The Hot Years Magazine - Issue 38

My Menopause Magazine

Bioidentical Hormones

What You Don’t Know Can Harm You

Age at First Period

Can Predict Early Menopause

Dr. Izabella Wentz

When Menopause Meets Hashimoto’s Thyroiditis

N 38 o

Can What You Eat Help You Live Longer?

5

Tips to Deal with Depression During Menopause

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Age of Menopause and Risk for Type 2 Diabetes

Water Exercises to Cool Your Hot Flashes and Control Weight

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The Hot Years

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In this Issue: Dr. Izabella Wentz When Menopause Meets Hashimoto’s Thyroiditis Bioidentical Hormones - What You Don’t Know Can Harm You

5 Tips to Deal with Depression During Menopause

Age at First Period Can Predict Early Menopause

Estrogen Use and the Risk for Depression In Perimenopause

Age of Menopause and Risk for Type 2 Diabetes

Can What You Eat Help You Live Longer?

Water Exercises to Cool Your Hot Flashes and Control Your Weight

Renewable Energy

Editorial

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The 7 C’s of Menopause

My Menopause Magazine

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he term “Seven Seas” has been used to refer to seven of the largest bodies of water in the world: the North and South Pacific Oceans, the Southern Pacific or Antarctic Ocean, the North and South Atlantic Oceans, the Indian Ocean and the Arctic Ocean.

Editorial But if you want to navigate midlife, you need to know how to navigate the 7 C’s of Menopause… Menopause can be a rough ride, but this framework can help you achieve smooth sailing. Some of these principles are based on a business model designed

by Dan Sullivan. The first three are about the problem. The last four address the solution.

1 2 3 4

Confused. The symptoms and treatments are confusing not only to most women, but also to many of their health-care providers.

Conflicted. Should I take action?

Treat or don’t treat? How much?

How long? What dose? When do I start? When do I stop? Is it safe?

Confined. Not knowing the consequences can lead to toughing it out rather than figuring it out causes inaction and avoidable suffering.

Commitment. When faced with the above 3 Cs, it’s challenging to have enough commitment to seek out the answers to questions that are challenging you. You need a starting point, and the reward is feeling empowered and more in control. Remember the Cowardly Lion in the Wizard of Oz. As soon as Dorothy needed his help, his reluctance transformed to commitment. “I’ll do it for Dorothy.”

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Courage. With his new found “Commitment” the Cowardly Lion discovered his courage.

Once you commit to helping yourself during this challenging time, you will also find your courage.

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Capability. You’re a capable woman in so many areas of your life. But until you make a commitment and gain your courage, you’re unlikely to risk moving forward to utilize your capabilities to find out how to navigate menopause. Your ability will only be realized when you muster your energy to channel your capability to achieve a healthier, happier and more hormonally balanced life.

7

Confidence. And having the commitment, courage and capability will provide you with the confidence to create your menopause breakthrough so you can become a partner in your healthcare.

To see a free training on my approach to creating a Menopause Breakthrough so you can navigate your menopause experience, visit www.

MenopauseBreakthrough.com

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When Menopause Meets

Hashimoto’s Thyroiditis Discover how to recognize thyroid disease and how to take back control

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o you or someone you know have thyroid disease? It’s surprisingly common, often starting around the time of menopause. Here to talk about this important but often unrecognized condition is Dr. Izabella Wentz, an internationally acclaimed thyroid specialist, licensed pharmacist and author of the number one New York Times best selling book, Hashimoto’s Protocol: A 90 Day Plan for Reversing Thyroid Systems and Getting Your Life Back.

She, herself, was diagnosed with Hashimoto’s thyroiditis in 2009 and there’s nothing like getting real up close and personal with a condition to motivate you to learn more about it.

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Dr. Mache Seibel: How common is thyroid disease?

Dr. Mache: It sounds like menopause, doesn’t it?

Dr. Izabella Wentz: It’s incredibly common. Based on the current statistics using more advanced diagnostic methods, we’re looking at anywhere from 13% to 28% of the US population. Using the old school diagnostic methods, you’re probably only going to come up with one to two percent of the population. So we probably have at least 40 million people with this condition who are walking around unaware they have it.

Dr. Wentz: Absolutely. As you mentioned, menopause is one of the peak times a woman might get diagnosed.

Pregnancy, puberty, perimenopause seem to be the most common times.

Dr. Mache: That’s a lot of people!

The thyroid gland is a butterfly-shaped gland on your neck. What does the thyroid actually do?

Dr. Wentz: It manages our metabolism. There’s thyroid hormone receptors in virtually every cell in our body.

When thyroid hormones are too high or too low, we end up with a whole host of symptoms. The most common thyroid condition is an underactive thyroid or hypothyroid disease.

