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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Discipline is Destiny – by Ryan Holiday
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We’ve previously reviewed another of Holiday’s books, The Daily Stoic, and here is another excellent work from the same author.
We’re not a philosophy newsletter, but there are some things that make a big difference to physical and mental health, the habits we build, and the path we take in life for better or for worse.
Self-discipline is one of those things. A lot of the time, we know what we need to do, but knowing isn’t the problem. We need to actually do it! This applies to diet, exercise, sleep, and more.
Holiday gives us, in a casual easy-reading style, timeless principles to lock in strong discipline and good habits for life.
The book’s many small chapters, by the way, are excellent for reading a chapter-per-day as a healthy dose of motivation each morning, if you’re so inclined.
Bottom line: if you’ve noticed that one of the biggest barriers between you and your goals is actually doing the necessary things in a disciplined fashion, then this book will help you become more efficient, and actually get there.
Click here to check out Discipline is Destiny, and upgrade yours!
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Walking… Better.
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Walking… Better.
We recently reviewed “52 Ways To Walk” by Annabel Streets. You asked us to share some more of our learnings from that book, and… Obviously we can’t do all 52, nor go into such detail, but here are three top tips inspired by that book…
Walk in the cold!
While cold weather is often seen as a reason to not walk, in fact, it has numerous health benefits, the most exciting of which might be:
Walking in the cold causes us to convert white and yellow fat into the healthier brown fat. If you didn’t know about this, neither did scientists until about 15 years ago.
In fact, scientists didn’t even know that adult humans could even have brown adipose tissue! It was really quite groundbreaking.
In case you missed it: The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
Work while you walk!
Obviously this is only appropriate for some kinds of work… but if in your life you have any kind of work that is chiefly thinking, a bunch of it can be done while walking.
Open your phone’s note-taking app, lock the screen and pocket your phone, and think on some problem that you need to solve. Whenever you have an “aha” moment, take out your phone and make a quick note on the go.
For that matter, if you have the money and space (or are fortunate to have an employer disposed towards facilitating such), you could even set up a treadmill desk… At worst, it wouldn’t harm your work (and it’ll be a LOT better than sitting for so long).
Walk within an hour of waking!
No, this doesn’t mean that if you don’t get out of the house within 60 minutes you say “Oh no, missed the window, guess it’s a day in today”
But it does mean: in the evening, make preparations to head out first thing in the morning. Set out your clothes and appropriate footwear, find your flask to fill with the beverage of your choice in the morning and set that with them.
Then, when morning arrives… do your morning necessaries (e.g. some manner of morning ablutions and perhaps a light breakfast), make that drink for your flask, and hit the road.
Why? We’ll tell you a secret:
You ever wondered why some people seem to be more able to keep a daylight-regulated circadian rhythm than others? It’s not just about smartphones and coffees…
This study found that getting sunlight (not electric light, not artificial sunlight, but actual sunlight, from the sun, even if filtered through partial cloud) between 08:30—09:00 resulted in higher levels of a protein called PER2. PER2 is critical for setting circadian rhythms, improving metabolism, and fortifying blood vessels.
Besides, on a more simplistic level, it’s also a wonderful and energizing start to a healthy and productive day!
Read: Beneficial effects of daytime light exposure on daily rhythms, metabolic state and affect
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Deskbound – by Kelly Starrett and Glen Cordoza
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We’ve all heard that “sitting is the new smoking”, and whether or not that’s an exaggeration (the jury’s out), one thing that is clear is that sitting is very bad.
Popular advice is “here’s how to sit with good posture and stretch your neck sometimes”… but that advice tends to come from companies that pay people to sit for a long time. They might not be the a very unbiased source.
Starrett and Cordoza offer better. After one opening chapter covering the multifarious ways sitting ruins our health, the rest of the book is all advice, covering:
- The principles of how the body is supposed to be
- The most important movements that we should be doing
- A dynamic workstation setup
- This is great, because “get a standing desk” tends to present more questions than answers, and can cause as much harm as good if done wrong
- The authors also cover how to progressively cut down on sitting, rather than try to go cold-turkey.
