Archive for the ‘Hormone Clinic’ Category

Is there a link between hypothyroidism and infertility? 5 lifestyle changes to manage thyroid disorders  |  Photo Credit: iStock Images

New Delhi: Hypothyroidism, or underactive thyroid, can make you feel unpleasant and affect many different systems in your body. In fact, a Harvard Medical School study reported that having even a slightly underactive thyroid may interfere with a womans ability to get pregnant. For women, treating this condition is a crucial part of any effort to improve fertility. Butlifestyle measures can help improve thyroid function and ease the symptoms of hypothyroidism.

Hypothyroidism is a medical condition in which your thyroid gland doesnt produce enough of certain crucial hormones. It occurs when the thyroid hormone regulations and production is disturbed and can lead to a wide range of issues like fatigue, low energy, weight gain, and constipation accompanied by infertility symptoms such as menstrual irregularity, difficulty in ovulation, and difficulty in conception.

The thyroid is a small butterfly-shaped gland in front of the neck which helps to regulate our hormones. The pituitary gland in the brain produces a hormone called thyroid-stimulating hormone which helps produce other two hormones known as triiodothyronine (T3) and thyroxine (T4) from the thyroid gland. These hormones aid in the normal functioning of the body.

Experts and medical doctors have known for some time that low levels of thyroid hormone can interfere with the release of an egg from the ovary (ovulation), which impairs fertility. Moreover, some of the underlying causes of hypothyroidism -such as certain autoimmune or pituitary disorders - may impair fertility, as per Mayo Clinic.

Even men suffer from hypothyroidism. In men, hypothyroidism can reduce the sperm volume and motility of sperm leading to decreased fertility. Ideally, anyone with a sedentary lifestyle and weight gain issues need to get their thyroid levels checked to rule out hypothyroidism, said Dr Richa Jagtap, clinical director & consultant - reproductive medicine, Nova IVF Fertility.

Hypothyroidism is commonly found alongside polycystic ovary syndrome (PCOS). There is a 2-4 per cent prevalence of hypothyroidism in women of the reproductive age group (20-40 years). Around 20-30 per cent of women with infertility may have hypothyroidism, added Dr Jagtap.

How to identify a thyroid problem

Once your doctor diagnoses the clinical symptoms, he or she will ask you to do a blood test called TSH or thyroid-stimulating hormone test and T3, T4 levels. Normal TSH levels fall between 0.5 to 4.5.

For a woman trying to conceive, even a mild increase in TSH should be appropriately corrected. This ideally needs to be corrected so that the TSH levels fall around the range of 2.5. These levels are safer for a woman to conceive because then her hormones will be in appropriate range while she is trying to get pregnant. The good news is that appropriate medication will help the thyroid hormones to get back to normal, added the doctor.

Usually, when one starts medication, it will take around 3 weeks for thyroid levels to start correcting. It also depends on how much the initial thyroid level was. For instance, if the TSH level is high then it will take a longer time to get back to the normal range. If it is borderline high then it wont take much time for the levels to get back to the recommended range. Lifestyle changes that can help manage thyroid disorders include:

Medication and lifestyle changes will help patients get back on track.If you are pregnant and have hypothyroidism, you mustget appropriate treatment. Also, you should not discontinue the medication without informing your doctor.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.

Read this article:
Is there a link between hypothyroidism and infertility? 5 lifestyle changes to manage thyroid disorders - Times Now

As a country, Japan is known for being at the forefront of technological advances, especially robotic tech. Japan has acted as the global leader in the revolution in robotics over the last several decades.

Bryan Brochu of rocketspace.com correctly notes that the island nation drives the advancement of artificial intelligence, machine learning, and machine vision technologies which are essential to powering the new age of innovation in robotic hardware.

Thus, it is no wonder that the newest and most innovative massage chair, the JPMedics Kawa Massage Chair, comes from the Japanese stable of innovative massage chair technology.

TheKawa Massage Chairincludes features such as:

At this juncture, it is reasonable to ask the question, why massage? Why is massage so important that massage chairs are designed to give expertly choreographed human-like massages?

The straightforward answer to this question is that massage is integral to maintaining human mental health and well-being, especially during the seemingly never-ending COVID-19 pandemic.

The Mayo Clinic reports that a sixty-minute massage lowers the stress hormone cortisol by 30% after one session. Additionally, a study titled Effectiveness of Therapeutic Massage for Generalized Anxiety Disorder: A Randomized Controlled Trial, reported that participants who underwent regular massage therapy for twelve weeks showed a 50% reduction in anxiety symptoms. And the 50% reduction in anxiety remained constant for over twenty-six weeks, even though the massage therapy had ended.

Lets take an in-depth look at some of the JPMedics Kawa features as a way to describe its health benefits to reduce stress and anxiety.

1. 3D humanistic massage mechanism

The 3D robotic engine moves along an extended L-track that reaches from the neck to the glutes. The 3D rollers move left, right, up, down, in, and out, mimicking the action of human hands, working deep into the shoulders and back, penetrating the shoulder and back muscles. The robotic engine plus the 3D rollers provides the most human-like massage found on any massage chair.

Lastly, a deep massage is designed to work out muscle knots, relax the muscles, and improve the blood flow to the areas massaged, helping the body relax and reduce stress and anxiety levels.

2. Air cell technology to position the body for an improved massage

The JPMedics Kawa massage chair uses air cell technology inside the chair to position the body for a more accurate and improved massage experience.

What is air cell technology?

In summary, air cell technology replaces the traditional foam inside the massage chairs back and seat with millions of individually constructed air pockets. These air pockets release air when weight bears down on them, acting as shock absorbers. And because these air pockets are separately built, they help spread the body weight evenly across the chair, resulting in increased blood circulation, the faster recovery of tired and tense muscles, and greater oxygen intake. When combined with a relaxing massage, this technology helps lower stress and anxiety levels, especially after a day plagued by low-grade anxiety and panic.

3. Foot rollers expertly massage the feet

The foot rollers supply a combination of pressure point massage and compression massage. Compression massage is when pressure is applied to the muscle or underneath of the foot in this instance. This pressure is held and released, facilitating relaxation and activation of the parasympathetic nervous system.

Juxtapositionally, pressure point massage is where direct pressure is applied to specific points on the foot, relieving muscle tension, and providing pain relief. Pressure point massage in the feet is also known as Reflexology, where pressure is applied to specific reflex points on the foot, triggering relaxation and healing of the corresponding organs and areas of the body.

In summary, the combination of Reflexology and compression massage on the feet relax the foot muscles and assists with stress and anxiety relief for the whole body.

Final Thoughts

There is no doubt that the information presented above shows that the JPMedics Kawa massage chair is a valuable purchase.

The Modern Back is the leading brick-n-click retailer in the United States, with the best and latest massage chairs are on offer both online and at The Modern Back's showrooms in Boynton Beach and Sarasota, Florida.

The company's virtual and land-based showrooms have the largest selection of massage chairs available for sale, including many different brands and models ofmassage chairsto suit every budget. Lastly, should clients require sales assistance, The Modern Back's friendly, knowledgeable staff are always on hand to answer questions and assist with their massage chair purchase.

Google Map Link: https://g.page/the-modern-back-boynton-beach?gm

Media ContactCompany Name: The Modern Back - Boynton BeachContact Person: Jessica HopeEmail: Send EmailPhone: 800-416-4304Address:1054 Gateway Blvd STE 108 City: Boynton BeachState: FL 33426Country: United StatesWebsite: https://themodernback.com

Original post:
JPMedics Kawa: The Newest Japanese Massage Chair and Its Health Benefits to Reduce Anxiety and Stress - Press Release - Digital Journal

Can you see this? Do you have to focus to read this text on your screen? Do you feel your eyesight is still strong or have your eyes deteriorated recently as well?

With the lockdown, homeschooling, and working from home, we are all staring at screens, tablets, and mobile phones even more than we already did before the COVID-19 pandemic. Most people spend endless amounts of time at home now and rarely go outside. But that means our eyes are constantly focused on objects in close range inside, and we're lacking the benefits of looking into the distance.

A lack of exercise is particularly noticeable in children including exercise for their eyes. Recent studies from the Netherlands and China show that as a result of COVID-19 restrictions, myopia has increased dramatically, especially in children. The phenomenon has been called "quarantine myopia".

Data from more than 120,000 Chinese school children showed that kids between the ages of six and eight were up to three times more likely to have myopia in 2020 than children of their age in previous years. In this age group, visual acuity shifted by a substantial 0.3 diopters towards myopia.

This drastic deterioration of eyesight in young children is particularly frightening because being nearsighted (not being able to see objects that are farther away) isdetermined at an early age. Once someone is nearsighted, they stay that way. In most cases, nearsightedness begins in primary school and it increases as children grow up. The earlier it starts, the more severe it becomes. The grown eye does not shrink again.

If the eyeball grows too much between the ages of six and 10, it means the child has a harder time seeing objects farther in the distance. Severe nearsightedness also increases the risk of retinal detachment, cataracts due to high pressure inside the eye, or even blindness later in life.

Focusing on objects in close range for too long can harm your eyesight

According to the Brien Holden Vision Institute, by the middle of the century around five billion people, or roughly half of the world's population, will be nearsighted. Especially in industrialized countries, the number of nearsighted people has risen rapidly in recent decades.

There is even a direct correlation between increased educational opportunities and poorer vision the higher the level of education, the higher the risk of myopia.

"The increase is mainly due to very early and intensive use of PCs, smartphones and tablets, combined with increasingly shorter amounts of time spent outdoors during the day," said Nicole Eter, Director of the Department of Ophthalmology at the University of Mnster.

Asian countries have above-average rates of nearsighted children and adolescents. For example, after World War II, about 20-30% of 20-year-olds in Hong Kong, Taiwan and South Korea were nearsighted; today the figure is more than 80%. In China, four out of five young people are now nearsighted. In other Asian countries, the rate is as high as 95%. In Europe too, about half of young adults are nearsighted.

Close to 85% of Chinese university students are nearsighted, raising the prospect of a significant swath of the country's population suffering loss of sight or blindness in old age

The risk of myopia can be reduced by not staring too long at an object in close range, regardless of whether it is a smartphone or an exciting book. The important factor is distance. The observer needs to look up regularly so that the gaze can wander into the distance.

The risk of myopia is reduced primarily by longer amounts of time spent outdoors, because daylight inhibits further growth of the eyeball. In enclosed rooms, the light intensity averages 300 to 500 lux (a measure of light levels), whereas on a bright summer day it can be around 100,000 lux outside. Studies from Scandinavia also show that myopia increases in the darker seasons, while it stagnates during brighter times of the year.

The blue light of smartphones robs us of sleep because it inhibits the release of the hormone melatonin.

Excessive use of electronic media does not justlead to more nearsightedness. It can also irritate, tire and dry out children's eyes. Constantly looking at screens also affects spatial awareness. Blurred vision or squinting can result from too much time spent on devices.

In addition, smartphone use in the evening may lead to sleep disorders.

"The high blue light content of the screens inhibits the release of the hormone melatonin, which makes you sleepy," explained Eter.

Although many devices now have a night mode that reduces the blue light, we should stop looking at them around two hours before bedtime.

Parents should limit their children's use of digital media, especially for the youngest age groups.

Parents should limit their children's screen time to help protect their eyesight

"From an ophthalmological point of view, PCs, smartphones and tablets are completely unsuitable for children up to the age of three," said Bettina Wabbels from the Bonn University Eye Clinic. The eye expert recommends daily use of no more than thirty minutes for four- to six-year-olds.

"At primary school age, media time of a maximum of one hour per day would be acceptable from an ophthalmological point of view, and up to two hours per day from the age of about ten," explained Wabbels.

However, her advice doesn't just apply to children and adolescents. Adults' eyes also need a break. So look up from the screen more often, let your eyes wander and spend more time outdoors.

Link:
COVID-19 and eyesight: Myopia on the rise during lockdown - DW (English)

A new womens health charity created by a Shelly Beach family is helping a whole generation of women find understanding, confidence and comfort as they undergo the change before the change.

The Debbie Gaunt Foundation was launched to build awareness about perimenopause, an often-challenging life event that can have devastating impacts on a womans physical and mental health.

The transitional period before a womans final menstrual period (menopause), perimenopause most commonly occurs in women in their mid-40s and signifies the ovaries winding down.

Lasting anywhere between one to ten years, women going through perimenopause often experience the same or even more intense symptoms of menopause.

Irregular periods, hot flushes and exhaustion are as common among perimenopausal women as they are during menopause, as are mood swings, anxiety and depression.

But unlike menopause, perimenopausal women often manage their condition independently and in private.

Medical research into health problems and complications linked to perimenopause is also surprisingly scant, something Foundation Founder, Craig Gaunt, became painfully aware of after losing his wife Debbie to suicide in 2019.

A wife, mother, friend and colleague, Debbie became severely mentally unwell shortly before her death, an episode that has since been partially attributed to the hormonal effects of perimenopause.

Vowing to honour Debbies memory to help other women and their families experiencing perimenopause, through the Debbie Gaunt Foundation, the Gaunt family now works tirelessly to raise awareness and understanding of perimenopause as well as funds for Australian led studies and projects that explore the mental health impacts of the condition.

Improving general awareness of perimenopause is also high atop the Foundations to do list.

Debbies perimenopause was very retrospective for my family.

We had never even heard of it before and sadly thats the case for most people, even women, so they just suffer throughout it all.

Thats why we made a promise to do something about it, Craig said.

The Foundations first major project has been to fund the development of a womens midlife mental health module for doctors to be delivered by Melbournes Monash Alfred Research Centre, the only specialised clinic in the country dedicated to helping women experiencing perimenopause.

The module will address perimenopausal depression, menopause and hormone replacement therapy, complex trauma disorder in perimenopause and family violence.

So far, the Foundation has donated $20,000 for the project and has committed to raising an additional $24,500 for it throughout 2021.

According to Craig, the Foundations long term goal is to help fund the opening of more specialist clinics like Monash Alfred around the country, including one here on the Coast.

Dilon Luke

Original post:
Debbie Gaunt Foundation putting perimenopause in the spotlight - Central Coast Community News

The medical group has locations throughout the Greater Los Angeles area and beyond.

LOS ANGELES (PRWEB) January 20, 2021

A December 18 article on 9Honey reports on a 27-year-old woman in New Zealand who was able to shed an astonishing 176 pounds after undergoing weight loss surgery. The patient, Claire Burt, said she battled eating disorders, depression, and isolation as a result of her excessive weight but was unable to slim down despite frequent dieting and medication. The article reports that Ms. Burt was finally able to receive gastric sleeve surgery in April when 80% of her stomach was removed. Ms. Burt stated that since the surgery, she hasnt faced any obsessive thoughts over food, and her mental state has significantly improved. Health and beauty medical center Beverly Hills Physicians says that losing weight and successfully keeping it off long term can be difficult to achieve naturally, and getting medical assistance for a healthier and better quality of life simply makes sense.

Beverly Hills Physicians says that, while most people have less weight to lose, what Ms. Burt experienced while attempting to lose weight on her own is exactly what many severely obese individuals face. The clinic says that, while it is possible for some people to lose weight naturally on their own, keeping the weight off is nearly always unsustainable because the body fights what it perceives as the threat of starvation. Beverly Hills Physicians says that, because the body becomes accustomed to receiving a certain number of calories every day, it sends hunger signals to the brain in an attempt to encourage the individual to eat more when that intake is significantly reduced.

The health and beauty medical group says that this is why medical intervention is often necessary to lose and maintain a healthy weight for those fighting obesity. By removing a portion of the stomach in such procedures as sleeve gastrectomy, the hormone center responsible for sending the hunger pangs is often minimized. In addition, Beverly Hills Physicians says that, with a drastically smaller stomach, patients are only able to eat smaller portions comfortably, further helping individuals maintain weight loss.

The bariatric center adds that when patients can lose a significant amount of weight, they are not only reducing the likelihood of developing health issues such as diabetes or cardiovascular disease, but they are also improving their overall quality of life. Mobility, energy levels, and more can all be subtle benefits of losing significant amounts of weight.

Readers interested in learning more about weight loss surgery or any other of Beverly Hills Physicians offerings can call 1-800-788-1416 or visit the health groups website at https://www.beverlyhillsphysicians.com/.

Share article on social media or email:

See the rest here:
Weight Loss Surgery Advantages Emphasized in New Zealand Woman's 175 Pound Weight Reduction, says Beverly Hills Physicians - PR Web

The Telegraph

Schools could open before Easter, Gavin Williamson has suggested, saying he will give a two-week warning to headteachers. The Education Secretary said he "would certainly hope" that children would be back in the classroom by early April, adding that he wants this to happen at the "earliest possible opportunity". It is the first time Mr Williamson has hinted at a possible timeline for the reopening of schools, and comes after Dr Jenny Harries, the deputy chief medical officer, suggested schools in some parts of the country will reopen sooner than those in others. Primary and secondary schools were ordered to close at the start of the month to all but the children of key workers and the most vulnerable youngsters. Announcing the latest national lockdown on January 4, Boris Johnson said schools would need to remain shut until the February half-term at the earliest. On Thursday, Mr Williamson said a key factor in determining when schools could reopen would be whether pressures on the NHS had eased sufficiently. He told BBC Radio 4's Today programme that headteachers will be given "absolutely proper notice" about when they need to prepare to reopen, adding that a "clear two-week notice period" will be factored in so schools have time to prepare for pupils' return. "Schools were the last to close, schools will be the first to open," the Education Secretary said. "I want to see that as soon as the scientific and health advice is there to open at the earliest possible stage, and I would certainly hope that that would be before Easter. "Any decision to reopen schools to all children as all decisions in terms of schools will be based on the best health advice and the best scientific advice."

