Who Should Be Tested For BRCA?

WhileBRCA1 and BRCA2 gene mutationsmay increase your odds of developing breast cancer, your odds of having either mutation are pretty small. An estimated 0.25% of the general population carries a mutated BRCA gene, or about one out of every 400 people.

For some people, though, the chances of having a BRCA gene mutation are much higher. Genes are inherited, which is why knowing your family history is important when determiningbreast cancer risks. If one of your parents has a BRCA mutation, you have a 50% chance of inheriting the mutated gene.

Odds can also vary depending on a persons ethnicity. For example, people of Ashkenazi Jewish descent have a 2.5% chance of inheriting a BRCA mutation, or about 10 times the rate of the general population.

Because the overall odds are so low, most experts recommend that only people with a heightened risk get tested for BRCA mutations. Likewise, insurance companies often only cover genetic counseling and testing for individuals who are at high risk. A person could be considered at high risk for BRCA mutations if they have a family history of:

There are alsoother gene mutations besides BRCA that could increase the risk of breast cancer. The most prominent of these is PALB2. As with BRCA1 and BRCA2, testing for other genetic mutations is recommended only if you are at high risk for that particular gene.

Genetic counseling is recommended for those who are interested in being tested for breast cancer gene mutations.You can talk to a doctor about getting a referral to a genetic counselor, who can help determine whether genetic testing would make sense based on family history and risk factors.Since many genetic tests only look for one specific gene mutation, the counselor can often help determine which mutations to test for.

The genetic test itself simply involves taking a small sample of blood or saliva, which is sent to a lab for analysis. Results can take several weeks or months.

Genetic testing results are not always clear-cut:

After receiving genetic test results, a patient should meet again with a genetic counselor to clarify what the results mean. Whether the results are positive, negative, or ambiguous can impact many life decisions, and a counselor can help navigate those decisions.

Genetic testing can be scary. The results also can impact other family members such as siblings and offspring; when someone tests positive for a gene mutation, their siblings and offspring will have a 50% risk of also testing positive. Having a discussion with a genetics counselor first is encouraged so a discussion about the potential scenarios can take place.

For a woman who tests positive for BRCA1 or BRCA2 gene mutation, bilateral mastectomies are usually recommended particularly if she has just been diagnosed with breast cancer.

Originally posted here:
Genetic Testing for Breast Cancer - National Breast Cancer ...

Recommendation and review posted by Bethany Smith

Turn up your hearing aid, will ya?

http://www.Shutterstock.com. Gene therapy, hearing loss.

As lewd and crude and rude as it sounds, it is the general response for the person on the street, even if muttered underneath his or her breath, when dealing with someonefriend, family, co-worker, etc.who suffers from mild to moderate hearing loss.

Aside from some surgical procedures that are not as commonly known, hearing deviceswhile being constantly upgraded in the digital agehave been the traditional source of help.

But there is one other ray of hope burgeoning on the horizon: Gene therapy.

From the Ivy League to the University of Miami to the University of Michigan to Oregon State to Tel Aviv, experts are on the verge of cracking the case.

Although not yet available, inner ear gene therapy for monogenic hearing loss is an emerging technology, explained Jeffrey R. Holt, PhD, a professor of Otolaryngology & Neurology at Harvard Medical School and of Boston Childrens -Hospital. There is growing interest from scientists, funding agencies, industry and patients, all spurred on by recent proof-of-concept studies showing recovery of auditory function in animal models of human hearing loss.

Holt added that genetic treatments for hearing loss sit on the horizon and the significance of this new therapeutic strategy for patients and families is high.

Nonetheless, he cautioned that the most common forms of genetic hearing loss, the result of mutations in GJB2, may be difficult to treat using gene therapy. Other rare forms of genetic hearing loss, due to mutations in OTOF, TMC1, or Usher syndrome, may be those first in line, but others will like follow.

Fan-Gang Zeng, PhD, the director of the Center of Hearing Research at the University of California-Irvine School of Medicine, explained that gene therapy addresses hearing loss biologically by repairing or restoring damaged cells, which hearing aids or cochlear implants do not accomplish.

Gene therapy is the future, but we dont know when the future will come, he said. While gene therapy is still in infancy, genetic screening of hearing loss is relatively matured. Concurrent screening with traditional audiological measures (OAE and ABR) and genetic testing can improve both the accuracy and prognosis of hearing loss while helping patients and doctors predict its course of development and management on an individual basis.

Yehoash Raphael, PhD, is a professor of Otolaryngology at the University of Michigans Kresge Research Institute. He has been recognized around the globe for his research, the interests of which include inner ear biology, protection and regeneration, gene therapy, genetic deafness, CHARGE Syndrome and stem cell therapy.

Raphael believes gene therapy should be advanced for several clinical conditions, both environmental and genetic.

At the cellular level, the goals would be related to repair and regeneration of cells that are injured or lost, he said. At present, amplification or cochlear implants provide an acceptable solution for many patients.

He cautioned, however, the biological therapy that restores function may work better, but is not currently available.

Ideally, we would like gene therapy to improve so it can be used for treating genetic deafness and sensorineural hearing loss caused by hair cell loss due to overstimulation, aminoglycosides, or infections, he said. As such, gene therapy presents an exciting prospect for future hearing restoration therapies.

At Michigan, Raphael and his colleagues are using combinatorial gene transfer methods to enhance the efficiency of new hair cells and are planning to enhance this approach and include other genes.

We are working on two mouse models for genetic inner ear disease, trying to better understand the biology of the mutation and also to design therapies, he said, adding that the research on therapies has met with mixed results.

Holts lab has focused on development of gene therapy for patients with mutations in TMC1 and for Usher syndrome patients.

We have remarkable data showing full recovery auditory function in some cases, he said. We are working with industry partners to bring these therapies into the clinic.

Meanwhile, in the private sector, companies such as Decibel Therapeutics are also seeking solutions.

According to Laurence Reid, PhD, it is simply a case of seeing the need and seeking to answer it.

The impact of significant hearing loss and balance disorders on individuals is profound and disrupts their connectivity with their human and physical environment, said Reid, the CEO of Decibel. We believe the inner ear represents an exciting new frontier for gene therapy, which will result in a pipeline of transformative medicines.

Reid added that the inner ear is an organ that is exquisitely suited to gene therapy. As such, the therapy can be delivered directly to the relevant cells, which are non-dividing and offer a durable potential for gene therapy. Lastly, the ear has a degree of immune privilege, which will moderate immune response against the therapy.

Said Reid, We are developing technologies that enable precision gene therapy, which will enable us to control the expression of the transgene in the gene therapy and limit the resulting pharmacology to precise cell types in which we intend to elicit a biological response.

Programs are in development to address both hearing loss and balance disorders and our therapies will comprise treatments for genetic forms of hearing loss, together with regenerative medicines, to treat acquired forms of hearing and balance disorders.

Looking ahead at the future of gene therapy as related to hearing loss, Raphael explained that the current technology for gene transfer for inner ear therapy needs to be improved in several cardinal and critical aspects to become a clinical reality.

He added that some of the parameters that need to be optimized include high cell-specificity, control of duration and extent of gene expression (how long and how much), acceptable route for delivering the vectors into the target site, and lack of toxicity and other side effects.

All these parameters are being addressed but still far from being accomplished, he said. Lack of accurate and reliable diagnostic tools, especially related to hair cell loss, also complicate the implementation of gene transfer technology.

Better technology would include upgraded batteries of tests that can predict the condition of the auditory epithelium, auditory nerve and other structures that are needed for biological hearing.

The promise of hearing restoration would become more realistic with these parameters resolved, he said.

Holt also cautioned against expected results tomorrow or the next day.

While hopes are high that this may soon be a therapeutic option for some patients with genetic hearing loss, it is important to keep in mind that a careful and systematic approach will be required to fully understand both the safety and efficacy of this treatment modality, he said. There are at least 100 forms of genetic hearing loss and each will need to be evaluated before use in patients can commence.

Reid further explained the importance of expanding access to genetic testing so families can understand the roots of their childs congenital hearing loss and seek out relevant clinical trials and ultimately tailored therapies.

Noting that accurate diagnosis of infant hearing loss is crucial to developing new treatments and providing clinical care, Reid added that Decibel hasin collaboration with Invitaelaunched Amplify, a sponsored testing program in the U.S. and Australia.

This program provides genetic testing at no charge for children with auditory neuropathy and aims to drive awareness of genetic testing and gain physician interest, as well as support enrollment into future clinical trials, he said.

What does all this mean for audiology professionals?

Holt predicts that audiologists will be an important part of the hearing health care team as this new wave of therapeutic options enters clinical trials, eventually wins approval, and becomes more broadly available.

He added that evaluation of auditory function before and after gene therapy treatments will be critical for understanding the efficacy, durability, and therapeutic window for hearing preservation and restoration.

In preparation for the coming wave, audiologists can understand basic genetics, familiarize themselves with the various genes associated with genetic hearing loss, and be prepared to field patient questions, he said. I suspect that as soon as the first inner ear gene therapies enter clinical trials, there will be an explosion of patient interest and inquiries. However, inner ear gene therapies will not be a magic bullet cure-all. Rather, a precision medicine approach will be required, as these therapies will need to be tailored to each patients specific genetic diagnosis.

Zeng had a similar view and explained that future audiologists will need to learn and understand the genetic component of hearing loss, which contributes half or more to the prevalence of hearing loss.

Dont expect gene therapy to be a silver bullet that can solve all the problems, said Zeng. There are a lot of things that gene therapy cannot solve (i.e., hearing loss related to mental issues).

Raphael made the distinction between audiologists doing research and clinicians, advising those in research to consider joining the research efforts to design diagnostic means that will determine presence/absence of hair cells and/or neurons, and if hair cells are absent, where in the cochlea this condition exists and what state the supporting cells are in.

He added: Are they differentiated or flat? The condition of supporting cells is an important factor in planning the set of genes that will be used to generate new hair cells.

Raphael explained that audiologists in the clinics need to be aware that there are currently no therapies based on gene transfer being offered. In some cases of genetic hearing loss, when the diagnosis is clear and the gene involved is not a very large gene, there is a chance that gene therapy could be offered in the relatively near future.

He added that this is especially true for mutations that affect hair cell, and where the hair cells survive but do not function properly.

I have a feeling that many of the patients asking about gene therapy options are those experiencing age-related hearing loss, which most of us are likely to develop at different speeds of progression, he said. Because many of these cases have long-term loss of hair cells and likely at least some neuronal regression or degeneration, the application of gene therapy would be very complex and challenging.

Reid added that, over the next several years, Decibel hopes that a range of pharmaceutical interventions will become available to people with hearing loss and their caregivers.

Audiologists will thus have therapeutic options in addition to the existing devices, which assist hearing improvement, he said. Diagnosis of particular forms of hearing loss will expand to include broader consideration of genetic mutations responsible for hearing loss.

Thoughts on something you read here? Write to us at [emailprotected]

View original post here:
Gene Therapy for Hearing Loss on the Horizon : The Hearing Journal - LWW Journals

Recommendation and review posted by Bethany Smith

NEW YORK, Dec. 30, 2021 /PRNewswire/ -- Jscreen.org, a national nonprofit that provides accessible and affordable genetic testing, education, and personalized support to help people and their families take control of their health, announces the 'Give A Spit" campaign that debuts with a New York Times Billboard on December 31, 2021. The campaign breaks with the New York Times Billboard and will continue with a robust social media campaign.The campaign also runs on http://www.jscreen.organd JScreen social media channels. The JScreen.org mission is to create healthy futures by preventing genetic diseases. And this year, they are calling out to people to help spread that message.

The goal of the billboard and social media 'Give A Spit" program is to get people to use #giveaspit and film their own video spitting into a cup. The program debuts on New Year's Eve with the Times Square billboard at 45th and Broadway and leads into a 2022 social media challenge. JScreen is calling to help raise awareness for genetic testing and its life-saving power. It's simple. Go to JScreenInstagram page @GetJScreened or use the QR code in the billboard:

1. Follow @getjscreened 2. Record a video of you spitting in a cup and why you "give a spit."3. Post it to your stories with the #GiveASpit and tag @getjscreened4. Tag and nominate three friends to Give a Spit, too.