- They also recognize that not everyone can stand at all, and…
- Optimizing the sitting position, for when we must sit
- Exercises to maintain our general mobility and compensate about as well as we can for the body-unfriendly nature of modern life.
The book is mostly explanations, so at 682 pages, you can imagine it’s not just “get up, lazybones!”. Rather, things are explained in such detail (and with many high-quality medical diagrams) so that we can truly understand them.
Most of us have gone through life knowing we should have “better posture” and “move more”… but without the details, that can be hard to execute correctly, and worse, we can even sabotage our bodies unknowingly with incorrect form.
This book straightens all that out very comprehensively, and we highly recommend it.
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Which Magnesium? (And: When?)
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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
❝Good morning! I have been waiting for this day to ask: the magnesium in my calcium supplement is neither of the two versions you mentioned in a recent email newsletter. Is this a good type of magnesium and is it efficiently bioavailable in this composition? I also take magnesium that says it is elemental (oxide, gluconate, and lactate). Are these absorbable and useful in these sources? I am not interested in taking things if they aren’t helping me or making me healthier. Thank you for your wonderful, informative newsletter. It’s so nice to get non-biased information❞
Thank you for the kind words! We certainly do our best.
For reference: the attached image showed a supplement containing “Magnesium (as Magnesium Oxide & AlgaeCal® l.superpositum)”
Also for reference: the two versions we compared head-to-head were these very good options:
Magnesium Glycinate vs Magnesium Citrate – Which is Healthier?
Let’s first borrow from the above, where we mentioned: magnesium oxide is probably the most widely-sold magnesium supplement because it’s cheapest to make. It also has woeful bioavailability, to the point that there seems to be negligible benefit to taking it. So we don’t recommend that.
As for magnesium gluconate and magnesium lactate:
- Magnesium lactate has very good bioavailability and in cases where people have problems with other types (e.g. gastrointestinal side effects), this will probably not trigger those.
- Magnesium gluconate has excellent bioavailability, probably coming second only to magnesium glycinate.
The “AlgaeCal® l.superpositum” supplement is a little opaque (and we did ntoice they didn’t specify what percentage of the magnesium is magnesium oxide, and what percentage is from the algae, meaning it could be a 99:1 ratio split, just so that they can claim it’s in there), but we can say Lithothamnion superpositum is indeed an algae and magnesium from green things is usually good.
Except…
It’s generally best not to take magnesium and calcium together (as that supplement contains). While they do work synergistically once absorbed, they compete for absorption first so it’s best to take them separately. Because of magnesium’s sleep-improving qualities, many people take calcium in the morning, and magnesium in the evening, for this reason.
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
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Behaving During the Holidays
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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
❝It’s hard to “behave” when it comes to holiday indulging…I’m on a low sodium, sugar restricted regimen from my doctor. Trying to get interested in bell peppers as a snack…wish me luck!❞
Good luck! Other low sodium, low sugar snacks include:
- Nuts! Unsalted, of course. We’re biased towards almonds 😉
- Mixed nuts are an especially healthy way to snack, though (assuming you don’t have an allergy, obviously)
- Air-popped popcorn (you can season it, just not with salt/sugar!)
- Fruit (but not fruit juice; it has to be in solid form)
- Peas (not a classic snack food, we know, but they can be enjoyed many ways)
- Seriously, try them frozen or raw! Frozen/raw peas are a great sweet snack.
- Chickpeas are great dried/roasted, by the way, and give much of the same pleasure as a salty snack without being salty! Obviously, this means cooking them without salt, but that’s fine, or if using tinned, choose “in water” rather than “in brine”
- Hummus is also a great healthy snack (check the ingredients for salt if not making it yourself, though) and can be enjoyed as a dip using raw vegetables (celery, carrot sticks, cruciferous vegetables, whatever you prefer)
Enjoy!
