#Cholesterol Normal Range

[truwellth]

Cholesterol

Here find detailed info on: Cholesterol Levels. Know about, Cholesterol Foods. Cholesterol Symptoms. Cholesterol Causes. Cholesterol Levels By Age Chart. Know, How To Reduce Cholesterol?... from Rajashree Gadgil… Top Nutritionist in Thane & the founder of TruWellth Integrative Health Center… the best nutrition center in Thane.

[so-much-for-subtlety]

my labs from yesterday morning were already done: my testosterone is actually a little above average (for my age) made coffee and walked to market to get apples and this very mid pan au chocolate and now home for duddy cuddles

[doberbutts]

I want to talk a bit about the whole "fat trans men are denied top surgery" thing because it's true. Many surgeons have BMI requirements and will not operate on anyone classified as more than "overweight".

But I also want to discuss how testosterone often makes you gain weight, putting trans mascs in a fairly difficult position.

When I started testosterone, I weighed 178lbs. I rapidly shot up to 198lbs. At 5'10" I'm classified as just over a BMI of 30 according to my discharge papers, making me classified as obese. I also started having a bit of a cholesterol problem and being that A: I've also hit my 30s in that time and B: I have an extensive family history of high cholesterol in the men in my family, we tried changing my diet and exercise to see if it was lifestyle or if it was genetic.

In that timespan I dropped 3lbs (bringing me to 195lbs, just under that obese line) and my cholesterol continued to climb. It's been about 7 or 8 months with no other change.

When I tell people that I weigh roughly 200lbs, they don't normally believe me. To be clear I don't really care about any of these numbers, I care about my overall health irt stamina, strength, fatigue, etc and I care about my actual muscle mass and body condition. There are, admittedly, times where I look at my stomach and go :( aww I used to be skinnier. But then there's also times like two nights ago when I looked in the mirror after my shower and just saw A Guy standing there looking at me.

Anyway. My point is, testosterone (and age) made me gain a significant amount of weight, and nothing really I've done has gotten it off. Which is fine with me, because I feel better at this current condition and am stronger and have more stamina than I ever did at lower weights even when I was a competing athlete. Everyone I tell my weight and BMI to is shocked to learn that I am 200lbs and classified as obese. From complete disbelief until I stand on a scale, to the immediate "you wear it well" or "it's all muscle though", to the inevitable "okay but BMI is a load of shit anyway", clearly even though that's what the numbers say I am not exactly the poster child for what lawmakers and fat phobic doctors fear monger about when they discuss the "obesity epidemic".

I am lucky enough that while my surgeon is being very annoying in other ways, she at least has no BMI requirement. For 7 or so months I have been putting in a lot of effort to try and lose some weight to fix my cholesterol and I have pretty much nothing to show for it. If it's that hard for me, someone who visually doesn't really look fat, how difficult must it be for someone who is definitely not toeing the line like I am. How impossible for someone who is in the 400lb, 500lb, 600lb range.

Testosterone makes you gain weigh, and then surgeons won't operate if you gain too much. What a fucking joke.

[marccurelab]

Everose capsule is an ayurvedic medicine for treating various diseases

Everose capsule is an ayurvedic medicine for treating various diseases such as problems related to your skin like acne, it also helps in the most common skin-related problem which is eczema. The oil has the main ingredient Gamma-linolenic Acid, which is an effective antioxidant. It also improves overall skin health. In Premenstrual syndrome, this capsule is very effective.

In case of high blood pressure, this medication can also be used. Along with these medical benefits, it also benefits many other conditions. It is a herbal and ayurvedic product so it could be taken daily without having any adverse effect on health.

[macgyvermedical]

The following information is from Sickening, by John Abramson:

Not to sound like a conspiracy theorist on main but when I say Big Pharma is a racket I mean...

Doctors work via particular guidelines. Many of them are punished by their hospital systems if they fail to follow those guidelines, which are considered "best practice". The guidelines are written largely by pharmaceutical companies or people paid by pharmaceutical companies.

Just like Disney likes to keep it's copyrights fresh, pharmaceutical companies like to keep their patents. And they do this by churning out new drugs. Only about 1 in every 8 of these new drugs actually represents an actual advantage over existing drugs or therapies. They, of course, market the absolute shit out of all of them as though they did.

