The Daunting Cost of Eating With Celiac Disorder
I was diagnosed with celiac disease eight years ago — an autoimmune disorder where the body attacks its own gut lining if you eat gluten. Changing my diet was more than a health adjustment, it was also a financial one, and the price I've been paying to eat gluten-free has been adding up ever since.
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CNN
31 minutes ago
- CNN
The testosterone trap: Why your problem might not be ‘low T'
Winding downFacebookTweetLink Follow Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida's College of Medicine. You're feeling unusually tired and sad, and your interest in sex has dropped off. That's no fun. If you're a guy, you may be thinking you have low testosterone. Wait a minute. Don't we all experience some or all of these symptoms at one time or another? After a late night out, a stressful workweek or even just a bad night's sleep, it's common to feel tired, irritable or unmotivated. But I know my patients want to eliminate low testosterone as the source, so I often start with a survey called the Androgen Deficiency in the Aging Male, or ADAM, questionnaire. Take a minute to see how many 'yes' answers you collect. Do you have a decrease in your libido, or sex drive? Do you have a lack of energy? Do you have a decrease in strength and/or endurance? Have you lost height? Have you noticed a decreased enjoyment of life? Are you sad and/or grumpy? Are your erections less strong? Have you noticed a recent deterioration in your ability to play sports? Are you falling asleep after dinner? Has there been a recent deterioration in your work performance? If you answered 'yes' to question 1 or 7, or to more than three questions overall, you might have low testosterone, according to this questionnaire. Or maybe you don't. These questions and answers are the start of this journey, not the end. While these questions can be helpful, they're broad enough to describe common life experiences we all face. As a urologist specializing in men's health, I often see patients convinced they have low testosterone based solely on these symptoms, only to find their testosterone levels are perfectly within range (more on those levels below). Even as an expert in the field, I have also run to get my testosterone checked — only to realize my symptoms were due to poor sleep habits rather than a true hormone deficiency. A quick note before we dive deeper: I understand this can be a sensitive topic. The information provided here isn't truth for every man. Many patients come to my clinic frustrated and seeking clear answers. Even within the medical community, there's significant debate about how to diagnose and manage 'low T.' My intention isn't to discount or downplay your concerns but rather to provide perspective and education, and to help you make informed decisions with your health care provider. Diagnosing low testosterone can be tricky, even for urologists like me. That said, a total testosterone level below 300 ng/dL (nanograms per deciliter) is recommended as the cutoff for diagnosing testosterone deficiency, according to the latest American Urological Association guidelines. But here's the tricky part: Labs don't always agree on what they consider normal, leading to confusion for patients and medical professionals. Take two of the most popular labs in the United States — Quest Diagnostics and LabCorp — as examples. Quest lists a normal testosterone range of 250 to 1100 ng/dL, while LabCorp uses 264 to 916 ng/dL. This means a level of 260 ng/dL might be flagged as 'low' by one lab but 'normal' at another. That's why most American urologists rely on the AUA guidelines, bearing in mind that every patient's situation is different. To ensure accuracy, guidelines recommend checking testosterone levels twice — on two separate mornings, ideally between 7 a.m. and 10 a.m. Why so early? Because that's when your fluctuating testosterone is at its peak, making it the best time to gauge your true levels. The first peak occurs in the morning, and the second peak (not as high as the morning) occurs in the afternoon, with your testosterone level gradually dropping by the end of the day. Lab companies also base their 'normal' reference ranges on the assumption that your testosterone tests are done during these specific morning hours. Additionally, the clinical diagnosis of testosterone deficiency relies not only on lab numbers but also on the presentation of symptoms such as low energy, reduced libido, loss of muscle mass or mood changes. When we start testosterone therapy, the goal is typically to raise testosterone levels into the range of about 450 to 600 ng/dL, which is considered the 'middle tertile' for most laboratory reference ranges. That middle third is the 'sweet spot' in which most men experience relief or resolution of their symptoms, without exceeding levels that could cause unwanted risks or side effects. It can take months to find the right and safe dose for a patient. Further adding to our dilemma as doctors, testosterone sensitivity varies from man to man. This variation may relate to genetic factors, according to research, including the sensitivity of your testosterone receptors. That's why a man with a testosterone level of 400 ng/dL may feel great, while another at the same level may experience countless symptoms. Currently, testing testosterone sensitivity isn't something readily available. The hope, however, is to someday have a routine test that helps us better personalize testosterone replacement therapy. Diagnosing and treating low testosterone is still very much a work in progress, with ongoing debates among experts. However, other medical issues that mimic low