Hormone Replacement
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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
❝I cant believe 10 Almonds addresses questions. Thanks. I see the word symptoms for menopause. I don’t know what word should replace it but maybe one should be used or is symptom accurate? And I recently read that there was a great disservice for women in my era as they were denied/scared of hormones replacement. Unnecessarily❞
You’d better believe it! In fact we love questions; they give us things to research and write about.
“Symptom” is indeed an entirely justified word to use, being:
- General: any phenomenon or circumstance accompanying something and serving as evidence of it.
- Medical: any phenomenon that arises from and accompanies a particular disease or disorder and serves as an indication of it.
If the question is more whether the menopause can be considered a disease/disorder, well, it’s a naturally occurring and ultimately inevitable change, yes, but then, so is cancer (it’s in the simple mathematics of DNA replication and mutation that, unless a cure for cancer is found, we will always eventually get cancer, if nothing else kills us first).
So, something being natural/inevitable isn’t a reason to not consider it a disease/disorder, nor a reason to not treat it as appropriate if it is causing us harm/discomfort that can be safely alleviated.
Moreover, and semantics aside, it is medical convention to consider menopause to be a medical condition, that has symptoms. Indeed, for example, the US’s NIH (and its constituent NIA, the National Institute of Aging) and the UK’s NHS, both list the menopause’s symptoms, using that word:
- NIA (NIH): What are the signs and symptoms of menopause?
- NHS: Common symptoms of menopause and perimenopause
With regard to fearmongering around HRT, certainly that has been rife, and there were some very flawed (and later soundly refuted) studies a while back that prompted this—and even those flawed studies were not about the same (bioidentical) hormones available today, in any case. So even if they had been correct (they weren’t), it still wouldn’t be a reason to not get treatment nowadays, if appropriate!
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Twenty-One, No Wait, Twenty Tweaks For Better Health
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Dr. Greger’s 21 Tweaks… We say 20, though!
We’ve talked before about Dr. Greger’s Daily Dozen (12 things he advises that we make sure to eat each day, to enjoy healthy longevity), but much less-talked-about are his “21 Tweaks”…
They are, in short, a collection of little adjustments one can make for better health. Some of them are also nutritional, but many are more like lifestyle tweaks. Let’s do a rundown:
At each meal:
- Preload with water
- Preload with “negative calorie” foods (especially: greens)
- Incorporate vinegar (1-2 tbsp in a glass of water will slow your blood sugar increase)
- Enjoy undistracted meals
- Follow the 20-minute rule (enjoy your meal over the course of at least 20 minutes)
Get your daily doses:
- Black cumin ¼ tsp
- Garlic powder ¼ tsp
- Ground ginger (1 tsp) or cayenne pepper (½ tsp)
- Nutritional yeast (2 tsp)
- Cumin (½ tsp)
- Green tea (3 cups)
Every day:
- Stay hydrated
- Deflour your diet
- Front-load your calories (this means implementing the “king, prince, pauper” rule—try to make your breakfast the largest meal of your day, followed my a medium lunch, and a small evening meal)
- Time-restrict your eating (eat your meals within, for example, an 8-hour window, and fast the rest of the time)
- Optimize exercise timing (before breakfast is best for most people, unless you are diabetic)
- Weigh yourself twice a day (doing this when you get up and when you go to bed results in much better long-term weight management than weighing only once per day)
- Complete your implementation intentions (this sounds a little wishy-washy, but it’s about building a set of “if this, then that” principles, and then living by them. An example could be directly physical health-related such as “if there is a choice of stairs or elevator, I will take the stairs”, or could be more about holistic good-living, such as “if someone asks me for help, I will try to oblige them so far as I reasonably can”)
Every night:
- Fast after 7pm
- Get sufficient sleep (7–9 hours is best. As we get older, we tend more towards the lower end of that, but try get at least those 7 hours!)
Experiment with Mild Trendelenburg(better yet, skip this one)*
*This involves a 6º elevation of the bed, at the foot end. Dr. Greger advises that this should only be undertaken after consulting your doctor, though, as a lot of health conditions can contraindicate it. We at 10almonds couldn’t find any evidence to support this practice, and numerous warnings against it, so we’re going to go ahead and say we think this one’s skippable.
Again, we do try to bring you the best evidence-based stuff here at 10almonds, and we’re not going to recommend something just because of who suggested it
As for the rest, you don’t have to do them all! And you may have noticed there was a little overlap in some of them. But, we consider them a fine menu of healthy life hacks from which to pick and choose!
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Dr. Kim Foster’s Method For Balancing Hormones Naturally
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Not just sex hormones, but also hormones like cortisol (the stress hormone), and thyroid hormones (for metabolism regulation) too! The body is most of the time self-regulating when it comes to hormones, but there are things that we can do to help our body look after us correctly.
In short, if we give our body what it needs, it will (usually, barring serious illness!) give us what we need.