For more information, visit jscreen.org/specialoffer

"Our #1 goal is to create a healthy future by preventing genetic diseases through genetic screening and education. In 2022, says Hillary Regelman, Director of National Outreach and Marketing at JScreen. "We are asking for your help in making that future a reality by raising awareness and showing your support for the life-saving power of genetic testing," adds Regelman.

#genetictesting #NewYearsEve #NYE2022 #getjscreened #nonprofitInstagram page @GetJScreened through the QR code in the billboard

The advertising and social media project is being created in cooperation with JIB Sheet Partners, a digital ad agency located in New York.

Whey this matters --Did you know?

The JScreen test on saliva screens for over 200 hereditary diseases and 60+ mutations associated with certain types of cancer. By creating awareness for genetic testing, JScreen.org can help more families turn their dream of having healthy children into a reality and provide others with life-saving information for early detection and prevention of many hereditary cancers.

About JScreen.

JScreenis anational non-profit public health initiative dedicated to preventing genetic diseases and cancercommon in the Jewish and other populations.Headquartered in Atlanta at Emory University School of Medicine, theJScreeninitiative provides convenient at-home access to cutting-edge genetic testing technology, patient education, and genetic counseling services.JScreenbelieves the combination of education, access to premier genetic screening technologies, and personalized, confidential support are the keys to preventing devastating diseases.

JScreenunderstands the importance of giving people a heads up if theyhave a hereditary risk for cancer.This not-for-profit home education andgeneticscreeningprogramstarted in 2013 withreproductive genetic testingcalledReproGEN andnow tests forrisk forover40 types ofhereditarycancerwith the addition oftheCancerGENtest.

One ofJScreen'sgoals is to make testing affordable.ReproGENcurrently costs $149, andCancerGENis$199.JScreenalso offersneed-basedfinancial assistance.

The proof ofJScreen'spassion for saving lives is in the incredible stories they hear, the healthy babies born, and the peoplewhocannowtake action to avoid a cancer diagnosis. As theJScreenteam likes to say "we are a small team with a huge footprint."

JScreen'sprogram is led by medical professionals at an academic medical center. It provides medical-grade testing that is used in doctor's officesin addition to specialized genetic counseling follow-up by phone orvideoconferencingfor people who are identified as carriers.

Please visitJScreen.orgfor more information.

For media interviews and more information, contact: Stacey Bender [emailprotected]973-650-1218

SOURCE JScreen.org

See the article here:
'Give A Spit' About Your Health in 2022 - PRNewswire

Recommendation and review posted by Bethany Smith

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Recommendation and review posted by Bethany Smith

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Direct Access Genetic Testing Market Size 2021 Analysis by Top Companies, And Forecast to 2028 | 23andme,Myheritage,Labcorp,Myriad Genetics ...

Recommendation and review posted by Bethany Smith

Genetic testing company Invitae (NYSE:NVTA) has seen its shares tumble from their highs despite aggressively ramping up its test volumes this year. The company is at the center of integrating genetics into healthcare, and this space still has so much potential.

However, sometimes a good story doesn't make for a good investment idea. Investors could buy the dip on Invitae, but they shouldn't ignore a major hang-up on its business model. Here is what you need to know.

Invitae generates revenue by administering genetic tests while steadily also building a genome information database over time. The more tests it administers, the larger and deeper its data is, which it can eventually leverage to create new opportunities to help patients and generate new revenue streams.

Image source: Getty Images

2021 has seen a big step forward in the number of genetic tests it administers. Its billable volume in the third quarter of 2021 surged 89% to 296,000 tests, driving revenue up 66% year over year to $114 million.

NVTA PS Ratio data by YCharts.

If the company is performing, why has the stock fallen? Growth stocks across the broader market were popular in early 2021, including Invitae, which sported a price-to-sales ratio of 24 -- well above where it's traded over most of the past five years. That valuation has since dropped dramatically to just over 8, and the shares have fallen more than 70%. This isn't just a dip -- this is a collapse. The result is a stock that is now much more reasonably priced.

However, Invitae has yet to progress toward generating free cash flow despite ramping up its business for more than five years in the public markets. The more Invitae generates in revenue, the more its free cash flow losses grow as well.

NVTA Revenue (TTM) data by YCharts.

Here's the problem. Invitae brought in $114 million in third-quarter revenue but spent almost as much ($93 million) on research and development and another $109 million on selling, general, and administrative costs. In other words, the costs to operate the business were 176% of revenue, which is worse than Q3 2020 when operating costs were 149% of revenue.

A young company often loses money as it invests for growth, but at some point the business needs to outgrow its expenses and begin generating free cash flow. Otherwise, the business model doesn't work.

It's too early to say that Invitae's business can't work, but years of losses have caused the company to repeatedly raise money by issuing new shares of stock. This is common for companies in their growth stage, and the key for investors is that as a company begins to generate cash flow, it no longer needs to issue shares to fund growth.

We can see below that the number of Invitae's outstanding shares has nearly quadrupled over the past five years. When a company issues new shares, the existing shares are worth less. Think of it as a pizza cut into four slices, and then cut two more times to make 16 slices. The pizza didn't get bigger; the slices just got smaller.

NVTA Shares Outstanding data by YCharts.

Investors need to consider the company's repeated equity raises before buying the stock. Dilution hurts investor returns because it lowers the amount of earnings per share (EPS). The company could be making more money, but if it keeps issuing shares, the stock might remain stagnant if the new shares keep EPS from growing.

Invitae has $1.2 billion in cash after burning through $148 million this past quarter, so the company shouldn't need to raise more funds in the near future. However, investors who buy the dip on Invitae will need to monitor how quickly the business is burning cash to determine whether shareholders remain at risk of dilution.

This article represents the opinion of the writer, who may disagree with the official recommendation position of a Motley Fool premium advisory service. Were motley! Questioning an investing thesis -- even one of our own -- helps us all think critically about investing and make decisions that help us become smarter, happier, and richer.

View original post here:
Should You Invest in Invitae Right Now? - The Motley Fool

Recommendation and review posted by Bethany Smith

When we think of cutting-edge technology, especially in the field of reproductive medicine, IVF promptly comes to mind. But as recent as this medical advent might seem, the truth is that IVF or in-vitro fertilisation is over 40 years old. And in these past four decades, science has moved ahead by leaps and bounds.

In fact, in the past few years, science has evolved so much that IVF is no longer the most advanced technology out there. Many new techniques suited for couples who cant be helped by traditional IVF exist. And thats exactly what were exploring today with the help of fertility specialist Dr S.Vyjayanthi, who has more than 20 years of experience and has performed more than 10,000 cycles of IVF. She has also several publications to her credit and has been providing fertility services at KIMS Fertility Centre, Secunderabad for more than a decade. Here, shes shedding light on some of the latest technological interventions in the field of fertility and IVF that you need to know about.

1. ICSI

Think of ICSI or intracytoplasmic sperm injection as a technique that is a notch more advanced than traditional IVF. Explains Dr Vyjayanthi: In IVF, we mix the sperm and egg in a dish in the lab, and the sperm gets inside the egg on its own to facilitate the process of fertilisation. Whereas in ICSI, one single sperm is injected into the egg using a big machine called micro-manipulator.

While in both cases the embryo is fertilised outside the womb, in a lab, the difference might not seem like much to laypeople. But in certain cases, ICSI can be a godsend. ICSI is mainly meant for men who have a very low sperm countanything less than 10 million per ml. In these men, fertilisation doesnt happen with straightforward IVF, she adds. For men with azoospermiawhere there is no sperm in the ejaculate and sperm has to be extracted surgically from the testesICSI process is used to make the embryo.

But male factor isnt the only indication for the use of ICSI. Dr Vyjayanthi suggests that in couples presenting with unexplained fertility (where all tests are normal, and yet the couple cant conceive), this technique can help achieve pregnancy too.

That said, with ICSI you also need to move ahead with caution and choose the doctor and clinic. Because it is a highly technical process, it involves a lot of expertise of the embryologist. So he/she has to be really very good to get good results with ICSI, she stresses.

2. IMSI

Also known as intracytoplasmic morphologically selected sperm injection, IMSI is the more technologically advanced version of ICSI. Here, the sperm is magnified six thousand times as opposed to ICSI where we magnify the sperm four hundred times to be able to put the most viable sperm inside the egg, explains Dr Vyjayanthi.

Much like ICSI, IMSI is employed for couples where the male partner has poor quality sperm to get better results. Whenever we surgically retrieve sperm from the testes, we prefer IMSI so as to make a better sperm choice, she adds.

3. Egg freezing

Egg freezing isnt unheard of. With celebrities like Diana Hayden opting for egg freezingand using their frozen gametes to get pregnantthere is much that has been said and done about this technique. But before you write off egg freezing as a celebrity-driven trend, know that it has plenty of real-world benefits.

Egg freezing is usually done for two purposes. First, for oncology purposes where women who are unmarried and are going to undergo chemotherapy are advised to opt for it so as to preserve fertility, explains Dr Vyjayanthi. Then there is social egg freezing that most of us are already aware of. Women in their late 20s or early 30s who are unmarried can have their eggs frozen. But this has to be done at the right time to get the benefits. If you opt for it in your late 30s or early 40s, youve already missed the boat, she stresses.

4. Embryo freezing

Not just eggs and spermembryos can also be frozen to be used for later use. And when it comes to freezing technology in IVF, the sciencecalled vitrificationhas advanced enough in the past decade to guarantee 95 to 99% success (when it comes to embryo quality) upon thawing.

But is there any need for frozen embryos in IVF? Well, explains Dr Vyjayanthi: Frozen embryos are definitely beneficial for a specific group of women, especially women with polycystic ovaries who have lots of eggs. When these women are stimulated with drugs, they produce more eggs and run the risk of hyperstimulation. So when we freeze their embryos and put them back in the next cycle, that risk is reduced.

Embryo freezing also provides an efficient solution for surplus embryos. Lets assume someone has made four good embryos and we have implanted two. The remaining two can be frozen, so that they can come back again, later on, to use the embryos for later on to complete their family, the expert explains.

5. Genetic testing of embryos

To rule out the risk of hereditary diseases, genetic testing of embryos is donewith technology so advanced that the embryo is not disturbed or damaged one bit. Explains Dr Vyjayanthi: There are two types of genetic testing. PGT-A or pre-implantation genetic testing for aneuploidy, where the embryos are checked to see whether they are chromosomally normal or not. We offer this to women who have had frequent miscarriages and/or are of advanced maternal age.

Yet another type of testing that is employed is PGD or preimplantation genetic diagnosis. This is used when either the male or female partner has a genetic disease in the family. So, we screen the embryos and implant only the normal ones, she adds.

While traditional PGT-A and PGD are tried-tested methods that have been used for years, the latest advancement in the field of genetic testing of embryos is minimally invasive. For the past few months we have been using PGT-A on spent culture media of the embryos. Simply put spent culture media is the solution in which the embryos are cultured in the lab for five days before being placed in the womb. While sitting in that media, embryos shed some cells which are then tested for chromosomal defects. The advantage with this technique is that it is non-invasive and causes no damage to the embryo, concludes Dr Vyjayanthi.

Read more:
Evolution Of IVF: 5 cutting-edge techniques you need to know about - Hindustan Times

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New laws go into effect in the D.C. area on Saturday, Jan. 1, 2022 related to plastic bags, leaf blowers, disposable utensils, car insurance and more. Heres a rundown.

Gas-Powered Leaf Blowers: In an effort to reduce noise, the use and sale of gas-powered leaf blowers will be banned in the District starting Jan. 1, 2022. A new law says any individual or company caught using one of the leaf blowers can be subject to fines of up to $500.

Violations can be reported to the Department of Consumer and Regulatory Affairs. Video and audio evidence of violations can be submitted but will not be required.

