Health

10 Tips for Starting Yoga at 50+

This is a great article over at Yoga International by Amber Burke & Bill Reif. Yoga is not always about increasing your flexibility. Sometimes your yoga journey can be more about learning to listen to and care for your body, and building strength and stability. Everyone's yoga is as unique as themselves!

Namaste,

-Leta (The Yogi)

10 Tips for Starting Yoga at 50+

by Amber Burke & Bill Reif

Medical practitioners and health-focused websites are increasingly recommending yoga to those of middle age and up, perhaps because yoga can help make you more flexible and mobile, improve your balance, reduce age-related changes in gait, increase your energy, reduce chronic pain and addictive behavior, decrease the risk of heart attacks and strokes, alleviate depression and anxiety, improve sleep quality, and even slow the effects of aging on a cellular level.

Older adults seem to be listening. According to one large survey, those 50 and up constitute 38 percent of all practicing yogis, making them the second largest group of practitioners (after those 30-49). If you are considering joining this number, it’s important to consider how best to approach a new yoga practice at and after middle age.

Although no single type of practice will ever be appropriate for everyone in any demographic, a yoga practice for those 50 and up is one that understands and works with the differences between younger bodies and older bodies, rather than one that pretends those differences do not exist.

In particular, a safety-focused approach to yoga may be especially valuable for older practitioners, who seem to run a higher risk of in-class injury than their younger counterparts. Yoga, like all forms of exercise, can both cause and exacerbate injuries, and while the rate of yoga injuries for all demographics rose between 2001 and 2014, injuries were most frequent among those 65 and up (57.9 injuries/100,000 practitioners), followed by those 45 and up (17.7/100,000). This may result from the way normal, age-related changes and preexisting wear and tear on our bodies interact with a yoga practice.

Although all bodies are different, in general, our bodies become less resilient as we age. To varying degrees, we experience decreases in muscle strength, connective tissue elasticity, and bone density, the combination of which may make us more vulnerable to injury than our younger counterparts. Older adults may also find that their injuries don’t heal as quickly as they did a decade or two ago.

By the time we reach middle age, it’s also likely that we bring to yoga conditions or injuries—diagnosed or undiagnosed—that affect our practice and can make injury more likely. Kyphosis, frozen shoulder, osteoporosis, and back pain (discussed further here) are among the common conditions experienced by older adults that may necessitate changes in our yoga practice.

Fortunately, by making careful decisions about what type of yoga to practice, and how to practice it, we can decrease the odds of injury. While much of the advice below applies to yoga practitioners of all ages and levels, it is especially crucial for those starting yoga at or after age 50, when safety must take center stage.

1. Seek out the type of yoga class that’s right for you.

There are many types of yoga. A high-intensity practice like ashtanga, vinyasa, or power yoga (in which students often “flow” quickly through poses) usually requires the hands to bear weight. These practices may work for some beginning practitioners, especially those who are athletic and free from competitive urges, and who can easily make adaptations within a group class when needed.

But if you are newer to exercise and/or working with injuries or pre-existing conditions (especially of the shoulders, elbows, or wrists), the fast pace of a vinyasa or power yoga class and the emphasis on weight-bearing with the hands may not suit you. Instead, you might consider choosing a class that moves slowly and focuses on alignment. Hatha classes, Iyengar classes, classes geared specifically toward older adults or billed as “alignment-focused,” and introductory, basic, or foundational classes could all be appropriate. Kundalini classes, which often emphasize seated poses, chanting, and working with the breath, may also be beneficial. Yin yoga and restorative yoga (both floor-based practices emphasizing long holds), and chair yoga, in which many poses are practiced with the help of a chair, are of value to many practitioners, but may be especially valuable for older students who are newer to exercise, find balancing to be a challenge, or have difficulty coming down to and up from the floor.

Teachers of all of these different styles are often happy to teach you privately. A private yoga session is considerably more expensive than a group class, but often far less expensive than an appointment with a physical therapist or doctor.

During one-on-one sessions, a teacher can check your form and help you make adjustments to poses that haven’t been feeling quite right, or about which you may be uncertain.

