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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  • What Hypothyroidism Does To Your Heart
    Hypothyroidism affects 4–7% of the population, but most goes undiagnosed. If you’re a woman, you’re 11–15% more likely to have it than if you’re a man. The epidemiology of this is interesting, but not our main topic today, so if you’d like to read more about that, then you might want to bookmark this paper…

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  • The Other Alzheimer’s Risk Factor

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    The usually-listed 7 known risk factors of dementia (in general, not just Alzheimer’s) do not include today’s item. For a recap, those were:

    The 7 Known Risk Factors For Dementia

    The bonus risk factor

    This idea is not completely novel; it’s been known for a while that traumatic brain injury (TBI) can increase the risk of dementia, but it has generally been chalked up to “if you damage an organ, then that organ does not function so well afterwards”.

    However, in the case of Alzheimer’s, it seems there’s something deeper at play. Specifically, a study that found…

    ❝…traumatic brain injury alters the small vessels in the brain, resulting in an accumulation of amyloid beta—a hallmark of Alzheimer’s disease.

    The findings suggest that vascular dysfunction could be an early driver in neurodegenerative disorders rather than being caused by neuronal damage.❞

    This association held true even in quite young patients!

    The study from Sweden looked at brain tissue from TBI patients (who had had to have brain tissue removed for medical reasons due to bleeding and swelling), and found that the (traumatic) changes to the vascular smooth muscle cells were associated with increased aggregation of amyloid-β.

    In terms of establishing cause and effect: since it could be safely concluded the amyloid-β had not caused the TBI (which all had external explanations such as “car crash” or such), it can be deduced that almost* certainly the TBI caused the amyloid-β aggregation.

    *because little to nothing in science is every truly certain. As in life in general, really; the difference is that scientists admit it!

    You may be wondering: what was the control? It would be a very generous group of citizens indeed who would volunteer bits of their brains that hadn’t needed removing. However, the answer is that the control brain bits came from a biobank, and were from uninjured patients with no history of TBI or neurodegenerative disorders, and who had died from systemic, unrelated causes. Having been dead for a matter of hours, and the fixation time for the brain bits from the living people taking long enough that everybody’s brain bits had been out of their respective living bodies for a similar length of time, this was deemed an acceptable, if imperfect, control.

    You can read the study in its entirety here; it is fascinating:

    Traumatic brain injury causes early aggregation of beta-amyloid peptides and NOTCH3 reduction in vascular smooth muscle cells of leptomeningeal arteries

    The practical take-away

    The practical take-away, of course, is: look after your brain

    Not just in the sense of eat fiber, get healthy fats, move more, get good sleep, stay intellectually stimulated, etc*, but also in the sense of “keep your brain physically safe”.

    Now, you may think that you already try not to get into car crashes, and perhaps you do not compete in contact sports, but do be aware that one of the leading causes of TBI in older people is, ignominiously, falling down.

    And if you think “that only happens to older/other people”, then be aware: there’s a first time for everything and you are not immune. With that in mind, do check out:

    Fall Special! ← the seasonal title notwithstanding, this is about not falling down in the first place, and being less injurable if you do fall down

    *This was a modest and vague list for brevity’s sake, so for much more detail, enjoy:

    How To Reduce Your Alzheimer’s Risk ← this is rather more comprehensive

    Want to know more?

    Here you can read about the largest study of its kind into lifestyle factors and Alzheimer’s disease:

    Alzheimer’s Causative Factors To Avoid ← the methods and conclusions of Dr. David Snowdon’s famous “Nun Study”

    Take care!

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  • The Blue Zones, Second Edition – by Dan Buettner

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    Eat beans & greens, take walks, have a purpose; you can probably list off the top of your head some of the “advices from Blue Zones”, so what makes this book stand out?

    This is perhaps one of the most thoughtful investigations; the author (a National Geographic researcher) toured and researched all the Blue Zones, took many many notes (we get details), and asked a lot of questions that others skipped.

    For example, a lot of books about the Blue Zones mention the importance of community—but they don’t go into much detail of what that looks like… And they certainly don’t tend to explain what we should do about it.

    And that’s because community is often viewed as environmental in a way that we can’t control. If we want to take supplements, eat a certain way, exercise, etc, we can do all those things alone if we want. But if we want community? We’re reliant on other people—and that’s a taboo in the US, and US-influenced places.

    So, one way this book excels is in describing how exactly people foster community in the Blue Zones (hint: the big picture—the form of the community—is different in each place, but the individual actions taken are similar), with particular attention to the roles actively taken on by the community elders.

    In a similar vein, “reduce stress” is good, but what mindsets and mechanisms do they use that are still reproducible if we are not, for example, Okinawan farmers? Again, Buettner delivers in spades.

    Bottom line: this is the Blue Zones book that digs deeper than others, and makes the advices much more applicable no matter where we live.

    Click here to check out The Blue Zones, and build these 9 things into your life!

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  • A Urologist Explains Edging: What, Why, & Is It Safe?