Rebates for electric equipment for residential and commercial use are available. Go here for more info and answers to frequently asked questions.

Disposable Utensils and Food Service Waste: D.C. restaurants will be banned from automatically handing out disposable utensils, napkins and condiment packets with orders, starting on Jan. 1, 2022. Restaurants and other food-serving entities must give out these items upon request or have them in a self-serve area so customers can take them. The requirements apply to in-person, online and mobile orders. Go here for more info.

Vaccination Entry Requirement: Later in the month, starting Jan. 15, D.C. will require people age 12 and older to provide proof of vaccination against COVID-19 in order to enter restaurants, bars and nightclubs. As News4 previously reported, the requirement will apply to movie theaters, concert venues, gyms, yoga studios and shared work facilities.Go here to see the order by Mayor Muriel Bowser.

Minimum Wage:The minimum wage in Maryland will increase.On Jan. 1, the rate will go up to $12.50 for people working for employers who have 15 or more employees. It will increase to $12.20 for those working for employers with 14 or fewer employees.

Organ Donation: Maryland residents who choose to be organ donors while registering for their drivers' licenses on or after July 1, 2022 will have the option to decide if they would like their organs to go to research and education or to transplantation and therapy. Motor vehicle administration locations must provide drivers with information about each choice. Any organs donated before July 1 from previously registered donors can only be used for transplantation or therapy.

Genetic Counselors: A new law requires the Maryland Board of Physicians to license genetic counselors and to establish a Genetic Counseling Advisory Committee within the board. Genetic counselors give patients and families information about genetic testing and how genetic conditions could affect them.

Minimum Wage: Statewide, the hourly minimum wage will increase to $11 an hour on Jan. 1, 2022.

Special ID for Undocumented Residents:Starting Jan. 3, undocumented residents of Virginia can apply for a special identification card at the Department of Motor Vehicles. Undocumented children are also eligible to receive an ID.The legislation was sponsored by Del. Elizabeth Guzmn.

In January 2021, undocumented drivers in Virginia became eligible to apply for a special driver's permit calleddrivers privilege card.According to estimates, over 300,000 people could benefit.Read more here.

Plastic Bag Tax: Locally, the city of Alexandria, Arlington County and Fairfax County adopted a 5-cent tax on disposable plastic shopping bags such as those found at grocery stores, convenience stores and drug stores. The tax will affect shoppers and will take effect in all three jurisdictions on Jan. 1, 2022.

Revenue collected will help fund "environmental cleanup, providing education programs designed to reduce environmental waste, and mitigating pollution and litter." The law does not ban plastic bags.

Local Elections Schedule: Statewide, municipal elections for city council and school board in Virginia will be moved from May to November, beginning with elections held after Jan. 1, 2022.

Virginia Residential Property Disclosure Act: Is your home at risk of flooding? Homeowners in Virginia who know that their property is a "repetitive risk loss structure" must disclose that fact to the purchaser of their home by using a form provided the Real Estate Board.

The state defines "repetitive risk loss structure" as any home that has two or more claims of more than $1,000 that were paid by the National Flood Insurance Program since 1978.

Inhalers in Public Schools: Virginia schools will change the way they treat students with asthma.

In the new year, local school boards are required to create and adopt policies to allow certain school employees to administer stock albuterol inhalers to students believed in good faith to be in need of such medication.Under the law, those administering the medication will be exempt from any liability.

Students with asthma or anaphylaxis, or both, will also be allowed to possess and self-administer "inhaled asthma medications or auto-injectable epinephrine."

Motor Vehicle Liability Insurance: There will be increases to liability insurance coverage amounts for policies effective between Jan. 1, 2022 and Jan. 1, 2025.

Coverage amounts will increase from $25,000 to $30,000 in "cases of bodily injury to or death of one person." And from $50,000 to $60,000 in "cases of bodily injury to or deathof two or more persons." Details on the amounts can be found here.

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New Laws Take Effect Jan. 1 in DC, Maryland and Virginia - NBC4 Washington

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The National Wildlife Rescue Center (NWRC) was established in 2013 in peninsular Malaysia by the Department of Wildlife and National Parks (PERHILITAN). The centers focus is on the rehabilitation of wildlife, including gibbons, for eventual release back into the wild.

The gibbons arrive at the rehabilitation center for various reasons. Some are kept illegally as pets, while others are found in plantations that have been displaced from their habitat.

Near the end of their rehabilitation, gibbons undergo a variety of assessments and procedures, such as genetic testing. This is partially an effort to identify subspecies for a successful and responsible reintroduction of the gibbons.

While checking the genetics of 12 captive white-handed gibbons at NWRC, experts made an exciting discovery. A team including Dr. Jeffrine J. Rovie-Ryan from University Malaysia Sarawak, and Millawati Gani and colleagues from the National Wildlife Forensic Laboratory of PERHILITAN, identified a genetically distinct population of gibbons new to science.

The researchers found unusual mutations in the gibbons DNA, which led them to the conclusion that these animals had been evolving in isolation.

Given the prolonged isolation, it is likely that the southern population has undergone some local speciation, but this finding should be regarded as preliminary and requires further investigation, explained Dr. Rovie-Ryan.

The gibbons in the study have not yet been released but are in pre-release at a semi-wild enclosure on Pulau Ungka (Gibbon Island) where they are being closely monitored. Without the dedicated work of PERHILITAN, and without genetic testing, this population of gibbons may have remained unknown for many years. With more research, additional information about the genetics of gibbons is likely to turn up.

The findings are published by Pensoft in the open access journal ZooKeys.

By Zach Fitzner, Earth.com Staff Writer

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New population of white-handed gibbons discovered - Earth.com

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Forty years ago this week, a couple from the Central Massachusetts town of Westminster, Judith and Roger Carr, had a baby girl named Elizabeth. She was the first child in the United States to be conceived via in vitro fertilization. Elizabeth Carr joined Judie Yuill on GBH's All Things Considered to talk about her life, how it all began and how she remains involved in the in vitro community. This transcript has been edited for clarity and length.

Judie Yuill: So I should start by saying "Happy birthday." It was yesterday, right?

Elizabeth Carr: It was. The entire world knows I am now 40 years old.

Yuill: What is that like?

Carr: Well, you know, my inbox was flooded, and I got a lot of lovely messages. It's a little bit surreal every birthday.

Yuill: I bet it is. Now, tell us how your parents came to rely on in vitro fertilization.

Carr: So my parents basically had trouble staying pregnant. My mother had something called three ectopic pregnancies. And as such, she had to have her fallopian tubes removed, which meant that the normal way of having a child was impossible. And when she was at her OB-GYN, she went in for a routine checkup after her fallopian tubes were removed. And he said, "Well, I don't know if this might be something for you, but I just came back from a conference and learned about something that was successful in England called in vitro. Maybe you should check it out." And that was it.

Yuill: So you're from Westminster, but you were actually born in Virginia, in part because in vitro fertilization was illegal in Massachusetts at the time. Why was that?

Carr: That's right. So essentially because IVF was a brand new, unknown technology that only had been successful in England. There was no public funding for IVF. And so any clinic that wanted to start and operate basically had to jump through a ton of hoops and had to be entirely privately funded. Actually, a former patient of my doctor, Georgiana Jones, is the reason that a clinic was even started at all. She actually donated just the right amount of money in order to form a clinic in Virginia.

Yuill: Now, sometimes people like you are referred to as "test tube babies," but that's not accurate, is it?

Carr: No, and it's a term I wish would go away forever and never come back. It's inaccurate because no test tubes are used at all. Actually, the term "in vitro" comes from the Latin under glass, which, you know, the procedure essentially is done in a petri dish. And so I always kind of laughed that the term test tube baby stuck because it's such a wildly inaccurate term.

Yuill: And I understand you're still very much a part of the in vitro community.

Carr: Yes, absolutely. So my day job is as a patient advocate at a pre-implantation genetic testing company called Genomic Prediction. Kind of by sideline, if you will, I have a book coming out in January about my life experience, and [I am] a patient advocate for organizations such as Resolve, the national infertility association.

Yuill: Now you've got to tell us the title of your book.

Carr: Oh, it's called "Under the Microscope" because my first "baby photo" is at 3 cells old under a Nikon microscope.

Yuill: That's pretty unique.

Carr: Yeah, absolutely. It's an interesting one to explain to friends. When they come over, they all go, "What are those three blobs?"

Yuill: That's your baby photo. That's right. Now what does your life seem like and look like now, 40 years later?

Carr: You know, it's pretty normal. You know, I just try and keep up with my 11-year-old son and my very busy and talented husband, who is a photographer and our dog. And we live a quiet life here in New Hampshire. I try to always make time for people who are struggling with infertility because I want to make sure that they know what options are out there. IVF is not the only option that's available, and it's so important for people to know about what they can do.

Yuill: But what's it like for you to know you played such a big role in helping people have the babies that they've been longing for?

Carr: My running joke is that I just showed up. I didn't do anything. My parents and the doctors and all of the people involved really did the heavy lifting. I am so humbled that I have the privilege of hearing people's very personal and painful stories when they're experiencing infertility. And to me, my parents and I have always lived by the philosophy that we wanted to tell our stories so that if it would help just one other person, then this lifelong lack of privacy essentially would be worth it.

Excerpt from:
Elizabeth Carr, first person in the US conceived through IVF, turns 40 years old - wgbh.org

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Prevalence of hypogonadism

In the Baltimore Longitudinal Study on Ageing, it was found that 19% of men over 60 years had low testosterone. The Hypogonadism in Males (HIM) study estimated the overall prevalence of hypogonadism at approximately 39% in men aged 45 years or older (18). It has been estimated that only 535% of hypogonadal males actually receive treatment for their condition (19,20).

Measuring testosterone levels in populations, while useful, is different from measuring hypogonadal symptoms. A subject can have low testosterone levels, but can also have no clinically significant symptomatology. Likewise, measurement of symptoms alone is not reliable, as hypogonadal symptoms are non-specific. The Massachusetts Male Ageing Study (MMAS) measured a combination of testosterone levels and hypogonadal symptoms and found between 6% and 12% of men had symptomatic androgen deficiency (21). An interesting observation from the MMAS was that half of the men found to have symptomatic androgen deficiency at one stage were found to be eugonadal when retested at a later stage (22). This is probably because there is subject-to-subject variation in testosterone secretion and in the testosterone threshold where symptoms become manifest. As discussed below, a measurement of low testosterone in a patient should be reconfirmed at a later stage before considering treatment.

Older men are more likely to have low testosterone levels: in the HIM study, for example, the prevalence of low testosterone in the 4554 age group was 34%, whereas it was 50% in men over 85 years (18). Likewise, in the Baltimore study the percentage of men with low testosterone increased from 12% in men in their 50s, to 49% in men over 80 years of age (23).

There appears to be no consistent evidence that the prevalence of hypogonadism differs between racial and ethnic groups (2426).

Higher rates of hypogonadism than those in the general population are associated with various common diseases or conditions. The HIM study calculated odds ratios for some common conditions (). It is not yet understood whether the low testosterone levels are a consequence of the disease, are connected with the diseases aetiology, or are one of the causes of the disease. Further studies are needed to determine if treating the associated hypogonadism is likely to improve the patients disease symptoms.

Odds ratios for hypogonadism for various comorbidities from the HIM Study (18)

Vascular tissue (including endothelium and vascular smooth muscle cells) contains androgen receptors, so it is to be expected that testosterone (or its metabolite, oestrogen) is likely to affect the cardiovascular system. In fact, the increased risk of cardiovascular disease in males compared with females has been taken to imply a role for testosterone (or oestrogen) in the disease. Human observational studies, however, have shown no associations between high testosterone levels and coronary artery disease, and testosterone has been shown to dilate the coronary arteries both in vitro and in vivo. Some studies have shown that testosterone can be considered to have a positive effect on reducing the risk factors for cardiovascular disease; for example, inverse relationships have been shown between testosterone levels and body mass index (BMI), waist circumference, waist-hip ratio, serum leptin, low-density lipoprotein (LDL) cholesterol, triglyceride and fibrinogen levels. Low testosterone is associated with dyslipidemia, hypertension, obesity and diabetes, all of which increase the risk of cardiovascular disease and are features of the metabolic syndrome (27,28).

