Avoiding/Managing Osteoarthritis

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Avoiding/Managing Osteoarthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation).

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

Some forms, such as rheumatoid arthritis, are of the inflammatory kind. We wrote about that previously:

See: Avoiding/Managing Rheumatoid Arthritis

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause.

So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can; it’s just not the prime focus.

So, what should we focus on?

First and foremost: avoiding wear-and-tear if possible. Naturally, we all must live our lives, and sometimes that means taking a few knocks, and definitely it means using our joints. An unused joint would suffer just as much as an abused one. But, we can take care of our joints!

We wrote on that previously, too:

See: How To Really Look After Your Joints

New osteoarthritis medication (hot off the press!)

At 10almonds, we try to keep on top of new developments, and here’s a shiny new one from this month:

Note also that Dr. Flavia Cicuttini there talks about what we talked about above—that calling it non-inflammatory arthritis is a little misleading, as the inflammation still occurs.

And finally…

You might consider other lifestyle adjustments to manage your symptoms. These include:

  • Exercise—gently, though!
  • Rest—while keeping mobility going.
  • Mobility aids—if it helps, it helps.
  • Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility.
    • Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

See: Managing Chronic Pain (Realistically!)

Take good care of yourself!

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  • How Ibogaine Can Beat Buprenorphine For Beating Addictions

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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

    ❝Questions?❞

    It seems that this week, everyone was so satisfied with our information, that we received no questions! (If you sent one and we somehow missed it, please accept our apologies and do bring our attention to it)

    However, we did receive some expert feedback that we wanted to share because it’s so informative:

    ❝I work at a detox rehab in Mexico, where we can use methods not legal in the United States. Therefore, while much of the linked articles had useful information, I’m in the “trenches” every day, and there’s some information I’d like to share that you may wish to share, with additional information:

    1. Buprenorphine is widely used and ineffective for addiction because it’s synthetic and has many adverse side effects. For heavy drug users it isn’t enough and they still hit the streets for more opioid, resulting in fentanyl deaths. Depending on length of usage and dose, it can take WEEKS to get off of, and it’s extremely difficult.
    2. Ibogaine is the medicine we use to detox people off opiates, alcohol, meth as well as my own specialty, bulimia. It’s psychoactive and it temporarily “resets” the brain to a pre-addictive state. Supplemented by behavior and lifestyle changes, as well as addressing the traumas that led to the addiction is extremely effective.

    Our results are about 50%, meaning the client is free of the substance or behavior 1 year later. Ibogaine isn’t a “magic pill” or cure, it’s an opening tool that makes the difficult work of reclaiming one’s life easier.

    Ibogaine is not something that should be done outside a medical setting. It requires an EKG to ensure the heart is healthy and doesn’t have prolonged QT intervals; also blood testing to ensure organs are functioning (especially the liver) and mineral levels such as magnetic and potassium are where they should be. It is important that this treatment be conducted by experienced doctors or practitioners, and monitoring vital signs constantly is imperative.

    I’m taking time to compose this information because it needs to be shared that there is an option available most people have not heard about.❞

    ~ 10almonds reader (slightly edited for formatting and privacy)

    Thank you for that! Definitely valuable information for people to know, and (if applicable for oneself or perhaps a loved one) ask about when it comes to local options.

    We see it’s also being studied for its potential against other neurological conditions, too:

    ❝The combination of ibogaine and antidepressants produces a synergistic effect in reducing symptoms of psychiatric disorders such as bipolar disorder, depression, schizophrenia, paranoia, anxiety, panic disorder, mania, post-traumatic stress disorder (PTSD), and obsessive–compulsive disorder. Though ibogaine and the antidepressant act in different pathways, together they provide highly efficient therapeutic responses compared to when each of the active agents is used alone.❞

    ~ Dr. Robert Kargbo

    Read more: Ibogaine and Their Analogs as Therapeutics for Neurological and Psychiatric Disorders

    For those who missed it, today’s information about ibogaine was in response to our article:

    Let’s Get Letting Go (Of These Three Things)

    …which in turn referenced our previous main feature:

    Which Addiction-Quitting Methods Work Best?

    Take care!

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  • Native Americans Have Shorter Life Spans. Better Health Care Isn’t the Only Answer.

