loaded up with ice packs and care instructions, my husband and I leave, get home, and crash. We sleep for two hours. We know it will be three to five days before we get the results. Compared with the past month, that feels bearable.

December 1

As I drive home from an errand, one of the radiologists calls. I pull over, get out a pencil and paper.

The left side is benign. The right, she tells me, has invasive tubular cancer.

Ive never heard of tubular cancer and, Googling later in the day, learn that its rare and not too bad. I am remarkably calm, so happy to know. Knowing even something awful is so much easier than not knowing. Im free of that horrid anxiety, the prison of fear.

The minute I get home, I tell my husband, then swing into action. I e-mail some doctors Id been lucky to meet over decades of medical reporting for the Globe, asking for help. Whats invasive tubular cancer? How bad is it? Am I going to die? They e-mail right back, cutting short the weeks it couldve taken to get the information they give me.

One oncologist source is especially reassuring. This is the most nothing of all breast cancers, he tells me, with zero chance of threatening your life. I know I still have to have surgery and nobody has told me yet whos in charge. A surgeon? I have no idea whom to call now. Still, Im delirious.

Im also curious about the hormone receptor status of my cancer, knowing from all my years of reporting that many breast cancers feed on estrogen, or progesterone, or both, and that will affect my treatment plan. Back to the patient portal. My test results file says information on hormone status will be forthcoming as an addendum. No addendum follows. I e-mail my primary care doctor again. She gets the results and tells me: The cancer is positive for both hormones. Why the patient portal can tell me I have cancer but not tell me the hormone receptor status is a mystery. Hospital bureaucracy again?

Then, suddenly, Im in the system at the Dana-Farber Cancer Institute, a place Ive written about for decades. I never thought Id be a patient there.

Now, phone calls are returned quickly.

Appointments are set up efficiently. Nurses call with questions. A COVID test is set up. Im no longer lost in medical limbo, unable to get information, unable to figure out whos in charge.

Im optimistic. A plan is in place. Ill be OK.

And the next time my mammogram rolls around, Im calling Bonnie beforehand.

Judy Foreman was the Health Sense columnist for the Globe for many years and the author, most recently, of CRISPRd, a medical thriller. Send comments to magazine@globe.com.

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They said I might have breast cancer. Why would I need to wait weeks for a biopsy? - The Boston Globe

Blood sugar less than 40, Pre diabetes tremendously increases the chance of developing type 2 diabetes The excellent news is that, in case you have prediabetes, you probably can forestall or delay the onset of full blown type 2 diabetes by making lifestyle modifications Hyperglycemia In DiabetesThese embrace eating a nutritious diet, reaching and maintaining a wholesome weight, and exercising often Insulin is vital to patients with type 1 diabetes they can not stay without a source of exogenous insulin Without insulin, sufferers with kind 1 diabetes develop severely elevated blood sugar levels. Bariatric blood sugar checker on arm surgical procedure has been shown to attain remission in some individuals with Type 2 diabetes This is a significant surgery that has its own dangers and issues If you haven t been diagnosed with diabetes, you should see your healthcare provider in case you have any symptoms of diabetes If you already have been identified with diabetes, you need to contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or when you develop any new symptoms In addition to the problems with a rise in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. Today, a broad range of computerized diabetes gadgets are available to help folks higher handle their blood sugar ranges whereas research towards a treatment for diabetesmoves forward In kind 1 diabetes, the body s immune system attacks the insulin producing islet cells within the pancreas The islet cells sense glucose in the blood and produce the appropriate quantity of insulin to normalize blood sugars. There are two major types of diabetes mellitus, kind 1 and type 2 More men than ladies have diabetes in the US, and the disease can affect males in one other way than girls Warning signs of diabetes that men have and ladies do not embrace low testosterone low t , sexual problems, impotence blood sugar level of 373 , decreased curiosity in sex, and retrograde ejaculation Treatment for type 1 diabetes is insulin, and treatment for kind 2 diabetes are life style adjustments like eating a healthy diet, getting exercise every day, and if needed, diabetes drugs The regular vary human blood sugar level chart of blood glucose levels for individuals with diabetes is between 80 and one hundred thirty milligrams per deciliter mg dL.

My blood sugar is 129, While there are heaps of ingredients that can be used to make a scrumptious soup, we ve chosen 9 of our favorites These wholesome soups are sure that can help you keep on monitor along with your diabetes management and weight reduction goals Cheri shares what Continuous Glucose Monitor is and what components blood sugar home remedy ayurvedic have an effect on your glucose levels that can, in turn, affect your overall well being Did you realize that roughly 80 percent of dieters who shed pounds find yourself regaining it Find out the way to create and sustain wholesome habits to keep up your goal weight after hitting your weight loss targets Oats have medium to excessive quantities of dissolvable fiber, which is crucial for blood sugar control. Participants who consumed alcohol with meals exhibited a 14 per cent decrease risk of kind 2 diabetes compared to consuming alcohol without eating meals Study members who consumed alcohol with meals exhibited a 14 per cent decrease risk of type 2 diabetes compared to consuming alcohol with out consuming food The course is the best, I learnt a lot, a beautiful refresher and Brilliant update on newest blood sugar 74 and 54 remedies Approximately 3 to 8 pc of all pregnant girls in the United States are diagnosed with gestational diabetes When the physique loses the power to make insulin or can only make a really small amount of insulin. The numbers below represent values within the hypoglycemic vary and blood sugar spike after breakfast require motion to convey blood sugar ranges up into a traditional range If low blood sugar is extreme, individuals may need to go to the hospital to help elevate their glucose stage or miss work because of the unwanted effects In the quick term, excessive blood sugar ranges can zap your energy, trigger extreme thirst and urination, and blur your vision High blood sugar ranges also can lead to dehydration, dry and itchy pores and skin, and infections. Other risk elements can embody having sure infections or diseases of the pancreas Glucose is a vital nutrient that provides vitality for the right functioning of the physique cells However, glucose cannot enter the cells alone and desires insulin to aid in its transport into the cells Without insulin, the cells turn out to be starved of glucose energy regardless of the presence of ample glucose in the bloodstream In sure kinds of diabetes, the cells inability to utilize glucose offers rise to the ironic scenario of hunger in the midst of plenty.

Blood pressure blood sugar cholesterol, This occurs whether as a outcome of the pancreas just isn t offering adequate quantity of insulin or target tissues aren t responding to insulin Diabetes is more prone to develop in households with known diabetes historical past I actually have been a relentless uninteresting headache on my forehead for the past 3 weeks with intermittent nausea Especially if there may be increased thirst, urination and weight reduction. But when someone has diabetes, this finely tuned system will get thrown out of whack In sort 2 diabetes which accounts for 90 to 95 of diabetes in adults, based on the CDC the body both can t make enough insulin or can t utilize insulin properly, based on the NIDDK If somebody has prediabetes, their blood glucose might be larger than regular however not fairly in the type 2 diabetes range but, per the NIDDK And in type 1 diabetes, the body doesn t make insulin or makes little or no Clients across the life span with diabetes have various clinical presentations. Keeping blood glucose above 4 mmol l for folks on insulin or certain medications for type 2 diabetes is necessary to prevent hypos occurring, which can be dangerous If a person with diabetes has a meter, take a look at strips and is testing, it s important to know what the blood glucose level means A steady glucose monitor, on the left, is a tool that measures your blood sugar each couple of minutes using a sensor inserted underneath the skin. Wait for 30 60 minutes without consuming, and test once more to see if your blood sugar has dropped to a stage that is safe for train Strenuous activity and train encourage your physique to produce glucose to gasoline your muscle tissue The patient should begin by discussing the excessive blood sugar stage with their doctor The doctor will be able to carry out a quantity of tests to offer them a better view of the patient How Is Diabetes Treateds diabetes Normally, the kidneys assist to filter out extra blood glucose by rising the amount of urine removed from the physique.

Low blood sugar of 40, The prognosis of diabetes is said to the extent to which the condition is stored underneath control to forestall the event of the issues described in the previous sections Some of the extra severe issues of diabetes corresponding to kidney failure and cardiovascular disease, could be life threatening Acute complications such as diabetic ketoacidosis can be Patient Discussion About Diabeteslife threatening As mentioned above, aggressive control of blood sugar levels can forestall or delay the onset of complications, and many individuals with diabetes lead lengthy and full lives Diabetes experts feel that these blood glucose monitoring units give patients a major amount of independence to handle their illness process and they are an excellent software for schooling as nicely. They keep a daily document of findings and are taught to regulate insulin dosage accordingly More current glucose monitoring devices can draw blood from different places on the body, such as the forearm The patient, physician, nurse, and dietician should carefully consider the patient s life type, dietary wants, and skill to comply with the proposed dietary prescription. More than 90 of the diabetics in the United States are Type II diabetics Sometimes referred to as age onset or adult onset diabetes, this form of diabetes happens most frequently in people who find themselves overweight and who do not train It can additionally be more common in folks of Native American, Hispanic, and African American descent People who have migrated to Western cultures from East India, Japan, and Australian Aboriginal cultures also usually have a tendency to develop Type II diabetes than those who remain of fasting blood sugar accu chek their unique nations. But, research suggests that consuming processed foods can enhance blood glucose High blood glucose, also called hyperglycemia, happens when there is too much sugar in the bloodstream Low blood sugar, or hypoglycemia, is the results of too little glucose in the bloodstream Hyperglycemia usually occurs as a result of your body doesn t produce sufficient insulin or can t correctly use the out there insulin to remove the glucose from the bloodstream CGMs are extra expensive than the standard finger prick glucose meters as About Ascensia Diabetes Carea outcome of more superior know how used in Early Signs And Symptoms Of DiabetesCGMs.

Bad blood sugar levels chart, Do you ve trouble losing weight, regardless of how hard you try to shed these undesirable pounds Find out extra concerning the weight loss plateau and what you are able to do about it From acupuncture to chiropractic treatments and homeopathy to holistic therapeutic, complementary and various drugs is rising in blood sugar level to a1c recognition Read on to be taught extra about Ayurveda, a therapeutic system that originated in India 1000 s of years in the past Did you know that menopause can have an effect on your metabolic well being, and vice versa Read on to know the connection between metabolic well being and menopause, and the method to manage metabolic health throughout your menopausal journey. For most girls, blood sugar ranges will return to regular after giving start And should you ve had gestational diabetes, you will want to be examined regularly since you might be at a lot greater danger for growing kind 2 diabetes later in life GLYCEMIC INDEX is a scale which helps to rank carbohydrate rich meals, relying on how they have an result on blood glucose levels, by evaluating them to glucose You may have to change your therapy or way of life to maintain your blood sugar ranges within a healthy range For typically healthy individuals who haven t eaten for eight hours or more, a normal blood sugar level is between mg dL. Some widespread legumes are lentils, beans, peas, and chickpeas Legumes are also excessive in fiber, which helps keep blood sugar from spiking because the fiber slows the breakdown of the meals Try making a hearty lentil soup or having a chickpea hummus to dip veggies into. I was normal but because I lost a lot of weight and felt too thirsty and urinate incessantly, I went to see a doctor In the morning I have a tendency to simply have porridge oats with skimmed milk My larger readings tend to be pre breakfast though the levels are coming down Is it attainable to get any graphical method of say weekly or some instances 10 days irregular days with NORMAL graphical lineSoas to check and be precautionary by diabetic patient itself Since diabetic food regimen is restrictive, you should change your view from focusing on the things you can t eat to specializing in the entire scrumptious issues you possibly can eat.

Blood sugar level is 265, Treatment of kind 2 diabetes primarily involves life style adjustments, monitoring of your blood sugar, together with diabetes drugs, insulin or each We publish material that s researched, cited, edited and reviewed by licensed medical professionals The info we provide just isn t meant to be a substitute for skilled medical advice, prognosis or therapy. You use a blood glucose meter to check your blood sugar This gadget uses a small drop of blood from your finger to measure your blood sugar degree You can get the meter and supplies in a drug retailer or by mail In addition to making meals selections that are blood sugar aware, train is a method to assist decrease your blood sugar When you re bodily active, your muscles burn sugar for power and use it for muscle constructing and restore This helps pull sugar from the blood, decreasing blood sugar ranges. There is a paucity of randomised controlled studies that specifically investigate pharmacological therapy of African American diabetic sufferers Type 2 diabetes is a typical condition that causes the level of sugar in the blood to turn out to be too excessive At least every year, get a blood test to check your cholesterol and triglyceride ranges Furthermore, half of all ladies with gestational diabetes will go on to develop kind 2 diabetes, in accordance with 153 blood sugar to a1c the CDC. They usually are not supposed to diagnose, cure, prevent or deal with any disease or condition This program and its companies shouldn t be used for the monitoring or administration of diabetes The NutriSense applications and services are to assist members uncover and attain their well being potential DKA could be deadly if left untreated, so anyone experiencing these signs should seek care immediately.

Smart blood sugar fix book, Most Read Food Labelsfruits naturally have blood sugar level of 700 a low glycemic index due to the fructose and fiber they include Verywell Health s content is for informational and academic functions solely Our web site just isn t meant to be an various to professional medical advice, diagnosis, or treatment Lark Diabetes Coach comes with a complete home glucometer equipment that s shipped to you and is simple to arrange The Lark app walks you through setup and reminds you when to take your blood sugar. It must be mentioned right here that there are a variety of conditions in which an A1c worth may not be correct For example, with significant anemia, the purple blood cell depend is low, and thus the A1c is altered This may be the case in sickle cell disease and different hemoglobinopathies Frequent infections usually tend to occur in folks with untreated or poorly controlled diabetes Nausea and vomiting also can happen in patients with untreated diabetes Some untreated diabetes patients also complain of fatigue. It consists of cinnamon, which is a strong antioxidant which will assist regulate your blood sugar levels Drinking in excess affects your body s capacity to produce insulin Specifically, too much alcohol can cause inflammation to the pancreas, which impairs your body s ability to emit insulin To drink sparsely, stick to 1 to 2 drinks per day at most. A meter can let you know what your ranges are in about 5 seconds Another choice is by taking an oral glucose tolerance test , which takes longer but may also provide extra accurate outcomes A person s individual level will rely upon many components together with how old they are, their ethnicity, their weight and top, and the activity they ve performed lately Blood sugar ranges can be checked by pricking a finger to get a drop of blood and placing it on a glucose meter.

Blood sugar levels 6 8, For this reason, a decrease dose of 300 mg is usually recommended Berberine is thought to help with blood sugar as a outcome of it may enhance insulin sensitivity and help sugar pass into your muscles easier This evaluate additionally noted that taking berberine alongside diabetes treatment lowered participant s blood sugar significantly more than simply medication alone If you have already got diabetes and are on medicine, focus on these dietary supplements together with your doctor Some ingredients can intrude with diabetes treatment since both are performing the same job. The plentiful, unutilized glucose is wastefully excreted within the urine Fluctuations in blood glucose ranges can lead to blurred imaginative and prescient In 2015, four7 of the whole burden of disease could have been prevented by reducing publicity to the modifiable risk factor high blood plasma glucose levels Crucial to diabetes management is common blood glucose monitoring This helps you to understand the connection between blood glucose, meals, exercise and insulin in your physique. Amount of glucose in blood measured regularly by patients with diabetes high blood sugar normal baby Tell your diabetes care staff should you ever have a severe hypo that caused you to have a seizure or fit Tell your diabetes care team should you ever have a extreme hypo that triggered you to lose consciousness It primarily affects people withdiabetes, particularly in the event that they take insulin. If your urine test reveals that ketones are current, call your doctor, who can give you further directions You might have to go to the emergency room to hunt remedy instantly The ADA says that if you have ketones current within the physique, you should not train In this case, exercise may cause your blood sugar levels to spike even blood sugar reading of 46 greater Blood sugar exams are used for prognosis Medterms Medical Dictionaryand management of diabetes.

Blood sugar count of 127, Research has shown that unsaturated fatty acids could play a part in blood sugar control via lowered insulin resistance In diabetes, the physique does not produce enough insulin to allow the cells to absorb sufficient sugar from the blood Or the physique might have enough insulin, however the cells do not respond to it In both instances, this results in there being an excessive amount of sugar in the blood, which, over time can result in critical well being points, corresponding to vision loss, heart disease, and kidney illness Much of the food you eat is broken down into sugar , which will get released into the bloodstream When blood sugar will increase, the pancreas, an organ responsible for digestion and blood sugar regulation, releases the hormone insulin. These check results can fairly aptly take a look at you for diabetes Below mentioned are the conventional blood sugar levels of fasting, before a meal, after food intake, and at bedtime in an age wise category Blood sugar or glucose is launched after consumption and breakdown of carbohydrates throughout food consumption It is the main sugar that is present in your bloodstream and its regulation is undertaken by pancreatic secretions Normal blood sugar levels chart for many adults ranges from eighty to 99 mg of sugar per deciliter before a meal and 80 to one hundred forty mg per deciliter after meals. Obesity is a leading danger issue for diabetesCalculate your BMIto see whether you re at a healthy weight If you re obese or overweight, start making small adjustments to your consuming habits and get extra bodily activity Even a small quantity of weight loss 7 , or about 14 pounds for a 200 pound How Is High Blood Sugar Diagnosedwoman can delay or even forestall type 2 diabetes Over time, this further glucose can lead to prediabetes or diabetes kaiser permanente blood sugar chart Diabetes puts you in danger for other serious and life threatening health issues, such asheart disease, stroke, blindness, and kidney injury Kidney damage from diabetes is identified blood sugar during pregnancy chart as diabetic nephropathy. Discover the remedy options for individuals with sort 2 diabetes, together with medicines and life style improvements Toe amputation is a typical process carried out by a wide variety of healthcare providers One of the most common indications for toe amputation is patients with a diabetic foot Toe amputation is normally carried out as a final resort when medical treatment fails, or the toe can t be salvaged Complications of toe amputation embody pain, swelling, bruising, blood clotting, and hematoma.

Lower blood sugar type 1, The latest sort of steady glucose monitor has an implanted sensor that can detect blood sugar ranges for as much as three months A transmitter worn on the physique sends blood sugar information wirelessly from the sensor to a smartphone app If you re taking insulin to handle type 2 diabetes, your health care supplier may recommend blood sugar drops after alcohol blood sugar testing several times a day, relying on the type and quantity of insulin you use Testing is often recommended before meals and at bedtime when you re taking multiple daily injections You might have to check solely earlier than breakfast and typically earlier than dinner or at bedtime if you use just an intermediate or a long acting insulin A good begin in how to preserve normal blood glucose is How are you able to reduce your blood sugar levels in this article. When blood sugar levels are excessive, it could point out that the physique does not have sufficient insulin or glucose reducing medicine Levels could also be elevated as a outcome of a big meal, if you have an sickness or infection, are careworn, or are inactive If you might be newly diagnosed, it could take some time to get you under this vary. Type 1 and kind 2 diabetes are the commonest forms of the illness, but there are additionally different kinds, similar to gestational diabetes, which happens throughout pregnancy, as well as different varieties From diet and train to treatment and care, there are tons of practical things you can do every day to make your life simpler Small changes in your diet and exercise could make a big distinction with prediabetes The most typical types of diabetes are type 1, sort 2, and gestational diabetes Over time, having too much glucose in your blood may cause well being issues. Taking too much medication taking too much insulin medication may cause a low blood sugar level These drugs are known as sulphonylureas or glinides An overproduction of insulin may cause the body to panic and improve its resistance to insulin, that means the blood sugar will not absorb properly Cells could develop a tolerance to insulin, making it necessary for the pancreas to produce and launch more insulin to lower your blood sugar ranges by the required quantity Eventually, the body can fail to produce sufficient insulin to maintain up with the sugar coming into the body Blood sugar supplements can be part of diabetes or prediabetes administration strategies.

Fasting blood sugar of 114, Inflammatory beta cell destruction in diabetes by professor Thomas Mandrup Poulsen During this module we Professor Mandrup Poulsen will guide you thru cytokines mediated destruction of the pancreatic beta cells moreover their potentiality as drugs targets Incretin biology is now applied in treating topics with diabetes and just lately approved by the FDA for weight reduction Don t hesitate to start out watching the videos as a end result of in this module you ll learn all concerning the incretin lead by Professor Jens Juul Holst The University of Copenhagen is the oldest University in Denmark based in 1479, and with over 38,000 college students and more than 9,000 employees The objective of the University is to conduct research and provide education to the best tutorial degree. 11Lai LL, Wan Yusoff WNI, Vethakkan SR, Nik Mustapha NR, Mahadeva S, Chan WK Screening for non alcoholic fatty liver disease in sufferers with type 2 diabetes mellitus utilizing transient elastography Exercise and a nutritious diet are useful in both sort 1 and sort 2 diabetes mellitus A food plan low in saturated fats, refined carbohydrates, high fructose corn syrup, and high in fiber and monounsaturated fats needs to be encouraged Aerobic train for a length of ninety to 150 minutes per week is also helpful. The fasting glucose test is usually repeated on one other day to confirm the results With Type II diabetes, the situation might not turn into evident until the affected person presents for medical treatment for some other condition A patient might have heart disease, persistent infections of the gums and urinary tract, blurred imaginative and prescient, numbness in the ft and legs, or slow healing wounds Every cell in the human physique needs power in order to perform The body s major energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates Glucose from the digested meals circulates within the blood as a prepared energy supply for any cells that want it. Injections are given subcutaneously, that is, slightly below the skin, utilizing a small needle and syringe Injection websites could be wherever on the physique where there s looser skin, including the upper arm, stomach, or upper thigh Home blood glucose monitoring kits are available so sufferers with diabetes can monitor their own ranges A small needle or lancet is used to prick the finger and a drop of blood is collected and analyzed by a monitoring gadget Some patients may test their blood glucose levels several times throughout a day and use this info to adjust their doses of insulin.

Blood pressure blood sugar chart, Soon after diagnosis, you may additionally likely meet with a diabetes educator and a dietitian to get more information on managing your diabetes Regular exercise might help forestall prediabetes and sort 2 diabetes, and it could possibly help those that already have diabetes to maintain up higher blood sugar management A minimum of 30 minutes of reasonable train corresponding to brisk walking most days of the week is recommended Aim for at least a hundred and fifty minutes of moderate cardio exercise every week Following your diabetes therapy plan takes round the clock dedication Careful management of diabetes can cut back your risk of serious even life threatening complications. Although the disordered carbohydrate metabolism is usually mild, immediate detection and remedy are necessary to keep away from fetal and neonatal morbidity and mortality Women identified with gestational diabetes mellitus should have lifelong testing a minimum of each three years For all other patients, testing should start at age forty five years, and if outcomes are regular, patients ought to be examined at a minimal of every 3 years. Saturated fats ought to be limited to lower than 7 of total caloric intake, and trans fatty acids minimized A regular, consistent stage of day by day train is prescribed, and participation in a supervised train program is recommended All individuals with diabetes should check for ketones during instances of acute sickness or stress and when blood glucose levels are consistently elevated Persistent hyperglycemia in uncontrolled diabetes mellitus can cause a number of issues, each acute and chronic Diabetes mellitus is amongst the main causes of cardiovascular disease , blindness, kidney failure, and amputation of decrease limbs Acute problems embody hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar state, and hyperglycaemic diabetic coma. This results in elevated urine glucose, which in turn results in extreme loss of fluid and electrolytes in the urine Lack of insulin also causes the lack to retailer fats and protein along with breakdown of present fats and protein stores This dysregulation, leads to the method of ketosis and the discharge of ketones into the blood Ketones flip the blood acidic, a situation referred to as diabetic ketoacidosis Symptoms of diabetic ketoacidosis embrace nausea, vomiting, and abdominal ache.

Diabetic high blood sugar ac1, Racial and ethnic minorities in the USA obtain lower quality health care Take time to take a blood sugar level of 150 look at your toes daily for any red patches If you may have sores, blisters, breaks within the pores and skin, infections, or build up of calluses, see a foot physician, known as a podiatrist In response to the COVID 19 pandemic, some pharmaceutical firms have launched initiatives to assist individuals with diabetes acquire the medications and The new recommendations apply to people with a excessive BMI and goal to establish silent cases of diabetes so that docs might prescribe fasting blood sugar of 88 immediate therapy. It is characterised by a sudden onset and happens more regularly in populations descended from Northern European countries than in these from Southern European countries, the Middle East, or Asia In the United States, approximately three individuals in 1,000 develop Type I diabetes This type also known as insulin dependent diabetes as a result of people who develop this type need to have every day injections of insulin At the identical time that the body is attempting to eliminate glucose from the blood, the cells are ravenous for glucose and sending indicators to the physique to eat more meals, thus making sufferers extraordinarily hungry To provide energy for the ravenous cells, the body additionally tries to transform fat and proteins to glucose. Since Type 1 is an immune system disease, immunotherapy holds promise as a method to use treatment to show off the elements of the immune system that trigger Type 1 illness Kidney harm that can result in kidney failure or the need for dialysis or transplant Like many other countries, the principal pre cursor to the development of sort 2 diabetes is obesity Standards of medical care in diabetes 2013Diabetes Care,36 Suppl 1 , S11 66 Learnhow to eat healthier and get extra bodily exercise. To account for the advanced sampling design of this study, we used SUDAAN software to acquire estimates of prevalence and the standard errors in accordance with the Taylor linearisation technique Estimates were weighted to mirror age, intercourse, and urban rural, distribution of provinces of the adults dwelling in China Weighting coefficients had been derived Diet Weight Managementfrom the 2010 Chinese population census knowledge, and the sampling scheme of our survey was to acquire a nationwide estimate Standard errors were calculated with acceptable statistical techniques with data from the advanced survey design Categorical information are introduced as percentages and 95 confidence intervals and have been analysed by a 2 take a look at or Fisher s precise test, as appropriate A binomial logit regression was used to look at the association of danger factors with the odds of complete diabetes and prediabetes.

Fasting blood sugar level 348, In this interview, we speak to Dr Gareth Hollands about his latest analysis that investigated using medical imaging to scale back well being risks and encourage habits change Since the molecular weight of glucose, C6H12O6, is about a hundred and eighty g mol, when calculated the entire quantity of glucose normally in circulating human blood is around threethree to 7g While selecting a Blood Sugar monitor CGM, different parameters have to be taken care of, which differ from individual to individual. This is the start of gaining a deeper understanding of how one can live a healthier life with all of the tools, well being suggestions, and food concepts you need Wherever you re at together with your diabetes, know that you have got choices and that you simply don t have to be held again Symptoms embrace excessive excretion of urine , thirst , constant starvation, weight reduction, vision modifications, and fatigue Type 1 diabetes previously known as insulin dependent, juvenile or childhood onset is characterized by poor insulin manufacturing and requires day by day administration of insulin In 2017 there have been 9 million folks with kind 1 diabetes the majority of them reside in high income nations. Michael Menna, DO, is board certified in emergency medication Verywell Health articles are reviewed fluctuating blood sugar icd 10 by board certified physicians and healthcare professionals Medical Reviewers affirm the content material is thorough and accurate, reflecting the latest evidence based analysis Content is reviewed before publication and upon substantial updates Nuts excessive in unsaturated fat embrace walnuts, almonds, pistachios, pecans, and peanuts. Can Diabetes Cause BlindnessIf you ve diabetes or are in danger for diabetes, make sure your train regimen just isn t inflicting health issues If you re feeling faint, have chest ache, really feel in want of breath, or notice blisters or pain in your toes, cease and name your physician In whole, you want to train 150 minutes or extra each week.

A1c to blood sugar chart, In addition, prediabetes is one other essential analysis that signifies an elevated threat of creating diabetes Diabetes mellitus is a gaggle of physiological dysfunctions characterised by hyperglycemia ensuing directly from insulin resistance, insufficient insulin secretion, or Definition Of Glucoseextreme glucagon secretion Type 1 diabetes is an autoimmune disorder leading to the destruction of pancreatic beta cells Type 2 diabetes , which is far more widespread, is primarily a problem of progressively impaired glucose regulation as a result of a mixture of dysfunctional pancreatic beta cells and insulin resistance The objective of this article is to review the basic science of kind 2 diabetes and its issues, and to discuss Prevention And Risk Factorsthe latest remedy pointers The overarching objective of these efforts is to determine the genetic underpinnings of this disease and translate that knowledge into medical and therapeutic interventions. Hyperosmolar high low blood sugar chart syndrome is caused by sky high blood sugar that turns blood thick and Pectin And Diabetessyrupy Your doctor also will monitor your blood sugar degree throughout labor If your blood sugar rises, your child may launch high ranges of insulin which may result in low blood sugar proper after start. More than 90 of the diabetics in the United States are Type II diabetics Sometimes referred to as age onset or adult onset diabetes, this type of diabetes happens most frequently in people who are chubby and who do not train It is also extra frequent in people of Native Medical Technologies GuidanceAmerican, Hispanic, and African American descent People who have migrated to Western cultures from East India, Japan, and Australian Aboriginal cultures additionally are extra doubtless to develop Type II diabetes than those who remain of their original nations. The kidneys concentrate on getting the extra glucose out of the low blood sugar of 62 bloodstream A high level of glucose means the kidneys might not be succesful of successfully adjust the patient s blood sugar ranges In turn, these organs will flip to flush out the excess glucose It s natural for blood sugar levels to go up and down, but when extreme levels occur incessantly, they will lead to varied issues that could jeopardize a person s quality of life If your blood sugar ranges continue to increase, signs can become worse and you might turn out to be confused and lethargic You also could turn into unconscious in case your blood sugar ranges are very excessive.

Signs of high blood sugar, A type of DM that has traits of each sorts 1 and 2 The patient could have episodes magnesium and blood sugar balance of diabetic ketoacidosis however marked insulin resistance and an overweight body type Difficulties In Diagnosing DiabetesIt is the most common complication of CF other than these circumstances that affect the lungs It is caused by destruction of islet cells as well as a decrease in sensitivity of the liver and muscles to the What Happens If My Blood Glucose Level Is Highactions of insulin The illness usually first turns into clinically obvious in younger adults. A diabetic diet doesn t have to be sophisticated and you don t have to give up all of your favorite meals The first step to creating smarter selections is to separate the myths from the details about consuming to forestall or control diabetes You can t change your beloved ones historical past, but it s still essential for you and your doctor to know if diabetes runs in your family Your danger for diabetes is larger if your mother, father, or sibling has diabetes Having some situations, such as polycystic ovary syndrome, can mean you are extra vulnerable to growing diabetes. Heart illness is easiest to treat when it s caught early It s very important to see your doctor on an everyday basis If your cholesterol is higher than the recommended level, your physician will discuss to you about way of life changes and medicine to help get your cholesterol under management. Wait for 30 60 minutes without consuming, and check once more to see in case your blood sugar has dropped to a level that is protected for train Strenuous activity and exercise encourage your physique to produce glucose to gasoline your muscle tissue The affected person should is 189 blood sugar bad begin by discussing the high blood sugar level with their physician The doctor will have the ability to perform a few tests to give them a better view of the patient s diabetes Normally, the kidneys assist to filter out extra blood glucose by rising the quantity of urine removed from the body.

Blood sugar home remedy ayurvedic, The only information she gave me was to alter his food regimen and get the degrees checked again in three months Is that a normal response or is there something else I must be doing I even have no best what the numbers said and I m just really confused Having a quantity of meals per day will help diabetics in maintaining optimal glucose blood ranges. Weight loss can appear overwhelming, however portion control and maintaining a healthy diet foods are an excellent place to start If the insulin can not do its job, the glucose channels can not open correctly Glucose builds up in the blood as a substitute of getting into cells for power High blood glucose levels trigger the health problems linked to diabetes, also recognized as issues Prediabetes is a condition the place blood sugar ranges are higher than normal, however are not but excessive enough to be recognized as sort 2 diabetes Although not everybody with prediabetes will develop sort 2 diabetes, many individuals will. A type of DM that has traits of each sorts 1 and 2 The patient could have episodes of diabetic ketoacidosis however fasting blood sugar of 105 marked insulin resistance and an overweight body type It is the most common complication of CF other than these circumstances that affect the lungs It is caused by destruction of islet cells as well as a decrease in sensitivity Why Is My Blood Glucose Level High How Does This Happenof the liver and muscles to the actions of insulin The illness usually first turns into clinically obvious in younger adults. A blood pattern for a random plasma glucose test may be taken at any time This doesn t require as much planning and is subsequently used within the diagnosis of kind 1 diabetes when How Well Is Your Type 2 Diabetes Treatment Plan Workingtime is of the essence Type 1 Diabetes Quiz What are the causes of kind 1 diabetes Take this quiz and problem your data of causes, symptoms, diagnosis and coverings for this common situation, blood pressure blood sugar charts previously generally identified as juvenile diabetes Mantra Care aims at providing inexpensive, accessible, and skilled well being care therapy to people across the globe Skipping or delaying meals lack of food, both skipping or delaying meals, could cause the insulin levels to drop too low after a while.