Yoga International and other yoga sites will give you many of the tools you need to be your own teacher and embark on a home practice. There, you’ll find online yoga videos that offer classes for a variety of different levels that you can practice at your convenience. However, even those who prefer practicing at home often find participating in group classes helpful—both for the instruction from a “live” teacher, and the encouragement from a community of other students.

2. Find the right teacher for you.

Even within each type of yoga mentioned above, classes often vary tremendously depending on the instructor. Some say there are as many styles of yoga as there are yoga teachers. For instance, some vinyasa teachers may move slowly, while some hatha teachers pick up the pace. Shop around. Try different teachers. It is not necessarily important that your teacher be the same age as you, but it is important that younger teachers know how to work with students older than themselves.

Go to class early enough to talk to the instructor, or visit with the studio manager to inquire about various teachers’ styles. Ask about their philosophy and goals. Consider steering clear of teachers who think all poses are uniformly attainable and beneficial for all bodies. Instead, seek out a teacher who seems to care about any needs and pre-existing injuries or conditions you might have, and is interested in making your practice productive for you.

Find someone who gives careful instruction, teaches poses that seem valuable and possible, and who offers directions you can easily interpret. Above all, look for a teacher whose emphasis is not on the “what” but the “how”—a teacher who is more interested in teaching students how to move safely and with awareness, than in achieving a particular pose.

3. Be clear about your goals.

If, instead of accomplishment—like achieving handstand or lotus pose, you see the goal of your yoga practice as improved physical and mental well-being, the poses themselves become less important, a means rather than an end. You will then be less inclined to do anything in the short term that puts you at risk for injury, which would interfere with your long-term goal.

Yoga’s benefits for your well-being do not hinge on the attainment of particularly adventurous or dramatic poses, keeping pace with the person next to you, or practicing a pose just the way your teacher does. Rather, the benefits derive from a consistent and mindful practice of poses that challenge your range of motion and strength to a sustainable degree.

4. If you have any injuries or pre-existing conditions, tell your teacher about them, and share any advice you’ve received from your doctor.

A discussion with your teachers regarding any injuries and conditions you may have is essential, so that they avoid encouraging you to make movements that are risky for you. Sometimes, your teachers can help you modify potentially problematic poses or suggest alternatives. Even if you aren’t seeking advice (because you know exactly which changes you’ll make to your practice to keep yourself safe), it’s also important to communicate with your teachers to avoid hands-on adjustments that could place pressure on a place of injury or vulnerability.

Past injuries and surgeries matter, too, since the area of a previous injury is often the area that’s most likely to be injured again.

Any information your doctor has given you about which movements to do and which not to do can be invaluable to your yoga teacher. Though many experienced teachers will know how to work with practitioners who have certain common injuries and conditions, it’s simply not possible for them to know the particulars of every diagnosis. So if, for example, your doctor has given you instructions not to twist or forward-fold, pass that information on.

5. Take charge of your own well-being throughout your practice.

It can be tempting to assume that whatever poses the teacher suggests will be a good idea for you, especially if you’ve communicated with them about any injuries or conditions you have. But it’s important not to surrender responsibility for either your own safety or your own good judgment. Sometimes classes are so large that teachers don’t feel they can attend to the particular needs of any one individual. Sometimes your teachers may not know how best to accommodate your needs.

But perhaps most critically, there will be times when only you will know what your needs are. For instance, only you can know when you are on the verge of losing your balance in a standing balance pose. But since, according to one study, falls from standing height are the most common cause of injuries in older athletes, it’s critical that you don’t wait for the teacher’s invitation: Exit the pose before your shaking destabilizes you.

Continually register what you are doing and how it feels. Stay attuned to warning signs like tingling, numbness, lightheadedness, and, of course, pain. These are cues telling you that it’s time to come out of a pose.

6. Move Slowly.

Moving slowly from pose to pose gives you time to both get your footing and to notice sensations in your body. And if you’re not in a rush during transitions, it may be easier to stay mindful of your alignment, as well as of any advice your yoga teacher or your doctor may have given you.

