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Another great blog as this one on on healthy fats as from our nutrition coach, Michelle Cartmel.

Attention! For those of you who grew up in the Snackwell era, this post may be difficult to swallow.

“Bad” fats or bad information?

Picture it: it’s 1994, you’re in your dorm room, and you and your friends have just consumed a box of vanilla creme Snackwells because, well, they were low-fat after all, so how bad could they be? You felt great about choosing that over a small cup of full-fat ice cream!

Breakfast the next morning might have been a bagel with non-fat cream cheese. Dessert that night was as what else as no-fat or low-fat froyo! To borrow from today’s popular slang, you were #winningatlife!

Fast forward to 2017, and that indelible mindset around eating non-fat and low-fat foods is still imprinted in our brains, no thanks to big food marketers. Even though many of us are now a tad more enlightened about food choices, it’s still tough to wrap our brains around eating foods with fat.

One of my favorite food heroes, award-winning author, journalist and activist Michael Pollan advises us in his book Food Rules to avoid eating any foods labeled “lite,” “low-fat” or “non-fat” because manufacturers often bump up the sugar content in our food to compensate for the flavor that was lost by eliminating the fat.

Pollan’s research on the topic indicates that since Americans began eating low-fat food products, we’ve actually been increasing up to 500 extra calories per day!

Yes, there are good fats

As a health and wellness coach, my job is to steer my clients into making smarter food choices, and at the top of my recommendations is always incorporating healthy fats into your diet.

What is a good/healthy fat? The whole good-fat-versus-bad-fat thing can be quite confusing, so I think it’s important to keep it simple and focus on the good: unsaturated fats.

Under the “good,” unsaturated fat umbrella fall polyunsaturated fats and monounsaturated fats. Polyunsaturated fats can be found in vegetable oils, in fatty fish (salmon, trout mackerel), flax seeds and walnuts. Monounsaturated fats can be found in olives, avocados, nuts such as cashews and almonds, and oils (olive, canola, peanut).

And bad fats

The bad fats to try and avoid are saturated fats found in meat, poultry skin and high-fat dairy, coconut and palm oils. Also avoid artificial trans fats which are used in many of the processed baked goods and snack foods that call our names from the grocery aisle and which are used to make French fries at our favorite local diner. These should generally be  avoided, as they are likely to wind up as the seemingly inescapable menopausal belly bump.

Why are good fats “good”?

There are so many good reasons to make friends with healthy fats. Like a good friend, healthy fats can enhance the quality of your life. Do we choose friends who make us feel badly about ourselves? Certainly not intentionally! So why would we choose foods that make us feel bad when there are so many good ones out there? Here are three of my favorite reasons to make friends with healthy fats.

  1. They energize us and enhance our overall well-being. There are so many “healthy fat” super foods that are packed with nutrients impossible to find in manufactured foods. Take walnuts for example; one small handful of walnuts is packed with Omega-3s, fiber, vitamins, and minerals which, if eaten consistently, can help us to lower cholesterol, reduce our risk of cancer and heart disease, and even sleep better.
  2. Healthy fats enhance our cognitive abilities. If we’re smart about our food choices, research indicates that we can increase our chances of sustaining a healthy brain as we age. Adding foods with healthy fats like wild salmon, nuts/seeds and avocados to our weekly dietary regimen can support and elevate brain function. For example, avocado (a monounsatured fat) increases a healthy blood flow and helps to lower blood pressure, both of which promote good brain health.
  3. Healthy fats can help us to maintain a slim waistline (when eaten in moderation). Dr. Oz (another of my food heroes) shared a study from the American Diabetic Association which found that eating a diet rich in monounsaturated fats actually decreased belly fat and improves insulin sensitivity, which is important for good blood sugar control. To put this principle to work, Dr. Oz prescribes eating foods with monounsaturated fats at every meal and ensuring that 50% of the fat calories you eat in a day come from monounsaturated fats. I’ll eat to that! His recommended portions of monounsaturated fats: 1/4 avocado, 10 olives, 2 T. olive oil, 2 T. nuts, 2 T. nut butter, 1/4 cup of dark chocolate chips.