testosterone symptoms are more straightforward, backed by strong research. Many men whose testosterone lab results are completely normal still experience persistent symptoms. Often, these issues have more to do with lifestyle or other medical factors rather than testosterone itself. In 2025, many medical professionals, including myself, have become more open to testosterone replacement therapy as newer research has disproven some of the significant risks previously feared, such as concerns over prostate cancer or cardiovascular disease. Still, testosterone replacement isn't the right choice for everyone, and there could be other medical conditions that mimic the same symptoms that should be the primary focus of your (and your doctor's) investigation. In my own experience, poor sleep has frequently been the reason behind feeling tired and irritable. Sleep is essential for hormone regulation, mood stability and overall health. Chronic sleep deprivation can lead to fatigue, mood swings, low libido and difficulty concentrating, according to the National Institutes of Health. Those are all symptoms that mimic what we see with low testosterone. A common cause of poor sleep is obstructive sleep apnea, a condition where breathing repeatedly stops and starts when you're trying to get a good night's rest. Sleep apnea can dysregulate your hormonal balance and lower your testosterone levels. The use of continuous positive airway pressure, or CPAP, machines has been shown to improve sleep quality, improve testosterone and alleviate symptoms. I started using an activity tracker 24/7, which quickly identified my own sleep issues. Eliminating late-afternoon caffeine and swapping evening screen time for reading before bed significantly boosted my sleep quality, energy levels and overall mood — without any hormone therapy. My own small changes led to big improvements. Chronic stress may make you feel like your testosterone is low. Elevated cortisol, your body's primary stress hormone, can temporarily suppress testosterone production, causing symptoms identical to testosterone deficiency, especially reduced libido and fatigue. Diet and exercise also play crucial roles. Studies have shown that testosterone levels in men have significantly declined over recent decades. Experts believe this decline is closely linked to rising obesity rates, chronic stress and increasingly sedentary lifestyles. Many of my own patients report dramatic improvements in energy, mood and libido simply by losing weight, eating healthier and staying physically active. Several medical conditions can mimic symptoms attributed to low testosterone. Low thyroid or vitamin deficiencies (vitamin D or vitamin B12) can cause fatigue, mood changes and low libido. Diabetes or heart disease commonly cause fatigue and sexual dysfunction. Many patients initially thinking they have testosterone deficiency improve significantly after addressing these (and other) medical conditions without any need for hormonal treatment. Another common scenario involves erectile dysfunction. Many patients mistakenly attribute their decreased libido or lack of sexual interest to low testosterone. In most cases, frustration and anxiety about sexual performance led to psychological withdrawal, decreasing sexual desire and confidence. There is a small percentage of men whose erectile dysfunction genuinely stems from low testosterone levels. In these cases, testosterone replacement therapy might help. However, in my personal experience, replacing testosterone alone often leads to more frustration: Men may experience higher libido, yet still face difficulty achieving or maintaining an erection. That's why it's usually better to treat ED directly — often with affordable generic medications like tadalafil or sildenafil — to restore sexual confidence and performance. These medications, once costing nearly $40 per pill, are now often as affordable as $40 for a three-month supply, providing a practical and reliable solution for most men. The number of men receiving testosterone tests and prescriptions has nearly tripled in recent years, according to the 2024 American Urological Association guidelines. Up to 25% of men starting testosterone therapy were never tested before starting treatment, the AUA noted. Nearly half never have their testosterone rechecked after initiating treatment. Up to a third of men receiving testosterone therapy don't meet the official clinical criteria for testosterone deficiency. Meanwhile, many men who would benefit from testosterone replacement therapy remain untreated because of lingering concerns among health care providers about potential prostate cancer or cardiovascular risks — concerns not strongly supported by current evidence found in the AUA guidelines and recent research published in the New England Journal of Medicine. Additionally, men who skip routine screenings or simply don't feel comfortable openly discussing their symptoms also miss out on the treatment and relief they could experience. This all feels like a 'chicken or egg' scenario: Will starting testosterone therapy motivate men to exercise more and manage their health better, or should we first address lifestyle and health issues before considering hormone therapy? These complexities highlight the importance of personalized conversations between you and your health care provider. In my practice, I always focus first on lifestyle: Are you getting quality sleep? How high are your stress levels? Are you physically active? How healthy are your personal relationships? By tackling these areas first, many of my patients see noticeable improvement without falling into the testosterone trap. Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being.