In theory, newer insulin analogs (lispro, glargine, etc...) work better and have fewer side effects than older recombinant human insulins (regular, NPH). In the actual trials the only difference between the two is a single average non-fatal hypoglycemic event over the course of 5 years of therapy. There was no difference in effectiveness. Oh. And the newer ones are 10 times the out of pocket price (an average of $468/year vs $5,224/year). Which is considerable considering 1 in 4 insulin-users report "rationing" their insulin for cost reasons. 90% of people on insulin take the newer insulin analogs because that's what's on the guidelines.

Pharmaceutical companies have all the data on their drugs, which they don't share and which they alone interpret. It took 4 years of near-daily pestering for Cochrane Reviews (a major independent reviewer) to get a copy of the data for the drug tamflu. When they got it, they found that in 77 trials, the only thing it consistently did was decrease the symptomatic time from an average of 7 days to an average of 6.3 days, even though the company was marketing it under claims that it reduced complications and hospitalizations- something none of the trials showed.

You have to treat 140 people who have not had a heart attack or stroke with statins (cholesterol-lowering medicines) for 5 years in order to prevent 1 single non-fatal heart attack or stroke. There is no difference in death rates from cardiovascular causes between statin-users and non-statin-users who have not had a heart attack or stroke. You have to treat 30 people who have had a heart attack or stroke to prevent one heart attack or stroke. You have to treat 80 to prevent a death.

According to a very large, independent (non-pharmaceutical industry) study called the ACCORD study, people with type 2 diabetes actually had significantly worse cardiovascular outcomes if their average blood sugar was kept in a "normal" (non-diabetic range) (under 125) vs a somewhat higher range (150-180). So significant were these findings that they ended the study early because too many people in the "normal" range were dying.

Omeprazole and Esomeprazole are technically the same drug that work exactly the same way and exactly as well when given at the same dose. The only thing that makes esomeprazole any better is that it is given at a higher dose. And it's way, way more expensive.

[fractallogic]

Well. Fuck. My very first therapist might have been right when she was like “mmm… I think you have Clinically Diagnosable Issues with food, weight, and body image” and I was like “lol no let’s talk about how depressed I am, I don’t have issues with food lol”

(She was also right about Q being abusive when I was in denial about that too, so… shit)

I’ve only been like 50% serious when I was like “lol orthorexia feels like it fits” but given how much of my day it ruins when I have to get weighed and I no longer weigh 140 lbs, or how personally I take it when I’m told my blood pressure is slightly high (I was at 122/86 on Thursday, which is SO SLIGHTLY above the high normal range, but I was already feeling Attacked that I Had To Remember) or my cholesterol is slightly high (again, last time it was measured it was like two points above high normal) or even (ffs) when I’ve gotten random UTIs that don’t have a clear origin

So there’s CLEARLY a lot of Anxiety there at the very least, coupled with how much it also ruined my day when I was trying to alleviate some of the anxiety (or prove it was right and I was Very Bad) by using myfitnesspal to log my food, no matter how much I tried to ignore or adjust the calories to make it not yell at me

Plus all of the RULES I make for myself (today I had ice cream for part of my lunch and poptarts for breakfast, therefore no sweets for the rest of the day and maybe not tomorrow either) around food. Plus how you know, the only people who have ever seen fit to comment on how my body looks/how fat I am/how I’m going to eat myself into diabetes one day are the two abusive exes and my mother, NONE of whom are good for my mental health in the first place for various other reasons… no fucking wonder when I finally stood up for myself at the drs office last week and said “no thanks I don’t want to be weighed at all” I burst into tears when the med assistant was like “well… we NEED to” and “[Dr] really wants us to… I’ll talk to her but you’ll probably need to get on the scale”. No wonder my stomach churns when scone talks about how he’s allowed certain amounts of carbs during the day and is gleeful about how many calories he burns during exercise and how much weight he’s lost (because wtf is wrong with me why can’t /i/ be that disciplined and drop the weight I want to get rid of to not have it hanging over my head and be presumed to be in fine physical condition)

ANYWAY!!! Time to go home for dinner and make some quesadillas and refried beans (fat, minimal carbs, protein, fiber, vegetables)!! Why must we introspect and come to conclusions about our beliefs about ourselves!!! God!!!

