Topping Up Testosterone?

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The Testosterone Drop

Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.

(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)

This has been called “the male menopause”, or “the andropause”.

Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.

Why “the male menopause” is misleading:

To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).

Why “the andropause” is misleading:

It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.

Is there a better clinical term?

Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.

Terms aside, what are the symptoms?

❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞

(Read more)

…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:

Source: Andropause: Current concepts

Can it be safely ignored?

If you don’t mind the sexual symptoms, then mostly, yes!

However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:

  • Depression
  • Loss of muscle mass
  • Increased body fat

Depression kills, so this does need to be taken seriously. See also:

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

(the above is a guide to managing depression, in yourself or a loved one)

Loss of muscle mass means being less robust against knocks and falls later in life

Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)

See also:

Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.

Will testosterone therapy help?

That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).

See for example:

Testosterone Therapy Improves […] and […] in Hypogonadal Men

(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)

Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:

❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.

The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).

Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞

Source: Effects of Testosterone Treatment in Older Men

We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.

That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).

And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)

Click here to see the results table for the vitality trial

Will it turn me into a musclebound angry ragey ‘roidmonster?

Were you that kind of person before your testosterone levels declined? If not, then no.

Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.

Is testosterone therapy safe?

A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.

As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…

❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development

For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.

Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞

Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:

Risks of testosterone replacement therapy in men

See also: Prostate Health: What You Should Know

Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!

For now, take care!

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  • The DASH Diet Mediterranean Solution – by Dr. Marla Heller

    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.

    Sometimes, an author releases a series of books that could have just been one book, with various padding and rehashes. In some cases, naming no names Dr. Mark Hyman, it means we have to carefully pick out the honestly very good and highly recommendable ones from the “you just republished for the extra income, didn’t you?” ones.

    In this case, today’s book is part of a series of books with very similar titles, and this one seems the most useful as a standalone book

    The Mediterranean Diet is still the scientific world’s current “gold standard” in terms of most evidence-based diet for general health, and as we’ve written about, it can be tweaked to focus on being best for [your particular concern here]. In this case, it’s the DASH variant of the Mediterranean Diet, considered best for heart health specifically.

    The style is repetitive, and possibly indicative of the author getting into a habit of having to pad books. Nevertheless, saying things too often is better than forgetting to say them, so hey. On which note, it is more of an educational book than a cookbook—it does have recipes, but not many.

    Bottom line: if you’d like an introduction to the DASH variant of the Mediterranean Diet, this book will get you well-acquainted.

    Click here to check out The DASH Diet Mediterranean Solution, and learn all about it!

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  • How Much Weight Gain Do Antidepressants Cause?

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    There’s a lot of talk in the news lately about antidepressants and weight gain, so let’s look at some numbers.

    Here’s a study from July 2024 that compared the weight gain of eight popular antidepressants, and pop-science outlets have reported it with such snippets as:

    Bupropion users were approximately 15–20% less likely to gain a clinically significant amount of weight than those taking the most common medication, sertraline.

    The researchers considered weight gain of 5% or more as clinically significant.❞

    Read in full: Study compares weight gain across eight common antidepressants

    At this point, you might (especially if you or a loved one is on sertraline) be grabbing a calculator and seeing what 5% of your weight is, and might be concerned at the implications.

    However, this is a little like if, in our This or That section, we were to report that food A has 17x more potassium than food B, without mentioning that food A has 0.01mg/100g and food A has 0.17mg/100g, and thus that, while technically “17x more”, the difference is trivial.

    As a quick aside: we do, by the way, try to note when things like that might skew the stats and either wipe them out by not mentioning that they contain potassium at all (as they barely do), or if it’s a bit more, describing them as being “approximately equal in potassium” or else draw attention to the “but the amounts are trivial in both cases”.