Slow movement can also help build strength. Slow doesn’t mean easy—quite the opposite. Try taking a few steps as slowly as possible. You’ll likely feel that moving slower requires more control and effort, rather than less. Moving slowly can also require mental strength to stick with the challenges it presents, as well as to keep a slow pace even when others are moving faster.

7. Give yourself permission to skip and alter poses as necessary.

Respect your feelings of hesitation. If you look at a pose and think, That looks like a bad idea, don’t do it.

Err on the side of caution. Take all directions as suggestions rather than mandates, and do only the poses you can do without strain and while breathing deep, comfortable breaths. Whenever you wish, take a break in child’s pose or any seated pose that is comfortable for you.

Often, there may be another way of approaching a pose to make it more accessible. Ask for help from the teacher in creating another version of the pose, perhaps using props. Having a wall to touch or lean against can help you with balance, and blocks or straps can arrest the depth to which you go in a pose, lessening strain and lowering the probability of injury.

8. Pay attention to how you feel, both after practice and the next day.

It’s important to take into account how you feel, not only during but also after your practice. Do you feel nothing at all? Do you feel you exerted yourself in a productive way? Maybe you’re sore in a “good way”?

Do you have a lightness in your step and a buoyancy in your mood? Or do you feel exhausted? Or maybe you even feel new pain somewhere?

If you feel nothing at all after the class you took, you might consider upping the intensity of your practice. If you feel absolutely exhausted or in pain, you may conclude that you did a little too much, and tone things down next time.

9. Give up comparisons.

You may or may not have something in common with the person practicing vigorously next to you. Do not expect your poses to look exactly the same way that other students' poses look. Besides, impressive as some of those demonstrations may be, you don’t know what is going on inside any of those other bodies. For all you know, those yogis have rotator cuff tears, repetitive motion injuries, or pain they are ignoring (and perhaps exacerbating by practicing that seemingly advanced pose). Who knows, some of them may have managed to get into their pose only by compromising their alignment or stability in some way. They may even be holding their breath!

Trust that the more advanced student is one who recognizes their own limitations, and practices the version of a pose that is appropriate for their body while maintaining their personal optimal alignment and breathing deeply. Be that student.

It may also be tempting to compare yourself with the person you were twenty years ago, who could have done the suggested adventurous pose with abandon. You can no longer do anything to help or hinder the person you used to be, but your actions today will have a direct impact on the person you will be tomorrow. Do your future self a service by respecting your limits as they are today.

10. Men: Patience and persistence will pay off.

Researchers have long-noted that women tend to be more flexible than men, a gender gap that is slight in preadolescence but increases toward seniority (when older women maintain greater range of motion in many joints than older men do). This difference may be due to a combination of muscle size, tendon elasticity, hormones, and the kinds of activities that men or women are more likely to engage in.

The fact that aging-related declines in flexibility appear to be joint-specific, with, for instance, the shoulder and trunk experiencing greater losses in range of motion than the elbows and knees, indicates that habitual joint usage patterns play a role in these losses.

Statistically, men tend to participate in more vigorous physical activities than women, do more strength-training activities, and play sports twice as much (or more) than women do. But muscle bulk, the wear-and-tear of repetitive movements, and the scar tissue that results from injuries may contribute to losses in flexibility.

Men’s comparative inflexibility is not a reason for them not to do yoga; rather, it makes yoga even more important. And the good news is that, when embarking on a program of stretching, men seem to make gains in range of motion at a similar rate to that of their female counterparts.

However, it’s important that they take things more slowly than they might be inclined to, and that they don’t expect themselves to be able to do everything their female neighbors in class are doing—at least not right away.

Reflections

What all these tips encourage is viveka: a Sanskrit term for the prized quality of discernment and discrimination. Although certain physical aspects of yoga may be more challenging as we age, discernment may also be easier to come by.

At middle age and beyond, we may have an easier time discerning our goals, the kind of practices and teachers that are right for us, and the speed at which we may safely proceed. We may be able to better discriminate between the poses and movements that are of benefit to us and those we would be better off skipping, between what is right for another and what is right for us, and even between what was right for us 20 years ago and what is right for us now.

If we apply this earned wisdom to our yoga practices, it will not only help to keep us safe, but it will also serve as a signal to others.