[weirdstrangeandawful]

My homocysteine is high but my B12 is normal? And I'm on lithium for bipolar which should lower it a bit.

And my LDL cholesterol is high when I can only eat like 600 calories on a good day??

And my glucose was normal despite my not having been able to eat anything for 24 hours at that point.

And my bilirubin keeps going high and then being normal as soon as they try to do further tests on it. Same with my phosphate! The whole reason for this panel was because my phosphate was high and now it's fine?!

This is why I don't bother medicating things unless they get severely out of range. My body doesn't know what the fuck is going on.

[lanaboodhoo]

An Overview of Conditions Treated by Cardiologists

Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease, and electrophysiology. A congenital heart defect may occur when the heart or one of its associated blood vessels fails to develop normally before birth. The spectrum of these defects ranges from mild to severe with some children not requiring treatment while others require multiple surgeries to correct. Coronary artery disease is the most common heart disease and accounts for 1 in every 4 deaths globally. It is due to narrowing or blockage of the blood vessels that supply the heart with blood and oxygen, usually due to cholesterol deposits. Heart failure is the inability of the heart to pump enough blood to meet the needs of the body. This may to be due to weakness of the heart muscle, or if the heart is unable to fill properly. Conditions such as coronary artery disease, high blood pressure, inflammation of the heart and abnormalities of the heart valves may cause heart failure. Valvular heart disease may affect one or more of the four valves of the heart, which normally keep blood flowing properly through the heart. Treatment for narrowed or leaking valves may be medical, surgical or catheter based. Electrophysiology focuses on the electrical system of the heart, disturbances of which may result in heart rhythm abnormalities. These may include irregular, slow or rapid heartbeats. Treatment may include drugs, implantable devices or catheter ablation, where tissue causing the problem is destroyed. Symptoms of a heart problem may include chest pain, abnormal shortness of breath, dizziness, blackout, palpitation, cough and swelling of the legs. These should prompt referral to a cardiologist if a cardiac cause is suspected.

[truwellth]

Cholesterol

Here get detailed info on: Cholesterol Levels. Cholesterol Normal Range. Cholesterol Symptoms. Cholesterol Causes. Symptoms of High Cholesterol in Females… from Rajashree Gadgil… the best nutritionist in Thane & the founder of TruWellth Integrative Health Center… the best nutrition center in Thane, Mumbai.

[shinra-makonoid]

I read those replies about risks of HRT, and it's interesting how one of those studies says "we actually need to study this more", but that person drew a conclusion that "HRT is definitely causing this".

It is annoying. Cofounding factors are a real tricky bit in regards to studies and that person just... Imagine they can know more of them than researchers.

It's in the notes of this post:

Even I kinda go rough when I say "yeah T raises risk for CVD" considering that, as the study says, trans men are smoking more, exercising less, having more anxiety etc than the general population. And despite the rising risks for CVD, mortality stays the same.

I agree there is still a lot we don't know about HRT, I agree we should research it more. Better yet, design specific meds for us to have that are perfectly attuned to our needs. For example, now I'm at almost a full vial of T every four weeks, (0.9ml out of 1ml, it decreased with my weight), so I don't throw away that much. But at one point I was at 0.5ml every two weeks, meaning I was throwing away half a vial every two weeks, aka a complete vial every month. It was crushing me because there are shortage of those meds and I hate throwing away stuff. Had there been a specific med tailored to specific trans needs, that wouldn't have happened.

But to claim that, because the specific med wasn't approved for, specifically, trans people it means it's dangerous and that we shouldn't use it.... Is just false. We have no evidence of that, we have even less evidence that it would outweigh the benefits. That person is just taking a stance that every med used off label should just have a 30 years cohort of test to decide whether it should be used, independently of whether the people who use it really need it or not. Which, even if it were to happen, would probably not even let pharmaceutical companies take the steps to actually make a med for us because we don't bring them enough money for it.

Doctors are also not usually just morons playing with molecules, they engage their responsibility using those meds and therefore make sure it's used well, they are experts in those domains. In my country at least, if you're not an endocrinologist, a gynecologist or a few other specific specialties dealing with hormones, you can't prescribe HRT. It does mean that yes, blood tests every 6 months are important, but like, if something really bad was happening to my body, we'd know. That's also how we realized that I had a fatty liver, which led me to eat better, which led me to have healthier habits in regards to food. So like... I guess T saved my liver in my case, as it has absolutely 0 symptoms before it's too late (the liver is a stealth bastard).