Blood sugar and body ache, It s additionally a good suggestion to avoid sitting for too lengthy aim to stand up blood sugar level at 470 and transfer when you ve been sitting for greater than 30 minutes Anyone older than age forty five is suggested to receive an preliminary blood sugar screening, after which, if the results are regular, to be screened every three years thereafter Your call is confidential, and there is no stress to commit to treatment until you re prepared. This is a blood take a look at that determines your common blood sugar degree for the past two to a few months It measures how much blood sugar is hooked up to hemoglobin, which is a protein in your pink blood cells that carries oxygen An A1C level of 65 or greater on two separate exams signifies that you have got diabetes Below 57 indicators that you simply don t have these well being points. However, they aren t going to be a whole cure for your situation Blood sugar supplements contain a wide range of elements While most supplements use berberine or cinnamon to reduce your blood sugar levels, this is not true for all supplements Some use a wide range of different components which have varying levels of effectiveness With a one hundred pc satisfaction assure, there isn t any reason to not give this complement a strive. You doubtless know the the cause why maintaining a wholesome weight is important to your longevity and high quality of life It hangs out Diabetes And Exercisein the bloodstream and ensures the macronutrients, notably carbs and fats, are metabolized correctly One study suggests that low chromium levels trigger glucose intolerance, incapability to make use of glucose for power and different metabolic issues If the Signos app sends you a glucose spike notification after consuming, take a brisk stroll or attempt one of our 10 minute workouts to deliver your blood sugar down extra quickly I am new at this diabetes and that i don t undestand diabetesearly within the morning my blood sugar someday in the 90 s could additionally be a hundred some morningsand through the day 122 never 200.

My blood sugar is 140, Clean the gadget and run quality control checks as directed Use a blood pattern size as directed within the user s information Touch and hold the sting of the test strip to the drop of blood Most of these gadgets still require finger stick checks to calibrate the machine. Bmj Open Diabetes Research CarePath To Improved HealthIf you are identified with diabetes, you will want toeat healthily, take common exerciseand carry out regular blood checks to make sure your blood glucose ranges stay balanced Type 2 diabetes mellitus accounts for round 90 of all circumstances of diabetes In T2DM, the response to insulin is diminished, and that is defined as insulin resistance During this state, insulin is ineffective and my blood sugar is 295 is initially countered Increases Blood Sugar Uptake Into Muscle Cellsby a rise in insulin manufacturing to hold up glucose homeostasis, however over time, insulin production decreases, resulting in T2DM. Diagnostic standards for diabetes associated disorders are introduced in desk 1 Treatment was defined because the proportion of individuals taking drugs for diabetes among those diagnosed with the disease Control was defined because the proportion of people with an HbA1c concentration of less than 70 among patients with diabetes who were taking medicine Conclusion The prevalence of diabetes has elevated slightly from 2007 to 2017 among adults residing in China The findings point out that diabetes is an important public well being problem in China. Yourblood sugarneeds to be in the right vary for you to be healthy At least some glucose is important on your muscle, liver, and another cells to use as fuel so they can operate Many folks s glucose will not ever fall below 60, even with prolonged fasting When you diet or fast, the liver retains your ranges regular by turning fats and muscle into sugar When you ve diabetes, your blood sugar levels could additionally be constantly high.

Blood sugar level is 105, Chronic microvascular issues are nephropathy, neuropathy, and retinopathy, whereas continual macrovascular issues are coronary artery disease , peripheral artery illness , and cerebrovascular disease It is estimated that yearly 1four to 47 of middle aged folks with diabetes have a CVD occasion The name of this situation is a bit deceptive, since diabetes insipidus has nothing to do with diabetes attributable to high blood sugar ranges, apart from the symptoms of thirst and passing massive volumes of urine Depending on the cause, diabetes insipidus can be handled with drugs, vasopressin replacement and a low salt food plan If a person with sort 1 diabetes skips a meal, exercises heavily or takes an excessive amount of insulin, their blood sugar levels will fall blood sugar 159 then 400 The signs embrace tremor, sweating, dizziness, hunger, headache and change in temper. Diabetes Tests For Diabetesalso can develop because of pancreatic disease, alcoholism, malnutrition, or different severe sicknesses that stress the physique A low socioeconomic status for most African Americans hinders access to health care As the Knowledge Portal is being mined and analyzed, the partnership is in search of to fill in knowledge gaps by executing particular analyses of the information Specifically, researchers are investigating targets of specific curiosity by sequencing DNA from select people Take benefit of actions developed by leaders within the subject of diabetes Listen to engaging talks on probably the most urgent issues in diabetes analysis, treatment and care. It should not be used instead of the recommendation of your physician or other certified healthcare supplier With alcohol and blood sugar, blood sugar can enhance, then decrease to a dangerous point This occurs as a outcome of alcohol is excessive in sugar, causing an initial spike. Cinnamon is the obvious instance of this and has essentially the most scientific analysis available to back it up However, other ingredients exist as nicely, corresponding to berberine Most supplements out there embrace certainly one of these components, however blood sugar level at 400 this isn t at all times necessarily true.

Morning blood sugar level chart, Valuable when a quick analysis of diabetes is required and in emergency settings As it s a blood test involving venipuncture, it can t be carried out in patients suffering from bleeding disordersIt can be utilized any time in the course of the day and no fasting is required The ease of doing it in home settings makes it a patient centric testExercising before an RBS test can lead to an inaccurate studying Moreover, directions need to follow diligently while performing a hone test The strategy of random blood sugar testing does not take greater than 5 10 minutes. Type 2 diabetes develops gradually over years as your body s insulin becomes much less effective at managing your blood glucose ranges As a end result, your pancreas produces increasingly insulin, and eventually the insulin producing cells put on out and turn out to be ineffective Type 2 diabetes is a combination of low insulin and ineffective insulin. As if the problem isn t extreme enough, irritation results in insulin resistance, Increased Blood Sugar Levels May Decrease Benefits Of Aerobic Exercisewhich only worsens hyperglycemia Risk elements that lead to cardiovascular problems are numerous, and excessive blood sugar is certainly one of them Although evidence on this topic is still relatively scarce, preliminary findings do show that hyperglycemia is a vital prognostic consider acute coronary heart failure Take breaks during a sedentary workday, add fasting blood sugar of 90 a walk around the block to your morning routine, or strive a model new type of exercise These actions bring great profit in both the brief and long term while helping cut back your total stress Including common energy training and cardio train will assist to blood sugar level of 33 lower glucose values, as well. Tuberculosis Skin Test The tuberculosis skin test is based on the fact that infection with M Tuberculosis produces a delayed type hypersensitivity skin response to certain elements of the bacterium The standard recommended tuberculin test is run by injecting 01mL of 5 TU PPD into the highest layers of skin of the forearm Reading the skin check means detecting a raised, thickened native area of skin reaction, referred sleepy with blood sugar 354 to as induration The area of induration around the website of injection is the response to tuberculin An estimated 72 million people within the United States have diabetes and don t even know it.

Blood sugar level before breakfast, A blood sugar stage vary between 140 and 199 mg What Is The Glucose Tolerance Test Like Do I Have To FastdL indicates prediabetes Keeping monitor of blood sugar levels fasting blood sugar of 107 is essential for people with diabetes Recording your blood glucose and sugar readings in a printable blood sugar chart is a convenient approach to determine patterns If you re chubby, shedding just 5 of your body weight could make a difference in your blood sugar control if you have Who Is Given Glucose Tolerance Test Gttprediabetes or sort 2 diabetes. It is dissolved in options that are given intravenously to extend a person s blood sugar levels The pancreas additionally produces a hormone called glucagon, which does the other of insulin, elevating blood sugar levels when wanted According to the Johns Hopkins University Sol Goldman Pancreatic Cancer Research Center, the two hormones work together to maintain glucose balanced Blood sugar supplements could interact with certain medicines If you re on a separate treatment on your blood sugar levels, a few of these dietary supplements could work together Having blood sugar that s too low is probably lethal. Strive for a food regimen of largely entire foods filled with plenty of vegetation and extra low glycemic foods than excessive If and when you do determine to eat higher glycemic carbs, pair them with protein and some fiber to help slow down your glucose response Sugar moving into your cells out of your blood from storage is definitely what gives you the vitality to maneuver Normal postprandial blood sugar stage is between 70 and 199 mg dl or three9 to 109 mmol l where 199 mg dl 109 mmol l is a borderline value and will already point out diabetes We randomly check my 4 year old daughters glucose and it has never been underneath 7 mmol L My household has a powerful history of diabetes and I had gestational diabetes along with her brother and sister, but not once I was pregnant with her. If your blood sugar studying is over four hundred mg dL, there is a likelihood that you have a false studying particularly should you aren t experiencing any signs For instance, if there were meals particles on your fingers otherwise you used outdated or improperly saved take a look at strips, you might have gotten an inaccurate studying The quantity of carbohydrates you are consuming isn t balanced with your insulin medicine dosage Without insulin, your body begins to interrupt down fat, triggering the manufacturing of chemical compounds referred to as ketones, according to the ADA Diabetes has changed every different condition to turn out to be the quickest rising way of life disease, globally Some people normal blood sugar level ada are more inclined Type 1 Diabetes High Blood Sugar Symptoms Hyperglycemia Symptomsto develop diabetes than others.

My blood sugar is 127, While the significance of constructing food choices that will keep blood sugar levels in Monthly Blood Sugar Logcheck can t be understated, it s also essential to note that finding what works is an individual alternative We share these concepts on meals that won t spike your blood sugar as a information and inspiration when everyday meals decisions are made Below are 10 foods that won t spike your blood sugar levels and some ideas for incorporating them into your meals. Insulin acts as the key that Send Article To Google Driveunlocks the cell wall door, which permits glucose to enter your body s cells Glucose supplies the fuel or energy tissues and organs must correctly perform People who use Low Carb Program have achieved weight loss, improved HbA1c, lowered medications and kind 2 diabetes remission Pan, A, Lucas, M, Sun, Q, van Dam, R, Franco, O, Manson, J, Hu, F. Although there are theories as to how these issues may be connected, none has but been proved This could also be because you tend to exercise much less, lose muscle mass and gain weight as you age But sort 2 diabetes is also rising among kids, adolescents and youthful adults. Diabetes can happen low blood sugar vs anxiety temporarily during pregnancy, and reviews counsel that it happens in 2 to 10 of all pregnancies Significant hormonal adjustments throughout being pregnant can result in diabetes high blood sugar 300 blood sugar elevation in genetically predisposed people Blood sugar elevation during being pregnant is identified as gestational diabetes Gestational diabetes often resolves once the child is born.

158 blood sugar diabetic blood sugar level 362 before breakfast, Strive for a diet of mostly complete meals crammed with loads of crops and extra low glycemic meals than high If and whenever you do decide to eat higher glycemic carbs, pair them with protein and some fiber to assist slow down your glucose response Sugar transferring into your cells out of your blood from storage is actually what provides you the vitality to maneuver Normal postprandial blood sugar degree is between 70 and 199 mg dl or 39 to 109 mmol l the place 199 mg dl 109 mmol l is a borderline value and will already point out diabetes We randomly take a look at my 4 year old daughters glucose and it has never been under 7 mmol L My household has a strong historical past of diabetes and I had gestational diabetes with her brother and sister, however not after I was pregnant along with her. Do you ve trouble losing weight, regardless of how hard you try to shed these undesirable pounds Find out extra concerning the weight loss plateau and what you are able to do about it From acupuncture to chiropractic treatments and homeopathy to holistic therapeutic, complementary and various drugs is rising in recognition Read on to be taught extra about Ayurveda, a therapeutic system that originated in India 1000 s of years in the past Did you know that menopause can have an effect on your metabolic well being, and vice versa Read on to know the connection between metabolic well being and menopause, and the method to manage metabolic health throughout your menopausal journey. Food and drinks that are excessive in carbohydrates are most impactful on blood sugar stage blood sugar levels recording chart What we eat provides us most of the vitamins our physique wants and sometimes, does not need That is to not say that food is a significant explanation for blood sugar level increasing or decreasing too dramatically When the body doesn t produce sufficient of the insulin hormone, blood sugar levels begin to extend. The number of occasions that you examine your blood sugar will rely upon the kind of diabetes that you ve got and the sort of medicine you re taking to treat your diabetes For example, individuals who take insulin may must check more typically than individuals who do not take insulin Talk together with your health care group about how often to verify your blood sugar If you sweat throughout work or train, that fluid needs to be replaced so you want to drink extra.

Fasting blood sugar at 160, Your doctor may also discuss with you about taking medication to delay or stop sort 2 diabetes Our bodies flip plenty of the meals we eat into sugar, known as glucose, which gives us vitality To use glucose as energy, our body needs insulin, a hormone that helps glucose get into our cells If you ve diabetes, your body may not make enough insulin, could not use insulin in the proper method, or both. This therapy also appears to assist with the secretion of the high blood sugar levels australia incretin hormone, which may contribute to improvements in glucose tolerance Oral hypoglycemic drugs may be effective if your situation is currently at a mild state, however a extra tailored approach may be needed in any other case Recognizing the symptoms of excessive blood sugar is important When blood glucose levels are excessive, a person must take applicable action This is the case with each sort 1 diabetes and type 2 diabetes. Resistance coaching, similar to energy workouts, has been proven to enhance blood sugar control For folks with diabetes, being aware of how meals will influence blood sugar is an on a daily basis feat Managing blood sugar has each short blood sugar level dangerous 100 term and long term advantages, together with lowering the risk of diabetes related complications When making meals choices while managing blood sugar ranges, you will want to choose ones that won t cause your blood sugar to increase rapidly and considerably Look for whether or not meals have advanced or easy carbohydrates and opt for advanced carbohydrates when potential Blood tests are extra widespread urine tests for measuring blood sugar. Diabetes mellitus is derived from the Submit A Response To This ArticleGreek word diabetes meaning siphon to pass through and the Latin word mellitus that means honeyed or sweet This is as a outcome of in diabetes excess sugar is present in blood as well as blood sugar 205 before bed the How Do You Treat Hypoglycemiaurine Among ladies with moderate baseline depressive signs, these receiving the lower dose had nominally decrease depression scores at follow up than those within the larger dose cohort Among women with extreme baseline depressive symptoms, the advance in follow up depression scores was the identical regardless of dose There was no distinction within the dosing impact of vitamin D3 supplementation for the therapy of depressive symptoms in ladies with T2D who present with important symptoms and low vitamin D Regardless of the dose, participants temper improved over time.

Tea for blood sugar balance, Binge ingesting extreme alcohol will eventually trigger a resistance to insulin Alcohol causes an increase in insulin The Bsd 5 2 Flexible Intermittent Fastingsecretion, which Intermittent Fasting For Improved Brain Healthmeans too much insulin is being launched in comparability to glucose being consumed and subsequently will go to waste Whilst the liver and muscular tissues produce some glucose, most comes from the foods we eat. Try mixing these fruits into oatmeal for a hearty breakfast or into Greek yogurt for a satisfying snack Emily is a health communication blood sugar level of 275 advisor, author, and editor at EVR Creative, specializing in public health research and well being promotion Getting 2 or extra of the values proven is indicative of gestational diabetes Any of the following are indicative of gestational diabetes If you had been not diabetic, you in all probability wouldn t know that your sugar was low as a end result of you wouldn t check and since you wouldn t symptoms, and you wouldn t act. If your blood sugar studying is over four hundred mg dL, there is a likelihood that you have a false studying particularly should you aren t experiencing any signs For instance, if there were meals particles on your fingers otherwise you used outdated or improperly saved take a look at strips, you might have gotten an inaccurate studying The quantity of carbohydrates you are consuming isn t balanced with your insulin medicine dosage Without insulin, your body begins to interrupt down fat, triggering the manufacturing of chemical compounds referred to as ketones, according to the ADA Diabetes has changed every different condition to turn out to be the quickest rising way of life disease, globally Some people are more inclined best rated blood sugar app to develop diabetes than others. Many meals have kinds of carbohydrates referred to as starches and sugars When you eat foods with most of these carbohydrates, your physique breaks them down into glucose, which is a kind of straightforward sugar, and releases the glucose into your bloodstream Aside from glucose produced by your liver, meals is the principle source of plasma glucose If you ve been told to look at your blood sugar levels, you could really feel a bit overwhelmed There is a lot of information to know, and it s onerous to keep track of all of the totally different numbers and what they mean Having a glucagon package handy is a lifesaver in case of low blood sugar levels.

Blood sugar level is 58, This will involve a small prick in your finger so blood sugar level of 272 receive a blood pattern Managing blood sugar ranges weekly diabetes blood sugar chart is easy to do at house if you understand the best measures to take Treatments are different for top and low blood sugar ranges Causes of low blood sugar ranges are very completely different and are as necessary to concentrate on, as they re in fact simpler to manage. The most appropriate choice is to consult your physician relating to this matter in order that they can guide you based on your health condition requirements Following are a few of the Common blood sugar level at 400 and important factors to consider whereas shopping for a CGM DisclaimerAll content on this website, together with dictionary, thesaurus, literature, geography, and different reference knowledge is for informational functions only. Several way of life factors can affect prediabetes, together with stress Here s everything you need to find out about the method it impacts the situation, and what you can do about it Find out what unhealthy weight reduction is and learn extra about its unwanted effects and what you can do to prevent them Check out a variety of the widespread and not so common reasons you re doubtless feeling drained Questions To Ask Your Doctorafter eating and browse our suggestions to assist prevent fatigue after meals. With Diabetes kind 1 body s cells that produce insulin are destroyed A person would want to use insulin injections to control their situation The next chart displays all possible blood sugar ranges along with a brief rationalization of what the indicators are A regular degree for a healthy person is somewhere between 72 mg dL 38 to 4 mmol L and 108 mg dL 5eight to 6 mmol L Blood sugar levels might fluctuate because of other reasons Check his fasting blood sugar within the morning to see if being extra active improves his blood sugar.

Kid blood sugar levels chart, So do people globally who reside in colder, northern climates Furthermore, sort 1 diabetes onset is more likely to happen in the winter blood sugar level of 85 months It has been observed to be triggered by viral infections A recent study found that individuals who saved a meals diary misplaced twice as a lot weight as those that didn t A written document helps you establish problem areas such as your afternoon snack or your morning latte where you re getting more energy than you realized It also increases your consciousness of Increased Ggt Concentrations In Patients With Dysglycemiawhat, why, and the way a lot you re consuming, which helps you cut back on senseless snacking. My sugar level in the early morning is 61 to six8 simply within the early morning During the day and after lunch in 2 hours never above 6 What does that mean If my fathers all examine Learn How Different Activities Affect Your Glucose Levels Now You Knowup values are regular only sugar value before lunch What Are The Different Types Of Diabetesis153 and after lunch is 307is it possible Learning the means to use natural means to keep both inside normal ranges My age is 52 and my sugar level is 229 so plz suggest me my sugar level normal or exceeded. Intramuscular injection may be simpler in uncommon cases of DKA or dehydration for the explanation that absorption fee is even larger The effectiveness, though, is normally a drawback in circumstances of hyperglycemia as a end result of the insulin could additionally be absorbed too readily and end in a drastic drop in blood sugar This signifies that apple juice has the potential to spike your blood sugar more than consuming the plain fruit would Non processed low sugar foods decrease the level of glucose going in the physique Where potential, try to obtain levels of between 4 and seven mmol L earlier than meals and underneath 85 mmol L after meals The goal stage for HbA1c is beneath forty eight mmol mol or 65 in the old units. With an increase in age, the prevalence of DM also increases About 25 of the population above sixty five years of age has diabetes You would possibly find that including a second drug doesn t convey your blood sugar underneath control.

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Low Blood Sugar Warning Signs, Ways To Treat And When To Call The Doctor - First Tracks

A recent study found no difference in invasive diseasefree survival between patients with HER2-negative breast cancer who took a full-strength aspirin daily and those who did not.

Although prior research has suggested that daily aspirin use may have antitumor effects, a recent study found no difference in invasive diseasefree survival between patients with HER2-negative breast cancer who took a full-strength aspirin daily and those who did not. Although inflammation may still play a key role in cancer, its also important to remember that aspirin may have different effects in other cancers, such as colon, or in a different setting, such as primary vs secondary prevention, study author Wendy Y. Chen, MD, MPH, a medical oncologist at the Dana-Farber Cancer Institute in Boston, Massachusetts, explained during a presentation of the data.

The study (NCT02927249), which was presented at the February 2022 American Society of Clinical Oncology (ASCO) Plenary Series,1 included more than 3000 patients under 70 years with HER2-negative breast cancer who were randomly split into 2 groups: half received 300 mg of aspirin every day, and the other received a placebo (FIGURE 1 ). The main goal of the study was to compare invasive diseasefree survival. Aspirin users had a slightly worse survival than those patients who received placebo, Chen said. Findings showed that the aspirin users had a higher amount of disease events than the placebo group (111 compared with 90, respectively), although the difference was not statistically significant and the types of events were relatively balanced between the 2 groups, the investigators explained.

There was also a similar amount of severe AEs between the arms. The incidence of grade 3 or higher [AEs] was similar for aspirin vs placebo. Further, there were no grade 4 cardiac, hematologic, or gastrointestinal events in the aspirin group, Chen said.

However, another expert involved in the ASCO Plenary Series noted that the characteristics of the patient population may play a role in the outcomes that were observed. From these data, we can conclude that this high event rate among a postmenopausal, overweight population who had hormone receptor positive, high-risk disease was to be expected. And this is exactly the group that one would want to try to intervene upon, because wed expect this group to have high levels of inflammation, said Angela DeMichele, MD, MSCE, coleader of the Breast Cancer Research Program and director of the Breast Cancer Clinical Trials Unit at Penn Medicines Abramson Cancer Center in Philadelphia, Pennsylvania.

Additionally, DeMichele pointed out that about 44% of patients dropped out in the early stages of the trial, although the reasons why were not made known and could be interesting to consider. Study participants reported on whether they were adherent to taking their aspirin or placebo daily, and DeMichele noted, Self-report can be notorious for overestimates of adherence.

Despite potential reasons for the poorer aspirin outcomes, this was not the first study to show that aspirin use may not improve cancer-related outcomes.

In 2018, findings from the Aspirin in Reducing Events in Elderly trial (ASPREE; NCT01038583)1 were published, and they showed worse outcomes for patients who were over age 70 years and who took daily aspirin.

Aspirin users [in the ASPREE trial] were found to have an increased risk of deaththat was mainly driven by increased risk of cancer deaths. Of note, 19% had a prior history of cancer, Chen said.

The United States Preventive Services Task Force recommends daily aspirin for the prevention of colorectal cancer in individuals aged 50 to 59 years who have a 10-year cardiovascular risk of 10% or higher. However, the jury is out when it comes to the risks and benefi ts of aspirin use in older adults.

What we can take away from this study... is that at this time, aspirin should not be used simply to prevent breast cancer recurrence. For those situations in which there are other options, decisions about aspirin use for other indications should include an individualized risk/benefit discussion between physician and patient, DeMichele said.

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Daily Aspirin Fails to Improve Disease-Free Survival in Breast Cancer - Targeted Oncology

Spring is the time for new beginnings, cleaning out your dusty musty basement, battling seasonal allergies, and, of course, discovering the latest TikTok trends.

With potentially permanent daylight savings on the table, that extra time spent luxuriating in the sunshine could mean more time to scroll (and scroll and scroll) through the latest health fads on the platform for better or for worse.

For a long time, menstrual cycles were considered taboo, and discussing them is still seen as inappropriate in many parts of the world. Organizations and online resources like Clue or Flo are seeking to normalize period-talk. Pixar has jumped on boardtoowith itslatest film, Turning Red, which depicts a 13-year-old's experience getting her first period. With a 95% rating on Rotten Tomatoes, it's clear that the public is willing to talk about periods.

Many people feel shame around discussing their periods, but this is something that social media has actually handled positively (for once).

Karan Raj, MD, a National Health Service surgeon and educator at Imperial College London, UK, uses his TikTok account to educate his followers and explain health concerns and issues using his platform. Raj stitched this video from someone else that was captioned, "When you're on your [period] and feel the stab in your booty."

In his video, Raj uses anatomical diagrams to explain exactly what's going on with this pain in the butt. The pain, which Raj explains is called proctalgia fugax, is caused by a type of hormone released during menstruation called prostaglandins. Prostaglandins tell the uterus to contract and shed its lining, but the uterus isn't the only part of the body receiving that message from the prostaglandins.

"The prostaglandins also cause contraction of the rectum, pelvic floor muscles, and muscles around the anal canal," Raj tells viewers. "These intense contractions can cause muscle spasms and anal cramps."

This video from Elliott Norris (@callmebelly) shows him preparing an unusual sleep aid. It's one of many videos of people trying the same trend, usually with the tag #lettucewater attached.

Like Elliott explains, the rumor is that boiling romaine lettuce and then drinking the water is a way to help one fall asleep faster, or sleep better at night. At the end of the video, Elliott even said that it worked for him. So where does this come from, and is it just a placebo?

Videos on TikTok recreating this trend cite a 2017 study titled, "Sleep-inducing effect of lettuce (Lactuca sativa) varieties on pentobarbital-induced sleep" (there's even a New York Times article about it). The star of the study is lactucarium, a milky white substance that's found in lettuce, usually visible if you squeeze it or break the stalks. The study suggests that lactucarium has "sedative-hypnotic" properties after lettuce extract was used in tandem with pentobarbital on mice, and it was found that the mice's sleep latency then decreased.

In an article from Parade discussing the trend, Rachel Salas, MD, MEd, weighs in. Salas is the assistant medical director at Johns Hopkins Center for Sleep and Wellness in Baltimore, so you could say she knows a thing or two about sleep. Her response to the mice study was that its limitations made the results not entirely reliable.

According to Salas, there was no control group, the extract the mice were given is much more concentrated than what's found in lettuce, and the mice were given a sedative that was going to make them sleepy anyway: "The mice were drugged to put the animals to sleep soon after they took the lettuce water."

So while Salas thinks it's good that people are open to talking about sleeping solutions, "lettuce tea" just doesn't have any evidence to back up what people claim it does.

Everyone knows how popular pimple popping, blackhead squeezing, and cyst squashing are on social media. Dermatologist Sandra Lee, better known as Dr Pimple Popper, used her YouTube platform of the same name which boasts over 7.42 million subscribers to cinch a reality television show on TLC. Viewers on TikTok are no different and love the satisfying (and often gross) relief of clearing out a nasty pimple or two.

In this stitched TikTok from emergency medicine physician Fayez Ajib, DO, aka @lifeofadoctor, Ajib reacts to an original video of someone popping a ganglion cyst with a textbook.

There are plenty of other videos on TikTok of people using books to smack ganglion cysts, which develop on the wrist. People have looked for remedies for ganglion cysts since the 1700s, at which point many strange options arose, as discussed in BBC Future. The one that still holds up, however, is smacking the cyst with a heavy book, like a Bible (hence the ganglion cyst's nickname, "Bible bump").

In his video, Ajib explains why smacking the cyst is a bad idea, even if it appears to temporarily resolve the issue.

"Not only have people broken the delicate bones in their wrist from getting hit," Ajib says, "but they actually have a high chance of recurrence. A doctor will actually remove the sac itself rather than just draining it from being hit."

The lessons we glean from TikTok remain the same: leave it up to the professionals.

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TikTok Trends: Lettuce Water, Cyst Smacking, and Period Pains - Medscape

LAS VEGAS, April 01, 2022 (GLOBE NEWSWIRE) -- Healthy Extracts Inc. (OTCQB: HYEX), a leading innovator of clinically proven plant-based products for heart and brain health, reported results for the fourth quarter and full year ended December 31, 2021.

Q4 Financial Highlights

Full Year 2021 Financial Highlights

2021 Operational Highlights

Management Commentary

Our record performance in 2021 was driven by the strong ramp up in sales through both our wholesale distribution and direct-to-consumer channels, which includes subscription options, commented Duke Pitts, president of Healthy Extracts. These results also reflect our rapidly expanding customer base, with estimated customer lifetime value or CLV now exceeding $500. Our growth in CLV and subscriptions demonstrates that once customers discover our products, they come back for more.

The growth was also supported by the continued expansion of our portfolio of natural products for heart and brain health. This included the mid-year launch of UBN ACTIVATE, representing our entrance into the multi-billion dollar brain health supplements market. Then in the fourth quarter, we introduced UBN RELIEF, which is specially formulated to reduce the symptoms associated with migraine headaches. In fact, we recently reported clinical study results that demonstrate UBN RELIEF naturally alleviates migraine symptoms. We believe such peer-reviewed, published clinical research highly differentiates our products in the marketplace and assures our customers they will see results. Like with ACTIVATE, we believe RELIEF is like no other product available today, and we see these products creating a tremendous market opportunity that supports the continued ramp up in sales over the months to come.

One of the most exciting events of 2021 was the introduction of our exclusive line of Whitney Johns natural health and fitness formulations. Backed by Whitneys tremendous personal endorsement and brand marketing strength, we see this new line dramatically elevating our social engagement, strengthening our brand identity, and especially accelerating our revenue growth at minimal cost. We believe major brand influencers like Whitney will help our formulations reach millions of new consumers and enable us to secure prime shelf placements at major retailers nationwide.

While we were able to grow our direct sales business at a fast pace in 2021, we saw reduced sales in our wholesale business due to the COVID-19 pandemic. This turned around at the beginning of this year with a large follow-on purchase order for our exclusive Citrus Bergamot SuperFruit from XYMOGEN, a major distributor to healthcare practitioners of clinical-grade nutraceuticals. This and similar follow-on wholesale orders demonstrates the growth of our B2B distribution segment is back on track for this year.

To support the further growth across all of our segments, we recently appointed Scott Landers as EVP of sales and marketing. He brings to us more than 20 years of exceptional executive experience and accomplishment, including the successful launch of new products and services for KPMG, IBM, DISH Network, CenturyLink, NEC and other industry leaders.

To add further fuel to our growth in 2022, we have in the works a number of new clinically-backed formulations for additional health offerings like hormone support and gut health. Combined with our expanding sales channels, including Amazon, where we have become a very active seller, we believe we are well on course for at least a doubling of our organic revenue growth in 2022. This excludes the potential positive impact of our active M&A program.

We also expect to realize certain advantages from our supply chain management and significant post-acquisition overhead reductions we implemented last year, which we see supporting a transition to cash flow positive in the second half of this year.

Q4 Financial Summary

Net revenue in the fourth quarter of 2021 increased 77% to $672,000 from $380,000 in the previous quarter and up 394% compared to $136,000 in the same year-ago quarter.

Gross profit totaled $48,000 or 7.2% of net revenue as compared to negative $1.3 million in the same year-ago quarter. The increase in gross profit was primarily due to the increased focus on Amazon marketplace along with a reduction in written off inventory.

Operating expenses increased 85% to $712,000 compared to $386,000 in the same year-ago quarter.

Net income totaled $535,000 or $0.00 per basic and diluted share compared to a net loss of $1.6 million or ($0.01) per basic and diluted share in the same year-ago period.

Cash totaled $222,000 as of December 31, 2021, as compared to $59,000 on December 31, 2020. In the first quarter of 2022, the company eliminated virtually all of its convertible debt.

Full Year 2021 Financial Summary

Net revenue in the full year 2021 increased 15% to a record $1.5 million from $1.3 million in 2020. The increase was due primarily to increased sales from heart health products and the focus on Amazon marketplace.

Gross profit was $695,000 or 47.4% of net revenue, compared to negative $578,000 in 2020.