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    HISLE, S.D. — Katherine Goodlow is only 20, but she has experienced enough to know that people around her are dying too young.

    Goodlow, a member of the Lower Brule Sioux Tribe, said she’s lost six friends and acquaintances to suicide, two to car crashes, and one to appendicitis. Four of her relatives died in their 30s or 40s, from causes such as liver failure and covid-19, she said. And she recently lost a 1-year-old nephew.

    “Most Native American kids and young people lose their friends at a young age,” said Goodlow, who is considering becoming a mental health therapist to help her community. “So, I’d say we’re basically used to it, but it hurts worse every time we lose someone.”

    Native Americans tend to die much earlier than white Americans. Their median age at death was 14 years younger, according to an analysis of 2018-21 data from the Centers for Disease Control and Prevention

    The disparity is even greater in Goodlow’s home state. Indigenous South Dakotans who died between 2017 and 2021 had a median age of 58 — 22 years younger than white South Dakotans, according to state data.

    Donald Warne, a physician who is co-director of the Johns Hopkins Center for Indigenous Health and a member of the Oglala Sioux Tribe, can rattle off the most common medical conditions and accidents killing Native Americans.

    But what’s ultimately behind this low life expectancy, agree Warne and many other experts on Indigenous health, are social and economic forces. They argue that in addition to bolstering medical care and fully funding the Indian Health Service — which provides health care to Native Americans — there needs to be a greater investment in case management, parenting classes, and home visits.

    “It’s almost blasphemy for a physician to say,” but “the answer to addressing these things is not hiring more doctors and nurses,” Warne said. “The answer is having more community-based preventions.”

    The Indian Health Service funds several kinds of these programs, including community health worker initiatives, and efforts to increase access to fresh produce and traditional foods.

    Private insurers and state Medicaid programs, including South Dakota’s, are increasingly covering such services. But insurers don’t pay for all the services and aren’t reaching everyone who qualifies, according to Warne and the National Academy for State Health Policy.

    Warne pointed to Family Spirit, a program developed by the Johns Hopkins center to improve health outcomes for Indigenous mothers and children.

    Chelsea Randall, the director of maternal and child health at the Great Plains Tribal Leaders’ Health Board, said community health workers educate Native pregnant women and connect them with resources during home visits.

    “We can be with them throughout their pregnancy and be supportive and be the advocate for them,” said Randall, whose organization runs Family Spirit programs across seven reservations in the Dakotas, and in Rapid City, South Dakota.

    The community health workers help families until children turn 3, teaching parenting skills, family planning, drug abuse prevention, and stress management. They can also integrate the tribe’s culture by, for example, using their language or birthing traditions.

    The health board funds Family Spirit through a grant from the federal Health Resources and Services Administration, Randall said. Community health workers, she said, use some of that money to provide child car seats and to teach parents how to properly install them to counter high rates of fatal crashes.

    Other causes of early Native American deaths include homicide, drug overdoses, and chronic diseases, such as diabetes, Warne said. Native Americans also suffer a disproportionate number of infant and maternal deaths.

    The crisis is evident in the obituaries from the Sioux Funeral Home, which mostly serves Lakota people from the Pine Ridge Reservation and surrounding area. The funeral home’s Facebook page posts obituaries for older adults, but also for many infants, toddlers, teenagers, young adults, and middle-aged residents.

    Misty Merrival, who works at the funeral home, blames poor living conditions. Some community members struggle to find healthy food or afford heat in the winter, she said. They may live in homes with broken windows or that are crowded with extended family members. Some neighborhoods are strewn with trash, including intravenous needles and broken bottles.

    Seeing all these premature deaths has inspired Merrival to keep herself and her teenage daughter healthy by abstaining from drugs and driving safely. They also talk every day about how they’re feeling, as a suicide-prevention strategy.

    “We’ve made a promise to each other that we wouldn’t leave each other like that,” Merrival said.

    Many Native Americans live in small towns or on poor, rural reservations. But rurality alone doesn’t explain the gap in life expectancy. For example, white people in rural Montana live 17 years longer, on average, than Native Americans in the state, according to state data reported by Lee Enterprises newspapers.

    Many Indigenous people also face racism or personal trauma from child or sexual abuse and exposure to drugs or violence, Warne said. Some also deal with generational trauma from government programs and policies that broke up families and tried to suppress Native American culture.