Every time we stay in a less extreme version of a pose, or take a break when we need it, we model to younger, more ambitious practitioners a kinder way of practicing. We tell another story about what yoga can be. Through the self-awareness and self-care that infuses our actions—and at times our inaction—we become arrows that point inward instead of outward.

Essential Oils Class with Leta

Fall Essentail Oils Class.jpg

Hey guys!

I'll be offering a free essential oils class this month over at Alex's office in Sand Springs. We're going to talk about how essential oils can help you find your focus for the new school year. Whether you're in the classroom, supporting a student. or working on your own projects this is a great time of year to refine your focus and help yourself get to work!

I'll be highlighting a couple of specific doTERRA oils that can help you focus, concentrate, get better sleep, help with memory support, and so much more. I hope you can come join us for a fun evening - call to reserve your spot at (918) 246-5808. See you there!

- Leta (The Yogi)

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

This article was past on to me and I thought every one should see what we already know. Chiropractic WORKS.

Thanks for reading.

- Dr. Alex (The Doc)

 

Written By: Aaron E. Carroll

THE NEW HEALTH CARE MAY 1, 2017

Spinal manipulation or physical therapy such as heat and stretches (above) seem as effective as traditional approaches to help lower back pain. Credit Joshua Bright for The New York Times

About two of every three people will probably experience significant low back pain at some point. A physician like me might suggest any number of potential treatments and therapies. But one I never considered was a referral for spinal manipulation.

It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases.

Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.

Most back pain resolves over time, so interventions that focus on relief of symptoms and allow the body to heal are ideal. Many of these can be nonpharmacological in nature, like the work done by chiropractors or physical therapists.

Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors and also because a few chiropractors have claimed they can address conditions that have little to do with the spine. Patients with back pain haven’t seemed as skeptical. A large survey of them from 2002 through 2008 found that more than 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.

Researchers have been looking at the evidence supporting spinal manipulation for some time. Almost 35 years ago, a systematic review evaluated the available research, most of which was judged to be low in quality, and found that there might be some short-term benefits from the procedure. Two reviews from 2003 agreed for the most part, finding that spinal manipulation worked better than a “sham procedure”, or placebo, but no better or worse than other options.

Almost a decade later, a Cochrane review assessed the literature once more, and found 12 new trials had been conducted. This review was more damning. It found that spinal manipulation was no better than sham interventions.

But since then, data have accumulated, as more higher-quality studies have been performed. Recently, in The Journal of the American Medical Association, researchers looked for new studies since 2011, as well as those that had been performed before.

The evidence from 15 randomized controlled trials, which included more than 1,700 patients, showed that spinal manipulation caused an improvement in pain of about 10 points on a 100-point scale. The evidence from 12 randomized controlled trials — which overlapped, but not completely with the other trials — of almost 1,400 patients showed that spinal manipulation also resulted in improvements in function.

In February, in Annals of Internal Medicine, another systematic review of nonpharmacologic therapies generally agreed with the other recent trials. Based upon this review, and other evidence, the American College of Physicians released new clinical practice guidelines for the noninvasive treatment of subacute back pain. They recommended that patients should try heat, massage, acupuncture or spinal manipulation as first-line therapies.

The only things that might detract from the use of spinal manipulation in this situation would be its cost and potential harms.

Because they fear those potential harms, some physicians are hesitant to refer patients to chiropractors or physical therapists for care. But in all the studies summarized above, there were really no serious adverse events reported. It’s possible to find anecdotes of harm to the spinal cord from improper manipulations, but these are rare, and almost never involve the lower spine.

Some physicians are concerned about the cost of spinal manipulation, especially since most insurance carriers don’t cover it. Visiting a chiropractor costs more than taking many non-narcotic pain medications. But more invasive interventions can cost a lot of money. In addition, studies have shown that, in general, users of complementary and alternative medicine spend less over all for back pain than users of only traditional medicine.

Medication and surgery can also lead to harms. We shouldn’t forget that prescription pain medications, like opioids, can lead to huge costs, especially when they’re misused.