Read the original here:
One Killed as Motorcyclists Ride in Wrong Direction on San Francisco's Bay Bridge - Yahoo News UK

January is National Thyroid Awareness Month, a time dedicated to promoting the prevention, treatment, and cure of thyroid-related illnesses. Thyroid disease is more common than you may thinkan estimated 20 million Americans have some form of thyroid disease and up to 60 percent of them dont know they have it, according to the Cleveland Clinic. Women are also at higher risk and are five to eight times more likely to develop thyroid disease than men.

Youre probably wondering what is the thyroid and why is thyroid disease so common? Small but mighty, the thyroid is a butterfly-shaped gland that sits at the base of your neck, says the Centers for Disease Control and Prevention (CDC). This gland controls the rate at which every cell, tissue, and organ in your body functions, including the brain, heart, and digestive tract. The thyroid is the master controller of metabolic function throughout the body, Dr. Ryan M. Green, DO, MS, the Medical Director of Preg Appetit! and Principal Medical Advisor at Monarch Athletic Club in West Hollywood tells The Beet. This is because the thyroid produces the hormones T3 and T4, which regulates your metabolism a chemical activity of cells converting nutrients into energy.

There are two main types of thyroid disorders most common in the United States:Hypothyroidism is when the thyroid gland doesnt make enough hormone and hyperthyroidism is when the thyroid gland makes too much hormone, says the Cleveland Clinic. Imbalance in either direction regarding thyroid function can have a major impact on how someone lives day-to-day, explains Dr. Green. As seen with most non-infectious illnesses nowadays, thyroid diseases are generally provoked by increased environmental toxins in the air, water, and food. Another popular cause entails nutritional deficiencies or imbalances, which means youre probably not getting the right nutrients to support your thyroid, says Dr. Green. Unfortunately, many of the nutrients that are essential for proper thyroid function are not made by the body and therefore need to be consumed in our diet, Ashley Shaw, MS, RDN, a registered dietician at Preg Appetit! tells The Beet. Adequate levels of these nutrients allow the thyroid to produce and secrete hormones that are invaluable to normal body processes, including but not limited to, rate of metabolism, bone development, muscle growth and contraction, speed of heartbeat, and body temperature regulation. Below, we have listed five nutrient-rich foods that can optimize thyroid function and help prevent disease.

If youre a big fan of sushi, youre surely going to love this one. Seaweed, aka sushi wrapper, is a form of edible algae that grows in the sea. It is naturally full of iodine with some varieties containing up to 2000% of the daily value. Iodine is a nutrient used by the thyroid gland, essential for the development of thyroid hormones that have many functions, says Shaw. It is not something our bodies make on their own, so we have to get it from foods or supplements. Its important to keep the right balance of iodine in your diet, according to a 2019 study. Researchers found that while some people can tolerate high amounts of iodine, it may lead to hyperthyroidism or thyroid autoimmunity. Be aware of your iodine intake and incorporate a variety of seaweed, such as hijiki, nori, and Irish sea moss in your diet.

Brazil nuts are one of the richest sources of selenium, a key nutrient in preventing thyroid disease. The recommended daily intake of selenium is 55 mcg for adults and brazil nuts, on average, contain 96 mcg per nut. Since the 1990s, selenium has been widely researched as an enzyme that activates the thyroid hormone, according to a 2020 study. Data from previous studies have shown that a low selenium status is linked to autoimmune thyroiditis and Graves disease an autoimmune disorder that causes hyperthyroidism. Start incorporating more selenium in your diet with brazil nuts but beware of consuming them in large numbers, says the National Institutes of Health (NIH). Taking more than 400 mcg of selenium per day (for adults) can lead to serious health implications like myocardial infarction, kidney failure, and more. So approach with caution its all about keeping the right balance!

Believe it or not, the most nutritious part of a pumpkin is the pumpkin seeds as they are filled with vitamins and minerals while being low in calories. Pumpkin seeds are high in zinc, which are especially important for the thyroid hormones T3 and T4, explains Shaw. A 2019 study found that zinc is a crucial part of the enzyme deiodinase which converts T4 into T3. These hormones play a significant role in homeostasis by facilitating the metabolism of blood sugar, responding to changes in energy intake, and controlling our bodys process of heat production. In other words, pumpkin seeds can do wonders for your thyroid. Add them to your salads, oatmeal, cereal, soup, and favorite dessert for a hearty and thyroid-boosting meal.

Weve surely raved about the powerful benefits of berries before in optimizing brain health, PMS symptoms, and PCOS. Its because berries are high in antioxidants that can neutralize harmful free radicals, which can cause inflammation and lead to negative health implications. Theyre also great for the thyroid as they have a low-glycemic index, considering too much sugar can create hormone imbalances and thyroid flares, according to a 2018 study. Researchers examined a case study and found that sugar substitutes can provoke the development of Hashimotos disease, leading to the failure of the thyroid gland. Berries are a great way to incorporate something sweet into your diet without compromising your thyroid health. Use them in smoothies, parfaits, and as a no-guilt, nutritious dessert.

A high fiber diet is not only beneficial for your heart and brain but also just as influential for your thyroid. Complex carbohydrates are full of fiber and also low-glycemic, which means they do not impact your blood sugar levels. Dietary fiber can help ease some of the symptoms associated with thyroid diseases, such as poor digestion and constipation, according to Harvard Health. It also prevents type 2 diabetes, weight gain, insulin resistance, and other health conditions that are associated with the greater risk of thyroid disease. Make sure to incorporate complex carbohydrates like brown rice, quinoa, and kidney beans in your diet to ensure a good supply of dietary fiber. However, do proceed with caution if youre on medication for your thyroid disorder as fiber can affect medication absorption, says Harvard Health.

Read more here:
The 5 Best Nutrient-Rich Foods to Improve Thyroid Function - The Beet

Medicare typically covers the cost of thyroid tests if a doctor deems them necessary. The diagnostic tools allow the healthcare provider to understand if someone has problems with their thyroid gland.

The thyroid gland, located in the neck, produces hormones that regulate metabolism. If an individual has a thyroid condition, they may experience weight control issues or cardiovascular complications.

This article explores thyroid dysfunction and discusses how Medicare covers thyroid and other blood tests. It also looks at treatments and therapies for thyroid dysfunction and examines costs.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

Thyroid dysfunction happens when the thyroid gland either makes too much or too little thyroid hormone.

The thyroid gland has two lobes on either side of the windpipe below the voice box or larynx. This endocrine gland makes two thyroid hormones, T3 and T4, which are chemical messengers controlling metabolism, growth, and mood.

If the thyroid gland does not make enough hormones for the body, this leads to hypothyroidism or an underactive thyroid. If the thyroid produces too much hormone, the individual experiences hyperthyroidism or overactive thyroid.

In hypothyroidism, symptoms include:

With hyperthyroidism, symptoms relate to increased metabolic rate and include:

Both forms of thyroid dysfunction affect the body in various ways and can lead to a range of symptoms. However, people with minor thyroid dysfunction may not experience any symptoms.

Learn more about common thyroid disorders here.

Different parts of Medicare cover the costs of thyroid tests and treatment.

Original Medicare is Part A, which is hospital insurance, and Part B, which provides medical insurance.

Medicare Part A covers the cost of inpatient stays in a hospital, clinic, or other nursing facilities. Medicare Part B covers medically necessary services in an outpatient setting, doctors visits, and prevention services, including diagnostic and blood tests.

Generally, Medicare covers thyroid testing under Part B, as long as a doctor has ordered the test to diagnose or treat a medical condition.

However, Part A covers the cost if a person is in a hospital or nursing facility, and a doctor orders a thyroid test during their inpatient stay. Medicare Part A also covers the cost if the doctor recommends surgical removal of the thyroid gland.

Learn more about the removal of the thyroid gland here.

People who qualify for Medicare can choose to get coverage through original Medicare (Parts A and B) or a through a Medicare Advantage plan.

While Medicare Advantage plans offer the same basic coverage as original Medicare, private insurance companies offer the plans, which means they may offer additional benefits, such as dental, vision, and hearing care. Many Advantage plans also provide Medicare Part D prescription drug coverage.

Learn more about choosing a Medicare Advantage plan here.

Medicare Part D is prescription drug coverage available to a person enrolled in original Medicare. Private insurance companies offer these plans.

If a doctor prescribes medication because a person has a mild thyroid condition, Medicare Part D covers the cost. People should check their plans list of drugs, called a formulary, to confirm coverage of thyroid medications.

Learn more about Medicare Part D here.

The various treatments and therapies for thyroid dysfunction depend on the severity of a persons condition. Medication is generally the first line of treatment.

Treatment usually includes synthetic thyroxine, which replaces the T4 hormone. The dosage depends on the levels of thyroid-stimulating hormone (TSH) in a persons blood.

Doctors use blood tests to monitor hormone levels and then adjust the dose of thyroxine as necessary.

Doctors may also recommend a dietary plan that improves iodine intake, including certain vegetables and soy products. Iodine is essential to healthy thyroid function.

Learn more about TSH tests here.

Doctors prescribe medications that either treat the symptoms of hyperthyroidism or address hormone production. Medications may include:

If the above treatments do not work or are not possible, surgery to remove the thyroid gland could be an option.

Learn about an overactive thyroid and Graves disease.

The cost of a thyroid blood test varies according to the laboratory and the location. Medicare covers most clinical diagnostic tests, including thyroid tests, but a person will generally have some costs, as shown below.

If a doctor orders a thyroid test while a person is an inpatient, Medicare Part A covers the cost after a person has met their deductible. The Part A deductible is $1,484 in 2021 for each benefit period. A benefit period starts as someone enters the hospital and continues for 60 days.

Medicare Part B covers the total cost for thyroid tests. However, a person must meet the annual deductible of $203. Other costs include the basic Part B monthly premium, which is $148.50 in 2021.

Costs for Advantage plans differ. In addition to paying the standard Part B premium, a person enrolled in an Advantage plan will pay the plan premium. In 2020, Advantage plan premiums averaged $25 per month.

Learn about the costs of Medicare in 2021.

Most people generally have zero costs for Medicare-covered clinical diagnostic tests, including thyroid tests. However, if a person needs help to cover the costs of thyroid treatment, they may find assistance from Medigap or Medicaid.

A Medigap plan helps a person enrolled in Medicare pay out-of-pocket costs such as copays, deductibles, and coinsurance that Medicare does not cover. Private insurance companies offer 10 Medigap plans with different levels of cover.

Costs vary by location and plan and can range from $64 to $500 per month.

Learn more about Medigap here.

Medicaid helps low-income, low resource households to access healthcare services. The government funds this program, and individual states set the eligibility criteria for income and assets.

Learn more about Medicaid here.

Original Medicare (Part A and Part B) and Medicare Advantage plans offer the same level of coverage for thyroid tests. Medicare Part B covers the cost of a blood test done as an outpatient, while MEdicare Part A covers the costs of a thyroid blood test done as part of an inpatient hospital stay.

Both Medicare Part D and Medicare Advantage plans cover the cost of thyroid medication. Medicare Part A also covers the cost of surgery if a doctor deems it necessary to remove the thyroid gland.

The thyroid gland is a small hormone-producing gland in the neck. People can experience problems if they produce too much or too little thyroid hormones that control metabolism and growth.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

Follow this link:
Medicare and thyroid tests: Coverage, options, therapies, and costs - Medical News Today

An NHS trust has been allowed to appeal against a high court decision that barred it from referring under-16s for puberty-blocking treatment.

The court ruled that children considering gender reassignment were unlikely to be able to give informed consent. Now the Tavistock and Portman NHS trust, which runs the UKs main gender identity development service for children, has been granted permission to appeal, alongside University College Hospitals NHS foundation trust and Leeds Teaching Hospitals NHS trust.

In a statement, a spokesperson for the Tavistock, which leads the national Gender Identity and Development Service (Gids), said it welcomed the courts decision. Our priority is to work together with our partners to support our patients and their families while legal proceedings are ongoing, the spokesperson said.

At the start of December last year the London clinic lost a case brought by Keira Bell, a 23-year-old woman who began taking puberty blockers when she was 16 before detransitioning, and the unnamed mother of a 15-year-old autistic girl who is on the waiting list for treatment.

In their decision, Dame Victoria Sharp, president of the Queens bench division, Lord Justice Lewis and Mrs Justice Lieven, ruled that it unlikely that children under the age of 16 who were considering gender reassignment were mature enough to give informed consent to be prescribed puberty-blocking drugs.

In addition the judges ruled that even in cases involving teenagers under 18 doctors may need to consult the courts for authorisation for medical intervention. They added: It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.

At the time of the ruling an NHS spokesperson said the Tavistock had immediately suspended new referrals for puberty blockers and cross-sex hormones for the under-16s, which would henceforth only be permitted where specifically authorised by a court.

Susie Green, CEO of Mermaids, a charity providing support to transgender or non-gender-conforming children, said the initial ruling forced transgender young people to go to court to get basic healthcare.

Whatever our beliefs, most of us can agree that it is the young people themselves, together with their parents and their doctor, who best understand their needs, she said.

We are pleased to see that this ruling will now be challenged for the sake of every child who deserves the chance to live a happy life and be true to themselves.

In September last year the NHS launched an independent review into the future of gender identity services for children and young people to examine the use of puberty blockers and cross-sex hormone drugs as well as looking at how care could be improved.

The NHS service at Tavistock, to which those under the age of 18 with concerns about their gender are referred for treatment, has had a surge in demand from 77 in 2009 to 2,590 in 2018-19.

An inspection of the Tavistock and Portman NHS foundation trust gender identity services for children and young people by The Care Quality Commission due to report on Wednesday is expected to include feedback from people using the service, parents, relatives, carers and staff.

Link:
High court grants leave to appeal to UK gender identity service - The Guardian

If she found the right guy, Kari Arenberg could see herself having kids. But her work was never conducive to dating, let alone to freezing her eggs in hopes of leaving her options open. The 31-year-old event producer traveled constantly between New York City and Los Angeles, with long days lifting heavy boxes and running around venues.

Then, in 2020, Arenberg was furloughed, and the egg-freezing process became, for the first time in her life, logistically possible. She moved in with her family in Chicago and visited a clinic. Soon she was giving herself as many as three shots a day to stimulate her ovaries, and visiting the clinic every few days for bloodwork and an ultrasound to determine when the eggs would be ready for retrieval. She was able to freeze 21 eggs, a feat that likely would have been impossible if she had had to give herself shots while stuffed into airplane bathrooms or trying to schedule visits to the clinic around the national events, like Comic Con, that she produces. I love my work and want to prioritize it, Arenberg says. So its ironic that my career also kept me from doing this earlier.

When the coronavirus pandemic hit, fertility clinics braced themselves for a downturn. People have been avoiding the doctors office since the spring, first because they feared exposure to the virus and later because many people who have been laid off or furloughed cannot afford the medical bills. Fertility treatments are expensive, and the cost of egg freezing ranges from $6,000 to $20,000. (Arenbergs was $12,000an especially daunting cost after losing work.)

But clinics across the country are reporting an uptick in women freezing their eggs during the pandemic. Though no organization in the U.S. collects national data, 54 clinics across major American cities including Denver, Atlanta and Seattle told TIME that the number of women freezing their eggs has increased year-over-yearan impressive stat considering most of those clinics were forced to shut down and suspend fertility treatments in the early months of the pandemic. An additional five clinics reported the same number of egg freezing cycles in 2020 as in 2019 despite being closed anywhere from one to three months in 2020. Only two clinics told TIME they had seen a decrease in the number of women freezing their eggs since 2019. We didnt know what to expect, says Colleen Wagner Coughlin, the founder of OVA Egg Freezing Center in Chicago. If anything we expected a downturn. But weve seen a huge increaseseveral hundred more new patients [in 2020].

At some clinics, the changes have been robust. When TIME collected data in November, Shady Grove Fertility, which runs 36 clinics across the Eastern seaboard, had seen a 50% increase in women freezing their eggs since 2019. Doctors at NYU Langone saw a 41% year-over-year increase in women fertilizing their eggs. And Seattle Reproductive Medicine had conducted 289 egg-freezing cycles in 2020, compared with 242 in 2019, a nearly 20% jump.

Unable to see friends in person during the pandemic, Kari Arenberg, bottom right, relieved her nerves about self-administering hormone injections by sharing the process with friends over video chat The hormone shots cause a lot of bloating and cramping and emotions, says Arenberg. Its not exactly conducive to getting work done. It literally feels like youre carrying around a sack of eggs."

Courtesy of Kari Arenberg.

Sharon Covington, a therapist who provides counseling services at Shady Grove Fertility Clinic, is busier than ever offering mental health support to women considering fertility treatments, including egg freezing. She says the women she sees are freezing their eggs because of the pandemic, not in spite of it. Women who normally travel for work, like Arenberg, are grounded. Those with busy social lives are alone at home. Their schedules are open. But that time in isolation has also afforded space for reflection. Everybody had to take a hard stop in their lives, Covington says. And I think what happened with that is that it gave people the time and the space to kind of reassess their priorities and the directions that theyre taking in their life.