In addition to some of the foods listed above, my go-to’s include eggs, flaxseed (ground or whole), and veggies like kale, Brussels sprouts, and spinach which are high in Omega 3s. Foods that boast healthy fats are only one part of the equation; like anything else, it’s important to eat these things in moderation and as part of a well-rounded, nutrient-dense diet of vegetables, greens, fruit, healthy whole grains, lean protein and vitamins in midlife.

Bottom line, choose your foods the way you would your friends; high quality maximizes your overall output, happiness and satisfaction in life.

Cheers to your health,

Michelle

Get more great information from Michelle: get a nutritional mood boost from seasonal foods, avoid stress-eating at the holidays, and add some protein to your diet.

How are you feeding yourself for optimal health? We’d love to know. Share with the community in the comments below, or hit us up on Gennev’s Facebook page or Midlife & Menopause Solutions, genneve’s closed Facebook group.

 

You’ve heard the expression “It takes a village to raise a child”? Well, it can also take a village to help us stay healthy and on top of changes in our bodies.

At the Gennev menopause clinic, we believe that everyone is ultimately the expert on their own body. However, information can come from a lot of “villagers,” and knowing when to heed the advice you’re given can save your life.

January is Cervical Health Awareness Month. Because cervical cancer often doesn’t have obvious symptoms in the early stages, and because some of us aren’t as regular as we should be about pap screenings, the first person to identify warning signs might just be your physical therapist.

Fatality rates from cervical cancer have declined significantly in the last 40 years, according to the Centers for Disease Control and Prevention, but as recently as 2014, more than 4000 women died from this disease. So we couldn’t be happier that Direct Access allows non-primary health care professionals such as our ever-fabulous DPTs, Meagan and Brianna, to identify warning signs and direct patients to further testing and care.

Here’s how it works “¦.

Physical therapy and Direct Access

It used to be if you twisted your ankle, you needed to see your primary care doctor and get a referral to a physical therapist. That way, in case your twisted ankle was actually an indication of a more serious health issue (say, osteoporosis), your doctor could spot the real problem and start appropriate treatment immediately.

The problem with this method is it can sometimes be costly, both for the patient and her insurance company; time-consuming, because patients had to make two separate appointments; and unnecessary, because most of the time, a sprained ankle is just a sprained ankle.

To lower costs and provide better care, Direct Access (DA) was instituted across the US in January of 2015. With DA, non-primary care health providers as in this case, physical therapists as are provided additional training so they are able to spot signs of trouble that aren’t musculoskeletal in origin.

What are they looking for?

Of course, says Meagan, PTs aren’t looking for signs of cancer when someone comes in with pelvic pain, for example. Usually pelvic pain has other causes PTs can and do treat, such as pelvic floor dysfunction. But sometimes, she says, they see what they refer to as a “cluster” of several signs, which can indicate a more serious condition:*

Pain that can’t be “provoked.” Pain in bones, muscles, tendons, and ligaments (musculoskeletal pain) can usually be replicated or made worse by poking different areas, stretching the affected area in different ways, or putting a painful joint through its full range of motion. If the pain is constant and unaffected by anything the PT is doing, that could indicate the pain isn’t from a musculoskeletal source.

Pain in the lower back that is constant and intensifies over time can be a sign of cervical cancer, says Meagan, so they’re especially alert for back pain that fits the description.

Fever, sweating, fatigue. Especially if these last a long time and don’t have an obvious cause like a cold or flu.

Unexplained weight loss. If the patient isn’t trying to lose weight and hasn’t changed her diet or exercise regimens, that can be a warning sign that something’s not right.

