Fast. Feast. Repeat – by Dr. Gin Stephens
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We’ve reviewed intermittent fasting books before, so what makes this one different?
The title “Fast. Feast. Repeat.” doesn’t give much away; after all, we already know that that’s what intermittent fasting is.
After taking the reader though the basics of how intermittent fasting works and what it does for the body, much of the rest of the book is given over to improvements.
That’s what the real strength of this book is: ways to make intermittent fasting more efficient, including how to avoid plateaus. After all, sometimes it can seem like the only way to push further with intermittent fasting is to restrict the eating window further. Not so!
Instead, Dr. Stephens gives us ways to keep confusing our metabolism (in a good way) if, for example, we had a weight loss goal we haven’t met yet.
Best of all, this comes without actually having to eat less.
Bottom line: if you want to be in good physical health, and/but also believe that life is for living and you enjoy eating food, then this book can resolve that age-old dilemma!
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Menopause, & When Not To Let Your Guard Down
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This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.
She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?
Untreated menopause is more serious than most people think
Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:
What Menopause Does To The Heart
…and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:
Alzheimer’s Sex Differences May Not Be What They Appear
Treated menopause is safer than many people think
The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.
The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).
It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.
In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).
However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.
You can read more about HRT and breast cancer risk (increases and decreases) here:
…and about the same with regard to HMT, here:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Lifestyle matters, and continues to matter
Menopause often receives the following attention from people:
- Perimenopause: “Is this menopause?”
- Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
- Postmenopause: “Yay, that’s behind me now, back to the new normal”
The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.
This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.
So, you can’t let your guard down!
Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.
Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.
See also: Resistance Is Useful! (Especially As We Get Older)
And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!
Want to know more from Dr. Shepherd?
You might like this book of hers that we reviewed not long back:
Generation M – by Dr. Jessica Shepherd
Take care!
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A New Tool For Bone Regeneration
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When it comes to rebuilding bones, one of the tools in the orthopedic surgeon’s toolbox is bone grafts. This involves, to oversimplify it a bit, gluing particles of bone to where bone needs rebuilding. However, this comes with problems, most notably:
- that the bone tissue and the adhesive “glue” need to be prepared separately and mixed in situ, which is fiddly, to say the least
- that the resultant mixture mixed in situ will usually be unevenly mixed, resulting in weak bonding and degradation over time
- having any more of one part or the other in any given site means that bone regeneration and adhesion become a “pick one” matter, when both are critically needed
You may be wondering: why can’t they mix them before putting them in?
And the answer is: because then either the glue will set the bone prematurely (and now we have a clump of bone outside of the body which is not what we wanted), or else the glue will have issues with setting in situ, and now we have bone tissue running down the inside of someone’s leg and setting somewhere else, which is also not what we want.
These kinds of problems may seem a little more “arts and crafts” than “orthopedic surgery”, but they are the kind of nitty-gritty real-life real challenges that actually get in the way of healing patients’ bones.
The new solution
Biomaterial research scientists have developed an injectable hydrogel (containing all the necessary ingredients* that uses light to achieve cross-linking of bone particles and mineralization without any of the above being necessary. In again oversimplified terms: they inject the hydrogel where it’s needed, and then irradiate the site with harmless visible light which instantly sets it in place. As to how the light gets in there: it’s just very shiny, like candling an egg to see inside, or like how you can still approximately see bright light even with your eyes closed.
*alginate (natural polysaccharide derived from brown algae), RGD peptide-containing mussel** adhesive protein, calcium ions, phosphonodiols, and a photoinitiator.
**unclear whether this would trigger a shellfish allergy. Probably kosher per “פיקוח נפש” and Talmud Yoma 85b, but we are a health science newsletter, not Talmudic scholars, so please talk to your Rabbi. Probably halal per Qur’an 5:4 and failing that, the same principle as previously mentioned, expressed in Qur’an 5:3 and 6:119, but once again, your humble writer here is no Mufti, so please talk to your Imam. As for if you are vegetarian or vegan, then that is for you to decide whether to take a “medications with animal ingredients are unfortunate but necessary” stance, as most do. This vegan writer would (she’d grumble about it, though, and at least try to find an acceptable alternative first).
