Blood, urine and other bodily fluids: how your leftover pathology samples can be used for medical research
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A doctor’s visit often ends with you leaving with a pathology request form in hand. The request form soon has you filling a sample pot, having blood drawn, or perhaps even a tissue biopsy taken.
After that, your sample goes to a clinical pathology lab to be analysed, in whichever manner the doctor requested. All this is done with the goal of getting to the bottom of the health issue you’re experiencing.
But after all the tests are done, what happens with the leftover sample? In most cases, leftover samples go in the waste bin, destined for incineration. Sometimes though, they may be used again for other purposes, including research.
Who can use my leftover samples?
The samples we’re talking about here cover the range of samples clinical labs receive in the normal course of their testing work. These include blood and its various components (including plasma and serum), urine, faeces, joint and spinal fluids, swabs (such as from the nose or a wound), and tissue samples from biopsies, among others.
Clinical pathology labs often use leftover samples to practise or check their testing methods and help ensure test accuracy. This type of use is a vital part of the quality assurance processes labs need to perform, and is not considered research.
Leftover samples can also be used by researchers from a range of agencies such as universities, research institutes or private companies.
They may use leftover samples for research activities such as trying out new ideas or conducting small-scale studies (more on this later). Companies that develop new or improved medical diagnostic tests can also use leftover samples to assess the efficacy of their test, generating data needed for regulatory approval.
What about informed consent?
If you’ve ever participated in a medical research project such as a clinical trial, you may be familiar with the concept of informed consent. In this process, you have the opportunity to learn about the study and what your participation involves, before you decide whether or not to participate.
So you may be surprised to learn using leftover samples for research purposes without your consent is permitted in most parts of Australia, and elsewhere. However, it’s only allowed under certain conditions.
In Australia, the National Health and Medical Research Council (NHMRC) offers guidance around the use of leftover pathology samples.
One of the conditions for using leftover samples without consent for research is that they were received and retained by an accredited pathology service. This helps ensure the samples were collected safely and properly, for a legitimate clinical reason, and that no additional burdens or risk of harm to the person who provided the sample will be created with their further use.
Another condition is anonymity: the leftover samples must be deidentified, and not easily able to be reidentified. This means they can only be used in research if the identity of the donor is not needed.
The decision to allow a particular research project to use leftover pathology samples is made by an independent human research ethics committee which includes consumers and independent experts. The committee evaluates the project and weighs up the risks and potential benefits before permitting an exemption to the need for informed consent.
Similar frameworks exist in the United States, the United Kingdom, India and elsewhere.
What research might be done on my leftover samples?
You might wonder how useful leftover samples are, particularly when they’re not linked to a person and their medical history. But these samples can still be a valuable resource, particularly for early-stage “discovery” research.
Research using leftover samples has helped our understanding of antibiotic resistance in a bacterium that causes stomach ulcers, Helicobacter pylori. It has helped us understand how malaria parasites, Plasmodium falciparum, damage red blood cells.
Leftover samples are also helping researchers identify better, less invasive ways to detect chronic diseases such as pulmonary fibrosis. And they’re allowing scientists to assess the prevalence of a variant in haemoglobin that can interfere with widely used diagnostic blood tests.
All of this can be done without your permission. The kinds of tests researchers do on leftover samples will not harm the person they were taken from in any way. However, using what would otherwise be discarded allows researchers to test a new method or treatment and avoid burdening people with providing fresh samples specifically for the research.
When considering questions of ethics, it could be argued not using these samples to derive maximum benefit is in fact unethical, because their potential is wasted. Using leftover samples also minimises the cost of preliminary studies, which are often funded by taxpayers.
Inconsistencies in policy
Despite NHMRC guidance, certain states and territories have their own legislation and guidelines which differ in important ways. For instance, in New South Wales, only pathology services may use leftover specimens for certain types of internal work. In all other cases consent must be obtained.
