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Are your hormones in tune? Mounting evidence suggests that exposure to light at night -- whether you're asleep or awake -- might play a crucial role in cancer, diabetes, and obesity. The World Health Organization classified "circadian disruption" as probably carcinogenic, and light at night is considered by some to be an endocrine disruptor that may affect melatonin, cortisol, ghrelin, leptin, and testosterone. "Most people think, and the drug companies want you to think, that waking up at night is bad for you," says Richard Stevens, ., a cancer epidemiologist at the University of Connecticut health center. But that's not the case, he says -- it's exposure to light at night that's the problem. "If you wake up at night, as most of us do, that is a period of quiet wakefulness -- stay in bed, in the dark, and enjoy it," Stevens suggests.
Alkaline phosphatase, hemoglobin and hematocrit, and creatinine may vary depending on the patient's current sex hormone configuration. Several factors contribute to these differences, bone mass, muscle mass, number of myocytes, presence or lack of menstruation, and erythropoetic effect of testosterone. Many transgender men do not menstruate, and those with male-range testosterone levels will experience an erythropoetic effect. As such an amenorrheic transgender man taking testosterone, registered as female and with hemoglobin/hematocrit in the range between the male and female lower limits of normal, may be considered to have anemia, even though the lab report may not indicate so. Conversely, the lack of menstruation, and presence of exogenous testosterone make it reasonable to use the male-range upper limit of normal for hemoglobin/hematocrit. Using the male-range upper limit of normal for alkaline phosphatase and creatinine may also be appropriate for transgender men due to increased bone and muscle mass, respectively. In these cases the provider should reference the male normal ranges for their lab.