Operating expenses decreased $471,000 to $2.6 million from $3.1 million in 2020. The decrease in operating expenses is primarily attributable to an impairment of assets of $1.6 million in 2020, partially offset by an increase in general and administrative expenses in 2021.

Net loss totaled $2.0 million or $(0.01) per basic and diluted share, as compared to a loss of $2.6 million or $(0.01) per basic and diluted share in 2020.

About Healthy Extracts Live Life Young AgainHealthy Extracts Inc. is a platform for developing or acquiring science-forward, clinically proven, plant-based proprietary products in select high-growth categories within the multibillion-dollar nutraceuticals market.

The companys subsidiaries, BergametNA and Ultimate Brain Nutrients (UBN), offer nutraceutical natural heart and brain health supplements. This includes the only heart health supplement containing Citrus Bergamot SuperFruit. This superfruit is known to have the highest quality and concentration of polyphenols and flavonoids, and with healthy heart benefits backed by more than 17 clinical studies.UBN KETONOMICS proprietary formulations have been clinically shown to improve brain health, including memory, cognition, focus and neuro-energy. UBN is pursuing intellectual property license opportunities for monetizing its IP portfolio of multiple issued and pending patents. For more information visit: healthyextractsinc.com, bergametna.com or tryubn.com. Forward-Looking Statements and Safe Harbor NoticeAll statements other than statements of historical facts included in this press release are "forward-looking statements" (as defined in the Private Securities Litigation Reform Act of 1995). Such forward-looking statements include our expectations and those statements that use forward-looking words such as "projected," "expect," "possibility" and "anticipate." The achievement or success of the matters covered by such forward-looking statements involve significant risks, uncertainties and assumptions. Actual results could differ materially from current projections or implied results. Investors should read the risk factors set forth in the Company's Annual Report on Form 10-K filed with the SEC on February 19, 2021, and future periodic reports filed with the SEC. All of the Company's forward-looking statements are expressly qualified by all such risk factors and other cautionary statements.

The Company cautions that statements and assumptions made in this news release constitute forward-looking statements and make no guarantee of future performance. Forward-looking statements are based on estimates and opinions of management at the time statements are made. The information set forth herein speaks only as of the date hereof. The Company and its management undertake no obligation to revise these statements following the date of this news release.

Food and Drug Administration DisclosureThe product and formulation featured in this release is not for use by or sale to persons under the age of 12. This product should be used only as directed on the label. Consult with a physician before use if you have a serious medical condition or use prescription medications. A doctors advice should be sought before using this and any supplemental dietary product. These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease. BergametNA, Ultimate Brain Nutrients, UBN, Citrus Bergamot SuperFruit and F4T are registered trademarks of Healthy Extracts Inc.

Healthy Extracts Company ContactDuke Pitts, PresidentHealthy Extracts Inc.Tel (720) 463-1004Email contact

Investor Contact:Ronald Both or Justin LumleyCMA Tel (949) 432-7566Email contact

Media Contact:Tim RandallCMATel (949) 432-7572

HEALTHY EXTRACTS, INC.CONSOLIDATED STATEMENT OF OPERATIONS

HEALTHY EXTRACTS, INC.CONSOLIDATED BALANCE SHEETS(Audited)

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Healthy Extracts Reports Fourth Quarter and Full Year 2021 Results - GlobeNewswire

Blood sugar levels normal blood sugar for adolescent covid 19, There is no perfect formula for exercising to reduce your blood sugar. Maintaining healthy blood sugar levels is important to your overall health, so remember to check your blood sugar frequently. Keeping your blood sugar levels under control can help reduce this risk. It features a unique combination of ingredients like licorice, cayenne, and juniper berry.

Blood sugar spikes to avoid, The incidence of gestational diabetes increased with age, peaking at 31 for females aged 45 49. Depending on your age and any other health conditions, your doctor may advise you to keep your blood sugar level in a range that they consider will be safe and healthy for you. Although lacking Gestational Diabetes Treatmentsa high quality national cohort to estimate the incidence of diabetes, our findings could add value to the assessment of diabetes epidemics in mainland China. Find out what happens when your Can Intermittent Fasting Impact Your Blood Pressurblood sugar levels are too high, as well as potential outcomes when they rise above 400 milligrams per who blood sugar range chart deciliter mg dL.

Low blood sugar muscle building, Anything under elevated blood sugar in child 70mg dl is known as low blood sugar or hypoglycemia. Whether you ve eaten recently or not, a blood sugar level higher than 200 mg dL may indicate you could have diabetes. Blood sugar must be carefully regulated to ensure that the body functions properly. As mentioned above, aggressive control of blood sugar levels can prevent or delay the onset of complications, and many people with diabetes lead long and full lives.

Blood improving blood sugar control before sugar average of 3050, The health information contained herein is provided for general education purposes only. Currently, information and communication technologies are considered as an integral part of clinical trials. Note the number of grams of sugar per serving as well as the total number of servings. Studies have also found that later or irregular sleeping schedules are correlated with higher blood sugar, even in non diabetic people.

Blood sugar levels in children, Additionally, it increases insulin level in the blood in a holistic way. Using Advisor Pro allows physicians and nurses to provide true patient centered care and everyone can receive the same top level of treatment wherever they are and whoever their caregiver is. Drinking moderately isn t likely to lead to type 2 diabetes, but excessive drinking over time fasting blood sugar of 135 can prediabetes blood sugar levels canada be a trigger for its development. For a new patient with diabetes, you should check blood sugar levels regularly.

Blood sugar levels of 600, It is caused by an absolute or relative deficiency of insulin and What Is The Treatment For Gestational Diabetes Mellitusis characterized, in more severe cases, by chronic hyperglycemia, glycosuria, water and electrolyte loss, ketoacidosis, and coma. Insulin deficiency diabetes This is when the dog s body isn t producing enough insulin. Over time, high blood glucose levels stiff neck blood sugar change can damage the body new blood sugar levels chart s organs. The pancreas tries to create more insulin for the glucose to use, but the body does not respond to it properly, called insulin resistance.

Acylovir raise blood sugar a1c, With blood sugar levels mmol chart this in place, researchers are now honing in on the final step of the process turning pancreatic endocrine cells into beta blood sugar level of 109 cells. So, if you have diabetes, drink alcohol and take insulin as a medicine, you may experience hypoglycemia. This occurs when cells starved for glucose begin to break down fats for energy, a process my blood sugar is 145 that creates chemicals called ketones, which make the blood more acidic. Normal blood sugar level for any individual before meals is between 80 to130 mg dL.

Gestational diabetes blood sugar chart, The questionnaire was designed to assess self care behaviours which can be related to the measure of HbA1c, so that the data are suitable for mediational analyses. I very much enjoy T Tapp though I am new to it and was excited to see another naturally minded person talking about it. Check out our dedicated platform and share your diabetes story. buy blood sugar the book This helps you to understand the relationship between blood glucose, food, exercise and insulin in your body.

Blood sugar support metabolism blend, These are not oral forms of insulin they are 145 average blood sugar a1c sulfonylureas, chemically related blood sugar reading at 30 to the sulfonamide antibiotics. Keep in mind blood sugar level age 80 that you cannot have the same reading throughout the day. Prediabetes is a condition where blood sugar levels are higher than normal, but are not yet high enough to be diagnosed as type 2 diabetes. The urine is convert blood sugar to ac1 checked for microalbumin or overt protein losses, an early indication of nephropathy.

Blood sugar vs a1c chart, Since T1DM is a disease primarily due to the absence of insulin, insulin administration through daily injections, or an insulin pump, is the mainstay of treatment. Even seemingly small problems can lead to organ damage and sepsis and can prove fatal. The French DESIR study of people diagnosed with prediabetes confirmed what the studies cited above have found. Blood Glucose Monitoring In Home CareIn her free time, she monitors her wildly fluctuating heartbeat whilst watching Arsenal FC.

Importance of blood sugar balance, GD greatly increases the risk of developing diabetes in your next pregnancy and in the future when you are no longer pregnant. Experts are still learning about all the factors that On The Video Below Dr Marlene Merritt Share A Few Tips To Fix Blood Sugarcan contribute to high blood glucose. You will need to track your blood sugar and do things to keep it under control. If you re on some sort of other diabetic medication, you should work closely with your doctor to use the correct dosages.

How What Is Low Blood Glucoseto reduce blood sugar level immediately, A random blood sugar test is the testing of the blood sugar level at any time or random time of the day. Type II diabetics should use Blood Sugar Blaster, according to Dr Carter, to assist control diabetes. Testing is usually recommended before meals and at bedtime if you Who Gets Diabetesre taking multiple daily injections. Before sleep values should be between 110 mg dL 61 mmol L and 200 mg dL 111 mmol L.

High blood sugar over 350, The small amount of refined honey in the recipe satisfies your sugar cravings but won t spike your blood sugar, because it is balanced with fats. The prevalence of total diabetes was higher in men than in women. When there isn t enough glucose stored to maintain normal blood sugar levels, the body can also produce its own glucose from noncarbohydrate sources. Oral diabetes medications are sometimes taken in combination with insulin.

Good blood sugar level a1c, After 80 90 of the beta cells are destroyed, hyperglycemia develops and diabetes may be diagnosed. The operation results in significant weight loss, remission of type 2 diabetes in nearly 80 percent of patients, and improvement of diabetes in an additional 15 percent. Diabetes mellitus is a group of physiological dysfunctions characterized by hyperglycemia resulting directly from insulin resistance, inadequate insulin secretion, or excessive glucagon secretion. 3 hour blood sugar 188 It s important to manage diabetes because, over time, it can cause serious health problems like heart disease, stroke, kidney disease, eye problems, and nerve is 83 blood sugar bad damage that may lead to amputation.

Elderly blood sugar levels chart, Foot care patient self care by maintaining foot hygiene wearing appropriate footwear seeking professional care for ulcer management and regular examination of feet by health professionals. Some options may include supplements such as Garcinia Cambogia, which has shown results for increasing insulin sensitivity. Diabetes is diagnosed based on a fasting blood sugar at 102 fasting blood glucose level of 126 milligrams blood sugar lelal 8 5 per deciliter mg dL or higher. One of the challenges of managing diabetes is maintaining consistent blood sugar levels.

157 blood sugar to a1c, These infections may ultimately require toe, foot or leg amputation. Insulin remains fasting blood sugar level 97 the mainstay of treatment for patients with type 1 diabetes. The glucose in your blood serves as a primary source of energy for all the cells in your body. If you suspect you may have high blood glucose already, Zanini says that any changes in your health count as cause to see your doctor.

Blood sugar testing iphone app, Further, iPS cells non fasting blood sugar 120 are genetically identical to the original patient, so all of Normal Blood Sugar Levels For Adults With Diabetesthe mutations that predisposed an individual Alcohol Intake And Diabetesto T1D are present. More than one in three adults in High Blood Sugar, Diabetes, And Your Bodythe United States has prediabetes, and the majority of them don t know it, according to the Centers for Disease Control and Prevention. A plant based blood sugar droped to 20 diet leads to twice as much weight loss as a traditional diabetes diet. When the blood glucose elevates , insulin is released from the pancreas.

Blood sugar high after cheese, Your doctor will also check your kidney function, including estimated glomerular filtration rate e GFR , with a blood test. If you re younger, have had diabetes for a shorter amount of time or are not taking any medicine for your diabetes, your glucose goals might be Blood Sugar Levels Chartmorning blood sugar of 173 a little tighter, or lower. blood sugar dropped to 35 Eye damage this is termed diabetic retinopathy and occurs due to damage of the fine blood vessels of the retina in the eye due to long term exposure to high blood sugar. If you choose animal products for protein, make sure you re choosing high quality animal protein sources that are unprocessed and low in saturated fat.

After eating blood sugar Blood Sugar Levels Chart Low, Normal, And High Ranges165, Finally, diabetes can make it harder to get pregnant and raises your risk of pregnancy complications. It means that in most cases, data were collected using paper based records and in a small number of studies funded by pharmaceutical and biotechnology companies, this process was completed electronically. African Sexual Function And DiabetesAmericans have a high rate of diabetic complications, because of poor glycaemic control and racial disparities in health care in the USA. Don t be embarrassed to reach out to your doctor for help in any of these areas.

Blood sugar levels, But these readings may not be as accurate as readings from high blood sugar levels chart the fingertips, especially after a meal or during exercise, when blood sugar levels change more frequently. In the United States, approximately three people in 1,000 develop Type I diabetes. For pregnant women who have pre existing diabetes or develop diabetes Blood Sugar Rising Preview With Spanish Subtitlesduring pregnancy, ADA guidelines are generally lower. As a result, they stress the body s insulin making machinery less, and so may help prevent type 2 diabetes.

Take blood sugar New Study Sheds Light On The Role Of The Brain When Completing Mathematical Sumspecs card, Anyone taking medication should consult Testing Blood Glucosetheir doctor before incorporating StrictionD in to your daily life. You are more likely to develop type 2 diabetes if you are 45 years old or older, have a family history of diabetes, or are overweight. Also, it is better to have an A1C test because it tests your blood sugar over a longer course. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle.

T1d blood sugar at 300, Ketogenic diets may be an ideal diet for people with type 1 diabetes as well. A1C testing also avoids the problem of day to day variability of glucose values as it reflects the average plasma glucose over the previous 2 to 3 months. It is also important to remember that these devices can be used intermittently with fingerstick measurements. Being blood sugar reading of 136 overweight is strongly linked to Normal Hba1c For Person Without Diabetesthe development of type 2 diabetes, but not everyone with type 2 is overweight.

Blood sugar icd 10 code, deibetes blood sugar conversion charg Despite low blood sugar of 40 their former classifications as juvenile or adult, either type of diabetes can occur at any age. Without insulin, there is no key So, the sugar stays in the blood and builds up. The test looks at the percentage of glycated hemoglobin in your red blood blood sugar level is 265 cells. Sharing your frustrations and your triumphs with people who understand what you re going through can be very helpful.

Normal blood sugar level australia, Insulin It is a hormone secreted by the beta cells of your pancreas and is important for the metabolism With Excellent Accuracy2,3, Manage Your Diabetes Betterof glucose that is derived from foods that you eat. Oatmeal and barley are especially good whole Molar Mass Of Glucosegrain options for most people with blood sugar three month average high blood sugar. Early on the road to developing high blood sugar and getting High Blood Pressurediagnosed with type 2 diabetes, an insulin resistant person usually has too much insulin in the blood. It is only by measuring both incidence and prevalence that a better understanding of the extent of diabetes can be achieved.

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The Top 12 Foods To Balance Blood Sugar - First Tracks

Introduction

Prostate cancer (PCa) is the most common malignancy and the second most common cause of cancer-related deaths affecting men in developed countries.1 PCa incidence has risen over the recent decades. Factors responsible for this rise include aging population, obesity due to western dietary habits, and increasing use of prostate-specific antigen (PSA) testing.2 Prostate cells, normal or cancerous, are dependent upon androgens for survival and growth. Consequently, androgen deprivation therapy (ADT) (also called hormone therapy by some clinicians) is still the mainstay of PCa treatment. Surgical (bilateral orchiectomy) or chemical (pharmaceutical) interventions resulting in the reduction of serum testosterone or blockade of the androgen receptor, are referred to as ADT. Antiandrogens alone like flutamide, enzalutamide, and apalutamide (the modern derivatives) are not considered ADT but are used in combination with surgical or chemical castration. ADT was initially achieved by orchiectomy as the testes are the principal source of circulating androgens (producing nearly 95% of total); the remaining 5% are produced by the adrenal glands. Luteinizing hormone-releasing hormone (LHRH) agonists are the most widely used contemporary ADT modality usually offered when patients are diagnosed either with recurrent cancer after first-line treatment (such as radical prostatectomy or radiation treatment) for local disease or with advanced (incurable) disease at presentation.3 This review provides for the practicing clinician and medical provider not only a systemic overview on the evolution and the oncologic dynamics in patients undergoing traditional ADT, but also the clinical aspects and indications for the emerging new pharmaceutical ADT modalities.

The HypothalamicPituitaryGonadal axis functions as a single system or entity due to direct interaction and feedback (Figure 1). Gonadotropin-releasing hormone (GnRH), also known as luteinizing hormone-releasing hormone (LHRH), is secreted from the hypothalamus by GnRH-expressing neurons and stimulates the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the anterior portion of the pituitary gland which then stimulates the gonads for producing estrogen and testosterone. The therapeutic principle of Androgen Deprivation Therapy (ADT) in prostate cancer (PCa) has been established and not changed much over the last 80 years since Charles B. Huggins demonstrated the testosterone dependency of PCa.4 Huggins and Hodges first reported the dramatic clinical effects of suppressing serum testosterone levels (Figure 2) in men with advanced prostate cancer in 1941.5 Following bilateral orchiectomy of eight subjects with prostate cancer, serum acid phosphate levels decreased indicating decreased activity of the cancer. Five subjects with prostate cancer injected with stilbestrol also showed decreased serum levels of acid phosphatase while three subjects injected with testosterone propionate had an increase in serum acid phosphatase levels. For this pioneering work in treatment of advanced and metastatic prostate cancer Huggins was awarded the Nobel Prize for Medicine in 1966.

Figure 1 The hypothalamus-pituitary-testicular axis.

Figure 2 Molecule structure of testosterone.

In 1938 diethylstilbestrol (DES, Figure 3) also known as stilbestrol or stilboestrol, was discovered and then introduced for medical use in 1939.6 DES is an estrogen and it suppresses luteinizing hormone-releasing hormone (LHRH) (Figure 4) production at the level of the hypothalamus. In the past, it was widely used for a variety of indications, including treatment of metastatic prostate cancer (chemical castration) and hormonal support during pregnancy for women with recurrent miscarriage. DES has excellent bioavailability and is well tolerated when taken by mouth.7

Figure 3 Molecule structure of diethylstilbestrol (DES).

Figure 4 Molecule structure of luteinizing hormone-releasing hormone (LHRH).

In 1959 the Veterans Administrative Cooperative Urological Research Group (VACURG) was established which further evolved ADT in the treatment of advanced prostate cancer. The VACURG used prospective randomized clinical trials for investigating the role of monotherapy of estrogen versus combined therapy of orchiectomy plus estrogen in advanced prostate cancer patients.8 The major conclusions were: 1.) A daily dose of 3 mg DES was considered the optimal dose and became the accepted regimen for pharmacologic castration. 2.) A lower DES dose (1 mg) was associated with reduced cardiovascular toxicity but did not reliably achieve castrate levels of testosterone. 3.) No survival advantage of early versus delayed initiation of hormonal therapy in advanced disease. Up to the 1970s DES as hormonal therapy was widely accepted as the treatment for advanced and metastatic prostate cancer. However, its main adverse effects were increased risks of blood clots and cardiovascular events.9

Furthermore, reports in the 1970s revealed that DES caused clear-cell carcinoma of the vagina, a rare tumor in girls and women who had been exposed to this medication in utero. Due to these discoveries and the significant cardiovascular side effects DES essentially disappeared from the pharmaceutical market.10

Both surgical and pharmacologic castration resulted in dramatic palliation of painful bony metastatic lesions, and improved quality of life in prostate cancer patients. In 1971 Schally and associates purified the decapeptide gonadotropin-releasing hormone (LHRH).9 Studies showed that constant exposure to LHRH ultimately suppressed testosterone serum levels by desensitizing pituitary cells through downregulation of the LHRH receptors.11 Modification of the sixth amino acid position of the LHRH molecule was significantly more potent.12 The monthly depot of leuprolide (Figure 5) was the first LHRH agonist granted FDA approval for advanced prostate cancer. In a randomized clinical trial, leuprolide was equivalent to 3 mg of DES in reducing serum testosterone to castrate levels, but with much lower cardiovascular toxicity.13 Ultimately in the 1980s Leuprolide replaced DES and orchiectomy as the preferred approach to androgen deprivation.

Figure 5 Molecule structure of leuprolide.

Over the following decades substitutions at the sixth amino acid position yielded a variety of more LHRH agonists (goserelin, triptorelin, and histrelin), which then also became commercially available in the United States. These LHRH agonists are differentiated by their route of administration (intramuscular injection vs subcutaneous injection vs subcutaneous implant) and frequency of administration (112 months). All these LHRH agonists have similar therapeutic effectiveness in lowering serum testosterone to castrate levels, but also have a similar profile of adverse effects. One study directly compared different LHRH agonists.14 Overall improved survival with triptorelin compared with leuprolide, 97% vs 90.5% at 9 months (P = 0.033). Although not statistically significant, triptorelin seemed to better maintain castrate levels of testosterone over a 9-month interval.

The luteinizing hormone-releasing hormone (LHRH) agonists offered true medical castration but showed clinical issues due to testosterone surge and tumor flare when first administered. The flare phenomenon is attributed to the surge of serum testosterone levels caused by the initial stimulation of LHRH receptors. The introduction of antiandrogens was considered to ease this clinical issue by inhibiting the stimulation effect at the level of the androgen receptor.15 Despite initial expectations, the combined medical therapy of antiandrogens and LHRH agonists did not improve cancer-specific survival. The costs, inconvenience of therapy, added toxicity, and the introduction of the saturation model were considered the main reasons why the combined treatment never became standard of care. A 2017 literature review concluded that there is no evidence of testosterone flare following initiation of an LHRH agonist.16 It was proposed that this is due to the limited ability of androgens to stimulate prostate growthalso known as the saturation model.16 The saturation model, introduced in 2009, showed tumor growth increased when exposed to low levels of androgen, however after reaching a certain threshold, androgens no longer affected tumor growth. In the current literature there is still an ongoing and controversial debate on the validity of this saturation model.17

The introduction of Gonadotropin-releasing hormone (GnRH) antagonists offered a solution for the above mentioned flare phenomenon. This new drug class proved a rapid reduction of serum testosterone to castrate level without the initial testosterone surge and tumor flare. However, the long-term clinical benefits are still debated. A recent meta-analysis study comparing GnRH agonists and antagonists in patients with metastatic prostate cancer, showed that GnRH antagonist use was associated with a lower risk for all-cause mortality and cardiovascular events, respectively. However, this study did not find any significant differences between groups in PSA progression, musculoskeletal events, fractures or serious adverse events such as hepatic failure.18

In summary, ADT has come a long way since its introducing by Huggins for treatment of advanced and metastatic prostate cancer 80 years ago. Whereas surgical ADT via orchiectomy has become obsolete, medical ADT plays still a main role in the repertoire of treatment options for patients with recurrent, progressive and advanced prostate cancer.

LHRH/GnRH agonists, such as leuprorelin/leuprolide, goserelin, and triptorelin, are by far the most commonly utilized forms of ADT in clinical practice in the treatment of PCa, targeting the LHRH/GnRH receptor in the anterior pituitary gland and administered as an intramuscular or subcutaneous injection. They stimulate the receptor, creating a temporary surge in LH and testosterone levels followed by downregulation of the receptor over the next 23 weeks with a subsequent reduction in LH and suppression of testosterone production by the testes.19 They achieve serum testosterone levels below castration (<50 ng/dL) within 46 weeks with a subsequent reduction in the PSA level.20 The most common adverse effects (AE) associated with treatment are hot flashes, fatigue, sexual/erectile dysfunction, testicular atrophy, cognitive decline, increased risk of diabetes and cardiovascular events, and decreased bone mineral density associated with joint disorders and/or osteoporosis that needs to be monitored periodically with bone density scanning.21

LHRH/GnRH antagonists, such as degarelix, abarelix, and relugolix, are newer agents that competitively bind to the LHRH/GnRH receptor, inhibiting downstream LH signaling and suppressing testosterone secretion from the testes. LHRH/GnRH antagonists are not associated with an initial surge of serum testosterone, and castration levels are achieved within 23 days, so they are a good therapeutic option for the initiation of ADT in a newly diagnosed PCa patient.22 While degarelix is only available as a 1-month subcutaneous dose with a higher risk of adverse skin reactions, relugolix is a daily oral agent, although a food effect can reduce exposure by 50%.23 The side effect profile of LHRH/GnRH antagonists is similar to that of LHRH/GnRH agonists although since degarelix reduces FSH more than the LHRH/GnRH agonists (90 vs 50%), these lower levels of FSH may be cardioprotective, especially in men with preexisting cardiovascular disease, and may produce less muscle mass loss.24

Antiandrogens, such as bicalutamide, flutamide, and nilutamide, are some of the oldest drugs that inhibit binding of dihydrotestosterone (DHT) to the androgen receptor (AR).25 Since they do not reduce serum levels of testosterone, they can be considered as monotherapy in nonmetastatic patients who want to preserve libido and avoid the metabolic and sexual side effects of traditional ADT.26 They are, however, less effective than surgical castration or LHRH agonists/antagonists in metastatic prostate cancer (PCa) and are typically utilized concurrently with these agents for dual androgen blockade, especially during initiation of treatment with LHRH agonists to prevent clinical manifestations of testosterone surge within the first month.27 Table 1 summarizes single use versus combined use of ADT drugs and antiandrogens.

Table 1 List of ADT Drugs and Antiandrogens That Can Be Used in Combination

After long-term testosterone suppression, reactivation of AR pathways in some cell populations occur from multiple mechanisms including production of androgens by the adrenal glands and PCa cells themselves, androgen-independent activation of the AR, and AR gene amplification or overexpression.28 In this state, elimination of testosterone production from the testes is no longer sufficient to fully suppress PCa tumor cell growth, and another generation of antiandrogens is available for further testosterone suppression typically below 20 ng/dL.29

Abiraterone (in combination with traditional ADT) reduces androgen production from all sources including the testes, adrenal glands, and PCa cells through selective and irreversible inhibition of the enzyme 17-hydroxylase/C17,20-lyase (CYP17), which can suppress testosterone levels even lower than with traditional LHRH/GnRH agonists alone. In the LATITUDE and STAMPEDE study, the addition of abiraterone acetate and prednisone to standard ADT significantly increased overall survival (OS) and radiographic progression-free survival (PFS) in men with newly diagnosed, metastatic, castration-sensitive PCa.30,31 In the LATITUDE study, OS was significantly longer in the abiraterone acetate plus prednisone group compared to the placebo group (median OS: 53.3 vs 36.5 months) when administered in combination with standard ADT.32 In a meta-analysis of both studies, abiraterone plus prednisone with standard ADT resulted in a 38% risk reduction of death compared to placebo with standard ADT for metastatic hormone-sensitive PCa.33 In addition to the expected AEs associated with testosterone suppression, abiraterone may also produce side effects associated with mineralocorticoid toxicity (ie, hypertension, hypokalemia, and fluid retention) and liver function abnormalities.34 Those patients with heart failure, recent myocardial infarction, cardiovascular disease, or ventricular arrhythmia need to be monitored more closely while on treatment.

Enzalutamide, another third-generation antiandrogen, competitively binds to the AR at the androgen-binding site, inhibiting nuclear translocation and interaction of the AR with chromosomal DNA, which prevents further transcription of tumor-associated Androgen genes. This prevention of AR-dependent transcription causes decreased cell proliferation and induces cell death. Enzalutamide blocks the action of testosterone at the cellular level regardless of where it is derived from and, in conjunction with traditional ADT, can be utilized for newly diagnosed, metastatic, castration-sensitive PCa.35 In the ENZAMET trial, enzalutamide with traditional ADT was associated with significantly longer PFS and OS compared to traditional ADT alone in men with metastatic, hormone-sensitive PCa (3-year OS: 80 vs 72%).36 In addition to the commonly expected AEs for an AR inhibitor, seizures and posterior reversible encephalopathy syndrome have also been seen on rare occasions, likely due to the drug crossing the bloodbrain barrier.37 Seizure occurred in 0.4% of patients receiving treatment, but in patients with predisposing factors, seizures were reported in 2.2% of patients.

Apalutamide, another oral, nonsteroidal third-generation antiandrogen that blocks the action of testosterone by blocking the ligand-binding domain of the AR, was also designed to supersede the current androgen pathway inhibitors by overcoming AR-related resistance mechanisms. Like enzalutamide, it blocks androgen-receptor nuclear translocation, inhibits DNA binding, and obstructs AR-mediated transcription. In patients with non-metastatic, castrate-resistant PCa, according to the SPARTAN trial, metastasis-free survival (MFS) and time to symptomatic progression were significantly longer with apalutamide compared with placebo in combination with standard ADT (median MFS was 40.5 months in the apalutamide group versus 16.2 months in the placebo group).38 At median 52-month follow-up, median OS was markedly longer with apalutamide than placebo (73.9 vs 59.9 months).39 In the TITAN trial of patients with metastatic, castration-sensitive PCa, OS and PFS were significantly longer with the addition of apalutamide to standard ADT compared with placebo (OS at 24 months was 82.4% in the apalutamide group versus 73.5% in the placebo group).40 The most common adverse reactions with apalutamide were fatigue, hypertension, rash, and diarrhea.

The second and third generation antiandrogen drugs typically cost more than first-generation ADT drugs such as leuprolide or antiandrogens (bicalutamide) because they are not generic and usually patent-protected.

Surgical removal of both testicles (bilateral orchiectomy) remains a viable option as an alternative to chemical castration to eliminate testicular production of testosterone. Surgical castration may be associated with significantly lower risks of peripheral arterial disease and cardiac-related complications compared to chemical castration.41 Chemical castration, however, has largely replaced bilateral orchiectomy in clinical practice in the treatment of PCa because of the ease of administration, reversibility, and the avoidance of disfiguring surgery with its associated aesthetic and psychological consequences for patients.