A negative view of testosterones impact on cardiovascular disease comes from the observation that high-density lipoprotein (HDL) cholesterol levels decrease in patients on oral testosterone therapy, or when taken in supraphysiological doses by athletes (29,30). However, when given as a transdermal gel to hypogonadal men, there is either no significant change or only minor changes in HDL levels (28,31,32). Whatever the subtleties of the effects of testosterone on lipids, recent data have demonstrated that low testosterone concentrations are associated with an increased incidence of cardiovascular events, and an increase in acute myocardial infarction and stroke.

The relationship between testosterone and HDL is confounded by the fact that both HDL and testosterone are inversely related to BMI. In fact, epidemiological analyses have found that HDL levels are positively linked to testosterone levels in middle-aged men. Data from the MMAS have demonstrated that there is a strong, positive relationship between HDL and testosterone in men with cardiovascular disease (low total or free testosterone correlates with low HDL cholesterol) (31).

Recent work in the Rancho Bernardo, California population has shown that men with serum total testosterone levels in the lowest quartile (< 241 ng/dl) were associated with a higher risk (38%) of cardiovascular mortality, compared with those who have higher total testosterone levels, independent of age, obesity and lifestyle choices (33). In fact, those with low testosterone were 40% more likely to die (all-cause mortality) than those with higher levels. This is in contrast to what was found in the MMAS study where total testosterone levels were unrelated to all-cause mortality (34,35).

A meta analysis, published in 2007, of randomised trials that assessed the effect of exogenous testosterone on cardiovascular events, however, concluded that the inference that testosterone use in men is not associated with important cardiovascular effects was only weakly supported. Large randomised trials using men with and without cardiovascular disease and with cardiovascular end-points are needed to better assess the consequences of testosterone treatment on cardiovascular risk (36).

A recent study (2009) from Italy demonstrates that testosterone treatment in elderly patients with chronic heart failure improves insulin sensitivity and various cardiorespiratory and muscular outcomes (37).

In 2007, it was estimated that 23.6 million people, or 7.8% of the US population, had diabetes (38). Projections based on data from the National Health and Nutrition Examination Surveys (NHANES) show that by 2021 there are anticipated to be approximately 33 million people with diabetes in the United States, representing 13.5% of the population (39).

Low testosterone concentrations are known to occur in association with type 2 diabetes. However, clinicians have often not related low testosterone concentrations to clinical hypogonadism. The first attempt to measure free testosterone and to establish hypogonadism as a feature of male type 2 diabetes was made by Dhindsa et al. in 2004 (40). This has been confirmed in several other studies including the HIM study (41). In the HIM study, a diabetic man was approximately twice as likely to be hypogonadal compared with a non-diabetic man (18). Prevalence in diabetic men has been estimated at 3350% (18,40,42). With such a high prevalence, hypogonadism is a candidate for the most common complication of male type 2 diabetes. Analysis of gonadotropin levels demonstrates that the hypogonadism in type 2 diabetes is mostly hypogonadotropic (secondary) hypogonadism (40). There is no relation between the degree of hyperglycaemia and testosterone concentration (40,43).

C-reactive protein, a marker for systemic inflammation, has been found to be markedly elevated in patients with secondary hypogonadism and type 2 diabetes. The concentrations of C-reactive protein in these patients are twice as high as those in eugonadal type 2 diabetics, whose C-reactive protein levels are already elevated compared with non-diabetics. Such patients have also been shown to have mild anaemia, low bone mineral density (BMD) in the arms and ribs, and increased adiposity when compared with eugonadal type 2 diabetics (44,45). These features are similar to those of hypogonadal patients without diabetes. Another intriguing observation is that prostate-specific antigen (PSA), a marker for prostate cancer, is significantly lower in type 2 diabetics and this is related to their lower plasma testosterone concentrations (46). The clinical significance of this remains to be elucidated.

Interestingly, low testosterone concentrations predict the development of type 2 diabetes. Utilising data from the NHANES III survey, it was found that men in the lowest free testosterone tertile were four times as likely to have diabetes as those in the highest free testosterone tertile (47).

Type 1 diabetes does not seem to be associated with hypogonadism, suggesting that hypogonadism is specific to type 2 diabetes and not related specifically to hyperglycaemia (43).

Obesity amongst adult men had a prevalence of 33.3% in 20052006 according to the most recent NHANES review (48). An adult who has a BMI between 25 and 29.9 kg/m2 is considered overweight, whereas an adult who has a BMI of 30 kg/m2 or higher is considered obese. This is not a rigid rule as BMI does not directly measure body fat, so athletes, for example, may have high BMIs even though they are not overweight (49).

The health risks associated with obesity are well known, increasing the risk for type 2 diabetes, hypertension, atherosclerotic diseases and coronary heart disease. Obesity is strongly associated with type 2 diabetes: approximately 83% of diabetic patients are overweight or obese (50). Obesity is also associated with low total testosterone and reduced SHBG levels. There is an inverse linear relationship between total testosterone and BMI, and free testosterone concentrations also decrease with increasing BMI. There is an inverse relationship between serum total and free testosterone levels and visceral fat mass. Thus, the degree of hypogonadism is positively correlated to the degree of obesity in obese men (51,52).

A person with metabolic syndrome is defined as having central obesity in addition to any two of these four factors: hypertension ( 130/85 mm Hg), reduced HDL (< 40 mg/dl in males), raised triglycerides ( 150 mg/dl) or raised fasting plasma glucose ( 100 mg/dl)(53). It is considered a high risk for coronary heart disease (19,54). As the constituent elements of metabolic syndrome are themselves correlated with testosterone concentrations, it is perhaps not surprising that hypogonadism is also associated with the metabolic syndrome, as has been shown in a number of epidemiological studies (55,56).

Low testosterone levels are correlated with insulin resistance in both epidemiological and interventional studies, and this may be attributable to the effect of testosterone on adiposity. Low testosterone levels increase fat mass and decrease lean muscle, resulting in increased adipose tissue (52).

Adipose tissue affects testosterone levels by increasing the aromatisation of testosterone to estradiol, because the aromatase enzyme is concentrated in adipocytes. This reduces serum and tissue testosterone levels. The estradiol produced by aromatisation also provides negative feedback on the HPG axis, further reducing testosterone. Thus, adiposity potentially leads to hypogonadism, which itself promotes further adiposity. illustrates the main hypogonadal-obesity-insulin resistance connections and also includes other factors such as TNF- (an adipokine), which is elevated in obese males (42,51,57,58).

The interrelationship between hypogonadism and insulin resistance (after (42,51)). LH, luteinizing hormone. Low testosterone stimulates an increase in adiposity. Adipose tissue contains high concentrations of aromatase, which reduces testosterone concentrations by converting it to estradiol. The estradiol negatively feeds back on the HPG system, reducing testosterone production in the Leydig cells. Increasing adipose tissue increases insulin resistance, which negatively impacts the Leydig cells as well as inhibiting the release of luteinizing hormone (LH) via the release of adipokines (inflammatory cytokines) such as TNF-. Leptin, released in response to increased adiposity, also inhibits the release of LH via its effect on the release of gonadotropin-releasing hormone

However, it seems likely that testosterone may suppress insulin resistance independently of its effects on adiposity. The withdrawal of testosterone therapy in hypogonadal patients that had been stabilised on this therapy leads to an increase in insulin resistance within 2 weeks and prior to significant weight gain (59). A recent study showed that supervised diet and exercise increased testosterone levels in hypogonadal men with metabolic syndrome and newly diagnosed type 2 diabetes. In addition, a small dose (50 mg/day) of testosterone gel improved both glycemic control and insulin sensitivity over and above the improvements because of diet and exercise (60). The mechanism underlying the insulin sensitising effects of testosterone needs to be elucidated.

An important proviso to this discussion is that further research into the role of hypogonadism in obesity, metabolic syndrome and diabetes is required to gain a better understanding of the pathogenic mechanisms involved and that, at present, it is not known whether hypogonadism is the cause or the consequence of these conditions.

Osteoporosis is an under-recognised problem in men. Ten to twenty per cent of individuals with osteoporosis over 50 years old in the United States are men (25). Up to 13 million men are at increased risk because of low BMD and up to 2 million of these have osteoporosis (61,62). Men have almost 30% of all hip fractures and men are twice as likely to die in hospital than women after a hip fracture. Hip fracture incidence is low until after 75 years, when the risk increases exponentially. Vertebral fractures are also common, although they are only about half as common in men compared with women (63).

There are many suspected causes of osteoporosis, and the most frequent are corticosteroid use, Cushings syndrome, hypogonadism and excessive alcohol consumption. In a study of elderly men in a nursing home who have experienced hip fractures, 66% were hypogonadal (64).

Other common secondary causes are smoking, low calcium intake and vitamin D deficiency or insufficiency (61).

Various epidemiological studies in men have examined associations between testosterone and estradiol levels and BMD. Estradiol levels in men have been consistently and positively associated with BMD. Testosterone is also positively associated with BMD, but the relationship is weaker than that of estradiol (65,66).

Interventional studies have shown that testosterone replacement therapy in hypogonadal males increased spine BMD and trabecular connectivity (61,67). However, studies of testosterone therapy in men with osteoporosis are limited and none have used fractures as an end-point; so although there is significant evidence of an association between hypogonadism and osteoporosis, there is no established causal link between the two.

Testosterone levels are lower in men being treated with corticosteroids. Systemic glucocorticoids can reduce testosterone biosynthesis in the testis; in addition, glucocorticoids impact the HPG axis by inhibiting the release of LH (17,68). As a result, patients being treated with glucocorticoids for such chronic conditions as rheumatoid and osteoarthritic inflammation, skin inflammations, asthma, chronic obstructive pulmonary disease (COPD) and inflammatory bowel disease are at an increased risk of hypogonadism.

There have been some studies that suggest that COPD patients have a higher incidence of hypogonadism than the general population and that glucocorticoid treatment is only part of the reason. The pathophysiology of this remains unclear, but suggestions have been made that it might be connected with chronic hypoxia, and a systemic inflammatory response (68). A number of studies have shown that testosterone therapy can improve lean body mass and BMD and strength in hypogonadal men with COPD (17).

Long-acting opioids such as methadone, morphine sulphate, fentanyl and oxycodone for the treatment of chronic pain often result in opioid-induced androgen deficiency (OPIAD). In a casecontrol study of 40 cancer survivors it was found that 90% of those on opioid treatment were hypogonadal compared with only 40% of the control group (69). The mechanism for OPIAD is thought to involve suppression of GnRH release by the hypothalamus, thereby inducing secondary hypogonadism (17,70).

Apart from the effects of testicular cancers, which may have a direct impact on testosterone secretion, the prolonged radiation treatment, chemotherapy using antimitotic drugs or corticosteroids or pain treatment medications characteristic of cancer treatment are likely to induce hypogonadism (17). These drugs may induce Leydig cell dysfunction or germinal epithelial failure (71). The HPG axis may also be affected by androgen-, or ectopic adrenocorticotropin hormone-producing tumours, leading to secondary hypogonadism (17).

Androgen deficiency is strongly associated with AIDS wasting syndrome, and testosterone therapy in HIV-positive hypogonadal men increases lean body and muscle mass and perceived well-being, and decreases depression (7274). Approximately 2050% of HIV-infected men receiving highly active antiretroviral therapy are hypogonadal. While these prevalence levels may superficially appear similar to the background figures in the population, most studies are based on middle-aged populations. HIV patients with AIDS are younger and therefore, comparisons have to be carried out with appropriately age-matched controls.

The cause of this hypogonadism is probably as a result of a number of factors, including lipodystrophy induced by highly active retroviral medications; testicular atrophy caused by opportunistic infection; disruption of the HPG axis resulting from malnutrition; and the results of medications such as the antimycotic ketoconazole, which inhibits steroid biosynthesis (17).