    Back to the antidepressants: in fact, for those two antidepressants compared in that snippet, the truth is (when we go looking in the actual research paper and the data within):

    • sertraline was associated with an average weight change of +1.5kg (just over 3lb) over the course of 24 months
    • bupropion was associated with an average weight change of +0.5kg (just under 1lb) over the course of 24 months

    Sertraline being the most weight-gain-inducing of the 8 drugs compared, and bupropion being the least, this means (with them both having fairly even curves):

    • sertraline being associated with an average weight change of 0.06kg (about 2oz) per month
    • bupropion being associated with an average weight change of 0.02kg (less than 1oz) per month

    For all eight, see the chart here in the paper itself:

    Medication-Induced Weight Change Across Common Antidepressant Treatments ← we’ve made the link go straight to the chart, for your convenience, but you can also read the whole paper there

    While you’re there, you might also see that for some antidepressants, such as duloxetine, fluoxetine, and venlafaxine, there’s an initial weight gain, but then it clearly hits a plateau and weight ceases to change after a certain point, which is worth considering too, since “you’ll gain a little bit of weight and then stay at that weight” is a very different prognosis from “you’ll gain a bit of weight and keep gaining it forever until you die”.

    But then again, consider this:

    Most adults will gain half a kilo this year – and every year. Here’s how to stop “weight creep”

    That’s more weight gain than one gets on sertraline, the most weight-gain-inducing antidepressant tested!

    What about over longer-term use?

    Here’s a more recent study (December 2024) that looked at antidepressant use over 6 years, and found an average 2% weight gain over those 6 years, but it didn’t break it down by antidepressant type, sadly:

    Trajectories of antidepressant use and 6-year change in body weight: a prospective population-based cohort study

    …which seems like quite a wasted opportunity, since some of the medications considered are very different, working on completely different systems (for example, SSRIs vs NDRIs, working on serotonin or norepinephrine+dopamine, respectively—see our Neurotransmitter Cheatsheet for more about those) and having often quite different side effects. Nevertheless, the study (despite collecting this information) didn’t then tabulate the data, and instead considered them all to be the same factor, “antidepressants”.

    What this study did do that was useful was included a control group not on antidepressants so we know that on average:

    • never-users of antidepressants gained an average of 1% of their bodyweight over those 6 years
    • users-and-desisters of antidepressants gained an average of 1.8% of their bodyweight over those 6 years*
    • continuing users of antidepressants gained an average of 2% of their bodyweight over those 6 years

    *for this group, weight gain was a commonly cited reason for stopping taking the antidepressants in question

    Writer’s anecdote: I’ve been on mirtazapine (a presynaptic alpha2-adrenoreceptor antagonist which increases central noradrenergic and serotonergic neurotransmission) for some years and can only say that I wish I’d been on it decades previously. I requested mirtazapine specifically, because I’m me and I know my stuff and considered it would most likely be by far the best fit for me out of the options available. Starting at a low dose, the only meaningful side effect was mild sedation (expected, and associated only with low-dose use); increasing after a couple of weeks to a moderate dose, that side effect disappeared and now the only remaining side effect is a slight dryness of the mouth, which is fine, as it ensures I remember to stay hydrated 🙂 anyway, my weight hasn’t changed (beyond very small temporary fluctuations) in the time I’ve been on mirtazapine. Disclaimer: the plural of anecdote is not data, and I can only speak for my own experience, and am not making any particular recommendation here. Your personal physiology will be different from mine, and may respond well or badly to any given treatment according to your own physiology.

    Further considerations

    This is touched on in the “Discussion” section of the latter paper (so do check that out if you want all the details, more than we can reasonably put here), but there are other factors to consider, for example:

    • whether people were underweight/healthy weight/overweight at baseline (sometimes, a weight gain can be a good thing, recovering from an illness, and in the case of the illness that is depression, weight can swing either way)
    • antidepressants changing eating and exercise habits (generally speaking: more likely to eat more and exercise more)
    • body composition! How did they not cover this (neither paper did)?! Muscle weighs more than fat, and improvements in exercise can result in an increase in muscle and thus an increase in overall weight.

    As researchers like to say, “this highlights the need for more high-quality studies to look into…” (and then the various things that went unexamined).

    Want to know more?

    Check out our previous main feature:

    Antidepressants: Personalization Is Key!

    Take care!

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  • The Pegan Diet – by Dr. Mark Hyman

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    First things first: the title of the book is a little misleading. “Pegan” is a portmanteau of “paleo” and “vegan”, making it sound like it will be appropriate for both of those dietary practices. Instead:

    • Dr. Hyman offers advice about eating the right grains and legumes (inappropriate for a paleo diet)
    • He also offers such advice as “be picky about poultry, eggs, and fish”, and “avoid dairy—mostly” (inappropriate for a vegan diet).

    So, since his paleo vegan diet is neither paleo nor vegan, what actually is it?