ADT is a mainstay second-line treatment of prostate cancer once primary curative treatment, such as radiotherapy or radical prostatectomy, has failed. ADT blocks the HPG axis (for details see chapter 1), upon which testosterone production depends this in turn starves androgen-dependent elements of a tumor. However, patients response to ADT is not uniform. Klotz et al 2015 performed a secondary analysis on data from the PR-7 trial, which had examined intermittent vs continuous ADT. They first excluded all patients who underwent intermittent ADT, then stratified the remaining men into three groups based on their nadir testosterone levels: a) <20ng/dL, b) 2050ng/dL, and c) >50ng/dL. They found that men who reached a nadir level of 2050ng/dL and >50ng/dL were at hazard ratios of 1.62 (95% CI 1.202.18) and 1.90 (95% CI 0.984.70) of developing castrate resistant prostate cancer compared to men who had reached a nadir below 20ng/dL (P<0.015). The same group of researchers also found that the median time to development of CRPC for the three subgroups (<20ng/dL, 2050ng/dL, and >50ng/dL) were 10.0, 7.21, and 3.62 years respectively.42 Morote et al 2007 studied patients with non-metastatic disease who were on ADT either as a primary treatment, or as an adjuvant treatment after radical prostatectomy. They showed that men who had testosterone levels above 50ng/dL after reaching their nadir were at higher risk for androgen-independent progression (defined as 3 consecutive rising PSA levels) (HR 2.8, 95% CI 1.35.9, P<0.008).43

It is a common clinical experience that patients on ADT will develop CRPC at some point in the future, even with low, castrate serum levels of testosterone. Montgomery et al 2008 demonstrated that testosterone levels within the tumor tissue of anorchid men had elevated intra-tumoral testosterone levels (0.74 ng/gm, 95% CI 0.590.89) when compared to tumor tissue samples from untreated eugonadal men (0.23ng/gm, 95% CI 0.030.44, P<0.0001). In addition, tumor tissue from anorchid men also had significantly increased levels of steroidogenic enzymes. The authors concluded that prostate tumors are capable of sustaining themselves through autocrine/paracrine signaling and endogenous androgen production, even when blocking the HPG axis with ADT.44

Adrenal androgens are another source of androgens missed by the central blockade of LHRH. Brendler 1973 reviewed cases of adrenalectomy and hypophysectomy in reactivated prostate cancer after failing castration therapy (nowadays we would call this CRPC). Symptomatic improvement in the adrenalectomy group was 65%, with a similar rate for hypophysectomy patients.45 However, these improvements were short lived, as the prostate cancer in these patients would apparently adapt to a more androgen poor environment. In 1983, Labrie et al revisited the clinical idea of total androgen blockade when studying 87 men with metastatic prostate cancer, some of whom had received previous hormonal therapy and some not. All patients were treated with LHRH and RU-23908, an AR blocker. The results showed that serum prostatic acid phosphatase (PAP) dropped to normal levels in 97% of patients who had not previously received hormonal treatment and had an elevated PAP prior. They also noted positive objective radiologic responses in 100% of treatment-nave patients, with several patients experiencing a complete disappearance of all bone lesions on imaging. They also noted that patients with previous systemic estrogen therapy showed a 55% response with PAP drop and an 80% response on bone imaging, respectively. The authors also found that men who had previously undergone hormonal therapy had a fast diminishing response to total androgen blockade, and they concluded that this clinical phenomenon was likely due to a selection process of tumor cell clones less dependent on systemic testosterone support.46 In 1991, Labrie et al published results of a prospective study based on a similar regimen as described earlier by substituting flumatide for RU-23908. They found that 93% of patients had a positive objective response, with 30% of patients experiencing objective regression of all bone lesions.47 In 1997, Ansari et al conducted a trial in which 100 men with metastatic castrate sensitive prostate cancer were randomized into either orchiectomy alone or orchiectomy plus flutamide. The results showed no significant difference in overall survival at 3 years, with orchiectomy alone at 45.83% and orchiectomy plus flutamide at 48.07%. This pattern held to the 5 year follow-up, with orchiectomy and orchiectomy plus flutamide at 20.83% and 23.07%, respectively.48

The next step forward came with abiraterone, a CPY17 inhibitor. It was first described in 1994 by Barrie et al as one of several novel compounds found to inhibit 17-hydroxylase/C17,20 lyase. When testing several of these compounds on mice, there were significant reductions in the weight of the prostate (50%), seminal vesicles (75%), and testes (25%) (P<0.01 for all).49 The first human trial was done by ODonnell et al in 2004. They tested different doses of abiraterone in men with advanced CRPC who were either still receiving or had received ADT. They found significant reductions in serum testosterone levels in all patients, with no grade III adverse events.50 In 2008, Attard et al performed a Phase I clinical trial of 21 patients who had known mCRPC. They found that 66% of patients experienced a reduction of PSA by 30% or more. In addition, serum testosterone became undetectable in all patients within 8 days of their first dose, and 8/11 patients who had required analgesics at baseline had reduced analgesic requirements after receiving abiraterone.51 There was a further improved response rate reported by Tran et al in 2009 in a phase I/II trial for enzalutamide: 43% of patients had a sustained reduction in PSA by 50% or more.52

The idea of maximum androgen blockade has been a goal for men with metastatic prostate cancer for decades. As mentioned earlier, Brendler described some positive therapeutic results in both patients who had undergone hypophysectomy to inhibit ACTH and thereby adrenal androgens, and in patients who had undergone adrenalectomy for the same reason. However, this success typically came at a high cost. The next step forward on maximum androgen blockade came with Labrie in 1983, when he described the use of both LHRH and a first-generation AR blocker. His results in CRPC were impressive, with many patients experiencing both objective responses on imaging as well as symptomatic relief. Newer anti-androgen pharmaceuticals like abiraterone and enzalutamide have shown impressive objective response rates in prospective and randomized FDA trials, and have evolved to be part of the updated AUA guidelines in the treatment repertoire for asymptomatic and symptomatic mCRPC.

The timing of androgen deprivation therapy (ADT) in the management of recurrent and advanced prostate cancer has been controversial for many years. This is mainly due to a lack of adequate randomized clinical trials comparing early vs delayed ADT in patients with recurrent PSA following failure of local curative treatment. To date the available studies and current guidelines are stating that early use of ADT to be only beneficial in symptomatic patients with recurrent or metastatic disease. The EAU recommends ADT only in symptomatic patients requiring palliative treatment.53 In the following we summarize the current practice guidelines on timing of ADT in patients with recurrent prostate cancer after failing local curative treatment.

Messing et al performed one of the first landmark studies addressing the timing of androgen deprivation therapy (ADT) and its effect on survival in patients with node positive prostate cancer following radical prostatectomy and pelvic lymphadenectomy. This randomized controlled trial enrolled 100 patients between 1988 and 1993 who had previously undergone surgery and had histologically proven nodal metastasis. The patients were randomly assigned to receive either immediate ADT or active surveillance with ADT intervention only given on proven symptomatic recurrences or detection of distant metastasis. This study revealed superiority of immediate ADT compared to delayed ADT: Significantly improved overall survival (hazard ratio 1.84 [95% CI 1.013.35], p=0.04), disease specific survival (4.09 [1.769.49], p=0.0004) and progression free survival (3.42 [1.965.98], p<0.0001). The main points of criticism for this study were the low number of recruited patients and that this study did not involve patients with high-risk local disease without node involvement leading to uncertainty of optimal ADT timing for this category of patients.54 Additionally, this debate emphasized the need for further clinical research on optimal ADT timing in patients with PSA recurrence following local curative treatment.

The EAU/ESTRO/SIOG guidelines for localized prostate cancer state that routine use of ADT should be avoided in nonmetastatic patients with the exception for symptom control. This clinical recommendation is based on the EORTC Trial 30,891 which compared immediate versus deferred ADT in T0-4 N0-2 M0 prostate cancer patients unsuitable for local curative treatment. While this trial did not address PSA recurrence following local curative intervention (i.e RP vs RT), it did, however, provide evidence for the benefit of immediate ADT in patients at increased risk of cancer-specific mortality. This study included patients with high baseline PSA (>50ng/mL) and/or a PSA Doubling Time <12 months. The authors stated that patients not meeting these high-risk inclusion criteria were indeed more likely to die of other causes unrelated to prostate cancer.55

Similar to the European guidelines, the AUA/ASTRO/SUO guidelines do also not recommend early initiation of ADT without proven metastatic disease in patients who have failed maximal local therapy.56 This recommendation is mainly based on the observational study by Garcia-Albeniz et al in 2006 where eligible patients had previously been recruited for the Cancer of the Prostate Strategic Urologic Research Endeavour (CaPSURE). These patients had failed prior local curative treatment and had been treated either with immediate or deferred ADT. The study revealed no survival benefits for immediate ADT vs deferred ADT initiation in patients with recurrent PSA. The adjusted mortality hazard ratio for immediate versus deferred ADT was 0.91 (95% confidence interval (CI), 0.521.60), which would be translated into a similar 5-year survival (difference between groups: 2.0% (95% CI: 10.0 to 5.9%). This suggests that in the absence of randomized control studies early ADT initiation does not provide a major survival benefit compared to deferred ADT therapy.57

Van den Bergh and colleagues performed a systematic literature review to assess the effectiveness of ADT in patients with PSA recurrence following local curative treatment. This meta-analysis found that the benefit of early/immediate ADT for nonmetastatic prostate cancer recurrence remains unproven. The conclusion was that early ADT should be reserved for patients with the highest risk of progression based on PSADT or Gleason Score, but having a long life expectancy. This falls in line with the current standard of care recommendations of the EAU/ESTRO/SIOG and AUA/ASTRO/SUO.58

Overall, currently there is a lack of randomized controlled trials (RCT) assessing the impact of early compared to delayed ADT in the management of recurrent prostate cancer following local curative therapy, which has led to the continued controversial debate on this subject. To date no RCT has addressed or shown the benefit of specific ADT timing in patients with recurrent PSA. Bruchovsky and colleagues proposed the idea of Intermittent Androgen Deprivation Therapy as a means to reduce side effects and improve quality of life. However, further research is needed for clarification of the optimal timing of reexposure of prostate cancer cells to androgens and its impact on delaying androgen resistance, which may also be influenced by early or delayed ADT.59 This situation has led to the clinical practice that early ADT is provided only to symptomatic patients in particular when weighing the long-term risks associated with ADT. Unfortunately, due to the lack of adequate RCTs we still are waiting for clear answers regarding the oncological benefits of early vs delayed ADT in asymptomatic patients with recurrent or advanced prostate cancer.53

Since the 1940s, androgen deprivation therapy (ADT) has been the foundational treatment for prostate cancer. Bilateral orchiectomy, the original form of ADT, is still used worldwide, in particular in the developing world. Medical ADT options are the standard of care when available. It is well documented in the literature that ADT is associated with numerous significant adverse effects which include hot flashes, loss of libido, erectile dysfunction, loss of muscle mass and strength, fatigue, anemia, breast enlargement and tenderness, mood swings, osteoporosis and bone fractures, obesity, cardiovascular disease, insulin resistance and diabetes. Some studies also see ADT associated with cognitive decline and dementia (for details see Chapter 9 of this review).

Intermittent androgen deprivation therapy (iADT) is a cyclic therapy with cessation of ADT (also called treatment holidays by some clinicians) allowing serum androgen recovery. The clinical idea is based on animal studies showing that iADT delayed tumor progression.60 Furthermore, the rationale for iADT is based on balancing drug-related toxicity and oncologic benefits. As continuous ADT (cADT) is associated with substantial side effects, which may increase with duration of therapy, many clinicians consider iADT as an alternative providing reduced morbidity, and thus improved quality of life, with the possible oncological benefit of delaying castration-resistant PCa.

The PR-7 trial, a landmark study, randomized patients for iADT and cADT with biochemical recurrence after either failing primary local treatment or salvage external radiotherapy.61 Eligible patients had PSA levels 3 ng/mL and no evidence for metastatic disease. The overall survival in patients that underwent iADT was 8.8 years compared to 9.1 years in patients that underwent cADT (HR=1.02, 95% CI= 0.861.21) indicating no significant difference. Furthermore, this study showed a non-inferiority P-value of 0.009 for iADT in overall survival. The study also revealed that other causes of death unrelated to PCa were more common in those receiving cADT, leading to the conclusion that intermittent therapy may not only reduce drug-related morbidity, but even mortality associated with cADT toxicity. Furthermore, patients with high-grade disease showed no improved overall cancer-specific survival when receiving cADT.

The ICELAND study published in 2016 is considered one of the main studies on iADT vs cADT in patients with relapsing prostate cancer.62 This prospective study included 102 different locations in 20 European countries and followed more than 700 participants randomized either to iADT or cADT. The authors found no difference in overall survival between the two groups, and they also emphasized the obvious reduced drug cost benefit of iADT over cADT.

The SWOG trial initiated by Dr. Hussain enrolled patients with metastatic, hormone-sensitive disease.63 All patients received an initial 7-month induction course of ADT. Patients with responding PSA levels 4 ng/mL were subsequently randomized to iADT or cADT (770 to iADT and 765 to cADT). The Kaplan-Meier curves were very similar, the hazard ratio was 1.10 with a confidence interval of 0.99 to 1.23. The pre-specified upper boundary of the confidence interval for non-inferiority was 1.20. Therefore, neither superiority nor non-inferiority could be concluded. However, the study data showed improved quality of life outcomes in the iADT arm: Better erectile function, improved bone density, less ischemic and thrombotic events.

A meta-analysis of seven studies with a total of 4810 patients treated with iADT or cADT between the years 2009 and 2015 showed no significant difference regarding cardiovascular events (risk ratio (RR): 0.95; confidence interval (CI) 95%=0.831.08) and thromboembolic events (RR: 1.05; CI 95%=0.851.30). However, iADT was associated with lower cardiovascular-related mortality.64

Another meta-analysis of randomized controlled trials (RCTs) assessed the risks of disease progression, all-cause, and cancer-specific mortality.65 Eight RCTs with 4664 patients were included in this report. It did not find any statistical difference in overall mortality and cancer-specific mortality between iADT and cADT. Again, the authors observed a better quality of life outcome for iADT, and therefore, they concluded that patients should be informed of the potential benefits of iADT.

Dason et al found that iADT was non-inferior to cADT in the primary setting of biochemical recurrence after radiation treatment of non-metastatic local prostate cancer. In the metastatic prostate cancer setting, iADT was also found to be non-inferior to cADT. Additionally, the authors reported that many ADT-related symptoms improved or resolved during the off-cycle with iADT.66

The results of a retrospective Japanese study on PSA recurrence after radical prostatectomy supported the hypothesis that iADT may delay castration-resistance in PCa.67 The iADT group had a significantly higher 5-year non-recurrence rate (92.9% vs 57.9%, p <0.001) and a better 10-year overall survival rate (95.9% vs 84.3%, p = 0.47) than the cADT group.

When summarizing the presented and pooled data, iADT provides better quality of life, whereas cancer-specific mortality shows interchangeable findings for iADT and cADT. Some studies even show improved overall survival for iADT patients likely due to reduced medication-related toxicity. Significantly reduced drug costs are also a strong rationale for iADT. Over more than one decade, iADT has evolved as the first option for patients after failing first-line local treatment in the absence of extensive metastatic disease. Although there are no well-defined recommendations or guidelines, the AUA/ASTRO/SUO website makes the following statement:

if ADT is initiated in the absence of metastatic disease, intermittent ADT may be offered in lieu of continuous ADT. (Conditional Recommendation; Evidence Level: Grade B)68

iADT may be considered after at least 912 months of ADT or until PSA nadir has been reached (in an ideal clinical scenario with PSA < 0.1 ng/mL). The off-treatment period varies depending on PSA monitoring and PSA rising, but also on patients and physicians preference. Again, there are no well-defined recommendations or guidelines at what PSA threshold ADT should be resumed. Some clinicians restart ADT when PSA doubling time (PSADT) is less than 6 months or when serum PSA has reached a level of 610 ng/mL. Some clinicians and medical providers set this threshold even far above 10 ng/mL.

Radiation Therapy (RT) and its part in prostate cancer (PCa) management has continued to evolve as this Technology has improved over time, and research has led to a better understanding of the oncologic disease dynamics. Radiation therapy for prostate cancer consists of targeted energy beams such as External Beam Radiation Therapy (EBRT) or implantable radioactive seeds such as Brachytherapy, which destroy and thus eliminate neoplastic cells. While there are diverse subcategories of radiation-based therapies (such as Intensity Modulated Radiation Therapy, Proton Beam Therapy, and Low/High Dose Rate Implants), the risk and benefits of each as well as other factors such as the patients preference ultimately guide the decision of the selected type of therapy. There are varying degrees of early and late mainly gastrointestinal and genitourinary complications caused by RT which underscore the need for shared decision making between treating physicians and PCa patients.56,69

The current AUA/ASTRO/SUO guidelines for management of advanced prostate cancer recommend primary radiotherapy in combination with ADT as a treatment option for selected patients with hormone sensitive prostate cancer and low volume metastatic disease (mHSPC). This is only a conditional recommendation with Grade C (low) level evidence and is mainly based on two preliminary Phase III trials (HORRAD and STAMPEDE Arm H) showing some benefit of combined therapy in these patients.56 These studies are still ongoing and may provide additional information to guide clinical practice in the upcoming years.

However, the AUA/ASTRO/SUO do not recommend combined therapy on localized, low risk prostate cancer except for the management of prostatic size reduction in selected patients undergoing brachytherapy.69 This recommendation stems from the randomized, phase III trial by Jones et al in 1979 which failed to show any overall survival benefit in low risk prostate cancer patients receiving EBRT with ADT vs EBRT alone; the 10-year overall survival was 64% to 67% (hazard ratio, 1.07; 95% CI, 0.83 to 1.39). In this trial the greatest clinical benefit of combined therapy was seen in the intermediate prostate cancer group: overall survival improved from 54% to 61% (hazard ratio, 1.23; 95% CI, 1.02 to 1.49).70

In the HORRAD trial prostate cancer patients with bone metastasis showed no overall survival benefit with the combination of ADT and Radiation Therapy. This study was a multi-Center randomized controlled trial on primary metastatic prostate cancer (20042014), and 432 patients were randomized to ADT with Radiation Therapy vs ADT alone. The median survival was not statistically different: 45 months (95% confidence interval [CI], 40.449.6) in the ADT plus radiation therapy group, and 43 months (95% CI: 32.653.4) in the control group (p=0.4). The overall survival was also not found different (hazard ratio [HR]: 0.90; 95% CI: 0.701.14; p=0.4).71

In the STAMPEDE phase III trial (Arm H) more than 2000 patients with metastatic prostate cancer on lifelong ADT were randomized to receiving additional radiation therapy. Radiation Therapy did improve failure-free survival (HR 0.76, 95% CI 0.680.84; p<0.0001), but not overall survival (0.92, 0.801.06; p=0.266). However, radiation therapy showed a trend to improve overall survival in those patients with low metastatic burden (73% vs 81% at 3 years).72

Shipley et al performed the landmark trial on the benefits of combining ADT and Salvage Radiation Therapy for post prostatectomy patients with persistent/recurrent PSA. These patients had either pT2 disease with positive surgical margins or pT3 disease without nodal involvement. This double blind, placebo-controlled trial recruited 760 eligible patients between 1998 and 2003 who underwent 24 months of ADT (Bicalumatide) in addition to salvage radiation therapy. This study showed in the ADT plus radiation arm significant higher rates in overall survival, but also decreased incidence of metastasis and cancer-related deaths compared to radiation therapy alone.73

The clinical trial done by Warde et al confirmed the unequivocal benefits of combining ADT and Radiation therapy in the management of nonmetastatic, locally advanced high-risk prostate cancer. This randomized, phase III trial included 1205 patients with high-risk pT2 and pT3/T4 prostate cancer over a 10-year period (19952005) who were randomized either to Radiation Therapy + ADT or ADT alone. The results showed an explicit overall survival benefit when receiving the combination therapy (74% vs 66%).74

Based on current guidelines Low and Intermediate Risk local Prostate Cancer may be treated with EBRT alone.69 However, the still ongoing EORTC 22991 trial with over 800 patients randomized to radiation therapy alone vs radiation therapy plus ADT showed at 7.2 years median follow-up that the radiation therapy plus ADT arm had significantly improved biochemical disease-free survival (DFS) (HR, 0.52; 95% CI, 0.41 to 0.66; P = 0.001) as well as clinical progression free survival (PFS) (HR, 0.63; 95% CI, 0.48 to 0.84; P = 0.001). Overall survival data is still pending. These results suggest an overall benefit with combination therapy in improving biochemical and clinical disease-free survival.75

A meta-analysis by Spratt et al revealed that ADT and radiation treatment sequencing may also be an important aspect. Adjuvant ADT post radiation therapy improved Metastasis Free Survival (MFS) and Progression Free Survival (PFS) compared to Neoadjuvant ADT without increasing long-term toxicity. The authors reviewed two randomized Phase II Trials (Ottawa 0101 and RTOG 9413) in the management of localized prostate cancer, and concluded that delaying radiation therapy to perform neoadjuvant ADT did not lead to additional tumor control or reduced toxicity and may actually be inferior to adjuvant ADT.76

Summarizing the present and available data, it appears that the combined therapy (RT + ADT) is of greatest benefit in patients with high-risk local disease. In addition, some patients with hormone sensitive prostate cancer and low volume metastatic disease may also benefit from combination therapy.

Docetaxel, a taxane-based systemic chemotherapy agent, was one of the first additional agents to emerge as a treatment with strong evidence for an overall survival (OS) benefit in patients with metastatic, castrate-sensitive prostate cancer in addition to standard ADT. In the CHAARTED trial, patients with metastatic, hormone-sensitive prostate cancer were randomized to treatment with either traditional ADT alone (which consisted of surgical castration with orchiectomy or medical castration with LHRH agonists such as leuprolide) versus ADT plus docetaxel, which they received as 75 mg/m2 every 21 days for six cycles.77 Median OS was 13.6 months longer (57.6 vs 44.0 months, HR: 0.61) in the ADT plus docetaxel group compared to traditional ADT alone.77 The survival benefit of adding docetaxel to ADT was even more pronounced in high-volume disease (defined as the presence of visceral metastases and/or greater than or equal to four bone lesions with at least one beyond the spine and/or pelvis) with median survival increased by 17.0 months compared to ADT alone (HR: 0.60).77 Additional benefits in the ADT plus docetaxel group included a longer time to the development of castrate-resistant disease, higher rate of decline of the PSA to <0.2 ng/mL at 12 months, and a lower incidence of prostate cancer-related death.77

Another trial called the STAMPEDE trial was published assessing the role of docetaxel in the metastatic hormone-sensitive prostate cancer space.78 When comparing the ADT plus docetaxel group to ADT alone, STAMPEDE again suggested an overall survival benefit with ADT and docetaxel for the subset of patients with metastatic disease (HR: 0.80).78 Patient selection in this trial notably included not only men with metastatic disease (61% of participants), but also patients with node-positive and high-risk localized disease.78

In a meta-analysis performed with the combined data from GETUG-AF15, CHAARTED, and STAMPEDE, men with metastatic castrate-sensitive disease across all three studies had a statistically significant overall survival benefit with the addition of docetaxel to traditional ADT (HR: 0.72).79 The combined data from all three trials yielded an overall 27% risk reduction of death for prostate cancer patients with metastatic disease (HR: 0.73), and a 33% risk reduction of death in high-volume, metastatic, castrate-sensitive prostate cancer patients (HR: 0.67).79

Abiraterone acetate is an androgen biosynthesis inhibitor. Another analysis of the STAMPEDE trial utilized standard ADT alone versus ADT with abiraterone (1000 mg) daily with prednisolone (5 mg daily) to assess its role in men with metastatic, castrate-sensitive prostate cancer, nodal disease, or high-risk localized disease.31 Over a three-year follow-up, overall survival was 83% in the abiraterone plus ADT group vs 76% in the ADT alone group (HR: 0.63).31

In the LATITUDE trial, patients were randomly assigned to ADT alone versus ADT with abiraterone (1000 mg) daily with prednisolone (5 mg daily).30 After a median follow-up of 30.4 months, overall survival was significantly longer in the abiraterone + ADT group than in the ADT alone group (not reached versus 34.7 months, HR: 0.62).30 Progression-free survival was 33.0 months in the abiraterone + ADT group and 14.8 months in the ADT along group (HR: 0.47).30

Enzalutamide is a potent androgen-receptor inhibitor. In the ARCHES trial, 1150 men with metastatic, hormone-sensitive prostate cancer were randomized 1:1 to receive either 160 mg enzalutamide daily plus ADT or ADT plus placebo.80 Sixty-three percent of the study participants had high-volume disease, defined as either visceral metastases or 4 bony metastases with at least one outside the spine/pelvis.80 The risk of radiographic progression or death was significantly reduced with enzalutamide plus ADT compared to placebo plus ADT (HR: 0.39).80 This benefit was similarly seen regardless of disease volume or prior docetaxel chemotherapy. Enzalutamide plus ADT significantly reduced the risk of PSA progression, initiation of new antineoplastic therapy, first symptomatic skeletal-related event, castration resistance, and reduced risk of pain progression compared to ADT with placebo.80

Another contemporary trial evaluating enzalutamide in the metastatic, hormone-sensitive prostate cancer space, ENZAMET, randomized 1125 men with metastatic, castrate-sensitive prostate cancer to treatment with enzalutamide 160 mg daily + ADT versus traditional ADT alone.36 At median follow-up of 34 months, overall survival was improved in the enzalutamide + ADT group compared to the ADT alone group (HR: 0.67).36 Better outcomes with enzalutamide + ADT were also seen in PSA and clinical progression-free survival (HR: 0.39 and 0.40, respectively) compared to ADT alone.36 Enzalutamide was associated with significantly longer progression-free and overall survival than standard care with traditional ADT in men with metastatic, hormone-sensitive prostate cancer.36

Apalutamide is an inhibitor of the ligand-binding domain of the androgen receptor. In the TITAN trial, over 1000 patients with metastatic, castration-sensitive prostate cancer were randomized to receive apalutamide (240 mg per day) with traditional ADT or placebo with ADT.40 A total of 10.7% had received previous docetaxel therapy, 62.7% had high-volume disease, and 37.3% had low-volume disease.40 Progression-free survival at 24 months was 68.2% in the apalutamide with ADT group versus 47.5% in the placebo with ADT group (HR: 0.48).40 Overall survival at 24 months was also greater with apalutamide + ADT than with placebo + ADT (82.4% versus 73.5%, HR: 0.67).40

All four agents (docetaxel, abiraterone, enzalutamide, and apalutamide) have been FDA-approved for the treatment of metastatic, castration-sensitive prostate cancer and are now listed as category 1 recommendations within the NCCN guidelines.81 Treatment choice between agents for metastatic, hormone-sensitive prostate cancer is a challenge, and there is currently no clear consensus on preferential initial selection or sequencing of these agents. There is, however, a moderate degree of uncertainty in the role of chemotherapy in low-volume disease patients.82 Marchioni et al systematically reviewed the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria and found that no treatment was superior to docetaxel in terms of overall survival.83 However, abiraterone (HR: 0.89), enzalutamide (HR: 0.90), and apalutamide (HR: 0.90) showed nonstatistically significant lower overall mortality rates when compared to docetaxel.83 Abiraterone (HR: 0.71), enzalutamide (HR: 0.61), and apalutamide (HR: 0.74) also showed statistically significant lower disease progression rates when compared to docetaxel.83

Despite its effectiveness, nearly all patients on ADT will progress to castrate resistant prostate cancer (CRPC).84 CRPC is defined as biochemical or radiologic progression of disease in spite of castrate level testosterone (<50ng/dL). In the past, ADT was stopped after a cancer became castrate resistant however, Taylor showed in 1993 that there was a survival benefit of 26 months with continued ADT.85 Since then, the AUA has recommended continuing ADT in both metastatic and non-metastatic CRPC.86 In 2015, Merseburger reviewed the rationale for continuing ADT as a backbone of treatment after development of CRPC, and found no trials to this point that compared either abiraterone or enzalutamide with ADT versus without. The SPARE trial done in Germany is comparing abiraterone monotherapy with abiraterone plus ADT however, the final results are still pending. Hen comparing clinical studies Merseburger et al noticed that patients with CRPC who were started on abiraterone with prednisolone benefited from continued ADT, as the LH surge after discontinuing ADT overcame the inhibition of abiraterone. Similarly, they found that there was limited data comparing enzalutamide alone versus enzalutamide with ADT all previously published phase III trials on enzalutamide had continuation of ADT as an inclusion criteria.87

In this context the NCCN guidelines state that androgen receptor activation and autocrine/paracrine androgen synthesis are potential mechanisms of recurrence of prostate cancer during ADT (CRPC), and they recommend continuation of traditional ADT.88 Harris et al 2009 studied mechanisms of androgen persistence in prostate cancer despite ADT they found that prostate cancer cells could bypass castration with multiple mechanisms, including upregulation of the androgen receptor and synthesis of DHT in prostate cancer cells.89 Dai et al 2017 discusses changes to the androgen receptor itself as prostate cancer is treated. The androgen receptor is an intracytoplasmic steroid hormone receptor that functions as a nuclear transcription factor after an androgen binds to its ligand binding domain. In men with prostate cancer treated with ADT, mutations in the androgen receptor are seen in 1030%. On of the most common involves the loss of the ligand binding domain (the target of enzalutamide), which uncouples transcription of the targets of the androgen receptor from its activation by androgens.90 As outlined below, these pathways provide targets for newer hormonal therapies.

For a CRPC to be considered non-metastatic, it must meet the criteria of castrate resistance without radiologic evidence of metastasis on CT or technetium-99m bone scan. Once non-metastatic CRPC (nmCRPC for short) has been confirmed, the next important clinical variable is PSA doubling time (PSADT).

In patients with a PSADT greater than 10 months, the AUA and NCCN recommend continued ADT to maintain castrate level. Serial PSAs should be drawn every 36 months for adequate monitoring PSADT. Additionally, imaging should be obtained every 612 months for re-staging and to rule out development of metastatic disease.

In patients with a PSADT less than 10 months, the AUA and NCCN recommend continued ADT with a non-steroidal anti-androgen such as apalutamide, darolutamide, or enzalutamide. Smith et al 2018 showed a difference in median metastasis-free survival of 40.5 months vs 16.2 months in the apalutamide vs placebo group (P<0 0.001), as well as a significant benefit in time to symptomatic progression, with a hazard ratio of 0.45 (95% CI, 0.320.63 - P<0.001).91 Similar benefits for enzalutamide were shown by Hussain et al in 2018, with a difference in median metastasis free survival of 36.6 months for enzalutamide versus 14.7 months for placebo (P<0.001).92 Fizazi et al 2019 showed a similar benefit for darolutamide, with median metastasis free survival at 40.4 months versus 18.4 months for placebo (hazard ratio 0.41, 95% CI 0.340.50, P<0.001).93 Finally, a review by Mori et al 2020 showed that apalutamide and enzalutamide were more effective than darolutamide in regards to metastasis free survival and PSA-progression free survival, while darolutamide had an overall lower rate of adverse events.94

A patient is considered to have progressed from nmCRPC to metastatic CRPC (mCRPC) when metastatic disease is confirmed on imaging. Depending on previous treatments, the patient may have several options for ADT. Importantly, both the AUA and NCCN recommend continuation of traditional ADT with either GnRH/LHRH agonists or antagonists. Further treatment options depend on prior treatment.

In men with mCRPC without any prior novel hormone therapies (including abiraterone, apalutamide, enzalutamide, or darolutamide) several different treatment options are recommended - these include abiraterone with a steroid, docetaxel, and enzalutamide. Abiraterone is an inhibitor of cytochrome P-450c17, which ultimately manifests in inhibition of 17-hydroxylase and 17,20-lyase. Ryan et al 2013 examined abiraterone with steroid versus placebo in patients with mCRPC on ADT, who had not been previously treated with chemotherapy. Median overall survival was not reached in the abiraterone plus steroid group, while it was 27.2 months in the placebo group (HR 0.75, 95% CI 0.610.93, P<0.01). They also benefit in radiographic progression free survival, with 16.5 months versus 8.3 months in the placebo group (Hazard ratio 0.53, 95% CI 0.450.62, P<0.001).95 De Bono et al 2011 examined the role of abiraterone in mCRPC after treatment with chemotherapy and noted an overall survival of 14.8 months for abiraterone plus prednisolone versus 10.9 months for placebo, with a hazard ratio of 0.66 (95% CI 0.560.79, P<0.001). The same study also noted a benefit to progression free survival according to radiographic imaging, with 5.6 months on abiraterone versus 3.6 months with placebo (HR 0.67, 95% CI 0.590.78, P<0.001).96

Similar results were found with the AR blocker enzalutamide in mCRPC. Beer et al 2014 examined enzalutamide in mCRPC before use of chemotherapy. They showed a benefit in in cancer-specific survival, where 72% on enzalutamide and 65% in the placebo group (Hazard ratio 0.71, 95% CI 0.600.84, P<0.001). Additionally, radiographic progression free survival was 65% in the enzalutamide group versus 14% in the placebo group (Hazard ratio 0.19, 95% CI 0.150.23, P<0.001).97 Scher et al showed similar benefits when enzalutamide was used after receiving chemotherapy for mCRPC, with a difference in survival of 18.4 months for enzalutamide versus 13.6 months for placebo (HR 0.63, 95% CI 0.530.75, P<0.001). The same study showed a benefit in radiographic progression free survival, with 8.3 months versus 2.9 months (HR 0.40, 95% CI 0.350.47, P<0.001).98

The conclusion of the above a data is that ADT is still standard of care in nmCRPC and mCRPC alike, even with the introduction of new modalities.

ADT has been associated with undesirable side effects ranging from musculoskeletal decline to autoimmune disorders. The aim of this narrative is to summarize and update the adverse effects of ADT with studies published within the past 6 years.