    Even when programs are available, they’re not always accessible.

    Families without strong internet connections can’t easily make video appointments. Some lack cars or gas money to travel to clinics, and public transportation options are limited.

    Randall, the health board official, is pregnant and facing her own transportation struggles.

    It’s a three-hour round trip between her home in the town of Pine Ridge and her prenatal appointments in Rapid City. Randall has had to cancel several appointments when family members couldn’t lend their cars.

    Goodlow, the 20-year-old who has lost several loved ones, lives with seven other people in her mother’s two-bedroom house along a gravel road. Their tiny community on the Pine Ridge Reservation has homes and ranches but no stores.

    Goodlow attended several suicide-prevention presentations in high school. But the programs haven’t stopped the deaths. One friend recently killed herself after enduring the losses of her son, mother, best friend, and a niece and nephew.

    A month later, another friend died from a burst appendix at age 17, Goodlow said. The next day, Goodlow woke up to find one of her grandmother’s parakeets had died. That afternoon, she watched one of her dogs die after having seizures.

    “I thought it was like some sign,” Goodlow said. “I started crying and then I started thinking, ‘Why is this happening to me?’”

    Warne said the overall conditions on some reservations can create despair. But those same reservations, including Pine Ridge, also contain flourishing art scenes and language and cultural revitalization programs. And not all Native American communities are poor.

    Warne said federal, state, and tribal governments need to work together to improve life expectancy. He encourages tribes to negotiate contracts allowing them to manage their own health care facilities with federal dollars because that can open funding streams not available to the Indian Health Service.

    Katrina Fuller is the health director at Siċaŋġu Co, a nonprofit group on the Rosebud Reservation in South Dakota. Fuller, a member of the Rosebud Sioux Tribe, said the organization works toward “wicozani,” or the good way of life, which encompasses the physical, emotional, cultural, and financial health of the community.

    Siċaŋġu Co programs include bison restoration, youth development, a Lakota language immersion school, financial education, and food sovereignty initiatives.

    “Some people out here that are struggling, they have dreams, too. They just need the resources, the training, even the moral support,” Fuller said. “I had one person in our health coaching class tell me they just really needed someone to believe in them, that they could do it.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Glucomannan For Weight Loss, Gut Health, & More

    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.

    Glucomannan is a water-soluble dietary fiber found in the root of the konjac plant.

    If you’ve had konjac noodles, also called shirataki, that’s what those are mostly made of, and it’s why they have next-to-no calories.

    You may be wondering: if it’s water-soluble, how do the noodles not dissolve in water? And the answer is that the noodle-making process involves making a gel out of the fiber and water, which is then extruded into noodle shapes. In this gelatinous form, they’re fairly stable (it’s one of the most viscous dietary fibers), but yes, if you were to boil them for a long time, they would indeed turn the entire liquid contents of the saucepan into gel.

    How it works for weight loss

    Because of its viscosity, adding even a small amount of powdered* glucomannan to a glass of water will turn the whole thing into gel in seconds. This means that if you take glucomannan capsules with a glass of water, then so far as your stomach is concerned, you just ate a cup of gel, and the water is now processed as food, staying longer in the stomach than it otherwise would, and promoting feelings of fullness.

    *i.e. dry powder, not in a gelatinous form like the noodles

    As for its efficacy in weight loss, see for example:

    ❝Glucomannan was well-tolerated and resulted in significant weight loss in overweight and obese individuals❞

    Read more: Glucomannan and obesity: a critical review

    So, that covers the basic requirements, but may be wondering: does it have other benefits? And the answer is yes, it does:

    ❝Glucomannan appears to beneficially affect total cholesterol, LDL cholesterol, triglycerides, body weight, and fasting blood glucose❞

    Read more: Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis

    To further corroborate that and comment on safety…

    ❝Results showed a significant mean weight loss using glucomannan over an eight-week period. Serum cholesterol and low-density lipoprotein cholesterol were significantly reduced in the glucomannan treated group. No adverse reactions to glucomannan were reported.❞

    Read more: Effect of glucomannan on obese patients: a clinical study

    As to whether other gel-making agents work the same way, the answer is no, they don’t seem to:

    ❝Glucomannan induced body weight reduction in healthy overweight subjects, whereas the addition of guar gum and alginate did not seem to cause additional loss of weight❞

    Read more: Experiences with three different fiber supplements in weight reduction

    How it works for gut health

    In the words of Dr. Yu Li et al.,

    ❝Konjaku flour can achieve positive effects on treating obesity, which manifest on reducing BMI, fat mass, blood glucose, and blood lipid, improving hepatic function, and also regulating intestinal microfloral structure.

