Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer – by Dr. Patrick Walsh & Janet Farrar Worthington

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Prostate cancer is not glamorous or fun, and neither is this book.

Nevertheless, it’s a disease that affects 12% of men in general, and 60% of men aged 60+, with that percentage climbing every year after that.

So, if you have a prostate or love someone who has one, this book is worthwhile reading—yes, even as a preventative.

Like many cancers, prostate cancer is easy to treat if caught very early, becomes harder to treat as it goes, and almost impossible to cure if it gets as far as metastasis (i.e., it spread). Like all cancers, it’s better off avoided entirely if possible.

This book covers all the stages:

  • How to avoid it
  • How to check for it
  • How to “nip it in the bud”
  • Why some might want to delay treatment (!)
  • What options are available afterwards

This latter is quite extensive, and covers not just surgery, but radiation, thermo- or cryoablation, and hormone therapy.

And as for surgery, not just “remove the tumor”, but other options like radical prostatectomy, and even orchiectomy. Not many men will choose to have their testicles removed to stop them from feeding the prostate, but the point is that this book is comprehensive.

It’s asking whenever possible “is there another option?” and exploring all options, with information and without judgment, at each stage.

The writing style (likely co-author Worthington’s influence; she is an award-winning science-writer) is very “for the layman”, and that’s really helpful in demystifying a lot of what can be quite opaque in the field of oncology.

Bottom line: absolutely not an enjoyable read, but a potentially lifesaving one, especially given the odds we mentioned up top.

Click here to check out Dr. Patrick Walsh’s Guide To Surviving Prostate Cancer, and be prepared!

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Recommended

  • Chatter – by Dr. Ethan Kross
  • Widen the Window – by Dr. Elizabeth Stanley
    Widen the Window offers practical exercises to respond better to stress and recover from trauma. A must-read for those seeking resilience.

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  • How Does One Test Acupuncture Against Placebo Anyway?

    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.

    Pinpointing The Usefulness Of Acupuncture

    We asked you for your opinions on acupuncture, and got the above-depicted, below-described, set of answers:

    • A little under half of all respondents voted for “It’s well-backed by modern science, per neurology, cardiology, immunology, etc”
    • Slightly fewer respondents voted for “We don’t understand how it works, but it works!”
    • A little under a fifth of respondents voted for “It may have some limited clinical applications beyond placebo”
    • One (1) respondent voted for for “It’s placebo at best”

    When we did a main feature about homeopathy, a couple of subscribers wrote to say that they were confused as to what homeopathy was, so this time, we’ll start with a quick definition first.

    First, what is acupuncture? For the convenience of a quick definition so that we can move on to the science, let’s borrow from Wikipedia:

    ❝Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine in which thin needles are inserted into the body.

    Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.❞

    ~ Wikipedia

    Now, that’s not a promising start, but we will not be deterred! We will instead examine the science itself, rather than relying on tertiary sources like Wikipedia.

    It’s worth noting before we move on, however, that there is vigorous debate behind the scenes of that article. The gist of the argument is:

    • On one side: “Acupuncture is not pseudoscience/quackery! This has long been disproved and there are peer-reviewed research papers on the subject.”
    • On the other: “Yes, but only in disreputable quack journals created specifically for that purpose”

    The latter counterclaim is a) potentially a “no true Scotsman” rhetorical ploy b) potentially true regardless

    Some counterclaims exhibit specific sinophobia, per “if the source is Chinese, don’t believe it”. That’s not helpful either.

    Well, the waters sure are muddy. Where to begin? Let’s start with a relatively easy one:

    It may have some clinical applications beyond placebo: True or False?

    True! Admittedly, “may” is doing some of the heavy lifting here, but we’ll take what we can get to get us going.

    One of the least controversial uses of acupuncture is to alleviate chronic pain. Dr. Vickers et al, in a study published under the auspices of JAMA (a very respectable journal, and based in the US, not China), found:

    ❝Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.

    However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture❞

    Source: Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis

    If you’re feeling sharp today, you may be wondering how the differences are described as “significant” and “relatively modest” in the same text. That’s because these words have different meanings in academic literature:

    • Significant = p<0.05, where p is the probability of the achieved results occurring randomly
    • Modest = the differences between the test group and the control group were small

    In other words, “significant modest differences” means “the sample sizes were large, and the test group reliably got slightly better results than placebo”

    We don’t understand how it works, but it works: True or False

    Broadly False. When it works, we generally have an idea how.