Some physicians are uncomfortable that we don’t have a clear picture of how spinal manipulation actually works to reduce pain. It’s also possible that some chiropractors do it “better” than others, and we can’t tell. This concern should be tempered by the fact that we don’t have a great understanding of why many other therapies work either. Some of the more traditional things we recommend don’t even work consistently. 

Still, there is no merit to many other claims about spinal manipulation — that it has been proved to work for things like infantile colic, painful periods, asthma, gastrointestinal problems, and more. For most conditions, the therapy lacks a good evidence base.

But given the natural course of back pain — that most of it goes away no matter what you do — the ideal approach is to treat the symptoms and let the body heal. Noninvasive therapies seem to do that well enough.

Cyclist’s Hands, Overcoming Overuse Injuries

After a ride on your bike, have you experienced numbness, tingling, or pain in your arm, hand, wrist, or little finger? If you have, you could be suffering from an overuse injury. Approximately one-third of all bicycling overuse injuries involves the hands.  The 2 most common are what we call “handlebar palsy” and carpal tunnel syndrome. By making some adjustments to your bike, posture, and by wearing some protective equipment, you can prevent these injuries from occurring.

 

Handlebar palsy

Ulnar neuropathy, known to cyclists as handlebar palsy, is caused by compression of the ulnar nerve at the hand and wrist. The ulnar nerve controls sensation in your ring and little finger and controls most of the muscular function of your hand. Compression of the ulnar nerve is a common problem for competitive and recreational cycle enthusiasts, alike. Compression is the result of direct pressure on the ulnar nerve from the grip on the handlebars. Often, the nerve may be over stretched or hyperextended (extension beyond its normal limit) when a drop-down handlebar is held in the lower position. The pressure placed on the ulnar nerve results in numbness and tingling in the ring and little fingers or hand weakness, or a combination of both. Symptoms can take from several days to months to resolve, but surgical treatment is rarely necessary. Rest, stretching exercises, and anti-inflammatory medications, such as aspirin, usually help relieve the symptoms. Applying less pressure or weight to the handlebars and avoiding hyperextension can help to prevent a recurrence.

Carpal tunnel syndrome

Although it is less common than handlebar palsy, carpal tunnel syndrome (compression of the median nerve at the wrist) is another overuse injury that cyclists often experience. Injury often occurs when a cyclist holds the handlebars on top and applies pressure directly on the median nerve. Symptoms include numbness and tingling in the thumb, index, middle, and ring fingers and weakness of the hand. Symptoms usually resolve quickly once you stop cycling for a short period of time. Although handlebar pressure contributes to these symptoms, there can be other causes for hand pain and numbness; therefore, an evaluation for other possible causes of carpal tunnel syndrome should be performed by your health-care professional.

Prevention with Equipment

Adjust your handlebars, seat and pedals to best suit your body and allow you to sit in a more upright position. Sitting upright will take the weight and pressure off of your hands and wrists. Wearing padded gloves may also reduce shocks and jolts to your body, which travel into your wrist joints from the road and can lead to pain.

The Correct Position for the Wrist

The carpel tunnel is a small gap between the many small wrist bones and a flat ligament at the base of the wrist. Ten tendons go through this small tunnel and are responsible for flexing the hand and fingers. A nerve also passes through this tunnel. Degeneration or mechanical stress can easily injure these small tissues resulting in a loss of function of the hand.

Riding with the wrist flexed like this stresses these small tissues:

I see this position quite often when I conduct rider assessments.

This hand position can lead to injury for two reasons:

  1. The tendons are stretched to near full length.

  2. Vibration or impact from the front wheel, such as a bump in the road, can then cause a trauma as the wrist is forced to extend too far.

The correct position is with the wrist straight like this:

This position allows shock to travel up the arm while supported by the bones and cartilage, which are much stronger tissues than the fine tendons and ligaments supporting the fingers.

 

 

 

Assess and Control Weak Wrist Flexors

One reason we ride incorrectly is simply due to lack of knowledge or bad habits. But another reason can be weak wrist flexors. If you are a regular gym-goer, there are some tests you can do with pressing exercises to assess and control these flexors.