Many single people feel as if theyve fallen a year behind on their life plans. Dating was almost impossible at the beginning of the pandemic. Even now, near-strangers must negotiate a difficult social dance with one another when they agree to meet up for a distanced drinkwhen can they hug, kiss or even just go indoors together? When will they feel safe with one another? I actually went on a few dates, says Arenberg, but sitting outside shivering in Chicago in the winter is not conducive to finding someone.

Read More: The Coronavirus Is Changing How We Date. Experts Think the Shifts May Be Permanent

Arenberg first heard about egg freezing when the winner of the Bachelors 2015 season, Whitney Bischoff Angel, revealed that she froze her eggs. Egg freezing has steadily grown more popular in the years since the American Society of Reproductive Medicine (ASRM) removed the experimental label from the procedure in 2012. Many women were already freezing their eggs for medical reasons, either because they were going through a medical procedure like chemotherapy that could reduce their fertility or had a medical condition like endometriosis that could negatively impact ability to conceive. But with the change in labeling came the rise of what doctors call social egg freezingwomen who freeze their eggs simply because they arent ready to have a child yet. In 2009, just 475 women froze their eggs, according to the Society for Assisted Reproductive Technology. By 2018, 13,275 women did so, an increase of 2,695%.

The spike comes thanks in part to celebrities like Chrissy Teigen, Michaela Coel and Emma Roberts sharing their own egg-freezing stories. Kourtney Kardashian went so far as to film her egg freezing preparation on Keeping Up With the Kardashians, and Amy Schumer shared pictures of her bloated and bruised stomach as she took the shots this summer to freeze her eggs as part of her IVF process. Theyve demystified a process that was little known just a few years ago, including, in Schumers case, the most uncomfortable aspects.

Ren Hurtado, a 28-year-old in Scottsdale, Ariz., knew that she might have to stay home in the weeks before her egg retrieval in case she suffered side effects like cramping or headaches, and believed the pandemic would be the ideal time to nurse those pains without missing meetups with friends. On day five of injections, I couldnt even walk. I only felt good if I was lying flat on my bed, she says. She had to take several days off from her job at WeWork while she recovered. In an alternate world, I was supposed to be in Miami for a bachelorette party that week. Thank God I did this during COVID so I didnt have to see anyone or go anywhere because I was in so much pain.

Ren Hurtado, 28, took a selfie before a doctor retrieved her eggs at a clinic in Arizona

Courtesy of Ren Hurtado.

Hurtados offered egg freezing as part of the companys benefits package, a perk thats become increasingly popular among startups as a means of attracting women workers (or, in critics eyes, pressuring workers to prioritize work over family). But the trendiness of egg freezing in Silicon Valley may be reaching its peak. Some doctors have cast doubt as to whether companies will continue to offer this costly benefit when many organizations are choosing between cutbacks and layoffs. Wagner Coughlin, the founder of OVA in Chicago, said that her organization is already looking into a new payment structure in anticipation of companies dropping the benefit.

Michael Jacobs, a doctor at the IVF Center of Miami, believes that moment has already arrived. He was one of the few doctors who told TIME his clinic was seeing a downturn in egg-freezing rates. In cities like New York and Los Angeles, maybe there are more people who can afford the cost of egg freezing right now, he says. But I think a lot of people here are just worried about paying their bills.

The high price of egg freezing has long meant only a specific subset of patientsmostly upper class, and mostly whitepursue the process: a study of nearly 30,000 egg retrievals by ASRM found that just 4.5% of the women who underwent the procedure described themselves as Hispanic and 7% identified as Black.

Read More: Women Are Deciding Not to Have Babies Because of the Pandemic. Why Thats Bad for All of Us.

Pavna Brahma, a doctor at the Shady Grove clinic in Atlanta, theorizes that this may be the boom period before a bust. People are coming in who are worried about losing their job or their coverage or their insurance, Brahma says. They want to take advantage of the moment when they know they have coverage and economic stability in their job.

She stresses to her patients that waiting until they receive the vaccine to freeze their eggs is a viable option: Two to six months rarely makes a huge change in their fertility. I dont want women to feel pressured by the pandemic.

Bryn Woznicki, who lives in Los Angeles, decided to dedicate the money she had saved for a move to New York City to freezing her eggs last year

Courtesy of Bryn Woznicki.

Still, pandemic or not, time remains a key driver in womens family-planning decisions. As a general rule, the younger you are, the more eggs you have, and the more likely an egg-freezing process will be successful. Many women fear the benchmark of 35 years old. Loss of eggs and risks to pregnancy happen gradually over time, not all at once, but 35 is when doctors begin calling pregnancies geriatric to reflect increased risks. Its also the age at which fertility doctors will advise freezing more eggs, often through several procedures to harvest as many eggs as possible and improve the chances that one can be fertilized later.

Bryn Woznicki, a 33-year-old filmmaker who lives in Los Angeles, has always known she wants to be a mother, but every year, she says, its a ticking time bomb working against your biological clock. When filming work dried up last spring and dating became more difficult, she took stock of what turning 34 during a pandemic could mean. Say I met someone today, she says. Say I really liked them and we got married. By the time I did that and enjoyed my partner and we decided to take on this huge responsibility of having kids, thats another few years down the line.

With her work and social life on pause, she decided to divert some of her savings towards a potential future family. I had some money saved to try to move to New York this fall and then, you know, COVID happened, she says. Meanwhile I was feeling the pressure from my biology telling me that time was running out, and I was like this is the one thing I can control in an unpredictable year.

For Arenberg, being able to freeze her eggs was a silver lining of the pandemic. As unfortunate as it is that Im technically unemployed, this really gave me the mental capacity to look ahead for the first time, she says. I dont know if I want kids, but maybe if I meet the right person some day, this just provided a nice comfort level where I can make some decisions about dating and kids and work when things get back to normal.

For your security, we've sent a confirmation email to the address you entered. Click the link to confirm your subscription and begin receiving our newsletters. If you don't get the confirmation within 10 minutes, please check your spam folder.

Write to Eliana Dockterman at eliana.dockterman@time.com.

Original post:
Data Show More Women Are Freezing Their Eggs During the Pandemic, Defying Doctors Expectations - TIME

Keira Bell brought legal action against the Tavistock and Portman NHS Trust. (YouTube/Sky News)

The NHS has been granted permission to appeal a High Court ruling that said transgender under-16s cannot give informed consent to puberty blockers.

The Tavistock and Portman NHS Trust, which runs GIDS, the only gender clinic for trans youth in England and Wales, said it would appeal the ruling when it lost the judicial review in December 2020.

The Tavistocks appeal has now been granted, it was confirmed Monday (18 January), and will be heard before 22 March, 2022. A spokesperson for the Trust said they welcome the courts decision to allow their appeal against the ruling.

Our priority is to work together with our partners to support our patients and their families while legal proceedings are ongoing, the spokesperson said. The judges ruled in December that the judgment will not be implemented until the outcome of the appeal is determined.

The High Courts verdict sent shockwaves through the LGBT+ community, as it meant young trans peoples access to healthcare in England and Wales was further restricted.

The case was brought by Keira Bell, 23, who took puberty blockers at 16 and had top surgery at 20 but has since detransitioned, and Mrs A, who is trying to prevent her 16-year-old child taking puberty blockers.

It hinged on whether under-16s can give informed consent to puberty blockers, which are currently the only medication available to trans under-16s experiencing gender dysphoria. Seventeen and 18-year-olds who have been taking puberty blockers for at least a year are eligible for hormone replacement therapy (HRT).

Puberty blockers are widely deemed safe, reversible and medically necessary, lawyers for the Tavistock maintained. Lawyers for Bell and Mrs A argued that trans teens should have to go before a court before being able to access the medication.

The High Court agreed, with the judges saying in their ruling that it is doubtful children aged 14 to 15 could understand the long-term risks and consequences of taking puberty blockers and then HRT, and highly unlikely that children under 13 would be competent to give consent.

As a result, the court said clinicians may regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment. The judges ruled that informed consent for puberty blockers should be tied to an understanding of the long-term implications of taking HRT or having gender-affirming surgery later in life.

At the hearing in October, the court heard that in 2019-2020, 161 under-18s were referred by GIDS to be assessed for puberty blockers by endocrinology specialists. Half of the trans youth referred were aged 16 or older even though puberty starts, on average, at age 11 for those assigned female at birth and at 12 for those assigned male.

Years-long waiting lists for GIDS mean trans young people referred to the service wait several years for their first appointment, and must be assessed over at least 10 appointments before being considered for referral on to an endocrinology service to be assessed for puberty blockers.

As a result, many trans teenagers in England and Wales age out of the youth gender clinic system before receiving any healthcare at all.

See the original post here:
NHS wins right to appeal cruel High Court ruling that restricts healthcare for trans kids - PinkNews

Every aspect of our lives has been reconfigured during the pandemic. For many people, this has meant experiencing changes in their gender identity or gender presentation.

Sheryl*, a 30-year-old Brooklyn-based trans woman working in business administration, said she connects the prolonged period of social isolation with her own transition experience a decade ago. For me, in the beginning of my transition, while I was learning how to dress myself and how to safely move through the world, I was treated hatefully for it a lot, she said. I would avoid going out during certain times; I was threatened, harassed, and followed. The amount of trauma... I dont think my brain allowed me to recognize how difficult it was to move through the world at that time. Once I started passing, that didnt happen as much, but my brain will never be able to let go of that when I leave the house. Before [the pandemic], a lot of transexual women were experiencing this, where youre just exhausted by carrying yourself through a world that was not made for you. That ends up translating to spending a lot of time inside.

Dulcinea Pitagora, an NYC-based psychotherapist and sex therapist, suggested that for people working from home, there might be more of a willingness to take risks in terms of gender presentation and expression when interacting with others from the safety of our own space, knowing theres always an option to turn off the screen at any time if we dont feel safe.

That said, not everyone is experiencing positive or affirming changes to their gender because of the conditions created by the pandemic, especially those who feel most affirmed within their communities. Still, many people are taking time to think more deeply about their gender and how it plays out in the world at large, whether that means not shaving for a prolonged period of time, choosing different clothing, or adjusting their pronouns in their Zoom window.

I opened my inbox to people who are experiencing changes in their gender during the pandemic. Here are a few of their stories.

Alex (they/them), nonbinary, 20, white, Ontario, Canada, currently unemployed

Since the pandemic began and Ive mostly been stuck at home with my family, Ive noticed that I have felt less pressure to present myself as feminine. Because Im at home, I can justify wearing clothing that is more gender-neutral or masculine in nature. I suppose the pressure of feeling like I have to present myself a certain way in public because of my assigned gender at birth has been lifted. I cut my hair to a shorter length and dont really care anymore about what gender I appear to be. Im just living as me and Im fine with that.

"I dont want to be male or female, I just wanna be Alex, you know? Plain old Alex."

I began feeling gender dysphoria in high school, and needless to say, it kicked my ass. I despised being female. I had a group of Catholic friends who thought all their problems could be solved by praying to God or Jesus, or whatever. Not to be bitter, I respect peoples beliefs and religious practices, but these friends forced me back into the closet when I opened up to them about my uncertainties surrounding my gender identity. Around this time, I was also forced to come out to my mother because of different circumstances, and she essentially told me to not tell anyone about it and to just go back to being normal. Fun times!

There are days where I fantasize about not having breasts, and there are days where I love my breasts. Same goes with my genitalia. Sometimes I like my vagina; sometimes I wish I had a penis. I wish I could just flip between the two whenever I wanted, while also being considered genderless. I dont want to be male or female, I just wanna be Alex, you know? Plain old Alex.

In a way, the pandemic has been a very, very small positive to me, as it has allowed me to just reflect on myself and come to terms with my identity. If I hadnt literally been forced to stop going out and thus feel the pressure to conform to a certain gender norm, I probably would have taken a lot longer to accept who I am. Of course, now Im ready for the pandemic to be over so I can flaunt my nonbinary ass around in public, but alas, I must wait for that day.

Seven (they/them), nonbinary, 39, Black, Minneapolis, metal fabricator[Since the pandemic began] I started taking T. I've grown some body hair and gained 20 pounds of muscle mass since July. As a queer Black human, I've had to deal with other peoples uncomfortable feelings my whole life. I'm tired. I've known I was nonbinary my entire life but felt as though it wasn't safe to express myself. Dysphoria is sneaky and complicated. I think I spent a good chunk of my life trying to bury it. Honestly, I've felt so at peace internally since I officially came out and started T in July. I finally stopped digging that hole. It's a beautiful thing to finally rest my mind. [Ive talked about these changes with] my wife. I'm kinda letting it present naturally. Changes are happening and people will obviously notice them. How I communicate, love, and go about the world have not shifted.

Without this pandemic and more importantly the civil unrest that ignited through the murder of George Floyd, I would not have truly acknowledged my authentic self. I wouldn't have started on my current path to live the rest of my life unphased by what might make others uncomfortable. With a world of uncertainty, I feel it's time to make the most important things within ourselves certain.

JoAnne (she/her), Delaware, teacher

I was given the name John at birth, but even as a kid, I would refer to myself as JoAnne other than at work. My pronouns were they/them, but this year they are she/her. As soon as I am able to meet with people at work, I will be presenting as female completely.

I live about 30 miles from Philadelphia, in a small college town. Even though we're in the South culturewise, its very LGBTQI friendly. I live with two other people: my wife, who refers to me as her wife, and our boyfriend. We've been a triad for the last five years, and he considers himself as living with two women.

"In other words, there was no reason to be anyone other than JoAnne."

I'm a teacher, college level, and since the pandemic started, I've been teaching remotely. At work I present as male, though that will change in the future, I'm sure. Before the pandemic, I was more gender-neutral, in that I split my time between my male and female sides. At home I was always female but outside the home, with family, I was John. Since the pandemic, I'm 99.9% female. The pandemic, because it enforced certain isolation, gave me the freedom to just stay female to the point where I'm forgetting what it was like to be male. In other words, there was no reason to be anyone other than JoAnne.

I remember a few years ago I was talking to a friend and I broke down crying and just screamed, "I'm the wrong sex." That was the start of a long period of coming to terms with who I am. I confessed to my wife about how unhappy I was and how I felt like I was in the wrong skin. I went to therapy, which helped.

It took the pandemic, really because you're home more and less distracted, to give me time to really work through my gender issues and to work through them with my wife and boyfriend. The good thing is they accept JoAnne and encourage me as I am.

Fanfi (he/she, prefers he), 25, brown/mixed, Santiago, Chile, freelance artist

Im from Santiago de Chile. I live with my nonbinary Venezuelan partner. They have been out since way before the pandemic.

Honestly I didnt feel too strongly about [my gender presentation]. [I used] cis female, woman, or femme at times when I felt particularly lesbian. I am not a woman. I am not a man. I am both a woman and man, only if those are used together. I am a boy, a really pretty one actually. I want to feel masculine. I want to be seen by masculine people who are not cis. Thats what I feel.

"I want to feel masculine. I want to be seen by masculine people who are not cis. Thats what I feel."

I always dyed my hair pink and cut it at a particular queer stylist, but since we were all quarantined, it was closed for months. My hair grew, my color faded, and I started feeling very uncomfortable. I knew I had to make a change so my partner shaved my whole head, and as the layers of hair came off, I saw who I could be: a boy. I didnt know it until I started crying while looking at packers giveaways that were only for trans and nonbinary people when I was cis, but that was the start of it. Now I own a packer that I wear daily if possible, only own a pair of male jeans, and use my partners binder when they arent. Still waiting for mine!

I have a hard time understanding dysphoria. It sounds so terrifying I keep thinking I must not have it, but I also do not have a name for the earth-shattering dread I feel when I try to feel my own vagina. I have never wanted to look at it. I have ignored it most of my life. It felt dreadful wearing a binder the first time too. I thought my tits were gone, and I was scared of [a permanent change]. I feel different about it now, though.

Euphoria I can understand, as I put on my new pair of jeans and read for men on the label, as my friends and partner call me masculine terms of endearment. And I managed to pee standing for the first time! Its great. It makes my day.

Im almost certain I would have kept living as I did were it not for the pandemic. I have a complicated relationship with my mother and immediate family. I try hard to please them. I was always too busy trying to be a pretty woman, to be a lovable, acceptable lesbian for them. The quarantine worked for me as a chrysalis stage: I kept myself still, but so much was happening inside me from this lack of movement. For the first time, I asked myself what I wanted to be without the eyes of others upon me. This was the answer, and its still developing. Its been such a hard year I feel frail and also the happiest Ive been in my body.

Ilde Senescence, she/her/hers, 35, white Jewish trans demigirl

"The pandemic represents about three-quarters of the time I've been on estrogen and progesterone hormone replacement."

The pandemic created conditions for me to be away from contact with (and more importantly the eyes of) most people, [especially] cis people. I had ideal conditions for taking on appearance changes that would otherwise seem drastic, and the space and time to puzzle out my feelings about and understanding of my gender. While this period also included health scares for me, the flexibility of working under pandemic conditions allowed me to recover.