    Placebo is, of course, the main explanation. And even in examples such as the above, how is placebo acupuncture given?

    By inserting acupuncture needles off-target rather than in accord with established meridians and points (the lines and dots that, per Traditional Chinese Medicine, indicate the flow of qi, our body’s vital energy, and welling-points of such).

    So, if a patient feels that needles are being inserted randomly, they may no longer have the same confidence that they aren’t in the control group receiving placebo, which could explain the “modest” difference, without there being anything “to” acupuncture beyond placebo. After all, placebo works less well if you believe you are only receiving placebo!

    Indeed, a (Korean, for the record) group of researchers wrote about this—and how this confounding factor cuts both ways:

    ❝Given the current research evidence that sham acupuncture can exert not only the originally expected non-specific effects but also sham acupuncture-specific effects, it would be misleading to simply regard sham acupuncture as the same as placebo.

    Therefore, researchers should be cautious when using the term sham acupuncture in clinical investigations.❞

    Source: Sham Acupuncture Is Not Just a Placebo

    It’s well-backed by modern science, per neurology, cardiology, immunology, etc: True or False?

    False, for the most part.

    While yes, the meridians and points of acupuncture charts broadly correspond to nerves and vasculature, there is no evidence that inserting needles into those points does anything for one’s qi, itself a concept that has not made it into Western science—as a unified concept, anyway…

    Note that our bodies are indeed full of energy. Electrical energy in our nerves, chemical energy in every living cell, kinetic energy in all our moving parts. Even, to stretch the point a bit, gravitational potential energy based on our mass.

    All of these things could broadly be described as qi, if we so wish. Indeed, the ki in the Japanese martial art of aikido is the latter kinds; kinetic energy and gravitational potential energy based on our mass. Same goes, therefore for the ki in kiatsu, a kind of Japanese massage, while the ki in reiki, a Japanese spiritual healing practice, is rather more mystical.

    The qi in Chinese qigong is mostly about oxygen, thus indirectly chemical energy, and the electrical energy of the nerves that are receiving oxygenated blood at higher or lower levels.

    On the other hand, the efficacy of the use of acupuncture for various kinds of pain is well-enough evidenced. Indeed, even the UK’s famously thrifty NHS (that certainly would not spend money on something it did not find to work) offers it as a complementary therapy for some kinds of pain:

    ❝Western medical acupuncture (dry needling) is the use of acupuncture following a medical diagnosis. It involves stimulating sensory nerves under the skin and in the muscles.

    This results in the body producing natural substances, such as pain-relieving endorphins. It’s likely that these naturally released substances are responsible for the beneficial effects experienced with acupuncture.❞

    Source: NHS | Acupuncture

    Meanwhile, the NIH’s National Cancer Institute recommends it… But not as a cancer treatment.

    Rather, they recommend it as a complementary therapy for pain management, and also against nausea, for which there is also evidence that it can help.

    Frustratingly, while they mention that there is lots of evidence for this, they don’t actually link the studies they’re citing, or give enough information to find them. Instead, they say things like “seven randomized clinical trials found that…” and provide links that look reassuring until one finds, upon clicking on them, that it’s just a link to the definition of “randomized clinical trial”:

    Source: NIH | Nactional Cancer Institute | Acupuncture (PDQ®)–Patient Version

    However, doing our own searches finds many studies (mostly in specialized, potentially biased, journals such as the Journal of Acupuncture and Meridian Studies) finding significant modest outperformance of [what passes for] placebo.

    Sometimes, the existence of papers with promising titles, and statements of how acupuncture might work for things other than relief of pain and nausea, hides the fact that the papers themselves do not, in fact, contain any evidence to support the hypothesis. Here’s an example:

    ❝The underlying mechanisms behind the benefits of acupuncture may be linked with the regulation of the hypothalamic-pituitary-gonadal (adrenal) axis and activation of the Wnt/β-catenin and OPG/RANKL/RANK signaling pathways.