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A practical guide to male hypogonadism in the primary care ...

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This article was originally published here

J Diabetes Res. 2021 Dec 20;2021:1347588. doi: 10.1155/2021/1347588. eCollection 2021.

ABSTRACT

INTRODUCTION: To evaluate whether waist circumference (WC) or hyperglycemia is more closely associated with hypogonadism in middle-aged men. Research Design and Methods. This cross-sectional study analyzed male participants under 65 years old from the MJ Health Screening Center in Taiwan from 2007 to 2016. Basic patient characteristics with relevant parameters were obtained. We used the chi-square test to perform a correlation analysis for HbA1c and WC between participants with and without hypogonadism. A one-way ANOVA with post hoc Scheffes method was applied to compare the mean testosterone (T) among the HbAlc and WC groups (normal blood sugar with normal WC (NBSNW), abnormal blood sugar with normal WC (ABSNW), normal blood sugar with abnormal WC (NBSAW), and abnormal blood sugar with abnormal waist circumference (ABSAW)).

RESULTS: The 5,680 participants were divided into two groups based on the presence (n = 599) or absence of hypogonadism (n = 5,081), which was defined as total testosterone (TT) < 300 ng/dL. The mean TT of group NBSAW (443.71 220.59 ng/dl) was significantly lower than that of group ABSNW (506.64 191.08 ng/dl, p < 0.001). Moreover, the mean TT of group ABSAW (398.89 146.24 ng/dl) was significantly lower than that of group ABSNW (506.64 191.08 ng/dl, p < 0.001). The ORs after adjusting for BMI, TG, HDL, SBP, and DBP were statistically significant when comparing NBSAW vs. NBSNW (OR = 2.846; 95%CI = 2.266-3.575; p < 0.001), ABSNW vs. NDNW (OR = 1.693; 95%CI = 1.309-2.189; p < 0.001), and ABSAW vs. NBSNW (OR = 4.613; 95%CI = 3.634-5.856; p < 0.001).

CONCLUSION: The current study showed that WC should be the risk factor that is more closely associated with hypogonadism than hyperglycemia in middle-aged men.

PMID:34966822 | PMC:PMC8712173 | DOI:10.1155/2021/1347588

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Waist Circumference Is More Closely Associated with Hypogonadism than Is Hyperglycemia, Independent of BMI in Middle-Aged Men - DocWire News

Recommendation and review posted by Bethany Smith

This article was originally published here

Urologiia. 2021 Dec;(6):130-135.

ABSTRACT

COVID-19 is a new highly contagious infectious disease caused by the SARS-CoV-2. The World Health Organization (WHO) on March 11, 2020, has declared the novel coronavirus (COVID-19) outbreak a global pandemic. More attention is currently paid to the fact that men are more at risk for worse outcomes. In addition, SARS-CoV-2 can infect the testes, potentially affecting testosterone production, as well as having a negative influence on the reproductive potential. Our aim was to review the current concepts of the possible influence of testosterone levels on the pathogenesis of COVID-19 in men and to present the available data on the impact of COVID-19 on the structure and function of the testis. Based on the analysis of 72 articles using the MEDLINE database (PubMed), it can be concluded that testosterone is involved in the co-regulation of the synthesis of angiotensin-converting enzyme-2 and transmembrane serine protease-2, facilitating the penetration of SARS-CoV-2 into target cells and promoting easier infection in men. On the other hand, low testosterone levels increase the risk of cardiopulmonary complications. Hypogonadism appears to be an important unfavorable prognostic factor for the disease. Orchitis is a reported complication of COVID-19. Damage to testicular tissue is possible due to direct invasion by a virus, a secondary autoimmune reaction, hyperthermia and thrombosis of testicular microvessels. Prophylaxis of possible vertical and sexual transmission of infection is recommended. Despite the available data, further studies are required to assess the definite role of androgens in the course of infection and the influence of SARS-CoV-2 on male reproductive potential.

PMID:34967175

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Andrological aspects of new coronavirus infection Covid-19 - DocWire News

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Male sexual health is often not taken seriously. As a result, the sex life of most men turns out to be miserable. Thousands of men across the world are suffering from premature ejaculation, erectile dysfunction, and many other sexual problems.

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The task becomes more confusing as most male enhancement pills claim to ensure better sexual arousal and sexual desire. Also, ongoing male enhancement scams may make you skeptical in terms of buying a natural male enhancement supplement.

In this article, we have shortlisted some natural male enhancement pills that have proven benefits in promoting better sexual health for men.

Any pill that is marketed for men to enhance their masculine performance is a male enhancement pill. A common myth is that only elderly males suffer from low testosterone levels and performance issues. However, this claim is not valid. Males in their 20 to 30 may also suffer from performance issues. Some face problems due to low testosterone levels, while others have erectile dysfunction.

These issues affect not only sexual performance but also family life, confidence, and self-esteem. Qualities such as hard work, stamina, exercise are all associated with manhood. Failures in the gym, acting unconfident, and lack of energy are distressing for a man, and many males struggle for years to achieve masculinity.

There are various male enhancement pills available in the market to help you improve your sexual performance. But the biggest shortcoming of the male enhancement supplement industry is scams. Many companies claim that their pills can permanently increase penis size or libido; however, this is not anatomically possible. Only surgery can increase the size of the sexual organ permanently.

To avoid scams and help you choose effective and safe male enhancement supplements, we have prepared a list of the 11 best male enhancement pills in 2021. Many pills use a fusion of natural ingredients such as Ashwagandha, Black Ginger extract, Yohimbe extract, and Maca Root.

These ingredients increase energy levels, libido and reduce stress. A study on mice suggests the beneficial effects of black ginger extract on physical performance and muscular endurance.

As the Food and Drug Administration (FDA) does not approve male enhancement pills, there is no scientific evidence of their benefits. However, some studies prove the advantages of ingredients added to these supplements.

The wrong supplement can be hazardous for your health. A recent study uncovered one of the most popular male enhancement supplements associated with a heart attack. Therefore, before consuming any pill, you must be extremely careful.

We rank male enhancement supplements considering the quality and efficiency of the ingredients, clinical dosages, transparent labels, and other valuable ranking factors. We do not include the supplements linked with severe adverse effects. We also check manufacturer reputation and rank those companies who have a long-standing record of producing effective and safe supplements.

Check our list of the best male enhancement pills for 2021:

Now, if none of the 5 best male enhancement supplements work for you, there are other suitable options worthy of consideration today:

Lets review each male enhancement supplement in detail.

VigRX Plus, reviewed in the AP News here, includes the finest quality and natural herbal ingredients such as Ginkgo Biloba, Saw Palmetto Extract, Korean Red Ginseng, and Tribulus Terrestris increase testosterone production and libido. The VigRx Plus supplement also claims to increase blood flow and support blood pressure.

Moreover, VigRX Plus includes Bioperine to increase the absorption of all essential ingredients. You must take two tablets regularly to charge your libido, control erection, and improve performance.

VigRX Plus Price: $69.99

Prime Male, reviewed in the Peninsula Clarion here, is a popular testosterone booster. The supplement contains minerals, herbal extracts, and vitamins to boost testosterone hormone levels in your body. The Prime Male supplements give you many benefits, such as it helps to lose excess weight, overcoming fatigue, boosting mood, and building lean body mass.

Some of the unique benefits that you cannot see in any other supplement are strong bones, optimal prostate function, improved cardiovascular health, and tighter skin. The company claims that Prime Male can boost testosterone levels by 42% in 12 days.

Prime Male Price: $69

Male Extra contains unique, natural, and safe ingredients to support erectile functions. It contains amino acid L-arginine, methyl sulfonyl methane (MSM), zinc, niacin, cordyceps, pomegranate, and L-methionine. These ingredients are linked to nitric oxide production and increase the blood flow to the penis and erectile tissues.

It also increases oxygen and nutrients delivery to the cells, giving you more robust erections and improving performance. Further, it increases stamina, makes you confident, and improves your sex life.

Male Extra Price: $65

Unlike other supplements that claim to increase blood flow and testosterone levels, Semenax targets orgasm intensity and semen volume. It contains L-arginine, L-lysine, Swedish flower Pollen, Butea Superba, L-carnitine, and Muira Pauma. These essential nutrients increase seminal vesicle fluid, prostate gland fluid, bulbourethral gland fluid, and seminal plasma.

The manufacturers also claim that these ingredients turbocharge the bodys natural semen and feed the male reproductive system.

The official website of Semenax shows testimonials and clinical studies. The results of the study found about a 20% increase in ejaculate volume in patients taking Semenax.

Semenax Price: $60

Performer 8 supports your manhood naturally with its effective herbal complex formula, non-GMO, and science-backed ingredients. This formula reclaims sexual energy and stamina, firmer erections, and increases semen volume and motility.

Performer 8 is a blend of nine ingredients: Panax ginseng, ashwagandha, maca root extract, barrenwort, pine bark extract, glucuronolactone, grape seed extract, and Muira Puama Extract, and Ferrous Bisglycinate.

If you are looking for an effective, soy-free, gluten-free, and vegan male enhancement supplement, Performer 8 may be the right choice for you.

Performer 8 Price: $65

Stone Force is a scientifically formulated supplement containing Ginseng, Epimedium Extract, Velvet Bean, Maca, Muira Puama Extract, and Catuaba Bark Extract.

The stone force is not only a male enhancement supplement, but it works for females as well. It boosts blood flow to improve sex drive. After consuming stone force, you will feel harder, stronger, and get prolonged-lasting erections.

The manufacturing company also gives a 60-day money-back guarantee.

Stone Force Price: $69

Savage Grow Plus is a male enhancement pill that claims to increase the size of the penis permanently. This supplement is developed by using the same ingredients as used by people in the village of Africa. For centuries, a penis elongation ritual was followed in this village; these ingredients give villagers extended penis sizes to about 12 to 18 inches long.

Coming to male sexual health, the natural male enhancement pills offered by Savage Grow Plus are the best options to improve sex life. If youre worried about treating erectile dysfunction or premature ejaculation, the natural ingredients of this male enhancement formula can resolve your concern. Also, you will start enjoying the innate sexual pleasure as you take these penis enhancement pills.

The manufacturers of Savage Grow Plus claim that it will increase blood flow, support erections, and sexual performance.

Savage Grow Plus Price: $69

The ExtenZe is a male enhancement pill and herbal blend of L-arginine, Yohimbe extract, horny goat weed, piper longum, ginger, zinc, pregnenolone, and folate. Unlike other supplements that use substantial doses, ExtenZe contains lower dosages of a large number of ingredients.

If you want to buy penis enhancement pills to increase nitric oxide production for penis enlargement, taking male enhancement supplements offered by Extenze is the best solution. This supplement improves erectile function as well as sexual pleasure.

The company claims that ExtenZe is the first line of defense against the small erect penis and low confidence. It improves the blood flow to your sexual organs and strengthens your erection. It will help if you consume the Extenze supplement once daily to experience its benefits.

ExtenZe Price: $45

Leading Edge Health is the producer of Pro Solution male enhancement supplements. The company considers this formula as the worlds top-rated male enhancement system. Pro Solution uses various ingredients such as Solidilin, Butea Superba, Momordica, Korean ginseng, cordyceps, amla, apigenin, and Arjuna to give you a healthier sex drive, firmer erections, more intense orgasms, reduce stress, and promote ejaculation control.

Also, manufacturers offer a 67-day refund policy and a 100% satisfaction guarantee.

Pro Solution Price: $60

Hyper Male Force claims to increase penis length permanently like Savage Grow Plus and Male Dominator supplements in this list. The manufacturers of this supplement claim that Hyper Male Force can increase the length of the penis within a few days by targeting critical areas in your brain.

The Hyper Male Force supplement is formulated by Dr. Kleimer, who is a well-known penis reconstruction specialist. He used his medical expertise and vast experience in developing hyper male force male enhancement supplements.