To conduct the test of your hand position you will need a set of grips, a suspension trainer, or a set of rings. You are going to check for correct wrist alignment while you perform a push up on this gear.

Correct wrist position:

Incorrect wrist position:

Elbow Position Is Important, Too

Avoiding injury doesn’t end at hand position, though. Should you hit a large bump in the road, and you manage to avoid wrist injury, the shock will continue to travel up the arm to the elbow. This is the second potential area of injury due to incorrect position.

Elbows should be slightly flexed like the cyclist shown here:

This allows any movement of the handlebars to be taken up by the elbow flexing. If you ride with your elbows stiff or locked, then vibration and shocks may extend the elbow too far and lead to trauma.

So please remember to keep your wrists straight and elbows flexed when out on the bike. 

- Dr. Alex (The Doc)

Sources: http://www.hughston.com/wp-content/uploads/Health-Alerts/vol15no3.pdf

https://breakingmuscle.com/fitness/pain-free-cycling-avoiding-wrist-and-elbow-injury

Statins for Women? Follow up article.

Statins for Women? Not for My Patients

Blog By: Kelly Brogan, M.D. Holistic Women’s Health Psychiatry, NYC

Sometimes, pharmaceutical companies and their doctorly friends collectively make a bold move that shows their hand. Usually, this is in the form of indiscriminately and categorically broadening the eligible candidates for the suddenly lifesaving benefits of a pre-existing product. Recent changes in guidelines put forth by the American Heart Association and the American College of Cardiology aim to expand the recommendations of lipid-modifying statins to include those for whom there is a stated “10-year risk of 7.5 percent or more” of cardiac events, based on a calculator that now eliminates LDL targets. Many thoughtful clinicians have come forth to express their concerns about the impact of this expansion of prescription treatment to 70 million patients, including Dr. Redberg and John Abramson, for the New York Times, stating:

We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them.

I’d like to talk about what this means, as a women’s health psychiatrist,  for my people — women, in America, suffering from depression, anxiety, and symptoms of mental illness. Several times a week, I “discuss” (euphemism) with colleagues, including integrative doctors, the fact that I do not want a single one of my patients on statins, for any reason, ever.

Here’s why:

Wrong-Headed Indication

As discussed by Dr. Tom O’Bryan, there is a 17-year lag between availability of paradigm-shifting data and implementation. Misconceptions about dietary — cholesterol and saturated fat — drivers of heart disease still linger despite widespread abandonment of this perspective. This was discussed in an important, recent BMJ commentary by British cardiologist, Dr. Malhotra, who states:

Virtually all the truths about preventing heart attacks that physicians and patients have held dear for more than a generation are wrong and need to be abandoned.

Based on unabated rates of cardiovascular disease despite a generation of statin users, and studies that demonstrate that patients presenting to the hospital with heart attacks don’t have elevated total cholesterol, but they do have (66 percent of the time) metabolic syndrome, or a constellation of findings such as obesity, high triglycerides, low HDL, and insulin resistance. This phenomenon is driven by sugar and trans fat, not dietary, naturally-occurring saturated fat, and not by a lack of statins, but, perhaps, is exacerbated by the statins themselves, and particularly, in women.

This is why, even in the only demographic that has been shown to benefit from statin use (men who have had a previous heart attack) 82 will experience no benefit before one will.  This is at the expense of interference with energy production in every cell because of coQ10 depletion, an unintended but tragic side effect.  In that 83rd patient, anti-inflammatory effects of statins (and not cholesterol-lowering) are thought to drive benefit. These effects are highly achievable in more benign and widely beneficial ways.

Inexcusable Risk

Contrary to what is demonstrated in industry studies, intolerable side effects occurred in 20 percent of those treated with statins in an eight-year retrospective cohort study. Given the total lack of demonstrated benefit in women, as a demographic, we are now, in the realm of iatrogenesis, or doctor-induced harm, which may include decreased cognitive function, cataracts, sexual dysfunction, depression, muscle pain, and now, diabetes. Understanding the pathogenisis of cardiovascular disease, induction of diabetes in women, who will then be put at risk for cardiovascular events, is inexcusable. We have known, at least since this study in the Archives of Internal Medicine, that the risk of new onset diabetes in postmenopausal women was increased by 48 percent. Plain and simple: “Statin medication use in postmenopausal women is associated with an increased risk for DM.”