    In summary, strong evidence may still come from prospective and well-designed clinical trials to shed light on the potential role of acupuncture in preserving bone loss❞

    Source: Acupuncture for Osteoporosis: a Review of Its Clinical and Preclinical Studies

    So, here they offered a very sciencey hypothesis, and to support that hypothesis, “strong evidence may still come”.

    “We must keep faith” is not usually considered evidence worthy of inclusion in a paper!

    PS: the above link is just to the abstract, because the “Full Text” link offered in that abstract leads to a completely unrelated article about HIV/AIDS-related cryptococcosis, in a completely different journal, nothing to do with acupuncture or osteoporosis).

    Again, this is not the kind of professionalism we expect from peer-reviewed academic journals.

    Bottom line:

    Acupuncture reliably performs slightly better than sham acupuncture for the management of pain, and may also help against nausea.

    Beyond placebo and the stimulation of endorphin release, there is no consistently reliable evidence that is has any other discernible medical effect by any mechanism known to Western science—though there are plenty of hypotheses.

    That said, absence of evidence is not evidence of absence, and the logistical difficulty of testing acupuncture against placebo makes for slow research. Maybe one day we’ll know more.

    For now:

    • If you find it helps you: great! Enjoy
    • If you think it might help you: try it! By a licensed professional with a good reputation, please.
    • If you are not inclined to having needles put in you unnecessarily: skip it! Extant science suggests that at worst, you’ll be missing out on slight relief of pain/nausea.

    Take care!

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  • The CBT Workbook for Mental Health – by Dr. Simon Rego & Sarah Fader

    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 have often reviewed psychology books here with a note saying “and no, it’s not just a book of the standard CBT techniques that you probably already know”.

    So today, this one’s for anyone who was ever thinking “but I don’t know the standard CBT techniques and I would like to know them!”.

    The authors outline specific solutions to many common quantifiable problems, with simple exercises that are well-explained and easy to implement.

    Cognitive Behavioral Therapy (CBT) is not a panacea, but for the things it can be used for, it’s very effective and is a very good “first thing to reach for” to see if it works, because its success rate for a lot of problems is very high.

    What kinds of things is this book most likely to help with? A lot of common forms of stress, anxiety, self-esteem issues, cravings, shame, and relationship issues. Other things too, but we can’t list everything and that list already covers a lot of very high-incidence stuff.

    Bottom line: if CBT isn’t something already in your toolbox, this book will help you add all its best tips and tricks.

    Click here to check out The CBT Workbook for Mental Health, and get tooled up!

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  • The Biggest Cause Of Back Pain

    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.

    Will Harlow, specialist over-50s physiotherapist, shares the most common cause (and its remedy) in this video:

    The seat of the problem

    The issue (for most people, anyway) is not in the back itself, nor the core in general, but rather, in the glutes. That is to say: the gluteus maximus, medius, and minimus. They assist in bending forwards (collaborating half-and-half with your back muscles), and help control pelvic alignment while walking.

    Sitting for long periods weakens the glutes, causing the back to overcompensate, leading to pain. So, obviously don’t do that, if you can help it. Weak glutes shift the work to your back muscles during bending and walking, increasing strain and—as a result—back pain.

    The solution (besides “sit less”) is to do specific exercises to strengthen the glutes. When you do, focus on good form and do not try to push through pain. If the exercises themselves all cause pain, then stop and consult a local physiotherapist to figure out your next step.

    With that in mind, the five exercises recommended in this video to strengthen glutes and reduce back pain are:

    1. Hip abduction (isometric): use a heavy resistance band or belt around legs above the knees, push outwards.
    2. The clam: lie on your side, bend your knees 90°, and lift your top knee while keeping your body forward. Focus on glute engagement.
    3. Clam with resistance band: use a light resistance band above your knees and perform the same clam exercise.
    4. Hip abduction (straight leg): lie on your side, keep legs straight, lift your top leg diagonally backward. Lead with your heel to target your glutes and avoid back strain.
    5. Hip abduction with resistance band: place a resistance band around your ankles, and lift leg as in the previous exercise.

    For more on all these, plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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Related Posts

  • Chatter – by Dr. Ethan Kross
  • Can You Gain Muscle & Lose Fat At The Same Time?