Symptoms of hypothyroid disease include sluggishness, fatigue, slower mentation, memory problems, brain fog, feeling cold, weight gain or difficulty losing weight, and difficulty with emotions.

And the effect on skin and hair for a lot of women can be very distressful.

They might have hair loss, thinner hair

13% to 28% of the US population has thyroid disease. 40 million are unaware they have it. or damaged hair that is less manageable and more difficult to brush.

They will also notice their skin is dryer and often more prone to breakouts. Some women say it seems like they’ve aged overnight as a result of thyroid disease.

Dr. Mache: Thyroid disease is not the only reason women have hair loss or changes, but it’s one of the most common.

Earlier you mentioned that some testing will only give you a 1-2% diagnosis rate, but that other kinds of diagnos-

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tic testing could increase the ability to figure out that it’s a thyroid condition.

What first round of testing would you recommend? And what tests would you do after that?

Dr. Wentz: Generally, if you were to go to your doctor and ask for a thyroid test, the TSH (Thyroid Stimulating Hormone) test would be done. That’s a wonderful test. It’ll find many cases of advanced thyroid disease. A challenge is that most doctors will not run additional tests unless the TSH is elevated or suppressed.

Another challenge is that when the TSH reference ranges for normal were first determined, there were people within the pool of “normal” that actually had thyroid disease, so the reference range was overly laxed.

Dr. Mache: So when a normal value for TSH was established, the blood samples they tested included some from normal and some from people with thyroid disease. So the “normal” range is really wider than it should be.

Dr. Wentz: Exactly. People in the sample of blood that was qualified as normal actually had underactive thyroid disease. So the referencing was overly lax. At one time the reference ranges for TSH were as high as 5 to 8.

Most people generally feel best with a

TSH between 0.5 and 2.0.

Of course, there may be outliers.

Various medical associations have changed their reference ranges to a narrower range, but not all of the lab companies have complied.

Another challenge is that for the first five to even fifteen years that a person has underactive thyroid disease the TSH test may actually be normal. That’s because there are five stages to thyroid disease (Hashimoto’s Thyroiditis).

In the first stage, a person has a genetic predisposition to the disease but has not been exposed to the necessary triggers to cause the disease to develop. So they will have normal TSH, T4/T3 hormones, no thyroid antibodies, and will not have any changes in their thyroid gland. Alternatively, this could be called Stage 0, because there are no symptoms.

In the second stage, antibodies attack the thyroid glands. In the third stage there are slight changes in TSH. The fourth stage is when you have significant changes in TSH and that’s usually when people get diagnosed. In stage five, the person is at greater risk for other autoimmune conditions like celiac disease, psoriasis, Sjogren’s, rheumatoid arthritis, Lupus, multiple sclerosis, and many other.

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The more advanced diagnostic testing that can be done are thyroid antibody tests, which include TPO (thyroid peroxidase antibodies) and TG (thyroglobulin antibodies). These tests can reveal that there’s an autoimmune process or autoimmune attack that’s directed at the thyroid gland by our own immune system, which then results in thyroid symptoms.

Dr. Mache: If the TPO and TG antibodies were positive, even if the TSH was within the normal test range of two and five, that combination might be an indication to treat.

Dr. Wentz: Absolutely. Thyroid antibodies have been correlated with

symptoms like anxiety, fatigue, weight gain and even depression. Actually the antibodies can play a role in our symptomatic profile, independently of the TSH or how much thyroid hormone you have circulating. Research has found that starting treatment with a tiny dose of thyroid hormone when a person has thyroid antibodies may be beneficial. And in some situations, lifestyle changes can actually prevent the need for thyroid hormone treatment.

Probably 95-99% of people with an underactive thyroid have Hashimoto’s and do not know about it.

Dr. Mache: Can you tell us more about what lifestyle things people can do?

Dr. Wentz: For many people with Hashimoto’s, adjusting your diet to eliminate gluten, dairy and soy can actually produce more positive symptom reduction and better improvement of quality of life than using thyroid hormone medications.

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•

•

88% of people with Hashimoto’s feel significantly better on a gluten free diet 80% feel better on a dairy free diet 60% to 70% feel better on a soy free diet

Selenium, thiamine and magnesium nutrient deficiencies can also contribute to symptoms. Selenium deficiency has been identified as a trigger for thyroid disease, so taking selenium 200400 micrograms a day can reduce thyroid antibodies, reduce anxiety, and improve and reduce hair loss.

Thiamine is something we typically think of as being deficient in alcoholics, but you don’t need to be an alcoholic to have a thiamine deficiency. People with thyroid disease and Crohn’s disease commonly have some clinical deficiencies of this important vitamin. You can restore this vitamin by taking 600 milligrams a day and can actually help a person’s energy levels in as little as three to five days.