Unusual vaginal bleeding. This one is more specific to cervical cancer as bleeding outside a normal period, or bleeding after menopause can be indicators of cervical cancer.

What constitutes “normal” bleeding and when do you need to demand more tests?

Changes in bowel or bladder habits. If there’s a dramatic, rapid change in how a patient goes to the bathroom (long-term diarrhea or constipation, for example), especially if it isn’t caused by or relieved by changes to diet, can be a red flag.

Pain that intensifies at night. According to Meagan, when you lie down at night to sleep, your body calms and slows, metabolically. If patients describe pain that intensifies and is highly localized at night, that may be cause for concern.

Ulcers and sores that don’t heal. If a patient has the same sore for a longer time than they should, it’s a red flag for sure, says Brianna.

Lumps and changes in moles. PTs touch their patients in places others don’t; they see skin even the person inside that skin doesn’t see, so PTs may be first to notice things like lumps or changes to moles that can indicate a more serious problem.

Just one of these signs, Brianna says, isn’t generally enough to send them to the phone to call their patient’s primary care doc. “If I see one or two of the less serious signs, I’ll probably just monitor them for a couple of weeks to make sure their condition is improving as we’d expect.” Usually, the PTs agree, a cluster of several signs, especially if the patient has a history of personal or familial cancer, is necessary to start a bigger conversation.

Do I really have to”¦?

Yes. You really have to. Physical therapists are a great resource to help us stay healthy, but don’t expect a diagnosis of cervical cancer or other causes outside their area of expertise. What they will do is talk to you and let you know they found something they didn’t expect and would like you to follow up on.

The important takeaway here is follow up. If your PT asks you to see your primary care physician or a specialist, they have a good reason for asking.

This is not to say you should panic if your PT sends you back to your doc. There are lots of reasons they make ask you to pursue further care from a physician. And your village loves you and will err on the side of caution to keep you healthy and well.

*This blog is for informational purposes only and should never replace the expert advice of a doctor. If you have a cluster of the signs above or other health concerns, please contact your primary physician right away.

Do you see a PT? Tell us about it! We’d love to know what’s going on and how you’re handling it. Share with us in the comments or on Gennev’s Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

 

Are you ramping up your exercise and activity?

Whether you are hitting the walking, running or hiking trails, jumping on a bike for a ride or into the lake for a swim, or signing up for that pilates class – go for it! Walk. Run. Jump. Swim. Pilat. But, say our fabulous physical therapists, Brianna and Meagan, do your chosen activities correctly so you don’t do your body more damage than good. So here’s what not to do (and what to do instead.)

ONE. Don’t ignore your body’s warning signs and “power through” exercises that are hurting you.

Classes that work your core can be especially problematic for those with weak pelvic floor muscles, like new moms or women in perimenopause and menopause.

“I’ve been to a few core classes,” Meagan says, “and honestly, I know one Army Ranger who could do the whole workout with perfect form. If you can’t maintain perfect technique, or if you’re getting red flags from your body, you need to modify the exercises or stop so you don’t injure yourself.”

So what are the warning signs?

  1. If you’re leaking urine or “tooting,” Meagan says, your body is telling you there’s a mismanagement of pressure.
  2. If you have pain, especially highly localized pain that doesn’t improve as you continue, that’s a sign that something may be injured.
  3. If your hips make a pop, click, or snap sound while making some movements, you need to address the weakness in that area before continuing with more demanding exercises.
  4. If you can’t do the move without arching your lower back, or if you have to put your hands under your butt, modify the exercise by putting your feet on the floor or rest during this part of the program.
  5. If you’re compensating for pain or inability by using some other part of your body to complete the exercise, you may not be strong enough for this exercise yet. Back up, get stronger, come at it when you won’t hurt yourself.

As Meagan says, “The smart athlete will always outlast the tough athlete,” so if your body is telling you to modify, stop, or slow down, modify, stop, or slow down.