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    “Edging” is the practice of intentionally delaying orgasm, which can be enjoyed by anyone, with a partner or alone.

    On the edge

    Question: why?

    Answer: the more tension is built up, the stronger the orgasm can be at the end of it. And, even before then, pleasure along the way is pleasure along the way, which is generally considered a good thing—especially for any (usually but not always women, for hormonal and social reasons) who find it difficult to orgasm. It’s also a great way to experiment and learn more about one’s own body and/or that of one’s partner(s), personal responses, and so forth. Also, for any (usually but not always men, for hormonal reasons) who find they usually orgasm sooner than they’d like, it’s a great way to change that, if changing that is what’s wanted.

    Bonus answer: for some (usually but not always men, for hormonal reasons) who find they have an uncomfortable slump in mood after orgasm, that can simply be skipped entirely, postponed for another time, etc, with pleasure being derived from the sexual activity rather than orgasm. That way, there’s a lasting dopamine high, with no prolactin crash afterwards ← this is very much tied to male hormones, by the way. If you have female hormones, there’s usually no prolactin crash either way, and instead, the post-orgasm spike in oxytocin is stronger, and a wave of serotonin makes the later decline of dopamine much more gentle.

    Question: can it cause any problems?

    Answer: yep! Or rather, subjectively, it may be considered so—this is obviously a personal matter and your mileage may vary. The main problem it may cause is that if practised habitually, it may result in greater difficulty achieving orgasm, simply because the body has got used to “ok, when we do this (sex/masturbation), we are in no particular rush to do that (orgasm)”. So whether not this would be a worry for you is down to any given individual. Lastly, if your intent was a long edging session with an orgasm at the end and then something happened to interrupt that, then your orgasm may be unintentionally postponed to another time, which again, may be more or less of an issue depending on your feelings about that.

    For more on these things including advice on how to try it, enjoy:

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  • Your Brain on Art – by Susan Magsamen & Ivy Ross

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    The notion of art therapy is popularly considered a little wishy-washy. As it turns out, however, there are thousands of studies showing its effectiveness.

    Nor is this just a matter of self-expression. As authors Magsamen and Ross explore, different kinds of engagement with art can convey different benefits.

    That’s one of the greatest strengths of this book: “this form of engagement with art will give these benefits, according to these studies”

    With benefits ranging from reducing stress and anxiety, to overcoming psychological trauma or physical pain, there’s a lot to be said for art!

    And because the book covers many kinds of art, if you can’t imagine yourself taking paintbrush to canvas, that’s fine too. We learn of the very specific cognitive benefits of coloring in mandalas (yes, really), of sculpting something terrible in clay, or even just of repainting the kitchen, and more. Each thing has its set of benefits.

    The book’s main goal is to encourage the reader to cultivate what the authors call an aesthetic mindset, which involves four key attributes:

    • a high level of curiosity
    • a love of playful, open-ended exploration
    • a keen sensory awareness
    • a drive to engage in creative activities

    And, that latter? It’s as a maker and/or a beholder. We learn about what we can gain just by engaging with art that someone else made, too.

    Bottom line: come for the evidence-based cognitive benefits; stay for the childlike wonder of the universe. If you already love art, or have thought it’s just “not for you”, then this book is for you.

    Click here to check out Your Brain On Art, and open up whole new worlds of experience!

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  • Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

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    An article published this week in the prestigious journal Nature Medicine documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.

    The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.

    Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.

    The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop Creuztfeldt-Jakob disease (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.

    What’s CJD got to do with Alzehimer’s?

    CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.

    Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised public health concerns over the eating of beef products in the United Kingdom in the 1980s.

    Human growth hormone used to come from donated organs

    Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.

    But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around 16,000 donated glands.

    An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.

    hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.

    Scientist in a lab
    Human growth hormone is now produced in a lab.
    National Cancer Institute/Unsplash

    What are the latest findings about Alzheimer’s disease?

    The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.

    The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.

    They considered other explanations for the findings but concluded donated hGH was the likely cause.

    Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.

    Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is increasing evidence these proteins spread in the brain in a similar way to prion diseases. So the mode of transmission the authors propose is certainly plausible.

    However, given the amyloid protein deposits in the brain at least 20 years before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.

    When was this process used in Australia?

    In Australia, donated pituitary material was used from 1967 to 1985 to treat people with short stature and infertility.

    More than 2,000 people received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.

    The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are considered to be incredibly small.

    Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for around 5% of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.

    Older man places his hands on his head
    Early onset Alzheimer’s means it occurs before age 65.
    perfectlab/Shutterstock

    The risk is very low – and you can’t ‘catch’ it like a virus

    The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.

    Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.

    The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.The Conversation

    Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • What immunocompromised people want you to know

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    While many people in the U.S. have abandoned COVID-19 mitigations like vaccines and masking, the virus remains dangerous for everyone, and some groups face higher risks than others. Immunocompromised people—whose immune systems don’t work as well as they should due to health conditions or medications—are more vulnerable to infection and severe symptoms from the virus. 