Ethical standards and their application in research are not static, and they evolve over time. As medical research continues to advance, so too will the frameworks that govern the use of leftover samples. Nonetheless, developing a nationally consistent approach on this issue would be ideal.
Striking a balance between ensuring ethical integrity and fostering scientific discovery is essential. With ongoing dialogue and oversight, leftover pathology samples will continue to play a crucial role in driving innovation and advances in health care, while respecting the privacy and rights of individuals.
Christine Carson, Senior Research Fellow, School of Medicine, The University of Western Australia and Nikolajs Zeps, Professor, School of Public Health and Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The 5 Love Languages Gone Wrong
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Levelling up the 5 love languages
The saying “happy wife; happy life” certainly goes regardless of gender, and if we’re partnered, it’s difficult to thrive in our individual lives if we’re not thriving as a couple. So, with the usual note that mental health is also just health, let’s take a look at getting beyond the basics of a well-known, often clumsily-applied model:
The 5 love languages
You’re probably familiar with “the 5 love languages”, as developed by Dr. Gary Chapman. If not, they are:
- Acts of Service
- Gift-Giving
- Physical Touch
- Quality Time
- Words of Affirmation
The idea is that we each weight these differently, and problems can arise when a couple are “speaking a different language”.
So, is this a basic compatibility test?
It doesn’t have to be!
We can, if we’re aware of each other’s primary love languages, make an effort to do a thing we wouldn’t necessarily do automatically, to ensure they’re loved the way they need to be.
But…
What a lot of people overlook is that we can also have different primary love languages for giving and for receiving. And, missing that can mean that even taking each other’s primarily love languages into account, efforts to make a partner feel loved, or to feel loved oneself, can miss 50% of the time.
For example, I (your writer here today, hi) could be asked my primary love language and respond without hesitation “Acts of Service!” because that’s my go-to for expressing love.
I’m the person who’ll run around bringing drinks, do all the housework, and without being indelicate, will tend towards giving in the bedroom. But…
A partner trying to act on that information to make me feel loved by giving Acts of Service would be doomed to catastrophic failure, because my knee-jerk reaction would be “No, here, let me do that for you!”
So it’s important for partners to ask each other…
- Not: “what’s your primary love language?” ❌
- But: “what’s your primary way of expressing love?” ✅
- And: “which love language makes you feel most loved?” ✅
For what it’s worth, I thrive on Words of Affirmation, so thanks again to everyone who leaves kind feedback on our articles! It lets me know I provided a good Act of Service
So far, so simple, right? You and your partner (or: other person! Because as we’ve just seen, these go for all kinds of dynamics, not just romantic partnerships) need to be aware of each other’s preferred love languages for giving and receiving.
But…
There’s another pitfall that many fall into, and that’s assuming that the other person has the same idea about what a given love language means, when there’s more to clarify.
For example:
- Acts of Service: is it more important that the service be useful, or that it took effort?
- Gift-Giving: is it better that a gift be more expensive, or more thoughtful and personal?
- Physical Touch: what counts here? If we’re shoulder-to-shoulder on the couch, is that physical touch or is something more active needed?
- Quality Time: does it count if we’re both doing our own thing but together in the same room, comfortable in silence together? Or does it need to be a more active and involved activity together? And is it quality time if we’re at a social event together, or does it need to be just us?
- Words of Affirmation: what, exactly, do we need to hear? For romantic partners, “I love you” can often be important, but is there something else we need to hear? Perhaps a “because…”, or perhaps a “so much that…”, or perhaps something else entirely? Does it no longer count if we have to put the words in our partner’s mouth, or is that just good two-way communication?
Bottom line:
There’s a lot more to this than a “What’s your love language?” click-through quiz, but with a little application and good communication, this model can really resolve a lot of would-be problems that can grow from feeling unappreciated or such. And, the same principles go just the same for friends and others as they do for romantic partners.
In short, it’s one of the keys to good interpersonal relationships in general—something critical for our overall well-being!