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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 😎

    ❝Is it possible to lose fat and gain muscle at the same time, or do we need to focus on one and then the other, and if so, which order is best?❞

    Contrary to popular belief, you can do both simultaneously! However, it’s not as easy as doing just one or the other, which is why most bodybuilders, for example, have a “building phase” and a “cutting phase”.

    The reason it’s difficult is because of the diet. Growing muscle doesn’t just take protein and micronutrients; it takes energy as well, which must come from carbohydrates and/or fats. Therefore, it is tricky to eat enough to build muscle and to fuel the workouts that are required to build the muscle (you can’t hit the gym in a state of rabbit starvation* and expect to perform well at your workout), while at the same time not eating enough carbs/fats to have any excess to store as fat.

    *So-called because rabbit-meat is very lean, such that when during times of famine, European peasants tried to subsist off mostly rabbits, their health quickly plummeted for lack of energy. It’s also been called “salmon starvation”, apparently, for the same reason:

    How ancestral subsistence strategies solve salmon starvation and the “protein problem” of Pacific Rim resources

    In French it’s called “Mal de caribou” (caribou sickness), by the way. But you get the idea: eat too much lean protein without enough carbs/fats, and woe shall befall.

    So, if you want to do both at once, you need to be incredibly on top of your macros, and the bad news is, only you (or a coach working directly with you) can work out what precise macros requirements your body has, because it depends on your body and your activities.

    The easier “half-way house”

    We will get to the “building phase” and “cutting phase” of bodybuilders, but first, here’s an option that’s very worthy of consideration, and it is: forget about your weight and just focus on health while incidentally doing regular resistance exercises and HIIT.

    What will happen if you do this (assuming a healthy balanced diet, nothing special and without counting anything, but we’re talking at least mostly whole-foods, and at least mostly plants; the Mediterranean diet is great for this, as it is for most things) is:

    • The dietary approach described will gradually improve your metabolic health if it wasn’t already good. If it was already good, it’ll likely just maintain it, rather than improve it.
    • The resistance exercises will, if engaged with seriously (it has to be difficult to do, or your muscles won’t have any reason to grow), gradually build muscle. This will be very gradual, because you’re not eating for bodybuilding, nor optimizing your general lifestyle for same. Historically many women have feared lifting weights because they don’t want to “look like a weightlifter”, but the kinds of bodies that word brings to mind are not the kind that happen by accident (especially for women, with our different hormones guiding our bodies to a different composition); it takes a lot of single-minded dedication to specifically optimize size gains, for a long time.
    • The high-intensity interval training (HIIT) will more rapidly improve your metabolic health, and unlike most forms of exercise, it will actually result in a gradual reduction of fat, if you have superfluous fat to lose. This is because whereas most forms of cardio exercise increase the heartrate for a while but then have a corresponding metabolic slump afterwards to make up for it, HIIT confuses the heart (in a good way) which results in it having to grow stronger, and not doing any compensatory metabolic slump:

    How To Do HIIT (Without Wrecking Your Body) ← as well as the “how to”, this also gives some of the science behind it, too

    This will, thus, result in gradual gain of muscle and loss of fat—or if you take it easier with the exercise, then you can easily settle into just maintaining your body composition as it is, but that wasn’t the question today.

    So, there you have it, that’s how to do both at once! Now, if you want more dramatic results, then more dramatic methods are called for:

    What bodybuilders (mostly) do

    Matters of genetic predisposition and commonplace use of steroids aside, here’s how bodybuilders get that “lots of muscle, no fat” figure:

    1. First, get into “moderate” shape if not already there.
    2. Bulk up: eat amounts of food that will seem unreasonable to a non-bodybuilder; eating 2x or even 3x the “recommended” daily calorie amount is common; focus is typically on getting adequate (for bodybuilding purposes) protein while also carb-loading for workouts and getting at least enough fats for fat-soluble vitamins to work. In the gym, focus on doing sets of very few reps with the heaviest weights one can safely lift, while doing minimal cardio, and also sleeping a lot (9–12hrs per day), which is essential because this is putting a huge strain on the body and it needs a chance to recover and rebuild.
    3. Cut down: maintain protein intake (to at least mostly maintain muscles) while keeping carbs and fats low, doing cardio work (HIIT is still ideal) and running a calorie deficit for a short while (there is no use in trying to maintain a long-term calorie deficit; your body will try to save you from starvation by storing any fat it can and slowing your metabolism).