Dr. Foster recommends…
Foods:
- Healthy fats (especially avocados and nuts)
- Lean proteins (especially poultry, fish, and legumes)
- Fruits & vegetables (especially colorful ones)
- Probiotics (especially fermented foods like sauerkraut, kimchi, etc)
- Magnesium-rich foods (especially dark leafy greens, nuts, and yes, dark chocolate)
Teas:
- Camomile tea (especially beneficial against cortisol overproduction)
- Nettle tea (especially beneficial for estrogen production)
- Peppermint tea (especially beneficial for gut health, thus indirect hormone benefits)
Stress reduction:
- Breathing exercises (especially mindfulness exercises)
- Yoga (especially combining exercise with stretches)
- Spending time in nature (especially green spaces)
Dr. Foster explains more about all of these things, along with more illustrative examples, so if you can, do enjoy her video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to read more about this topic?
You might like our main feature: What Does “Balance Your Hormones” Even Mean?
Enjoy!
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Berberine For Metabolic Health
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Is Berberine Nature’s Ozempic/Wegovy?
Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.
It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).
Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:
- Reduced fasting blood sugar levels
- Improved insulin sensitivity
- Reduced LDL and triglycerides
- Increased HDL levels
So, what does the science say?
It’s (mostly!) not nature’s Wegovy/Ozempic
It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.
Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.
Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.
In less arcane words: it boosts some enzymes and inhibits others.
Each of these boosts/inhibitions has a positive effect on metabolic health.
However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.
See: Effects of Berberine on the Gastrointestinal Microbiota
Does it work for weight loss?
Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.
- Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity ← Wegovy and Ozempic are both brand names of semaglutide
- The effect of berberine supplementation on obesity parameters: A systematic review and meta-analysis of randomized controlled trials ← a good recent research review giving clear data on many factors
- Lipid-lowering effect of berberine in human subjects and rats ← this is an older study, 2012, but it gives 3-month weight loss percentages rather than discrete values in the abstract, so it’s easier to compare to the semaglutide study without grabbing a calculator
❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.
However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)
Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞
(click through to read in full)
Is it safe?
It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.
Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.
Where can I get it?
As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.
Enjoy!
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Cardiac Failure Explained – by Dr. Warrick Bishop
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The cover of this book makes it look like it’ll be a flashy semi-celebrity doctor keen to sell his personalized protocol, along with eleventy-three other books, but actually, what’s inside this one is very different:
We (hopefully) all know the basics of heart health, but this book takes it a lot further. Starting with the basics, then the things that it’s easy to feel like you should know but actually most people don’t, then into much more depth.
The format is much more like a university textbook than most pop-science books, and everything about the way it’s written is geared for maximum learning. The one thing it does keep in common with pop-science books as a genre is heavy use of anecdotes to illustrate points—but he’s just as likely to use tables, diagrams, callout boxes, emboldening of key points, recap sections, and so forth. And for the most part, this book is very information-dense.
Dr. Bishop also doesn’t just stick to what’s average, and talks a lot about aberrations from the norm, what they mean and what they do and yes, what to do about them.
On the one hand, it’s more information dense than the average reader can reasonably expect to need… On the other hand, isn’t it great to finish reading a book feeling like you just did a semester at medical school? No longer will you be baffled by what is going on in your (or perhaps a loved one’s) cardiac health.
Bottom line: if you’d like to know cardiac health inside out, this book is an excellent place to start.
Click here to check out Cardiac Failure Explained, and get to the heart of things!
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Laugh Often, To Laugh Longest!
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Putting The Abs Into Absurdity
We’ve talked before about the health benefits of a broadly positive outlook on life:
Optimism Seriously Increases Longevity!
…and we’re very serious about it, but that’s about optimistic life views in general, and today we’re about not just keeping good humor in questionable circumstances, but actively finding good humor in the those moments—even when the moments in question might not be generally described as good!
After all, laughter really can be the best medicine, for example:
From the roots
First a quick recap on de-toothing the psychological aspect of threats, no matter how menacing they may be:
Hello, Emotions: Time For Radical Acceptance!
…which we can then take a step further:
What’s The Worst That Could Happen?
Choose your frame
Do you remember when that hacker hacked and publicized the US Federal no-fly list, after already hacking a nationwide cloud-based security camera company, getting access to more than 150,000 companies’ and private individuals’ security cameras, amongst various other cyber crimes, mostly various kinds of fraud and data theft?
Imagine how she (age 21) must have felt, when being indicted. What do you suppose this hacker had to say for itself under such circumstances?
❝congress is investigating now 🙂
but i stay silly :3 ❞
…the latter half of which, usually rendered “but I stay silly” or “but we stay silly” has since entered popular Gen-Z parlance, usually after expressing some negative thing, often in a state of powerlessness.
Which is an important life skill if powerlessness is something that is often likely.
It’s important for many Gen-Zs with negligible life prospects economically; it’s equally important for 60-somethings getting cancer diagnoses (statistically the most likely decade to find out one has cancer, by the way), and many other kinds of people younger, older, and in between.