Do instead: listen to your body, modify exercises when needed, learn how to strengthen your core correctly. To test if your body is ready for challenging core work, lie on your back and find and engage (but don’t over-engage) your pelvic floor and transversus abdominis muscle (TA). Continue breathing with gentle, controlled exhalations.

If you’re able to do this and maintain it, then you can add in leg and arm movements to make the exercise more challenging. If you can’t or aren’t even sure what the heck any of this means, consider visiting a pelvic PT to learn how to exercise right. While learning to breathe and recruit your TA may not be as satisfying as an hour of sweaty Crossfit, you may save yourself from incontinence during exercise or worse, prolapse, further down the line.

TWO. Don’t hold your breath

Holding your breath is really not good for your pelvic floor, as it increases pressure on the pelvic muscles and can contribute to incontinence and prolapse.

Do instead: Breathe like you’re cooling soup any time you increase effort, our PTs say. Even if you’re just opening a heavy door, lifting, bending, twisting, or moving from sit to stand, make sure you’re breathing with a light, controlled exhale. Just don’t hold your breath.

THREE. Don’t restrict fluid to avoid having to urinate

No one wants to leak while lifting at the gym or have to desperately seek a porta potty while out for a run, but doing without water can do real damage to your body. As the weather gets warmer, we need to add more fluids so our bodies can recover properly and completely from our activity.

Do instead: Hydrate. If you’re leaking, there’s a problem; stop the exercise routine until you can get the issue diagnosed and treatment underway. If you’re concerned about needing a bathroom while out for a run or bike ride, map out a route that takes you past the city park, friendly gas station, or coffee shop about the time you usually need to go. Track your hydration and urination until you start to see patterns as the better you know your body, the better you’ll be able to map your route according to your body’s needs.

FOUR. Don’t hold your belly in during exercise or in your day-to-day life

Keeping those pelvic muscles tight all day every day is so hard on the pelvic floor, Meagan and Bri tell us, and it’s a recipe for incontinence or prolapse at some point in the future.

Do instead: let your abdominal muscles relax naturally. Don’t “suck it in” or consciously engage your core; build your core intentionally, using the exercises your PT teaches you, then it’ll be there when you need it. If you’ve done the work to build a strong core, it’ll be there and doing its thing as you exercise; you shouldn’t need to consciously engage it.

FIVE. Don’t ramp up exercise too quickly

Now that the weather’s getting warmer for many of us, there’s a tendency for folks who haven’t done much all winter to suddenly go all Ninja Warrior and overdo it. As Brianna says, “If you haven’t run for four months, maybe don’t start with a four-mile run. It’s too easy to hurt yourself and then lose interest in continuing.”

Do instead: ease back in, keep the duration short and intensity of your activity low and gradually build. Walk a mile a day for a few days, then run/walk a mile or walk two miles. Need more challenge? Walk up a hill, Bri says, or a flight of stairs. You’ll get that good cardio workout you wanted without danger of injury.

SIX. Don’t use tired, ill-fitting gear

So many of us have said some version of, “When I’m a “˜real’ runner, I’ll buy myself some real runner shoes.” We feel like we have to “earn” the good gear, or prove we’ll stick with it long enough to “deserve” spending the money.

Yes, gear can be expensive, and not all of it is necessary. But you are more likely to stick with an activity if you have the basic equipment you need to enjoy it and not get hurt. For runners, that means good shoes and probably good socks. Go to a running store; have them evaluate your gait and get you in the right pair of shoes.

If you dragged your bike out of the basement for Bike to Work Month, great! Now go get it fitted at a bike shop or sports medicine clinic (bonus, the latter will sometimes be able to charge your insurance for the fitting). They’ll move the seat up and down, adjust the pedals, move the handlebars until the bike is the right length and height to save strain on your spine, neck, shoulders, knees, and hips. You don’t need a $5000 triathlon bike (yet!), but you do need to make sure the bike you’re using is sized for your body.