Magnesium citrate in doses of 200400 milligrams daily can be very helpful for many people with thyroid disease and can help with joint pains, cramps, constipation, or headaches. Look at the recommendations on the bottle and start at the lower range. Just start off with one capsule and then see if you need a little bit more.

Dr. Mache: Are there other important vitamins and minerals?

Dr. Wentz: Vitamin D3, ferritin (which is the iron source protein), as well as vitamin B12 are nutrients that can help with balancing your immune system, getting your energy levels up, and help with the digestive process and hair loss.

Test these with your doctor before supplementing alone because the fat soluble vitamins (K, A, D, and E) can build up in your body fat. The other ones get peed out if you take too many. But too much iron can lead to iron overload, and that can lead to joint and abdominal pain and fatigue. Iron is one of the most common supplement overdoses.

Dr. Mache: Can you share your thoughts about which thyroid medication to consider?

Dr. Wentz: I think T4 is a wonderful medication. It is the same hormone that we have in our bodies and it works really well for many people, but not for some people. T4 needs to be converted to a more active T3 version inside the body. T4 has some activity in our bodies, but T3 has more activity in our bodies. T3 is what creates beautiful shining hair, gives us energy, and has a profound impact on our metabolism.

But due to genetic mutations, nutrient deficiencies, or even due to stress, T4

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may not get converted to T3. Some people take T4 and don’t feel any different. They say, “My head still feels like it’s detached from my body. I don’t think this is how I’m supposed to feel.” Their TSH looks fine, but they don’t feel fine.

may be a more appropriate choice.

It’s not a one size fits all approach. I really advocate for patients to work with a doctor or practitioner who knows how to utilize all the medications, not just one of them.

Those people may benefit from taking T3 directly. You can do that either by adding a stand alone T3 medication like Cytomel to the T4 treatment, or by using a natural desiccated thyroid (thyroid glands from pigs or cows, dried and powdered for therapeutic use) that contains both T4 and T3. You can utilize a T4/T3 formulation made by a compounding pharmacist.

Dr. Mache: How do you follow patients; blood tests, or how they feel?

All of these medications have their advantages and disadvantages. A person who is a vegan may not want to utilize natural desiccated thyroid, which comes from the glands of a pig, right?

For them, a compounded medications

Thyroid antibody tests, which include TPO (thyroid peroxidase antibodies) and TG (thyroglobulin antibodies) can reveal an autoimmune process

Dr. Wentz: In about four weeks when the drug starts to stabilize in the body, the person should start feeling better.

At about four to six weeks, they should get their labs drawn again. And importantly, you want to make sure that if you’re taking T3, you actually do your thyroid hormone lab work first, before you take your thyroid medications.

Otherwise the T3 results will not be accurate. Because if you take thyroid medications that have T3, and then do your labs, you may come out with lab results that show that you have too much thyroid hormone when you’re actually in the normal range. Or, you may appear to have a normal range of thyroid hormone when you don’t have enough, because of the way that the medication is metabolized in the body and the way that it releases.

Dr. Mache: So you need thyroid levels drawn both before treatment and during treatment at intervals of time to evaluate it as an evolving work in progress.

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Dr. Wentz: Absolutely.

Dr. Mache: Also, people’s needs change. One of the common things that I see is the need to adjust thyroid doses as a woman enters menopause.

Hormone therapy with estrogen can affect the levels of thyroid hormone that are available in your body. It’s not a problem, just something you have to be aware of. If you adjust your estrogen, you’ll need to adjust your thyroid medication.

Dr. Wentz: Any kind of changes in how you feel, your health conditions, menopause, more estrogen, less estrogen, various medications that you may be taking, these are all things that could impact how your thyroid hormone is working in the body. I actually do recommend periodic testing. If you’re stable, every six to twelve months is fine. If you’re having thyroid symptoms, then test more frequently, even every four to six weeks until you get stable.

Dr. Mache: Would you mind spending just a moment on the impact of stress and gut and other things on thyroid?

Dr. Wentz: Of course. Some of the biggest triggers are toxins. They cause an impaired stress response.

Some toxins like mercury have been

One of the common things I see is the need to adjust thyroid doses as a woman enters menopause found to trigger or exacerbate thyroid disease. We also have toxins in our day to day environment, like fluoride in our water supply. And Triclosan, which is in our antibacterial soaps and was banned by the FDA in September 2016. These can potentially contribute to thyroid dysfunction. Also, toxins that are present in flame retardants and on mattresses.

A lot of recent studies have come out on the impact of these on our bodies and our thyroid functions. Toxins can damage the thyroid gland and cause an autoimmune response.