    It’s a whole foods diet that encourages the enjoyment of a lot of plants, and discretion with regard to the quality of animal products.

    It’s a very respectable approach to eating, even if it didn’t live up to the title.

    The style is somewhat sensationalist, while nevertheless including plenty of actual science in there too—so the content is good, even if the presentation isn’t what this reviewer would prefer.

    He has recipes; they can be a little fancy (e.g. “matcha poppy bread with rose water glaze”) which may not be to everyone’s taste, but they are healthy.

    Bottom line: the content is good; the style you may love or hate, and again, don’t be misled by the title.

    Click here to check out The Pegan Diet, if you want to be healthy and/but eat neither paleo nor vegan!

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  • Women and Minorities Bear the Brunt of Medical Misdiagnosis

    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.

    Charity Watkins sensed something was deeply wrong when she experienced exhaustion after her daughter was born.

    At times, Watkins, then 30, had to stop on the stairway to catch her breath. Her obstetrician said postpartum depression likely caused the weakness and fatigue. When Watkins, who is Black, complained of a cough, her doctor blamed the flu.

    About eight weeks after delivery, Watkins thought she was having a heart attack, and her husband took her to the emergency room. After a 5½-hour wait in a North Carolina hospital, she returned home to nurse her baby without seeing a doctor.

    When a physician finally examined Watkins three days later, he immediately noticed her legs and stomach were swollen, a sign that her body was retaining fluid. After a chest X-ray, the doctor diagnosed her with heart failure, a serious condition in which the heart becomes too weak to adequately pump oxygen-rich blood to organs throughout the body. Watkins spent two weeks in intensive care.

    She said a cardiologist later told her, “We almost lost you.”

    Watkins is among 12 million adults misdiagnosed every year in the U.S.

    In a study published Jan. 8 in JAMA Internal Medicine, researchers found that nearly 1 in 4 hospital patients who died or were transferred to intensive care had experienced a diagnostic error. Nearly 18% of misdiagnosed patients were harmed or died.

    In all, an estimated 795,000 patients a year die or are permanently disabled because of misdiagnosis, according to a study published in July in the BMJ Quality & Safety periodical.

    Some patients are at higher risk than others.

    Women and racial and ethnic minorities are 20% to 30% more likely than white men to experience a misdiagnosis, said David Newman-Toker, a professor of neurology at Johns Hopkins School of Medicine and the lead author of the BMJ study. “That’s significant and inexcusable,” he said.

    Researchers call misdiagnosis an urgent public health problem. The study found that rates of misdiagnosis range from 1.5% of heart attacks to 17.5% of strokes and 22.5% of lung cancers.

    Weakening of the heart muscle — which led to Watkins’ heart failure — is the most common cause of maternal death one week to one year after delivery, and is more common among Black women.

    Heart failure “should have been No. 1 on the list of possible causes” for Watkins’ symptoms, said Ronald Wyatt, chief science and chief medical officer at the Society to Improve Diagnosis in Medicine, a nonprofit research and advocacy group.

    Maternal mortality for Black mothers has increased dramatically in recent years. The United States has the highest maternal mortality rate among developed countries. According to the Centers for Disease Control and Prevention, non-Hispanic Black mothers are 2.6 times as likely to die as non-Hispanic white moms. More than half of these deaths take place within a year after delivery.

    Research shows that Black women with childbirth-related heart failure are typically diagnosed later than white women, said Jennifer Lewey, co-director of the pregnancy and heart disease program at Penn Medicine. That can allow patients to further deteriorate, making Black women less likely to fully recover and more likely to suffer from weakened hearts for the rest of their lives.

    Watkins said the diagnosis changed her life. Doctors advised her “not to have another baby, or I might need a heart transplant,” she said. Being deprived of the chance to have another child, she said, “was devastating.”

    Racial and gender disparities are widespread.

    Women and minority patients suffering from heart attacks are more likely than others to be discharged without diagnosis or treatment.

    Black people with depression are more likely than others to be misdiagnosed with schizophrenia.

    Minorities are less likely than whites to be diagnosed early with dementia, depriving them of the opportunities to receive treatments that work best in the early stages of the disease.