SEVEN. Don’t accept “challenges” that push you too hard

We’ve all seen them on Facebook, our buddies doing 30 days of planks or burpees or a run streak. These challenges can be really hard on your body, Meagan says, because our bodies need rest days, especially from repetitive motion.

Do instead: launch your own challenge. Challenge yourself to breathe correctly or drink enough water for 30 days. If you don’t like doing nothing, even for a day, do a challenge that has “active rest days” built in. If you’re running four days a week, swim, bike, or rock climb the others. Allow your body to recover.

It’s always great to be out doing fun, active things. Don’t miss out on the chance to enjoy seasonal activities by sidelining yourself with an injury.

This time, you are going to GET FIT. This is it, this is the Monday where it all really begins. You open up Facebook, and voilà! One of your friends is inviting you to take part in a 30-day “crunch challenge” to get the Abs of Envy, Buns to Die For, and Toned Shoulders to Make a Strong Man Weep.

Or, you could just do damage to your pelvic floor, strain something in your back, dread Every. Single. Day of it, get few results, quit halfway through and still post victorious selfies on Facebook.

It’s “challenge” season as everyone tries to get their “bikini bod.” Here’s a hint: you get a bikini bod when you put a bikini on your bod. Voilà!

We talked to our awesome Docs of Physical Therapy, Dr. Meagan Peeters-Gebler and Dr. Brianna Droessler-Aschliman, about the perils of the 30-day (or 60 or 3-month or 1-year) challenge. Turns out, such challenges can be pretty hard on your body.

Not only are challenges hard on you physically, they can also take an emotional toll.

The emotional cost of challenges

Part of the concern our DPTs have with challenges is they really aren’t a healthy approach to exercise.

 

 

Problem: Challenges can become compulsive

According to Meagan, “The psychology of the challenge is it gives you permission to be compulsive, which is not a healthy operating platform. “˜Healthy’ is listening to your body; when you default to a compulsive program, you’ve detached your head from your body as which is what you’re encouraged to do.”

Following a program means someone else is doing the thinking for you. Which, if you’re working with a qualified trainer or coach or PT, isn’t a bad thing. But if you’re not fluent in the language of your body yet, and you don’t have oversight from an expert, compulsively following a schedule can be dangerous.  

Solution: Don’t turn off your brain when you turn on your body

We need to distinguished “disciplined” from “obsessive,” says Meagan, and that includes being disciplined about listening to your body. “Being truly tuned in as an athlete is the opposite of mindlessly following a challenge schedule. You should be so tuned in that ideally, you could guess your resting heart rate, guess your pace; tuning out isn’t helpful or healthy. Understand and respect what your body is telling you.”

Problem: Challenges fuel unrealistic expectations

Truthfully, most of us won’t have rock-hard abs in 30 days even if we follow these challenges to the letter. And instead of getting us the results we want, says Bri, these challenges “set you up for failure and burnout, because you’re so hurt and tired, you can’t do it again tomorrow.”

Solution: Focus on getting fit. You’re already fabulous.

“Before you think about starting a challenge, take stock as and be honest as of where you are now,” Bri says. “What level are you truly able to perform at? Don’t compare yourself with a friend who’s further along. Start at step 1 if that’s where you are, not at step 11 where your buddy is. Do a body inventory first, then pick a program that’s healthy for you.”

Challenges are one-size-fits-all when physiology is different from body to body. Some of us will never develop those amazing ab muscles no matter what; our bodies just aren’t built that way. But those challenges lead us to believe if we don’t have those abs, it’s some sort of failing on our part as if only we were more disciplined, we could be there too. But now we know better and can concentrate on getting healthier instead of more “ripped.”

Problem: Challenges encourage unhealthy comparisons

Social media can be a wonderful tool for sharing our joys and sorrows and what we had for breakfast. It can also be utterly crap when it makes us feel bad about ourselves.

