Hormones & Health, Beyond The Obvious
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Wholesome Health
This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.
What does she want us to know?
Beyond “bikini zone health”
Dr. Gottfried urges us to pay attention to our whole health, in context.
“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.
And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.
That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:
- The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
- The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one
Nor are brains exempt from his…
The female brain (kinda)
While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…
The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.
See for example:
Alzheimer’s Sex Differences May Not Be What They Appear
Dr. Gottfried urges us to take the above seriously!
Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.
She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:
Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)
The other very relevant hormone
…that Dr. Gottfried wants us to pay attention to is insulin.
Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.
In other words: to fight neurodegeneration, keep your blood sugars healthy.
This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:
The Surprising Link Between Type 2 Diabetes & Alzheimer’s
Want more from Dr. Gottfried?
You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:
Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD
…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.
Enjoy!
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Health Tips for Males Too
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Articles are very informative and helpful. Maybe it’s me but things seem to lean more toward females. That being said don’t forget us males❞
Rest assured, we could never forget you! We try to make as much as possible of our content applicable to as many as possible of our readers, but of course not everything can be relevant for everyone.
This is, presumably, in response to our recent feature on menopausal health, because previous to that, our next-most-recent main feature that centred women’s health was a month ago—that was about breast cancer, and did have a section on breast cancer in men too. You might also enjoy the book we reviewed recently about prostate health, or our regular sponsor offering testosterone therapy. Please feel free to check out our articles on saw palmetto against male pattern baldness and BPH, as well as mental health issues that disproportionally affect men.
And of course, if you have specific questions/requests about men’s health (or any other health topic) we’re only ever an email away (or use the handy feedback widget, as you did to make this request)!
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16 Overlooked Autistic Traits In Women
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We hear a lot about “autism moms”, but Taylor Heaton is an autistic mom, diagnosed as an adult, and she has insights to share about overlooked autistic traits in women.
The Traits
- Difficulty navigating romantic relationships: often due to misreading signs
- Difficulty understanding things: including the above, but mostly: difficulty understanding subtext, when people leave things as “surely obvious”. Autistic women are likely to be aware of the possible meanings, but unsure which it might be, and may well guess wrongly.
- Masking: one of the reasons for the gender disparity in diagnosis is that autistic women are often better at “masking”, that is to say, making a conscious effort to blend in to allistic society—often as a result of being more societally pressured to do so.
- Honesty: often to a fault
- Copy and paste: related to masking, this is about consciously mirroring others in an effort to put them at ease and be accepted
- Being labelled sensitive and/or gifted: usually this comes at a young age, but the resultant different treatment can have a lifetime effect
- Secret stims: again related to masking, and again for the same reasons that displaying autistic symptoms is often treated worse in women, autistic women’s stims tend to be more subtle.
- Written communication: autistic women are often more comfortable with the written word than the spoken
- Leadership: autistic women will often gravitate to leadership roles, partly as a survival mechanism
- Gaslighting: oneself, e.g. “If this person did this without that, then I can to” (without taking into account that maybe the circumstances are different, or maybe they actually did lean on crutches that you didn’t know were there, etc).
- Inner dialogue: rich inner dialogue, but unable to express it outwardly—often because of the sheer volume of thoughts per second.
- Fewer female friends: often few friends overall, for that matter, but there’s often a gender imbalance towards male friends, or where there isn’t, towards more masculine friends at least.
- Feeling different: often a matter of feeling one does not meet standard expectations in some fashion
- School: autistic women are often academically successful
- Special interests: often more “socially accepted” interests than autistic men’s.
- Flirting: autistic women are often unsure how to flirt or what to do about it, which can result in simple directness instead
For more details on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Related reading:
You might like a main feature of ours from not long back:
Miss Diagnosis: Anxiety, ADHD, & Women
Take care!
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How To Avoid Slipping Into (Bad) Old Habits
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Treating Bad Habits Like Addictions
How often have you started a healthy new habit (including if it’s a “quit this previous thing” new habit), only to find that you slip back into your old ways?
We’ve written plenty on habit-forming before, so here’s a quick recap before we continue:
How To Really Pick Up (And Keep!) Those Habits
…and even how to give them a boost:
How To Keep On Keeping On… Long Term!
But how to avoid the relapses that are most likely to snowball?
Borrowing from the psychology of addiction recovery
It’s well known that someone recovering from substance addiction should not have even a small amount of the thing they were addicted to. Not one sip of champagne at a wedding, not one drag of a cigarette, and so forth.
This can go for other bad habits too; make one exception, and suddenly you have a whole string of “exceptions”, and before you know it, it’s not the exception anymore; it’s the new rule—again.
Three things that can help guard against this are:
- Absolutely refuse to romanticize the bad habit. Do not fall for its marketing! And yes, everything has marketing even if not advertising; for example, consider the Platonic ideal of a junk-food-eating couch-potato who is humble, unassuming, agreeable, the almost-holy idea of homely comfort, and why shouldn’t we be comfortable after all, haven’t we earned our chosen hedonism, and so on. It’s seductive, and we need to make the choice to not be seduced by it. In this case for example, yes pleasure is great, but being sick tired and destroying our bodies is not, in fact, pleasurable in the long run. Which brings us to…
- Absolutely refuse to forget why you dropped that behavior in the first place. Remember what it did to you, remember you at your worst. Remember what you feared might become of you if you continued like that. This is something where journaling helps, by the way; remembering our low points helps us to avoid finding ourselves in the same situation again.
