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Niacin’s effect on cholesterol may help prevent heart disease — but newer research suggests an additional mechanism by which it benefits your heart.

It can help reduce oxidative stress and inflammation, both of which are involved in atherosclerosis, or the hardening of your arteries.

Some research indicates that niacin therapy — either alone or in combination with statins — could help lower the risk of health problems related to heart disease.

The coronavirus should have everyone's attention by now, health experts say. And people with heart disease have extra reasons to be alert.

Magnesium is an essential mineral for good health. As the fourth most abundant mineral in the human body, "it is necessary for healthy bones, heart, muscles, and nerves. It also helps your body control energy, blood sugar, blood pressure, and many other processes," says Allie Gregg, RD, a licensed dietitian with a private practice in Kansas City, Missouri. 

More so resembling a hormone, vitamin D is not technically a vitamin—and our bodies do not produce it on their own; it can only be processed through consuming specific foods, such as fatty fish, egg yolks, and fortified dairy products, and synthesized through our skin with direct exposure to sunlight—

Diabetes causes kidneys to become less efficient at filtering blood. It also causes blood vessels to stiffen, which leads to high blood pressure. And high blood pressure, he said, accelerates kidney disease like kerosene thrown on a fire. That worsens the high blood pressure, the root of many heart-related problems.

Hormones, hormones, hormones. So anti-Mullerian hormone (AMH) might not be the most talked-about hormone — or even the most well-known related to reproductive health. But it’s certainly worth understanding, especially if you hope to get pregnant in the future.

Zinc is an essential trace mineral that's important to your body in a variety of ways, says Dr. Yufang Lin, an integrative medicine physician with the Center for Integrative Medicine at Cleveland Clinic.

Made by your liver and also found in foods derived from animals, cholesterol is a waxy substance that’s important for many functions in the body, including building new cells. But when there’s too much of it in your blood, it can contribute to the buildup of plaque — a hard coating of cholesterol and other substances — on the inside of your blood vessels, known as atherosclerosis.

As you age, the amount of vitamins and minerals your body needs to function at optimal health changes. As you reach your 60s and 70s, for example, your body may need more of certain vitamins and minerals.

Vaping has become one of the most popular ways to consume both tobacco and marijuana. But, as with anything, with popularity comes attention to the potential risks.

The isolation and anxiety prompted by the coronavirus pandemic and the associated social and economic fallouts have led to an increase in substance abuse¹ even by people who have not previously had problems. But the pandemic also means that access to needed healthcare, support and social services for substance abuse problems, already in short supply, is increasingly difficult.

VITAMIN B12 is crucial for nerve tissue health, brain function and the production of red blood cells. A deficiency in the nutrient could appear in an unlikely place - your hair.

Taking in high levels of electrolytes without a doctor’s guidance can create another imbalance and lead to health complications. Also, some people require additional treatment to address the underlying issue.

Insects typically inject formic acid. This can lead to blisters, inflammation, redness, swelling, pain, itching, and irritation.

The reaction depends on the type of insect and the individual’s sensitivity.

Bites from fleas, mites, and mosquitoes tend to cause itching rather than pain.

You probably never thought so much about disinfecting your home, your car, and your personal spaces as much as you have during the coronavirus pandemic. So, what exactly are disinfectants doing to your body and how can you protect yourself from COVID-19 without putting health on the line?

Hypothyroidism and hyperthyroidism can each negatively impact fertility—both the ability to become pregnant and the ability to carry a fetus to term. The presence of autoimmune antibodies, with or without hyper or hypothyroidism, can also impact your fertility.

Routine cancer screenings can catch the disease before it’s even progressed to the point where you have symptoms, leading to less invasive treatment and best outcomes. Case in point: between 1990 and 2015, the mortality rate for cancer dropped by 25%, and even more for commonly screened cancer types, like colorectal (47% for men and 44% for women) and breast cancer (39% for women).

Testosterone affects a man’s appearance and sexual development. It stimulates sperm production as well as a man’s sex drive. It also helps build muscle and bone mass. A range of symptoms can occur if testosterone production drastically drops below normal.

Total sperm count in North America, Europe, Australia and New Zealand dropped by up to 60% in the 38 years between 1973 and 2011 research found -- an acceleration of a trend that began in the 1940s. More recent studies show the trend is continuing.