    Phases 2 and 3 are then cycled, alternating every month, or every 6 weeks, or every 2 months or so, depending on personal preferences and scheduling considerations (bodybuilders will often have competitions they are working towards, so they need to time things to be at the end of a cutting phase to look their “best” by bodybuilder standards).

    Disclaimer: bodybuilding is complex, and can be ruinous to the health if practised inexpertly, because of its extreme nature. We don’t recommend serious bodybuilding per se in general, but if you are going to do it, please consult with a professional bodybuilding coach, and do not rely on a few paragraphs from us that are intended only to give the most basic overview of how bodybuilders can approach the “gain muscle, lose fat” problem.

    Want to know more?

    We’ve written on some related topics previously; here’s a three-part series:

    1. How To Lose Weight (Healthily!)
    2. How To Build Muscle (Healthily!)
    3. How To Gain Weight (Healthily!) ← this one’s specifically about gaining healthy levels of fat, for any who want/need that

    And also:

    Can We Do Fat Redistribution? ← yes we can, but there are caveats

    Take care!

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  • Ham Substitute in Bean Soup

    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.

    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

    I am interested in what I can substitute for ham in bean soup?

    Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.

    Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).

    Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.

    Wondering about the health aspects of MSG? Check out our main feature on this, from last month:

    What’s the deal with MSG?

    Don’t Forget…

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  • The Counterintuitive Dos and Don’ts of Nail Health

    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.

    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

    ❝I take a vitamin supplement for strengthening my nails (particularly one of my big toes!) – but they are running out! What do you recommend for strengthening nails? What is/are the key ingredient(s)?❞

    Vitamin-wise, biotin (vitamin B7) is an underrated and very important one. As a bonus, it’s really good for your hair too (hair and nails being made of fundamentally the same “stuff”. Because it has exceptionally low toxicity, it can be taken up to 10,000% of the NRV, so if shopping for supplements, a high biotin content is better than a low one.

    A lot of products marketed as for “skin, hair, and nails” focus on vitamins A and E, which are good for the skin but aren’t so relevant for nails.

    Nutritionally, getting plenty of protein (whatever form you normally take it is fine) is also important since keratin (as nails are made of) is a kind of protein.

    Outside of nutritional factors, a few other considerations:

    • Testosterone strengthens nails, and declining testosterone levels (as experienced by most men over the age of 45) can result in weaker nails. So for men over 45 especially, a diet that favors testosterone (think foods rich in magnesium and zinc) is good.
    • Because estrogen doesn’t do for women’s nails what testosterone does for men’s nails, increasing our magnesium and zinc intake won’t help our nails (but it’s still good for other things, including energy levels in the day and good sleep at night, and most people are deficient in magnesium anyway)
    • Those of us who enjoy painted nails would do well to let our nails go without polish sometimes, as it can dry them out. And, acrylic nails are truly ruinous to nail health, as are gel nails (the kind that use a UV lamp to harden them—which is also bad for the skin)
    • When nails are brittle, it can be tempting to soak them to reduce their brittleness. However, this is actually counterproductive, as the water will leech nutrients from the nails, and by the time you’ve been out of the footbath (for example) for about an hour, your nails will bemore brittle than before you soaked them.
      • Use a moisturizing lotion or nail-oil instead—bonus if it contains biotin, keratin, and/or other helpful nutrients.
      • Keep yourself hydrated, too! Hydration that comes to your nails from the inside will deliver nutrients, rather than removing them.

    About those supplements: we don’t sell them (or anything else) but for your convenience, here are some great ones (this writer takes pretty much the same, just a different brand because I’m in a different country):

    Magnesium Gummies (600mg) & Biotin Gummies (10,000µg)

    Enjoy!

    ❝I was wondering whether there were very simple, clear bullet points or instructions on things to be wary of in Yoga.❞

    That’s quite a large topic, and not one that lends itself well to being conveyed in bullet points, but first we’ll share the article you sent us when sending this question:

    Tips for Avoiding Yoga Injuries

    …and next we’ll recommend the YouTube channel @livinleggings, whose videos we feature here from time to time. She (Liv) has a lot of good videos on problems/mistakes/injuries to avoid.

    Here’s a great one to get you started:

    !

    Don’t Forget…

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