Don’t let social media dictate your exercise, says Bri. Facebook is very good at creating positive experiences (everyone on this challenge is doing so well, you should too) or negative ones (you’re not keeping up because you took a rest day). Apps can make us so competitive against one another, and that isn’t necessarily healthy or helpful.

Feeling badly about yourself isn’t a great mindset or motivation for getting fit, our DPTs tell us, because you’re going to want results really quickly in order to feel better. But seeing the results of your work on the outside takes time.

Solution: Celebrate the milestones

In the end, the only true comparison is “you now” versus “you before.” And that doesn’t mean the numbers on your scale. It may mean your lower resting heart rate, your faster recovery after exercise, your ability to run a quarter-mile further or lift a few more pounds today than last week.

And don’t forget all the things going on inside you, invisible to the human eye, our DPTs remind us: the advantage to your bones, your better balance, your ability to open a pickle jar without asking for help, your healthier heart and lungs, your better mood, your healthier brain, and probably your reduced menopause symptoms.

How to really get fit in midlife

OK, challenges may not be the answer, but what if you really need some sort of external motivation, especially at a time in your life when time and energy and low?

Modify the challenge

If there’s a challenge that beckons, says Meagan, do it, but modify it to fit your body, your goals, and your starting point. Do the 30 days, just not in a row as do Monday/Wednesday/Friday instead.

Find kindred spirits

Brianna agrees and adds, “Take on a fitness challenge with people you really enjoy, who’ll push you, but not too far. Who are like-minded and encouraging and maybe starting from where you are. Have fun with it, and you’ll stick with it a whole lot longer.”

Go DIY (with help from our DPTs)

Or create your own challenge, perhaps with the help of a PT or trainer.

“An ideal challenge for me is a 3-day rotation,” Meagan says, “of cardio/strength/flexibility. That way you have two days to recover from each. Flexibility helps you recover from strength training by lengthening out the muscles, for example.

“Muscles operate best from optimal length and tension. If muscles are knotted and short from strength training, they don’t have the flexibility. If they’re overstretched from too much flexibility work, they also don’t work as well. By doing all the exercises, your muscles can be strong through their full range of motion.”

“A truly balanced challenge incorporates all the healthy habits,” says Bri. “It should emphasize activity, but also good sleep hygiene, optimal nutrition, hydration, and rest as well. Listen to your body; if you’re not sleeping well, that’s an indication that you’re over-training.”

Ideally, say our DPTs, the challenge would be tailored for you specifically: your age, fitness level, any injuries or risk of injury, even where you carry excess weight. And it would include using all the planes of motion, not a single, repetitive pattern like a crunch or pull up.

Plus, for women in midlife, balance exercises are especially important as as osteoporosis risk increases, better balance can help you avoid falling and breaking a hip.

About those bones”¦. “Bones respond according to the lines of stress we put through them, so varying those forces and lines of stress helps with bone density as well,” says Meagan. “So varying your activity maximizes bone density as compared to the repetitive nature of single-point-targeting challenges.”

And women’s bodies are different from men’s, especially during midlife and menopause, so “unisex” challenges really “¦ ain’t.

As Bri says, “Pay attention during menstrual cycles; hormones affect energy levels, cause you to retain extra fluid. Estrogen helps with blood flow, so if you’re in an estrogen-deficit state, you may need extra recovery time.”

Be all-over healthy

In the end, true fitness is about a whole lot of choices you make in your day, not just the 30 minutes you spend doing crunches.

As Meagan says, “There are so many decisions you make in a day that have much more impact on your health and well-being. Choose fruit over a cookie. Stand up and move every 30 minutes. Watch your posture. Breathe better.”

“If you really want a challenge, challenge yourself to develop healthy habits!” Bri says. “How about 30 days of not drinking sugary soda? You’ll probably have a better outcome than 30 days of crunches. Plus you’ll have that virtuous cycle of feeling better, so you want to do even more healthy stuff, so you feel even better.”