He added 19 ingredients, including ashwagandha, Rhodiola Rosea, L-theanine, hawthorn, and skullcap.

Hyper Male Force Price: $59

Male Dominator is a natural male enhancement pill that contains 14 powerful ingredients to increase penis size by 4 inches in just 30 days. Some of the ingredients found in Male Dominator are Saw Palmetto, Cayenne, Epimedium Sagittatum, Damiana Leaf, Muira Puama, Oat Straw, and Inosine.

The makers of the Male Dominator supplement claim that it permanently increases your penis size and supports testosterone production, blood flow, and energy levels.

Male Dominator Price: $69

There are many male enhancement supplements available today, each claiming to improve sexual performance and sex drive. However, not all supplements are effective. To help you pick the best supplement, we have made a list of the 11 best male enhancement pills according to the following ranking factors.

Many male enhancement supplements contain natural ingredients and herbs, while others include dangerous substances that cause side effects. We rank supplements that use science-backed ingredients with proven safety and efficiency.

Along with adding quality ingredients, it is also necessary to add the correct dosages of ingredients. An average adult needs substantial doses of ingredients to gain the required benefits. We have ranked those male enhancement pills that contain clinically significant dosages of effective ingredients.

There is no clinical evidence and trials that prove the efficacy of male enhancement pills; however, some clinical studies indicate the benefits of ingredients added in male enhancement pills. Most supplements in our list contain active ingredients in the exact dosages as used in clinical studies.

You can get male enhancement pills in different price ranges from $10 to $100, but we rank the products that offer good value for the money. In our list, you will find male enhancement pills in your budget whether you want to spend a few dollars or more, and all of these products offer good value for their cost.

Checking a companys reputation is one of the most crucial ranking factors. Some companies have a long-standing record of producing high-quality products, while others make cheap male enhancement pills to earn a few bucks.

We rank those companies that are transparent in disclosing ingredients, dosages, benefits, and side effects of the product. Also, the companies with a long-standing record of producing effective supplements are on our list of best male enhancement pills.

Many companies advertise unrealistic and anatomically impossible benefits. They claim that their male enhancement pill can increase the length of the penis permanently. However, this is not possible. We rank the supplements that advertise actual benefits and are effective in improving your sexual drive.

These are the ranking factors that we used to rank the 11 best male enhancement supplements.

According to science, some natural ingredients can improve male sexual performance, libido, and energy levels. It can also help the body to produce more testosterone and increase blood flow to support erection.

With increasing age, the testosterone levels in the body drop, developing the chance of erectile dysfunction. The blood flow also decreases. About 40% of males above 40 years of age have erectile dysfunction. A 2013 study found that 26 percent of males seeking treatment for erectile dysfunction were above 40 years of age. These studies show that erectile dysfunction is more common in aged males. Therefore, many male enhancement supplements specifically cater to age-related performance issues.

Yohimbe, a natural herb extracted from Pausinystalia Yohimbe, has been used as traditional medicine for sexual issues in areas of west Africa. This herbal extract is added to many male enhancement pills, including ExtenZe. According to the research, Yohimbe blocks alpha-2 adrenergic receptors and increases the production of nitric oxide. Thus, increasing blood flow to the penis and improving erection in males.

Some male enhancement pills contain black ginger extract. A study in 2016 suggests the effects of black ginger extract on improving physical fitness performance and muscular endurance.

Several popular male enhancement pills contain the amino acid L-arginine. A few studies prove the effects of 5000 mg arginine on increasing blood flow. However, other studies suggest L-arginine be ineffective for treating erectile dysfunction. Bodybuilders and athletes consume L-arginine before and after the workout to boost their performance.

Horny Goat Weed, another popular ingredient found in many male enhancement pills, contains icariin. Icariin blocks phosphodiesterase type 5 that stops the widening of arteries in the penis to get an easy erection. Studies on rats also suggest the effects of horny goat weed in improving erectile dysfunction symptoms in rats.

Furthermore, research shows that males deficient in zinc have lower testosterone levels than those who get the recommended daily dose of zinc. A study proves that about 17.3% of the population that suffers from zinc deficiency has low testosterone and hypogonadism. In another study, researchers found that 30mg of zinc intake increases the level of testosterone. However, there are no extra benefits of zinc supplements if you are already taking recommended daily doses.

Vitamin D is the main ingredient of male enhancement supplements. You can get vitamin D from dairy products, multivitamins, and other foods. Only 20 to 30 minutes of sunlight exposure can also raise vitamin D levels in your body. Researchers gave vitamin D supplements to a group of people in a study, and their testosterone levels increased by 20%. Another study conducted in 2011 concluded that vitamin D3 increases bioactive and free testosterone levels by 25%.

Tribulus Terrestris is a plant-based extract used in multiple male enhancement supplements. It has been used as an aphrodisiac for centuries. The research found that three months of Tribulus Terrestris supplement boosted testosterone production by 13%. During these three months, males also experienced fewer symptoms of erectile dysfunction. Another study found an improved sexual drive in women taking Tribulus Terrestris. With 7.5mg of Tribulus Terrestris extract intake per day, women also experienced better desire, lubrication, arousal, and satisfaction.

Some male enhancement supplements claim to improve semen volume, sperm production, and orgasm intensity.

These pills contain zinc, fenugreek, ashwagandha, maca root, and D-aspartic acid. Several studies suggest the benefits of all these ingredients. One study shows that a daily intake of 500mg of fenugreek increases free and total testosterone levels in the body. Another study in 2012 found that D aspartic acid increases sperm concentration and motility.

Many male enhancement pills in our list contain ginseng. Asian Ginseng is an herb native to southern China and Korea. Ginseng raises luteinizing hormone, which signals the body to form more testosterone.

Research states that ginseng increases the nitric acid in the blood and aids in reducing body fatigue, boosts mood, improves memory, and improves the quality of sleep. Another research proves that the ginseng herb increases testosterone, luteinizing hormone, DHT, and adrenocorticotropic hormone.

Science suggests that one of the best male enhancement formulas is the daily workout. Regular exercise for only 20 to 30 minutes raises blood flow to the penis and improves sexual performance. Studies show that slim males have better sexual performance than overweight males.

Overall, no research proves the efficiency of male enhancement pills, and the claims that these supplements can permanently enlarge the size of the penis are invalid. However, scientific evidence proves the effects of herbs, vitamins, and minerals in improving sexual function. Therefore, by picking male enhancement pills containing science-backed ingredients, you can boost your testosterone levels and sexual performance.

FDA does not approve male enhancement supplements. Therefore, most male enhancement pills do not undergo lab testing or clinical trials before being sold to consumers.

Moreover, many male enhancement pills manufacturing companies are also not transparent in showing the ingredients and dosages. Consuming pills with unknown ingredients can be hazardous for you. We recommend you check each supplement you take; if the elements have GRAS status, it is safe to use at standard dosages.

Also, always check for the manufacturers reputation before making any purchase and never exceed the recommended dose of the supplements. On exceeding the amount, you may feel indigestion, stomach discomfort, dizziness, and other symptoms.

Male enhancement supplements contain different types of ingredients, each with different recommended dosages.

As per science, a daily intake of 30 mg zinc is associated with normal testosterone levels. While other studies suggest recommended daily intake of zinc as 11 mg per day.

Similarly, some studies use 1000mg of Tribulus Terrestris, and others use about 5mg of this herb.

We recommend you follow the dosage instructions on the label of the male enhancement supplement you consume to avoid side effects.

Some of the top natural ways to improve male sexual performance are:

Studies suggest growth hormone production is most noteworthy during sleep. If you get enough sleep daily, you will not face hormonal imbalance. Getting 8 to 9 hours of uninterrupted sleep per day helps maintain hormone levels in the body. Also, good and deep sleep reduces stress and anxiety, supporting your sexual performance.

Eating a balanced diet is crucial for health and wellness. You must add vegetables, vitamins, fruits, minerals, protein, zinc, vitamin D, and other essential nutrients to your diet. If your body does not get all the necessary elements for producing testosterone, you cannot enjoy healthy sex. Also, try to add foods rich in omega 3 fatty acids such as avocados, tuna, salmon, and olive oil to your diet.

Smoking impacts badly on your heart and everyday wellbeing. Quitting smoking will raise blood flow in the body, improve cardiovascular health, and support all other body functions.

Weight lifting and strength training are some of the best ways to raise hormones such as testosterone in the body. A study shows, a strength training program for four weeks can increase the testosterone levels in the body. Exercises such as squats, deadlifts, and bench presses that target big muscles significantly influence testosterone levels. It also supports you in reducing weight, thus improving sexual functions.

High-intensity interval training and sprinting are the best workouts for raising testosterone levels and reducing weight. This workout requires an individual to exert maximum energy for a short time. If you can spend 10 to 20 minutes sprinting daily, you can enjoy high testosterone levels and improved sexual performance.

Stress increases cortisol levels, accumulates fats, and reduces testosterone levels in the body. Lowering anxiety and stress levels is vital to boost testosterone levels and increase your sexual performance. You can decrease your anxiety with the help of meditation, brisk walking, reading books, and other methods. Reducing stress will improve your bedroom performance.

Consult your doctor if you are anxious about your sexual function and none of the natural remedies or supplements improve your condition. We also suggest you talk to your doctor before starting any male enhancement pills.

Go here to read the rest:
Reviewing the Top 5 Best Male Enhancement Pills in 2022 to Buy - The Daily World

Recommendation and review posted by Bethany Smith

Rendering of the new Polar Security Cutter (Image: Halter Marine)

Halter Marine, Mississippi, USA The contract has been awarded to build the second U.S. Coast Guard Polar Security Cutter (BSC) based in Pascal.

Halter Marine will serve as the primary contractor on a fixed price incentive agency contract issued by the Navy. Initial efforts under the contract include the purchase of materials with long lead times, especially generator sets, to support production while ensuring common ground between the first two PSCs.

The $ 745 million deal for Halter Marine in 2019 designed and built the first new heavy duty ice breaker in the United States after 40 years. The deal includes two options, which, if implemented, would bring the total value of the deal to $ 1.9 billion.

The PSC project is a multi-year project Department of Homeland Security USCG to acquire three multi-mission PSCs to recapitalize the next generation polar icebreaker fleet.

Works with Halter Marine, ST Engineering Company of North America Technology Associates (TAI) As the ships designer. The ships design is based on the German Polarstern II design. The Halter Marine and TAI teams, along with other suppliers, finalize the PSC plan.

The Polar protection cutter It is 460 feet long and has a total beam of 88 feet. The impetus is diesel power of 45,200 horsepower and is capable of continuously breaking ice up to six to eight feet thick. The ship can comfortably accommodate 186 people for 90 days.

In addition to TAI, the Halter Marine has partnered with ABB and Trident Marine for its Azipod propulsion and power distribution system, Raytheon for integrating command and control systems, Caterpillar for key engines, Jamsstown Metal Marine for armholes and Bronzework for the HVAC system. .

By creating a second polar security cutter, Halter Marine will continue its mission of giving national priority to the U.S. Coast Guard. Our talented staff at Halter Marine here are proud to be a part of such an important company , He announced Bob Mercant, Chairman and CEO of Halter Marine.

Construction of the first BSc is expected to begin in 2022, with delivery scheduled for 2025.

The Coast Guards Operational Polar Snow Navy currently has 399-feet of heavy snow, the Coast Guard Cutter Polar Star, launched in 1976, and the 420-foot medium-sized icebreaker, Coast Guard Cutter Healy, launched in 2000.

The Pole Star was reactivated three years later and reactivated in late 2013. Since then, icebreakers have completed six deployments of Operation Deep Freeze to refuel the McMurdo station in Antarctica. Pole Star entered the Life Extension Program (SLEP) in 2021 to extend the effective life of the cutter by four years.