- Absolutely refuse to let your guard down due to an overabundance of self-confidence in your future self. We all can easily feel that tomorrow is a mystical land in which all productivity is stored, and also where we are strong, energized, iron-willed, and totally able to avoid making the very mistakes that we are right now in the process of making. Instead, be that strong person now, for the benefit of tomorrow’s you. Because after all, if it’s going to be easy tomorrow, it’s easy now, right?
The above is a very simple, hopefully practical, set of rules to follow. If you like hard science more though, Yale’s Dr. Steven Melemis offers five rules (aimed more directly at addiction recovery, so this may be a big “heavy guns” for some milder habits):
- change your life
- be completely honest
- ask for help
- practice self-care
- don’t bend the rules
You can read his full paper and the studies it’s based on, here:
Relapse Prevention and the Five Rules of Recovery
“What if I already screwed up?”
Draw a line under it, now, and move forwards in the direction you actually want to go.
Here’s a good article, that saves us taking up more space here; it’s very well-written so we do recommend it:
The Abstinence Violation Effect and Overcoming It
this article gives specific, practical advices, including CBT tools to use
Take care!
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Avoid Knee Surgery With This Proven Strategy (Over-50s Specialist Physio)
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A diagnosis of knee arthritis can be very worrying, but it doesn’t necessarily mean a knee replacement surgery is inevitable. Here’s how to keep your knee better, for longer (and potentially, for life):
Flexing your good health
You know we wouldn’t let that “proven” go by unchallenged if it weren’t, so what’s the evidence for it? Research (papers linked in the video description) showed 70% of patients (so, not 100%, but 70% is good odds and a lot better than the alternative) with mild to moderate knee arthritis avoided surgery after following a specific protocol—the one we’re about to describe.
The key strategy is to focus on strengthening the quadriceps muscles for joint protection, as strong quads correlate with reduced pain. However, a full range of motion in the knee is essential for optimal quad function, so that needs attention too, and in fact is foundational (can’t strengthen a quadriceps that doesn’t have a range of motion available to it):
Steps to follow:
- Improve knee extension:
- Passive knee extension exercise: gently press your knee down while lying flat, to increase straightening.
- Weighted heel props: use light weights to encourage gradual knee straightening.
- Enhance knee flexion:
- Use a towel to gently pull the knee towards the body to improve bending range.
Regular practice (multiple times daily) leads to improved knee function and pain relief. Exercises should be performed gently and without pain, aiming for consistent, gradual progress.And of course, if you do experience pain, it is recommend to consult with a local physiotherapist for more personalized guidance.
For more on all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Treat Your Own Knee – by Robin McKenzie
Take care!
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- Improve knee extension:
Younger You – by Kara Fitzgerald
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First, a note about the author: she is a naturopathic doctor, a qualification not recognized in most places. Nevertheless, she clearly knows a lot of stuff, and indeed has been the lead research scientist on a couple of studies, one of which was testing the protocol that would later go into this book.
Arguably, there’s a conflict of interest there, but it’s been peer reviewed and the science seems perfectly respectable. After an 8-week interventional trial, subjects enjoyed a reversal of DNA methylation (one of various possible markers of biological aging) comparable to being 3 years younger.
Where the value of this book lies is in optimizing one’s diet in positive fashion. In other words, what to include rather than what to exclude, but the “include” list is quite extensive so you’re probably not going to be reaching for a donut by the time you’ve eaten all that. In particular, she’s optimized the shopping list for ingredients that contain her DNA methylation superstars most abundantly; those nutrients being: betaine choline, curcumin, epigallocatechin gallate, quercetin, rosmarinic acid, and vitamins B9 and B12.
To make this possible, she sets out not just shopping list but also meal plans, and challenges the reader to do an 8-week intervention of our own.
Downside: it is quite exacting if you want to follow it 100%.
Bottom line: this is a very informative, science-based book. It can make you biologically younger at least by DNA methylation standards, if the rather specific diet isn’t too onerous for you.
Click here to check out Younger You, and enjoy a younger you!
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Built from Broken – by Scott Hogan, CPT, COES
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So many exercise programs come with the caveat “consult your doctor before engaging in any new activity”, and the safe-but-simple “do not try to train through an injury”.
Which is all very well and good for someone in fabulous health who sprained an ankle while running and can just wait a bit, but what about those of us carrying…
- long-term injuries
- recurring injuries
- or just plain unfixable physical disabilities?
That’s where physiotherapist Scott Hogan comes in. The subtitle line goes:
❝A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body❞
…but he does also recognize that there are some things that won’t bounce back.
On the other hand… There are a lot of things that get written off by doctors as “here’s some ibuprofen” that, with consistent mindful training, could actually be fixed.
Hogan delivers again and again in this latter category! You’ll see on Amazon that the book has thousands of 4- and 5-star ratings and many glowing reviews, and it’s for a reason or three:
- The book first lays a foundational knowledge of the most common injuries likely to impede us from training
- It goes on to give step-by-step corrective exercises to guide your body through healing itself. Your body is trying to heal itself anyway; you might as well help it accomplish that!
- It finishes up with a comprehensive (and essential) guide to train for the strength and mobility that will help you avoid future problems.
In short: a potentially life-changing book if you have some (likely back- or joint-related) problem that needs overcoming!
And if you don’t? An excellent pre-emptive guide all the same. This is definitely one of those “an ounce of prevention is better than a pound of cure” things.
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