I have grown out my hair longer than it's been in my life and colored it an ombre purple-blue-cyan. I have embraced my emotions and my mood in a way I had not understood prior in the least. The pandemic represents about three-quarters of the time I've been on estrogen and progesterone hormone replacement, so I have seen a number of appearance, functional, and emotional changes simply from that.

My dysphoria has manifested in the past as a fear of not passing, of not feeling my gender intensely or demonstrating it authentically enough, that I wasn't "worthy" of being trans, or that I couldn't present any way other than "diet male." Physically, my body hair has been the primary source of my dysphoria. My biggest sources of gender euphoria have been the changes to my hair, and buying more femme clothes from Torrid, but also in being able to wear a mask and how that has helped me to be passed by cis people in multiple situations.

I have a medium-sized set of trans friends in the area and my roommate. I've talked to them all at length, and we've celebrated each others positive gender feelings due to the pandemic. I also have a psychotherapist who is trans, and with whom I've shared feelings about my transition and the pandemic.

Ezra (they/them), 34, white and Jewish, Chicago, unemployed, former barista

I have worked in the service industry my whole adult life, mostly as a barista. I think Im pretty lucky to have had mostly casual dress codes. Ive only had to take out facial piercings for one place I think, but I never worked anywhere where that relaxed attitude seemed to extend to gender presentation. For three years before the pandemic (and my first three years on T), I worked downtown, and that was probably the most conservative culture Ive worked in. Thats when I had to learn how often I needed to shave my face to pass versus how often I could shave it without leaving the skin raw.

I had been on T for almost three years when the pandemic started, but having been in customer service the whole time, and at the same job since before I started T, I never felt comfortable growing a beard, so I had never seen my facial longer than a few days Id have off for work. So now I have a full beard! Its been really exciting to watch it happen, and now Ive gotten to the point where I feel pretty comfortable trimming it with clippers. Im pretty hairy and I also have big boobs, so when it was hot earlier in the year, doing things like going out in a tank top was a major source of stress for me. I get really hot which makes me really anxious, so Ill do almost anything to stay cool, but going out with size G breasts with lots of chest and shoulder hair makes me feel really nervous. Navigating that felt new this year.

Im so lucky to have many other queer and trans people around me to talk to. A few of my closest friends are trans and/or queer, and I also am part of a group through a clinic that meets virtually once a week to chat about gender stuff. For Thanksgiving, we did a call and I decided to get a little dressed up and I put on makeup, which isnt something I ever really did before I came out, and only a few times since, but I wanted to play with the look of my beard, my mullet, some new long, dangly earrings I got, and makeup. I was excited to do it, and then before the call, I got incredibly nervous! I almost chickened out. But I went through with it, and I got compliments from my friends and it was really affirming, though I was still very ready to get off the phone when it was over because I felt kind of exposed. I dont think I would feel comfortable wearing that out of the house, even if it was just to go to an in-person gender group, and if it wasnt for the pandemic, I wouldnt be Zoom-chatting with people, so I just feel so lucky to have that space to play like that!

As a person whos always worked in customer service, I dont think I could have predicted the positive impacts that isolation would have on my mental health and gender identity stuff. In part because of unconscious trauma patterns as well as gender stuff, my life has always included so much performance, and so going from a stressful home to crappy relationships and the service sector has basically just meant a changing of the audience. For me, stepping into my gender and my identity (and my life) is about making those performances intentional as opposed to defensive and reactionary. With no audience but the one I choose, with my friends over Zoom, my internal sense of who I am has gotten clearer, and the fact that I interact almost exclusively with queer people just feels like it affirms my process as I go. This is certainly not to say that it has all been easy, but as far as the pandemic and isolation goes (and the privilege I have to be able to isolate, of course), I feel its been mostly positive. Of course I miss socializing, but Im kind of a quiet, keep-to-myself, doesnt-like-crowds person to begin with, and Im not really interested in being physically intimate with people, so it may not be as hard for me as for others.

Ive also had a heck of a time sending care packages to my friends through the UPS store thats near my apartment. All of their employees needed some kind of special handling when it came to taking my personal information (my legal first name is Emma) they should probably pay me to train their staff. One guy, who seemed really distressed, decided that someone else, someone named Emma, must have used my account to send a package recently. Sure, dude, whatever.

*Sheryl is a pseudonym.

See original here:
Six Trans People Talk About Their Pandemic Bodies - BuzzFeed News

[Los Angeles], [United States], January 2021, The Follicle Stimulating Hormone Test Kit Market research report includes an in-sight study of the key [Title] market prominent players along with the company profiles and planning adopted by them. This helps the buyer of the Follicle Stimulating Hormone Test Kit report to gain a clear view of the competitive landscape and accordingly plan Follicle Stimulating Hormone Test Kit market strategies. An isolated section with top key players is provided in the report, which provides a complete analysis of price, gross, revenue(Mn), Follicle Stimulating Hormone Test Kit specifications, and company profiles. The Follicle Stimulating Hormone Test Kit study is segmented by Module Type, Test Type, And Region.

Get PDF Sample Copy of Report: (Including TOC, List of Tables & Figures, Chart) https://www.qyresearch.com/sample-form/form/2385056/global-follicle-stimulating-hormone-test-kit-market

In addition, market revenues based on region and country are provided in the Follicle Stimulating Hormone Test Kit report. The authors of the report have also shed light on the common business tactics adopted by players. The leading players of the global Follicle Stimulating Hormone Test Kit market and their complete profiles are included in the report. Besides that, investment opportunities, recommendations, and trends that are trending at present in the global Follicle Stimulating Hormone Test Kit market are mapped by the report. With the help of this report, the key players of the global Follicle Stimulating Hormone Test Kit market will be able to make sound decisions and plan their strategies accordingly to stay ahead of the curve.

Competitive landscape is a critical aspect every key player needs to be familiar with. The report throws light on the competitive scenario of the global Follicle Stimulating Hormone Test Kit market to know the competition at both the domestic and global levels. Market experts have also offered the outline of every leading player of the global Follicle Stimulating Hormone Test Kit market, considering the key aspects such as areas of operation, production, and product portfolio. Additionally, companies in the report are studied based on the key factors such as company size, market share, market growth, revenue, production volume, and profits.

Key Players Mentioned: Easydiagnosis, Wondfo, Daan, Bioscience, BGI, Chivd, AccuBioTech, Ameritek

Market Segmentation by Product: Chemiluminescence ImmunoassayTime-resolved Immunoassay

Market Segmentation by Application: HospitalClinic

The Follicle Stimulating Hormone Test Kit Market report has been segregated based on distinct categories, such as product type, application, end user, and region. Each and every segment is evaluated on the basis of CAGR, share, and growth potential. In the regional analysis, the report highlights the prospective region, which is estimated to generate opportunities in the global Follicle Stimulating Hormone Test Kit market in the forthcoming years. This segmental analysis will surely turn out to be a useful tool for the readers, stakeholders, and market participants to get a complete picture of the global Follicle Stimulating Hormone Test Kit market and its potential to grow in the years to come.

Key questions answered in the report:

Request for customization in Report: https://www.qyresearch.com/customize-request/form/2385056/global-follicle-stimulating-hormone-test-kit-market

Table of Contents:

1 Follicle Stimulating Hormone Test Kit Market Overview1.1 Product Overview and Scope of Follicle Stimulating Hormone Test Kit1.2 Follicle Stimulating Hormone Test Kit Segment by Type1.2.1 Global Follicle Stimulating Hormone Test Kit Production Growth Rate Comparison by Type 2020 VS 20261.2.2 Chemiluminescence Immunoassay1.2.3 Time-resolved Immunoassay1.3 Follicle Stimulating Hormone Test Kit Segment by Application1.3.1 Follicle Stimulating Hormone Test Kit Consumption Comparison by Application: 2020 VS 20261.3.2 Hospital1.3.3 Clinic1.4 Global Follicle Stimulating Hormone Test Kit Market by Region1.4.1 Global Follicle Stimulating Hormone Test Kit Market Size Estimates and Forecasts by Region: 2020 VS 20261.4.2 North America Estimates and Forecasts (2015-2026)1.4.3 Europe Estimates and Forecasts (2015-2026)1.4.4 China Estimates and Forecasts (2015-2026)1.4.5 Japan Estimates and Forecasts (2015-2026)1.5 Global Follicle Stimulating Hormone Test Kit Growth Prospects1.5.1 Global Follicle Stimulating Hormone Test Kit Revenue Estimates and Forecasts (2015-2026)1.5.2 Global Follicle Stimulating Hormone Test Kit Production Capacity Estimates and Forecasts (2015-2026)1.5.3 Global Follicle Stimulating Hormone Test Kit Production Estimates and Forecasts (2015-2026)1.6 Follicle Stimulating Hormone Test Kit Industry1.7 Follicle Stimulating Hormone Test Kit Market Trends

2 Market Competition by Manufacturers2.1 Global Follicle Stimulating Hormone Test Kit Production Capacity Market Share by Manufacturers (2015-2020)2.2 Global Follicle Stimulating Hormone Test Kit Revenue Share by Manufacturers (2015-2020)2.3 Market Share by Company Type (Tier 1, Tier 2 and Tier 3)2.4 Global Follicle Stimulating Hormone Test Kit Average Price by Manufacturers (2015-2020)2.5 Manufacturers Follicle Stimulating Hormone Test Kit Production Sites, Area Served, Product Types2.6 Follicle Stimulating Hormone Test Kit Market Competitive Situation and Trends2.6.1 Follicle Stimulating Hormone Test Kit Market Concentration Rate2.6.2 Global Top 3 and Top 5 Players Market Share by Revenue2.6.3 Mergers & Acquisitions, Expansion

3 Production and Capacity by Region3.1 Global Production Capacity of Follicle Stimulating Hormone Test Kit Market Share by Regions (2015-2020)3.2 Global Follicle Stimulating Hormone Test Kit Revenue Market Share by Regions (2015-2020)3.3 Global Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)3.4 North America Follicle Stimulating Hormone Test Kit Production3.4.1 North America Follicle Stimulating Hormone Test Kit Production Growth Rate (2015-2020)3.4.2 North America Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)3.5 Europe Follicle Stimulating Hormone Test Kit Production3.5.1 Europe Follicle Stimulating Hormone Test Kit Production Growth Rate (2015-2020)3.5.2 Europe Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)3.6 China Follicle Stimulating Hormone Test Kit Production3.6.1 China Follicle Stimulating Hormone Test Kit Production Growth Rate (2015-2020)3.6.2 China Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)3.7 Japan Follicle Stimulating Hormone Test Kit Production3.7.1 Japan Follicle Stimulating Hormone Test Kit Production Growth Rate (2015-2020)3.7.2 Japan Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)

4 Global Follicle Stimulating Hormone Test Kit Consumption by Regions4.1 Global Follicle Stimulating Hormone Test Kit Consumption by Regions4.1.1 Global Follicle Stimulating Hormone Test Kit Consumption by Region4.1.2 Global Follicle Stimulating Hormone Test Kit Consumption Market Share by Region4.2 North America4.2.1 North America Follicle Stimulating Hormone Test Kit Consumption by Countries4.2.2 U.S.4.2.3 Canada4.3 Europe4.3.1 Europe Follicle Stimulating Hormone Test Kit Consumption by Countries4.3.2 Germany4.3.3 France4.3.4 U.K.4.3.5 Italy4.3.6 Russia4.4 Asia Pacific4.4.1 Asia Pacific Follicle Stimulating Hormone Test Kit Consumption by Region4.4.2 China4.4.3 Japan4.4.4 South Korea4.4.5 Taiwan4.4.6 Southeast Asia4.4.7 India4.4.8 Australia4.5 Latin America4.5.1 Latin America Follicle Stimulating Hormone Test Kit Consumption by Countries4.5.2 Mexico4.5.3 Brazil

5 Follicle Stimulating Hormone Test Kit Production, Revenue, Price Trend by Type5.1 Global Follicle Stimulating Hormone Test Kit Production Market Share by Type (2015-2020)5.2 Global Follicle Stimulating Hormone Test Kit Revenue Market Share by Type (2015-2020)5.3 Global Follicle Stimulating Hormone Test Kit Price by Type (2015-2020)5.4 Global Follicle Stimulating Hormone Test Kit Market Share by Price Tier (2015-2020): Low-End, Mid-Range and High-End

6 Global Follicle Stimulating Hormone Test Kit Market Analysis by Application6.1 Global Follicle Stimulating Hormone Test Kit Consumption Market Share by Application (2015-2020)6.2 Global Follicle Stimulating Hormone Test Kit Consumption Growth Rate by Application (2015-2020)

7 Company Profiles and Key Figures in Follicle Stimulating Hormone Test Kit Business7.1 Easydiagnosis7.1.1 Easydiagnosis Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.1.2 Easydiagnosis Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.1.3 Easydiagnosis Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.1.4 Easydiagnosis Main Business and Markets Served7.2 Wondfo7.2.1 Wondfo Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.2.2 Wondfo Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.2.3 Wondfo Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.2.4 Wondfo Main Business and Markets Served7.3 Daan7.3.1 Daan Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.3.2 Daan Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.3.3 Daan Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.3.4 Daan Main Business and Markets Served7.4 Bioscience7.4.1 Bioscience Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.4.2 Bioscience Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.4.3 Bioscience Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.4.4 Bioscience Main Business and Markets Served7.5 BGI7.5.1 BGI Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.5.2 BGI Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.5.3 BGI Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.5.4 BGI Main Business and Markets Served7.6 Chivd7.6.1 Chivd Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.6.2 Chivd Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.6.3 Chivd Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.6.4 Chivd Main Business and Markets Served7.7 AccuBioTech7.7.1 AccuBioTech Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.7.2 AccuBioTech Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.7.3 AccuBioTech Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.7.4 AccuBioTech Main Business and Markets Served7.8 Ameritek7.8.1 Ameritek Follicle Stimulating Hormone Test Kit Production Sites and Area Served7.8.2 Ameritek Follicle Stimulating Hormone Test Kit Product Introduction, Application and Specification7.8.3 Ameritek Follicle Stimulating Hormone Test Kit Production Capacity, Revenue, Price and Gross Margin (2015-2020)7.8.4 Ameritek Main Business and Markets Served

8 Follicle Stimulating Hormone Test Kit Manufacturing Cost Analysis8.1 Follicle Stimulating Hormone Test Kit Key Raw Materials Analysis8.1.1 Key Raw Materials8.1.2 Key Raw Materials Price Trend8.1.3 Key Suppliers of Raw Materials8.2 Proportion of Manufacturing Cost Structure8.3 Manufacturing Process Analysis of Follicle Stimulating Hormone Test Kit8.4 Follicle Stimulating Hormone Test Kit Industrial Chain Analysis

9 Marketing Channel, Distributors and Customers9.1 Marketing Channel9.2 Follicle Stimulating Hormone Test Kit Distributors List9.3 Follicle Stimulating Hormone Test Kit Customers

10 Market Dynamics10.1 Market Trends10.2 Opportunities and Drivers10.3 Challenges10.4 Porters Five Forces Analysis

11 Production and Supply Forecast11.1 Global Forecasted Production of Follicle Stimulating Hormone Test Kit (2021-2026)11.2 Global Forecasted Revenue of Follicle Stimulating Hormone Test Kit (2021-2026)11.3 Global Forecasted Price of Follicle Stimulating Hormone Test Kit (2021-2026)11.4 Global Follicle Stimulating Hormone Test Kit Production Forecast by Regions (2021-2026)11.4.1 North America Follicle Stimulating Hormone Test Kit Production, Revenue Forecast (2021-2026)11.4.2 Europe Follicle Stimulating Hormone Test Kit Production, Revenue Forecast (2021-2026)11.4.3 China Follicle Stimulating Hormone Test Kit Production, Revenue Forecast (2021-2026)11.4.4 Japan Follicle Stimulating Hormone Test Kit Production, Revenue Forecast (2021-2026)

12 Consumption and Demand Forecast12.1 Global Forecasted and Consumption Demand Analysis of Follicle Stimulating Hormone Test Kit12.2 North America Forecasted Consumption of Follicle Stimulating Hormone Test Kit by Country12.3 Europe Market Forecasted Consumption of Follicle Stimulating Hormone Test Kit by Country12.4 Asia Pacific Market Forecasted Consumption of Follicle Stimulating Hormone Test Kit by Regions12.5 Latin America Forecasted Consumption of Follicle Stimulating Hormone Test Kit13 Forecast by Type and by Application (2021-2026)13.1 Global Production, Revenue and Price Forecast by Type (2021-2026)13.1.1 Global Forecasted Production of Follicle Stimulating Hormone Test Kit by Type (2021-2026)13.1.2 Global Forecasted Revenue of Follicle Stimulating Hormone Test Kit by Type (2021-2026)13.1.3 Global Forecasted Price of Follicle Stimulating Hormone Test Kit by Type (2021-2026)13.2 Global Forecasted Consumption of Follicle Stimulating Hormone Test Kit by Application (2021-2026)14 Research Finding and Conclusion

15 Methodology and Data Source15.1 Methodology/Research Approach15.1.1 Research Programs/Design15.1.2 Market Size Estimation15.1.3 Market Breakdown and Data Triangulation15.2 Data Source15.2.1 Secondary Sources15.2.2 Primary Sources15.3 Author List15.4 Disclaimer

In Order to place the Purchase Query Click Here:https://www.qyresearch.com/settlement/pre/2385056/global-follicle-stimulating-hormone-test-kit-market

About Us:

QY Research established in 2007, focus on custom research, management consulting, IPO consulting, industry chain research, data base and seminar services. The company owned a large basic data base (such as National Bureau of statistics database, Customs import and export database, Industry Association Database etc), experts resources (included energy automotive chemical medical ICT consumer goods etc.