    Misdiagnosis isn’t new. Doctors have used autopsy studies to estimate the percentage of patients who died with undiagnosed diseases for more than a century. Although those studies show some improvement over time, life-threatening mistakes remain all too common, despite an array of sophisticated diagnostic tools, said Hardeep Singh, a professor at Baylor College of Medicine who studies ways to improve diagnosis.

    “The vast majority of diagnoses can be made by getting to know the patient’s story really well, asking follow-up questions, examining the patient, and ordering basic tests,” said Singh, who is also a researcher at Houston’s Michael E. DeBakey VA Medical Center. When talking to people who’ve been misdiagnosed, “one of the things we hear over and over is, ‘The doctor didn’t listen to me.’”

    Racial disparities in misdiagnosis are sometimes explained by noting that minority patients are less likely to be insured than white patients and often lack access to high-quality hospitals. But the picture is more complicated, said Monika Goyal, an emergency physician at Children’s National Hospital in Washington, D.C., who has documented racial bias in children’s health care.

    In a 2020 study, Goyal and her colleagues found that Black kids with appendicitis were less likely than their white peers to be correctly diagnosed, even when both groups of patients visited the same hospital.

    Although few doctors deliberately discriminate against women or minorities, Goyal said, many are biased without realizing it.

    “Racial bias is baked into our culture,” Goyal said. “It’s important for all of us to start recognizing that.”

    Demanding schedules, which prevent doctors from spending as much time with patients as they’d like, can contribute to diagnostic errors, said Karen Lutfey Spencer, a professor of health and behavioral sciences at the University of Colorado-Denver. “Doctors are more likely to make biased decisions when they are busy and overworked,” Spencer said. “There are some really smart, well-intentioned providers who are getting chewed up in a system that’s very unforgiving.”

    Doctors make better treatment decisions when they’re more confident of a diagnosis, Spencer said.

    In an experiment, researchers asked doctors to view videos of actors pretending to be patients with heart disease or depression, make a diagnosis, and recommend follow-up actions. Doctors felt far more certain diagnosing white men than Black patients or younger women.

    “If they were less certain, they were less likely to take action, such as ordering tests,” Spencer said. “If they were less certain, they might just wait to prescribe treatment.”

    It’s easy to see why doctors are more confident when diagnosing white men, Spencer said. For more than a century, medical textbooks have illustrated diseases with stereotypical images of white men. Only 4.5% of images in general medical textbooks feature patients with dark skin.

    That may help explain why patients with darker complexions are less likely to receive a timely diagnosis with conditions that affect the skin, from cancer to Lyme disease, which causes a red or pink rash in the earliest stage of infection. Black patients with Lyme disease are more likely to be diagnosed with more advanced disease, which can cause arthritis and damage the heart. Black people with melanoma are about three times as likely as whites to die within five years.

    The covid-19 pandemic helped raise awareness that pulse oximeters — the fingertip devices used to measure a patient’s pulse and oxygen levelsare less accurate for people with dark skin. The devices work by shining light through the skin; their failures have delayed critical care for many Black patients.

    Seven years after her misdiagnosis, Watkins is an assistant professor of social work at North Carolina Central University in Durham, where she studies the psychosocial effects experienced by Black mothers who survive severe childbirth complications.

    “Sharing my story is part of my healing,” said Watkins, who speaks to medical groups to help doctors improve their care. “It has helped me reclaim power in my life, just to be able to help others.”

    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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  • You’ve Got Questions? We’ve Got Answers!

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    From Cucumbers To Kindles

    Q: Where do I get cucumber extract?

    A: You can buy it from BulkSupplements.com (who, despite their name, start at 100g packs)

    Alternatively: you want it as a topical ointment (for skin health) rather than as a dietary supplement (for bone and joint health), you can extract it yourself! No, it’s not “just juice cucumbers”, but it’s also not too tricky.

    Click Here For A Quick How-To Guide!

    Q: Tips for reading more and managing time for it?

    A: We talked about this a little bit in yesterday’s edition, so you may have seen that, but aside from that:

    • If you don’t already have one, consider getting a Kindle or similar e-reader. They’re very convenient, and also very light and ergonomicno more wrist strain as can occur with physical books. No more eye-strain, either!
    • Consider making reading a specific part of your daily routine. A chapter before bed can be a nice wind-down, for instance! What’s important is it’s a part of your day that’ll always, or at least almost always, allow you to do a little reading.
    • If you drive, walk, run, or similar each day, a lot of people find that’s a great time to listen to an audiobook. Please be safe, though!
    • If your lifestyle permits such, a “reading retreat” can be a wonderful vacation! Even if you only “retreat” to your bedroom, the point is that it’s a weekend (or more!) that you block off from all other commitments, and curl up with the book(s) of your choice.