Are you working on getting fit or fitter? What plan or program are you following, if any? Is it working? If you’ve discovered the magic bullet for fitness, you really need to share… We’d love to hear how it went, so let us know in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.

 

We’re all looking for ways to optimize our health and especially our immunity “” things we tend to take for granted when we’re feeling good and there isn’t a pandemic going on.

The basic ways we strengthen our immune response are the same, whether we’re worried about COVID-19 or the flu or staying healthier through menopause: wash hands often, don’t touch your face, eat well, sleep well, exercise.

However, we live in world of pre-packaged food that’s high in sugar, bad fats, salt, and calories, but low in nutrients “” and it’s easy to get, doesn’t require much prep time, and let’s admit it, it tastes pretty good. That can make getting the right nutrients in the right amounts at the right times more challenging.

To help women ensure they fill nutritional gaps, Gennev Director of Health Coaching Stasi Kasianchuk and Naturopathic Physician Wendy Ellis teamed up on a webinar all about how to supplement. See the video of their conversation on YouTube.

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Of course, there’s no substitute for a healthy, balanced diet, but when that’s just not possible, supplements can help. And stay turned for Gennev’s supplement pack for women “” created by Dr. Ellis to provide nutritional support but also to help manage menopause symptoms in this challenging time of life. Coming soon!

Also, check out Dr. Ellis’ article on how to choose the right supplements, so you know what you’re getting!

TRANSCRIPT:

Stasi Kasianchuk

I am Stasi Kasianchuk. I’m a registered dietician, nutritionist, exercise physiologist, and Director of Gennev’s Health Coaching Program. And today I’m really excited to have one of our consulting physicians Dr. Wendy Ellis. She’s a naturopath and she also has her own practice in Seattle and I’m going to give her a chance to talk about her role with Gennev and a little bit more about herself. So Wendy, go ahead and introduce yourself.

Dr. Wendy Ellis

Sure, thank you. As Stasi mentioned, actually Stasi and I had the opportunity to work at another wellness company a couple of years back. So it’s really nice to be working with people who already have a shared interest. I’ve been in practice since 2002, which is a long time and really focused more on menopause starting in 2005. So I’ve taken my practice really along the way. I’ve done work in genetics and I’ve done work with other physicians, but I’m currently in my own practice primarily focusing on menopause. But it’s been really great to consult with Gennev since last summer with some of our products, which we’ll talk about that are specific for menopause.

But we’ll also soon be doing telemedicine consultations for menopausal women as well. It’s something that I feel very passionate about, especially as I approach menopause myself. But I really like menopause in practice because I feel like it’s, it really doesn’t just involve giving someone hormone replacement. It involves every aspect of their health, whether it be how well they’re sleeping or are they exercising, are they, you know, we are at increased risks for so many things just by going into menopause. And so I feel like it’s really great to hit on all the many aspects of health while helping them through menopause.

Stasi Kasianchuk

Excellent. Well, we, and I, are very glad to have you as a part of Gennev and excited about this topic today. You mentioned menopause puts women at greater risk or there are different challenges women face during menopause. And right now as we’re going, as we’re in this pandemic with COVID19, I’m getting a lot of questions from women of “What can I take? What can I do?” And I know you have a background with your medical training around supplements. So we brought you on today to really discuss the supplements. And just could you start off by talking about immune function COVID19 and how do supplements play a role here if they do? But give the audience just a basis on some of the things to be thinking about this virus and our immune system.

Dr. Wendy Ellis

Right? So if we think about the public in general, like what we’ve really noted with the data that’s been collected thus far and Coronaviruses are not a new virus, although this is a new strain of Coronavirus that’s new to all of us. And so when it comes to viruses like that, it really depends. I really liked a quote that I heard the other day that really said, we need to not so much focus on the virus so much as we need to focus on the host, which is, you know, which is us. And so whether we have a host that is a five-year-old person or an 85-year-old person, I think one of the most important things that we can do is have a, have good foundational health to be able to fight viruses off because the data there’s a study out of Italy now that suggests that 80 are actually 43% of people that are infected have no symptoms.

