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Gender-affirming hormone therapy impacts results of lab tests for trans patients

The fact that many medical protocols do not account for sex/gender incongruence is a significant barrier for transgender individuals seeking healthcare.

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Gender-affirming hormone therapy markedly impacts the results of common laboratory tests for transgender patients. This is according to a study that underscores the need for transgender-specific reference intervals to ensure this underserved population receives accurate diagnoses and effective treatments.

The fact that many medical protocols do not account for sex/gender incongruence is a significant barrier for transgender individuals seeking healthcare. In particular, for the nearly 50% of transgender individuals on hormone therapy, the medical field has yet to define reference intervals, which are the ranges of test result values observed in a healthy population that are used to determine whether individual lab results are normal or concerning.

Without tailored reference intervals, test results for transgender patients on hormone therapy could indicate an underlying condition but go unrecognized if they are considered normal for cisgender individuals (those whose gender matches their assigned-at-birth sex). Conversely, if lab results for transgender patients fall outside of cisgender reference intervals, they could trigger unnecessary follow-up work even if the results are actually normal.

To help build the case for developing transgender reference intervals, a research team led by Jeff SoRelle, MD, of University of Texas Southwestern Medical Center in Dallas, investigated whether transgender patients on hormone therapy exhibit altered results for laboratory tests ordered during yearly check-ups. The study authors recorded lab values for a complete blood count, comprehensive metabolic panel, and lipid tests in 264 healthy transgender patients undergoing hormone therapy in transgender clinics from 2007 to 2017. Of these patients, 133 were taking estradiol to transition from male to female, and 89 were taking testosterone to transition from female to male. The scientists also gathered lab results for 149 transgender patients not undergoing hormone therapy to serve as a point of comparison.

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From this, the researchers determined that both transgender women and men taking hormones displayed altered values for measures of red blood cell, kidney, and liver health. Transgender women taking hormones also had altered sodium, calcium, total protein, glucose, and platelet levels, while transgender men taking hormones displayed altered lipid values. Interpretation of these altered test results in the context of cisgender reference intervals could have serious consequences, from preventing diagnosis of anemia or kidney disease to affecting assessment of cardiovascular disease risk.

“Transgender patients will need their own reference ranges for several important parameters such as hemoglobin and creatinine,” said SoRelle. “It will also be important to determine whether proteins from cardiac muscle or the prostate, such as troponins or prostate specific antigen, are altered, too, which could affect diagnosis of heart attacks and prostate cancer.”

Health & Wellness

How easy is it to get on the Keto Diet train?

Our bodies know what’s going on when we are eating too much and thus, the digestive system begins to try and first hasten and then stabilize our metabolism. Eventually however, age will mean our bodies slow down whether we like it or not. You will put on more weight and easier, than when you were in your teenager years when you’re over 30.

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The majority of people don’t gain weight suddenly. It happens over a long extended period of time. Our bodies know what’s going on when we are eating too much and thus, the digestive system begins to try and first hasten and then stabilize our metabolism. Eventually however, age will mean our bodies slow down whether we like it or not. You will put on more weight and easier, than when you were in your teenager years when you’re over 30.

So how does this even happen? It’s the little things that eat away at your weight goals. The snacking between meals is definitely going to have an accumulative effect on our health. The bag of chips here and there will eventually pile up. Carbs are the thing you need to avoid or at least decrease in your overall diet. It’s not the butter on your toast that’s making you fat, it’s that plate of pasta or noodles that is doing the damage. The only modern solution when it comes to diets then is, the keto diet.

Do you want to know how you can jump aboard this train?

A leaner breakfast

For the most part the modern day breakfast is full of carbs. Take a look at your cereal box and for every 100 grams, check out the carbohydrates grams. It’s common for 100 grams of cereal to be made up of 40-50 grams of just carbs. That is a lot for just 100 grams and that should tell you what you’re up against. This normality of consuming so many carbs is astonishing in our culture. It should be the opposite whereby we focus on getting a leaner breakfast. If you’re unsure or are leaning towards not changing your breakfast habits, you’ll love this.