Go here to read the rest:
Follicle Stimulating Hormone Test Kit Market Overview, Trend Analysis, Competitive Landscape, Forecast to 2027 | Easydiagnosis, Wondfo, Daan - Splash...

The Telegraph

Joe Bidens daughter Ashley has said she will not have a job in her father's administration, unlike Ivanka Trump, in her first interview since the election. The only child of President-elect Biden and wife Jill, Ashley, a 39-year-old social worker in Delaware, said she instead wanted to use her new platform to advocate for social justice and mental health. I will not have a job in the administration, she told NBC's Today Show, in what could be seen as a jibe at the current First Daughter, who, along with husband Jared Kushner, had adviser roles in the White House. I do hope to bring awareness and education to some topics, subjects that are, you know, really important. Ms Biden, who is married to plastic surgeon Howard Krein, was active in her father's presidential campaign, speaking at the 2020 Democratic National Convention, and hosting an event for women in Wisconsin.

Here is the original post:
Parler reappears on web, still not in app stores - Yahoo News UK

The Telegraph

Joe Bidens daughter Ashley has said she will not have a job in her father's administration, unlike Ivanka Trump, in her first interview since the election. The only child of President-elect Biden and wife Jill, Ashley, a 39-year-old social worker in Delaware, said she instead wanted to use her new platform to advocate for social justice and mental health. I will not have a job in the administration, she told NBC's Today Show, in what could be seen as a jibe at the current First Daughter, who, along with husband Jared Kushner, had adviser roles in the White House. I do hope to bring awareness and education to some topics, subjects that are, you know, really important. Ms Biden, who is married to plastic surgeon Howard Krein, was active in her father's presidential campaign, speaking at the 2020 Democratic National Convention, and hosting an event for women in Wisconsin.

More here:
Trump Administration begins moving out of the White House - Yahoo News UK

When asked to trial the ProLon 5-Day Fasting Mimicking Diet, I was sceptical. As a health and nutrition coach, my advice is based on promoting long-term lifestyle changes no gimmicks, and forget about juice cleanses or diets that cut out whole food groups and instead focusing on making simple, sustainable, and well-balanced food choices for that individual. So I was pleasantly surprised.

ProLon is a patented five-day, plant-based meal plan that provides you with a daily meal kit containing all youll eat for each day. It contains some macro- and micronutrients that are scientifically selected for inclusion, but the low-calorie content and specific nutrient breakdown are designed to mimic fasting, and so provide some of the benefits you can get from fasting.

According to ProLon, its a programme of scientifically designed meals that give you the nourishment you need without activating your bodys food sensing system. Your body thinks that its on a prolonged fast, allowing for fasting gains, but without all the hunger pains.

Each small box, helpfully labelled Day 1 through to Day 5, contains a nut-based energy bar, two soups, a variety of snacks (including kale chips, olives and even the occasional Choco-crisp bar), energy drinks and supplements. You can eat the contents in any order and at any time of the day, but you must stick to the food for that day. Day 1 was slightly higher in calories with approximately 1,200, while Days 2 to 5 were approximately 800 calories. Wearing my nutritionist hat, I quickly realised that the taller you are and the more active you are, the harder this fast would be. For the first time ever, I was grateful for my five-foot frame.

ProLon is a scientific eating plan that directly lowers circulating insulin and as such is an excellent way to lose the most toxic and voluminous fat on the body

ProLon claims its diet can help rejuvenate your body while getting it to eat real food, helps your body reset and rejuvenate, and supports your bodys natural processes of intracellular clean-up and cell renewal. It also helps maintain lean body mass while lowering body fat.

ProLon came on to the market after 20 years and US$36 million in research and development. Initial clinical studies seem promising. Over a three-month period, ProLon was shown over three cycles to help individuals lose an average of 2.6 kg and 4 cm off their waist circumference. In another study on fast-mimicking diets, published in the magazine Science Translational Medicine in 2017, it aided in maintaining healthy systolic blood pressure and helped the body to rejuvenate.

What intrigued me most is that the brain behind the ProLon fast is Dr Valter Longo, director of the Longevity Institute at the University of Southern California, a man well known for research into longevity.

Here in Hong Kong, ProLon is also recommended by Dr Lauren Bramley, MD, LMCHK, MSc Endocrinology, Diabetes and Metabolism at her medical and anti-ageing clinic. Based on her medical expertise, ProLon is a scientific eating plan that directly lowers circulating insulin and as such is an excellent way to lose the most toxic and voluminous fat on the body, which centres around the abdomen, buttocks, chest, and back. As insulin is a hormone that can negatively impact many other hormones, including thyroid, reducing it improves other hormone levels and ratios to be truly anti-ageing. People look and feel much better with lower insulin levels. The sweetener used in ProLon is inulin, a natural substance that actually preserves muscle, burns fat, and improves insulin resistance this cannot be said for any other sweeteners found in weight loss products.

This in addition to the growing body of research showing that fasting can promote cellular regeneration encouraged me to take the first step. And so with an open mind and prompted by the promises of longevity and anti-ageing, I opened my first box.

By Day 4, I felt like I could go on forever; by the start of Day 5, though, I was glad I wasnt

After the elation of committing to a new plan has passed, youll likely feel hungry and (if anything like me) at a bit of a loss with all the extra time on your hands time youd usually spend chatting over a long meal, a glass of wine, grocery shopping or simply making dinner. This hit me around Day 2.

At the halfway point of the plan, I was feeling great. By Day 3, I was clear-headed and more energised, sleeping better and noticing that some of my inflammation and bloating had gone. I was waking up without an alarm and with a spring in my step, feeling that now is a good time to read up on all the benefits of fasting to keep me going! By Day 4, I felt like I could go on forever; by the start of Day 5, though, I was glad I wasnt. This was the hardest day for me, but by the end of the day I felt a real sense of accomplishment, not to mention that I looked and felt great in the days following!

I wont lie, not eating real meals and going low-calorie isnt for the faint-hearted. That said, after the first two days youre on a roll and with the right strategies you can absolutely survive five days and reap all the benefits that come with it.

Choose a week when youre mentally in a good space to undertake the fast no big social events centred around food and wine, and the ability to keep your schedule as flexible as you can.

Start each day with positive affirmations and remind yourself why you chose to do this. Remember that this is entirely your choice, so enjoy the process rather than focus on what you cant have. It will all still be there in five days!

Depending on how you feel, consider delaying your first meal. You dont want to end up at 5pm with no food to look forward to and a long night ahead.

Youre allowed one coffee a day I had more (decaffeinated) and I dont think it was a disadvantage. I also drank tons of herbal teas hot and cold as well as the glycerine drink provided in the meal kit. Its hard to feel hungry when constantly sipping on a flavoured drink.

I also added herbs and salt to spice up the flavour of the soup. Trust me, it really helped with some of the green-vegetable-based soups!

Go easy on exercise and do lots of activities that help switch on your para-sympathetic nervous system, such as yoga, pilates, stretching and gentle walks, as well as anything that helps detoxification, such as hot yin yoga, infra-red saunas and contrast showers.

Use this newly found time to do low-key activities with friends or anything that distracts you from thinking about food! I Marie Kondod my apartment and even managed to sort out my wardrobe, possibly inspired by the knowledge that, post-fast, I might even fit into those jeans Id kept since 2015.

Use the quiet time to catch up on books youve been meaning to read but never got round to.

Go to bed early and focus on a good nights sleep, knowing that sleep is one of the best things you can do to improve health (and is also scientifically proven to aid fat loss).

I also consciously didnt look at any food-related social-media pages or TV programmes why torment yourself unnecessarily?

Transition out of the fast sensibly. On Day 6, light foods, soups and cooked foods are ideal. I tend to be an all-or-nothing person, so the temptation to go out for a slap-up meal and glass of wine was huge. I resisted and was really glad I did!

If youre looking for a quick reboot, a way to recharge yourself or simply to kickstart a new health regime in the New Year, this could be a great option. Its also a good way to shift a few kilograms and mentally get into a good place to start a healthier way of living. If fat loss is a goal, then clinical trials have shown that the three-month protocol can produce some great results. However, its not a long-term solution and Id highly recommend ensuring you have a proper nutrition plan in place for after you finish the fast.

Also, its not for everyone and especially not suitable for those who are pregnant, breast feeding or underweight, or have pre-existing food disorders or any serious medical condition. Its also not a replacement for a proper nutrition plan and should always be done in conjunction with a health-care practitioner.

When I first embarked on the fast, my goal was to see if it lived up to its multiple claims and genuinely to understand how someone would feel during each stage of the five days. I was surprised by how good I felt by the end and can honestly say that I felt rejuvenated and would probably even do it again.

Its simple and effective enough to do whenever you need a reboot, and to create the momentum to springboard yourself into a healthier, happier you. Youll also notice that the results should continue after the fast is completed. With newly sensitised tastebuds, a body thats become used to consuming less food, fewer food cravings and a new appreciation for real food, this usually means that you continue to reap the benefits long after. If anything, Id say the reset benefits far outweigh the five-day fast itself.

Dr Lauren Bramleys clinic is offering a great deal, in which you can book a consultation with a health and nutrition coach, plus either one Prolon Fast or a package of three Prolon Fasts spread over three months. By quoting Prestige, you receive a 15 percent discount off the total package cost.

Beth Wright is a qualified health and nutrition coach focused on creating truly personalised nutrition and lifestyle programmes for her clients. She takes a holistic approach, looking at nutrition, fitness, hormones, supplementation, sleep and stress to help take peoples health, well-being and performance to a new level. Find out more about her programmes at bfit-thewrightway.com.

View original post here:
The ProLon Fasting Mimicking Diet: Whats the Skinny? - Prestige Online

The University of Glasgow has joined a large-scale European research project investigating the fundamental causes of hypertension, or high blood pressure.

The multidisciplinary research programme termed MINDSHIFT (www.eumindshift.eu) started on January 1 and is made possible by a European grant of over four million euros from the European Unions Horizon 2020 research and innovation programme.

Led by Maastricht UMC+ and Maastricht University and involving the Universitys Institute of Cardiovascular and Medical Sciences, UoG the four-year programme, includes 14 other partners from the United Kingdom, Spain, Italy, France, Austria, Switzerland and Poland.

The collaborative network includes academic institutions, research centres and industry with specific expertise and interest in hypertension that. Over the next few years the network will unravel new mechanisms of hypertension and will advance knowledge in the field.

Hypertension is called the silent killer because there are no symptoms yet it causes almost all cardiovascular diseases and is therefore a main cause of death globally. There is a clearly identifiable cause for high blood pressure in less than 15 per cent of cases, while in the remaining 85 per cent it is unclear. The researchers are keen to understand the underlying mechanisms that cause hypertension.

The University of Glasgow team will be contributing to four projects within the MINDSHIFT programme. Early stage researchers will be supervised by clinical and basic scientists within the College of MVLS and closely collaborate with other consortium partners across Europe.

Prof. Rhian Touyz will study the molecular make-up of small blood vessels and how they contribute to the development of high blood pressure. Prof. Christian Delles will study how hypertension leads to damage of the heart, kidneys and other organs and why some patients are more affected than others.

Prof. Eleanor Davies will dissect the role of aldosterone in the development of hypertension and how this hormone is regulated by small RNA molecules; and Prof. Paul Shiels will put hypertension into the context of ageing, and will develop new treatments to interfere with the ageing process.

Prof. Rhian Touyz, Director of the Institute of Cardiovascular and Medical Sciences, said: Hypertension is the major cause of cardiovascular disease worldwide and despite decades of research, we still do not fully understand how and why it develops, how to prevent it and how to properly treat it.

In the MINDSHIFT Consortium, we aim to address these gaps in knowledge. We will train the next generation of hypertension researchers and provide them with skills in basic and clinical science so that they can translate their research into the clinic and make a real difference to our patients with high blood pressure. The collaborative approach makes this programme particularly attractive and we look forward to working with our colleagues across Europe.

Excerpt from:
UofG PART OF INTERNATIONAL RESEARCH NETWORK STUDYING CAUSES OF HYPERTENSION - India Education Diary

A man reads newspapers reporting about Uganda's upcoming elections at a kiosk in Kampala.Photo: SUMY SADURNI/AFP via Getty Images

One night in Kampala, Vinka Silk, 20, a trans woman and sex worker, was in a bar when a friend she had come with told the bouncers that she was a man dressed as a woman.

My friend got jealous because I was getting rich men [that night], Silk says.

Silk was taken to the police station where she was frisked and undressed so the police officers could check her genitals. She was held till the next morning.

That was the [worst] moment of my life, she says. Following the incident at the bar, Silk decided she wanted to transition and start hormone replacement therapy. She didnt know anything about the process so she turned to the trans community, both in Uganda and outside of it, for help, advice and support.

I asked someone about hormones and that someone is in Canada, so she told me, you can go to these pharmacies [in Uganda] and you can buy them, she says.

Since she started taking hormones in July 2020, Silk has relied on a group of fellow trans sex workers for support.

The group is run by Anna Xwexx Morana, 24, another trans woman and sex worker in Uganda who, frustrated by how alone she felt at the start of her own transitioning journey, decided to create a support system, especially for trans sex workers to find community before, during and after they transition.

It was like something was missing, like some part of me was missing, Silk says about her life before discovering the group. At first, I thought I was born alone, like me alone in this world. But coming to the community, I realised I am not alone, that we are many, [and that made me feel] good.

Ideally, trans people looking to undergo hormone replacement therapy have to see an endocrinologist and then get a prescription unique to them.

This is not an opportunity many trans women in Uganda have, primarily for the transphobia ubiquitous in Ugandas healthcare system but also for how expensive endocrinologists are outside of that. Uganda has little to no services available to support transitions. Transgender people are not included in studies, they say, and so data about them is not readily obtainable. Many trans people like Silk and Morana report experiencing often violent transphobia when aiming to access medical services within the country and without the financial capability to look elsewhere, some of their needs are left unaddressed.

Informal networks like the kind Morana is fostering have stood in the gap.

Its a privilege for me, Morana says about creating a community for women like her. It's like I have a child and I am giving my child everything they've never had: a family, good health, anything.

The support groups are held under the auspices of Moranas Anna Foundation an NGO that uses innovative advocacy methods to address the problems faced by trans women who are sex workers in Uganda.

Outside of the support sessions though, Anna Foundation has organised trainings, conducted routine testing for sexually transmitted diseases, and provided safe housing for dozens of trans sex workers.

I can't say that it has been an easy road, but there's light at the end of the tunnel, Morana says. And [as] for me, I'm not waiting for the light at the end of the tunnel, I am creating my own light to get me to the end of the tunnel.

True to her word, the foundation has over 200 registered members, some of whom self-administer hormones.

Since I have started to take hormones, I am me, says JujuBee, 29, a trans woman and sex worker who started taking hormones in September 2019. I can go on the road and people start to call me a woman, and that makes me feel good. When someone tells me nyabo, you are a girl, you are beautiful, that makes me feel good.

Jujubee is originally from Burundi but has lived in Uganda since 2015 when she fled repeated harassment in her country for being trans.

I was arrested four times, she says. So I [decided] that I have to go, there is nothing [in Burundi] for me.

Now over a year into her transitioning journey, Jujubee is in a much better place mentally.

However, self-administering hormones, like self-administering any drugs, comes with considerable risks, according to Dr Alma Perez, an endocrinologist based in Mexico City who works with transgender patients.

Silk, for instance, takes two tablets each day, one in the morning and another in the evening, it is a prescription she arrived at by herself.

Many times when [trans people] are [self-administering], they are taking medications that are really not the best ones, Dr. Perez says. Second of all, they are taking higher doses, and with higher doses there are more risks of complications.

In this case, complications include the possibility of liver diseases, thrombosis and even heart attacks.

That's the point of really doing it with knowledge, not just like, what I heard, what my friend said, or what I read in a blog, she says. That is why it's so important to really go to the expert.

Nonetheless, Dr Perez is not oblivious to the systemic challenges that prevent this from being the case both in Uganda and in Mexico.

We can really help all those [transitioning] to get the knowledge of what is happening and what really could happen if they self administer higher doses, she says.

One day after taking her hormones, Morana says she became unconscious. I passed out. I was in my bed, I just felt dizzy. I felt like I couldn't raise my hand and I think I was in that bed unconscious for almost 40 minutes, she says.

While Morana describes it as her worst experience with hormones, she is unable to afford to consult with an endocrinologist and still doesnt know why it happened.

She has also had to struggle with gender dysphoria and feeling like the changes are not happening fast enough. You get up in the morning and get to look at your body having a penis in it. That is another type of trauma on its own, Morana says. Looking at your body and you're expecting to have bigger rounded hips and they are not coming but youre having a bigger ass. And you're like, Okay, what is this ass doing?

Her experience is not uncommon though, according to Dr Perez, who says its something she sees happen often in her work with trans women.

We wish [the changes] would happen faster, but even if you are taking higher doses, it won't happen earlier, it will still happen in the time it will, she says. That is why it's called a transition, it's not just everything in one day.