It is well documented that ADT is associated with decreased bone mineral density (BMD) and an increased risk of developing osteoporosis and bone fractures. In one study, BMD decreased by 2.5%, 4.28%, 5.34%, and 6.16% after 6, 12, 18 and 24 months respectively following initiation of ADT.99 Patients on ADT also had an increased risk for any fracture (HR=1.4, CI=1.281.53), hip fractures (HR= 1.38, CI=1.201.58), and major osteoporotic fractures (HR=1.44, CI 1.281.61).100

Subsequent studies also illustrated the effect of ADT on muscle strength and volume. A 2016 study showed a decrease in self-reported physical functioning in men receiving ADT. Objective measurements of both grip strength and chair rise showed that grip strength was significantly diminished after 12 months of receiving ADT (P=0.01), and chair rise performance was significantly worse at both 6 and 12 months (P=0.02, P=0.003).101 Another study has confirmed differences in muscle volumes, measured by MRI, in patients on ADT. The levator ani muscle volume in men receiving ADT was significantly lower than in men of the control group (P=0.002). These men lost 16% of their initial baseline muscle volume when compared to the control. Patients on ADT had significant muscle loss in the gluteus maximus, iliopsoas, and quadriceps (P=0.017, P=0.013, P=0.031) along with increased intramuscular fat in the gluteus maximus (P=0.003).102

Metabolic syndrome is a set of symptoms that increase the risk of stroke, cardiovascular disease, and type II diabetes mellitus (DM). There is an increased risk of developing DM in prostate cancer patients treated with ADT than patients not treated with ADT (HR=1.49, CI= 1.341.66).103 ADT was also associated with higher risk of complications in patients previously diagnosed with DM. Patients on ADT had a 17% increased risk of developing diabetic retinopathy, 14% higher risk for diabetic neuropathy, and twice as likely to have diabetic amputations.104

In longitudinal cohort study of 190 men undergoing ADT, mean triglycerides (P<0.001), HDL cholesterol (P<0.001), and waist circumference (P<0.001) were significantly increased 6 months and 12 months after initiating ADT.105 Although HDL cholesterol is known to improve cardiovascular Health, an increase in overall cholesterol and triglycerides have negative effects as shown in the next two studies. Patients on ADT were at a higher risk of coronary heart disease and myocardial infarctions (OR=2.07, P<0.01).106 ADT also increased the risk for ischemic stroke (HR= 3.32, CI-1.149.67, P=0.028) when compared to non ADT users.107

The effect of ADT on cognitive function is still controversial. In one study, patients on ADT had more cognitive deficits in language ability, short-term memory, mental flexibility, and inhibitory control (P<0.05) when compared to a control group.108 A literature review and meta-analysis found an increased risk of new dementia onset (of any cause) and Alzheimer disease in patients on ADT (HR=1.21, CI=1.111.33; HR=1.16, CI=1.071.72).109 However, study results are conflicting as another retrospective study using the Taiwan Longitudinal Health Insurance Database in 5340 patients found no significant difference in Alzheimer or Parkinsons disease between patients receiving ADT and patients who did not receive ADT (HR=1.76, CI=0.555.62; HR=1.13, CI=0.582.20).110 When summarizing the reported data, several investigators think that there is a trend of cognitive decline under ADT, but they also agree that further prospective clinical studies are necessary.

A diagnosis of prostate cancer can be devastating patients and their families, and published data has shown that ADT can further increase psychiatric stress, and therefore, its impact must be considered when choosing the best alternative of therapy. The self-reported depression scores were higher in patients on ADT at 12 and 15 months when compared to patients with BPH or post prostatectomy.111 Furthermore, 43.1% of patients on ADT experienced higher incidence of anxiety when compared to control (P<0.001). This study also showed a correlation between longer duration of therapy and higher risk of anxiety (HR= 1.16, CI=2.041.29, P=0.01).112

Androgens can affect hematopoiesis and immunology. Patients on ADT are at increased risk of developing iron deficiency anemia (HR=1.62, CI 1.242.12).113 A retrospective study showed the association between ADT and the risk of developing any hematologic disorder including anemia and hematologic malignancy when compared to patients who underwent radical prostatectomy (HR=1.60, CI=1.291.97; HR 1.98, CI=1.62, 2.42). This associated risk even increased with longer duration of ADT (P<0.001).114

A study in 2016 analyzed the association between ADT and community acquired pneumonia: 62.2% of patients on ADT had respiratory events compared to 54.5% patients who did not receive ADT and 47.8% of patients who underwent one-sided orchiectomy (P<0.001). Patients with more than 11 doses of ADT were at increased risk for developing sinusitis, bronchitis, and pneumonia (HR=1.13; HR=1.26; HR=1.15; all P<0.001).115

The association between ADT and autoimmune diseases apparently depend on the type of disease. Whereas patients on ADT had a 23% increased risk of developing rheumatoid arthritis (HR1.23, CI 1.091.40),116 ADT seems to have a protective role in developing inflammatory bowel diseases: A decreased risk for ulcerative colitis (HR= 0.52, CI= 0.280.99) and Crohns disease (HR=0.38, CI 0.111.37).117

Although ADT is an effective treatment for prostate cancer, it comes with many risks and potentially harmful side effects. Therefore, a detailed risk-benefit discussion should be provided to the patient before initiating this form of treatment.

Bone mineral density (BMD) testing in patients on ADT is underutilized, and many men are unaware how to monitor and maintain good bone health. Clinical investigators have recommended to address patient education on risks of osteoporosis and strategies to improve bone health while on ADT. A 2018 study showed that a bone health pamphlet and support from a bone-health care coordinator resulted in a significantly higher percentage of men undergoing BMD testing when compared to men who underwent usual care (P<0.001). This bone health pamphlet given by the family physician also resulted in a significantly higher percentage of BMD testing (P=0.047).118

Lifestyle modifications including smoking cessation and reduced alcohol intake are recommended for patients on ADT.119 In addition, recent studies have confirmed the benefits of exercise on muscle and bone health for men on ADT. A 2019 study compared BMD in ADT patients who were randomized into immediate exercise and delayed exercise (6 months of usual activity followed by a 6-month exercise program). There was significant preservation of lumbar spine BMD in the immediate exercise group when compared to the delayed exercise group. There were no significant differences in whole body, spine, or hip BMD. Lean mass, appendicular skeletal muscle, and muscle density were preserved in the immediate exercise group after 6 months, while the delayed exercise group recovered after 12 months.120 A 2018 randomized and controlled trial evaluated the effect of home-based exercise intervention on bone-health outcomes. Although there was no difference in bone health, this study showed significantly improved muscle strength in the home-based exercise group when compared to the placebo intervention of stretching exercise.121 Improved muscle strength not only improves vitality in patients on ADT, but may also improve some of the metabolic side effects of ADT. There is some evidence of reduced risks of accidental falls and fractures in patients on ADT when participating in exercising programs, however there is a lack of robust prospective and randomized clinical trials to support this hypothesis.

The National Osteoporosis Foundation recommends a daily calcium intake of 1200 mg and vitamin D supplement of 8001000 IU/d for all men over the age of 50.122 A 2015 study analyzed whether the recommended vitamin D supplementation of 800IU/d increased blood levels of 25-OH vitamin D in patients receiving ADT. Regression analysis showed vitamin D supplementation was associated with increased 25-OH vitamin D serum levels supporting the current recommendation of 800 IU/d for men receiving ADT.123

Two controlled studies have analyzed the effect of zoledronic acid on BMD in patients undergoing ADT. In one study with 32 ADT patients diagnosed with nonmetastatic prostate cancer and osteopenia or osteoporosis received zoledronic acid for 12 months or no treatment. The patients on zoledronic acid treatment were significantly older than the control group and had lower BMD at baseline. BMD of the lumbar spine and hip were significantly increased in the patients on zoledronic acid following 12 months of treatment.124 Similar results were found in a 2-year trial of 76 men showing increased BMD in the lumbar spine and hip when on zoledronic acid versus the control. However, there was no difference in bone microarchitecture measured by high-resolution peripheral quantitative computed tomography indicating that zoledronic acid may slow but does not prevent unbalanced bone modeling.125 These studies have small sample size and inconsistencies in dosing of zoledronic acid, which limit the scientific value, and therefore, larger prospective and randomized clinical trials are needed.

Denosumab, a RANKL inhibitor, has been shown to have similar clinical efficacy when compared to alendronate (Fosamax). One study divided patients into 4 groups: 1) treated with denosumab, 2) treated with alendronate, 3) no treatment, 4) previously treated with alendronate and switched to denosumab. After 1 year, the patients who were treated with denosumab or alendronate had increased bone mass in the lumbar spine and femoral neck when compared to the control. Men treated with denosumab had significantly higher bone mass in the total hip while there was no significant change in men treated with alendronate.126 A subsequent 2017 study on denosumab showed significantly increased bone turnover markers and BMD when compared to alendronate; furthermore, a decreased rate of vertebral fractures were observed.127

Osteonecrosis of the jaw is the most common significant adverse effect of zoledronic acid and denosumab. A retrospective study in 2021 analyzed the incidence of agent-related jaw osteonecrosis in prostate cancer patients: 27.5% developed this feared osteonecrosis of the jaw within 5 years of treatment with a bone-modifying agent.128

Maintaining bone health in prostate cancer patients on ADT is an important clinical aspect as musculoskeletal side effects are common with ADT. The use of vitamin D, calcium, and bone modifying drugs should be properly discussed with patients on ADT in order to protect bone health.

The authors report no conflicts of interest in this work.

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):1029.

2. Ito K. Prostate cancer in Asian men. Nat Rev Urol. 2014;11(4):197212.

3. Connolly RM, Carducci MA, Antonarakis ES. Use of androgen deprivation therapy in prostate cancer: indications and prevalence. Asian J Androl. 2012;14(2):177186.

4. Debruyne F. Hormonal therapy of prostate cancer. Semin Urol Oncol. 2002;20(3 Suppl 1):49.

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Evolution of Androgen Deprivation Therapy | RRU - Dove Medical Press

Assessing readiness and appropriateness

While historically a "referral letter" from a mental health professional was required prior to initiation of hormone therapy, many large volume and experienced providers of transgender care have for years used an "informed consent" pathway to hormone initiation. WPATH Standards of Care, Seventh Version recognizes both of these pathways to the initiation of gender affirming hormone therapy as valid. Medical providers who feel comfortable making an assessment and diagnosis of gender dysphoria, as well as assessing for capacity to provide informed consent (able to understand risks, benefits, alternatives, unknowns, limitations, risks of no treatment) are able to initiate gender affirming hormones without a prior assessment or referral from a mental health provider.[1] A study of the practices of 12 such clinics in a diversity of settings found minimal risk of regret and no known cases of malpractice suits.[2] More detail on assessing readiness and appropriateness for various gender affirming treatments can be found in the topic on mental health.

Prescribing gender affirming hormones is well within the scope of a range of medical providers, including primary care physicians, obstetricians-gynecologists, and endocrinologists, advanced practice nurses, and physician assistants.[1] Depending on the practice setting and juris diction, other providers with prescriptive rights (naturopathic providers, nurse midwives) may also be appropriate to prescribe and manage this care. Most medications used in gender affirming hormone therapy are commonly used substances with which most prescribers are already familiar due to their use in the management of menopause, contraception, hirsutism, male pattern baldness, prostatism, or abnormal uterine bleeding.

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Initiating hormone therapy | Gender Affirming Health Program

Diet culture is the water we're all swimming in. Its a system that upholds thinness and says the smaller your body, the greater your moral superiority. But theres no body shape thats intrinsically good or bad.

Host Anita Rao unpacks the science that props up diet culture with anti-diet registered dietician Christy Harrison and certified internal medicine physician Dr. Louise Metz. She also hears from Mirna Valerio, ultrarunner and author of A Beautiful Work in Progress, about how shes pushing back against the ways diet culture manifests in the doctor's office and on the trails.

Also joining the conversation are Ilya Parker, owner of Decolonizing Fitness, and Natalia Petrzela, associate professor of history at The New School, to talk about the history of fitness culture and its intersections with diet culture.

10 important lessons to take away about diet culture

1. Diet culture is rooted in racism and misogyny.

Early evolutionary biologists who were working around [the 1800s] started to point to fatness as a mark of evolutionary inferiority, says Christy Harrison, registered dietician and author of "Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating."

This thinking has been used to justify the oppression of people considered to have excess body fat, including women and people of color.

2. Body Mass Index (BMI) wasnt meant to be used as an indicator of health.

In fact, this method of determining ones body mass wasnt even invented by a medical professional.

It was actually originally created by a Belgian astronomer in the 1830s, says Dr. Louise Metz, an internal medicine physician based in Chapel Hill, North Carolina. It was designed for populations not for individuals and was not designed to define health in any way.

3. Its impossible to determine someones health or fitness based on the way they look.

Just ask Mirna Valerio, creator of the blog Fat Girl Running, who frequently fields concerns about her larger size despite the fact that she trains for marathons on a near-daily basis.

The questions are always there on people's faces, Valerio says of the weight stigma she encounters on the trail. The questions about whether I really do the things that I say that I do because I'm still fat, despite the fact that I've done 14 ultramarathons and 10 marathons.

4. Medical fatphobia prevents people of all sizes from receiving adequate healthcare.

For those in larger bodies, the prevalence of medical fatphobia means doctors can be quick to attribute their symptoms to their weight a phenomenon that causes them to rule out other and often more insidious explanations.

The same goes for someone in a smaller body, says Metz. If we assume they are healthy based on their body, we will misdiagnose a high number of people who have metabolic conditions.

5. Medical fatphobia means you can also be denied treatment based on your size.

Ilya Parker, physical therapist assistant and founder of Decolonizing Fitness, describes the experience of being denied gender-affirming treatment as a result of weight stigma: I experienced a lot of medical gatekeeping from my primary care physicians, who were literally refusing to initiate gender-affirming care or refer me to an endocrinologist, which is who I needed to see to receive hormone replacement therapy.

6. Diet culture has always been about money, not health.

At the turn of the century, many doctors took their cues from the burgeoning life insurance industry when deciding which bodies posed the highest financial risk. According to Harrison, doctors at the time began encouraging patients to lose weight as a way of supposedly reducing health risks, but really, it was about reducing monetary risks from the insurance industry.

7. Intentional weight loss is rarely permanent

We see in the research that up to 98% of the time when people embark on weight loss efforts, they end up regaining all the weight they lost within five years, says Harrison. In fact, up to two-thirds of people who embark on weight loss efforts may regain more weight than they lost.

8. Language used in fitness spaces perpetuates transphobia.

Based on his own experiences of being a transmasculine participant in group exercise classes, Parker urges fellow fitness instructors and trainers to reconsider their gendered language.

It's countless group classes that I've been in where language was so important, especially when you're like: Hey, guys can only do this exercise, ladies can only do this exercise. And then also making the assumption that you know who's in the room.

9. Diet culture claims that fatness is un-American.

Historian Natalia Petrzela traces this connection back to the 1950s, when physical fitness began to be touted as a key component of American citizenship. [Politicians] spoke of this in unapologetically fat-shaming ways, Petrzela says. I mean, JFK gives this big talk about the soft American and how an American who is physically soft is a national liability.

10. You can decline to be weighed at the doctors office.

Let your provider know that you would like medical care from a Health at Every Size perspective, says Metz. And if you do not want to discuss weight or weight management at your visit, then you have the right to ask for that.

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Deconstructing diet culture: Lessons unlearned from a thin-obsessed society - WUNC

In recent years, intermittent fasting has gained popularity as a way to lose weight, improve health, and enhance performance.

Some studies suggest that this dietary approach may even extend healthy lifespan without the need for the severe caloric restriction that classic anti-aging diets entail.

People who practice intermittent fasting eat few or no calories for anything from 12 hours a day to 1 or more days every week. The former technique is known as time-restricted feeding, whereas the latter is known as periodic fasting.

A recent review of the evidence suggests that this type of diet may help people with type 2 diabetes safely reduce or even remove their need for medication.

However, people should seek the advice of a diabetes professional before embarking on such a diet.

The review, by Dr. Michael Albosta and Jesse Bakke, Ph.D., of Central Michigan University College of Medicine in Mount Pleasant, appears in Clinical Diabetes and Endocrinology.

According to the Centers for Disease Control and Prevention (CDC), diabetes affects 34.2 million people in the United States, which equates to about 1 in every 10 people. In 2017, it was the seventh leading cause of death in the country.

People with type 2 diabetes have abnormally high concentrations of glucose in their blood, known as hyperglycemia.

Several factors may contribute to hyperglycemia in type 2 diabetes. These include reduced secretion of the hormone insulin, which regulates blood sugar levels, and reduced sensitivity of the bodys tissues to the hormone. Doctors refer to this reduced sensitivity as insulin resistance.

The condition can cause a range of severe complications, including kidney failure and blindness.

The goal of treatment for type 2 diabetes is to prevent or delay these complications and maintain the persons quality of life.

Healthcare professionals encourage people with type 2 diabetes to exercise regularly, reach a moderate weight, and eat a well-balanced diet. However, most individuals also need to take drugs to lower their blood glucose levels.

Most of these drugs raise insulin levels, which the authors of the review say can have an unintended negative consequence.

While this works to reduce hyperglycemia in these patients, the idea of treating a disease of insulin resistance by increasing insulin may be counterproductive, leading to the requirement of increasing amounts of medication over a long period of time, they write.

People who take the drugs can gain weight and develop increased insulin resistance.

In addition, they can have raised levels of a hormone called leptin, which normally reduces appetite. This may suggest that they become increasingly resistant to this hormone, too.

They also have lower levels of a third hormone, called adiponectin, which usually counters diabetes and inflammation.

Some people with diabetes could minimize their need for diabetes medication by continually restricting their calorie intake, which scientists know reduces body weight and improves metabolic health.

However, the authors of the review note that people can struggle to sustain daily calorie restriction for extended periods.

Some people may find it easier to practice intermittent fasting, which shows promise as a way to improve metabolic risk factors, reduce body fat, and promote weight loss in obesity.

To assess the evidence, the authors searched databases for review articles, clinical trials, and case series related to type 2 diabetes and intermittent fasting published between 1990 and 2020.

They concluded that this type of diet may improve several key features of the disease. The improvements include:

Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician, they write.

For example, a case study followed three people with type 2 diabetes for several months after they started an intermittent fasting diet, which involved three 24-hour fasts per week.

Over the course of the study, all participants had significantly reduced levels of HbA1c, which is a measure of the average amount of glucose in the blood.

All three individuals lost weight and were able to stop their insulin therapy within 1 month of the start of the diet.

Crucially, they reported that they found the diet easy to tolerate, and none of them chose to stop the diet at any point.

Within less than a month, they had significantly reversed their type 2 diabetes, says one of the authors of the case series, Dr. Jason Fung, a kidney specialist who is an advocate for intermittent fasting.

Even a year later, I think two of them are off all meds [], so doing ridiculously well for an intervention that is actually free, available to anybody, and has been used for thousands of years, Dr. Fung tells the Weight Loss Motivation podcast.

The review authors also cited a clinical trial that randomly assigned 137 people with type 2 diabetes to either a continuous calorie-restricted diet or an intermittent fasting diet.

After 12 months, the two groups had similar reductions in their HbA1c levels. However, those in the intermittent fasting group lost more weight on average.

The review authors conclude that intermittent fasting may reduce body fat and insulin resistance not only by limiting overall calorie intake but also through metabolic reprogramming.

This reprogramming involves a switch from using glucose as fuel to burning fatty acids and ketones from the breakdown of fat stores.

By reducing body fat, they write, intermittent fasting may also improve sensitivity to leptin and adiponectin, which in turn improves appetite control and reduces chronic inflammation.

However, they conclude that this kind of diet may not be for everyone, writing:

While alternate day fasting and periodic fasting have demonstrated efficacy in improving metabolic risk factors, it may be difficult to convince patients to give up or severely restrict calories for an entire 24-[hour] period. In America, we often eat three meals per day in addition to frequent snacking.

They also caution that there may be safety issues with intermittent dieting.

For example, they say that healthcare professionals should closely monitor individuals who take medications that increase insulin levels. This is to prevent episodes of hypoglycemia, or dangerously low blood sugar levels, during fasting.

[People with diabetes] should consult their physician prior to beginning an intermittent fasting regimen in order to allow for appropriate oversight and titration of the patients medication regimen during periods of fasting, they write.

The authors note some limitations of the available evidence.

For example, many randomized controlled trials of intermittent fasting have not included people with diabetes. They call for more trials in people with this condition.

They also emphasize that most of the evidence for improvements in body composition and metabolic health with intermittent fasting comes from research in animals.

More here:
Intermittent fasting: Can it treat or reverse diabetes? - Medical News Today

The literature mentioned that another hormone abnormality can cause C.V.G.: acromegaly. This disorder is caused by an abnormal growth on the pituitary gland of the brain, a tumor that makes excess growth hormone. As a medical student, Mathis had been taught to recognize the disorder by looking for features of the most famous patient in his lifetime with acromegaly, Andr Ren Roussimoff, best known by the name he adopted first in his wrestling career and later as an actor: Andr the Giant. And he was a giant: 7-foot-4 and weighing over 500 pounds. His face, well known to so many of us thanks to his role as Fezzik, the kind giant in Rob Reiners classic movie The Princess Bride, serves as a template for the effects of acromegaly. The excess growth hormone causes enlargement of the soft tissues of the face, including the ears, the nose and the tongue, as well as the soft tissues of the hands and feet. Untreated, this kind of tumor causes premature death.

Mathis looked at the patient not just his skin but the whole person. He was a big man, over six feet tall and weighing more than 250 pounds. He had prominent ears and a large nose. Even his tongue was large. Acromegaly was certainly possible. He asked the patient if he had noticed any changes in the size of his feet or hands over the past few years. He certainly had, the man answered promptly. A few years ago, he and his wife replaced the wedding rings they bought each other when they married and didnt have much money, and he needed a bigger ring. And his feet were growing, too. He used to wear a size 12 but now needed size 14. He figured it was because he was getting fatter. He had put on 75 pounds since their wedding day.

The dermatologist explained his thinking. He had never made a diagnosis of acromegaly and quickly looked up how to do it. The first step was to check the level of one of the growth factors usually stimulated by this kind of brain tumor. If that was high, the patient would need imaging of his brain to look for a tiny tumor on the pituitary gland. The blood test took days to come back. It was abnormal. And the CT scan revealed a growth about the size of a lima bean on his pituitary. Mathis referred the patient to a neurosurgeon, who removed the tumor. He didnt see the patient again until the following year. By then, the patient reported, his fingers and nose had gotten smaller, and his gratitude to the young doctor had grown. Mathis was thrilled with his diagnosis. Im curious, he told me recently, and that has been one of his most reliable and valuable tools as a doctor. And hes not ashamed to have to look things up.

Two years have passed since the patient had his operation, and he and his wife have watched with interest as the mans former face emerged. The lumpy scalp is unchanged, but his wife was particularly happy to welcome her husbands old nose back. He is starting to lose his hair maybe it needed the excess growth hormone to stay but, his wife told me, she considers that a small price to pay.

Lisa Sanders, M.D., is a contributing writer for the magazine. Her latest book is Diagnosis: Solving the Most Baffling Medical Mysteries. If you have a solved case to share, write her at Lisa.Sandersmd@gmail.com.

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What Was Causing the Strange Grooves in the Mans Scalp? - The New York Times

Shoveling snow can cause heart attacks or sudden cardiac arrest in folks with heart conditions and even in those who are unaware that they have heart disease, theAmerican Heart Association (AHA)warns.

Shoveling snow is a very strenuous activity, made even more so by the impact that cold temperatures have on your body, increasing the blood pressure while simultaneously constricting the coronary arteries. It really is a perfect storm for acute cardiac events, Barry Franklin said in an AHA news release. He is the lead author of an AHA scientific statement on exercise-related heart risks.

Men with lower concentrations of total testosterone do not have an increased risk for cardiovascular events, while lower concentration of sex hormone-binding globulin (SHBG) is associated with a higher incidence of myocardial infarction (MI), according to a study published online Dec. 28 in theAnnals of Internal Medicine.

Bu B. Yeap, Ph.D., from the University of Western Australia in Perth, and colleagues examined the associations of serum total testosterone and SHBG with incident cardiovascular events among community-dwelling men ages 40 to 69 years from the U.K. Biobank prospective cohort.

A machine learning (ML) score based on clinical data and stress cardiovascular magnetic resonance (CMR) measurements can predict 10-year all-cause mortality in patients with known or suspected coronary artery disease (CAD), according to a study presented at EuroEcho 2021, a scientific congress of the European Society of Cardiology, held from Dec. 9 to 11 in Berlin.

Researchers, led by Timothy Williams, MD, from the Sussex Cardiac Centre at the Brighton and Sussex University Hospitals, examined the impact of the coronary revascularization strategy during admission on outcomes in patients with multivessel coronary artery disease (MVD) undergoing percutaneous coronary intervention (PCI). Their report, published in Catherization and Cardiovascular Interventions, found that a physician-directed CR strategy including sirolimus-eluting thing-strut stents appeared to result in more optimal clinical outcomes and less angina.

According to Dr. Williams, Our findings suggest that a CR should be aimed for. The researchers investigated 15,441 patients with MVD, defined as two or more major epicardial vessels with 50% stenosis, from the observational all-comer e-Ultimaster registry. The degree of revascularization achieved was assessed by a physician at the index procedure or a later procedure during hospitalization. The primary outcomes were complete revascularizations (CR), incomplete revascularizations (IR), target lesion failure (TLF), and patient-oriented composite outcome (POCE).

Four weeks of anticoagulation therapy after an electrical cardioversion procedure (ECV) in patients with atrial fibrillation (AF) is suggested by current guidelines to reduce the risk of stroke. However, according to a study published in the International Journal of Cardiology, there is a lack of recent data on acute ischemic stroke (AIS) risk and timing after ECV for AF.

The team reviewed data of patients from the National Health Insurance Research Database (NHIRD) in Taiwan. Their final cohort included 5,723 patients with AF who received an ECV procedure and 5,723 propensity score-matched controls. The primary outcome assessed was the cumulative incidence of AIS during the two follow-up periods listed above.

Compared to the controls, patients with AF who received an ECV procedure demonstrated a significantly increased incidence of seven-day AIS development (adjusted hazard ratio [HR] = 1.524; p = 0.003). However, the increase was not significant at day 30 (HR = 1.301; p = 0.426).

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Cardio Round-Up: Beware of Heart Hazards Amid Winter Season; and More - DocWire News

Beginning Jan. 1, 2022, a new law will take effect that ends surprise medical bills for insured people receiving emergency medical care and other health services in the United States.

Congress passed the No Surprises Act last December with bipartisan support, establishing new federal protections against surprise medical bills.

But what types of medical bills are covered under the law, how does it protect consumers, and will it affect overall healthcare costs and premiums?

Healthline spoke with two healthcare policy experts to shed some light on these questions.

The No Surprises Act defines surprise medical in a specific context.

This is important because there are numerous situations that can be surprising but dont fall into this official bucket of surprise medical bills, said Jack Hoadley, PhD, research professor emeritus in the Health Policy Institute of Georgetown Universitys McCourt School of Public Policy.

These situations may include not being aware that your health insurance plan has a high deductible or that a certain procedure costs so much.

While such bills can certainly be surprising, they are not covered under the No Surprises Act.

When we talk about surprise medical bills for the purposes of the No Surprises Act, it means situations where you end up using an out-of-network healthcare facility or healthcare provider, generally, through no fault of your own, Hoadley explained.

This most commonly occurs in emergency situations.

If an ambulance brings you to a hospital that is out of network, for example, you may receive a costly surprise medical bill for the services performed.

Thats not something you chose, Hoadley said. You got to whatever hospital you were taken to.

Even in hospitals that are in your insurance plans network, there are situations in which a doctor who sees you is out of network. This can happen during an urgent or elective procedure.

So even if youve done your due diligence and pick an in-network facility and picked an in-network surgeon to do your procedure or an in-network obstetrician to deliver your baby, while youre there, you can also be treated by an out-of-network anesthesiologist, or radiologist, or a cardiologist, Hoadley said. And again, its not something you were told about or could control.

The result of these scenarios is often a surprise bill asking people to pay the balance bill, or the difference between what the insurance company paid and the total charged.

Research has found 1 in 5 inpatient emergency department cases may lead to surprise medical bills.

Studies show surprise medical bills average more than $1,200 for anesthesia, $2,600 for surgical assistants, and $750 for childbirth.

The No Surprises Act ensures privately insured patients will pay no more than the in-network rate when treated at out-of-network facilities or by out-of-network healthcare professionals without their consent.

On January 1, patients will be protected from surprise medical bills in emergency cases, nonelective emergency cases, and air ambulances, said Christopher Garmon, PhD, assistant professor of health administration at the Henry W. Bloch School of Management at the University of MissouriKansas City.

Currently, the law does not cover ground ambulances, but it has created an advisory committee to develop recommendations related to disclosure of charges, surprise-billing protections, and enforcement mechanisms.

People can still opt to be treated by out-of-network healthcare professionals and facilities for elective procedures, but the new law stipulates that they must be told ahead of time and consent.

The No Surprises Act also establishes a procedure for how balance bills will be handled between providers and insurers.

The two will negotiate pricing, and if a solution cant be reached, an independent arbiter will be brought in to determine a fair reimbursement.

Importantly, the patient is completely taken out of the middle, Garmon said.

In September, a new rule from the Biden administration providing more details on how out-of-network balance bills are to be settled under the No Surprises Act has garnered much criticism, particularly among physician and hospital groups.

According to the rule, when a dispute goes to arbitration, the arbiter must begin with the presumption that the qualifying payment amount (defined as the median in-network rate for similar services provided in an area) is whats appropriate to pay for out-of-network care.

Other factors may be considered as well, such as healthcare professional experience, the type of hospital, and complexity of care, but are not given equal weight.

Several healthcare professional organizations, including the American Hospital Association and the American Medical Association, have filed lawsuits, stating this rule gives insurers an unfair advantage.

Some have also raised concerns that the No Surprises Act will lead to an increase in healthcare premiums.

Garmon said he doesnt think this is likely. In fact, the Congressional Budget Office estimates that the No Surprises Act is set up to reduce premium growth by 0.5 to 1 percent in most years.

I think that thats a good, reasonable estimate, Garmon said.

Hoadley said it might swing either way, depending on how in-network negotiations go in the future.

When an insurance company negotiates with a group of anesthesiologists, for example, over what their fees should be in the insurance plan for the in-network doctors, this new set of rules will cast some shadow on that negotiation, he said. It could lead to lower rates, which would actually help on premiums, or they could lead to higher rates, which could raise premiums.

However, he doesnt anticipate the impact to be that great either way.

Were probably talking about a 1 percentage point swing one direction or the other, he said.

While the No Surprises Act is meant to stop the issuance of surprise medical bills to patients, if you do receive one after Jan. 1, there are some steps you can take to rectify it.

We do expect there will be some of those situations, Hoadley said. It may take some time for insurers, providers, and facilities to understand the new rules and get it right.

The first step, Hoadley recommends, is to contact your health insurance company.

When you receive your explanation of benefits, it will tell you how much youre liable to pay and how much the policy is paying, and then you can compare that with the bill you got from the medical facility, and see whether youre getting billed for more than you should be, he said.

Finally, under the new law, a complaint line and website operated by the Department of Health and Human Services will be set up for people who believe they have been wrongly issued a surprise medical bill.

The toll-free number for the No Surprises Help Desk will be 800-985-3059. The line goes live Jan. 1.

Read more here:
Surprise Medical Bill Ban Now in Effect: What to Do If You Get One - Healthline

Regular eye checkup can help detect potential health problems early and get treated before they worsen. Read on to find out what your eyes are trying to tell you about your health.

Written by Longjam Dineshwori | Updated : December 29, 2021 11:09 AM IST

Doctors usually check our eyes during a medical checkup. Have you ever thought why they do so? This is because our eyes can tell a lot about our overall health. Not just vision problems, but doctors can spot early sign of many diseases and medical conditions just by observing the changes in the eyes. Here are a few health complications that your eyes can indicate:

An eye twitch can be a sign that you're too stressed and that you need some rest. Eye twitching or myokymia occurs when the muscles and nerves around the eye are stimulated. Having too much caffeine, being tired, or stress can cause this condition. Rarely, eye twitching may indicate Parkinson disease, multiple sclerosis, bell palsy, brain damage from inflammation or a stroke, or Meige syndrome, a nervous system movement disorder.

Itchy eyes, also known as ocular pruritis, are often caused by allergies that can be triggered by pollen, pet dander, irritants like dust and smoke, or products such as lotions, makeup or contact lens solutions. Itchy eyes can be caused by infection, strain or a condition called dry eye syndrome.

Blood-red eyes or bloodshot eyes may result from of sun exposure, dust, allergies or a hangover. But fatigue, stress or insomnia can also cause swelling of the blood vessels present in the surface of the sclera (white portion of the eye) and appear as bloodshot eyes. In addition, a subconjunctival haemorrhage can also cause build-up of blood on conjunctiva due to bursting of blood vessel. However, such cases are rare.

Ageing causes droopy eyes (ptosis), but in rare cases, drooping of eyelids could be a sign of more severe conditions like strokes, brain tumours or myasthenia gravis (an autoimmune disorder that causes weakness in the skeletal muscles).