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Instead of a bowl of cheerios or granola, cook up 3 to 4 slices of bacon. Instead of a toast, cook yourself a French crepes omelette with chives, butter, tomatoes and some roast chicken. Rather than making yourself a bowl of oatmeal, make yourself a plate of smoked salmon and avocado. What’s not to like? What are you really missing out on if you didn’t have a big bowl of kellogs or weetabix this morning?

Not every meal is a hassle

Meals with carbs as the main part, are not as quick and easy to make as you might think. Pasta is by far the most popular dish when it comes to a carb-heavy meal. You might read on the back of a packet of rigatoni that it only takes 5 minutes to cook in boiling water, but how long will it take to bring the water up to a boil? In reality you’re looking at around 15 or 20 minutes to make a pasta dish with all the other ingredients. With a keto diet, you need only to begin cooking lean mean straight in a pan. Actually you don’t have to cook one meal out of your day. You can lower the risk of heart complications with KetoLogic which swaps one meal out for a KetoMeal that comes in the form of a milkshake. You’re not eating a meal that’s heavy in carbs but gives you some natural sugars, fats and proteins in one. This meal can be made in under a minute, so you have more time to get on with things in the day.

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No ditching the deserts

Contrary to almost every other diet out there, the keto diet doesn’t say you need to cut out deserts. In fact a cheesecake is quite within the normal boundaries of this diet. A lemon strawberry cheesecake is more than going to satisfy your cold sweet tooth. You can chop some fresh strawberries on top as well. Some whipped cream is also okay to have with it. Dairy ice cream is also allowed by this diet as really, you’re eating frozen fat and protein anyway. Butter chocolate tiffins are another great choice. The fat from the butter and the sugar from the chocolate is better than a slab of carbs such as a slice of cake. The only thing you need to take care of is though, is your calorie count. Don’t have a desert if it means you’re going to go over your limit.

The keto diet is incredibly inviting. You’re not missing out on anything. You get your fats and proteins from the bacon and eggs in the morning. You can take some salmon and salad with you to work. And still after dinner, enjoy a cheesecake or dairy ice cream. It’s little wonder that more people haven’t adopted this as their go-to diet.

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Health & Wellness

The benefits of sustained happiness

Maintaining a happy state of mind is not the easiest thing to do, but it does have some major benefits. We look at how happiness affects your body.

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The benefits of being happy…

For most people, happiness is an elusive state of being, a transitory experience that sneaks up on you on an idle Tuesday when you are drinking coffee and staring out the window. For a prejudiced community, or someone who is labelled as different, happiness can be even more fleeting.

The truth is that happiness is a skill that can be learned. Research has proven that levels of happiness can fluctuate depending on mental and physical input. Like any skill, it can be learned and perfected as long as you put in the time and effort to maintain a healthy mental state. The benefits of being happy are only now being researched and clinically proven. Here is how happiness can improve your quality of life.

STRONGER IMMUNE SYSTEM

The link between body and mind has long been discussed and debated on. Today, clinical experiments have proven that people exposed to the common cold are less likely to get sick if they are in positive emotional state. Researchers found that people who people who experienced longer periods of calmness, humility and happiness didn’t get sick and if they did, their recovery time was much shorter. They also found that if a person is depressed, moody or angry, their immune system was more vulnerable to attack.

Researchers found that people who people who experienced longer periods of calmness, humility and happiness didn’t get sick and if they did, their recovery time was much shorter.

BETTER HEART HEALTH

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It may sound clichéd, but happiness really is good for your heart, and that’s why having fun and playing at the mobile casinos Canada has to offer can actually keep you healthier! Multiple experiments have been done on heart health and happiness. The most significant research was done over a 10-year period where people were asked to rate their happiness levels every month while their blood pressure and cholesterol levels were tested. The data shows a direct correlation between a happy disposition and lower cholesterol and lower blood pressure.