    Public Good News spoke with three immunocompromised people about the steps they take to protect themselves and what they want others to know about caring for each other.

    [Editor’s note: The contents of these interviews have been condensed for length.]

    PGN: What measures have you been taking to protect yourself since the COVID-19 pandemic began?

    Tatum Spears, Virginia

    From less than a year old, I had serious, chronic infections and have missed huge chunks of my life. In 2020, I quit my public job, and I have not worked publicly since. 

    I have a degree in vocal performance and have been singing my whole life, but I haven’t performed publicly since 2019. I feel like a bird without wings. I had to stop traveling. Since no one wears a mask anymore, I can’t go to the movies or social outings or any party.

    All my friends live in my phone now. It’s a community of people—a lot of them are immunocompromised or disabled in some way. 

    There are a good portion of them who just take COVID-19 seriously and want to protect their health, who feel the existential abandonment and the burden of all of this. It’s really isolating having to step back from any sort of social life. I have to assess my risk every single time I leave the house.

    Gwendolyn Alyse Bishop, Washington 

    I was hit by a car when I was very young. I woke up from surgery, and doctors told me I had lost almost all of my spleen. So, I was always the sickest kid in my school.

    When COVID-19 hit, I started working from home. At first, I wore cloth masks. I didn’t really learn about KN95 masks until right around the time that COVID-19 disabled me. [Editor’s note: N95 and KN95 masks have been shown to be significantly more effective at preventing the transmission of viral particles than cloth masks.]

    I actually don’t get out much anymore because I am disabled by long COVID now, but when I do leave, I wear a respirator in all shared air spaces. My roommate and I have HEPA filters going in every room.

    And then we test. I have a Pluslife testing dock, and so we keep a weekly testing schedule with that and then test if there are any symptoms. I got reinfected [with COVID-19] last winter, and a Pluslife test helped me catch it early and get Paxlovid. [Editor’s note: Pluslife is a brand of an at-home COVID-19 nucleic acid amplification test, which has been shown to be significantly more effective at detecting COVID-19 than at-home antigen rapid tests.]

    Abby Mahler, California

    I have lupus, and in 2016, I started taking the drug hydroxychloroquine, which is an immunomodulator. I’m not as immunocompromised as some people, but I certainly don’t have a normal immune system, which has resulted in long-term infections like C. diff.

    I started masking early. My roommates and I prioritize going outside. We don’t remove our masks inside in public places. 

    We are in a pod with one other household, and the pod has agreements on the way that we interact with public space. So, we will only unmask with people who have tested ahead of time. We use Metrix, an at-home nucleic acid amplification test.

    While it’s not easy and it’s not the life that we had prior to COVID-19’s existence, it is a life that has provided us quite a lot of freedom, in the sense that we are not sick all the time. We are conscientiously making decisions that allow us to have a nice time without a monkey on our backs, which is freeing.

    PGN: What do you want people who are not immunocompromised to know?

    T.S.: Don’t be afraid to be the only person in a room wearing a mask. Your own health is worth it. And you have to realize how callous [people who don’t wear a mask are] by existing in spaces and breathing [their] air [on immunocompromised people].

    People think that vaccines are magic, but vaccines alone are not enough. I would encourage people to look at the Swiss cheese model of risk assessment. 

    Each slice of Swiss cheese has holes in it in different places, and each layer represents a layer of virus mitigation. One layer is vaccines. Another layer is masks. Then there’s staying home when you’re sick and testing.

    G.A.B.: I wish people were masking. I wish people understood how likely it is that they are also now immunocompromised and vulnerable because of the widespread immune dysregulation that COVID-19 is causing. [Editor’s note: Research shows that COVID-19 infections may cause long-term harm to the immune system in some people.]

    I want people to be invested in being good community members, and part of that is understanding that COVID-19 hits the poorest the hardest—gig workers, underpaid employees, frontline service workers, people who were already disabled or immunocompromised. 

    If people want to be good community members, they not only need to protect immunocompromised and disabled people by wearing a mask when they leave their homes, but they also need to actually start taking care of their community members and participating in mutual aid. [Editor’s note: Mutual aid is the exchange of resources and services within a community, such as people sharing extra N95 masks.]

    I spend pretty much all of my time working on LongCOVIDAidBot, which promotes mutual aid for people who have been harmed by COVID-19.

    A.M.: An important thing to think about when you’re not disabled is that it becomes a state of being for all people, if they’re lucky. You will become disabled, or you will die. 

    It is a privilege, in my opinion, to become disabled because I can learn different ways of living my life. And being able to see yourself as a body that changes over time, I hope, opens up a way of looking at your body as the porous reality that it is. 

    Some people think of themselves as being willing to make concessions or change their behavior when immunocompromised people are around, but you don’t always know when someone is immunocompromised. 

    So, if you’re not willing to change the way that you think about yourself as a person who is susceptible [to illness], then you should change the way that you consider other people around you. Wearing a mask—at the very least in public indoor spaces—means considering the unknown realities of all the people who are interacting with that space.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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