Cataracts, which is characterized by clouding of the eye lens, are among the earliest complications of diabetes mellitus and one of the major causes of visual impairment in diabetic patients. High blood sugar makes cataracts more likely to form in people with diabetes. However, age is the greatest risk factor for cataracts and occur frequently in older people.

Early-onset cataracts are also associated with increased risk of cancer. Clouding of the lens of the eye is also a possible side effect of cancer treatments, including radiation, chemotherapy, and hormone therapy.

Yellow eyes could be a sign of liver diseases such as hepatitis, cirrhosis or jaundice. An increase in the levels of bilirubin, a bile salt produced in the liver, in the body can cause your eyes to turn yellow in colour. If you have yellow eyes along with other symptoms like fever, loss of appetite, darker urine, itching, abdominal pain, see a General Physician right away.

Do you have swollen or puffy eyes? Our eyes get puffy after crying, excessive alcohol consumption and due to viral conjunctivitis, but styes, allergies, eye injury or hormonal problems can also cause swollen eyelids.

Over time, untreated high blood pressure can cause damage to the retina and cause vision problems. Reduced vision, eye swelling, bursting of a blood vessel, double vision accompanied by headaches are possible signs and symptoms of hypertensive retinopathy.

Gray rings around the cornea, medically termed are arcus senilis, may indicate high blood cholesterol and triglycerides in the body. High cholesterol is a major risk factor for heart disease and stroke. Eating fatty food, lack of exercise, being overweight, smoking and drinking alcohol can lead to high cholesterol.

Eye movement abnormalities are common in people with multiple sclerosis (MS). Optic neuritis, inflammation of the optic nerve which connects the eye to the brain, is often the first sign that someone has the disease. About half of people with MS will experience optic neuritis at least once, and when it happens, they may develop symptoms like blurred vision, graying of vision, blindness in one eye for a short time, and pain with eye movement.

Believe it or not, your eyes can also tell if you had faced any traumatic experiences in the past. According to a UK-based pupillometry study published in the journal Biological Psychology in 2020, the pupils of people with post-traumatic stress disorder (PTSD) did not constrict quickly in response to changes in light level. Based on their findings, the researchers suggested that PTSD may affect both branches of the autonomic nervous system.

Bug eyes, clinically known as exophthalmos, are one of the common symptoms observed in Graves' disease, an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). Too much thyroid hormones in the body cause the eye tissues to swell leading to bulging eyes.

If you notice a yellowish patch on the white parts of your eyes, it may be because you're spending a lot of time in the sun. Called a pinguecula, these patches are usually harmless, but a small percentage are pre-cancerous, say experts. So, it is advisable to see an ophthalmologist if you start seeing yellow patches on your eyes.

There is a long list of eye problems and health issues that could cause teary eyes. Too much screen time, pinkeye (conjunctivitis), allergies, blepharitis (infection of the eyelid margins) could cause your eyes to tear up more often. But watery eyes also be a symptom of other medical conditions like Bell's palsy, Sjogren's syndrome, chronic sinus infections, thyroid problems, and rheumatoid arthritis. See a doctor if your eyes tear up often for unknown reasons.

Sickle cell disease is a group of inherited red blood cell disorders. Red blood cells move through small blood vessels to carry oxygen to all parts of the body. Normal red blood cells are round, but in people with sickle cell disease they form a distorted shape (sickle-shape). This interferes with oxygen delivery to the tissues, as well as causes blocked vessels in the eyes, which further leads to eye pain, redness, loss of peripheral vision, blurry vision, floaters, jaundice, etc.

It is an inflammatory form of arthritis, and people suffering from this condition have a higher risk of developing iritis, inflammation of the iris (the coloured ring around your eye's pupil). Iritis, also called anterior uveitis, can cause eye pain, redness, and sensitivity to light.

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As it comes from cows, milk has many nutrients. After all, its natural purpose is for the development of calves, just as breast milk is intended for the development of human babies. And in todays society, dairy milk is often used as a nutritional shortcut for kids and adults. Some people actually have diets so reliant on dairy, that simply removing it can cause deficiencies. So how do you get proper nutrients without dairy? Fortunately, a little planning and dietary shuffling can help fill in the nutritional gaps without too much fuss.

Many people report feeling detox symptoms when they cut out dairy, or say they feel worse on a dairy-free diet. But in cases where people merely cut out dairy foods, and dont replace them with foods that fulfill essential nutrients, these might actually be low nutrient or deficiency symptoms.

Deficiencies can lead to all types of symptoms, ranging from skin issues to digestive complaints to fatigue, and can become serious. So its important to address them early with your doctor. Below, I have a basic guide to the macronutrients, vitamins, and minerals in milk, and tips to help ensure you still get all the nutrients you need on a dairy-free diet.

This post is for informational purposes only and should not be construed as medical or dietary advice. Always consult a physician before undergoing any change in diet.

Milk isnt considered a good carbohydrate source. The only carbohydrate in cows milk is milk sugar, otherwise known as lactose. But it does contain notable amounts of water, protein, and in some cases, fat, as outlined below.

Cows milk is approximately 88% water. This might sound obvious, but if you are a milk drinker, and cut it out, be sure to add another hydration source into your diet. A couple more glasses of water each day might cover it. See the 10 Warning Signs of Dehydration.

A glass of cows milk contains about 8 grams of protein, and more concentrated forms of dairy can contain more. If you are only cutting out dairy, and still eat meat, fish, and perhaps eggs, your diet is likely rich in enough protein. But if you are vegan, or following a high protein diet, you can look to sources like beans, lentils, nuts, seeds, and whole grains. Dairy-free protein powders are another way to augment your protein intake, if needed. See the Signs and Symptoms of Protein Deficiency.

Tips: For most people, getting enough protein at lunch or dinner is easy, but breakfast ends up becoming too carb heavy. If you arent a fan of eggs or breakfast meats, try enjoying nut butter on whole grain bread, or spiking your morning oatmeal with nuts and seeds. Dairy-free protein shakes are another favorite way to start the day.

A glass of milk has 0 to 8 grams of fat depending on the type (nonfat to whole). But other types of dairy can provide much more fat, like cream, butter, and cheese. On a dairy-free diet, fat sources shift to meat, fish, eggs, nuts, seeds, and oils. Certain fruits, like coconut and avocado, are also popular dairy-free sources of fats. Fats like these help to nourish our skin, joints, brain, and more. See the 5 Signs Youre Not Getting Enough Fat.

Tips: Avocado is a great stand-in for sour cream, atop chili, tacos, and other Mexican-inspired foods. You can also add avocado or guacamole to sandwiches and wraps. Full fat coconut milk can be used as a substitute for cream, and is also a delicious addition to smoothies and smoothie bowls. Mayonnaise is a naturally dairy-free staple, and many vegan mayos are available if you need egg-free, too.

The following micronutrients are listed in order of RDA percentages, starting with the heftiest first. A glass of milk isnt a great source of the vitamins following vitamin B12. But if you consume quite a bit of dairy, you might be at least somewhat nutritionally reliant on dairy for all of these vitamins. For example, if you consume three glasses of milk per day, you are getting roughly 27% of the RDA for pantothenic acid from milk.

Natural milk contains a fair amount of B vitamins, but about 38% of them are weakened or destroyed during pasteurization. Even so, cows milk can be a relatively good source of some B vitamins, like riboflavin. Riboflavin plays a vital role in energy production and in helping to maintain healthy organs. If you arent vegan, eggs, lean meats, and fish are good sources of riboflavin. For vegans, mushrooms, almonds, spinach and other greens offer a dose of riboflavin. See the NIHs Information on Riboflavin Deficiency.

Tips: Before you consider supplementation, check your everyday foods for fortification. Tofu, nutritional yeast, breakfast cereals, and dairy alternatives are sometimes fortified with riboflavin. If a supplement is needed, speak to your doctor about individual vitamins versus a B-complex vitamin.

Contrary to popular belief, milk isnt a great source of vitamin D. Milk naturally contains a small amount of this fat soluble hormone (yes, its a hormone!), but its removed with the fat in the production of reduced fat, low fat, and non-fat milks. Some dairy farmers choose to fortify with vitamin D, but it isnt required. However, if they do choose to fortify, it must be at least 400 I.U. per quart.

Fortunately, vitamin D fortification has become common in dairy-free products, too, and vitamin D supplements are inexpensive options that many doctors recommend. Vitamin D is essential for bone health, immunity, heart health, and more. See the Symptoms of Vitamin D Deficiency.

Tips: The top source of vitamin D is the sun! See our post on Vitamin D for Dairy-Free Living for tips, information on vitamin D fortification, supplements, and more.

This vitamin is a little trickier, particularly for vegetarians. Vitamin B12 naturally occurs in animals, not plants. Just dairy-free consumers can get plenty of vitamin B12 via meat, fish, and eggs, but vegans do need to find fortified sources and/or take supplements. Low vitamin B12 can lead to a condition called pernicious anemia. See the Signs and Symptoms of Vitamin B12 deficiency.

Tips: Nutritional yeast is a fortified source of vitamin B12, not a natural source. Consequently, not all brands of nutritional yeast contain cobalamin. If you are counting on nutritional yeast as a supplement, be sure to purchase a brand that is fortified with vitamin B12. Anthonys, Bragg, Bobs Red Mill, NOW, and Terrasoul are all good quality, amply fortified brands that tend to be sold for a fair price.

This is another fat soluble vitamin that is removed with the fat in the production of milk. But unlike vitamin D, dairy processors are required to fortify milk with a minimum of 300 I.U. per cup (10-12% of the RDA). Some processors opt to add as much as 500 I.U. per cup (16-22% of the RDA). Vitamin A supports our vision, healthy skin, reproduction, immunity, and more. See the Signs and Symptoms of Vitamin A Deficiency.

Tips: Vitamin A in the form of retinol is found in meats, fish, and eggs. But our bodies also convert carotenoids into vitamin A. Orange, red, yellow, and green fruits and vegetables are typically rich in carotenoids.

This vitamin helps to break down fats and also aids in energy conversion. Fortunately, its found in most plants and animals, so its fairly easy to obtain via a natural diet. Milk is a good source of pantothenic acid, but so are lean meats, fish, eggs, sweet potatoes, avocados, mushrooms, legumes, nuts, and seeds. See the Signs of Deficiency.

Tips: As with all B vitamins, check packaged foods in your cupboard for fortification. B5 isnt supplemented as often as B2 or B12, but is still sometimes added in notable quantities to foods.

I have listed the following in order of the RDA percentages found in milk, starting with the heftiest first. A glass of milk isnt a great source of the minerals following phosphorous. But if you consume quite a bit of dairy, you might be at least somewhat nutritionally reliant on dairy for all of these minerals. For example, if you consume three glasses of milk per day, you are getting roughly 30% of the RDA for potassium from milk.

Ah, calcium milks claim to fame. Cows milk has roughly 300 milligrams of calcium per glass, which is a hefty amount. But its far from the only source of calcium. See our Calcium Chart for 150 different dairy-free foods, How to Choose Calcium Supplements, and How Much Calcium is in Your Plant Milk. Calcium is the foundation of our bones, and is also needed to keep our nerves and muscles (including heart muscles) functioning properly. See the Signs of Calcium Deficiency.

Tips: Dont become too calcium obsessed. It is an essential mineral, but supplements and fortification can make it easy to get too much calcium, which isnt a good thing. Toxicity symptoms can set in at amounts much lower than you might think. And building strong bones isnt purely about calcium. Many other vitamins and minerals, like magnesium and vitamin D, play equally important roles. See How Much Calcium Do I Need on a Dairy-Free Diet for more information.

Milk is a great source of phosphorous, which is an essential building block for bones and acts as a buffer to help maintain a healthy pH level in our bodies. Fortunately, phosphorous is abundant in protein-rich foods, including meat, fish, eggs, beans, nuts, lentils, and grains. Dark chocolate is also a great source! So a phosphorous deficiency is quite rare. But vegans should keep in mind that the phosphorous in plant foods has much lower absorption than the phosphorous from animal sources.

Tips: Its far more common to consume too much phosphorous than too little. Unlike many other vitamins and minerals, phosphorous isnt as abundant in fruits and vegetables. But it is used by manufacturers in many processed foods, like sodas, snack foods, and ready-to-eat meals.

This mineral plays important roles in our immune health, thyroid function, reproduction, DNA synthesis, and more. Consequently, selenium is particularly important for people with certain types of thyroid dysfunction, with impaired immune systems, or who are pregnant. Nuts, seeds, whole grains, lentils, meats, fish, and greens are all great sources of selenium. See this article on Selenium Deficiency to understand the risks.

Tips: The amount of selenium in foods depends heavily on the soil it is grown in. This isnt as much of a problem for North America, but can be an issue in less developed nations.

Potassium is an electrolyte that helps your nerves function and muscles contract, including the very important heart muscle. Produce is a key source of potassium, including bananas, leafy greens, potatoes, sweet potatoes, avocadoes, and tomatoes. Legumes and fish are also top potassium sources.

Although potassium deficiency is considered uncommon, its estimated that most Americans do not consume enough potassium. Dairy milk provides about 10% of the RDA per cup, so its important to add other good potassium sources on a dairy-free diet. Read about Low Potassium vs Potassium Deficiency.

Tips: Of course fresh fruits and vegetables are always good options, but dried apricots and prunes are also quite high in potassium. And coconut water is a quick, hydrating source of this key mineral.

Some of you might be wondering about these two important minerals, which many of us dont consume enough of. They are both found in milk, but not in particularly high amounts. If you are a truly high dairy consumer, make sure you consume other high protein foods (meat, shellfish, beans, etc.) to meet your zinc quota and more plants (greens, grains, etc.) for magnesium. See this information on Zinc Deficiency and Magnesium Deficiency for more helpful details.

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Moles and skin tags are common skin problems. They might be aggravating as well. They could turn out to be harmful at times. The etiology of all skin tags is unknown. Some people develop skin tags due to friction, such as when their jewelry or seat belt scrapes against a particular portion of their body.

The majority of skin tags are completely safe. Theyre just clumps of some free collagen fibrils that have grown on the covered or folded skin. The majority of moles are likewise noncancerous; however, certain moles should be examined by a specialist to ensure they arent cancerous. Skin tags and moles may be easily removed at home, fortunately. Skin tag and mole removal techniques and treatments are available today that can be used at home itself, which could safely, rapidly, and discreetly remove skin tags. Skin tags can also be removed using natural therapies.

Our skin changes dramatically as we get older. Caring for our skin may feel like a full-time job, from dry patches and fine wrinkles to dark spots and rosacea. One of the most problematic aspects of growing older is skin tags, which may be easily treated, fortunately. The most delicate skin tag removers are simple to apply, extremely powerful, quick to work, and dont require a dermatologists visit.

A skin tag is most commonly caused by friction and so appears where the skin scrapes against clothes or other skin. Skin tags typically occur in the armpits, beneath the breasts, necks, and eyelids. These fleshy lumps can appear at any age, but they are more frequent in older adults in their forties and fifties, especially those aged 60 and over. They can also be ugly, despite their benign nature.

Getting a skin tag removed at a dermatologists clinic might be costly. Furthermore, insurance may or may not cover it based on whether the excision is judged for cosmetic reasons. Fortunately, there is another option. Over-the-counter skin tag removers can be safe, effective, and far less expensive than a doctor visit.

Weve compiled a list of the best-rated skin tag removers so you can get rid of those pesky lumps without having to visit a specialist. These solutions, which range from topical lotions to high-tech gadgets, will clean things up in no time.

This article consists of the most popular items on the market today to answer that question. Here are the results of our poll.

Attempting to eradicate skin tags, moles, or warts is usually not worth it. Dermatologists have spent years developing the appropriate treatment for many skin diseases. Most of the time, they either fail to identify a cost-effective and straightforward solution or fail altogether.

Hence you can use Derma Correct, a well-known dropper-dispensing skin tag removal solution that is packed in a container made up of glass. You apply the solution to your skin tag with the dropper regularly. The company says it securely removes skin tags from any part of your body in just a few days.

Derma Correct promises to naturally eliminate skin tags and moles while making your skin seem younger and more vibrant. Derma Correct tags and mole removal serum has been thoroughly researched. Lets have a look at the findings of our investigation.

Bloodroot, Aloe vera, and other fruit extracts and essential oils are among the substances used by Derma Correct. Theyre high in antioxidants, nutrients, and minerals.

Derma Correct is a ground-breaking scientific solution that has been endorsed by international authorities in the United States and other countries as well. It cleanses the skins subcutaneous tissues by penetrating deep into them. It eliminates any toxic elements that might lead to skin growth or scarring. Remove any skin tags after that. It may also be able to remove stains, spots, and discoloration.

Derma Correct for skin tags is also an effective serum. It works well on moles, skin tags, and warts. Read Derma Correct skin reviews to get the truth. Derma Correct is a painless procedure that is used all over the world. The reason for this is due to the use of natural substances. This solvent skin tag remover claims to be a non-invasive and cost-effective way to deal with obstinate skin problems. It can also create a protective barrier that is both reasonable and active, shielding the skin from contaminants.

Derma Correct also contains turmeric, which is not seen in other skin tag removal products. Urethane, a natural anti-inflammatory found in turmeric, may help to sustain irritation. It can aid in the reduction of scarring following the removal of a skin tag.

This lotion was created to remove skin tags and moles from your skin safely. The composition, which contains natural substances such as camellia oil, sunflower seed oil, argan oil, and others, aids in developing newer healthy skin growth and preventing scarring. For optimal effects, clean the affected areas and use the lotion 2 or 3 times a day.

Unlike most other treatments, Extreme Skin Tag Remover Cream goes straight to the source of your skin tags or moles and eliminates them permanently. This low-cost solution yields rapid results. This item is more than sufficient! You just have to spread the ointment to your moles or skin tags.

Skin tags are unpleasant to look at, so get rid of them at home! Apply it just 3-4 times each day to the afflicted region. Theres no need to worry about freezing, bands, or pricey medical procedures! Extreme Skin Tag Removal Cream is an excellent choice rather than surgery, which may be costly and time-consuming. Skin tags or blemishes will usually come out on their own after three weeks.

This is an excellent skin tag remover for all skin types and delicate places! Your moles or skin tags will come out painlessly! This sophisticated skin tag remover is safe to use on both your body and face. Other products can cause burns by chemically dissolving or scorching skin tags, causing pain and scars. This solution does not use chemicals to remove skin tags or moles; instead, it dries them up, allowing them to shrink and fall off naturally when washing and in everyday life.

SkinCell Pro is a 100% organic, chemical-free serum filled with plant antioxidants and minerals. Skincell Pro is used as a skin tag removal solution that eliminates skin tags and moles from any part of your body using a novel, all-natural formula. It is designed to target tags, moles, dark spots, and dead tissue without causing discomfort. As per the company, Skincell Pro might eliminate blemishes in as little as 8 hours, which is faster than practically every other skin tag removal technique on our list.

The all-natural recipe also helps to fortify the skin by providing the right amount of natural precipitation and suppleness. If used properly, even the most unsightly skin warts and blemishes can be removed, and considerable skin improvement can be accomplished. Overall, Skin Cell provides reliable skin treatment for persons having various skin problems. Skincell Pros topical solution comprises sanguinaria Canadensis and zincum muriaticum to achieve these results. These substances act in four stages to eliminate the skin tag from your body while preventing scarring.

Most skincare solutions address the surface symptoms, leaving the core reason unaddressed. It is the primary cause of treatment failure since they are ineffective in addressing the core cause. Though some of them treat the problem, they arent manufactured so that you wont experience any adverse side effects.

You need to be careful about whether the remedy you select is safe, natural, and efficient. SkinCell Pro is built to meet these requirements and deliver the promised outcomes. To make the serum safe and dependable, the developer worked at an FDA-approved facility in the United States.

The moment you spread and apply this liquid solution to the damaged skin area, the Skin Cell with its active and Pro components penetrate the affected area and signal your blood and the immune system to release WBC and eradicate the mole or skin tag. Additionally, the serum-applied region becomes irritated, and a scab forms over it. You can stop using the serum at this point, which is precisely 8 hours after the initial application. The scab then develops over the lesion, allowing it to fall off naturally. After removing it from your skin, apply Skin Cell repair lotion or a Neosporin-type substance to prevent scarring and let the skin heal back.

CompoundW is the most renowned mole and skin tag removal method in the market today, both online and in shops. CompoundW is a safe and efficient approach to removing small tags at home, as recommended by specialists. CompoundWs technology, the first do-it-yourself topical skin tag removal, employs a pinpoint-precision applicator to quickly freeze skin tags with a specially designed solution of dimethyl ether and propane. This set includes TagTarget skin shields, which are essentially circle-shaped stickers that cover your surrounding skin while exposing only the skin tag to avoid discomfort.

CompoundW works in a two-step process: first, you have to clean the skin tag area with the little plastic gadget that comes with the package. The skin tag is then quickly frozen using the foam tip applicator. CompoundW is one of our favorites since it allows you to remove the skin tag without hurting the skins surrounding area. The TagTarget enables you to concentrate on the skin tag or mole. This drug is only to be used on the skin. Do not allow this drug to come in contact with your eyes, nose, mouth, groin, or any damaged skin to avoid irritation. If you receive the medicine in specific locations, rinse it out for 15 minutes with lukewarm water. After each usage, wash your hands.

CompoundW, which costs roughly $34 for an 8-application home removal kit, can assist you to remove a skin tag fast, conveniently, and affordably at home without having to see a physician or dermatologist. The dosage is determined by your medical condition, medication type/brand, and treatment response. Do not take larger doses, use this drug more frequently, or use it longer than recommended. Your health will not improve faster, but the risk of adverse effects will be higher.

Skincell Advanced is a highly concentrated serum that may remove moles and skin tags. Using the supplied brush, apply the solution to your skin tag. Salicylic acid is used in the skin tag remover to loosen and eradicate it, which helps in healing skin defects such as skin tags, warts, and moles. The Skincell Advanced is an excellent serum composed entirely of natural components that help to avoid unsightly moles and troublesome skin tags. This is a quick and straightforward remedy suitable for all skin types.

This Skincell Advanced liquid serum reaches the mole or skin tags root, stimulating the WBC to blemish, eliminate, and mend the problem. In addition, this serum might be used anyplace on the body to provide benefits in as little as 8 hours. To ensure quality, the Skincell Advanced serum is created and manufactured in the United States under rigorous guidelines and in an FDA-approved facility.

Applying two applications of Skin Cell Advanced twice a day is all it takes to get rid of a skin tag. Allow for drying time between treatments, then repeat the procedure each day for up to 12-14 weeks to complete the removal. All moles and skin tags are removed from the skin using the Skin Cell Advanced Serum. The serums potent formula enters the skins outer and inner layer and treats the underlying causes of the problems. The Skincell Advanced Mole Treatment operates in three steps to achieve tight and smooth skin.

The response will deploy an army of white blood cells to the affected area to begin healing. A scab will grow over the blemish if the applied area becomes somewhat irritated. After that, the serum will allow the body to function normally. As a result, if a scab appears after using the serum, you should cease using it. A unique mix of castor oils and tea trees is used in Skin Cell Advanced. This blend of oils has long been used as purifiers and cleaners. You may safely and swiftly eradicate the unsightly blemish by treating your skin tag or mole with it regularly.

The Ulensy Skin Tag Remover is the most extensive skin tag removal kit on our list, with 36 parts. Each package includes 36 healing skin patches, 12 cleaning wipes, 24 standard bands, and an instruction handbook, as well as everything you need to remove skin tags swiftly and safely. Get two skin tag removal procedures for the price of one. To help you target your most problematic skin tags, this package contains a band applier, bands, skin patches, and cleaning wipes. Rather than spending money on cosmetic surgery, try this easy and painless procedure to help cut the blood flow to skin tags, leaving you with smooth skin in your stead.

Ulensy suggests utilizing their Skin Tag Remover Kit for tiny and big skin tags. Using the kit appropriately, you may safely remove skin tags without causing deep scars or irritations.

Soft and Smooth skin, which is healthy inside and outside and blemish-free, is an essential factor closely linked to your self-esteem. The Ulensy tag remover is a simple but highly effective and efficient treatment that helps restore the attractiveness of your skin while also removing unsightly skin tags! This skin tag removing gadget has everything youll need for a comfortable and easy experience, including a remover cone, 30 healing skin patches, band remover, 24 bands, ten cleansing wipes, and one handbook.

Follow the Ulensy Skin Tag Remover guide manuals six simple procedures. Skin tags may be removed in the comfort zone of your own house, without the need for a painful or costly doctor appointment. These skin tag removal treatments effectively remove medium and big skin tags without any permanent marks leftover or uncomfortable sensations. This mole remover for the face cuts the blood supply to skin tags or moles, leaving your skin smoother, cleaner, and fresher than before!

Another effective skin tag removal kit is the Micro TagBand. TagBand employs ligation to stop blood flow to your skin tag, enabling it to come off rapidly. TagBands tool, the Micro TagBand skin tag pen, targeted more petite, more difficult-to-treat skin tags. It works the same way as other kit items, slipping an even tinier rubber band around minuscule skin tags. To use, wrap one of the rubber bands around the pens base and click the pen to release it around the unwanted growth. Precision targeting is a snap with this easy-to-hold pen, which easily bands off even the most miniature skin tags.

TagBand uses small bands to cut blood supply to treat the skin tags like several other skin tag removals. This blood flow is necessary for the skin tags development and survival. You may remove the skin tag safely and naturally by reducing blood flow. The Micro TagBand is designed for skin tags that are small to medium in size. TagBand is intended for use on skin tags on the face and body, although it is not recommended to be used near the eyes.

Each package contains 1x TagBand removal gadget, 10x Micro removal bands, and 10x cleaning wipes to treat ten skin tags. Each Micro TagBand kit is capable of treating up to ten skin tags. Each package includes one TagBand removal gadget, ten tiny removal bands, and ten washing wipes. The box is intended for skin tags that are tiny to medium in size. However, the original TagBand kit can be used for more extensive skin tags.

Every technology for removing skin tags and moles claims to do it safely. Unfortunately, the majority of them are ineffective.

We evaluated the following parameters to identify the top genuine and worst skin tag removal kits to establish the rankings above:

A few skin tag removal kits include features such as a protective cover that allows you to concentrate on the skin tag while avoiding damage to the skin area. We chose skin tags with a focus on security.

Salicylic acid, tea tree oil, Freezing solutions, and other proven components are used in certain skin tag removal essentials to eradicate skin tags. Few others utilize dubious chemicals like apple cider vinegar or homeopathic medicines. Skin tag removal kits that employed tried-and-true substances or processes were our favorites.

Most dermatologists do not recommend skin tag removal kits. They can be harmful if misused. Thats why dermatologist-recommended or authorized skin tag removal kits are very valuable. Dermatologists have authorized, certified, and promoted some of our lists top-ranked skin tag removal kits.

Some skin tag removal kits appear inexpensive, but youll need three or four to remove a typical skin tag. Other skin tag removal kits are affordable, allowing you to remove a skin tag for a fraction of the cost of a doctors visit.

All good skin tag manufacturers offer a money-back or satisfaction guarantee on their goods. Even the most effective skin tag removal products arent practical for everyone. You should be able to get a refund if your skin tag removal kit fails to remove your skin tag. Our favorites were skin tag removal kits with a strong money-back or satisfaction guarantee.

A skin tag or mole is a little, soft, dangling skin with a peduncle or stalk. They can appear anywhere on the body, although they are more common where skin scrapes against flesh or clothes. A skin tag is a strand of collagen fibers in the skin. Collagen is the most prevalent protein in the body, and its what gives your skin its structure. A skin tag can be creased when strips of collagen gather together in folds of your skin.

Skin tags are usually unharmful. Some people, though, find them irritating. Others think theyre unattractive. You may acquire a skin tag or mole removal kit to use at home if you are suffering from a skin tag that you wish to remove. Alternatively, you might get the skin tag removed by a dermatologist or another expert.

They might show on:

When theyre in a conspicuous location or are constantly touched or scraped, such as by clothes, jewelry, or shaving, they generally go unnoticed. Some people may have skin tags and are entirely unaware of them. They rub off or fall off painlessly on their own sometimes. However, under strain, huge skin tags may explode.

Skin tags can have a smooth or uneven look on their surface. On fleshy peduncles or stalks, they are lifted from the skins surface. They are generally fleshy or somewhat brownish. Skin tags begin as a tiny, flattened lump, similar to a pinhead bump. Some remain tiny, while others expand. They can be 2 mm to 1 cm in diameter, some reaching 5cm.

The etiology of all skin tags is unknown. However, we are aware of several risk factors related to skin tags. Skin tags are caused when clusters of collagen and blood arteries become caught inside more significant portions of the skin, although the specific reason for this is unknown.

They may be generated mainly through skin rubbing against skin since they are more frequent in skin creases or folds. Some people appear to be predisposed to developing skin tags. The most significant risk here in getting skin tags is obesity. Skin tags are far more likely to occur in those with a higher risk of developing obesity. Skin tags affect both men and women; however, they are more common in obese persons, those with diabetes, and during pregnancy.

Skin tags are another typical pregnancy side effect linked to pregnancy hormones and weight increase. In rare situations, multiple skin tags might indicate a hormone imbalance or an endocrine disorder.

Researchers discovered that type 2 diabetes and pre-diabetic patients were highly prone to get skin tags in a 2010 study. Your body absorbs glucose from your body and blood vessels less effectively if you have diabetes or pre-diabetes. Hence, Skin tags are more likely to form as a result.

A 2008 study discovered a link between human papillomavirus (HPV) and skin tags. Some samples of these Skin tags were obtained from all over the body by the researchers. HPV DNA was found in around half of the skin tags analyzed.

When pregnant, a woman is more likely to acquire skin tags. Skin tags appear to be more likely to form when pregnancy hormones and weight gain are combined.

Skin tags can indicate a thyroid problem or an endocrine disorder in certain people. In general, additional study is needed to establish the etiology of all skin tags.

Follow the directions given in the instruction manual for the product you purchased to remove the moles. Alternatively, you can get a skin tag removed by a doctor or dermatologist. Skin tags that are too small to see may fall out independently. The majority of skin tags remain adhered to your skin. Skin tags, in general, do not require treatment. You can get skin tags removed if they hurt or disturb you.

Dermatologists may use cryotherapy to remove a skin tag. A skin tag can be burned away under the treatment of dermatologists. They use a wire to pass an electrofusion current. The wire heats up to the point where it burns the top layers of flesh. Big skin tags are more likely to be treated this way.

Small skin tags may typically be removed without an anesthetic. Your doctor may use a local anesthetic when removing big or many skin tags.

To get rid of skin tags, you may also use natural therapies: tea tree oil, lemon juice, and apple cider vinegar. Keep in mind that no scientific data backup these therapies.

Attempting to remove skin tags on your own is not a good idea. Many websites provide DIY skin tag removal procedures, such as tying them off with rope or using a chemical peel. Even in a sterile atmosphere, removing skin tags can result in bleeding, burns, and infection. Its advisable to delegate the task to your doctor.

Remember the ABCDEs while identifying hazardous moles and skin tags:

Color: The majority of moles are uniformly colored. You should get your mole checked if it has several hues or tints throughout, such as black, blue, red, white, or brown at different portions of the mole.

Skin tags can be either symmetrical or asymmetrical. If one half of your mole is different from the other, it might be a symptom of skin cancer.

Heights and Evolution: If your mole has been elevated or risen after being flat for a long time, or if it evolves or changes over time, it might be an indication of skin cancer.

Most skin tags are small, measuring less than 2 millimeters in length. Some can grow to be several centimeters long. Skin tags are smooth and gentle to the touch.

Kits for removing skin tags and moles function in different ways. Skin tags and moles can be frozen away using some kits. Others apply topical ointments on the affected area to relieve pain. Bands or patches are used in several skin tag removal techniques.

Some individuals use scissors, nail clippers, a needle, or a sharp blade to remove skin tags at home. A skin tag should never be cut or clipped without the guidance of a medical practitioner. While you may be able to eliminate the skin tag on your own, theres a risk of leaving a permanent scar in the area. Alternatively, you may not be able to remove the entire skin tag safely, leaving parts of it behind.