IMPROVED PHYSICAL FUNCTION

While more research needs to be done in this area, some data shows that being happy can reduce the amount of pain you feel from inflammation or physical ailments. The feedback loop then kicks in allowing you to be more physically active which releases endorphins, which makes you feel happier and healthier. Just improving your outlook on life can change how you look on the outside.

LONGEVITY

Research into happiness and longevity is still on going but initial data shows that happier people tend to lead a more active and productive lifestyle, which in turn leads to a longer life.

The truth is that happiness is a skill that can be learned. Research has proven that levels of happiness can fluctuate depending on mental and physical input.

HOW TO KICK START YOUR HAPPINESS?

There are a few simple ways to boost your mood and get you on the path to sustained happiness.

  • Eat a healthier diet – Research has shown that eating more fruits and vegetables improves your diet, your mood and your health.
  • Get a good night’s sleep – Sleep is essential for maintaining a healthy body and mind. If you want to boost your mood, get a solid 7 to 9 hours of uninterrupted sleep every night.
  • Get out into nature – Studies have shown that being outside, in a park or in nature can boost your mood and your mental outlook. Just five minutes in nature can do more for your body than most prescription drugs.
  • Get active – Daily physical activity is the key. Do something physical every day and you body will thank you for it. Not only will you be physically stronger, you will also feel happier and more alive.
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Health & Wellness

Bias may affect providers’ knowledge of trans health

According to a study, increased hours of education related to caring for transgender patients may not correlate to more competent care.

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As it is, transgender people already face many barriers in accessing health care, from dealing with issues with intake forms that use non-inclusive language, to challenges finding providers who are knowledgeable about transgender-specific health issues.

But a Michigan Medicine-led study is suggesting that more training may not be the answer to improving competent care, since this study found that more hours of education in the field was not associated with improved knowledge of transgender care among physicians and other providers.

Published in the journal Medical Education, the study found that nearly half of providers said they had cared for a transgender patient, but as many had received no training on the topic. What distinguished knowledgeable providers from those who were less so, however, appeared to have little to do with their medical education.

Transphobia, or a prejudice against people who are transgender, was the only predictor of provider knowledge.

“We were surprised to find that more hours of education about transgender health didn’t correlate with a higher level of knowledge about this topic among providers,” said lead author Daphna Stroumsa, M.D., MPH, an obstetrician gynecologist at University of Michigan’s Von Voigtlander Woman’s Hospital and a National Clinician Scholar at the U-M Institute for Healthcare Policy and Innovation.

“Transgender and gender diverse individuals often face discrimination in health care settings and many are unable to find competent, knowledgeable and culturally-appropriate health care,” Stroumsa added. “Lack of provider knowledge is a significant barrier, but our findings suggest that simply increasing training may not be the solution.

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Because of this, “medical education may need to address transphobia and implicit bias in order to improve the quality of care transgender patients receive,” Stroumsa said.

Researchers surveyed 389 attending physicians, advanced practitioners and residents from the departments of internal medicine, family medicine and obstetrics and gynecology in a large urban health system.

It is worth noting that the study did not evaluate the content or format of the education providers were exposed to; but it is still likely that educational efforts that address unconscious bias would be more effective. Stroumsa noted that even in educational programs that address transgender health, the topic is usually presented as a separate section of provider education, rather than as an integral part of general medical education and training – a distinction which may further fuel “othering” of transgender patients.

Many providers – especially those traditionally considered “women’s health” professionals – likely need to be better prepared to care for transgender patients, Stroumsa said.

People who identify as transgender and non-binary may require many of the services provided by Ob/Gyns and other “women’s healthcare” providers, including prenatal and fertility care, cervical cancer screening, menstrual cycle management, as well as gender transition-related care (i.e. hormone therapy), and other routine Ob-Gyn care.

“We obviously have a lot of work to do in improving health outcomes for gender diverse people,” Stroumsa said. “We need to take a close look at our healthcare environments, practices and approaches to medical education. These are just beginning steps in reducing wide health disparities. Creating a safe, knowledgeable, trustworthy care environment will help us expand the care we provide to a broader more diverse patient population.”