Brain and Hormone Sabotage

As a women’s health psychiatrist, I am principally concerned with the effects of a low fat diet, poor cholesterol production, and medication-disrupting lipid effects because cholesterol is a primary component of cell membranes, acting as both a filter and a structural reinforcer. Cell membranes are where all of the action is at including receptor function and trafficking of nutrients and toxic elements. Cholesterol is also the precursor to vitamin D, and to pregnenolone and the sex hormones that derive from it, making it critical for appropriate production, feedback, and balance. I discuss these relationships, and its relevance to risk of depression, here:

Perhaps related to these vital functions, perhaps to others yet undiscovered, low cholesterol has also been linked to suicide and depression. (Kunugi et al, Biol Psych, 1997) (Modai at al, J Clin Psych, 1994) ( Lindberg et al, BMJ, 1992) In patients hospitalized for affective episodes, significantly more patients than controls were noted to have low plasma cholesterol. Another looking at the Melbourne Women’s Midlife Health Project suggested that improved performance on memory testing was achieved with increased total cholesterol in women longitudinally monitored.

Controlling for multiple confounding variables, 300 women in Sweden were found  to be significantly more depressed when they had the lowest percentage of total cholesterol in the cohort. This is a concerning correlation in light of recommendations that aim to throw women under the cholesterol-sabotaging bus.

Better Medicine for Healthier Brains and Hearts

Cardiovascular disease is a multi-factorial inflammatory problem with disparate drivers in different people. Lifestyle medicine is the best and most sophisticated intervention, and the only one indicated here, with no exceptions for women.  This begins with good old exercise and diet. I advocate for no grains and sugar, consistent with what our genome is expecting to see. This is a naturally high fat approach with a focus on pastured meats, wild fish, eggs, nuts, and seeds. Know that any increase in cholesterol that may occur is consistent with beneficial profiles, and improvement in inflammatory markers.  Most of the time, however, I am aiming to increase cholesterol to support my patient’s mental and hormonal health, working at improving liver synthesis and healthy dietary fats.

Most of my patients know that I’m a huge eggophile. Studies such as this one that noted three eggs (yolks) daily with carbohydrate restriction resulted in improvement in all lipid parameters and HDL help to support my assertion that whole, natural foods do not promote diseases that have only come into existence since the gifts of the industrial revolution and Snackwells over bacon type recommendations.

We all know, intuitively, that exercise is a critical answer to the burning question of how do we heal ourselves, and particularly, in a population concerned about cardiovascular disease and the Interheart study demonstrated that 90 percent of first cardiac events could be prevented by lifestyle modification. The known and validated benefits of exercise, however, may be eclipsed by use of a statin, which is just the cherry on top!

What are the parameters that relate, in a predictive manner, to metabolic syndrome and associated inflammation? Unfortunately, none of these figure into the handy calculator the AHA is planning to use for the new statin indications.  These include:

  • fasting insulin
  • hemoglobin A1C
  • homocysteine
  • NMR or VAP lipid profiles which screen for particle density
  • hsCRP
  • fasting glucose

Balancing thyroid function is an important and vastly overlooked variable, particularly in women, because of its role in the enzymatic processing of LDL cholesterol in the liver — i.e., you don’t have a “cholesterol problem” if you also have a “thyroid problem,” which is grossly overlooked by most conventional physicians, as I discuss here.

Strategic implementation of activated B vitamins such as B12 and folate and vitamin D can also mitigate inflammatory compounds such as homocysteine and hsCRP.

All told, we have here an unsafe, unnecessary product that will now be recommended to healthy people to make them sicker, all when simple, health-fortifying lifestyle changes have been proven to be effective and globally transformative in ways no pill could ever hope to be. Women, listen up, and listen good to those trying to save you from a pharmaceutical fate. It’s a depressing, confusing, libido-less, fat, and potentially lethal destiny, and there’s a path to vitality paved with common sense. Walk it.