    Therefore, changes in gut microbiota may explain in part the effects of konjaku flour.❞

    Read in full: Effects of Konjaku Flour on the Gut Microbiota of Obese Patients

    This has extra positive knock-on effects too:

    Glucomannan promotes Bacteroides ovatus to improve intestinal barrier function and ameliorate insulin resistance

    Want to try some?

    We don’t sell it, but here for your convenience are example products on Amazon:

    Konjac noodles | Glucomannan capsules

    Enjoy!

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  • The Procrastination Cure – by Jeffery Combs

    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.

    Why do we procrastinate? It’s not usually because we are lazy, and in fact we can often make ourselves very busy while procrastinating. And at some point, the bad feelings about procrastinating become worse than the experience of actually doing the thing. And still we often procrastinate. So, why?

    Jeffery Combs notes that the reasons can vary, but generally fall into six mostly-distinct categories. He calls them:

    1. The neurotic perfectionist
    2. The big deal chaser
    3. The chronic worrier
    4. The rebellious rebel
    5. The drama addict
    6. The angry giver

    These may overlap somewhat, but the differences are important when it comes to differences of tackling them.

    Giving many illustrative examples, Combs gives the reader all we’ll need to know which category (or categories!) we fall into.

    Then, he draws heavily on the work of Dr. Albert Ellis to find ways to change the feelings that we have that are holding us back.

    Those feelings might be fear, shame, resentment, overwhelm, or something else entirely, but the tools are in this book.

    A particular strength of this book is that it takes an approach that’s essentially Rational Emotive Behavior Therapy (REBT) repackaged for a less clinically-inclined audience (Combs’ own background is in marketing, not pyschology). Thus, for many readers, this will tend to make the ideas more relatable, and the implementations more accessible.

    Bottom line: if you’ve been meaning to figure out how to beat your procrastination, but have been putting it off, now’s the time to do it.

    Click here to check out The Procrastination Cure sooner rather than later!

    Don’t Forget…

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  • Antidepressants: Personalization Is Key!

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    Antidepressants: Personalization Is Key!

    Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:

    • Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
    • Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
    • Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
    • Four respondents said “They are no better than placebo, and are more likely to harm”
    • Two respondents said “They merely mask the problem, and thus don’t really help”

    So what does the science say?

    ❝They are no better than placebo, and are more likely to harm? True or False?❞

    True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:

    Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.

    Otherwise it is like getting a flu shot and being surprised when you still catch a cold!

    ❝They merely mask the problem, and thus don’t really help: True or False?❞

    False, categorically.

    The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).

    ❝They may help some people, but the side-effects are alarming: True or False?❞

    True or False depending on more factors than we can cover here.

    Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.

    One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.

    ❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞

    True! Contingently.

    That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.

    *common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.

    For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.

    Want to know more about the different kinds?

    Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:

    Mind | Comparing Antidepressants

    Want a drug-free approach?

    You might like our previous main feature:

    The Mental Health First-Aid That You’ll Hopefully Never Need

    Take care!

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  • Why do I poo in the morning? A gut expert explains

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    No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.

    But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?

    To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.

    Here’s what the science says.

    H_Ko/Shutterstock

    So morning poos are real?

    In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.

    The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.

    About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.

    But why the morning?

    There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.

    For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.

    There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.

    Diagram of digestive system including colon and rectum
    Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock

    But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.

    One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.

    Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.

    Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.

    How important are morning poos?

    Large international surveys show the vast majority of people will poo between three times a day and three times a week.

    This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.

    So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.

    Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.

    Can you train yourself to be regular?

    Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.

    A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.

    Man preparing Italian style coffee at home, adding coffee to pot
    A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock

    Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.

    We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.

    Fibre from fruits and vegetables also helps make bowel motions more regular.

    Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.

    Monitoring your bowel habits

    Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.

    If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.

    But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.

    Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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