And again, I could go on and on about antidepressants and antipsychotics. I wouldn't advise anyone to stop them or anything, I think sometimes they outweigh the risks, but I personally had disastrous side effects from antipsychotics (taken to treat depression and anxiety, which is not even for that normally so yeah talk about off label I think that's a bigger issue, but i was at a mental hospital and pressured to take them and all) which led to hypothyroidism and prolactin level issues for me. Those side effects are studied and known to belong to antipsychotics, and little do you know when I stopped (after suffering from massive insomnias and bad feelings, it was a real shit med for me) it vanished.

I don't understand why HRT is the main issue when it's about such a tiny number of people, hasn't shown any bad metabolic side effects (except maybe like raising bad cholesterol but it doesn't mean much, it can still very much be in normal range, i still have normal range for ex), and hasn't had any evidence of shortening lives so far. If it ever changes, then I'll change my opinion, but I really don't think we'll find in ten years that T caused people to die, every expert on the issue argues that it's probably safe.

I think it's saner to argue that, even if you have no issue whatsoever, it's important to exercise, eat well, socialize, and avoid drinking and smoking. That advice is for every single person and it will save lives, way more than stopping T will ever do.

[antidrumpfs]

Trump, on Biden’s 81st birthday, releases doctor’s note that says he’s in ‘excellent’ health

NEW YORK (AP) — GOP front-runner Donald Trump marked President Joe Biden ‘s 81st birthday on Monday by releasing a letter from his physician that reports the former president is in “excellent” physical and mental health.

The letter posted on Trump’s social media platform contained no details to support its claims — measures like weight, blood pressure and cholesterol levels, or the results of any test. Dr. Bruce A. Aronwald, a New Jersey physician who says he has been Trump’s doctor since 2021 and most recently examined him in September, reported that Trump’s “physical exams were well within the normal range and his cognitive exams were exceptional.”

He added that Trump’s most recent lab results were “even more favorable than prior testing on some of the most significant parameters” thanks to recent weight loss he credited to “improved diet and continued daily physical exercise, while maintaining a rigorous schedule.”

Source: JILL COLVIN AP November 20, 2023

Trump, on Biden's 81st birthday, releases doctor's note that says he's in 'excellent' health | AP News

[hinumdom]

(top photos - right side cheek and bottom photos - left side cheek)

acne journal entry #2

here's a three-month progress of my acne.

just by looking at these pictures, i can totally see how much my skin has improved which i'm grateful for honestly.

before my derma prescribed me with isotretinoin, i was required to submit blood test results to determine the appropriate dosage. that's how i found out i have borderline high cholesterol which means i'm still in the normal range but on the higher spectrum and that i have a fatty liver. i was advised to manage my diet for my cholesterol and was prescribed with a supplement for my liver.

it's been a month since i started using isotretinoin. during the first two weeks, there were no significant changes yet. but, on the 3rd week, i felt the dryness on my skin due to the medication. i do still feel like my face gets oily but when i use a blotting paper, it's completely dry. interesting, isn't it? anyway, now i'm dealing with so much dryness all over my body. i would wake up with super dry lips that if i try to just move it a little, it would tear and bleed. i'm also experiencing micro peeling that's why i switched my moisturizer from gel to cream which did the trick (at least for now). my back pain worsened albeit just a little bit. my doctor told me before that it's possible to experience muscle and joint pains when taking isotretinoin. i would still get pimples but not as often and as big as before. now what essentially remain are the dark spots.

i had a follow up consultation just this monday with new blood test results since my derma needs to closely monitor my cholesterol and ensure my liver is still in a good condition. fortunately, results for my liver came back normal. however, my cholesterol slightly increased. i was prescribed isotretinoin for another month and in my follow up consultation, which is a month after, i'll have to provide blood test results again.

[pedrostylez]

I know I’ve vented about this before, but I have to again. Please do not interact if this is triggering for you 💜

I had my doctor’s appointment, and blood test results. Literally EVERYTHING is normal-my thyroid, my blood sugar, all of it. My cholesterol has come down 10 points in the year, and I’m healthier in those ways.