To combat this, Dr Perez says she encourages patients at her clinic who start hormone replacement therapy to take selfies every day.

[With these photos], they can see how they have evolved, how they have transitioned, because you see yourself and you hear yourself every day and you really don't see the evolution, the transition or how big the change has been.

Follow this link:
Trans Women are Taking Hormones Without Medical Supervision in Uganda - VICE UK

A flurry of stories broke this fall about the versatility of HIV medications and how they battle other diseases and conditions, in addition to news that a medication currently utilized for multiple sclerosis could fight HIV.

Researchers at Penn State University College of Medicine reported findings in October that indicated antiretroviral therapy for HIV reduces the risk of Alzheimers disease and early-onset Alzheimers. People living with HIV have a heightened chance of the degenerative disease, which impairs memory, speech, and most cognitive functions. The risk is even more pronounced, researchers found, for early-onset Alzheimers among people living with HIV. But for HIV-positive people who maintain their treatment regimen, the risk of Alzheimers is comparable to that of the general population.

Using public information on nearly 75,000 people aged 64 or younger and living with HIV, researchers looked at those not on HIV treatment and found the prevalence of Alzheimers higher among this group (0.11 percent) than those without HIV (0.07 percent). Early-onset Alzheimers was even more pervasive among those not on HIV meds (0.16 percent) than those without HIV. The occurrence of Alzheimers among HIV-positive people on treatment, though, was the same as for HIV-negative people (0.07 percent).

While no specific HIV medication was cited by researchers, the results appear to indicate that antiretrovirals battle more than just HIV. Scientists will now try to figure out how these antiretroviral drugs fight Alzheimers they currently theorize it may be because the medications hinder neurological toxicity caused by unsuppressed HIV or because these meds also reduce the incidence of medical conditions seen as risk factors for Alzheimers, like hypertension, diabetes, and high cholesterol.

The Penn State findings are important for many reasons, including the fact that the survivors of the early waves [of the HIV epidemic] are entering seniorhood, Guodong Liu, Ph.D., associate professor of public health sciences and neurology, pediatrics, psychiatry, and behavioral health at the Penn State University College of Medicine, told Healio.

Just days before the Penn State announcement, researchers with the University of Virginia School of Medicine reported that medications used to treat HIV and hepatitis B slash the risk of developing diabetes by a third for these patients.

The drugs could be repurposed to prevent type 2 diabetes, a condition the Mayo Clinic describes as the body resisting the effects of insulin a hormone that regulates the movement of sugar into your cells or not producing enough insulin to maintain normal glucose levels.

Information for the findings was culled from records of over 128,000 people with HIV or hepatitis B, some of whom are veterans who receive their care from the Veterans Health Administration.

The fact that the protective effect against the development of diabetes was replicated in multiple databases in studies from multiple institutions enhances confidence in the results, researcher Jayakrishna Ambati, MD, of the University of Virginia School of Medicine, said in a statement.

The researchers also studied the effects of one specific drug, lamivudine, sold under the brand name Epivir and a component of Dovato, in human cells and in animals, and found evidence that it could reduce the risk of diabetes among people living with HIV.

Most recently, researchers at George Washington University and the University of Montreal found that the multiple sclerosis drug fingolimod, sold as Gilenya, can hinder several key steps of the HIV lifecycle, AIDSMap reported in November. Taken orally, fingolimod is now used to treat MS, a chronic autoimmune disease of the central nervous system that disrupts communication between the brain and the body. During their studies, the researchers found that fingolimod prevented cell-to-cell transmission of HIV.

Fingolimod may be useful as a strategy to limit the size of the latent [HIV] reservoir if used prior to [antiretroviral] initiation, such as in acute infection, researcher Rachel Resop, Ph.D., and her colleagues noted.

Read more:
Multitasking Meds Combat HIV, Along With Alzheimer's and Diabetes - HivPlusMag.com

Medically defined, infertility is the inability to become pregnant after one year or longer of unprotected sex. Emotionally, its a nightmare for any person who has ever dreamed of becoming a parent. Its a medical condition that many suffer in silence, treat in secret, and pay for out of pocket. And the worst part is: Not everyone has equal access to the treatments that offer hope for couples struggling to conceive.

If you or your partner have trouble getting pregnant or sustaining a pregnancyas one in eight couples doyou are in for a hell of a fight, regardless of your race. But if youre Black, Latinx, or Native American, you are in for a war. You cannot downplay the fairly substantial evidence that suggests minorities have it worse than their white counterparts, says Will Kiltz, the communications director at CNY Fertility, a clinic in Syracuse, New York.

Here are the facts: Twelve percent of U.S. women used fertility services between 2006 and 2010, according to data collected by the National Survey of Family Growth. But white women were almost twice as likely as Black or Latinx women to have done so15 percent of non-Hispanic white women used medical help to get pregnant, while only 8 percent of (non-Hispanic) Black women and 7.6 percent of Hispanic women reported the same. So why the racial disparities in care? The reasons are complex, and experts say there is a long road ahead to positive change.

Following a preliminary visit to the OB/GYN, the journey to parenthood for many heterosexual couples begins at home. Depending on the age and overall physical health of both parties, experts say that following six months to a year of contraceptive-free sex, a pregnancy should result. If a pregnancy is not achieved in that timeframe, the standard practice is for an OB/GYN to refer the couple to a fertility specialist.

However, some Black, Indigenous, and people of color (BIPOC) say their doctors made them wait much longer to get that all-important referral. My husband and I have been trying for 21 years to have this baby, says Racheal Martinez, now age 40. When Martinez was 20, she was newly married and living on a military base with her husband. She shared with her OB/GYN that she wanted to have a child but was having trouble conceiving. She asked her provider for a referral to a fertility specialist. She says her doctor refused and told her she was too young for treatment and that having a baby with her husband would make her another statistic. (Martinez is Black and her husband Roberto is Mexican American.)

It took another six years before a physician provided Martinez with a referral to a fertility specialist. In that time, and the years that followed, Racheal and her husband experienced 22 miscarriages, a diagnosis of polycystic ovarian syndrome (a hormone disorder that can lead to infertility if untreated), a diagnosis of recurrent miscarriages, and a diagnosis of hypothyroidism (a hormone condition that can also negatively affect fertility).

There are some studies that show that patients of color are referred to fertility specialists a little later than white patients, says Michael Thomas, MD, chief of the division of reproductive endocrinology and infertility at the University of Cincinnati College of Medicine. He says delays in treatment for patients of colorlike what Martinez facedoccur for a variety of reasons.

One small survey of 50 Black women found that 26 percent of them believed that their encounters with medical professionals had been influenced by gender, race, and/or class discrimination, and some reported that their doctors made assumptions about their inability to pay for services based.

Martinez was young when she approached her physician for a referral, and perhaps the provider assumed time was on her side. But its also possible that her doctor was making assumptions about her fertility based on her race. In the case of Black patients like Martinez, there is data to support this. Although Black women are at a higher risk for fibroid tumors and health issues such as diabetes and hypothyroidism that can lead to an increased risk of fertility issues, only 16 percent of doctors correctly identified Black women as the racial group most at risk for infertility, according to a 2019 survey of 150 family doctors and OB/GYNS conducted by Fertility IQ.

It was horrible. [The fertility doctor] had his arms and legs crossed the whole time. You could tell he thought we couldnt afford [treatment] and wondered what we were doing there. Nicole Vaughn, 34, fertility patient

When doctors make assumptions about their patients, the results can be costly. A persons fertility declines with age and a two- or three-year delay in seeking infertility treatment can decrease the chances of a successful pregnancy. OB/GYNs have to treat all patients the same, says Dr. Thomas. They have to understand that if a patient needs a fertility expert, its important to send them early rather than later.

Once a patient gets their foot in the door of the fertility specialists office, its not an instantaneous lassoing of the stork. Fertility treatment comes with a price tag, and for many people, this cost is the biggest obstacle of all. According to the National Conference of State Legislatures (NCSL), one cycle of IVF costs on average between $12,000 to $17,000. (That doesnt include the cost of medication required for IVF, which can bring the total cost closer to $25,000 for one cycle.) And in the majority of states, infertility treatment is not covered by insurance (only 19 states legally require some level of fertility coverage for residents). This leaves patients without the means to pay the bill the tough decision between walking away or going into debt.

This was the case for Nicole and Vaughn Hill, 34 and 33 respectively, educators from Texas. The couple (both Black) began the process of trying to start a family about three years ago. Nicole had long experienced irregular periods, which her OB/GYN told her was normal. When she and Vaughn struggled to conceive, Nicoles provider prescribed a fertility drug called Clomid to help boost their chances. After four failed cycles on the drug, Nicoles doctor referred the couple to a reproductive endocrinologist.

Dr. Smug, recalls Nicole. It was horrible. He had his arms and legs crossed the whole time. You could tell he thought we couldnt afford [treatment] and wondered what we were doing there. He didnt go into a lot of detail about any of the treatment options. I felt more confused than anything. Worst experience I could have ever had, says Nicole.

Like many people experiencing infertility, Nicole and Vaughn were not rich. So that we could afford treatment, we both taught summer school, and I also received a promotion while we were going through the process, says Vaughn. In the end (after finding a new fertility doctor), Nicole and Vaughn spent approximately $25,000 for two IVF procedures and four embryo transfers. It was a hefty price, but they say worth every penny for just one giggle from their daughter Amaya, who is now eight months old.

While the Hills found a way, many others are not as fortunate. According to the U.S. Census Bureau, the median household income for non-Hispanic white households is $76,057; for Black households, $45,438; for Hispanic households of any race, its $56,113income disparities largely due to systemic racism that historically has made accessing wealth, loans, and equitable pay more difficult for many BIPOC communities. To afford treatment, many families must consider various financing options such as refinancing their homes, working second or third jobs, changing jobs to work for an employer who offers fertility benefits, moving to a state with mandated coverage, and/or applying for loans.

And even if a couple has the means to undergo infertility treatment, that doesnt mean they feel comfortable doing so. Many patients who have trouble sustaining a pregnancy keep their struggles private. While the stigma of infertility is nearly universal, it can be compounded by social and religious beliefs. There are a lot of conversations in the Black community about what we dont do, Regina Townsend, founder of online fertility support group The Broken Brown Egg, previously told Well+Good. We dont go to therapy, we pray. We dont give our kids away or adopt. Phrases like that are really damaging. Its the wrong story to tell ourselves, she said. To her point, these types of beliefs may cause a couple to reject, or in some cases refuse to discuss, medical options available.

Beyond price, the fertility industry at large has also not made itself particularly available to BIPOC patients. The industry relies on physician referrals and marketingpromotional materials with testimonials from patients, websites, and social mediato bring in new patients. But many of these efforts do not include or reach potential BIPOC patients. In one review of the websites for 372 fertility clinics, 63 percent of those sites only featured pictures of white babies, according to a paper published in the Indiana Law Journal. The lack of diverse imagery hammers home the concept that fertility treatments are not available for all people, just certain people.

The racial disparities in fertility treatment are not going to be solved overnight. This has been a problem for a long time, and we have to address it, says Rebecca Flick, the chief external affairs officer for Resolve: The National Infertility Association. Fortunately, things are starting to change. The fertility startup Kindbodywhich aims to be a more inclusive company through its marketing, promotional materials, and staffsays 44 percent of its patients are people of color, suggesting that the message is being heard and received. According to Kindbody founding physician Fahimeh Sasan, MD, inclusivity is imperative for progress in the industry. The key is to educate people about fertility, to educate them about facts, she says. We cant improve access if people dont know about the process.

Advocacy and educational organizations such as The Broken Brown Egg, Sister Girl Foundation, and the Cade Foundation are also helping to improve the situation by offering resources, support, and opportunities to women of color dealing with infertilityresources that can help break stigma and help BIPOC patients be better advocates for their care. And in 2020, Kindbody partnered with Fertility for Colored Girls, an organization dedicated to raising awareness surrounding the issues of fertility and race, to award a collective $50,000 to four BIPOC women looking for financial assistance for fertility treatment. (After receiving more than 300 applications, Dr. Sasan says the company is open to extending the program due to the response.)

Making fertility treatment more affordable will also help. Both the Martinezes and Vaughns ended up getting pregnant with the help of CNY Fertility. Our mission has always been to make fertility care accessible to everyone, including the traditionally underserved, says Kiltz. An IVF cycle at the clinic costs, on average, $3,900, a price that makes its services more accessible to a wider group of people. Our patient population is approximately 40 percent minority populations, 20 percent of whom are African American, he adds.

CNY Fertility and Kindbody have also instituted open-door policies that allow patients to schedule a consultation without a referral, which can help mitigate some of the delays experienced by many BIPOC patients. The first person to know something is wrong with their body is the patient. So, let them go straight to the experts, says Kiltz. Although CNY Fertility also accepts referrals from OB/GYNs, more than 50 percent of their patients are self-referred.

Doctors who specialize in reproductive medicine are also working to improve access to their care for all patients. The American Society of Reproductive Medicine (ASRM) recently created a diversity, equity, and inclusion task force (Dr. Thomas is the chair). One of its goals is to recruit more physicians of color into the field. When I started back in the 80s, there were fewer than 10 reproductive endocrinologists of color. Its increased since then, but not substantially, says Dr. Thomas. I think that by slowly increasing the number of physicians of color, we will have a better understanding of what African American women go through. And that, he says, would be helpful to all patients.

While the work is underway, patients who have been through infertility say there is still much to be doneand you cant rely on the system to do it for you. You have to advocate, says Martinez. You have to do a lot of research. You may need a second or third opinion because some doctors are going to be biased, but you have to do what you have to do and be smart. The experts are listening. Its how they act from here that will make the difference.

If you love free workouts, discounts for must-have wellness brands, and exclusive Well+Good content, sign up for Well+, our online community of wellness insiders, to unlock your rewards instantly.

View original post here:
Racism and Bias Make Infertility Treatment Even More Inaccessible to Couples of Color - Well+Good

Study data published in NeuroImage: Clinical suggest that pre-therapy neuroimaging profiles may be able to predict outcomes of cross-sex hormone therapy in transgender individuals. In a cohort study of transgender women and men, post-therapy reductions in gender dysphoria were predicted by greater pre-therapy connectivity within the cingulo-opercular and fronto-parietal networks. Such data may provide insight into the body-brain effects of hormone therapy and support the use of certain pre-therapy characteristics to predict whether individuals may need additional support during hormone replacement therapy.

Participants were recruited from a clinic specializing in gender-affirming medical care in Stockholm, Sweden. Participants underwent magnetic resonance imaging (MRI) at 2 time points: (1) prior to hormone intervention and (2) an average of 14 months post-therapy initiation. During the MRI scans, participants were asked to complete a body morph task, in which they were presented with a set of images taken of their own bodies.

The body photographs were morphed towards 5 different iterations of female-presenting bodies and 5 different iterations of male-presenting bodies. While being presented with this continuum of images, participants were asked to rate each one on how closely it represented their own self-image. Results from these body image tasks were used to produce a body index (BI) score, or the degree to which each patient felt their bodys physical characteristics aligned with their gender identity.

More negative scores on the BI were indicative of greater congruence between body image and gender identity. The mean MRI-determined activity within 7 regions of interest (ROIs) was compared between the pre- and post-hormone therapy time points. A least absolute shrinkage and selection operator (LASSO) regression model was used to predict post-therapy BI scores using pre-therapy imaging and clinical data.

Data from 16 trans women and 9 trans men were used in analyses. Mean age at enrollment was 25.2 7.8 years. Mean pre-therapy BI score was -10.4 21.8; mean post-therapy score was -23.1 25.7 (P =.002). The majority of patients (n=18; 72%) experienced a significant decrease in BI score over time, indicating better congruence between body image and gender identity. In regression models which incorporated both clinical features and imaging data, functional connectivity in the fronto-parietal network (P <.005) and the cingulo-opercular network (P <.006) were significantly associated with post-therapy BI ratings.

Models which incorporated all 7 ROIs with clinical features were less accurate in predicting post-therapy BI scores. The best-fitting algorithm combined pre-therapy clinical features with functional connectivity within the fronto-parietal and cingulo-opercular networks (P =.001). Predictive clinical features included age, body mass index, years of education, sexual orientation, and duration of hormone therapy. However, clinical features alone did not predict post-therapy congruence.

Per these data, network connectivity in certain brain regions was associated with hormone therapy outcomes in transgender individuals. Specifically, the front-parietal and cingulo-opercular networks were predictive of post-therapy BI scores. It remains unclear why these specific regions were implicated in therapy outcomes.

Regarding study limitations, investigators cited the small cohort size, relatively short follow-up duration, and use of BI score as a measure of body congruence. While the BI is a validated measure of body congruence, it likely fails to capture the full spectrum of patient experiences.

Even so, [this study] illustrates the potential for predicting hormone therapy responsiveness in transgender individuals with [gender incongruence], the investigators wrote. Results could help identify the need for personalized therapies in individuals predicted to have low body-self congruence after standard therapy.

Reference

Moody TD, Feusner JD, Reggente N, et al. Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity. Neuroimage Clin. Published online December 2, 2020. doi:10.1016/j.nicl.2020.102517

Read the original here:
Functional Connectivity in Certain Brain Regions May Be Associated with Hormone Therapy Outcomes in Transgender Patients - Psychiatry Advisor

Whether you're trying to get pregnant for the first time or you've been trying for a while, a prenatal multivitamin is standard care. Some specific vitamins may be a worthwhile option to further explore, says Jennifer Hirshfeld-Cytron, MD, a reproductive endocrinologist with FertilityCenters of Illinois.