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- Nuts! Unsalted, of course. We’re biased towards almonds 😉
Managing Chronic Pain (Realistically!)
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Realistic chronic pain management
We’ve had a number of requests to do a main feature on managing chronic pain, so here it is!
A quick (but important) note before we begin:
Obviously, not all chronic pain is created equal. Furthermore, we know that you, dear reader with chronic pain, have been managing yours for however long you have, learning as you go. You also doubtlessly know your individual condition inside out.
We also know that people with chronic health conditions in general are constantly beset by well-meaning unsolicited advice from friends and family, asking if you’ve heard about [thing you heard about 20 years ago] that will surely change your life and cure you overnight.
It’s frustrating, and we’re going to try to avoid doing that here, while still offering the advice that was asked for. We ask you, therefore, to kindly overlook whatever you already knew, and if you already knew it all, well, we salute you and will not be surprised if that’s the case for at least some readers. Chronic pain’s a… Well, it’s a chronic pain.
All that said, let’s dive in…
How are you treating your body right now?
Are you hydrated; have you eaten; are you standing/sitting/lying in a position that at least should be comfortable for you in principle?
The first two things affect pain perception; the latter can throw a spanner in the works if something’s not quite right.
Move your body (gently!)
You know your abilities, so think about the range of motion that you have, especially in the parts of your body that hurt (if that’s “everywhere”, then, our sympathies, and we hope you find the same advice applies). Think about your specific muscles and joints as applicable, and what the range of motion is “supposed” to be for each. Exercise your range of motion as best you can (gently!) to the point of its limit(s) and/or pain.
- If you take it past that limit, there is a good chance you will make it worse. You don’t want that.
- If you don’t take it to the limit, there is a good chance your range of movement will deteriorate, and your “safe zone” (i.e., body positions that are relatively free from pain) will diminish. You definitely don’t want that, either.
Again, moderation is key. Yes, annoying as the suggestion may be, such things as yoga etc can help, if done carefully and gently. You know your limits; work with those, get rest between, and do what you can.
For most people this will at least help keep the pain from getting worse.
Hot & Cold
Both of these things could ease your pain… Or make it worse. There is an element of “try it and see”, but here’s a good general guide:
Here’s How to Choose Between Using Ice or Heat for Pain
Meditation… Or Distraction
Meditating really does help a lot of people. In the case of pain, it can be counterintuitively helpful to focus for a while on the sensation of the pain… But in a calm, detached fashion. Without judgement.
“Yes, I am experiencing pain. Yes, it feels like I’m being stabbed with hot knives. Yes, this is tortuous; wow, I feel miserable. This truly sucks.”
…it doesn’t sound like a good experience, does it? And it’s not, but paying it attention this way can paradoxically help ease things. Pain is, after all, a messenger. And in the case of chronic pain, it’s in some ways a broken messenger, but what a messenger most needs is to be heard.
The above approach a) is good b) may have a limit in how long you can sustain it at a time, though. So…
The opposite is a can be a good (again, short-term) approach too. Call a friend, watch your favorite movie, play a video game if that’s your thing. It won’t cure anything, but it can give you a little respite.
Massage
Unless you already know this makes your pain worse, this is a good thing to try. It doesn’t have to be a fancy spa; if the nature of your pain and condition permits, you can do self-massage. If you have a partner or close friend who can commit to helping, it can be very worth them learning to give a good massage. There are often local courses available, and failing that, there is also YouTube.
Here’s an example of a good video for myofascial release massage, which can ease a lot of common kinds of chronic pain:
Some quick final things to remember:
- If you find something helps, then it helps, do that.
- That goes for mobility aids and other disability aids too, even if it was designed for a different disability. If it helps, it helps. You’re not stealing anyone’s thunder (or resources) by using something that makes your life easier. We’re not in this life to suffer!
- There is no such thing as “this pain is not too much”. The correct amount of pain is zero. Maybe your body won’t let you reach zero, but more than that is “too much” already.
- You don’t have to be suffering off the scale to deserve relief from pain
Don’t Forget…
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