I weigh the most I ever have and am not able to reduce it-not just the number, but fat content also. I swim and lift weights 3 times a week, walk 20+ minutes during my lunches, and follow what my nutritionist says to a T. And I don’t feel that is an exaggeration.

I have no muscle definition from working out. I wouldn’t say my body looks better or necessarily feels better. I’m still the same pants/shirt/bra size.

I asked my doctor multiple times multiple ways if we could have my testosterone, estrogen and progesterone tested based on my symptoms. She ignored me each time (during this 15 minute physical, what the hell) and was offered anti depressants to “help me sleep” and that there’s “nothing she can do for me unless I want to spend 100+ extra dollars a month for ozempic.”

My search for a second opinion was met with “because of a normal cycle, your hormone levels won’t be accurate no matter how we test them.”

I feel fucking crazy??? How is it that I can be active, eating properly and only gain weight? It’s one thing to be at my size and to FEEL different, but the number not change or size no change, but I don’t feel better. I feel the same as I did when I was eating McDonald’s every day.

And all of my friends (bless them, they are all skinny) keep asking what specifically I’m eating. Are we serious??

Anyways, I vent all this to ask-does anyone know or have an idea of what could be wrong? Or is nothing at all wrong? Please keep in mind that I grew up slimmer and an athlete, with larger amounts of muscle mass. I typically sat around 145. I would think after growing out of puberty (ya know what second wave in your 20s) that being in the 170-185lb range for me is healthy, but I can’t get down below 225.

Any suggestions at this point are helpful. I eat a 90/10 clean diet, workout easily 150 minutes a week, but I have all the symptoms of a thyroid issue with the blood tests to say otherwise 🫠

[usascripthelpersofficial]

DOES WATER FASTING HELP YOU LOSE WEIGHT?

In recent years, water fasting has emerged as a popular method among those seeking to lose weight quickly. Unlike other diet plans that restrict calories or certain types of food, water fasting requires individuals to consume only water for a specific period, which can range from 24 hours to several days. Proponents of water fasting claim it not only aids in rapid weight loss but also offers detoxification benefits and improves metabolic health. But what does science say about these claims, and is water fasting a safe and effective way to lose weight? Let's dive into the evidence.

Understanding Water Fasting

Water fasting is a type of fast that involves abstaining from all food and beverages except water. The duration of a water fast can vary widely, with some lasting for a day and others extending up to 40 days, although prolonged fasts should only be undertaken under medical supervision. The primary goal of water fasting is to induce a state of ketosis, where the body begins to burn fat for energy in the absence of glucose from food. This process can lead to rapid weight loss, as the body consumes its fat stores to sustain itself.

The Weight Loss Mechanism

Short-Term Weight Loss

Initially, water fasting can lead to significant weight loss, much of which is water weight. When you stop eating food, your body uses up its glucose reserves stored in the liver and muscles. Each gram of glycogen (stored glucose) is bound to about 3 to 4 grams of water, so as these stores are depleted, the water is also released and expelled from the body, leading to rapid weight loss in the first few days.

Fat Loss and Metabolic Changes

After depleting glycogen stores, the body transitions to burning fat for energy, leading to fat loss over time. This metabolic switch not only contributes to weight loss but may also offer other health benefits, such as improved insulin sensitivity and reduced inflammation. However, the rate of fat loss can slow down after the initial phase, as the body adapts to the fast.

Health Benefits and Risks

Potential Benefits

Detoxification: Fasting proponents argue that abstaining from food allows the body's digestive system to rest and detoxify. However, the body is naturally equipped with organs like the liver and kidneys that are effective at removing toxins without the need for fasting.

Improved Metabolic Health: Some research suggests that fasting can improve markers of metabolic health, including blood sugar levels and cholesterol profiles, though more studies are needed to confirm these effects.

Risks and Considerations

Nutrient Deficiencies: Prolonged water fasting can lead to nutrient deficiencies, as the body is deprived of essential vitamins and minerals found in food.

Muscle Loss: While the body primarily burns fat for energy during a fast, it may also break down muscle tissue for protein, especially during longer fasts.

Potential for Weight Regain: Once normal eating resumes, there's a risk of regaining the lost weight, particularly if healthy eating habits are not adopted.