Apple cider vinegar, iodine, Tea tree oil, and other natural substances are used in specific skin tag removal procedures. The following are examples of natural ointments and solutions:

Tea tree oil can be used to treat a variety of skin conditions. Apply the tea tree oil to a cotton ball, then apply it to the skin tag to remove it. Do this several times a day. Tea tree oil can aggravate sensitive skin, but it can also help you get rid of a skin tag.

Apple Cider Vinegar: A common traditional remedy for skin tags is apple cider vinegar. There is minimal evidence that apple cider vinegar can remove skin tags at home. However, you can apply apple cider vinegar on a cotton ball and use it to your skin tag regularly, just like tea tree oil.

Iodine: Some people remove skin tags at home with iodine solutions. Use coconut jelly or petroleum jelly to safeguard the surrounding skin while applying iodine to a cotton ball.

Salicylic acid, tea tree oil, and other components used in skin tag removal treatments are comparable to those found in acne medications. According to some dermatologists, these systems are an effective way to remove skin tags. Other dermatologists advise against using these removal creams because they can cause skin irritation.

If you choose a suitable skin tag removal cream, the skin tag may fall off in 2-3 weeks.

Avoid utilizing homemade skin tag removal kits if the skin tag is around your eyes or genitals. If the skin tag removal kit gives you discomfort, bleeding, or itching, you should stop using it. Skin tags that are excessively big or long should not be removed using DIY skin tag removal kits.

Natural substances can be used to eliminate skin tags at home. In reality, some people eliminate skin tags and moles without the need for a dermatologists help.

Skin tags are more prevalent than ever before. Skin tags, on the other hand, have been treated for ages. Before modern medicine and dermatology, people utilized natural therapies like tea tree oil to eliminate skin tags.

According to research, tea tree oil contains inherent antiviral and antifungal qualities and is safe to use on the skin. After washing the afflicted region, rub the oil into the skin tag. Overnight, wrap the tape around the skin tag to absorb the tea tree oil. You may be able to eliminate the skin tag swiftly and safely if you continue this therapy for many nights.

Others eliminate skin tags and moles with banana peels. Although there is no scientific evidence to support this claim, some people believe that banana peels might help dry skin tags. Wrap the skin tag with a banana peel, then wrap it with bandages. Repeat every night until the skin tag is gone.

Vitamin E and C are 2 of the most well-known antioxidants found in nature. Both vitamins are commonly present in foods, mainly fruits. Some individuals use vitamin E-based solutions straight to their skin to aid skin tags, wrinkles, skin irritation, and aging.

Garlic might be one of the most effective treatments to remove a skin tag or reduce skin irritation. Garlic contains anti-inflammatory and antioxidant effects. Apply crushed garlic to the skin tag as a home cure, then bind the area with a gauze overnight.

A: The peduncle, the little stalk linking the skin tag to your body, is the best way to recognize a skin tag. A peduncle is not present in moles or other skin growths, and also it is not present in all skin tags.

A: The exact etiology of all types of skin tags is unknown. However, it appears that scratching or irritating a region often increases the likelihood of acquiring a skin tag. A skin tag can be caused by touching your body with a shirt collar, jewelry, or anything else. Skin tags seem to be more frequent in overweight or obese people. On the other hand, skin tags can arise on anyone for no apparent cause.

A: Skin tag and mole removal kits can be used at home to remove skin tags. Before eliminating skin tags, however, you should see a doctor (a dermatologist). Attempting to remove huge skin tags on your own may result in scarring, bleeding, and infection.

Its simple to obtain DIY home removal kits for your skin tag or a mole. Skin tags are prevalent, especially as you become older.

You can safely and efficiently remove the skin tag at home without visiting a dermatologist if you purchase one of the top-rated mole home removal kits listed above. Follow the instructions on our suggested skin tag removal kits to get started. Skin tags and moles can be removed quickly with the suitable kit, allowing you to return to a normal, healthy, and blemish-free lifestyle.

Its possible that getting a skin tag wont bother you. Skin tags are a nuisance for the majority of individuals. You can ignore them if they disturb you and youre sure of the diagnosis. Keep in mind that you can develop more if you have one skin tag. They arent harmful and dont need to be treated in most cases. If they cause irritation or you dont like how they appear, a dermatologist or other healthcare expert can remove them. Self-removal is dangerous and not advised.

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Disclaimer:

Please understand that any advice or guidelines revealed here are not even remotely a substitute for sound medical advice from a licensed healthcare provider. Make sure to consult with a professional physician before making any purchasing decision if you use medications or have concerns following the review details shared above. Individual results may vary as the statements made regarding these products have not been evaluated by the Food and Drug Administration. The efficacy of these products has not been confirmed by FDA-approved research. These products are not intended to diagnose, treat, cure or prevent any disease.

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Best Skin Tag Remover Review: Top Remedy to Get Rid of Skin Tags - Enumclaw Courier-Herald

By: Mark Glennon*

Reported COVID cases are surging in Illinois and many hospitals are severely overburdened, so Gov. JB Pritzker and Illinois Department of Public Health Director Ngoze Ezike held a press conference Monday.

It was overwhelmingly devoted to vaccines and masks, to the exclusion of all else. Get vaccinated, boosted and wear a mask, they said over and over again. Vaccines and boosters, they said, are the key to lowering the burden on hospitals, avoiding the need for hospitals to shift to a crisis standard of care and reducing the risk of hospitalization and death.

But the subject of treatments was almost entirely ignored. None of the reporters questions addressed treatments.

That omission is baffling. Timely use of the right treatments for those infected unquestionably would reduce the number of deaths and hospitalizations. Prompt treatment, however, is essential, and that message is not being delivered.

The safety and effectiveness of various treatments are now well-established and the number of available options is growing. The effectiveness of monoclonal antibody treatments for the Delta variant, which is still the primary source of serious hospitalizations and deaths, has been known for over a year. Even Dr. Anthony Fauci acknowledged that, belatedly, in August, saying that the treatments can reduce the risk of COVID-19 hospitalization or death by 70% to 85%. Aside from antibody treatments, a new pill from Pfizer recently authorized reportedly decreases the risk of hospitalization and death from the virus by nearly 90%. A pill from Merck received authorization, though its not as effective as Pfizers. Some other treatments appropriate in certain circumstances were authorized earlier.

But the only mention of treatment in the Monday news conference was this, from Pritzker: We are also increasing testing and continuing to distribute monoclonal antibodies, anti-viral pills and any treatments or personal protective equipment communities need. That told us nothing.

The first question that should have been asked is why the state isnt warning those at risk to ask their doctors quickly about treatments after they know they have the virus?

Pfizers new pill has only proven effective if given within five days of symptoms appearing. Experts worry it may be unrealistic for patients to self-diagnose, get tested, see a physician and pick up a prescription within that narrow window, as reported often. Antibody treatments are also supposed to be given as soon as possible. Why is government not broadcasting that?

Other questions the state should be pushing out answers to should be obvious, especially in light of complexities raised by the new Omicron variant and new treatments. And standard tests do not tell you which variant you are infected with.

For example, arent the antibody treatments still of value, even though only one of those on the market (GlaxoSmithKlines sotrovimab) is effective against Omicron? Some treatments are in short supply and are being rationed. Which ones are available and for whom? Which treatments are available only at hospitals and how does one get them? What are the drug interaction risks for the new treatments? Issues have arisen for those taking widely used statins, blood thinners and even anti-depressants.

Regarding that last question, the best answer appears to be that those at risk should contact their doctors fast after an infection to get the right treatment. That message, however, is not being delivered. Look at IDPHs web page on what to do if you are infected. It is not there.

Weve speculated before about why the State of Illinois and federal health authorities seem to deliberately ignore the topic of treatments. They seem hell-bent on sticking to a doctrine that we always prefer prevention over treatment, as Ezike has stated it. Hence, they have been two-trick ponies since the start vaccines and masks.

That doctrine may make sense as a general epidemiological rule, but it certainly does not seem adequate at this time for COVID. None of this is to imply that vaccines dont significantly reduce the chances of hospitalization or death. They do, vaccines save lives, and thats something experts agree on, but thats no excuse for ignoring how those who nevertheless get infected should get treated.

*Mark Glennon is founder of Wirepoints.

UPDATE: Another remedy not initially mentioned in this column is Fluvoxamine. As the Wall Street Journal says in the article below, it is being overlooked. Because this is important, I am taking the liberty of reprinting their article on it below:

Is Fluvoxamine the Covid Drug Weve Been Waiting For?

A 10-day treatment costs only $4 and appears to greatly reduce symptoms, hospitalization and death.

By Allysia Finley Follow Dec. 28, 2021 6:44 pm ET

The Food and Drug Administration last week authorized two oral antiviral medicines for the early treatment of Covid-19. But dont get too excited. The U.S. will still have a meager treatment arsenal this winter.

The U.S. has been relying on monoclonal-antibody treatments, but most dont hold up against the Omicron variant. One, by GlaxoSmithKline and Vir Biotechnology, does better at neutralizing the variant, but supply is limited. Pfizers newly authorized antiviral pack Paxlovid will also have to be rationed. There will be more of Merck and Ridgeback Biotherapeutics newly authorized antiviral, molnupiravir, but patients may be reluctant to take the drug. Some scientists worry it could cause DNA mutations in people, though the FDA determined that the likelihood of this was low when used on a short-term basis.

Yet a promising alternative isnt getting its due: fluvoxamine, a pill the FDA approved in 1994 to treat obsessive-compulsive disorders. Doctors often prescribe it off-label for anxiety, depression and panic attacks. Studies show that fluvoxamine is highly effective at preventing hospitalization in Covid-infected patients, and its unlikely to be blunted by Omicron.

Doctors hypothesize that fluvoxamine can trigger a cascade of reactions in cells that modulate inflammation and interfere with virus functions. It could thus prevent an overreactive immune response to pathogenswhats known as a cytokine stormthat can lead to organ failure and death. It also increases nighttime levels of melatoninthe hormone that makes you sleepywhich evidence suggests can also mitigate inflammation.

While experimenting with mice in 2019, researchers at the University of Virginia discovered that fluvoxamine could be an effective

treatment for sepsis, or blood-borne infection. A large study in France during the early months of the pandemic found that Covid-19 patients treated with selective serotonin reuptake inhibitors such as fluvoxamine were significantly less likely to be intubated or to die.

A small randomized control trial last year by psychiatrists at the Washington University School of Medicine in St. Louis was a spectacular success: None of the 80 participants who started fluvoxamine within seven days of developing symptoms deteriorated. In the placebo group, six of the 72 patients got worse, and four were hospitalized. The results were published in November 2020 in the Journal of the American Medical Association and inspired a real-world experiment.

Soon after the study was published, there was a Covid outbreak among employees at the Golden Gate Fields horse racing track in Berkeley, Calif. The physician at the track offered fluvoxamine to workers. After 14 days, none of the 65 patients who took it were hospitalized or still had symptoms. Of the 48 who didnt take the drug, six, or 12.5%, were hospitalized and one died. Twenty-nine had lingering symptoms, which might have resulted from inflammatory damage to their organs. Those who took the placebo were more likely to be asymptomatic when they tested positive, so they would have been expected to fare better.

The studies drew the attention of Francis Collins, director of the National Institutes of Health. A big need right now is for a drug that you could take by mouth, that you could be offered as soon as you had a positive test, and that would reduce the likelihood that the virus is going to make you really sick, he said in an interview with 60 Minutes in March. Fluvoxamine could certainly be something you want to put in the tool chest, Dr. Collins added. It looks as if it has the promise to reduce the likelihood of severe illness.

Researchers at McMaster University in Hamilton, Ontario, last winter launched a large clinical trial in Brazil. The results from their trial, published in the Lancet in October, were stunning: Fluvoxamine reduced the odds of hospitalization or emergency care by 66% and death by 90% among unvaccinated high-risk patients who mostly followed the treatment regimencomparable to monoclonal antibodies. There was no difference in adverse effects between the fluvoxamine and placebo groups.

The three fluvoxamine trials were conducted while different variants were circulating, so theres no reason to think the drug wouldnt work as well against Omicron. A 10-day course of fluvoxamine costs $4, compared with the $2,100 the U.S. government has been paying for monoclonal antibodies, and $530 to $700 for a course of the Pfizer and Merck treatments. Multiple drugmakers manufacture fluvoxamine and could ramp up supply without much difficulty were demand to increase.

While the FDA doesnt need to grant fluvoxamine emergency-use authorization for doctors to prescribe it, some may be reluctant to do so unless the NIH recommends it in its Covid-19 treatment guidelines. Physicians have been investigated by state medical boards for prescribing the antiparasite ivermectin off-label for Covid-19.

The NIH states that there is insufficient evidence . . . to recommend either for or against the use of fluvoxamine for the treatment of COVID-19. It wants evidence from another large clinical trial. Yet the U.S. is recording nearly as many deaths from Covid-19 today as when Dr. Collins made his statement in March. If the NIH doesnt budge, states could enact laws that protect doctors who prescribe fluvoxamine, They could also order doses to administer to patients, which would cost little but could save many lives.

Ms. Finley is a member of the Journals editorial board. Appeared in the December 29, 2021, print edition.

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Why No Discussion Of COVID Treatments In Illinois? Updated Wirepoints - Wirepoints

The majority of people in the US are overweight, obese, or trying to lose weight. Diet and exercise seem to be a bit of a challenge and time-consuming for many people. As a result, many health issues have been created as a result of the lack of attention given to extra body weight. These include infertility, cardiovascular disease, high blood pressure, diabetes, stroke, and many more. With the busy and modern lifestyle that we live today, a weight loss supplement may be a good idea.

Exipure is one of the best dietary supplements recently launched. It is getting huge attention among people who are looking for a natural weight loss supplement. Exipure claims to increase brown fat levels, which according to many proven weight loss studies, is the root cause of unexplained weight gain. Moreover, the improved brown adipose tissue levels curb appetite and burn calories faster.

Its pretty impressive to see results after just a few weeks of using easy-to-use Exipure capsules. The proprietary blend of Exipure supports weight loss to keep users in shape and to maintain optimum health.

Exipure weight loss supplement is created with plant-based ingredients which are both effective and safe. By following FDA-cGMP instructed manufacturing guidelines, there are no significant side effects of the weight loss formula. Because of all these studies and claims about Exipure, we decided to write this Exipure review. You can read on to learn more about Exipure in detail in this review.

Exipure, launched on October 21, 2021, is a weight loss supplement that converts regular fat into brown adipose tissues (BATs). By doing so, youll burn more calories, resulting in weight loss within short periods of time. This proprietary blend uses all-natural ingredients that have been scientifically proven to be beneficial for weight loss and overall health.

Exipure formula is completely based on many recent studies revealing brown adipose tissues (BAT) or brown fat as a root cause of weight gain. Brown adipose tissue (BAT) is a healthy type of fat that can mostly be found in lean people. In comparison, people with obesity and unexplained weight gain tend to have more white fat and low brown adipose tissue levels, making weight loss a difficult task.

Furthermore, brown fat is known to burn calories by enhancing body temperature and producing more heat. The use of Exipure helps to lose weight and increases stamina, metabolism, and heal the body.

Scientific studies since years show that the human body produces two types of fat, brown fat and white fat. The brown adipose tissue (BAT) is primarily working as a fat shrinker to transform body fat into heat. It energizes thermogenesis to significantly reduce body fat and improve metabolism levels, making your body burn fat rapidly. The eight exotic nutrients of the Exipure diet pill have the properties of converting your bodys excess fat into brown adipose tissue (BAT).

Instead of storing fat in your body, brown fat burns and shrinks it. Your body now avoids storing excess fat and releases more energy to make you feel active in everyday tasks. Brown fat is higher in mitochondria than normal fat cells and generates about 300% more energy than regular fat burning.

Exipure pills are a great alternative to lower body fat. The product is specially made for those who find a healthy diet, extreme workouts and joining the gym a hard task. Without workout or dieting, this easy-to-follow habit will let you lose weight noticeably. Also, for those who have a bit tight schedules and less time to focus on their weight and health, one capsule of Exipure daily will at least help them start losing weight.

Exipure is made with eight exotic nutrients and plants that boost the brown adipose tissue (BAT) levels in the users body to offer them desired weight reduction results. Apart from that, this product offers the following health benefits:

Here are the following eight exotic nutrients and ingredients of Exipure that work to improve low brown adipose tissue (BAT):

One of the key ingredients in this dietary supplement is Perilla leaves, which naturally boost BAT levels and are what the whole product is about. Some users notice an increase in healthy cholesterol levels while taking Perilla. The remedy helps to maintain brain health by boosting memory and cognition for the user.

Holy Basil is also included in weight-loss solutions because of its properties that boost the low brown adipose tissue levels and support brain health. Holy basil reduces oxidative stress, causing the body to produce less cortisol. The stress hormone cortisol increases appetite and, as a result, causes users to eat more often, despite no physical stress. More cravings lead to more calories consumed by consumers, causing them to gain weight and belly fat without knowing why.

Using White Korean Ginseng results in increased levels of BAT, as well as a healthy immune system. To keep fat cells healthy and prevent illness, the immune system plays a significant role in the body. Most diets aim to shed the extra pounds by going to great lengths, and those who follow them often lose the nutrients their bodies require.

White Korean Ginseng also has antioxidant properties.

In the Exipure weight loss formula, Amur Cork Bark does not receive the same attention as some of the other ingredients. Researchers need to conduct more research to discover the link between BAT levels and amur cork bark. Early indications, however, suggest that the ingredient may also ease digestion and bloating for consumers.

Digestion and liver supplements usually contain this ingredient. The core function of this ingredient is to boost the digestive system as well as liver health.

The supplement industry considers quercetin to be a well-known compound due to its ability to regulate sugar levels, brain health, and repair aging cells . This antioxidant also supports healthy blood pressure and can be used in various health formulas.

Oleuropein may seem like a bizarre addition to this type of formula, but most consumers use it all the time in olive oil. This ingredient supports artery health and prevents cholesterol damage. Additionally, it reduces the stress obesity puts on the heart, which is especially advantageous for obese individuals.

One of the premier boosting BAT levels is Propolis, which is not a new name in the health and wellness space. Propolis has a chemical called pinocembrin, which helps manage blood sugar levels and protect your body from free radicals. Because of its anti-inflammatory and antimicrobial properties, it heals wounds, fights inflammation, creates healthy cells in the body, and offers healthy immunity.

In addition to boosting BAT levels, kudzu is beneficial for treating several health problems, such as fever, diabetes, the common cold, heart disease, and so forth. Kudzu contains many antioxidants that help the body fight disease. Anti-inflammatory properties reduce free radicals and ease pain, helping you stay active throughout the day.

As with Kudzu root, this herb has been used in Asian medicine for centuries. Among the most common conditions it treats are alcoholism, diabetes, fever, heart disease, and many more.

A large number of people choose Exipure weight loss pills because of the scientific evidence supporting its ingredients. Despite the fact that this combination hasnt gone through any clinical trials or peer-reviewed studies as a whole, it still allows anyone who wishes to burn fat to do so. The scientific studies that Exipure bases its research on are also accessible on the companys Website.

Brown adipose tissue (BAT) has been on researchers minds since 2004, when they wanted to figure out how it transforms food energy into heat. In this study, the experts discovered that brown adipose tissue makes it feasible for fat cells to break down fat and sugar, which individuals consume in the mitochondria. It stimulated the release of fats and calories to aid users in losing weight and increasing their energy levels.

Weight reduction is primarily caused by establishing a calorie deficit, according to most doctors and scientists. It is necessary to maintain a healthy weight loss plan to burn more calories than the body processes through digestion. In addition to a healthy diet and exercise, brown adipose tissue helps individuals see greater results. Ultimately, the Exipure supplement helps users reduce their weight and resist gaining it back by increasing brown adipose tissue in their bodies.

Numerous studies have been conducted on ginseng, but one in 2014 showed that obesity is closely linked to gut microbiota. Several Korean women in their 40s to 60s were given ginseng as part of a study to test its effects. The researchers observed healthy weight loss after eight weeks of using ginseng. Furthermore, the participants experienced improved gut health as well.

Although holy basil isnt as well known as ginseng, it seems to have some weight reduction properties. In their 2017 study, researchers analyzed other laboratory reports on the plant because it has a long history of use in both Ayurvedic and Siddha medicine.

Studies have shown that the natural ingredients of Exipure supplement promote weight loss, as well as offer other essential health benefits. By activating brown fat in your body, you can lose weight without dieting or exercising.

You can read Exipure reviews and testimonials about it from others who have used it successfully.

A customer, Lauren, says in her Exipure review that she lost 35 pounds. By using this diet pill. She says she now feels less anxious and stressed and has more energy than before.

Zach, who is in his 40s, lost 26 pounds using Exipure weight loss supplements. He feels better about his appearance now than he did in his 30s. It has yet to be seen how his development continues while he is taking the supplement.

Taking Exipure pills resulted in another lady losing 40 pounds in just a few weeks. For her, this weight loss was comparable to a four-size reduction in clothing size. Exipure has been so successful in helping her lose weight that she continues to use it.

You can buy Exipure only at the official Website Exipure.com.

A single bottle of Exipure dietary supplement will cost you $59. However, if you buy a pack of 3 or 6 Exipure bottles, the price comes down to as low as $49 or $39 per bottle, respectively. Let us take a look at pricing and packages in details provided by Exipure on the official Website:

As above mentioned pricing indicates, buying larger packs will have amazing discounts and perks. However, a single bottle pack is also fine to check how these pills are affecting your body in a few weeks of use.

Note: Exipure is not available on other websites such as Walmart and Amazon. As Exipure has no authorized partners, it is highly recommended to buy it only from the official Website to avoid scams and mis-selling. Sometimes the product is out of stock due to bulk orders, so you better check the availability in advance.

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As mentioned above, if you order 3 or 6 bottles of Exipure, you are eligible for the Exipure bonus. But what exactly are Exipure bonuses? Well, these are two eBooks that guide you throughout your Exipure journey. Lets know more about these eBooks:

This eBook guides you about how to detox, flush, and cleanse your organs to kickstart your weight reduction journey. It mentions 20 tea recipes with ingredients easily found in your kitchen to detox your body and utilize Exipure at its best. The recipes are very easy to prepare and hardly take 15 minutes to get ready.

As stress and anxiety are somehow related to weight gain, Exipure makers offer their customers Renew You. The eBook has potential methods that anyone can start right away to calm their mind, relieve stress, and lower anxiety. Renew New focuses on providing the reader with a completely new positive mindset.

Your Exipure journey has a lot more to offer you with other weight loss products of Exipure. Here are some of the other products Exipure offers:

Once you find Exipure working, there is an opportunity to order 9 Exipure bottles packs, which come with huge discount offers. This pack is highly recommended for those with long-term weight loss goals or who want to give this weight loss remedy to someone as a present.

Worth $620, the Exipure Wellness Box includes 5 different dietary products that are highly beneficial for losing some extra pounds and offering you many other health and wellness benefits. Let us discover what Exipure Wellness Box has to offer you:

The MCT oil pure contains 2,000mg of Medium-chain triglycerides (MCTs) that helps to boost endurance and support weight loss. Furthermore, the oil also supports memory health, cholesterol levels, blood sugar levels and improves weight management.

Low immunity is something that an overweight person usually deals with. Immune Boost is designed to improve users immunity and energy levels. The main ingredient in the blend is echinacea that supplies necessary antioxidants to enhance healthy immunity and fight infections.

Biobalance Probiotics is a supplement that reduces the number of harmful bacteria in your gut to improve your digestive system. With the help of 20 billion colony-forming units (CFUs), it takes care of your gut health throughout your journey with the Exipure supplement.

This hydrolyzed collagen and peptides supplement rejuvenates your skin and aging cells to make you look younger. Collagen is an essential protein in the human body that is responsible for skin elasticity, joint health, and skin health.

Last but not least, Deep Sleep 20 is a supplement that aids your sleep. Being overweight and obese can bring the situation where people struggle to complete their sleep cycle. Natural ingredients of Deep Sleep 20 such as Ashwagandha, chamomile, lemon balm, goji, and melatonin make sure you have a peaceful night and calm mind during sleep.

Trying Exipure weight loss pills is easy as they come with a no-questions-asked money-back guarantee of 180 days. If you are not satisfied with the product and its outcomes, you are eligible for a complete refund within the duration of 180 days.

However, while seeing so many amazing Exipure reviews, you probably wont have a need to return the product. In case you do, claim your refund by contacting Exipure support via email- contact@exipure .com or call-1-888-865-0815.

The Exipure supplement is completely safe for use. It is made in the USA under GMP and FDA-approved facilities. Makers use exotic nutrients that are 100% natural, plant-based, soy-free, non-GMO, and dairy-free. Also, the product is gone through third-party inspection to ensure purity and quality standards.

Above in the article, we read Exipure customer reviews that imply anyone using Exipure daily can lose weight and belly fat in a sufficient amount. However, results may not be similar for everyone. On average, you can reduce up to 30 lbs while taking Exipure daily for a few weeks to months.

Exipure results in desired and healthy weight loss while consuming it at least for 3 to 6 months. This is the reason why formula creators recommend buying larger packs. Also, 3 and 6 bottles packs come with a special discount and additional bonus, making it worth the deal.

Using Exipure does not require a prescription. Anyone above 18 years struggling to lose weight can start taking Exipure pills. However, people with critical health situations, like allergy, sickness, existing medication, pregnant women are recommended to consult their physician or healthcare professional.

Exipure is completely different than other weight loss programs and supplements available in the market. Till now, many of you have already known that Exipure weight loss supplement targets the root cause, low brown adipose tissue in the body for burning fat. Maximum statements made by Exipure creators are backed by several animal and human studies that support the formula. All these details sound encouraging. However, it is still not clear how the complete Exipure formula can aid in brown adipose tissue levels. Also, studies about BAT effects in humans are still a thing of research.

On the other hand, if we see Exipure reviews and testimonials, they have some really appealing weight loss results. The contained ingredients also have substantial health and weight loss benefits that make Exipure a must-try supplement for people looking for a reliable weight loss solution.

To reduce obesity and get rid of unexplained weight gain, you must take action as soon as possible. Dont wait to get things out of your hands. You must understand the difference between overweight and obesity before its too late. With Exipure, your body will be able to lose a sufficient amount of weight and maintain healthy cholesterol, sugar levels, and healthy blood pressure. If your health is affected by excessive weight gain, trying Exipure can be life-changing.

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The links contained in this product review may result in a small commission if you opt to purchase the product recommended at no additional cost to you. This goes towards supporting our research and editorial team and please know we only recommend high quality products.

Disclaimer:

Please understand that any advice or guidelines revealed here are not even remotely a substitute for sound medical advice from a licensed healthcare provider. Make sure to consult with a professional physician before making any purchasing decision if you use medications or have concerns following the review details shared above. Individual results may vary as the statements made regarding these products have not been evaluated by the Food and Drug Administration. The efficacy of these products has not been confirmed by FDA-approved research. These products are not intended to diagnose, treat, cure or prevent any disease.

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Exipure Reviews - Underrated or Overpriced? You Be the Judge! - Journal of the San Juan Islands

The skyrocketing craze for weight loss supplements is not unknown to anyone. An unhealthy lifestyle and poor dietary habits trigger unwanted weight gain and obesity. Therefore, obese individuals have no other option apart from weight loss supplements. With this escalating popularity and demand for diet pills, new weight loss supplements are launched by different companies every other day.

If body fat is the main reason behind your social embarrassment and you arent as fit as you used to be, weight loss pills can be your last choice. Every dietary supplement comes with a specific capability to accelerate fat burning, but not all of them can deliver the expected weight loss results.

So, which dietary supplement should you go for? Which weight loss supplement will turn out to be the ultimate savior for you?

Well, the PhenQ fat burner can be a premium pick for burning fat any day. If you want to support weight loss and increase muscle mass with a standard weight loss supplement, Phenq is the best choice you have.

However, you may remain skeptical while deciding to buy PhenQ weight loss pills to lose weight significantly. Several PhenQ reviews are live on the internet, but most of them lack the necessary information you seek about PhenQ weight loss pills.

This article unfolds everything you need to know about PhenQ diet pills, including how it helps in losing weight and why you should go for this product over other weight loss pills.

PhenQ is an elementary diet pill supplement that helps lose weight significantly. For many people, stored fat is equivalent to curses, and the PhenQ weight loss supplement is manufactured to induce the weight loss journey of everyone. The PhenQ dietary supplement attempts to suppress appetite and food cravings to shed excess weight.

The PhenQ weight loss supplement comprises natural ingredients to cut off stored body fat from your entire body. The all-natural ingredients make it possible to attain enormous health benefits apart from burning fat. Laterally, the manufacturers claim that the product is an exceptional choice for uncontrollable weight gain.

Being a compilation of proportionate ingredients, this supplement caters to other health benefits like better mood and energy levels, better cognitive capabilities, and many more. Now, lets have an insight into how the PhenQ supplement aids in losing weight.

Firstly, PhenQ diet pills assist in the fat-burning process by increasing your bodys heat. Thermogenesis is the natural fat-burning process to lose fat effectively. As your body fat percentage increases, your bodys capability of losing weight naturally decreases. The ingredients of PhenQ make it possible to trigger the state of thermogenesis in your body to cut off stored body fat more rapidly.

By the side, the supplement also takes up your bodys metabolic rate to maximize your weight loss process. As your metabolism gets boosted naturally, nutrient absorption improves, and you lose weight drastically.

The powerful ingredients of the product increase the levels of fat-dissolving hormones and chemicals that eliminate fat cells. To sum up, the PhenQ can overlap any other weight loss product available in the market in terms of fat burning. The supplement takes your weight loss journey through the natural and effortless fat-burning process.

You need to follow a proper diet plan to maintain your body weight. No matter how many pounds you lose, your bodyweight wont decrease unless the production of new fat cells stops. PhenQ makes that possible with relevant ingredients to help you lose weight efficiently.

Unlike other weight loss supplements, PhenQ blocks your bodys natural fat accumulation process by enhancing the fat-dissolving hormones. Mainly, you get to maximize your results as you limit your daily calorie intake.

On one side, the supplement burns fat and pauses unwanted weight gain on the other side. Thats why the results offered of this dietary supplement are way more evident than other nutritional supplements.

The official website of PhenQ demonstrates that the fat burner promotes appetite suppression to deliver weight loss results. It can suppress appetite to some extent and makes you feel full. Also, your food cravings are reduced, and your bodys natural fat production rate is minimized. With that, PhenQ can accelerate fat burning to the maximum level within a short span.

Its essential to be high on energy to elevate the fat-burning speed of your body with workouts and an active lifestyle. The ingredients in PhenQ dont let you run out of energy while youre working out or doing other activities. As already mentioned, inactivity is the root cause behind unrestrainable fat accumulation, and that can be reversed with intense and energetic workouts and exercises only.

Besides fat-reducing elements, PhenQ contains some energizing ingredients to help your body produce enough energy from fat. The enhanced fat metabolism of your body results in an increment in your bodys energy levels naturally. Therefore, you burn fat and obtain excellent energy levels throughout the day.

Different studies have proved the association between the cognitive state of a person and his body fat percentage. Its evident that people with poor mental health tend to gain weight faster than ordinary people, and they face challenges while reducing stored fat. Most weight loss supplements overlook this point, but PhenQ doesnt.

PhenQ has certain potent elements that are favorable for a better mental state. As you start consuming PhenQ, youll see an uplifted mood, and youll feel better as well. Thats why you can achieve your weight loss goals quickly with this particular supplement.

Anyway, we have to look deeper at the list of ingredients present in PhenQ to understand how it works.

This ingredient makes PhenQ stand out among thousands of dietary supplements. This component is nothing but capsicum extract, effective in weight loss. The primary function of the powder is to reduce oral and gastric burning, but it participates in increasing free fatty acids and glycerols in your blood immediately. As you consume the powder right after your workout session, the increased levels of fatty acids and glycerols make you burn fat more intensely.

However, Niacin powder and Peperine powder are mixed with capsicum extract powder to prepare the Capsimax powder. Tryptophan is one of the essential amino acids that help convert food into energy, and Niacin powder is generated from this amino acid only. Therefore, the consumption of the Capsimax powder helps your body convert meals into fuel by increasing nutrient absorption.