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The Herbal Supplement That Rivals Prozac
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Flower Power: St. John’s Wort’s Drug-Level Effectiveness
St. John’s wort is a small yellow flower, extract of which can be bought inexpensively off-the-shelf in pretty much any pharmacy in most places.
It’s sold and used as a herbal mood-brightener.
Does it work?
Yes! It’s actually very effective. This is really uncontroversial, so we’ll keep it brief.
The main findings of studies are that St. John’s wort not only gives significant benefits over placebo, but also works about as well as prescription anti-depressants:
A systematic review of St. John’s wort for major depressive disorder
They also found that fewer people stop taking it, compared to how many stop taking antidepressants. It’s not known how much of this is because of its inexpensive, freely-accessible nature, and how much might be because it gave them fewer adverse side effects:
Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis
How does it work?
First and foremost, it’s an SSRI—a selective serotonin reuptake inhibitor. Basically, it doesn’t add serotonin, but it makes whatever serotonin you have, last longer. Same as most prescription antidepressants. It also affects adenosine and GABA pathways, which in lay terms, means it promotes feelings of relaxation, in a similar way to many prescription antianxiety medications.
Mechanism of action of St John’s wort in depression: what is known?
Any problems we should know about?
Yes, definitely. To quote directly from the National Center for Complementary and Integrative Health:
St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as:
- Antidepressants
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Some heart medications, including digoxin and ivabradine
- Some HIV drugs, including indinavir and nevirapine
- Some cancer medications, including irinotecan and imatinib
- Warfarin, an anticoagulant (blood thinner)
- Certain statins, including simvastatin
I’ve read all that, and want to try it!
As ever, we don’t sell it (or anything else), but here’s an example product on Amazon.
Please be safe and do check with your doctor and/or pharmacist, though!
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Is Cutting Calories The Key To Healthy Long Life?
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Caloric Restriction with Optimal Nutrition
Yesterday, we asked you “What is your opinion of caloric restriction as a health practice?” and got the above-depicted, below-described spread of responses:
- 48% said “It is a robust, scientifically proven way to live longer and healthier”
- 23% said “It may help us to live longer, but at the cost of enjoying it fully”
- 17% said “It’s a dangerous fad that makes people weak, tired, sick, and unhealthy”
- 12% said “Counting calories is irrelevant to good health; the body compensates”
So… What does the science say?
A note on terms, first
“Caloric restriction” (henceforth: CR), as a term, sees scientific use to mean anything from a 25% reduction to a 50% reduction, compared to metabolic base rate.
This can also be expressed the other way around, “dropping to 60% of the metabolic base rate” (i.e., a 40% reduction).
Here we don’t have the space to go into much depth, so our policy will be: if research papers consider it CR, then so will we.
A quick spoiler, first
The above statements about CR are all to at least some degree True in one way or another.
However, there are very important distinctions, so let’s press on…
CR is a robust, scientifically proven way to live longer and healthier: True or False?
True! This has been well-studied and well-documented. There’s more science for this than we could possibly list here, but here’s a good starting point:
❝Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models.
Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity.
In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality❞
Source: Ageing Research Reviews | Calorie restriction in humans: an update
See also: Caloric restriction in humans reveals immunometabolic regulators of health span
We could devote a whole article (or a whole book, really) to this, but the super-short version is that it lowers the metabolic “tax” on the body and allows the body to function better for longer.
CR may help us to live longer, but at the cost of enjoying it fully: True or False?
True or False, contingently, depending on what’s important to you. And that depends on psychology as much as physiology, but it’s worth noting that there is often a selection bias in the research papers; people ill-suited to CR drop out of the studies and are not counted in the final data.
Also, relevant for a lot of our readers, most (human-based) studies recruit people over 18 and under 60. So while it is reasonable to assume the same benefits will be carried over that age, there is not nearly as much data for it.
Studies into CR and Health-Related Quality of Life (HRQoL) have been promising, and/but have caveats:
❝In non-obese adults, CR had some positive effects and no negative effects on HRQoL.❞
❝We do not know what degree of CR is needed to achieve improvements in HRQoL, but we do know it requires an extraordinary amount of support.