Angelo Martinengo.The first pioneer of modern digital advertising in shipping container fleetsThe first pioneer of modern digital advertising in shipping container fleets_______________Senior Journalist, Container World, FerrodromaEmail: [emailprotected] >https://www.farodiroma.it/?s=a.+martinengo >

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Use. "Halter Marine" won the contract for the second polar security cutter icebreaker for the US Coast Guard (A. Martinenko). - Hardwood...

Recommendation and review posted by Bethany Smith

Since youre here, you probably are one of us. You already know how beneficial fish can be for your overall health, and you probably have promised yourself that youll try to eat fish at least once a week. However, here you are, looking for a fish oil supplement, not knowing where to start.

Well, we have some good news! Fish oil supplements arent just for people who do not want to obsess over their nutrient intake. Even those who watch out for their diets should consider taking supplements to improve their health. And for those like you and all our crew, who dont have time to follow nutrient-rich diets, fish oil supplements are the best choice.

However, we know how challenging it is to find a quality product. Especially these days, every other dietary supplement manufacturer tries to sell its poor fish oil products that give bad fish burps and nothing more.

If youre interested in finding the best fish oil supplements, were more than happy to present you with our selected products. First, weve done thoughtful research based on companies reputations and customer reviews. Then weve chosen these 5 products as the best Omega-3 supplements on the market.

Life Extension has a reputation as one of the best supplement companies. For more than 40 years, this brand has joined forces with health experts to achieve its goal find the best ways to improve health and live a better life.

All Life Extension products are exclusively made in facilities in the U.S. They contain high-quality ingredients that undergo rigorous lab tests for potency and purity. Additionally, all products are tested from third-party labs, and you can search for COAs on the Life Extension website.

Furthermore, Life Extension is nominated for number-one Catalog/Internet Merchant and has won the award 6 times. The companys products are often awarded and recognized by several reputable labs, doctors, and medical magazines.

Life Extension uses quality raw materials, primarily from the U.S., European, and Japanese sources. Each material is mostly analyzed and tested through U.S. Pharmacopeia, but the company uses several other pharmaceutical standards as well. The analyzing methods include liquid chromatography and mass spectrometry, through which the material purity and effectiveness are tested.

Life Extension creates an excellent fish oil supplement that has a unique formula. The product contains EPA and DHA fatty acids, olive polyphenols, and sesame lignans.

The products formula is based on a wild fish oil concentrate from the South Pacific Ocean. Life Extension adds olive extract to provide polyphenol, which will impact your body as taking 4 tablespoons of extra virgin olive oil. As for the sesame lignans, they have many properties in increasing the benefit of the fish oil. In addition, both extracts may help prevent heart diseases. To avoid the fishy taste after the supplement consumption, Life Extension added a natural lemon flavor.

The Fish Oil supplements are GMO-free and are an excellent choice for more sensitive people since theyre gluten-free. Furthermore, Super Omega-3 Fish Oil capsules are certified by IFOS with a 5-star rating.

The Super Omega-3 Fish Oil is available in several package sizes. You can buy the supplement in the form of softgels, enteric-coated softgels, and tiny, easy-to-swallow softgels. The first form comes in two size bottles of 60 and 120 capsules. The Enteric-coated kind its also available in 60 or 120-capsules bottles, and its the best option for a more sensitive stomach. Lastly, the Omega-3 Fish Oil supplement with easy-to-swallow softgels comes in only one size package of 240 extra small capsules.

Each bottle of Super Omega-3 Fish Oil contains 700mg of EPA and 500mg of DPA. The serving size is 4 softgels, and its recommended to take 2 capsules with meals twice a day.

Life Extension has millions of customers in the U.S. and all across the globe. Customers are highly satisfied with the products and their quality. However, some complaints have been reported regarding the shipping schedule, because some people waited a little longer for their orders.

When it comes to the Super Omega-3 Fish Oil, almost every consumer would recommend the product to a friend. Additionally, people say that the product has excellent value for money.

Visit the Official Website of Life Extension

Born in 2012 from a family of natural-food enthusiasts, Wileys Finest has already surpassed its competition in producing nothing but quality Wild Alaskan Fish Oil products. Before they launched Wileys Finest, the brothers sold their unique fish oil to numerous supplement brands. Since they were disappointed by the treatment and disinterest from the companies, they decided to create their own brand that will be focused on producing and selling AlaskOmega, the fish oil ingredient made from a family recipe.

Wileys Finest meets all international standards used for purifying and refining raw fish oil. In particular, the company is a member of the Global Organization for EPA and DHA (GOED), which sets the ground rules along with U.S. and E.U. Pharmacopeia and California Proposition 65.

Besides being supported by GOED, Wileys Finest produces MSC-certified products too. MSC stands for Marine Stewardship Council, and if a product has this label, it means that it meets the most rigorous, science-based standards for sustainable fishing. Additionally, it means that all the ingredients are traceable to a certified source. Blue-labeled products ( MSC certification ) are divided from non-certified products, and this is confirmed with DNA testing.

Wileys Finest uses molecular distillation to remove PCBs and fishy odors without damaging the EPA and DHA components. Furthermore, the company tests every product for other harmful contaminants like mercury and heavy metals.

Easy Swallow Minis are one of the many fish oil supplements created by Wileys Finest. As in the other Wiley products, the Minis are made from Alaska Pollock and labeled with an MSC certificate.

The Easy Swallow Minis are distilled and dont contain fish protein. In addition, they are free from soy, eggs, nuts, wheat, dairy, artificial colors and flavors, and shellfish. Furthermore, they are made from highly-concentrated fish oil, and the softgels are encapsulated with gelatin, water, and glycerin. These softgels are 55% smaller than regular capsules but have more Omega-3 than many other products you can buy on the market.

Wileys Finest Easy Swallow Minis are packed in bottles of several sizes. You can buy this product with 60, 120, 180, and 240 softgels. The recommended dosage is 2 softgels per day, and you should take them with meals.

As for the nutrient value, each serving contains 270 mg DHA and 360 mg EPA, which means youll get a total of 630 mg Omega-3.

People love Wileys Finest products because they are potent and effective. Furthermore, customers choose this company because it uses Alaskan Pollock, and the fish is caught by U.S.-registered vessels. In addition, customers recommend the Easy Swallow Minis for their size and nutrient value.

However, some customers find Easy Swallow Minis more expensive than other supplements if purchased in small packages.

Visit the Official Website of Wileys Finest

Natures Best is a UK company that produces quality dietary supplements. The brand has existed for more than 30 years, and its one of the most popular and preferred in the old continent. Fortunately, the company ships internationally, so we can all enjoy its high-quality products.

Why is Natures Best on our list of the best fish oil supplements? Well, this brand strictly sticks to industry regulations, and its been recognized and certified by many trustworthy and professional scientific organizations.

All Natures Best products are made to meet GMP standards. Furthermore, the fish oil supplements are certified by Friend of the Sea, which is an internationally recognized organization.

As we mentioned earlier, Natures Best fish oil supplements are supported by Friends of the Sea. Therefore, the company guarantees to its customers that it operates in responsible and sustainable ways. The brand sticks to professional and legal practices to keep its certification badge. This means that the products must come from quality sources of fish oil, the used ingredients must be pure, natural, and GMO-free. Furthermore, all raw ingredients are tested by the company but by third-party labs as well.

Natures Best Omega-3 Fish Oil softgels are made through a 5-stage process of purification. The product is certified by Friends of the Sea and meets the rigorous standards set by GOED and the European Commission.

The softgels contain 360mg of EPA and 240mg of DHA, delivering a total of 700mg of Omega-3s with each piece. Additionally, Natures Best adds Vitamin E in the capsules to protect the formula from oxidation.

This fish oil supplement contains fish oil concentrate, antioxidants, gelatine, and glycerin. Furthermore, its free from wheat, dairy, soy, nuts, yeast, and gluten. However, its not suitable for vegans, which its logical since its made from fish oil. Still, if youre interested in vegan alternatives, Natures Best creates plant-based supplements, such as Veg Omega-3 Oil and Flaxseed Oil.

The Pure Fish Oil 1100mg comes in one package size of 180 capsules. However, Natures Best produces several fish oil supplements that come in different pack sizes, including 1300mg or 1000mg. Also, you can find supplements with additional plant antioxidants, CoQ10, or Omega-3 chewies.

Pure Fish Oil 1100mg supplements are suitable for all adults. The recommended daily intake is 1 to 3 capsules per day, and you should take them with a meal.

Well, we searched through many customer reviews on this brand. So far, the only thing that people are complaining about the most is the size of the capsules. On the other hand, consumers are delighted with the supplements effectiveness and potency. Many reviews show that Natures Best helped many people improve their health and reduce their Omega-3 deficiency.

Additionally, customers are pleased with the affordable prices and the fish oil supplement diversity.

Visit the Official Website of Natures Best

All vegans gather up! Whether youre a long-time vegan or youve recently decided to change your daily habits, Vegetology is the best place to go. This pro-vegan company has built its reputation by producing unique nutritional formulas that are super eco-friendly at the same time.

Even if youre not vegetarian or vegan, we recommend you consider Vegetology. Its mission is to provide natural and plant-based dietary supplements that help in the battle for a better future for the planet and the global environment.

Furthermore, Vegetology is recognized by the Vegetarian Society and the Vegan Society. The company is a proud partner with the Vitamin Angels and has donated money and supplements to millions of people via Unicef, Middlesbrough Foodbank, Mansfield Soup Kitchen, and Care Sector. Vegetology also supported the NHS during the Covid-19 pandemic by donating over 20,000 bottles of Vitamin D3.

Vegetologys team puts in a lot of work, analysis, and research to deliver gluten and GMO-free supplements by using ingredients from nature along with plant-based technologies. This brand is way ahead of its competition because it found healthy alternatives for nutrients we all need to consume daily. Therefore, at Vegetology, you can find Omega-3 EPA and DHA from algae, Phytodrotin as a substitute for Chondroitin, and Vitashine, a plant-source Vitamin D3

Moreover, Vegetology recently changed all supplement bottles into a 100% biodegradable version. Each bottle is CO2 neutral, and its made with eco-plastic from sugar cane. The bottles biodegrade within 10 years.

Opti3 is a 100% natural dietary supplement that contains Omega-3 EPA and DHA from algae. Many people think that these fatty acids are ingredients found only in fish. However, thats not true. Omega-3 EPA and DHA are found in the water algae, and thats the place where fish initially get the ingredients. Vegetology only skipped the mediator and jumped directly to the source.

Furthermore, the supplement contains additional Vitamin D3. However, were not talking about widely used Vitamin D3 from animal sources. Vegetology invented its own alternative, called Vitashine. Vitashine doesnt have any pesticides or harmful solvents and is 100% plant-based Vitamin D3.

Additionally, Opti3 by Vegetology is 100% natural, GMO and gluten-free, and suitable for all people. The product can be used during pregnancy too.

Opti3 Omega-3 supplement by Vegetology comes in a package of 60 capsules. One supplement bottle is enough for a months supply because the recommended daily dosage is 2 capsules per day.

With each serving size, youll get 300mg of EPA and 500mg of DHA. Additionally, the product has 100% natural Vitamin D. Moreover, the capsules can be pierced and consummated like liquid for those who dont want to swallow tablets.

Customers so far adore Vegetology for its eco-friendly principles and actions. Even non-vegan customers have chosen Vegetology as their supplements supplier because of its advanced plant-based technologies and vegan alternatives.

However, some people think that Opti3 is more expensive than some fish oil supplements. This claim is hardly a disadvantage since more expensive equipment and work are needed to purify the ingredients and create a 100% natural product.

. Visit the Official Website of Opti3 Omega-3

Efamols story started in the late 50s when a group of researchers started investigating the properties of the Evening Primrose plant. Since then, Efamol has developed numerous dietary supplements based on high-standard studies and research.

For more than 40 years, Efamol has been concentrated on producing quality over quantity. The companys product range contains several high-quality supplements for improving brain function, energy, memory, and skin beauty. Its products are based on the importance of Essential Fatty Acids.

Furthermore, Efamol has done numerous studies over the years, and all of them are publicly published. The company its still putting all the effort into creating better products for more health benefits.

