8 Signs Of High Cortisol & How To Reverse “Cortisol Face”

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Dr. Shereene Idriss has insights about the facial features that might indicate chronically elevated cortisol levels, and what to do about same:

At face value

Dr. Idriss notes that for most people, this should not be cause for undue concern, although hypercortisolism can also be associated with genetic disorders such as Cushing’s syndrome, as well as prolonged use of certain medication, or the presence of certain tumors. As well as facial swelling, hypercortisolism can also result in other physical changes like acne, weight gain, skin thinning, stretch marks, infections, and hair loss.

As for what to do about it, she recommends addressing lifestyle factors like poor sleep, unhealthy diet, alcohol consumption, and lack of hydration to reduce facial puffiness related to stress. Diet suggestions include incorporating foods rich in magnesium, vitamin C, and omega-3s, such as leafy greens, fatty fish, nuts and seeds, and berries.

She also suggests some supplements to consider, such as ashwagandha, magnesium, omega-3s, and/or l-theanine, but you might want to speak to your doctor/pharmacist to check in case of contraindications per any other conditions you may have, or medications you may be on.

For more on all of this, enjoy:

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  • Eat To Beat Cancer

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    Controlling What We Can, To Avoid Cancer

    Every time a cell in our body is replaced, there’s a chance it will be cancerous. Exactly what that chance is depends on very many factors. Some of them we can’t control; others, we can.

    Diet is a critical, modifiable factor

    We can’t choose, for example, our genes. We can, for the most part, choose our diet. Why “for the most part”?

    • Some people live in a food desert (the Arctic Circle is a good example where food choices are limited by supply)
    • Some people have dietary restrictions (whether by health condition e.g. allergy, intolerance, etc or by personal-but-unwavering choice, e.g. vegetarian, vegan, kosher, halal, etc)

    But for most of us, most of the time, we have a good control over our diet, and so that’s an area we can and should focus on.

    Choose your animal protein wisely

    If you are vegan, you can skip this section. If you are not, then the short version is:

    • Fish: almost certainly fine
    • Poultry: the jury is out; data is leaning towards fine, though
    • Red meat: significantly increased cancer risk
    • Processed meat: significantly increased cancer risk

    For more details (and a run-down on the science behind the above super-summarized version):

    Skip The Ultra-Processed Foods

    Ok, so this one’s probably not a shocker in its simplest form:

    ❝Studies are showing us is that not only do the ultraprocessed foods increase the risk of cancer, but that after a cancer diagnosis such foods increase the risk of dying❞

    Source: Is there a connection between ultraprocessed food and cancer?

    There’s an unfortunate implication here! If you took the previous advice to heart and cut out [at least some] meat, and/but then replaced that with ultra-processed synthetic meat, then this was not a great improvement in cancer risk terms.

    Ultra-processed meat is worse than unprocessed, regardless of whether it was from an animal or was synthetic.

    In other words: if you buy textured soy pieces (a common synthetic meat), it pays to look at the ingredients, because there’s a difference between:

    • INGREDIENTS: SOY
    • INGREDIENTS: Rehydrated Textured SOY Protein (52%), Water, Rapeseed Oil, SOY Protein Concentrate, Seasoning (SULPHITES) (Dextrose, Flavourings, Salt, Onion Powder, Food Starch Modified, Yeast Extract, Colour: Red Iron Oxide), SOY Leghemoglobin, Fortified WHEAT Flour (WHEAT Flour, Calcium Carbonate, Iron, Niacin, Thiamin), Bamboo Fibre, Methylcellulose, Tomato Purée, Salt, Raising Agent: Ammonium Carbonates

    Now, most of those original base ingredients are/were harmless per se (as are/were the grapes in wine—before processing into alcohol), but it has clearly been processed to Hell and back to do all that.

    Choose the one that just says “soy”. Or eat soybeans. Or other beans. Or lentils. Really there are a lot of options.

    About soy, by the way…

    There is (mostly in the US, mostly funded by the animal agriculture industry) a lot of fearmongering about soy. Which is ironic, given the amount of soy that is fed to livestock to be fed to humans, but it does bear addressing:

    ❝Soy foods are safe for all cancer patients and are an excellent source of plant protein. Studies show soy may improve survival after breast cancer❞

    Source: Food risks and cancer: What to avoid

    (obviously, if you have a soy allergy then you should not consume soy—for most people, the above advice stands, though)

    Advanced Glycation End-Products

    These (which are Very Bad™ for very many things, including cancer) occur specifically as a result of processing animal proteins and fats.