Dr. Mache: So, the environment can affect you indirectly by all the fish you eat, from the mercury that’s gotten in our oceans and it can affect you more directly through the flame retardants and different substances that are in water and foods that we ingest. It’s difficult because you have to be thinking and be your own advocate and have some level of awareness of all of this.

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These seemingly small and common things are often not talked about, yet they can play a big role in our health.

What about inflammation in the gut?

Does that impact the thyroid? Some people are unaware that we all have three pounds of bacteria in our intestines.

and dairy on Hashimoto’s. There’s a whole lot of things like sugar and processed food that we shouldn’t be eating if we want our intestines and intestinal bacteria to be healthy. Are there any final take away points that you would like to wrap up with?

Dr. Wentz: Every case of Hashimoto’s is related to intestinal permeability or an impaired digestive process - a “leaky gut.” We find people who lack digestive enzymes. They will potentially have infections within their gut, food sensitivities or an imbalance of gut bacteria. All of these different things can reset the immune system to be more hypervigilant and to attack the thyroid gland. Getting the gut in balance is a key component of restoring thyroid function.

Kind of interesting, gut cells and our thyroid cells have the same fetal origin. It’s very evident to me, whatever we do to help our gut will help our thyroid and vice versa.

Dr. Wentz: Yes. Stress is a huge trigger for people with thyroid disease and for any kind of chronic illness. And one of the biggest stresses is not getting enough sleep. So one of my recommendations to help a person with thyroid disease feel better is to sleep more and work on their stress response. That could be a stress relief hobby like yoga or knitting or gardening.

Find that opportunity for yourself and direct your body to rest, digest, de-stress, and heal. That is really gonna go a long way for you.

Every case of Hashimoto’s is related to intestinal permeability or an impaired digestive process - a “leaky gut.”

Dr. Mache: We’ve come full circle, back to our earlier discussion about food and the impact of gluten, soy,

Visit Dr. Izabella Wentz at thyroidpharmacist.com/gift and get access to the chapter on nutrient depletion and deficiencies and a diet quick starter guide as well as some recipes to get started on your thyroid journey toward better health!

Get it NOW!

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Bioidentical Hormones

Don’t Know What You

Can Harm You

Mache Seibel, MD

Most women and many healthcare professional are not well informed about bioidentical hormones.

W

hat do you know about bioidentical hormones? It seems that most people don’t know as much as they think they do - and that includes your friends, your pharmacist and maybe even your doctor.

A new article in the August 2017 issue of the journal Menopause says there needs to be way more communication about menopause therapies.

Here’s why. According to the article, women today often get their information about treatment from the Internet, television, and print, as well as family and social or work

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contacts. In fact, a healthcare provider is typically not the primary source of healthcare information.

Why? Many women report they are unsatisfied with information given -- or in some cases not given -- by their provider. And many providers don’t ask if their patients use traditional drugstore hormone alternatives.

The authors looked at 100 websites advertising hormones from compounding pharmacies to see what women are being told. They found that overall, the quality of information was often low and their claims were often dubious and contradicted scientific studies or professional society recommendations.

For example: Over 60% of the sites claimed a lower health risk associated with hormones from compounding pharmacies than from those obtained from traditional drug stores...

Not true.

Almost one in four sites claimed that estrogen from compounding pharmacies protects against breast cancer...

Not true.

The study also found that compounded hormones were described as “natural” and “individualized” compared

with traditional drug stores, and traditional drugstore estrogen was described as “synthetic.”

Not true.

Neither group of hormones are “natural.”

They both come from the same plant...a chemical plant. And both can be individualized by dosages.

All of these things I discuss in detail in my book, The Estrogen Fix, which will be available in paperback September 19.

There are now between 1 and 2.5 million US women aged 40+ currently using hormones obtained at traditional drug stores. That’s about 80% less than used them before a 2002 study called the WHI or Women’s Health Initiative incorrectly reported that estrogen caused breast cancer, heart disease and more.

With all the misinformation out there, it’s easy to see why many women use estrogen that they obtain from com-

One in four sites claimed that estrogen from compounding pharmacies protects against breast cancer...

Not true.

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pounding pharmacies. They are being falsely told that compounded hormones are safer, have fewer side effects and are more natural.

In two recent surveys, less than 15% of participants realized that compounded hormones are not FDA approved. In another survey, more than three-quarters of respondents who are currently using compounded hormones believe they are safer than traditional drugstore hormones.

It’s also more challenging for patients because many providers are not as knowledgeable about hormones as they could be. Only 35% of Canadian pharmacists were aware that both compounding pharmacies and traditional drugstores both sell bioidentical hormones, and almost a quarter of them believed compounded hormones were lower risk and had fewer side effects that hormones obtained from traditional drugstores. Over 75% lacked the confidence to provide patient education.