Back to the more general practicalities…
How it works, in less oversimplified terms:
❝The coacervate-based formulation, which is immiscible in water, ensures that the hydrogel retains its shape and position after injection into the body. Upon visible light irradiation, cross-linking occurs, and amorphous calcium phosphate, which functions as a bone graft material, is simultaneously formed. This eliminates the need for separate bone grafts or adhesives, enabling the hydrogel to provide both bone regeneration and adhesion.❞
“That’s great, but I was hoping for something I can do right now, ideally at home”
If getting glued back together was not on your bucket list, that’s understandable. There’s still a lot you can do for bone density; here’s a quick overview:
- Get it checked. Yes, this first, if you haven’t already! You want a basis for comparison later. Book a bone density scan. See for example this case study with bone density scans at each end: 21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)
- Enjoy a diet rich in calcium and vitamin D yes, but be aware that you can have too much of a good thing, and doing so will result in more harm than good, including (paradoxically) for your bones. See: Vitamin D + Calcium: Too Much Of A Good Thing?
- Enjoy a diet rich is phosphorus, potassium, and magnesium, which things are also necessary for bone health, and in which people are much more likely to be deficient (especially magnesium). If you’re going to supplement, then there are very big difference in the efficacy of different kinds of magnesium supplement (brace yourself; the cheapest and most common kind barely does anything at all). See: Which Magnesium? (And: When?)
- Enjoy a diet rich in high quality protein—collagen is very useful, but if you want a plant-based approach, don’t worry, our body can and will make it for yourself if you give it a hand—and vitamin C to help its absorption, as well as glycine if you’re going the no-animals route. See: Collagen For Bones: We Are Such Stuff As Fish Are Made Of and: The Sweet Truth About Glycine: Making Your Collagen Work Better
- Consider medication, if your bone density is already lower than what it should be. There are meds to stop further deterioration, and different meds to encourage your body to rebuild bone. However, there are downsides to each of them: Which Osteoporosis Medication, If Any, Is Right For You?
- While we’re on the topic of medications, consider bioidentical HRT if you are female and not otherwise producing your own estrogen and progesterone in adequate quantities to maintain your skeletal integrity: HRT: A Tale Of Two Approaches
- Look after your gut too! So much starts there: Is Your Gut Leading You Into Osteoporosis? Bacterioides Vulgatus & Bone Health
- Lastly, exercise, but exercise right, because with insufficient resistance exercise your bones will not “think” they need to remain strong, and with the wrong kind of resistance exercise, you could break/compress your bones if they are already weak, so check out: Osteoporosis & Exercises: Which To Do (And Which To Avoid)
Too much information?
If that was too much information all at once, then we recommend this as your one-stop article:
The Bare-Bones Truth About Osteoporosis
Want more information?
We are but a humble newsletter and can only include so much per day, but we highly recommend this book we reviewed a little while back, which goes into everything in a lot more detail than we can here:
Enjoy!
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Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how
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With so many high-profile people diagnosed with cancer we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are increasing among younger people in their 30s and 40s.
On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are improving greatly and some cancers are now being managed more as long-term chronic diseases rather than illnesses that will rapidly claim a patient’s life.
The mainstays of cancer treatment remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.
PeopleImages.com – Yuri A/Shutterstock Keep moving if you can
Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.
Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue to identify and kill cancer cells.
Our skeletal muscles (those attached to bone for movement) release signalling molecules called myokines. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells slowing their growth and causing cell death.
Exercise can also greatly reduce the side effects of cancer treatment such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of developing other chronic diseases such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health for patients with cancer.
Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as chemotherapy and radiation therapy. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then rehabilitating them after surgery.
These mechanisms explain why cancer patients who are physically active have much better survival outcomes with the relative risk of death from cancer reduced by as much as 40–50%.
Mental health helps
The second “tool” which has a major role in cancer management is psycho-oncology. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.
Supporting quality of life and happiness is important on their own, but these barometers can also impact a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.
If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression through hormonal and inflammatory mechanisms. So it’s essential their mental health is supported.
Chemotherapy can be stressful on the body and emotional reserves. Shutterstock Putting the good things in: diet
A third therapy in the supportive cancer care toolbox is diet. A healthy diet can support the body to fight cancer and help it tolerate and recover from medical or surgical treatments.
Inflammation provides a more fertile environment for cancer cells. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This generally means avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.
Some cancer treatments cause muscle loss. Avoiding processed foods may help. Shutterstock Muscle loss is a side effect of all cancer treatments. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so supplementation may be indicated.
Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called cachexia and needs careful management.
Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).
Working as a team
These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.
If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.
For exercise medicine support it is best to consult with an accredited exercise physiologist, for diet therapy an accredited practising dietitian and mental health support with a registered psychologist. Some of these services are supported through Medicare on referral from a general practitioner.
For free and confidential cancer support call the Cancer Council on 13 11 20.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What’s Your Vascular Dementia Risk?