    Note: not even necessarily ultra-processing, just processing can do it. But ultra-processing is worse. What’s the difference, you wonder?

    The difference between “ultra-processed” and just “processed”:
    • Your average hotdog has been ultra-processed. It’s not only usually been changed with many artificial additives, it’s also been through a series of processes (physical and chemical) and ends up bearing little relation to the creature it came from.
    • Your bacon (that you bought fresh from your local butcher, not a supermarket brand of unknown provenance, and definitely not the kind that might come on the top of frozen supermarket pizza) has been processed. It’s undergone a couple of simple processes on its journey “from farm to table”. Remember also that when you cook it, that too is one more process (and one that results in a lot of AGEs).

    Read more: What’s so bad about AGEs?

    Note if you really don’t want to cut out certain foods, changing the way you cook them (i.e., the last process your food undergoes before you eat it) can also reduce AGES:

    Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet

    Get More Fiber

    ❝The American Institute for Cancer Research shows that for every 10-gram increase in fiber in the diet, you improve survival after cancer diagnosis by 13%❞

    Source: Plant-based diet is encouraged for patients with cancer

    Yes, that’s post-diagnosis, but as a general rule of thumb, what is good/bad for cancer when you have it is good/bad for cancer beforehand, too.

    If you’re thinking that increasing your fiber intake means having to add bran to everything, happily there are better ways:

    Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)

    Enjoy!

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  • When Doctors Make House Calls, Modern-Style!

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    In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:

    • About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
    • About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
    • And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”

    *We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.

    So, what does the science say?

    A quick note first

    Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.

    Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.

    Nevertheless, we’ll do what we can with the science we have!

    Telehealth is more accessible than in-person consultations: True or False?

    True, for most people. For example…

    ❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.

    Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.

    Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞

    Dr. Wiam Alashek et al.

    whereas…

    ❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞

    Ibid.

    Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review

    Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.

    The quality of care provided via telehealth is as good as in-person: True or False?

    True, ostensibly, with caveats. The caveats are:

    • We’re going offreported patient satisfactionnot objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
    • We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.

    *we did find some, but it wasn’t very helpful yet. For example:

    An electronic trigger to detect telemedicine-related diagnostic errors

    this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.

    While most oft-considered demographic groups reported comparable patient satisfaction (per racegender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).

    However!

    Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:

    ❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞

    Dr. Raghad Elgamal

    Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology

    There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?

    True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:

    ❝The doctor uses his five senses to assess. This cannot be attained over the phone❞

    ~ 10almonds subscriber

    A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!

    Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).

    However, nowadays indeed a doctor will use sightsoundtouch, and sometimes even smell.

    In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.

    With this in mind, it really comes down to what you need from your doctor in that consultation.

    • If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
    • If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
    • If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.

    If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.

    Take care!

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  • Workout Advice For Busy People

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    Hampton at Hybrid Calisthenics always has very sound advice in his uplifting videos, and this one’s no exception:

    Key tips for optimizing workouts without burning out

    “We all have the same 24 hours” is a folly when in fact, some of us have more responsibilities and/or other impediments to getting things done (e.g. disabilities).

    A quick word on disabilities first: sometimes people are quick to point out Paralympian athletes, and “if they can do it, so can you!” and forget that these people are in the top percentile of the top percentile of the top percentile of human performance. If you wouldn’t disparagingly say “if Simone Biles/Hussein Bolt/Michael Phelps can do it, so can you”, then don’t for Paralympians either 😉

    Now, as for Hampton’s advice, he recommends:

    Enjoy short, intense workouts:

    • You can get effective results in under 30 minutes (or even just a few minutes per day) with compound exercises (e.g., squats, pull-ups).
    • Focus on full-body movements also saves time!
    • Push closer to failure when possible to maximize efficiency. It’s the last rep where most of the strength gains are made! Same deal with cardiovascular fitness, too. Nevertheless, do take safety into account in both cases, of course.

    Time your rest periods:

    • Resting for 2–3 minutes between sets ensures optimal recovery.
    • Avoid getting distracted during rest by setting a timer to stay focused.
    • 10almonds tip: use this time to practice a mindfulness meditation. That will greatly reduce the chance of you becoming distracted.

    Remember holistic fitness:

    • Fitness isn’t just about exercise; diet, sleep, and stress management are equally important for your fitness as much as for the rest of your health.
    • Better sleep and reduced stress will help you exercise more consistently and avoid junk food.