Safety and Precautions

Water fasting is not suitable for everyone. Individuals with certain health conditions, such as diabetes, or those who are pregnant or breastfeeding, should avoid fasting. Before embarking on a water fast, it's crucial to consult with a healthcare provider, especially for fasts lasting longer than 24 hours. It's also important to ease back into eating gradually after the fast to avoid refeeding syndrome, a potentially fatal condition caused by the rapid reintroduction of food after a period of malnutrition.

Conclusion

Water fasting can lead to rapid weight loss, primarily from water weight and fat loss. However, it also carries risks and may not be a sustainable weight loss method in the long term. While there are potential health benefits, they must be weighed against the risks of nutrient deficiencies and possible muscle loss. Ultimately, adopting a balanced diet and regular physical activity is the most effective and safe strategy for long-term weight management and overall health.

[fatgirlgetsfitatlast]

Lab Results, Jan 2023

I got my lab results back from the blood and urine tests the doctor did on Wednesday. The highlights are:

Cholesterol is high, but not OTT high. I feel like continued low carb dieting and exercise can improve these numbers.

My A1C number is high for someone without diabetes, but I'm sure I am diabetic, though it is under control because of doing keto for the last month or so. For someone with diabetes, it says the diabetes is well controlled.

Blood glucose is IN NORMAL RANGE! I know this would not have shown in normal range prior to me dropping the sugar and refined carbs from my diet for the last month or so. I'm SUPER HAPPY about this.

Urinalysis shows traces of ketones, which means am in ketosis. This IS GOOD! (this is not the same as ketoacidosis, which is dangerous). I am worried that this might confuse my doctors, because many of them don't subscribe to the low carb eating and being in ketosis theory of health, but I guess we'll see when I go back.

Overall, I'm happy with what the last month and a half of (mostly) eating low carb and exercising have done for my lab results.

I do have high blood pressure (142/100 per the nurse at the doctor's office), and will start taking LOSARTAN 50 MG TAB for that today. I hope that continued weight loss and healthful eating and exercise will make that unnecessary in the future.

[fractallogic]

So at my last doctor’s appointment, the doc was like “please have a period at some point soon. Please have two periods a year for your bone health”

And I’m really not into that, because a) my periods have been getting more and more painful and crampy and the latest one I was IN BED FOR TWO FUCKING DAYS because I was so miserable and hurting and sick, and b) whatever hormonal shifts happen when I’m getting a period make me at best very depressed, and at worst actively suicidal, so like idk, I feel like that also has to do with my bone health at some point

And furthermore, like with the cholesterol bullshit, you don’t actually seem to understand that there are many other ways I accidentally promote my bone health through other activities, like as a side effect of weightlifting, yoga, and even taking mg dumb little pokewalks, or as a side effect from taking 500 mg of calcium and 500 mg of magnesium every single night to help me sleep better (and let’s not forget the calcium present even in small amounts in ice cream, cheese, and almond milk)

So given that this doctor seems stubborn, and very inclined to talk down to me, AND I’d like to say “fuck you I have a research degree too”, I’ve also spent maybe an hour poking around the internet for well-informed popular articles and scientific articles about bone density and continuous oral contraceptive use, and. Well. Guess the fuck what

Continuous oral contraceptive use only affects bone mineralization in adolescents

When it’s tested in adults, it doesn’t seem to have an effect. The differences in bone density levels are evidently minuscule. (And I’m 32, where I’m basically at the point where my bones are at peak density (approx. age 28-35)—no longer mineralizing and improving, and not yet decreasing in density.)

Every gynecological website (important, because she’s a GP, not a GYN) I’ve found has said “no, you do not actually have to have a period for any kind of health reason when taking birth control continuously”, which matches what two gynecologists in two very different practicing conditions have told me. (It’s because it virtually stops the endometrium from growing, which is why it also helps people with endometriosis.)

AND FURTHERMORE, we actually don’t know anything about how dense (or not) my bones are. I’ve never broken a bone. The amount of calcium in my bloodstream in the labs is within the normal range (which, what does that mean? No fucking idea).

So anyway, all this to say that no, I won’t be having any periods in the near future unless there are more fuckups with my prescription. You don’t have enough information—and haven’t requested more information—for me to trust you.

Also I think I need to find a new doctor so that I can actually trust them