In a different survey that included MDs, DOs, NPs and PAs only 9% believed compounded hormones were safer than traditional drugstore hormones and 8% believed the “natural” quality of it would make them better tolerated.

But less than half (45%) of the professionals surveyed were familiar with

In two recent surveys, less than 15% realized that compounded hormones are not FDA approved bioidentical hormones or compounded hormones and 38% didn’t prescribe because of their lack of knowledge. In addition, less than half of the 45% of responders who had ever prescribed them felt comfortable doing so.

So where does all this leave you?

In need of good and accurate information about hormone therapy and in need of good and accurate sources of information. It’s exactly why I wrote my book The Estrogen Window, which is coming out in paperback September 19 as The Estrogen Fix. It has received excellent reviews from many of the nation’s top menopause experts, and the North American Menopause Society, which recommended the book both for patients and for doctors in training.

Invest the time to get accurately educated on this very important aspect of menopause - hormone therapy. Time spent on you isn’t lost, it’s invested.

And the ROI is health, happiness and hormonal balance.

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Age at First Period Can Predict

Early

Menopause Women who have their first period early and don’t give birth to children are at greater risk for premature or early menopause Â

D

oes having your period early impact when you go into menopause? What about whether or not you have given birth to children?

Dr. Gita Mishra, PhD and her colleagues asked this question of 51,450 women who had their first period at age 11 or younger, or ages 12 to 15 years or older. They also asked those women if they had ever given birth to children and if so, how many.

Mache Seibel, Md

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Patients who went through early menopause (final menstrual period between the ages of 40 and 44 years) or premature menopause (before age 40) were more likely to have had their first period at age 11 or earlier. They were also more likely to never have given birth to any children.

The researchers evaluated data from the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE). Because the women had never given birth during their reproductive years, the researchers speculated they might have had a genetic condition or infertility condition that contributed to their early menopause.

Dr. Mishra, who is a PhD at the School of Public Health at the University of Queensland in Australia, found that participants with early menarche (age 11 or younger) and who had never given birth to a child had five times the risk for premature menopause (RR = 5.64; 95% CI, 4.04-7.87) and twice the risk for early menopause (RR ratio = 2.16; 95% CI, 1.48-3.15).

Mishra stated, “Women should be informed of their elevated risk of premature menopause if they began menstruating at a young age, especially those with fertility problems, so that they can

Participants with a first period at age 11 or younger and who never gave birth to a child had five times the risk for premature menopause and twice the risk for early menopause make informed decisions. If you went into early or premature menopause and never gave birth to a child, talk with your healthcare provider.

Want more information?

Click here and receive a free download to discover if you are at risk for early menopause.

WHAT’S YOUR MENOPAUSE SCORE?

use Take the Menopa t Now! Quiz and Find Ou

Wondering how much your menopause symptoms impact your health, your happiness and your hormone balance?

Then this quiz is for you!

It’s FREE and only takes 2-minutes.

Then watch your email and in minutes get a summary of your results and some valuable suggestions on next steps to support you in navigating “the change” for a healthy, happy life.

Retake the Menopause Quiz in three to six months and find out how much your symptoms have changed.

Visit MenopauseQuiz.com now and discover your Menopause Score.

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Age of Menopause & for

Risk

Type 2 Diabetes

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omen today have a one in three risk of developing diabetes, and it often starts around the time of menopause. But does a woman’s age at the time of her last menstrual period have anything to do with her later risk of developing type 2 diabetes?

Taulant Muka, MD, MPH, PhD, at the University Medical Center in the Netherlands thinks that it does.

Premature or early menopause increases type 2 diabetes risk even if you don’t have traditional type 2 diabetes risk factors

Dr. Muka and his associates analyzed data from 3,639 postmenopausal women without diabetes at baseline from a 1990 Dutch study called the Rotterdam Study. The women then had follow-up evaluations every 4 years (mean baseline age, 67 years).

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Women in early menopause should check their blood sugar and hemoglobin A1c levels to screen for diabetes Women self-reported how old they were at the time of natural menopause, how healthy they were, and what medication they were taking. The investigators reviewed the women’s medical records to determine whether or not they developed type 2 diabetes.

Women reported when the entered menopause 1. Premature (before aged 40 years) 2. Early (aged 40-44 years) 3. Normal (aged 45-55 years) and 4. Late menopause (55 years or older) Here’s what they found.

Of the women tested, 2.3% went through premature menopause, 8.2% went through early menopause, and the median time since menopause was 15 years.

During 9.2 years of follow-up, 348 women developed type 2 diabetes.

Women with both premature and early menopause were associated with higher risk for developing type 2 dia-

betes when compared with women who experienced late menopause.

“Our results indicate that menopause might be a critical period to evaluate women’s risk for type 2 diabetes as it may be an appropriate time to introduce interventions to reduce this risk,” Muka said. “Women who enter menopause early may want to regularly control their blood sugar, cholesterol, lipid levels and other factors affecting their health.”