Vogue
36 minutes ago
- Vogue
Best time to take collagen, according to experts
K-dramas are continually teaching me about life. First, there's the incredible skincare and makeup—and now, a much more surprising habit: Collagen supplements, which are shown as a stable in the regimens of the stars morning routines. For me, incorporating collagen into my morning cup of coffee (just like Jennifer Aniston!) has been a total game-changer. So, what is collagen and how does it work? Read on for more about the skin-supporting, body-strengthening supplement that's recommended for anybody over 25 years old. The supplement is popular among all ages for skin protection, improved texture, firmness, and hydration, though experts recommend it for those aged 25 and above. It even benefits your hair and nails, making them stronger. As for the best time to take collagen, consistency in daily intake is key, giving you room for flexibility with the timing. How do collagen supplements work? 'Randomized, controlled trial studies these have shown a significant improvement in a person's overall skin health when taking collagen supplements,' says Dr. Deepthi Atmakuri, dermatologist and founder of Clinica Derm. 'In some cases, it's been seen in less than eight weeks.' While the particles ingested from the supplements don't directly reach the skin, they are broken down in the digestive system into amino acids, which are the building blocks of protein in the body. These amino acids are then absorbed into the bloodstream and can help stimulate the production of new collagen in the body. Dr. Deepthi says you may notice improvements in two to three months, but immediate effects like plumper-looking skin and reduced dullness can present themselves as early as 15 days. When is the best time to take collagen supplements? While collagen supplements don't require a strict schedule, they do require need consistency. 'A regular intake of collagen is most important because your body needs a consistent supply to feel any long-term benefits,' says Dr. Archana Batra, a dietitian and certified diabetes educator. She presents a couple of options for setting daily reminders.
Entrepreneur
37 minutes ago
- Entrepreneur
Starbucks Wants to Remove Seed Oils From Egg Bites
The coffee giant is also launching a new egg bite made with avocado oil. Canola oil, a seed oil made by crushing canola seeds, is used in several Starbucks food items in the U.S., from the popular egg white and roasted red pepper bites to its sandwiches. But that may soon change. Bloomberg is reporting that the coffeehouse is exploring how to remove seed oils, including canola, from its lineup. A Starbucks spokesperson told the outlet that the company is also adding a new egg bite option to its menu made with avocado oil. Related: Starbucks Is Hiring a 'Global Content Creator' to Travel, Drink Coffee, and Get Paid Six Figures Last month, Starbucks CEO Brian Niccol met with the U.S. Health and Human Services Secretary, Robert F. Kennedy Jr., to discuss health and the company's menu. Seed oils are a top talking point for Kennedy, which he says are ultra-processed and linked to chronic diseases. His administration suggests using beef tallow, or rendered beef fat, instead of seed oils. Salad chain Sweetgreen and burger chain Steak 'n Shake have already made the switch. "We have made a commitment to remove seed oils from our restaurants," Steak 'n Shake wrote on its website. "Our fries, onion rings and chicken tenders are now cooked in 100% beef tallow in our restaurants." Yesterday, I met with @Starbucks CEO Brian Niccol, who shared the company's plans to further MAHA its menu. I was pleased to learn that Starbucks' food and beverages already avoid artificial dyes, artificial flavors, high fructose corn syrup, artificial sweeteners, and other… — Secretary Kennedy (@SecKennedy) June 18, 2025 Still, scientists say seed oils are safe for consumption in moderation, and the FDA says that when substituted for fats or oils high in saturated fat, like beef tallow, using canola oil may reduce the risk of coronary heart disease. There have also been a number of analyses that indicate seed oils do not impact inflammation, Bloomberg notes. Related: It's Pay-to-Stay at Starbucks as the Coffeehouse Reverses Open Door Policy