Because at the end of the day, we all start powerless and we all end powerless.
Learned helplessness (two kinds)
In psychology, “learned helplessness” occurs when a person or creature gives up after learning that all and any attempts to resist a Bad Thing™ fail, perhaps even badly. A lab rat may just shut down and sit there getting electroshocked, for example. A person subjected to abuse may stop trying to improve their situation, and just go with the path of least resistance.
But, there’s another kind, wherein someone in a position of absolute powerlessness not only makes their peace with that, but also, decides that the one thing the outside world can’t control, is how they take it. Like the hacker we mentioned earlier.
Sometimes the gallows humor is even more literal, laughing at one’s own impending death. Not as a matter of bravado, but genuinely seeing the funny side.
But how?
Unfortunately, fortunately
The trick here is to “find a silver lining” that is nowhere near enough to compensate for the bad thing—and it may even be worse! But that’s fine:
“Unfortunately, I didn’t have time to do the dishes before leaving for my vacation. Fortunately, I also forgot to turn the oven off, so the house burning down covered up my messy kitchen”
Writer’s personal less drastic example: today I set my espresso machine to press me an espresso; it doesn’t have an auto-off and I got distracted and it overflowed everywhere; my immediate reaction was “Oh! I have been blessed with an abundance of coffee!”
This kind of silly little thing, on a daily basis, builds a very solid habit for life that allows one to see the funny side in even the most absurd situations, even matters of life and death (can confirm: been there enough times personally—so far so good, still alive to find the remembered absurdity silly).
The point is not to genuinely value the “silver lining”, because half the time it isn’t even one, really, and it is useless to pretend, in seriousness.
But to pretend in silliness? Now we’re onto something, and the real benefit is in the laughs we had along the way.
Because those worst moments? Are probably when we need it the most, so it’s good to get some practice in!
Want more ways to find the funny and make it a life habit?
We reviewed a good book recently:
The Humor Habit: Rewire Your Brain To Stress Less, Laugh More, And Achieve More’er – by Paul Osincup
Stay silly!
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Fast Diet, Fast Exercise, Fast Improvements
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Diet & Exercise, Optimized
This is Dr. Michael Mosley. He originally trained in medicine with the intention of becoming a psychiatrist, but he grew disillusioned with psychiatry as it was practised, and ended up pivoting completely into being a health educator, in which field he won the British Medical Association’s Medical Journalist of the Year Award.
He also died under tragic circumstances very recently (he and his wife were vacationing in Greece, he went missing while out for a short walk on the 5th of June, appears to have got lost, and his body was found 100 yards from a restaurant on the 9th). All strength and comfort to his family; we offer our small tribute here today in his honor.
The “weekend warrior” of fasting
Dr. Mosley was an enjoyer (and proponent) of intermittent fasting, which we’ve written about before:
Fasting Without Crashing? We Sort The Science From The Hype
However, while most attention is generally given to the 16:8 method of intermittent fasting (fast for 16 hours, eat during an 8 hour window, repeat), Dr. Mosley preferred the 5:2 method (which generally means: eat at will for 5 days, then eat a reduced calorie diet for the other 2 days).
Specifically, he advocated putting that cap at 800 kcal for each of the weekend days (doesn’t have to be specifically the weekend).
He also tweaked the “eat at will for 5 days” part, to “eat as much as you like of a low-carb Mediterranean diet for 5 days”:
❝The “New 5:2” approach involves restricting calories to 800 on fasting days, then eating a healthy lower carb, Mediterranean-style diet for the rest of the week.
The beauty of intermittent fasting means that as your insulin sensitivity returns, you will feel fuller for longer on smaller portions. This is why, on non-fasting days, you do not have to count calories, just eat sensible portions. By maintaining a Mediterranean-style diet, you will consume all of the healthy fats, protein, fibre and fresh plant-based food that your body needs.❞
Read more: The Fast 800 | The New 5:2
And about that tweaked Mediterranean Diet? You might also want to check out:
Four Ways To Upgrade The Mediterranean Diet
Knowledge is power
Dr. Mosley encouraged the use of genotyping tests for personal health, not just to know about risk factors, but also to know about things such as, for example, whether you have the gene that makes you unable to gain significant improvements in aerobic fitness by following endurance training programs:
The Real Benefit Of Genetic Testing
On which note, he himself was not a fan of exercise, but recognised its importance, and instead sought to minimize the amount of exercise he needed to do, by practising High Intensity Interval Training. We reviewed a book of his (teamed up with a sports scientist) not long back; here it is:
Fast Exercise: The Simple Secret of High Intensity Training – by Dr. Michael Mosley & Peta Bee
You can also read our own article on the topic, here:
How To Do HIIT (Without Wrecking Your Body)
Just One Thing…
As well as his many educational TV shows, Dr. Mosley was also known for his radio show, “Just One Thing”, and a little while ago we reviewed his book, effectively a compilation of these:
Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley
Enjoy!
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