Have you been through early or premature menopause? Did you know that taking hormone therapy (HT) lowers the risk of diabetes in menopause? I talk about this in my newly released book, The Estrogen Fix. Be sure to have your doctor or healthcare provider check your blood sugar or other blood tests such as a hemoglobin A1c to see if you are at risk for type 2 diabetes.

Curious about how much your menopause symptoms are affecting you?

Visit www.MenopauseQuiz.com and find out in just two minutes.

Taulant Muka , MD, MPH, PhD, can be reached at Erasmus University Medical Center, Department of Epidemiology, Dr. Molewaterplein 50, Office NA29-14, PO Box 2040, 3000, CA Rotterdam, the Netherlands; email: t.muka@erasmusmc.nl.

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Water Exercises My Menopause Magazine

to Cool Your Hot Flashes and

Control Your Weight

By Suzanne Andrews

Looking for an alternative exercise that is easy on your joints, controls weight and even cools hot flashes? Water exercises may be just the answer.

S

ince the buoyancy of water supports your body weight, water exercise puts less stress on your joints and is a great way to lose weight. Water exercise also helps ease joint pain so if you have weight to lose and exercise is

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2

Work out in water that is waist to chest deep. The deeper you go, the more challenging your workout will be. You can burn up to 500 calories with one hour of intense water aerobics.

CORRECT JOGGING FORM: Keep your shoulders back slightly, knees in line with hips and chin parallel to the pool floor. Bring your knees up high (shown below) as you propel yourself off the pool floor. Make sure to plant your foot all the way down on the landing as jogging on just the balls of your feet causes strain to your calves.

too painful, water exercise may be your best way to fight menopausal weight gain.

Here are five great water exercise tips to get you started:

1

Get water shoes. Water shoes provide safe traction on the pool floor. To lose weight in the water, you need to jump as high as you can to get your heart rate pumping. A good pair of water shoes also protect your feet, drain quickly and have good support and mesh insert covers to protect your feet from water hazards you may encounter while jumping.

3

Integrating water weights or noodles. Water weights or noodles can increase muscle density which speeds up your metabolism.

That’s important since we lose on average five percent of our muscle mass every ten years after age 35. And since muscles burn more calories than fat, less muscle mass adds to weight gain. So it’s always a good idea to incorporate strength training into your workouts for weight loss.

4

Webbed water gloves and flippers. These accessories make great resistance tools for water exercise and help to keep your water workout interesting while firming up your arms and legs. Start now and

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Doing water exercises you still need plenty of drinking water handy to minimize dehydration you may be able to wear a sleeveless dress in just 90 days.

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Stay hydrated. It may seem counterintuitive since water exercise takes place in the water, but it’s super important to stay hydrated. Because you won’t be perspiring at all or at least as much as you do when you land exercise, water exercises can be intense and have a sneaky tendency to be dehydrating. So you still need plenty of drinking water handy to minimize dehydration.

Water exercise is a great addition to your weight loss plan and can help ease joint pain, ease swelling and improve your mobility - all this while you trim down and tone up! And it may even lower hot flashes.

For more medically proven water exercise moves to help you lose weight and ease joint pain, see Suzanne An-

drews Arthritis Water Therapy DVD with laminated water exercise booklet at healthwiseexercise.com

Suzanne Andrews founded Functional Fitness in 2008, the most popular fitness series for boomers and seniors broadcasting on over 159 Public Television stations throughout the US and Canada. Read Suzanne’s inspiring comeback story of how she survived a near fatal accident, From Deaths Door to Producing a National Fitness Series. Feel free to send Suzanne a message here.

Get Suzanne Andrews Get Stronger Bones DVD that includes her osteoporosis-walking workout at www.amazon.com/Suzanne-Andrews-Stronger-Workouts-Osteoporosis/dp/B01BM2X6GY

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5

Tips to Deal with

DEPRESSION During Menopause

Depression is common.

Here are 5 Tips to Help you Feel Better

F

eeling sad and depressed can be debilitating and seem impossible to combat at any time in life. But that is particularly true if you experience it during menopause. And menopause is a common time for de-

pression to raise its head because of all the hormonal changes.

Approaching menopause, your body is going through enough physical stress as it is, and all the emotional turmoil that comes with depression can cause

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If you have a history of major depression, postpartum depression, or PMS, you are at a higher risk during menopause for a clinical depression you to lose your sense of hope and leave you seeing no end to the deep sadness you’re experiencing.

Some sadness is common and often passes. But if you are a woman with a history of major depression, postpartum depression, or PMS, you are at a higher risk during menopause for a clinical depression lasting two weeks or more. And that can be a serious condition.