For many women, the various stages of menopause (which include perimenopause, menopause, and postmenopause) are a mystery until they actually happen. A woman is officially in menopause when she hasn’t had her period for 12 months, notes Dr. O’Toole. It can happen in your 40s or 50s, but in the U.S., the average age is 51, according to the Mayo Clinic.

Iodine is an important nutrient for the human body. It is mostly available in saltwater and plant-based foods. It is also an important component of brain development and thyroid hormone production.

It’s hard to keep track of the alphabet soup of hepatitis viruses (there are A, B, C, D, and E strains), but here’s what you need to know about this one: Hepatitis C....

The herpes simplex virus is incredibly common in the United States and worldwide.

As many as 1 in 2 American adults have oral herpes, which is often caused by herpes simplex virus type 1 (HSV-1).

An estimated 1 in 8 Americans ages 14 to 49 years old have genital herpes from herpes simplex virus type 2 (HSV-2), which causes most cases of genital herpes.

The rates of food allergies continue to rise. What are the most common food allergies, and how do they affect digestion? More commonly, people have intolerances to foods, rather than allergies. An example of food intolerance is when someone has bloating and diarrhea after consuming lactose. These people have low levels of the enzyme lactase, which prevents the lactose sugar from being broken down.

 After a consistent increase in the intensity and length of allergy season over the last several years (you can blame climate change), allergy season 2020 will likely be worse than usual or potentially the most intense and longest yet if the trend continues. Whomp, whomp. By giving small increasing doses of what you are allergic to, you train the immune system to slowly stop being as allergic," she says. "This is the best way to address allergies, as it targets the underlying problem and builds your immunity to a specific allergen."

Among women, 90 percent have one or more risk factors for heart disease at some point in their lives, according to American Heart Association statistics. Yet 80 percent of cardiovascular diseases are preventable.

The knowledge about heart function and structure is important for those who want to maintain and enjoy cardiac health. The heart functions involve the supply of oxygenated blood to all parts of the body. The circulatory system consists of three main types of blood vessels: arteries, veins and capillaries.

Severe or prolonged hypothyroidism or hyperthyroidism may result in hair loss.

When the body has too much or not enough thyroid hormone, it can "shock the system" into a state of telogen effluvium.

Telogen effluvium is a scalp disorder where the hair roots enter the resting stage of the hair cycle too early. As many as 70% of scalp hairs can fall out within about 2 months during a state of telogen effluvium.

Yoga is a significant stress reliever, and in the case of thyroid, it tends to increase the flexibility in the body as well as maintains a balance between pressure and thyroid. The thyroid can be underactive or overactive, also known as Hypothyroidism and Hyperthyroidism, respectively.

The A1C test provides an average of your blood sugar readings for the past three months. It’s not accurate for any given day, but it gives your doctor a good idea of how effective your blood sugar control has been over time.

Heavy metals are found naturally in the earth’s crust and may end up in the environment, our water supply, food, medicine and the herbal supplements we take, especially those made overseas. The most common metals that impact humans are lead, cadmium, arsenic, aluminum, mercury and chromium. 

I survived, thrived and learned how to live with herpes — and if you find yourself with a herpes diagnosis, you can, and will, too. Simply stay safe and informed. And you can start here. It’s time to set the record straight: Herpes is not the end of the world. Read on for facts about this all-too-common STD and answers to questions about living with herpes.

Sexually transmitted diseases are not a popular topic, but perhaps if it were talked about more it wouldn’t be a taboo and rates may finally decrease due to an increase in knowledge. A survey conducted by OnePoll of 2,000 sexually active Americans highlights how misinformed a large part of the public is when it comes to STDs. 

With the introduction of iodized salt, iodine deficiency is much less common than it used to be. But it can still occur—about 30 percent of the world’s population is at risk, reports the American Thyroid Association. Watch out for these nine signs of iodine deficiency.

Antibodies are proteins produced by your body to help protect you against infections. They can, however, mistakenly attack your own tissues, causing illness. There are several types of thyroid antibodies, and each one attacks a different target in the thyroid hormone production process, ultimately causing thyroid disease.

Experts agree that, in large amounts, alcohol is toxic, damages a wide range of different organs, and is a significant factor in many dangerous and fatal accidents. 