Therefore, the incentive to offer this intervention to a low-risk, normal or overweight individual is lacking and likely not sustainable in practice.❞
CR a dangerous fad that makes people weak, tired, sick, and unhealthy: True or False?
True if it is undertaken improperly, and/or without sufficient support. Many people will try CR and forget that the idea is to reduce metabolic load while still getting good nutrition, and focus solely on the calorie-counting.
So for example, if a person “saves” their calories for the day to have a night out in a bar where they drink their calories as alcohol, then this is going to be abysmal for their health.
That’s an extreme example, but lesser versions are seen a lot. If you save your calories for a pizza instead of a night of alcoholic drinks, then it’s not quite so woeful, but for example the nutrition-to-calorie ratio of pizza is typically not great. Multiply that by doing it as often as not, and yes, someone’s health is going to be in ruins quite soon.
Counting calories is irrelevant to good health; the body compensates: True or False?
True if by “good health” you mean weight loss—which is rarely, if ever, what we mean by “good health” here at 10almonds (unless we clarify such), but it’s a very common association and indeed, for some people it’s a health goal. You cannot sustainably and healthily lose weight by CR alone, especially if you’re not getting optimal nutrition.
Your body will notice that you are starving, and try to save you by storing as much fat as it can, amongst other measures that will similarly backfire (cortisol running high, energy running low, etc).
For short term weight loss though, yes, it’ll work. At a cost. That we don’t recommend.
❝By itself, decreasing calorie intake will have a limited short-term influence.❞
Source: Reducing Calorie Intake May Not Help You Lose Body Weight
See also…
❝Caloric restriction is a commonly recommended weight-loss method, yet it may result in short-term weight loss and subsequent weight regain, known as “weight cycling”, which has recently been shown to be associated with both poor sleep and worse cardiovascular health❞
Source: Dieting Behavior Characterized by Caloric Restriction
In summary…
Caloric restriction is a well-studied area of health science. We know:
- Practised well, it can extend not only lifespan, but also healthspan
- Practised well, it can improve mood, energy, sexual function, and the other things people fear losing
- Practised badly, it can be ruinous to the health—it is critical to practise caloric restriction with optimal nutrition.
- Practised badly, it can lead to unhealthy weight loss and weight regain
One final note…
If you’ve tried CR and hated it, and you practised it well (e.g., with optimal nutrition), then we recommend just not doing it.
You could also try intermittent fasting instead, for similar potential benefits. If that doesn’t work out either, then don’t do that either!
Sometimes, we’re just weird. It can often be because of a genetic or epigenetic quirk. There are usually workarounds, and/but not everything that’s right for most people will be right for all of us.
Take care!
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Food Expiration Dates Don’t Mean What Most People Think They Mean
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Have you ever wondered why rock salt that formed during the Precambrian era has a label on it saying that it expires next month? To take something more delicate, how about eggs that expire next Thursday; isn’t that oddly specific for something that is surely affected by many variables? What matters, and what doesn’t?
Covering their assets
The US in particular wastes huge amounts of food, with 37% of food waste coming from households. Confusion over date labels is a major contributor, accounting for 20% of household food waste. Many people misinterpret these labels, often discarding food that is still safe to eat—which is good for the companies selling the food, because then they get to sell you more.
Date labels were introduced in the 70s with the “open dating” system to indicate optimal freshness, not safety. These dates are often conservative, set by manufacturers to ensure food is consumed at its best quality and encourage repeat purchases. However, many foods remain safe well past their labeled dates, including shelf-stable items like pasta, rice, and canned goods, as well as frozen foods stored properly.
Some foods do pose safety risks, especially meat and dairy products, as well as many grain-based foods, all of which which can harbor harmful bacteria. Infant formula labels are strictly regulated for safety. However, most date labels are not linked to health risks, leading to unnecessary waste.