Both genders see age-related declines in fertility by age 30. This makes infertility a common issue, affecting up to one-third of couples trying to conceive.

For people trying to get pregnant, the Mayo Clinic advises that women of reproductive age should start taking prenatal vitamins daily even before they start trying to conceive.

Here are some of the top recommended prenatal vitamins and supplements that help with female fertility and achieving a healthy pregnancy.

Many of the recommended prenatal vitamins and supplements contain antioxidants as one of the main ingredients. This is because research suggests that antioxidants combat oxidative stress which may be linked to female infertility. However, it's important to note that more research is needed to determine if antioxidants actually boost fertility.

Hirshfeld-Cytron suggests these common prenatal vitamins and supplements to help increase female fertility:

Coenzyme Q10. This is an over-the-counter (OTC) antioxidant that Hirshfeld-Cytron says can improve the quality of eggs. In theory, better egg quality is associated with less risk of genetic abnormalities, such as too few or too many chromosomes, which can cause trisomy 21 (Down Syndrome), Turner Syndrome, and other conditions. Coenzyme Q10 may also reduce cellular damage and boost energy production in cells.

"I would recommend holding to start this supplement until a physician sees you to confirm issues around egg quality," Hirshfeld-Cytron says. If you can take it, she suggests 200 mg, three times a day with food.

Melatonin. This is a hormone with antioxidant activity that can be found as an OTC supplement. A 2012 review suggests the hormone helps promote fertilization by reducing cellular damage inside the ovaries.

Hirshfeld-Cytron says this may be particularly important for female night-shift workers whose schedule disrupts their circadian rhythm an internal clock regulated by melatonin. She recommends 3 mg each evening, as melatonin also helps to promote sleep.

Omega-3 fatty acids. Commonly found in fish and flaxseed, omega-3 fatty acids can aid hormone production. Hirshfeld-Cytron says they may also help to produce higher quality eggs and better reproductive functioning as you age.

"Elevated levels of omega-3 have shown to improve embryo development and baseline estrogen levels," she says. Estrogen helps to thicken the uterine lining to prepare the body for pregnancy. Hirshfeld-Cytrom recommends 1200-1500 mg EPA + DHA daily, but not to exceed 3000 mg/day.

Vitamin D.Your body produces this fat-soluble vitamin when it's exposed to sunlight. You can also get vitamin D through certain foods and as a supplement. It helps to control the genes involved in producing estrogen, as well as embryo implantation.

"Most of us are Vitamin D deficient. I strongly recommend adding at least 1000 IU, which can be found in some prenatal vitamins," says Hirshfeld-Cytron. There is no need to take additional vitamin D along with a multivitamin unless directed by your doctor.

Folic acid. According to the Centers for Disease Control and Prevention (CDC), folic acid is a B vitamin that all women of reproductive age should take because of its ability to produce new cells, such as for nails, hair, and skin. When taken as a supplement, a 2015 study found it increased the likelihood of pregnancy.

Folic acid is also important to avoid birth defects. The MGH Center for Women's Health says that most pregnancies go undetected in the first few weeks, a critical period for the formation of the neural tube which creates the brain and spinal cord in the fetus. A daily minimum dose of 400 mcg of folate is recommended for most people.

Hirshfeld-Cytron says that an all-inclusive prenatal vitamin or multivitamin "should contain folic acid, calcium, and iron, and ideally also have vitamin D, vitamin C, vitamin A, vitamin E, zinc, and copper. These are a must if you are trying to conceive."

If prenatal vitamins in pill form cause an upset stomach, you can try liquid supplements or chewables. However, when choosing gummies, it's important to have extra supplementation as they may lack iron.

When taking your prenatal vitamin, it's best to have it with a full glass of water. For better absorption, Hirshfeld-Cytron says to take prenatal vitamins with a meal. Speak with your physician if you are having issues with nausea or constipation.

Hirshfeld-Cytron also says it doesn't make much difference if vitamins are prescribed or not. "The nutrients in over the counter and prescription prenatal vitamins are similar. In some cases, prescription prenatal vitamins may be easier on the stomach," she says.

Typically, your OB-GYN will administer the first round of fertility tests. Women attempting to conceive for more than one year, or more than 6 months if age 35 or older, may choose to undergo an evaluation by a fertility specialist. Fertility tests can include checking reproductive hormone levels along with:

Beyond aging, female fertility is affected by a range of conditions such as endocrine disorders, endometriosis, and polycystic ovary syndrome (PCOS). People with untreated gonorrhea or chlamydia are at risk of pelvic inflammatory disease, which may block fallopian tubes.

Taking prenatal vitamins can potentially improve egg quality and the antioxidant activity may boost fertility.Overall, Hirshfeld-Cytron recommends a variety of prenatal vitamins to increase your chance of fertility success. She says including prenatal vitamins, particularly a multivitamin that includes vitamin D and folic acid, to your health regimen is a critical proactive measure when seeking to boost your fertility.

Continued here:
The best prenatal vitamins for women and how to take them to boost your fertility - Insider - INSIDER

A column about being a pregnant trans dad, and all the prejudices, healthcare challenges, personal dilemmas, and joys that come with making a family in 2021.

Its Christmas eve. Chilly Gonzales contemplative yet comforting festive album fills my English seaside living room. Our TV is wearing tinsel. Golden fairy lights shine in the corner of my eye. The tree my almost-3-year-old and I decorated is festooned with seahorse ornamentsa symbol affectionately adopted by trans dads such as myself, because male seahorses are the ones who get knocked up.

It finally feels Christmassy at home, if not outside. Our town, our entire countyall 1.9 million of usis in Tier 4, the highest level of Coronavirus lockdown in the UK. The new restrictions were imposed with less than 12 hours notice on December 20th. I still hadnt got anything for my mum, and now, all non-essential shops are closed.

Im not worried too much on that front, though. Yesterday, I was able to give her an early Christmas present of sorts: I did a pregnancy test and the result was positive. I immediately rang to tell her the news. Its early days, but still, there it is. For now, it worked, and on first attempt at that. If all works out, I will be having my second child via IVF embryo transfer.

Just like the first time, Im using my eggs and sperm from a donor who can be contacted later on. Anonymous sperm donation ended in the UK in 2005 and donors are now only reimbursed for expenses, up to around $50.

Like many queers who seek fertility support, I did so for practical reasons, not because of infertility. I have been medically transitioning since 2013, but so far Ive retained my reproductive ability. Ive been on testosterone (T) for years, but this hormone has never been shown to harm trans male fertility, despite what you may have heard. My ovaries dont bother me and I dont bother them, most of the time.

Some quick context: For a wide range of reasons, many trans men choose not to have hysterectomies, be that ever or until many years into transition. We used to be told that retaining our reproductive organs would likely give us cancer, but thankfully, that has since been debunked. Its common knowledge in our community that many of us continue to ovulate or have light periods, even while taking testosterone. And, because the idea that we all hate our entire bodies is only a reductive and insulting generalization, it is worth clarifying that we can enjoy all kinds of sex, penetrative or otherwise.

If we pause our hormone treatment, we can, and increasingly do, become dads who give birth. So, given all this, its not quite a Christmas miracle that my recent fertility treatment was successful. It was just the best Christmas gift I could have dared hope for. In terms of IVF, after creating healthy embryos and waiting for my body to give all the right signals, my chances were as good as they get.

Many prospective queer parents go the DIY route, meaning they simply have sex. Or they do at-home insemination, aka the turkey-basting method. But I chose to attend a clinic because, well, Im a pragmatist. First, Im (happily) single and I dont have a known donor with semen on tap. Despite donors no longer getting paid, frozen donor sperm is still expensivearound $1,400 a popso creating multiple embryos with just one vial was cost-effective for me. Second, I find being off T really hard and with my first pregnancy, the uncertainty of how long it would take to conceive was truly agonizing. This time, knowing more about what my mental health can withstand, I chose IVF. Insemination (IUI) is noninvasive and affordable, but IVF success rates, round for round, are generally much higher.

I know its unorthodox to share news of a pregnancy this early. In fact, I am hyper aware of this (thanks, anxiety!). Im not immune to the phobia of pregnancy being somehow jinxed by being announced early on but, at the same time, I am sick of it. Part of my reason for doing this column is to push against the normative assumptions surrounding pregnancy, and that includes superstitions. Does any good come of keeping this a secret for any length of time? If not, why do we do it?

Historically, misogyny has told us that miscarriage is an individual failure and therefore, should be a private shame.

When a cis, straight couple tries for a baby, they might mention it to close friends or family. Or they might well not. Beyond that, the fairly universal norm is for silence to enshroud the process, until, at the very earliest, a 12-week scan is safely navigated. That potentially means months and months of having no one, or perhaps just one other stressed-out person, to confide in.

Such a tangle of social mores, ancient superstitions, and personal comfort levels is impossible to tease apart. Still, Ill hazard a guess that the fact pregnancy has been understood as an essentially female experience is mostly to blame for the secrecy. It would also explain the stigma that accompanies being open about this stuff too soon or too much. Whoever is going through it might worry that if they do not abide by The Rules, they are inviting judgement, or worse, blame if something goes wrong.

Historically, misogyny has told us that miscarriage is an individual failure and therefore, should be a private shame. That means, too often, people experience miscarriage or baby loss in complete and devastating isolation.

Anecdotally, Ive noticed that secrecy or shame around pregnancy and pregnancy loss is less of a thing in LGBTQ+ communities and certainly in online community spaces. On the contrary, people often actively reject these concepts, perhaps having already realized the power in rejecting them in relation to their sexual and gender identities. So, finding that other queer parents have shared their experiences before me is not in the least bit surprising.

I get that its something of a matter of necessity. Queer people who are Trying To Conceive (TTC as the lingo has it) would have no where else to turn if we didnt find each other and get candid about our family-making methods, hacks, and struggles. In short, we are usually our only source of information and support. One of the few upsides of not being reflected in mainstream society might be avoiding, or at least having space to unlearn, its neuroses around fertility.

I want to share the nuts and bolts of this process, both the highs and lows, because before I started my own family, all the media about people like me was sensationalist and left me with the same unhelpful questions: Am I a freak? And not the good kind?

There should never be another trans or nonbinary person relying on luck, or the difficult unlearning of shame, to fulfill their dreams of family, whatever form it takes.

I had no positive role models and no practical advice. The very possibility of creating a family the way I did was something I learned about totally by accident. Today, when I look at my beautiful kid, this detail in particular makes my heart lurch. What if Id never been put straight about my fertility and my options for becoming a parent? What if that doctor who assumed I didnt want kids had also managed to convince me that I could never really be me without a hysto? I know people who were robbed of this knowledge and these choices and it has to stop. There should never be another trans or nonbinary person relying on luck, or the difficult unlearning of shame, to fulfill their dreams of family, whatever form it takes.

I also want to use this space to explore lots of other ideas and questions relating to gender, fertility, family, parenthood, and the society in which they currently, somewhat unsteadily, percolate. Anecdotally, Ive noticed that, regardless of gender, prioritizing starting a family makes me a bit of an outlier as a Millennial. If its true more broadly that my peersboth straight and queerhave different priorities, is it out of choice or economic necessity? Ive also learned firsthand that, while more parents are trying to free their kids from the chains of gendered expectations, those expectations seem to have an ever greater influence on us from before were even born. Why do gender reveals and the pink/blue binary still dominate?

So, here I am, carrying on this fine queer tradition of oversharing. As I write this, I am four weeks pregnant. I feel nauseous all the time and I hope beyond hope that this poppy seed-sized life finds its way earthside in 40-ish weeks time to meet us. I am also conscious that it might not and that if it doesnt, that I will not be alone, nor will I feel like a failure.

Its a privilege to be able to share this experience with you, whether youre here to see yourself reflected, out of pure curiosity, or somewhere in between. I hope you will stick with me, too.

Follow Freddy on Twitter.

Originally posted here:
Why I'm Sharing Everything About My Experience As a Pregnant Dad - VICE

TipRanks

Wall Streets best firms dont just look at the stocks, they look at the big picture, too. And Oppenheimers chief investment strategist, John Stoltzfus, is particularly adept at showing us the macro view. In his first note of the new year, Stoltzfus notes a series of factors that are going to impact the markets. The big news, of course, the 800-pound gorilla that cannot be ignored, is the ongoing COVID epidemic. The disease is coming back strong now that were well into winter which was somewhat expected, as its typical behavior for flu-like respiratory viruses. With the winter virus surge, we also must contend with a new round of lockdown policies, imposed from state or local levels. Its hoped that the newly available COVID vaccines will, by springtime, start to put a damper on the novel coronavirus."The length of time that households and economies have been negatively impacted by the spread of the virus across the world in our view will likely result in less resistance to inoculation against Covid-19 than many experts had feared early on in the pandemic. We expect that equity markets will remain sensitive to developments tied to the pandemic that have held the US and global economy hostage for nearly a year," Stoltzfus said.The second-biggest news, but the one most likely, in Stoltzfus view, to make an impression on the market, is the Georgia election. Both Democratic candidates won Senate seats, giving the incoming Biden Administration the ability to push policies through Congress over any opposition at least for the next two years.This Democrat victory, ensuring short-term one-party control of the Presidency and Congress, has Stoltzfus worried. In his campaign, Joe Biden promised to roll back Trumps tax policies, and to enact a series of large spending initiatives. Should he now follow through, Bidens stated policy is likely to raise both taxes and Federal spending. And in Stoltzfus view, that will probably cost the markets; Stoltzfus believes that unfettered progressive/Democrat policy enactments will leave the S&P 500 vulnerable to losses on the order of 6% to 10%.Before rushing to sell-off holdings, Oppenheimers stock analysts remind investors that compelling opportunities can still be found. The firm's analysts have tagged three stocks that they see gaining upwards of 80% for the year ahead. UsingTipRanks database, we learned that the rest of the Street is in agreement, as all three boast a Strong Buy analyst consensus. miRagen Therapeutics (MGEN)miRagen Therapeutics aims to develop new treatment options for diseases that todays therapies cannot adequately ameliorate. The company's flagship drug candidate is VRDN-001, an anti-IGF-1R monoclonal antibody in clinical-stage research as a treatment for thyroid eye disease (TED). miRagen acquired the rights to VRDN-001 late last year, after its October acquisition of Veridian Therapeutics. The monoclonal antibody is about to enter Phase 2 clinical trial, with initial results expected around mid-year 2021.miRagen is funding its current research with a $91 million capital raise, arranged in a private placement financing agreement. With that agreement in place, miRagen ended the third quarter with $144 million in cash on hand, but more importantly, a clear cash runway extending to 2023.Among the bulls is Oppenheimer analyst Leland Gershell, who rates MGEN an Outperform (i.e. Buy), along with a $37 price target. This figure indicates room for 102% one-year growth. (To watch Gershells track record, click here)Backing his stance, Gershell says, Recent Viridian acquisition and $91M raise set miRagen on a new course, as the incoming programs position it to compete in the fertile thyroid eye disease market we see ample revenue potential for [VRDN-001], and its higher potency may enable differentiation... We expect that progress in the development of MGEN's TED candidates will support outperformance. Overall, Wall Street likes the risk/reward factor at play here, as TipRanks showcases a Strong Buy consensus rooting for MGEN's success. Shares are selling for $18.26 and have an average price target of $32. This target implies a 75% upside from current levels. (See MGEN stock analysis on TipRanks)Oric Pharmaceuticals (ORIC)The success of the pharmacological industry has, ironically, caused a significant challenge: many diseases are becoming resistant to existing therapies. Many cancers are among the diseases subject to resistance and consequent relapse, serious problems that both impact the patients quality of life and increase mortality rates. Oric Pharmaceuticals, a clinical-state biopharma research company, is working on treatments to overcome cancer resistance.Orics lead candidate is ORIC-101, which shows promise as a glucocorticoid receptor (GR) antagonist. The drug is entering two separate Phase 1b trials, one for prostate cancer and one for solid tumors. Modern drug research is expensive, and Oric recently raised capital through a successful public offering of stock. The company put over 5.79 million new shares on the market back in November, at $23 each, and grossed over $133.3 million.5-star Oppenheimer analyst Kevin DeGeeter covers Oric, and he is bullish. DeGeeter backshis Outperform(i.e. Buy) rating with a $62 price target, implying a one-year upside potential of 88%. (To watch DeGeeters track record, click here)In support of his optimistic stance, DeGeeter writes, We view ORIC as an investment in a leadership team with prior history of successfully developing clinically important cancer drugs. Our thesis assumes clinical data supporting best-in-class profile of ORIC-101 based on either ease of use or superior efficacy in biomarker selected population. We believe current investor expectations assign material value to potential best-in-class profile of ORIC-101 and skills of management. Overall, ORIC shares get a unanimous thumbs up from the analyst consensus, with 3 recent Buy reviews adding up to a Strong Buy rating. The stock is priced at $32.91, while the $50.67 average price target indicates room for an ~54% growth. (See ORIC stock analysis on TipRanks)Triterras (TRIT)Next up is a unicorn, a billion-dollar fintech startup that has been on the public markets for less than three months. Triterras provides an online trading and trade finance platform, Kratos, based on blockchain technology. Trade finance, or the provision of credit services in the physical transport of market commodities, is worth an estimated $40 billion annually; Triterras platform uses the secure nature of blockchain as a selling point for online traders.Triterras went public through a SPAC merger; that is, a business combination with a special acquisition company. These companies exist to purchase a target company, injecting capital, and then put the combined entity on the public markets.Analyst Owen Lau, in his coverage of this stock for Oppenheimer, likes what he sees. Of the companys current status, he writes, results and momentum appear strong, and the full-year guidance implies a 235% and 142% YoY growth in revenue and net income off a low base. More importantly, while the company is growing faster than other high growth marketplaces, the stock trades at a discount to low growth marketplaces on average.At the bottom line, Lau is bullish, saying, We see an intriguing paper-to-electronic opportunity in Triterras, which leverages blockchain technology to disrupt the low-tech adoption in the trade and trade finance industry.In line with these comments, Lau rates TRIT shares an Outperform (i.e. Buy), and his $23 price target implies 93% growth for the year ahead. (To watch Laus track record, click here)Overall, this company has 3 recent reviews on record, and they are all to buy, making the Strong Buy analyst consensus unanimously positive. Shares are priced at $10.94 with an average price target of $19, giving the stock ~60% one-year upside potential. (See TRIT stock analysis at TipRanks)To find good ideas for stocks trading at attractive valuations, visit TipRanks Best Stocks to Buy, a newly launched tool that unites all of TipRanks equity insights.Disclaimer: The opinions expressed in this article are solely those of the featured analysts. The content is intended to be used for informational purposes only. It is very important to do your own analysis before making any investment.