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We often say that “what’s good for your heart is good for your brain”, and this is because the former feeds the latter, with oxygen and nutrients, and also clears away detritus like beta-amyloid (associated with Alzheimer’s) and alpha-synuclein (associated with Parkinson’s).
For more on those, see: How To Clean Your Brain (Glymphatic Health Primer)
For this reason, there are many risk factors that apply equally cardiovascular disease (CVD), and neurodegenerative diseases like Alzheimer’s and other vascular dementias, as well as stroke risk.
The link between the two has also been studied; recently a team of scienists led by Dr. Anisa Dhana asked the question:
❝What is the association between cardiovascular health (CVH) and biomarkers of neurodegeneration, including neurofilament light chain and total tau?❞
To answer this, they looked at data from more than 10,000 Americans aged 65+; of these, they were able to get serum samples from 5,470 of them, and tested those samples for the biomarkers of neurodegeneration mentioned above.
They then tabulated the results with cardiovascular health scores based on the American Heart Association (AHA)’s “Life’s Simple 7” tool, and found, amongst other things:
- 34.6% of participants carried the APOE e4 allele, a genetic risk factor for Alzheimer’s.
- Higher CVH scores were associated with lower NfL levels, but not with t-tau concentrations.
- APOE e4 carriers with high CVH had significantly lower NfL levels.
- Race did not influence the CVH-NfL relationship.
- Higher CVH was linked to a slower annual increase in NfL levels but did not affect t-tau changes.
- Over 10 years, participants with the lowest CVH scores saw a 7.1% annual increase in NfL levels, while those with the highest CVH scores had a 5.2% annual increase.
- Better CVH is linked to lower serum NfL levels, regardless of age, sex, or race.
- CVH is particularly crucial for APOE e4 carriers
In other words: higher cardiovascular health meant lower markers of neurodegeneration, and this not only still held true for APOE e4 carriers, but also, the benefits actually even more pronounced in those participants.
You may be wondering: “but it said it helped with NfL levels, not t-tau concentrations?” And, indeed, it is so. But this means that the overall neurodegeneration risk is still inversely proportional to cardiovascular health; it just means it’s not a magical panacea and we must still do other things too.
See also: How To Reduce Your Alzheimer’s Risk
And as for the study, you can read the paper itself in full here:
Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults
Life’s Simple 7
We mentioned that they used the AHA’s “Life’s Simple 7” tool to assess cardiovascular health; it is indeed simple, but important. Here it is:
Metric Poor Intermediate Ideal Current smoking Yes Former ≤12 mo Never or quit >12 mo BMI, kg/m2 ≥30 25–29.9 <25 Physical activity None 1–149 min/wk of moderate activity or 1–74 min/wk of vigorous activity or 1–149 min/wk of moderate and vigorous activity ≥150 min/wk of moderate activity or ≥75 min/wk of vigorous activity or ≥150 min/wk of moderate and vigorous activity Diet pattern score* 0–1 2–3 4–5 Total cholesterol, mg/dL ≥240 200–239 or treated to goal <200 Blood pressure, mm Hg SBP ≥140 or DBP ≥90 SBP 120–139 or DBP 80–89 or treated to goal <120/<80 Fasting plasma glucose, mg/dL ≥126 100–125 or treated to goal <100 *Each of the following 5 diet elements is given a score of 1: (1) ≥4.5 cups/day of fruits and vegetables; (2) ≥2 servings/week of fish; (3) ≥3 servings/day of whole grains; (4) no more than 36 oz/wk of sugar‐sweetened beverages; and (5) no more than 1500 mg/d of sodium.
As the AHA notes,
❝Unfortunately, 99% of the U.S. adult population has at least one of seven cardiovascular health risks: tobacco use,
poor diet, physical inactivity, unhealthy weight, high blood pressure, high cholesterol or high blood glucose.❞It then goes on to talk about the financial burden of this on employers, but this was taken from a workplace health resource, and we recognize the rest of it won’t be of pressing concern for most of our readers. In case you are interested though, here it is:
American Heart Association | Life’s Simple 7® Journey to Health™
For a more practical (if you’re just a private individual and employee healthcare is not your main concern) overview, see:
Want to know more?
Here are some very good starting points for improving each of those 7 metrics, as necessary:
- Which Addiction-Quitting Methods Work Best?
- How To Lose Weight (Healthily!)
- The Doctor Who Wants Us To Exercise Less, & Move More
- Which Diet? Top Diets Ranked By Experts
- Lower Cholesterol Naturally, Without Statins
- 10 Ways To Lower Blood Pressure Naturally
- 10 Ways To Balance Your Blood Sugars
Take care!
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Dandelion Greens vs Collard Greens – Which is Healthier?