Experts say gabapentin is now being mixed with other opioids in an apparent effort to get a stronger "high."

Since the drug was first approved for use in the United States in 1993, it’s largely been considered safe with little or no potential for misuse.  But the opioid epidemic could be changing that.

It’s the time of year when many people are spending time outdoors. But some worry about encountering mosquitoes or ticks that might be carrying a disease.

Ben Beard of the Centers for Disease Control's Vector-Borne Diseases Division says there’s no sugarcoating the risk of contracting Lyme disease or other vector-borne illnesses. He says more than 700,000 cases were reported in the United States from 2004 to 2017. This number of reported cases of disease from mosquitoes, ticks and fleas has more than tripled over this period of time,” Beard says.

Stings and bites from these small bugs aren’t just annoying. They can cause big health dangers, too.

For bites, common over-the-counter remedies, including antihistamines and topical steroid creams like hydrocortisone, can help with itchy redness and inflammation.

But don’t be afraid to seek out a doctor or allergist if the bite doesn’t resolve or additional symptoms appear.

Rocky Mountain spotted fever is a serious, life-threatening bacterial infection transmitted by several types of ticks in the United States, according to the Centers for Disease Control and Prevention. It is imperative to remove a tick as quickly as possible because the longer it is attached, the higher the risk it may transmit disease.

Sneezing, congestion, and runny nose—these are all classic symptoms of both a cold and allergies, making it difficult to self-diagnose and treat either at home. But despite their similar symptoms, an allergic reaction is quite different from the common cold. 

Triglycerides are lipids, a type of fat. Triglycerides are necessary for certain bodily functions, but high levels of them can lead to health problems.

C-reactive protein, once obscure, may play an important role in predicting the risk of heart disease.

When tissues become inflamed, they release several different proteins, including CRP. For this reason, CRP is a "marker" for systemic inflammation. While injuries and infections can cause brief spikes in CRP, a persistently elevated level of C-reactive protein may (in the absence of other reasons) suggest that blood vessels are inflamed. 

Iron deficiency is when a person does not have enough healthy red blood cells in their bloodstream. This is also known as iron-deficiency anemia.

The signs of an iron deficiency might be hard to spot at first, as they are similar to other disorders. Nonetheless, a combination of the below symptoms might mean it is time for you to see your primary care physician.

Tucked under your right rib cage, this 3-pound organ cleans toxins from your blood; produces bile to help you digest what you eat and drink, turning that food and drink into nutrients; maintains your blood’s clotting function so you don’t bleed to death; and gives you physical energy.

Because your liver is such a crucial multitasker, you need to keep it healthy—yet unfortunately, 30 million Americans currently have some form of liver disease, according to the American Liver Foundation.

K2 or "spice" is a mixture of herbs, spices or shredded plant material that has been sprayed with chemicals that are similar to but not the same as THC, the psychoactive ingredient in marijuana. "So these chemicals, which are more correctly termed 'synthetic cannabinoids,' they're designed to stimulate cannabinoid receptors in the brain," Baumann explained.  THC, the active ingredient in marijuana, also stimulates these receptors, but K2 is much more potent than THC.

Folic acid is needed for healthy growth and development, especially for women who may become pregnant. Folic acid is one of the B-complex vitamins that are essential for the development and growth of new cells during growth and replacement of cells as we age.

 There are two main types of herpes: oral herpes and genital herpes. Even though genital herpes is fairly common (roughly one in six Americans has it, according to the Centers for Disease Control & Prevention [CDC]), it's highly stigmatized, in large part because there is no cure. Oral herpes is extremely common: in fact, the CDC estimates that roughly 48% of Americans between 14–49 years old have oral herpes.

Rates of three sexually transmitted diseases — syphilis, gonorrhea and chlamydia — have hit a record high for the fourth year in a row. The CDC said that the rising rates are likely because these STDs go undiagnosed and untreated, despite effective antibiotics.

The number of people around the world who have cancer is "rapidly growing," with 18.1 million new cases and 9.6 million deaths in 2018 alone, researchers estimate in a new report.

Have your doctor run the following tests, all of which can be obtained through a simple blood draw.

Everyone who is sexually active should be screened for STDs at some point.