The good news is that depression is treatable and you should seek help from your healthcare provider. They may suggest hormone therapy (HT) with estrogen and possibly antidepressant medication as well as HT. For women who are experiencing the menopause blues, here are 5 tips to help get you out of your funk.

1

Get a new hobby: If you’re not clinically depressed, a simple act like trying a new activity may snap you out of your funk. Try it, even something you never thought you would like. Challenging yourself engages the parts of your brain associated with happiness. When you do something unfamiliar, you focus on the task and forget about your worries, and that makes your body less tense. Plus, it releases endorphins that further elevate your mood.

2

Workout: Exercise, especially cardiovascular exercise, has been proven to elevate people’s moods. In fact, it can be as effective as taking medication for mild to moderate depression. Working up a sweat makes you feel refreshed and energized and can significantly improve your mood.

Plus, exercise releases feel-good chemicals, signaling to your brain that you’re happy. There are lots of ways to exercise besides running a marathon. Try a Zumba class or jog around your neighborhood - you’ll start to feel better both physically and emotionally. And depression improved following exercise is less likely to relapse than depression improved with medication.

3

Learn Yoga: Yoga is a terrific way to help get your emotions under control. Stretching your muscles eases tension making you feel loose and

The Hot Years Mind

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son’s mood and make them feel more light-hearted. If you don’t like gardening try reading outside or feeding the birds at the park. The more time you spend outdoors, the quicker you’ll start to feel better. Use sunscreen please!

5 relaxed, and concentrating on poses teaches control of other aspects of your body and mind. All great benefits from something that helps keep you strong and supple. A Woman’s Book of Yoga has some great exercises for women in and around menopause.

4

Garden: Not only is gardening relaxing, it takes place outdoors so your body absorbs sunlight. Sunlight has been shown to alter a per-

Exercise, especially cardiovascular exercise, has been proven to elevate people’s moods

Party Hardy: Yes, partying, or more specifically, getting out and socializing with family and friends, can instantly improve your mood. So go out to dinner, go dancing or just visit a friend. Being around people who truly know and love you can improve your outlook and make you less depressed.

Just don’t drink alcohol, as alcohol is a known depressant and can leave you feeling worse. And avoid friends who “bring you down.”

Be sure to consult your healthcare provider if you’re feeling depressed during menopause (or any other time) to make sure there are no underlying causes. If your depression lingers or feels like it’s too much to bear you may need medication. It’s important to realize that with proper help you can beat depression and start smiling again.

About the author.

Meighan Sembrano is a passionate health, beauty, fitness and skincare writer. You can follow Meighan on Pinterest and Facebook.

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Estrogen and Use the Risk for Depression In Perimenopause

Can being on estrogen before menopause lower your risk of depression as you enter menopause and beyond? This study evaluates how that may be just the case.

P

erimenopause, that 10 years window before and just after menopause, can be challenging. And feeling a bit sad and weepy may seem almost unavoidable. So can those symptoms be prevented?

To do it, they reviewed data from the Study of Women’s Health Across the Nation (SWAN) study on 1,306 regularly menstruating premenopausal women to evaluate what effect taking estrogen eventually had on their mood during the menopause transition. Â

Wendy K. Marsh, MD, MSc, associate professor in the department of psychiatry at the University of Massachusetts Medical School in Worcester, and colleagues wanted to answer that question.

They used a tool called The Center for Epidemiological Studies Depression Scale to assess depressive symptoms, and a score of 16 or greater indicated clinical depression.

The also determined how long the

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women had taken estrogen between the time of their first menstrual period and their transition into menopause, their pregnancies, whether or not they breastfed, how long they took birth control, and whether or not they developed depression.

The women who reported depression during their menopausal transition or up to 10 years after menopause were more likely to have a premenopausal history of depression and a history of using antidepressant medication. They also tended to have a lower level of education, be Hispanic and a smoker.

In general, the longer time interval a woman was on estrogen between

her first period and the beginning of her menopause transition (perimenopause) and the fewer the number of hot flashes she experienced, the lower her risk of depression during perimenopause and up to 10 years postmenopause. A longer usage of birth control was associated with a decreased risk of depression, but  the number of pregnancies or breastfeeding was not.

These results, published in the July 2017 issue of the journal Menopause, give women and their doctors insight into the benefits of taking estrogen earlier in life on preventing depression in perimenopause, menopause and beyond.

The Hot Years Fitness

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Can What You Eat

Help You

Live Longer?

A large study suggests it’s never too late to improve your diet and live healthier

I

t almost seems crazy to still be asking if eating healthy keeps you healthier. But that is just what this study did... with a twist. The study, published in the July 13 issue of the New England Journal of Medicine wanted to know if adults who were middle-aged and older when they started eating better would live longer.