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Our Verdict
When comparing dandelion greens to collard greens, we picked the dandelion greens.
Why?
Collard greens are great—they even beat kale in one of our previous “This or That” articles!—but dandelion greens simply pack more of a nutritional punch:
In terms of macros, dandelions have slightly more carbs (+3g/100g) for the same protein and fiber, and/but the glycemic index is equal (zero), so those carbs aren’t anything to worry about. Nobody is getting metabolic disease by getting their carbs from dandelion leaves. In short, we’re calling it a tie on macros, though it could nominally swing either way if you have an opinion (one way or the other) about the extra 3g of carbs.
In the category of vitamins, things are more exciting: dandelion greens have more of vitamins A, B1, B2, B3, B6, B7, B9, C, E, and K, while collard greens have more vitamin B5. An easy and clear win for dandelions.
Looking at the minerals tells a similar story; dandelion greens have much more calcium, copper, iron, magnesium, phosphorus, potassium, and zinc, while collard greens have slightly more manganese. Another overwhelming win for dandelions.
One more category, polyphenols. We’d be here until next week if we listed all the polyphenols that dandelion greens have, but suffice it to say, dandelion greens have a total of 385.55mg/100g polyphenols, while collard greens have a total of 0.08mg/100g polyphenols. Grabbing a calculator, we see that this means dandelions have more than 4819x the polyphenol content that collard greens do.
So, “eat leafy greens” is great advice, but they are definitely not all created equal!
Let us take this moment to exhort: if you have any space at home where you can grow dandelions, grow them!
Not only are they great for pollinators, but also they beat the collard greens that beat kale. And you can have as much as you want, for free, right there.
Want to learn more?
You might like to read:
Collard Greens vs Kale – Which is Healthier?
Enjoy!
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The Dopamine Precursor And More
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What Is This Supplement “NALT”?
N-Acetyl L-Tyrosine (NALT) is a form of tyrosine, an amino acid that the body uses to build other things. What other things, you ask?
Well, like most amino acids, it can be used to make proteins. But most importantly and excitingly, the body uses it to make a collection of neurotransmitters—including dopamine and norepinephrine!
- Dopamine you’ll probably remember as “the reward chemical” or perhaps “the motivation molecule”
- Norepinephrine, also called noradrenaline, is what powers us up when we need a burst of energy.
Both of these things tend to get depleted under stressful conditions, and sometimes the body can need a bit of help replenishing them.
What does the science say?
This is Research Review Monday, after all, so let’s review some research! We’re going to dive into what we think is a very illustrative study:
A 2015 team of researchers wanted to know whether tyrosine (in the form of NALT) could be used as a cognitive enhancer to give a boost in adverse situations (times of stress, for example).
They noted:
❝The potential of using tyrosine supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis.❞
More on this later, but first, the positive that they also found:
❝In contrast, tyrosine does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that tyrosine is an effective enhancer of cognition, but only when neurotransmitter function is intact and dopamine and/or norepinephrine is temporarily depleted❞
That “but only”, is actually good too, by the way!
You do not want too much dopamine (that could cause addiction and/or psychosis) or too much norepinephrine (that could cause hypertension and/or heart attacks). You want just the right amount!
So it’s good that NALT says “hey, if you need some more, it’s here, if not, no worries, I’m not going to overload you with this”.
Read the study: Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands
About that limitation…
Remember they said that it seemed unlikely to help in treating clinical disorders with impaired neurotransmitter function and/or synthesis?
Imagine that you employ a chef in a restaurant, and they can’t keep up with the demand, and consequently some of the diners aren’t getting fed. Can you fix this by supplying the chef with more ingredients?
Well, yes, if and only if the problem is “the chef wasn’t given enough ingredients”. If the problem is that the oven (or the chef’s wrist) is broken, more ingredients aren’t going to help at all—something different is needed in those cases.
So it is with, for example, many cases of depression.
See for example: Tyrosine for depression: a double-blind trial
About blood pressure…
You may be wondering, “if NALT is a precursor of norepinephrine, a vasoconstrictor, will this increase my blood pressure adversely?”
Well, check with your doctor as your own situation may vary, but under normal circumstances, no. The effect of NALT is adaptogenic, meaning that it can help keep its relevant neurotransmitters at healthy levels—not too low or high.
See what we mean, for example in this study where it actually helped keep blood pressure down while improving cognitive performance under stress:
Effect of tyrosine on cognitive function and blood pressure under stress
Bottom line:
For most people, NALT is a safe and helpful way to help keep healthy levels of dopamine and norepinephrine during times of stress, giving cognitive benefits along the way.
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