    Address burnout:

    • If feeling too exhausted to apply these tips, focus on getting better rest and reducing stress first.
    • Taking a short break to reset can help in the long run.

    For more on all of this, enjoy:

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    Want to learn more?

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    Take care!

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  • The Disordered Mind – by Dr. Eric Kandel

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We don’t generally include author bios in these reviews, but it’s worth mentioning that Dr. Kandel won the Nobel Prize in Physiology/Medicine, for studies related to the topics in this book.

    The premise in this book is as per the subtitle: what unusual brains tell us about ourselves. He assumes that the reader has a “usual” brain, but if you don’t, then all is not lost, and in fact he probably talks about your brain in the book too.

    Examining the brains of people with conditions ranging from autism to Alzheimer’s, schizophrenia to Parkinson’s, or even such common things as depression and anxiety and addiction, tells us a lot about what in our brain (anatomically and physiologically) is responsible for what, and how those things can be thrown out of balance.

    By inference, that also tells us how to keep things from being thrown out of balance. Even if the genetic deck is stacked against you, there are still things that can be done to avoid actual disease. After all, famously, “genes load the gun, but lifestyle pulls the trigger”.

    Dr. Kandel writes in a clear and lucid fashion, such that even the lay reader can quite comfortably learn about such things as prion-folding and inhibitory neurons and repressed transcription factors and more.

    Bottom line: if you’d like to understand more about what goes wrong and how and why and what it means for your so-far-so-good healthy brain, this is the book for that.

    Click here to check out The Disordered Mind, and understand more!

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  • Calisthenics for Beginners – by Matt Schifferle

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    For those who are curious to take up calisthenics, for its famed benefit to many kinds of health, this is a great starter-book.

    First, what kind of benefits can we expect? Lots, but most critically:

    • Greater mobility (as a wide range of movements is practiced, some of them stretchy)
    • Cardiovascular fitness (calisthenics can be performed as a form of High Intensity Impact Training, HIIT)
    • Improved muscle-tone (because these are bodyweight strength-training exercises—have you seen a gymnast’s body?)
    • Denser bones (strong muscles can’t be built on weak bones, so the body compensates by strengthening them)

    A lot of the other benefits stem from those, ranging from reduced risk of stroke, diabetes, heart disease, osteoporosis, etc, to improved mood, more energy, better sleep, and generally all things that come with a decent, rounded, exercise regime.

    Schifferle explains not just the exercises, but also the principles, so that we understand what we’re doing and why. Understanding improves motivation, adherence, and—often—form. Exercise diagrams are clear, and have active muscle-groups highlighted and color-coded for extra clarity.

    As well as explaining exercises individually, he includes three programs, increasing in intensity. He also offers adjustments to make exercises easier or more challenging, depending on the current condition of your body.

    The book’s not without its limitations—it may be a little male-centric for some readers, for instance—but all in all, it’s a very strong introduction to calisthenics… Enough to get anyone up and running, so to speak!

    Get started with “Calisthenics for Beginners” from Amazon today!

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  • Total Fitness After 40 – by Nick Swettenham

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    Time may march relentlessly on, but can we retain our youthful good health?

    The answer is that we can… to a degree. And where we can’t, we can and should adapt what we do as we age.

    The key, as Swettenham illustrates, is that there are lifestyle factors that will help us to age more slowly, thus retaining our youthful good health for longer. At the same time, there are factors of which we must simply be mindful, and take care of ourselves a little differently now than perhaps we did when we were younger. Here, Swettenham acts guide and instructor.

    A limitation of the book is that it was written with the assumption that the reader is a man. This does mean that anything relating to hormones is assuming that we have less testosterone as we’re getting older and would like to have more, which is obviously not the case for everyone. However, happily, the actual advice remains applicable regardless.

    Swettenham covers the full spread of what he believes everyone should take into account as we age:

    • Mindset changes (accepting that physical changes are happening, without throwing our hands in the air and giving up)
    • Focus on important aspects such as:
      • strength
      • flexibility
      • mobility
      • agility
      • endurance
    • Some attention is also given to diet—nothing you won’t have read elsewhere, but it’s a worthy mention.

    All in all, this is a fine book if you’re thinking of taking up or maintaining an exercise routine that doesn’t stick its head in the sand about your aging body, but doesn’t just roll over and give up either. A worthy addition to anyone’s bookshelf!

    Check Out Fitness After 40 On Amazon Today!

    Looking for a more women-centric equivalent book? Vonda Wright M.D. has you covered (and her bio is very impressive)!

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