Efamol uses fish body oil as a raw material for its supplements. According to the company, fish body oil is better than liver oils because it is lower in environmental toxins. The company uses the Molecular Distillation process three times so that the fish oil meets all pharmacopoeial standards. Additionally, all supplements are subject to rigorous testing and made under GMP standards.

Besides creating fish oil products for adults, Efamol produces one of the best Omega-3 supplements suitable for kids. The companys research shows that fatty acids are essential for kids development and general health. Thats why Efamol Kids DHA Drops contain tasteless and high-quality fish oil, which is carefully extracted through Molecular Distillation.

Efamol Kids Drops are made from the triglyceride form of fish oil since this form has a natural structure of Omega-3, and our bodies recognize it. The fish oil used in the Kids Drops undergoes strict checks, and its tested for over 50 environmental contaminants.

Furthermore, the formula is suitable for the whole family, and it can be consumed by children that are 6 months old. The supplement is free from sugar, lactose, dairy, yeast, and artificial additives, such as colors and preservatives. Additionally, a natural lemon flavor is added so that the supplement is tasteful.

Each 1ml of these Kids DHA Drops contain 400mg of DHA and 70mg of EPA. Along with the Omega-3s, your kid will get approximately 19% of Vitamin E. The recommended dosage is exactly 1ml for kids, so Efamol Omega-3 DHA Drops are a relatively affordable supplement.

This fish oil supplement is an excellent choice for kids because you can add drops to food. Furthermore, the drops are packed in a recyclable glass bottle.

More than 90% of parents that have purchased the Efamol Omega-3 Drops are highly-satisfied and recommend the supplement to their friends. Customers say that the drops are perfect for smaller children or young adults who have a problem with swallowing capsules. Also, customers recommend this product for its purity and tasteless fish oil.

On the other hand, weve read some complaints about the low level of EPA in the supplement. However, the company is focused on the benefits of the DHA, so its work is mainly focused on providing authentic products.

Visit the Official Website of Efamol Omega-3

One simple wish to lead a healthier life isnt enough for achieving that particular goal. We have to do a series of activities, such as eating healthy food, exercising, and working on our mental health.

However, can you imagine eating fish every day just to get the needed level of Omega-3? Probably not. It takes time to prepare the meal and also some culinary skills. Even if you find a few hours in your daily schedule, its hard to believe youre going to do so four or five times a week. Since Omega-3 is essential for our body and brains function, fish oil supplements are a must in everybodys daily routine.

At this point, we landed on the main problem. How to find a quality and effective supplement that will improve your health but at the same time wont make a hole in your wallet? The answer is simple. During the research about our article, we found out how to set some standards, eventually finding the most suitable supplement.

Since were sure that you already know the real benefits of Omega-3, the following sections goal is to help you find the right ones. Just to mention our enlisted companies for fish oil supplements are meeting all necessary criteria that well discuss next. We kindly suggest you read our basic rules so that youll be able to find the best fish oil supplement for you.

Essential fatty acids, such as EPA, DHA, and ALA, together make the well-known Omega-3s. Each of these acids has its own function and impact on our bodies. The DHA and EPA are found in animal food and algae, while ALA is mainly found in plants. Since we dont produce these fatty acids, we have to obtain them from our meals.

However, just like we mentioned before, modern living and fast life dont allow us to cook all day, so heres where fish oil supplements appear on the stage.

While ALA is the most common Omega-3 fatty acid, the DHA is the most important for your body. This is the reason why a small percentage of ALA and EPA is converted into DHA in our bodies. The DHA fatty acid is a component in our brain and several other body parts.

You should be careful because many companies claim that their product contains a high level of Omega-3, but it turns out that they lack DHA. We recommend you buy products with a considerable amount of EPA since this fatty acid is also important.

We all have different preferences, and to be honest, different swallowing abilities. Fortunately, supplement manufacturers take customers preferences seriously, so they aim to create more consumable pills.

However, many ignorant companies dont try to satisfy their customers. They produce supplements with sizes of horse pills which are hard to consume and will eventually repel customers.

Thoughtful brands make easy-to-swallow fish oil supplements. Furthermore, theyre aware of the fish oil smell and taste, so they devote a whole special period to ensure the flavor of the supplement.

Additionally, you should know that fish oil supplements can be packed as softgel capsules or liquid. So, if you for any reason cant consume capsules, you should look for a company that sells liquid fish oil. Moreover, the Omega-3 liquid form is more convenient for smaller children.

Lastly, you should always check the ingredients list on your product. Besides the DHA and EPA, many companies add additional ingredients for more health benefits or flavor. If you have allergies, we recommend you check the supplement label, whether its GMO, gluten, dairy-free, etc.

Additionally, its essential to choose a transparent manufacturer that allows its customers to read third-party reports. In those reports, you can find details on the type of fish where the oil is coming from.

Well, we cant naturally produce fatty acids, so our body takes them from our diet. However, not every person has the ability to eat fish several times a week. Some people are allergic, others dont have time to cook, some people cant afford to eat fish regularly, and others simply dont want to eat fish.

Whichever the reason is, Omega-3s are quite essential for our health and well-being. So, we can obtain all the benefits we get from a fatty fish meal by consuming fish oil supplements.

There cant be a side effect from taking a product intended to improve your health. Omega-3 can increase good cholesterol, reduce blood pressure, treat certain mental disorders, help you lose weight, improve your eye health, and reduce inflammation. These are just a few of the countless health benefits you can enjoy by taking Omega-3 fatty acids.

However, just like with anything else, its not recommended to overuse taking fish oil supplements. If you take a large amount, you may experience stomach upsets, loose stools, nausea, and a fishy taste in your mouth. Furthermore, taking more fish oil supplement dosage than recommended, in the worst-case scenario, can increase the risk of bleeding.

So, if you want to take a higher dose, its better to consult with your doctor.

Thats all, folks! In the end, let us remind you once more to be careful. As we mentioned earlier, as modern technology advances, more and more companies try their luck in dietary supplements. Since this is the health were talking about, we dont want to be lab rats for some unknown, low-standard company.

To produce pure and effective fish oil supplementation, companies should base their work on science, research, and quality ingredients. We followed high criteria regarding their production methods, certification, and third-party lab tests to find brands worth our attention. Furthermore, we listened to other peoples experiences to enlist the best fish oil supplement companies.

In the end, we hope that our article will be of great help to you, and that youll find the most suitable supplier.

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Best Fish Oil Supplements: Fish Oil Pills With Omega 3 Supplement in 2022 - Blog - The Island Now

Recommendation and review posted by Bethany Smith

Whether a deadly disease like cancer and Alzheimers or a lifelong affliction like diabetes, eczema, or arthritis, 2021 has been a year of breakthroughs and advancements.

Beyond COVID-19 and the developments of the mRNA vaccines created to halt the pandemic, medical researchers around the world continued to focus on the long-entrenched problems that have plagued our health for centuries.

Here are some of the top Health stories from 2021:

Routinely polled as one of the most-feared diseases, Alzheimers researchers have hailed several achievements this year.

One fascinating focus has been on prevention, or what contributes to the disease.

A neuroscientist who authored a book called The First Survivors of Alzheimers is not so much focused on drugs as he is focused on brain prevention and is achieving results never before seen in the history of Alzheimers treatment. (Read more)

The findings of a drug that seemed to restore normal cognition in a variety of cases ranging from traumatic brain injury, to noise-related hearing loss, to neurodegenerative disease seem to suggest, its creators write, that age-related cognitive loss may be down to a physiological blockage rather than permanent damage. (Read More)

As seen many times before, sometimes the best new cure is an old drug. Four drugstwo non-steroidal anti-inflammatories, along with two anti-hypertensives, proved effective at reversing Alzheimers disease and neutralizing symptoms in mice suffering from various stages of the illness. (Read More)

As long as theres lifeforms, there will be cancer, but that doesnt mean we cant learn how to treat it, strike at the root cause, and hopefully turn at least some forms of it from one of the major killers to a minor inconvenience.

With 12,000 Britons diagnosed with head and neck cancer every year, the results of a phase III trial that saw complete eradication in some patients, and side-effect-free life extension in others, has the country excited. (Read More)

Discovering an RNA molecule that regulates a key driver in the growth of prostate cancer cells is noteworthy because prostate cancer is one of the most common in men around the world, and because most drugs work for a short period of time before the cancer becomes resistant to it. (Read More)

Despite the gradual awareness of the harmful effects of sugar and bread on the body, chronic diabetes and juvenile diabetes continues to be a major problem in our society.

It turns out that all it takes for this potential cure to rid a patient of a debilitating autoimmune disease is a small piece of adult skin no larger than a housefly. With FDA trials underway, hundreds of thousands of Type-1 diabetics have a chance at a potential cure. (Read More)

Nearly 500 million diabetics around the world need to mildly stab themselves in order to ensure they are in no danger of going into shock. An Australian med-tech company has a new solution. (Read More)

Afflicting a quarter of all Americans, and the leading cause of workplace disability resulting in $303 billion in lost productivity, arthritis took a step towards a cure in 2021.

An alternative to highly addictive painkillers is offering those who undergo knee replacements a large measure of safe relief. Many arthritis patients have knees and hips replaced in the hope of regaining some measure of mobility later in life, but the resulting pain and stiffness can sometimes only be treated with opioids. (Read More)

Osteoarthritis is the most common form, and it affects 8.5 million people. Nasal cells come from a special class of adaptive tissues produced in the brain and spinal cord that can be used to relieve chronic inflammation in the knee and lay the groundwork for a therapeutic treatment that spares patients of surgery and prosthesis. (Read More)

It would seem silly to write a list such as this without addressing the elephant in the room, but as the pandemic petered on through 2021, breakthroughs continued to be made.

One of Americas most favorite medicines was found, unsurprisingly to some doctors, to have as strong an effect as vaccines in some cases at mitigating the severe symptoms of COVID-19. (Read More)

Along with an Israeli nasal spray that prevented infection in 99% of patients, another was found in trials at the University of Oxford which killed 99% of the virus in the nasal passage. (Read More)

Some demonstrations of prosthetic internal organs have shocked the world in 2021, providing a glimpse of a sci-fi future for human anatomy.

A bio-tech implant that allowed a 78-year old blind man to see his family again actually binds with the inside of the eye-socket in a way that had never been done before. (Read More)

The worlds first legit prototype for an artificial kidney was successfully tested when the blood filter and bio reactor components were demonstrated to work together, offering hope to free kidney disease patients from dialysis machines and transplant lists. (Read More)

Ticks, as awful as they are, have their place in the Web of Life. Researchers have identified a soil microbe that eliminates Lyme Disease but essentially nothing else, not even the ticks, opening the door to ecosystem wide treatment against Lyme Disease. (Read More)

Stem cells prepared with the patients own bone marrow were used to repair damaged spinal cords and restore mobility and motor functions in more than half of a Yale scientists trial. (Read More)

An incurable autoimmune disorder that results in progressive motor function loss and neurodegeneration, an MS breakthrough was achieved using the same mRNA vaccines that worked so well originally to stop the COVID pandemic. (Read More)

A monoclonal antibody that reduces the amount of inflammatory molecules that cause a hormonal dysregulation leading to eczema was a treatment generated by this totally surprise finding. (Read More)

Habit Cough the name for a cough without a cause has been cured through a YouTube video relying mostly on the power of suggestion. While this may seem a little sketchy, many people with habit cough have no underlying respiratory condition of any kind, and therefore an ounce of suggestion may beat a cure. (Read More)

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Best 2021 Medical Breakthroughs And Treatments to Beat Cancer, Alzheimer's, Diabetes & More - Good News Network

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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

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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

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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

Recommendation and review posted by Bethany Smith

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

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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

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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

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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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Find Out What Your Eyes Are Trying to Tell You About Your Health | TheHealthSite.com - TheHealthSite

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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.

See more here:
How to Get the Healthy Nutrients in Milk on a Dairy-Free Diet - Go Dairy Free

Recommendation and review posted by Bethany Smith