Alongside, the presence of Peperine powder triggers the feeling of fullness, and you feel less hungry. As a result, your natural food intake decreases automatically, and your gut health remains optimum too.

Combining these fat burn powders makes the Capsimax powder an excellent item for eliminating extra body fat. The presence of this powder as a key ingredient makes PhenQ more potent than other weight loss pills available in the market to help you lose weight.

Though this is not a conventional fat-reducing ingredient, its one of the critical ingredients in PhenQ. The weight loss supplement is rich in calcium, making it a common choice for overall well-being. Clinical studies have confirmed that regular calcium intake in sufficient amounts can make your body temperature higher. With that, your bodys metabolism increases, and you lose weight significantly.

By the side, calcium is one of the natural ingredients that make you stronger from the inside. Calcium strengthens your bone density, improves the functions of your heart and nerves. Still, it can be considered a supportive ingredient for fat burn.

L-carnitine is a natural fat burner that PhenQ contains to block fat production. Also, it helps convert more food into energy, including fatty foods, and thats how it makes you burn extra body fat as per your expectations. This is one of the natural ingredients found in the most popular diet pills.

As a naturally-occurring amino acid, this component prevents fluid retention inside your body. Unnecessary fluid retention is the reason behind multiple health complications, and L-carnitine fumarate can stop them.

Alpha-lipoic acid is a crucial ingredient to induce lipolysis in the human body. a-LACYS Reset is a blend of alpha-lipoic acid and cysteine. Lipolysis is the natural fat-dissolving mechanism of the human body, and a-LACYS Reset boosts the rate of lipolysis to help you lose weight faster than you assume.

On top of that, L-cysteine is directly linked to the secretion of the hunger hormone, Ghrelin. The component reduces the secretion of Ghrelin to ensure that your food intake and calorie intake decrease. With a controlled appetite and moderate hunger frequency, your body tends to burn fat pretty fast.

Being a perfect blend of these ingredients, a-LACYS Reset offers both kinds of benefits mentioned above. 25 g of a-LACYS Reset is present in PhenQ, which does the job of fat reduction very smoothly.

PhenQ contains chromium picolinate in a significant dosage, and thats what makes the fat burner an exceptional choice. Almost every weight reduction supplement contains chromium picolinate, as this edible formation of chromium boosts metabolism and controls blood sugar levels.

Chromium picolinate is directly associated with the functions of insulin in the human body. Adequate intake of chromium picolinate reduces sugar cravings and helps retain blood sugar levels. Excess sugar cravings often lead to unintended weight accumulation. Being rich in the ingredient, the PhenQ supplement can prevent fat production.

If youve been trying to lose weight for a long time, you dont need further clarification about the effectiveness of caffeine in triggering weight loss. Caffeine anhydrous can amplify the results offered by caffeine as it is a dehydrated and more concentrated version of caffeine. The compilation of the PhenQ supplement impacts your energy levels positively. You enjoy elevated mood and energy levels as you regularly consume the product.

Moreover, the ingredient boosts your natural metabolism to reduce fat and manage body weight successfully.

Each diet pill in a bottle of PhenQ is rich in this ingredient. Nopal cactus is a unique cactus species that promotes a wide variety of health benefits. As the fibers extracted from the plant are rich in amino acids, the fibers can reduce high blood sugar levels and ensure decent cardiovascular functions. Also, the necessary amino acids are rich in antioxidants to detoxify your body.

According to our research and editorial team, these are the critical ingredients in PhenQ diet pills. If you continue taking these pills along with an appropriate diet and exercise plan, you can retain lean muscle mass while going through an effective weight loss procedure.

The official website of PhenQ states that it delivers noticeable results within short spans. According to the PhenQ reviews on the official website, the fat burner pills have helped users shed approximately 2 lbs every week if consumed continuously regularly. However, users are expected to follow an effective exercise routine to get the products best benefits.

The supplement has millions of satisfied users across different cities worldwide, and they claim to reduce up to 8 lbs over a month. Again, a strict diet and exercise routine can help you maximize the results.

You dont need to keep consuming the pills after youve got to your weight reduction goals. Anyway, you can resume consuming them if you feel that youve started accumulating fat again.

You must have realistic weight loss goals to get the most out of the product. You cant aim to get lean within a week or two as you start taking the product. Instead, it would help if you were patient and consistent with the process.

A healthy diet can help you achieve realistic weight loss goals within the mentioned time frame.

If you want your weight loss goals to be successful with the PhenQ supplement, youre supposed to take two capsules daily. You can start consuming more pills if your doctor recommends you to do so. Most importantly, it would help if you took every dose of PhenQ before your lunch.

As PhenQ pills contain high doses of caffeine, they can mess up your sleep pattern if you take them after lunch. We strongly recommend you seek the consultation of your physician to find out the proper dosage for yourself to lose weight.

As one of the leading weight reduction supplements, PhenQ comes with almost zero side effects. The supplement is certified by the Food and Drug Administration. However, users arent expected to overdose on the pills as that may lead to minor symptoms like- stomach discomfort, nausea, fatigue, etc.

However, the mild side effects of the product can be overruled as you stop consuming the pills. Once you do so, the symptoms will disappear themselves. Anyway, users prone to developing allergies due to certain ingredients should refrain from consuming the tablets.

According to the manufacturers, the pills are manufactured for adult users, and patients with existing diseases should not consume them. Also, the tablets arent meant to help pregnant women reduce weight. Though the PhenQ tablets dont interact with birth control pills, pregnant women should strictly avoid these pills to avoid any unwanted circumstances.

Every bottle of PhenQ consists of 60 capsules, and each bottle is considered a one-month supply. The prices of PhenQ packages are as follows:

Every bottle of PhenQ comes with a 60-day money-back guarantee, and that makes the product a safe option to purchase. The tenure 60-day money-back guarantee starts from the day of the delivery of the product.

The 60-day money-back guarantee means that you can return the product within 60 days after purchase if youre not satisfied with the products performance. By doing so, youll get your money refunded, excluding shipping and delivery charges. Most importantly, the manufacturer will hold no authority to ask you why youre returning the product.

To get your money refunded, you need to get in touch with the customer support team of PhenQ. If you purchase three bottles at once, you need to return two opened bottles within the first 30 days and the unused one within the remaining tenure to get your money refunded.

Once you get in touch with the support team to claim a refund, you can expect a response within the next two days. Customer service is available for further information via:

ALSO READ:Exipure Reviews: Does It Really Work? What They Wont Show You!

A: Though PhenQ is marketed as a product that supports natural weight reduction without a healthy diet, users are advised to follow effective weight-reducing diet plans customized by their doctors or trainers to get the best benefits.

A: No specific restrictions have been mentioned by the manufacturers regarding this. Contradictorily, PhenQ contains nopal cactus fiber and chromium picolinate that are practical elements to manage healthy blood sugar levels. So, it can be stated that diabetic patients can improve their conditions by consuming the PhenQ pills.

A: The manufacturers say that a standard serving of PhenQ consists of 2 pills. It would help if you attempted to take one tablet with breakfast and another with lunch to witness beautiful benefits as a user.

A: PhenQ was launched and marketed by Wolfson Brands, one of the leading pharmacological manufacturers in Europe. Apart from PhenQ, the brand came up with several health supplements to promote users overall well-being.

Unlike most renowned supplements, every package of PhenQ comes with ten Buyers Guides to educate users about weight reduction programs and effective calorie-burning techniques. The Buyers Guides are downloadable, and they contain all the information related to your diet, meals, workout plans, and other aspects of your weight reduction journey.

If you purchase three bottles of PhenQ altogether, you get a bottle of Adavana Cleanse with the package for free. This is a detoxifying supplement that helps you eliminate the excess wastes of your body while boosting your metabolism and keeping your gastrointestinal health sound. If you include the Adavana Cleanse in your daily routine with PhenQ, weight reduction will be a matter of time.

Like every other supplement, duplicate and fake packages of PhenQ are sold in the online and offline markets. The fake PhenQ bottles dont deliver expected weight reduction results, and they tend to trigger harmful side effects.

The manufacturers of PhenQ instruct their users to purchase their PhenQ packages from the official website only. Even eCommerce stores like Amazon, Walmart arent trustworthy in buying supplements like PhenQ. Moreover, they forbid you to buy from the local stores either.

To avoid the ongoing PhenQ scams, you must purchase your bottles from the official website and scan the authentication barcode of the product.

As youve gone through the entire review, you must have understood why PhenQ is counted among the leading fat-reducing supplements across the world.

The supplement can deliver unbelievable transformational success if taken correctly. Also, the product becomes a safe purchase as it is covered with a dedicated and assured money-back guarantee.

The PhenQ reviews on the companys official site will show how much the users loved the product. PhenQ takes your weight reduction journey a step ahead of what you can imagine. So, if youre in doubt about purchasing the product, we suggest you take the risk and buy the product once.

None of the information and advice provided above is an alternative to professional medical advice. Get in touch with a certified medical consultation provider before consuming the pill.

RELATED:Top Fat Burner Supplements That Work for Best Weight Loss Results

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The links contained in this product review may result in a small commission if you opt to purchase the product recommended at no additional cost to you. This goes towards supporting our research and editorial team and please know we only recommend high quality products.

Disclaimer:

Please understand that any advice or guidelines revealed here are not even remotely a substitute for sound medical advice from a licensed healthcare provider. Make sure to consult with a professional physician before making any purchasing decision if you use medications or have concerns following the review details shared above. Individual results may vary as the statements made regarding these products have not been evaluated by the Food and Drug Administration. The efficacy of these products has not been confirmed by FDA-approved research. These products are not intended to diagnose, treat, cure or prevent any disease.

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Overview Kenai Farms CBD Gummies Reviews & Cost

Kenai Farms CBD Gummies Reviews: In these times, when the world is changing so rapidly and everything is moving so fast, it would be quite miraculous to dodge any kind of stress and lead a healthy and happy life. With increasing age, the stress increases and so does the joint pains and chronic aches. These issues create a big hindrance in our daily lives.

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Now, one of the most effective supplements to deal with these issues are considered to be CBD based food supplements. The CBD supplements are popular and very helpful in dealing with stress, anxiety and relieving pain. There are several such products available in the market these days as well.

But the question arises that are these supplements really safe? There is no denying in the fact that the food which has CBD supplements connect to marijuana and may cause psychoactive effects such as a sensation of being high.

Therefore, it is difficult and essential to find a product that is safe and effective.

Kenai Farms CBD Gummies are a candidate in that field. Let us have a look at this product in a bit more detail.

Kenai Farms CBD Gummies is an organic food supplement. This dietary supplement contains full-spectrum CBD. All the ingredients are 100% natural to ensure quality and safety. CBD Gummies are using by the people all over the world these days to relieve stress and anxiety and deal with chronic and joint pains. This food supplement has FDA certificate that clears that it ensures safety. Even though it is a product containing CBD, it does not contain marijuana or large amounts of THC. Therefore, it is non-addicting and does not have any effects of high sensation.

CBD Gummies are manufactured in the United States of America at an FDA approved facility, following all the good manufacturing practices. It is a non-GMO product and is free from any kind of artificial fillers. Kenai Farms CBD Gummies is a safe to use product, without any intoxicating or addicting property.

Kenai Farms CBD Gummies have all the natural ingredients that have stress relieving properties. The key ingredients of this full spectrum CBD food supplement are melatonin and, of course, CBD. Let us have a look at the role of these two contents in a bit detail:

CBD: Cannabinoid, without any doubt, is the most well-known and the most widely used ingredient in supplements to relieve stress and anxiety as well as chronic aches. CBD is a extract that comes from the hemp plant and relieves stress by releasing into the ECS (Endocannabinoid System).

The ECS is the central system in the body that is responsible for the smooth inner functioning as well as for regulating mood and providing pain relief.

The ECS receptors CB1 (found in the central nervous system) and CB2 (present in certain peripheral tissues) receive the signals from the ECS and transmits them, resulting in the corresponding response and relief or functioning.

The CBD added in Kenai Farms CBD Gummies is based on hemp extract and does not create any harmful psychoactive effect. Moreover, it also enhances good sleep and improves metabolism.

Melatonin: Melatonin helps in getting proper sleep. In fact, it is used in several medicines to deal with insomnia. In addition to this, it also helps in improving the immune system, manages blood pressure and cortisol levels. It can also act as an antioxidant.

Moreover, melatonin has been proven quite effective in dealing with seasonal depression. Melatonin is also known to have an effect in increasing the levels of HGH (Human Growth Hormone). It also improves eye health and may help treat GERD (Gastroesophageal Reflux Disease). Hence melatonin is the Midas of ingredients when it comes to developing a healthy food supplement.

Kenai Farms CBD Gummies are natural and safe. People often worry that the CBD based supplements often lead to intoxication. But that is not the case with CBD Gummies. That is because it contains only trace amount of THC, only about 0.03%, which is quite negligible and hence ineffective in causing any psychoactive effects or a high sensation.

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Kenai Farms CBD Gummies have not one but multiple health benefits. some of the health benefits are as follows:

As we know, Fun Drops CBD Gummies have all the natural ingredients only, there are no harmful side effects of this product. This dietary supplement is using by people all over the globe and there have not been even a single case of any serious health issue or side effect of using this supplement.

In fact, this product is clinically tested and approved to ensure safety. Moreover, all the ingredients are grown and harvested in the United States of America. This ensures quality of the product. Also, it is a vegan product and easy to take by everyone.

The biggest fear that people generally have in their mind while consuming a CBD based product is that it might lead to some psychoactive effects. But Kenai Farms CBD Gummies do not cause any such effect or any high sensation. That is because it contains only trace amount of THC, less than 0.03%.

Therefore, this product is safe to use.

It is always better to follow certain safety precautions while consuming any medication or food supplements to ensure safety. These are some of the safety measures you must keep in mind while consuming the Kenai Farms CBD Gummies:

Usually 1-2 gummies are advisable, as per the pack of Kenai Farms CBD Gummies. You can take one gummy in the morning and one gummy in the evening, preferably with a glass of milk. You can also consult a physician before consuming these gummies and then follow the dosage instructions prescribed by them.

Kenai Farms CBD Gummies are easily available on the official website. When you visit their website, you will find multiple offers and packages on this product, depending on the quantity of Pure Potent bottles you buy. You can select the package as per your choice and requirement. After that, you will be presented with several payment options.

Choose the most feasible payment option and make payment. Provide your shipping address and place the order. Order your product and your CBD Gummies Australia bottle will come at your doorstep within 7-10 business days.

CBD Gummies also provide easy return policies to ensure best customer service. So, if you want to return the product, you can raise a request within 1 month of buying the product, no questions asked. The money will be refunded within 15 days. Therefore, this product guarantees 100% results.

These days when most CBD products cause serious effects on your mental health, or makes you dizzy or tired, it is very rare to find a product that helps you deal with your stress and anxiety without causing any other ill effect on your health. Kenai Farms CBD Gummies is one of those rare products that improve your mental as well as overall health in a natural manner, without causing any side effect or a sensation of being high. This product is safe to use and is proving its worth worldwide by giving the most positive outcomes.

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Black men with prostate cancer may respond better to radiation therapy than White men, according to a new study. Photo by Joshua Woroniecki/Pixabay

Dec. 29 (UPI) -- Black men with prostate cancer appear to respond better than White men to radiation therapy for the disease, an analysis published Wednesday by JAMA Network Open found.

Based on data from seven clinical trials, Black men with the disease who are treated with radiation therapy were 12% less likely to experience cancer recurrence and 28% less likely to their tumors metastasize, or spread, to distant organs compared with White men, the data showed.

In addition, Black men who received radiation therapy were 28% less likely to die from prostate cancer than White men given the treatment.

This is despite the fact the Black men seemed to have more aggressive disease when they enrolled in clinical trials of radiation, according to the researchers.

"These results provide high-level evidence challenging the common belief that Black men who are diagnosed with prostate cancer will necessarily have a worse prognosis than White men," analysis co-author Dr. Amar Kishan said in a press release.

"This is especially important because an unfounded belief can inadvertently contribute to 'cancer injustice,' leading to the use of more aggressive treatments than might be necessary," said Kishan, chief of the Genitourinary Oncology Service at the David Geffen School of Medicine at UCLA.

These aggressive treatments can, in turn, potentially lower quality of life, he said.

About one in eight men in the United States will be diagnosed with prostate cancer, or a tumor in the gland of the same name, and there are nearly 250,000 new cases of the disease annually, with Black men considered to be at increased risk, the American Cancer Society estimates.

Less than 3% of those diagnosed with the disease will die from it, but the risk for death is twice as high among Black men than for those in other racial and ethnic groups, according to the society.

Radiation therapy, which uses high-energy rays or particles to kill cancer cells, is often the first treatment used in men with prostate cancer, as it preserves function in the gland, which plays a key role in urinary and sexual health, it says.

For this analysis, Kishan and his colleagues looked at individual patient data from seven clinical trials of radiation therapy that collectively enrolled 8,814 participants.

All patients in the trials received either standard or high-dose radiation therapy, and some patients also underwent short- or long-term androgen deprivation therapy, a hormone-based treatment for the disease, the researchers said.

Of all participants in the seven trials, 1,630 men self-identified as Black and 7,184 as White.

Most of the Black men in the studies were in their late 60s, as opposed to early 70s for the White participants, and most had been diagnosed with high-risk disease, meaning it was likely to spread.

Still, Black men in the trials had lower rates of disease recurrence, tumor metastasis and death compared with White men, the data showed.

When adjustments were made for age and other factors, Black men still had better outcomes following treatment than White men, the researchers said.

"This information will help us identify potential drivers and mitigators of disparities in prostate cancer care," co-author Dr. Ting Martin Ma said in a press release.

However, because Black men tend to be less willing to entertain the idea of participating in clinical trials, due to "medical mistrust," the equity in access to care and receipt of treatment may not be representative of what normally occurs, added Ma, resident physician at UCLA.

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Study: Black men given radiation for prostate cancer do better than White men - UPI News

On December 16, the U.S. Food & Drug Administration (FDA) decided to permanently allow doctors to administer medical abortions by telemedicine and through the mail. The prior rule (from before the pandemic) required a doctor to see a patient in person while giving her the two medications that terminate a pregnancy of up to 10 weeks gestation. The first medicine, mifepristone, blocks progesterone, the pregnancy hormone (literally pro-gestation) that directs the uterus to thicken and become hospitable to a growing embryo and fetus. The second medicine, misoprostol, induces uterine contractions that expel the excess uterine lining and the products of conception.

Medication abortions are safe and effective, so it is unclear why a doctor ever had to hand the medicine to the patient in person, especially when the patient goes on to take the drugs somewhere else. Doctors prescribe other medicines for their patients without having to interact with them in person or hand them pills directly. Even controlled substances like Fentanyl do not require this special procedure. Only politics could explain the old rule.

The pandemic presented another reason not to demand that doctor and patient see each other in person during the transfer of pills. Attempts to limit the spread of COVID-19 seemed inconsistent with enforcing a rule that lacks a plausible rationale and has the downside of exposing many more people to the virus. Indeed, medication abortion may be the primary method of abortion during the first eleven weeks of pregnancy. And the overwhelming majority of abortions happen during the first trimester (thirteen weeks). With almost 900,000 abortions a year in the United States, a rule requiring face-to-face pill handoffs amounts to a lot of unnecessary face-to-face meetings, particularly during a pandemic.

In response to COVID-19 and for its duration (whatever that might have meant), a federal judge suspended enforcement of the in-person medication abortion rule. Under the suspension, a doctor could meet the patient virtually (e.g., over Zoom) and then send her the medicine by mail. In anticipation or in response, nineteen states have already banned telemedicine visits for abortion medication, and others have put limits on the practice, presumably in the expectation that the Supreme Court will overrule Roe v. Wade this term.

Even in states that prohibit telemedicine abortion or limit it to some number of weeks short of ten, women still have more options than they did before. Traveling to another state to terminate a pregnancy is burdensome, to be sure. But driving to another state to talk with a doctor in that state on ones laptop through telemedicine, after which the doctor mails the woman two pills, exposes her to far less harassment and intimidation by advocates of forced pregnancy and birth than visiting an actual clinic to have the procedure. Patients can take the two pills at home or anywhere they feel comfortable and enjoy the privacy that both legislators and protesters have routinely denied them. Telemedicine abortionseven out of statewill also generally cost less than the surgical variety.

Abortion may soon become completely illegal in many states and perhaps in the whole country, if Republicans take over both houses of Congress and the presidency. Nonetheless, the illegal termination landscape too will look different with the availability of medical abortion. Asking a friend or an unlicensed practitioner to scrape products of conception out of the womb is far more likely to end in infection and death (of the woman) than is ordering some pills over the internet. The drugs may occasionally not be entirely pure, of course, but the image of the coat hanger can recede a little in the wake of medical abortion, at least for early terminations. And as the proportion of medication abortion rises in response to legal developments, first trimester terminations might now involve a choice between a nonexpert in a back alley and a couple of pills purchased from another country over the internet. For the government to keep track of who orders such pills would require something close to a police state, which even the most zealous anti-abortion advocates might prefer to avoid.

So medical abortions are likely to make terminating a pregnancy more accessible and affordable and less dangerous even when illegal, a welcome development in light of the Courts no-longer-hidden plans for Dobbs v. Mississippi, the abortion case it heard earlier this month. There is something especially satisfying for opponents of forced pregnancy and birth about a technology that takes some of the power to successfully regulate abortion away from states just as the Court is poised to give them that very power.

Beyond bringing good news for people who support the right against forced pregnancy and birth, medical abortions also offer an ethical argument to consider for those who generally condemn abortion. When I have discussed the issue with people on the other side, I generally explain (the rather obvious fact) that pregnancy is an active state in which the body works hard, and the placenta siphons nutrients away from the mother to meet the needs of her fetus, thus burdening the woman. The other side insists, by contrast, of speaking as though all it is asking from the pregnant woman is that she refrain from committing an act of violence. Just as you may not stab your neighbor or co-worker to death (even if you would very much like to do so), the pregnant woman may not kill the embryo or fetus. In reality, being pregnant is an affirmative burden of hard and hazardous work, not a passive refraining from attack.

Still, if I must answer the question of whether terminating a pregnancy involves direct violence to the embryo or fetus or whether it just involves ending a pregnancy, the question is hard to answer. Most abortion methods involve killing the embryo or fetus and then removing it from the womans body. Later in pregnancy, the abortion methods that bother many people involve suctioning the brain and then taking apart the fetuss body and removing each of the parts. The reason for the latter procedure is that later in pregnancy, the fetuss head is already large, and it seems pointless to force the woman to endure hard labor when the fetus cannot even survive outside the womb. Disassembling the fetuss body makes removal less injurious to the patient.

Nonetheless, if one believes that killing an embryo or fetus directly is wrong, then all of these surgical methods of abortion are wrong. Medication abortion is different. Taking the first pill simply blocks progesterone and thus stops the building of the uterine lining, and the second removes the products of conception (the embryo, blood) from the body by causing contractions. Neither pill poisons the embryo or otherwise kills it. The death of the embryo is an incidental effecta collateral casualtyof removing it from the womans body. The woman is therefore deciding not to have the embryo in her body, and it is the embryos pre-viability status that results in its death.

So long as it is legitimate for the woman not to want to invest the enormous and intimate bodily effort involved in turning an embryo into a baby inside her body, there is an argument that she is at least as justified in removing it as she would be in removing a catheter that connected her to someone (a full person) who was using her body as a respirator or a dialysis machine. (And yes, I am aware of similarities to Judith Jarvis Thompsons violinist.) The death results from the other entitys or persons need, not from the direct action of the pregnant woman or the human respirator/dialysis machine in disconnecting the embryo or person. The Supreme Court has insisted, in keeping with this distinction, that even though an individual has a presumed right to remove life support if she no longer wants it, she does not enjoy a right to physician assistance in dying.

Those familiar with Catholic theology will recognize that I am making what sounds a little like a Doctrine of Double Effect (DDE) argument. I am putting the finishing touches on a scholarly article about my own version of DDE. Most people understand this doctrine to hold that if a person intends something bad, then the action he takes with that intent is wrong, but if he intends something legitimate and sufficiently good to justify the bad effect, then the action he takes with the good intent is fine or even good. A familiar example is that if you want to help your patient dieand assisting a suicide is, by hypothesis, wrongthen giving the patient a morphine overdose to that end is wrong. If, on the other hand, you want to alleviate your patients excruciating painand alleviating terrible pain with the high morphine dose is necessary and legitimate and proportionate to the harm of death caused by the overdosethen giving your patient that same overdose is a fine thing to do.

Many have criticized the DDE, as described above, for distinguishing between identical actions based on intention and defining one as legitimate and the other as bad. I propose in my article (and here, briefly) that the more sensible application of DDE is that we do not literally ask what is in the persons mind as a matter of intent. If a doctor gives a patient enough morphine to alleviate terminal pain, and that amount of morphine brings about death, then even someone opposed to assisted suicide should be comfortable with what the doctor did and need not inquire into her true motives. But if the doctor kills the patient in a way that could not possibly alleviate pain, like injecting a poison, then there is no DDE defense because the only way the injection could address the patients pain is by killing the patient and therefore his pain forever. That is direct killing as a means of ending pain, and that is illegitimate, by hypothesis.

I support the right to physician assistance in dying as well as the right to direct abortion (i.e., even the type that involves killing the embryo or fetus). However, I understand the difference between directly doing something objectionable and having something objectionable happen as a result of doing something legitimate. For instance, if a military bombs a munitions plant knowing that three civilians will die (and that there is no way to spare the civilians without aborting the mission), then that mission might be legitimate. It pursues an acceptable objective, and the harm is not disproportionate relative to the benefit. By contrast, if a military just dropped a bomb on three civilians, that action would not be legitimate at all. It is clearly not a side effect of some legitimate action because there is no such legitimate action. We can tell when we are dealing with a DDE situation because we can plausibly explain the action as aimed at a permissible objective (regardless of what the actual intentions of the actors might be). Likewise, when we cannot explain the actions by resort to a legitimate and proportionate objective, then the action is impermissible.

Returning to abortion, for people who believe that killing an embryo or a fetus directly is wrong, the medication abortion offers a potential loophole. A person can be anti-abortion because affirmatively killing the embryo or fetus strikes the person as wrong. But in medication abortion all we are doing is removing the embryo or fetus from inside the woman because the woman does not want to be a respirator, a dialysis machine, and a source of calcium and other nutrients all rolled up into one. Neither medication kills the embryo. Each simply moves it from inside the woman who does not want it there to outside of her body. She does not wish to aid the embryo. Because the embryo is not viable, death is a collateral consequence of removal.

Now it is quite possible and even likely that the person getting a medication abortion intends for the embryo to die. Its death is part of why she is having an abortion. Under my approach to DDE, however, we do not care what her true intention is. We simply ask whether her actions could be understood as aimed at a legitimate purpose whose benefits are sufficient to justify the harmful impact (here, the death of the embryo). One could have a medication abortion because one refuses the extremely invasive, burdensome, and risky experience of pregnancy and birth. One could do so without specifically wanting the embryo to die. The situation is accordingly a double effect circumstance. Death is a side effect of removal.

Some might say that gestation is not sufficiently burdensome to justify removing the embryo and the pregnancy at the cost of the embryos dying. Such people may be ignorant of what it feels like to be a person who does not want to have her body taken over in the way that gestation takes over a womans body but who must be a respirator, etc. because someone or something is forcing her to. I know of people who consider themselves pro-life who have acknowledged privately that if all the woman does is to induce labor (which is effectively all that a medication abortion does), then it seems that she is choosing not to kill the embryo or fetus but simply not to keep it inside her body. We all presumably have the right to consent or not consent to being physically occupied by a foreign body, even the body of our own embryo.

Medication abortion thus opens some new windows on a very old problem. Terminating a pregnancyfinallycan truly be private so that unwanted third parties have no access to the pregnant woman. It can be less expensive than surgical abortions so that poorer women can afford it. And finally, it can be morally defensible even for those whose religious beliefs tell them that embryos are people but distinguish between killing someone and refusing aid in the form of serving as a 40-week life support machine. If you believe you have the right not to donate blood or a kidney or even your dead body once your life ends, then it seems that medical abortions ought to calm your objections to women who choose not to grow a baby from raw materials inside their wombs.

Link:
How Medical Abortion Challenges the Practice and the Moral Condemnation of Ending a Pregnancy - Justia Verdict

DURHAM, N.C., Dec. 20, 2021 /PRNewswire/ -- REVIAN Inc., an aesthetic medical technology company dedicated to stimulating the body's natural processes to rejuvenate hair and skin with light, today announced the REVIAN RED System was named as the best treatment cap for androgenetic alopecia in a storypublished by New York Magazine. Tagged as "Recommended by Experts" the authors spoke with numerous doctors and dermatologists about the most effective products to treat hair loss, from topical and oral pharmaceuticals to more "natural" methods like scalp serums and light treatments.

The doctors and dermatologists interviewed for this story all agreed that hair loss can be slowed, stopped, or even reversed if the underlying problems are addressed. The REVIAN RED System uses patented dual colors of LED light in the 620 and 660 nm wavelength ranges, to stimulate the body's generation of nitric oxide and unlock the body's natural ability to accelerate healing and renew the cells that grow hair. Nitric oxide targets the three main pathogenic factors known to be associated with androgenetic alopecia: reduced local blood flow, inflammation, and elevated levels of DHT (dihydrotestosterone - a hormone responsible for shrinking hair follicles, which ultimately leads to hair loss and eventually baldness).

"The cap delivers precisely engineered red light to the scalp, which enhances circulation to the hair follicles. Improved delivery of oxygen and nutrients helps optimize activity of hair follicle. I use it to amplify the efficacy of other hair growth products," said Dr. Joshua Zeichner M.D., Director of Cosmetic and Clinical Research in Dermatology and Associate Professor of Dermatology at Mount Sinai Hospital.

The REVIAN RED System consists of a lightweight rechargeable cordless cap controlled by a user-friendly mobile app designed to control treatments, provide treatment feedback, and keep users on track. Understanding that ease-of-use and lifestyle fit are of paramount importance, this integrated system allows for complete freedom of movement and use almost anywhere during the 10-minute daily hair growth treatments.

"The biggest issue with any treatment is patients' compliance," added Dr. Zeichner. "Making it easy to fit into their personal daily routines can make all the difference."

"We believe the first place to seek help for hair loss is a qualified doctor or dermatologist. They can diagnose the problem and make sure it is not a symptom of a more serious disorder," said Tim Waite, VP of Sales, Revian, Inc. "If you are one of an estimated 50million menand 30 million women suffering with pattern baldness in the in the United States, you should talk to your physician about the REVIAN RED System and learn more at http://www.revian.com."

About REVIAN RED

The REVIAN RED System is an FDA cleared, wireless wearable cap controlled by a mobile "smart" app that functions to provide a hair loss treatment for men and women using LED light. The patented dual-band, LED technology provides broader scalp coverage and better skin penetration than red lasers used in low level laser therapy (LLLT). Dual wavelengths of LED light facilitate and accelerate scalp healing, allowing the body to renew cells associated with hair growth and retention.

Indications for use: The REVIAN RED System is indicated to treat androgenetic alopecia and to promote hair growth in males who have Norwood-Hamilton classifications of IIaV patterns of hair loss and to treat androgenetic alopecia and promote hair growth in females who have Ludwig-Savin Scale I-1 to I-4, II-1, II-2 or frontal patterns of hair loss; both with Fitzpatrick Skin Types IIV.

About REVIAN

REVIAN is an aesthetic medical technology innovator dedicated to stimulating the body's natural processes to rejuvenate hair and skin with light. We create products that precisely deliver light and allow people to experience its regenerative potential in the convenience of their own home. We are committed to partnering with health-care providers and other caring professionals to deliver meaningful results, backed by scientific data. For more information, visit http://www.revian.com

REVIAN Inc., headquartered in Durham, is an operating subsidiary of KNOW Bio, LLC.

Media Contact:Al SafarikasKNOW BIO, LLC [emailprotected] (919) 887-4350

Investor Contact: John OakleyKNOW BIO, LLC[emailprotected] (919) 939-7715

SOURCE REVIAN, Inc.

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REVIAN RED System, Among the Best Hair-Loss Treatments According to Doctors - PRNewswire