Read more from the original source:
Forum Health, LLC adds Meridian Health Center to its growing community of Integrative and Functional Medicine practitioners - Yahoo Finance

The treatment goals of mBC are to ameliorate symptoms, maintain quality of life, and prolong overall survival (OS).3,4 Management of mBC is based on tumor expression of estrogen receptor (ER), progesterone receptor (PR), and HER2 receptors.1 For frontline therapy in the metastatic setting in hormone receptor (HR)positive mBCs that are ER positive or PR positive, hormone therapy with either a selective ER downregulator (fulvestrant) or an aromatase inhibitor forms the foundation of treatment. If the HR-positive mBC is HER2 negative, the preferred regimen is hormone therapy combined with a CDK4/6 inhibitor. In HR-positive/HER2-positive mBC, HER2-directed therapy (trastuzumab and/or lapatinib) in combination with hormone therapy is primarily recommended.1

In HR-negative mBC, cytotoxic chemotherapy remains the backbone of treatment regimens.1,3 In HR-negative/HER2-positive mBC in the frontline setting, HER2-targeted therapy (pertuzumab plus trastuzumab) combined with docetaxel or paclitaxel is the preferred regimen.1 In subsequent lines, other cytotoxic chemotherapy agents are combined with HER2-targeted therapy. Treatment options for triple-negative breast cancer (TNBC), which is ER negative, PR negative, and HER-negative, are more limited because of the lack of therapeutic targets.3 In TNBC, sequential, single-agent cytotoxic chemotherapy remains the primary option in the frontline and later-line settings. In patients with TNBC and high tumor burden, visceral crisis, or rapidly progressing disease, chemotherapy combinations may be considered.1

Recent trials of immunotherapy and BRCA mutationtargeted therapy in TNBC have shown some promise. In the phase 3 double-blind, placebo-controlled IMpassion130 trial (NCT02425891), the PD-L1 inhibitor atezolizumab improved progression-free survival (PFS) when combined with albumin-bound (nab)-paclitaxel compared with nab-paclitaxel alone in metastatic TNBC.5 In the intention-to-treat population, which included patients with and without PD-L1 cell positivity, the addition of atezolizumab to nab-paclitaxel led to a PFS of 7.2 months compared with 5.5 months in the placebo group (hazard ratio 0.80; 95% CI, 0.69-0.92; P=.0021). In patients with positive PD-L1 expression, median PFS was 7.5 months and 5.3 months in the atezolizumab and placebo groups, respectively (hazard ratio 0.63; 95% CI, 0.50-0.80; P<.0001).5 Overall survival (OS) in the intention-to-treat population was not significantly different between the arms (21.0 months vs 18.7 months; hazard ratio 0.86; 95% CI, 0.72-1.02; P=.078).5 In an exploratory analysis, patients without PD-L1 tumors did not have OS benefit. However, among patients with PD-L1positive tumors, median OS was 25.0months with atezolizumab and 18.0 months with placebo (hazard ratio 0.71; 95% CI, 0.54-0.94).5 Atezolizumab was approved in 2019 for patients with locally advanced or metastatic TNBC who have PD-L1expressing tumors when used in combination with nab-paclitaxel.6,7

Sacituzumab govitecan-hziy was also recently approved for patients with metastatic TNBC who have received at least 2 prior lines of therapy in the metastatic setting.8 Sacituzumab govitecan-hziy is an antibody-drug conjugate that contains an antibody that targets Trop-2, a glycoprotein overexpressed in many epithelial cancers, including TNBC.9,10 The monoclonal antibody delivers the toxic payload SN-38, an active metabolite of irinotecan, to the tumor microenvironment and intracellularly.9,10 Approval of this agent was based on results of a phase 1/2 single-group multicenter trial in 108 patients with metastatic TNBC.11 Included patients were heavily pretreated with a range of 2to 10 previous lines of anticancer regimens (median=3).11 After a median of 9.7 months of follow-up, the response rate was 33.3%, and the clinical benefit rate, which included patients with stable disease for 6 months or more, was 45.4%.11 The median PFS was 5.5 months (95% CI, 4.1-6.3).11

Challenges and Unmet Needs

In HR-negative mBC, chemotherapy remains the backbone of treatment regimens. The majority of recommended regimens contain agents requiring intravenous (IV) infusion or intramuscular administration (fulvestrant). The only oral agents are cyclophosphamide, capecitabine, tucatinib, lapatinib, and neratinib.1 Despite the number of treatment options for patients with mBC, unmet needs remain pertaining to disease control, prolonging the interval to intensive cytotoxic therapy, and treatment-related complications. Additionally, there is a greater need for treatment regimens that are less burdensome for patients and their caregivers, as well as reducing health care costs associated with the IV administration of anticancer regimens.

Disease Control

The past decade has marked dramatic progress in biomarker-based treatment in mBC. However, progress in the treatment of metastatic TNBC is limited by the lack of therapeutic targets. Effective therapy for patients with metastatic TNBC is an unmet need.3 The recent approvals of atezolizumab for PD-L1expressing metastatic TNBC and sacituzumab govitecan-hziy for patients with TNBC who have received at least 2 prior lines of therapy in the metastatic setting have expanded the options for this patient group. However, mBC eventually will progress in most patients.6,8 There is an immense medical need for new treatment options to prolong the interval to starting intensive cytotoxic therapy, which has potentially serious adverse effects (AEs) that can reduce the quality of life.12

Metronomic therapy has been explored to prolong the interval in the need for intensive cytotoxic therapy. Metronomic therapy is the frequent, long-term administration of chemotherapy at low doses without a break in therapy.13 Metronomic therapy maintains plasma concentration of the cytotoxic agent above the therapeutic threshold but substantially below the maximum tolerated dose. Data suggest metronomic therapy may inhibit angiogenesis and have antiproliferative and immunomodulatory activities.12 There is also possible synergy with molecularly targeted agents.13 Hence, metronomic therapy may be able to improve the therapeutic index of cytotoxic agents by decreasing treatment-associated toxicities and exerting disease control activity.12 In mBC, studies of metronomic therapy have included oral vinorelbine and cyclophosphamide.13 The addition of metronomic oral cyclophosphamide to pertuzumab plus trastuzumab in older patients with HER2-positive mBC improved PFS by 7 months compared with pertuzumab plus trastuzumab alone (12.7 months; 95% CI, 6.7-24.8 months vs 5.6 months; 95% CI, 3.6-16.8 months).14

Although metronomic therapy has the potential to increase antitumor efficacy while limiting chemotherapy-related toxicity, advancing the field of metronomic chemotherapy would require the development of oral cytotoxic agents. Oral agents, unlike IV ones, can eliminate the logistical barriers for chemotherapy to be administered as a continuous/frequent low-dose regimen. In addition, the development of oral chemotherapy agents will facilitate further clinical trials to evaluate the efficacy and toxicity of metronomic oral therapy in patients with mBC.

Treatment-Related Complications

Taxanes are widely used in mBC, but they are highly hydrophobic and insoluble.15 To make parenteral administration possible, polyoxyethylated castor oil and ethanol are used as the vehicle for paclitaxel, and polysorbate 80 and ethanol are used as the vehicle for docetaxel.15 These solvents lead to hypersensitivity reactions and prolonged peripheral neuropathy that may be irreversible.15 Patients receiving paclitaxel require premedication with corticosteroids, H2-receptor antagonists, and diphenhydramine. Despite premedication, fatal hypersensitivity reactions have occurred in patients receiving IV paclitaxel.16 Additionally, patients with certain comorbidities (eg, diabetes) may not tolerate corticosteroid premedication, which can lead to hyperglycemia requiring intensive glycemic control and monitoring.

Besides hypersensitivity reactions, the taxanes solvent vehicles may directly contribute to neutropenia. In a clinical trial comparing nab-paclitaxel and conventional paclitaxel, among patients treated with nab-paclitaxel, treatment-related grade 4 neutropenia was significantly lower than conventional paclitaxel (9% vs 22%, P<.001) despite a higher dose, suggesting that the polyoxyethylated castor oil vehicle may be partly responsible for the neutropenia associated with paclitaxel.15 Recent studies of oral paclitaxel without solvent vehicles also demonstrated a decreased incidence of peripheral neuropathy and alopecia.17 Additionally, solvents may decrease the efficacy of taxanes because of entrapment of the active drug in micelles within the patients plasma, leading to increased systemic exposure and inadequate dose-dependent antitumor activity.15

Chemotherapy also may be poorly tolerated, especially in the older population. Avoiding significant toxicities and maintaining quality of life may be just as important as prolonging survival in mBC.14 Because of the lower potential for toxicity while maintaining efficacy, oral metronomic chemotherapy at frequent, low doses is an attractive treatment option for older patients with cancer who are not suitable candidates for conventional chemotherapy.13 Indeed, a meta-analysis of patients treated by metronomic chemotherapy for various tumor types indicated that grade 3 or 4 AEs were rare (eg, neutropenia, 5.39%; anemia, 1.73%; febrile neutropenia, 0.53%).18

Complications of IV access sites also are a concern with chemotherapies administered by IV infusion. With chronic venous and/or central line access, access-related complications are not uncommon, including sclerosis of the veins (31%), extravasation (7%-17%), access-related infections (6%-13%) and catheter-associated thrombosis (6%-18%).19 Furthermore, patients are concerned about the pain associated with IV placement and the IV site. In a survey, 47.4% of patients with breast cancer reported apprehension about IV linerelated pain, and 65.7% were concerned about problems locating a vein for infusion.20

During the coronavirus disease 2019 (COVID-19) epidemic, the American Society of Clinical Oncology has encouraged physicians to use telemedicine to help exposure to and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition, patients with COVID-19 should be symptom-free before receiving in-office IV therapy.21 Because of concerns regarding infusion-related AEs, disposal of cytotoxic agents, and risk of SARS-CoV-2 exposure to medical staff, home infusion generally is not recommended.21 Effective oral chemotherapy regimens, if widely available, could potentially play a substantial role in preventing transmission of SARS-CoV-2.

Patient Preference

The current mechanisms for delivery of treatment options present significant burdens for patients. One of the often overlooked considerations is the impact of a chemotherapeutic regimen on a patients daily life. With an IV regimenbesides the actual time patients and/or caregivers spend at the infusion clinicpatients must travel to and from the clinic and wait for their treatment to be administered.22 The time commitment interferes with the patients and caregivers work obligations and other responsibilities. Additionally, practical concerns exist regarding travel to and from infusion clinics. For example, in a survey study, 55.4% of patients worried about having nausea during their trip home after chemotherapy infusion.20

One solution is the use of oral chemotherapy that patients can administer at home. Findings from a survey study of 224 patients with breast cancer receiving either oral chemotherapy (n=60) or IV chemotherapy (n=164) revealed that 48.3% of patients receiving oral treatments believed they were more able to handle the disease.23 Approximately 60% of patients stated that an oral regimen gave them more autonomy outside the clinic.23 Similarly, in another survey study of 59 patients with breast cancer starting oral chemotherapy, findings showed that 67% of the patients perceived that an oral chemotherapy regimen would lessen the effort to cope with the disease.24 These results were echoed by a findings from a survey study, in which 73% patients in Spain with metastatic lung or breast cancer who had previously received IV therapy and oral chemotherapy stated that their everyday life would be less affected by oral medications.20 Among patients with mBC in this study, 66.9% were concerned about inconvenience of an IV regimen.20

Because of the interference of IV regimens with patients daily lives and autonomy, it is no surprise that the majority of patients with breast cancer prefer an oral regimen. In fact, findings from a previously mentioned study showed that 76% of patients preferred an oral regimen administered at home instead of infusion at a clinic.20 In an internet-based cross-sectional survey study in the United States, women with breast cancer were asked to indicate the acceptability of various AEs and regimens of different frequency and duration of administration.25 Most of the participants (77%) preferred an oral regimen compared with 19% who were willing to choose a less convenient regimen.25 In a utility analysis using a similar internet-based survey design, patients with breast cancer were asked to trade off the preferred oral administration in exchange for a reduction in AEs (eg, alopecia, neutropenia).26 Results showed that patients were willing to tolerate a 5% increased risk of alopecia or grade 1 to 2 hand-foot syndrome in exchange for an oral regimen.26 In general, the more infusion days per treatment cycle and the longer the infusion time (eg, 3 hours vs 30 minutes), the less willing patients were to tolerate such a regimen.26

In a review of literature on patient preference on the modes of cancer treatment administration, reasons for patients preference for oral chemotherapy regimens included the ability to take the therapy at home, convenience, desire to continue working, impact on daily life and relationships, autonomy, and an increased ability to cope with the disease.27 However, patients are generally not willing to accept reduced efficacy or increased treatment-related toxicity in exchange for a convenient regimen.27

Costs

Costs associated with IV chemotherapy can be substantial. Treatment with IV chemotherapy entails not only drug acquisition cost but also costs related to specialized supplies and equipment, personnel needed to prepare and administer the IV drug, and management of AEs related to IV administration.28 In an administrative database study, investigators evaluated costs associated with IV chemotherapy administration in 828 patients with mBC during 7406 visits for single-agent IV therapy.28 IV administration constituted 10% to 11% of the overall cost of therapy, and other visit-related services (eg, antihypercalcemic agents, hematopoietic support, anticancer drugs used off label) accounted for 31% to 32% of costs.28 Although the costs of IV administration were approximately one-tenth of overall therapy costs, they could have been avoided with the use of oral regimens.28 The authors hypothesized that even if an all-IV multiagent therapy were replaced with an oral plus IV regimen, some costs related to IV administration could still be avoided.28 In a more recent study assessing health care costs in patients with stage 0 to IV breast cancer and service types, costs associated with the day of chemotherapy accounted for more than 25% to 26% of total costs.29

Direct comparisons of health care costs between IV and oral chemotherapy have also been reported. In a population-based study, investigators compared the relative cost impact among women starting capecitabine (oral regimen, n=114) versus taxanes (IV regimen, n=619) as first-line chemotherapy for mBC from 1998 to 2002.22 Participants were identified from the North Carolina Central Cancer Registry and Medicaid claims linked databases, and their claims were followed through 2005.22 In the first year after starting the respective first-line therapies, women receiving IV taxanes had higher total health care utilization compared with those who received oral capecitabine ($43,353 vs $35,842; P=.0089). The cost differences were mainly due to higher outpatient costs associated with IV taxanes (P<.001).22 After adjusting for confounders, health care costs associated with oral capecitabine were 32% lower compared with IV taxanes (P=.0001).22

In another study, investigators conducted a budget impact model comparing the health care costs associated with trastuzumab-based therapy (IV regimen) vs lapatinib plus capecitabine (oral regimen) among an estimated 43,707 patients with mBC in the French national hospital database.30 Despite slightly lower drug acquisition costs for the IV regimen, the 1-year treatment cost per patient was 2 times higher for the IV regimen compared with the oral regimen when costs included administration and nondrug expenditures.30 Estimated annual cost difference between the IV and oral regimens was 90.8 million.30 Use of an oral regimen also would lead to 25,357 fewer outpatient hospitalizations for chemotherapy administration, resulting in substantial savings in hospital and transportation costs.30

Summary

There have been many recent advances in the treatment of mBC. The current mechanisms for delivery of these options, however, present significant burdens for patients. In addition, some IV formulations of taxanes, which are frequently used in the management of patients with mBC, may directly contribute to treatment toxicities and complications. The need for IV administration for most chemotherapy regimens increases health care costs. New approaches and delivery mechanisms are needed to optimize outcomes and maintain the quality of life in patients with mBC.

References

Read more from the original source:
Current Approaches and Unmet Needs in the Treatment of Metastatic Breast Cancer - AJMC.com Managed Markets Network