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Health & Wellness

The amazing health benefits of using a gaming chair

When you are a frequent gamer, your playing experience shifts from one of seeking comfort to one of demanding comfort. With the long hours that you will spend in front of a screen playing different games, you will feel the pressure mount on your back.

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Gaming has come a long way thanks to the advancements in technology. The population of gamers on the internet today is a lot higher than it has been in previous years. That said, there is quite the technology to support every aspect of gaming, be it diverse games, gaming accessories and peripherals, gaming chairs and tables, to mention a few.

Talking of gaming chairs, could it be that they had more benefits than meet the eye? Here are the fantastic health benefits of using a gaming chair.

Figure 1: GAMING CHAIRS

ADEQUATE NECK SUPPORT

The thing with gaming chairs is that they are made to support a lot more than your rear region, much as a sitting surface is for the comfort of your lower part of the body, you need equal support for the top part. Since gaming chairs have a high-back, your neck gets adequate support. This way, you do not need to worry about getting neck cramps from straining your neck too much.

REDUCE BACK PAIN

When you are a frequent gamer, your playing experience shifts from one of seeking comfort to one of demanding comfort. With the long hours that you will spend in front of a screen playing different games, you will feel the pressure mount on your back. Most people fail to realize that when sited on any surface, a lot of pressure is directed in the rear region, but also on the back.

If you do not get a quality gaming chair like the omega gaming chair, then you may suffer a lot of back pain. A gaming chair will align your back and spinal column in the most comfortable and natural curve position, allowing your weight to balance out evenly across your body. This way, you do not pleasure in gaming at the expense of your back. Remember that your priority is in protecting your spinal column from any harm whatsoever.

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Figure 2: RECLINING CHAIR

BETTER SITTING POSTURE

Posture happens to be a crucial health concern that most people take for granted. Not just in the gaming world, but in other scopes of life, a good sitting posture at all times has an added health advantage. Ideally, the regular chairs, or worse, sitting on the floor when gaming, does not allow for a proper sitting posture. The body will always try to adjust to a position of utmost comfort, even when it means compromising the sitting posture. That said, you will need a gaming chair to help with the posture. Since most gaming chairs are ergonomic, they are customized to adopt a better sitting posture than traditional chairs.

The best bit is that the gaming chairs have a reclining function that allows you to fashion a sitting posture that best suits the angle you want to sit while playing, not to mention, protects your spinal alignment.

FATIGUE PREVENTION

Fatigue in the body is a factor that can not only cause your body to strain but accounts for the stress levels in your body. As a gamer, you may not have the privilege of enjoying social interaction and activities to help with coping with fatigue. Form the different sitting positions, slouching and postures you take up as your play; there is a high likelihood that your body will end up being fatally fatigued. Technically, the crucial body parts like the lower back, neck, shoulders, and even feet, require proper support.

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Without a gaming chair, most of your sitting positions will result in weakly feelings after extensive gaming. With time, muscles in some of your crucial body areas become weak, until you are too fatigued to play effectively and make your moves.

BETTER BLOOD FLOW

Another critical concern is that of proper blood circulation in the body at all times. Most of the health practices people take up, including drinking a lot of water, walking and stretching the body every once in a while, eating proper foods, among others, are all in support of better blood flow in your body.

When playing video games, a lot of time is spent sitting around, without much movement of the body. This means that the body may not enjoy a proper blood flow, especially in parts of the body like the feet, and the head. That said, with a regular chair, you will be exposing your body to the risk of reduction in lower body circulation.  To avoid such issues as dizziness, shortness of breath, among others, you must consider a gaming chair to ease the flow of blood throughout your system. The bottom and sides of a gaming chair are usually made in a way to keep the body in the correct posture that facilitates pumping of the blood to all parts of the body, even the legs.

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Health & Wellness

Negative messages about same-sex marriage linked to greater psychological distress

The study showed that the stigmatized social status of lesbian, gay and bisexual identity may be a source of stress, but could also serve as a source of resilience when it provides individuals with opportunities for social support.

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The fight for marriage equality shows the true colors of people around us. And we’re getting sick with the realization of how people really see us and our relationships.