    Q: Any study tips as we approach exam season? A lot of the productivity stuff is based on working life, but I can’t be the only student!

    A: We’ve got you covered:

    • Be passionate about your subject! We know of no greater study tip than that.
    • Find a willing person and lecture them on your subject. When one teaches, two learn!
    • Your mileage may vary depending on your subject, but, find a way of studying that’s fun to you!
    • If you can get past papers, get as many as you can, and use those as your “last minute” studying in the week before your exam(s). This will prime you for answering exam-style questions (and leverage state-dependent memory). As a bonus, it’ll also help ease any anxiety, because by the time of your exam it’ll be “same old, same old”!

    Q: Energy drinks for biohacking, yea or nay?

    A: This is definitely one of those “the dose makes the poison” things!

    But… The generally agreed safe dose of taurine is around 3g/day for most people; a standard Red Bull contains 1g.

    That math would be simple, but… if you eat meat (including poultry or fish), that can also contain 10–950mg per 100g. For example, tuna is at the high end of that scale, with a standard 12oz (340g) tin already containing up to 3.23g of taurine!

    And sweetened carbonated beverages in general have so many health issues that it’d take us a full article to cover them.

    Short version? Enjoy in moderation if you must, but there are definitely better ways of getting the benefits they may offer.

    Q: Best morning routine?

    A: The best morning routine is whatever makes you feel most ready to take on your day!

    This one’s going to vary a lot—one person’s morning run could be another person’s morning coffee and newspaper, for example.

    In a nutshell, though, ask yourself these questions:

    • How long does it take me to fully wake up in the morning, and what helps or hinders that?
    • When I get out of bed, what do I really need before I can take on my day?
    • If I could have the perfect morning, what would it look like?
    • What can evening me do, to look after morning me’s best interests? (Semi-prepare breakfast ready? Lay out clothes ready? Running shoes? To-Do list?)

    Q: I’m curious how much of these things you actually use yourselves, and are there any disagreements in the team? In a lot of places things can get pretty heated when it’s paleo vs vegan / health benefits of tea/coffee vs caffeine-abstainers / you need this much sleep vs rise and grinders, etc?

    A: We are indeed genuinely enthusiastic about health and productivity, and that definitely includes our own! We may or may not all do everything, but between us, we probably have it all covered. As for disagreements, we’ve not done a survey, but if you take an evidence-based approach, any conflict will tend to be minimized. Plus, sometimes you can have the best of both!

    • You could have a vegan paleo diet (you’d better love coconut if you do, though!
    • There is decaffeinated coffee and tea (your taste may vary)
    • You can get plenty of sleep and rise early (so long as an “early to bed, early to rise” schedule suits you!)

    Interesting note: humans are social creatures on an evolutionary level. Evolution has resulted in half of us being “night owls” and the other half “morning larks”, the better to keep each other safe while sleeping. Alas, modern life doesn’t always allow us to have the sleep schedule that’d suit each of us best individually!

    Have a question you’d like answered? Reply to this email, or use the feedback widget at the bottom! We always love to hear from you

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  • The Age-Proof Brain – by Dr. Marc Milstein

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    Biological aging is not truly just one thing, but rather the amalgam of many things intersecting—and most of them are modifiable. The cells of your body neither know nor care how many times you have flown around the sun; they just respond to the stimuli they’re given.

    Which is what fuels this book. The idea is to have a brain that is less-assailed by the things that would make it age, and more rejuvenated by the things that can make it biologically younger.

    Dr. Milstein doesn’t neglect the rest of the body, and indeed notes the brain’s connections with the immune system, the heart, the gut, and more. But everything in this book is done with the brain in mind and its good health as the top priority outcome of all the things he advises.

    On which note, yes, there is plenty of practical, implementable advice here. For a book that is consistently full of study paper citations, he does take care to make everything useful to the reader, and makes everything as easy as possible for the layperson along the way.

    Bottom line: if you would like your brain to age less, this is an excellent, very evidence-based, guidebook.

    Click here to check out The Age-Proof Brain, and age-proof your brain!

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