Sexually transmitted diseases are common, but the types of STD testing you need may vary by your risk factors.

The National Hockey League saw an outbreak of mumps earlier this season.  Over 20 players and two officials were diagnosed with or showed signs of the disease.

For certain vaccinations, your doctor can perform a test for evidence of immunity, whether from a prior vaccination or an infection.

Drug and alcohol testing continue to be a critical part of the hiring process for most employers.

Lyme disease is known to inhibit the immune system and 20-30% of patients have falsely negative antibody tests.

West Nile virus (WNV) testing is used to help determine whether a person with signs and symptoms and a history of recent exposure has an acute WNV infection.

Web-based medical laboratory testing companies give consumers the option to purchase lab tests at cheap prices

Consumers wanting to get their own tests have a number of options

Direct-to-consumer lab testing gives us a chance to see our biochemical realities more clearly — sometimes with surprising results.

Are you between the ages of 50-60 and concerned about the tests and exams needed to maintain your health?

Your scheduled to have a complete physical exam. Can you tell me what lab tests I’ll need and how often I should have them?

Encourages people to proactively request these tests as a way to identify potential problems.

Learn what your doctor is looking for when he orders a vial of blood or draws fluid from an inflamed knee.

A simple blood test is available to screen for celiac disease antibodies. People with celiac disease who eat gluten have higher than normal levels of these antibodies in their blood.

Viral hepatitis, such as hepatitis C (HCV), hepatitis B (HBV) and hepatitis A (HAV), is diagnosed by your symptoms, a physical exam, and blood tests.

This is important because a person can have a sexually transmitted disease without knowing it.

You always go to your physician, for your yearly check-up. Many, if not most, private doctors do not screen for sexually transmitted diseases.

Healthy kidneys remove wastes and excess fluid from the blood. Blood and urine tests show how well the kidneys are doing their job.

Chronic kidney disease may seem to have come on suddenly. But it has been happening bit by bit for many years as a result of damage to your kidneys.

Your blood offers many clues about your heart health. It's important to remember that one blood test alone doesn't determine your risk of heart disease.

For many patients, screening results can serve as a wake-up call.

Thyroid hormones regulate metabolism—the way the body uses energy—and affect nearly every organ in the body.

 Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

Have your doctor run the following tests, all of which can be obtained through a simple blood draw.

According to the Office on Women’s Health, more than 19 million new sexually transmitted diseases (STDs) occur each year in the United States.

Most people think they would know if they had a sexually transmitted infection (STI) . . . wrong!

Save 10% with promo code STD10.  This offer expires 11/30/14.

Diabetes is a complex group of diseases with a variety of causes.

There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes.

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Drug abuse costs American industry over $140 billion annually. Employee drug abuse causes as much as 50% of all on-the-job accidents.

The prospect that your teen could be using drugs is perhaps one of the scariest things imaginable, and often leads us to look for evidence to the contrary.

Lyme disease is an infection spread by the bite of certain types of ticks. If caught and treated early, the infection most often clears quickly.

Use promo code LYMED10 to save.  Offer expires August 31, 2014.

Order the new Alcohol ETG Urine Test from the drug testing category.

Order new Ritalin tests from the Drug Testing category

Men spill it and seal friendships with it, but blood also tells a detective story.

Making the decision to have a PSA test depends on a variety of factors. Here are some tips that can help you make a good decision.

Let's schedule some blood work." Most people hear that from their doctor every so often, but what exactly does "blood work" entail?

As you get older, your health needs change. Are you and your doctor keeping up? From STD tests to colonoscopies, here are the most important health tests for women.

Most STDs/STIs can be "silent," causing no noticeable symptoms. These asymptomatic infections can only be diagnosed through testing.

This year alone, 19 million Americans will be infected. Half of all sexually active people will contract an STD by the time they're in their mid-20s.

While knowing your cholesterol levels provides important information, there are other indicators of heart and circulatory system health that are currently available and equally important as well.

The VAP test can analyze cholesterol beyond the total cholesterol, LDL and HDL levels.

New blood and urine fluoride testing is available from Request A Test.

Let's schedule some blood work." Most people hear that from their doctor every so often, but what exactly does "blood work" entail?

So which blood tests are critical for you to take? We gathered the evidence here to help you plan for your doctor visits in the coming year.