When it comes down to it, our senses of sight, smell, and taste are more reliable than dates on packaging. Some quick pointers and caveats:
- If it has changed color in some way that’s not associated with a healthily ripening fruit or vegetable, that’s probably bad
- If it is moldy, that’s probably bad (but the degree of badness varies from food to food; see the link beneath today’s video for more on that)
- If a container has developed droplets of water on the inside when it didn’t have those before, that’s probably bad (it means something is respiring, and is thus alive, that probably shouldn’t be)
- If it smells bad, that’s probably bad—however this is not a good safety test, because a bad smell may often mean you are inhaling mold spores, which are not good for your lungs.
- If it tastes different than that food usually does, that’s probably bad (especially if it became bitter, pungent, tangy, sour, or cheesy, and does nor normally taste that way).
Some places have trialled clearer labelling, for example a distinction between “expires” and merely “best before”, but public awareness about the distinction is low. Some places have trialled removing dates entirely, to oblige the consumer to use their own senses instead. This is good for the seller in a different way than household food waste is, because it means the seller will have less in-store waste (because they can still sell something that might previously have been labelled as expired).
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Play Bold – by Magnus Penker
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This book is very different to what you might expect, from the title.
We often see: “play bold, believe in yourself, the universe rewards action” etc… Instead, this one is more: “play bold, pay attention to the data, use these metrics, learn from what these businesses did and what their results were”, etc.
We often see: “here’s an anecdote about a historical figure and/or celebrity who made a tremendous bluff and it worked out well so you should too” etc… Instead, this one is more: “see how what we think of as safety is actually anything but! And how by embracing change quickly (or ideally: proactively), we can stay ahead of disaster that may otherwise hit us”.
Penker’s background is also relevant here. He has decades of experience, having “launched 10 start-ups and acquired, turned around, and sold over 30 SMEs all over Europe”. Importantly, he’s also “still in the game”… So, unlike many authors whose last experience in the industry was in the 1970s and who wonder why people aren’t reaping the same rewards today!
Penker is the therefore opposite of many who advocate to “play bold” but simply mean “fail fast, fail often”… While quietly relying on their family’s capital and privilege to leave a trail of financial destruction behind them, and simultaneously gloating about their imagined business expertise.
In short: boldness does not equate to foolhardiness, and foolhardiness does not equate to boldness.
As for telling the difference? Well, for that we recommend reading the book—It’s a highly instructive one.
Take The First Bold Step Of Checking Out This Book On Amazon!
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HRT: Bioidentical vs Animal
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HRT: A Tale Of Two Approaches
In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).
- A little over a third said “It can be medically beneficial, but has some minor drawbacks”
- A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
- Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
- Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”
So what does the science say?
Which HRT?
One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:
❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞
And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.
So to quickly clear up any confusion:
- Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
- Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.
There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).
A quick jumping-off point if you’re interested in that:
Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer
this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.
Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.
In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.
Bioidentical hormones are safer: True or False?
True! This is an open-and-shut case:
❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.
Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞
Further research since that review has further backed up its findings.
Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?
So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.
HRT can increase the risk of breast cancer: True or False?
Contingently True, but for most people, there is no significant increase in risk.
First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.
There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:
❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.
Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞
In fewer words:
- Estradiol by itself: no increased risk of breast cancer
- Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
- Estradiol with actual progesterone: back to no increased risk of breast cancer
So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!
However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:
❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.
Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞
Source: HRT in difficult circumstances: are there any absolute contraindications?
HRT makes you happier, healthier, and smell nice too: True or False?
Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.
The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.
More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:
Read more: Skin, hair and beyond: the impact of menopause
We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.
HRT does have some drawbacks: True or False?
True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.
For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.
It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.
If you experience anything more alarming than that, then indeed check with your doctor.
HRT is a dangerous scam and sham: True or False?
False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.
The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.
As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.
They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.
See for example:
Our apologies, gentlemen
We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!
To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space
Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.
That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.
Meanwhile… take care, all!
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