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If you’ve been under the impression that it’s too late to start, it’s time to think again.

The researchers basically just reinforced the same messages people have been hearing for years.

But this time they demonstrated that eating better, even in middle age and older, might extend people’s lives.

And just like mom always said, eating more fruits and veggies and whole grain is good for you. Those who did had a lower risk of premature death than those whose diets stayed the same.

Eating better, even starting in middle age and older, might extend people’s lives

Mercedes Sotos-Prieto, a visiting scientist at the Harvard School of Public Health, in Boston and lead researcher on the study was quoted as saying, “A main take-home message is that it’s never too late to improve diet quality.”

The study included nearly 74,000 U.S. health professionals who were mostly 60 years of age or older and part of ongoing studies that began in the 1970s and 1980s. Nearly 10,000 of those study participants had died.

So the investigators sought to find out how their deaths related to dietary changes they had made during the previous 12 years of the study (1986 to 1998).

In contrast, people who actually worsened their diet and made less healthy choices had a 6 percent to 12 percent higher higher risk of dying during the study period compared to stable eaters.

To quantify their findings, the researchers used three scoring systems: the Alternate Healthy Eating Index; the Alternate Mediterranean Diet score; and the DASH (Dietary Approaches to Stop Hypertension) diet score.

All of these scoring systems differ slightly, but they each give more points to foods like fruit, vegetables, whole grains, fish, low-fat dairy and foods containing “good” fats, such as olive oil and nuts. Lower ratings were given to processed foods, sugary foods, red meat and butter.

Overall, improving your diet quality by 20-percentile yielded an 8 percent to

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17 percent decrease in the risk of early death from any cause. There was a similar dip in the risk of dying from heart disease or stroke, specifically.

fessor of nutrition science at Tufts University, in Boston said, “The key is to make changes that you can stick with for the rest of your life.”

Lest you think that a 20-percentile shift is a monumental task, it turns out just swapping out one daily serving of red meat for one serving of legumes or nuts, for example, would do the trick, according to Sotos-Prieto.

As Connie Diekman, a registered dietitian commented, “Shifting one meal from meat and potatoes to sauteed veggies, quinoa and a topping of grilled chicken or lean flank steak would be one way to move to a healthier eating pattern.”

“Our results underscore the concept that modest improvements in diet quality over time could meaningfully influence mortality risk,” she said.

This study strongly demonstrates that although eating is a lifelong requirement and most people have habits they have developed over decades, it clearly demonstrates that you are never too old to change, and small changes can yield huge benefits. As Alice Lichtenstein, a spokeswoman for the American Heart Association and a pro-

Given the benefit of adding years to your life, this article should be one that you literally take to heart.

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Renewable My Menopause Magazine

Mache Seibel, MD

I

Energy

There is a lot of talk about renewable energy.

t’s energy from a source that is not depleted when used. Examples are wind, solar and water.

The benefits are that we don’t have to deplete resources to create large amounts of energy. Tomorrow the wind will blow again, the sun will shine and the tides will come in and out. That’s very different from coal, oil and gas. Eventually, those resources will be depleted and all the engines that depend on them will no longer have an available source of fuel.

There is another type of energy that is also limited. It is the energy that we use to get us through the day. From wake up, to skip breakfast, to play full out at work, to rush through lunch, to wrap up the day, to rush through dinner, intense quality time with family, catch up on emails, to shower, rinse and repeat.

For most people, days are a blurring sequence of actions punctuated by too little sleep and an occasional pause for vacation during which time the routine just changes location.

When is the last time you slept till you woke up? Spoke with your partner, parent or child and just listened to their issues? Meditated? Chewed your food thoroughly before you swallowed it?

Or just blocked out time to think?

Life without rest periods is a run on sentence and no one wants to be sentenced for life. So “Take a break before you have one – or you run out of gas.”

Ask yourself, “Am I making time to renew my energy?”

Click Here to hear Dr. Mache narrate this over a soundtrack of his original music.

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Time spent on you isn’t lost…It’s invested! And the ROI is better health, happiness and hormone balance.

Mache Seibel, MD

CLICK HERE to hear the Song of The Month. I wrote Red Hot Mama to celebrate menopause.

Visit www.DoctorSeibel.com/store/cds for additional songs and CDs. Every effort has been made to ensure that the information contained in this magazine is complete and accurate. However, neither the publisher nor the author(s) is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this magazine are educational and not intended as a substitute for consulting with your physician. All matters regarding health require medical supervision. Neither the authors nor the publisher shall be liable or responsible for any loss, injury, or damage allegedly arising from any information or suggestion in this magazine. The opinions expressed in this magazine represent personal views of the author(s) and are not a substitute for medical care.

All content in this magazine is Copyright © HealthRock, LLC

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