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If you're sexually active, particularly with multiple partners, you've probably heard the following advice many times: Use protection and make sure you get tested.

It is a good idea to get yourself an STD test on a regular basis.

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Have your doctor run the following tests, all of which can be obtained through a simple blood draw:

Blood tests help doctors check for certain diseases and conditions. They also help check the function of your organs.

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This test provides two measurements to help monitor your ability to manage blood sugar levels.

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Antibody tests can sometimes be used to help identify Lyme disease.

Lead exposure from Firing Ranges can be monitored through periodic blood testing.

Annual blood testing is the most important step aging adults (25yr olds and above) can take to prevent life-threatening diseases.

Screening tests can find diseases early when they are easier to treat. These tests can save your life.

Request A Test has launched a new category for Stool Testing.  These tests are important for aiding in the diagnosis of digestive disorders. 

A person seeking diagnosis MUST be following a daily diet that contains gluten for at least 4 weeks in order for test results to be accurate.

What are the appropriate screening tests for celiac disease? The tests of choice are antibody measurements in the blood, ideally performed before the patient has removed gluten from the diet.

Use discount code CELIAC10 to save 10% on all Celiac orders.  Offer expires May 31st, 2013.

To many Americans, tuberculosis may seem like an obscure disease...

Tuberculosis is a disease that is spread through the air from one person to another.

The Centers for Disease Control (CDC) has released its new TB guidelines...

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Order today for affordable prices and convenient testing options.

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You may not know it now, but one day soon your C-reactive protein level may be as familiar to you as your cholesterol numbers.

The key to preventing cardiovascular disease is managing your risk factors.

Various tests are used to diagnose heart disease.

CRP testing can help evaluate risk for heart attack.  Save with promo code GWELL10.

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STD tests are something no one likes to talk about

Doctors have their own opinions about who should be tested..

The A1C test is a blood test that provides information about a person’s average levels of blood glucose.

Thankfully, testing for type 2 diabetes is lot easier now

What's your A1c?

Medical screening tests are a great way to keep on top of your health.

Suck in and measure your waist at your belly button. It should ideally be less than half your height

The higher your blood cholesterol level is, the greater the chance of developing heart disease.

The importance of cholesterol screening hit home with me recently as a member of my family suffered a heart attack.

The only way to be absolutely certain about what vaccinations you’ve received is...

I'm unsure of my current immunization status. How can I tell if I'm immune to a disease?

Only a quarter of US individuals in the generation most likely to have hepatitis C have been tested

The federal government has called for all baby boomers to be tested for hepatitis C

Health officials have recommended that all pregnant women be tested for type B hepatitis

A recently published report by the CDC includes some good news...

Getting tested for HIV can be scary...

In honor of National HIV Testing Day, Request A Test is offering discounted HIV testing June 16 through June 30, 2012.

Lyme disease tests are used to determine if a person with characteristic symptoms has been infected by Borrelia burgdorferi.

Lyme disease is caused by bacteria called Borrelia burgdorferi. Blacklegged ticks carry these bacteria.

Lyme disease has many nonspecific symptoms that often are found in other conditions.

Celiac disease is suspected when individuals have signs or symptoms of malabsorption or malnutrition.

Something you're eating may be killing you, and you probably don't even know it!

Celiac disease is often misunderstood and misdiagnosed.

Sexually transmitted diseases (STDs) can be transmitted without sex, that is, without intercourse.

Sexually transmitted infections (STIs) are some of the most widespread infections both in the United States and the world

Tests for chronic kidney disease are vital to help find out:

Diabetes and high blood pressure are common causes of kidney disease.

GFR - glomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease.

Ninety-nine percent of heart disease is preventable by changing your diet and lifestyle.

A number of new screening methods are available to spot heart trouble ahead.

Diagnosing early heart failure can be a challenge.

New study finds breast cancer patients more likely to have benign thyroid disease and may benefit from thyroid testing. Read article courtesy of Request A Test today.

Be proactive and stay informed. Learn what hypothyroidism is and what prominent organizations say about getting routine testing. Visit Request A Test today.

Non-prescription "thyroid support" dietary supplements commonly used for weight loss and fighting fatigue are mostly ineffective and may pose a health threat, a new study warns

In patients with depression, anxiety and other psychiatric problems, doctors often find abnormal blood levels of thyroid hormone.