This is the gist of a study done by psychologists at the University of Sydney, which showed that increased exposure to negative messages about same-sex marriage was associated with greater psychological distress for lesbian, gay and bisexual people (in this case in particular, Australians during the 2017 Australian Marriage Law Postal Survey).

Published in the Australian Psychological Society’s journal, Australian Psychologist, the study assessed the mental health of 1,305 Australians who identified as gay, lesbian, or bisexual during the Australian Marriage Law Postal Survey in 2017.

The research found increased exposure to homophobic campaign and media messages was related to increased levels of depression, anxiety and stress among same-sex attracted Australians.

“The findings highlight how political decision-making and legislative processes related to the rights of minority populations have the potential to negatively affect their mental health,” said lead author Stefano Verrelli, a doctoral candidate at the University of Sydney’s School of Psychology.

A silver lining: The study showed that the stigmatized social status of lesbian, gay and bisexual identity may be a source of stress, but could also serve as a source of resilience when it provides individuals with opportunities for social support.

The research also identified factors that can protect the mental health of same-sex attracted people during periods of intense public and political scrutiny.

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“The family and friends of same-sex attracted people appear to play an important role – and seem to even offset some of the harm done by the negative side of these debates – by openly supporting LGBT rights,” Verrelli said.

LGBT rights and mental-health organizations also have an important role to play by continuing their public support of minority issues. Their public messages of support appear to improve the psychological well-being of same-sex attracted people who require it most.

Verrelli and his research team in the School of Psychology – working with researchers at Macquarie University – used the minority stress model and surveys of mental health with lesbian, gay and bisexual Australians to reach their findings.

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Lesbian and bi women at increased risk of being overweight

Gay men however are less likely to be overweight than their straight counterparts, and more at risk of being underweight.

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Lesbian and bisexual women are at increased risk of being overweight or obese compared to heterosexual women, according to new research from the University of East Anglia and UCL.

Gay men however are less likely to be overweight than their straight counterparts, and more at risk of being underweight.

The study (‘Sexual orientation identity in relation to unhealthy body mass index (BMI): Individual participant data meta-analysis of 93,429 individuals from 12 UK health surveys’), published in the Journal of Public Health, is the first to investigate the relationship between sexual orientation and body mass index (BMI) using population data in the UK.

The findings support the argument that sexual identity should be considered as a social determinant of health.

The research team pooled data from 12 UK national health surveys involving 93,429 participants and studied the relationship between sexual orientation and BMI.

Lead researcher Dr. Joanna Semlyen, from UEA’s Norwich Medical School, said: “We found that women who identify as lesbian or bisexual are at an increased risk of being overweight or obese, compared to heterosexual women. This is worrying because being overweight and obese are known risk factors for a number of conditions including coronary heart disease, stroke, cancer and early death. Conversely, gay and bisexual men are more likely than heterosexual men to be underweight, and there is growing evidence that being underweight is linked to a range of health problems too, including excess deaths.”

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The study also found that gay men are significantly less likely than straight men to be overweight or obese.

According to the researchers, this study demonstrates that there is a relationship between sexual identity and BMI and that this link appears to be different for men and women.

“There are a number of possible explanations for these findings. We know that sexual minority groups are more likely to be exposed to psychosocial stressors, which impacts on their mental health and their health behaviours such as smoking and alcohol use and which may influence their health behaviours such as diet or physical activity,” Semlyen said. “These stressors include homophobia and heterosexism, negative experiences that are experienced by the lesbian, bisexual and gay population as a result of their sexual orientation identity and are known to be linked to health.”

Until 2008, sexual orientation wasn’t recorded in health surveys. This means that until recently it has not been possible to determine health inequalities affecting lesbian, gay and bisexual people.

The researchers hope that policy makers and clinicians will be able to use this evidence “to provide better healthcare and tailored advice and interventions for lesbian, gay and bisexual people.”

“We need longitudinal research to understand the factors underlying the relationship between sexual orientation and BMI, and research to understand more about being underweight, especially in this population,” Semlyen ended.

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