Google "thyroid disease" and you'll find well over five million references.

And that's precisely the problem, says thyroid expert Sara Rosenthal.

Doctors have their own opinions about who should be tested for which sexually transmitted disease (STD), but it's really up to you.

The word "test" makes most people cringe. Images of grammar school, pop quizzes, and the SATs come to mind.

A decade ago, the sexually transmitted disease syphilis was on the verge of elimination.  Today, a new study by the U.S. Centers for Disease Control and Prevention (CDC) shows a 39 percent increase in the disease from 2006 to 2009, with most new cases appearing in young black men.

Wonder how often you should be tested for STDs? This article can help you decide. Keep on top of your health with confidential STD testing from Request A Test online.

Confidential and pain-free STD urine testing does exist. Learn more now because untreated STDs can cause irreversible damage, even for men. Get urine testing info.

Learn the similarities and differences of Hepatitis A, Hepatitis B and Hepatitis C and why you should test. Confidential online hepatitis testing is available. Get info.

An estimated 366 million people worldwide now suffer from diabetes and the global epidemic is getting worse, health officials said Tuesday.

Parents want to protect their kids from everything, which is virtually impossible, of course. But can you prevent your child from getting diabetes?

The number of adults with diabetes in the world has more than doubled since 1980, a study shows.

Celiac disease testing can identify if gluten is your body’s enemy. Learn about celiac disease and why testing is important. Visit Request A Test today.

Glucose testing can help identify diabetes risks. Do you know where your health stands with the national diabetes epidemic? Get info about online glucose testing.

It took three decades to figure out what was making Donna Sawka so sick. 

Complaints of celiac disease are on the rise in the United States, with more and more people growing ill from exposure to products containing gluten.

Celiac disease is often misunderstood and misdiagnosed. Yet, experts believe that nearly one in 100 people may have this autoimmune ailment, which is triggered by exposure to the protein gluten in wheat and similar proteins in rye and barley. People with celiac disease, or CD, have a genetic predisposition to the illness.

Learning your cholesterol numbers -- the good, the bad and the total -- is a well-established part of the annual physical exam.

It may surprise you to know that cholesterol itself isn't bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy.

People who exhibit any range of symptoms associated with celiac disease after eating gluten should be tested as soon as possible. Early detection can help prevent serious complications such as lymphoma and gastrointestinal cancer, the latter of which has an increased chance 40 to 100 times that of the normal population.

The month of August is the most practical time to promote immunization awareness because children are going back to school, older students are entering college, and healthcare workers are getting ready for the upcoming flu season. Before vaccinations were available, children were disproportionately affected by mortality rates associated with tuberculosis, polio, smallpox and many other diseases that can now be prevented.

As one of five known hepatitis viruses that infect the liver

Throughout life, we contract or are exposed to numerous infections.

Hepatitis B is the most common serious liver infection in the world.

With summer upon us, ticks are out again,

Lyme disease gets its name from Lyme, Connecticut

Lyme disease is the most common tick-borne disease in America, with 16,000 new cases reported each year.

With the demands of work, family, and other activities, it's often difficult for people to find the time to exercise and eat right.

When you think of testosterone, what comes to mind? Macho men? Aggressive, impatient, type A behavior? Road rage? Violence?

Request A Test, Ltd., a privately held business offering direct-to-consumer lab screenings in a rapid, discreet and affordable way, has just announced the addition of prenatal and thyroid testing to its list of screening services.

Earlier this year, I had my vitamin D level checked for the first time in my life.

Medical screening tests are a great way to keep on top of your health.

A recently published report by the US Centers for Disease Control and Prevention (CDC) includes some good news

If you've decided to get pregnant, you may already be emotionally prepared to have a baby.

Hepatitis is a general term that means inflammation of the liver.

Triglycerides are a type of fat derived from the food we eat.

The chances of HIV being transmitted from an HIV+ person to an HIV-negative person depends on the type of contact.

Better treatments are extending the lives of people with HIV,

I was asked the other day if I recommended sexually transmitted disease (STD) testing before sex for older couples. The answer is a firm yes!

With over 1.2 million cases reported annually, Chlamydia trachomatis infection (chlamydia) is