And so, you know, we can’t just, you know, as especially as we start to unfold our rollout of re-introduction to life, we’re going to be exposed to people and what we can do to reduce our own risk as to the most important thing. And so that’s when supplements come in.

There are certain supplements that really help improve our immune system. And I know that if we look at data about, you know, traditional studies that have looked at supplements, oftentimes supplements fail. And it’s because they’ll take someone that’s in a full-blown outbreak of something or a full-blown health condition. And just by giving them a vitamin, it’s not going to just automatically take it away because you’re looking at years and years or decades of damage. And just by taking, for example, vitamin D or a B vitamin, it’s not going to undo that damage.

But what we can do is we can prepare our bodies with supplements to improve our immune systems. So our bodies are stronger and more able to actually fight off a virus because this more, this recent virus basically starts in the nose and it basically has all of the head symptoms. So people will have headaches, congestion, sore throats, you know, sometimes they’ll have body aches. But if we can stop the replication of the virus by taking things like vitamin a and vitamin D those are the things that can actually help ramp up your immune system to fight the virus. So the counts are reduced. So it doesn’t further travel down into the body and become a more aggressive viral illness.

Stasi Kasianchuk

Got it. So it’s about supporting, again going back to that host, it’s supporting what’s already there. Not creating something new and not completely, you know, eliminating any symptoms you may have. It’s more helping your body to fight the virus that’s in there.

Dr. Wendy Ellis

Exactly. And what I think the challenge is… yes, there are some antiviral medications, but very frequently those medications have to be started at the first onset of the virus before it replicates and invades all of our cells and starts mutating. And so if we can support the body while the virus is in its lower counts by taking things like vitamin D or vitamin a or herbs and we can talk about some of the most important things that we recommend then you can basically try to keep that at Bay and help the body’s innate ability to support this sort of immune system to work for us instead of against us. Exactly. Okay. So working with what you have, I guess is the summary of that piece of it. Yeah, exactly. And you know, it’s like the virus attacks our bodies, basically, it sort of goes undetected for sometimes a week or two before our bodies are able to, before the immune system is saying, “Hey wait, there’s something here that shouldn’t be here. I’m going to mount a response against it.”

So, to try not to get too technical, we have something called cytokines. And cytokines are there: they could either be pro-inflammatory or anti-inflammatory. So as most of us are on this webinar, we’re sitting here in a chair and our bodies are producing more interleukin six which is an inflammatory cytokine. But if we got up and we went for a run after this, then our body is in response to exercise, produce more of the anti-inflammatory cytokines like interleukin 10 and so, you know, I think the most important thing is to support our bodies, not only with supplements but also with lifestyle factors that create more of an anti-inflammatory response with our cytokines versus further producing more of those inflammatory cytokines. So the whole idea of, you know, some of the medications that are being recommended or suggested by sort of laypeople, some of those really work to reduce that cytokine storm that they’re discussing.

And basically, you know, we can, we can work on that with basic lifestyle things. And obviously, a cytokine storm is a very dangerous thing and that happens much further on in the, in the disease state. And also the people who are more susceptible to that are people who have high blood pressure. They already have lung conditions. They have. Actually I pulled some data on that and in some of the studies that have been done, I think one-third of patients who succumb to the disease had preexisting lung disease nearly as many had type two diabetes and then at least half as many as half have high blood pressure. So, of course, those are things that happen for a long time before. And so anything we can do at present to reduce our risk of those diseases is going to help us in the long run.

Stasi Kasianchuk

I love how you made that connection. It’s not, there’s no one-stop shopping. There’s not a one fix-all for this. And so much, again goes back to how can you make yourself the healthiest environment and those lifestyle things, which we’ll definitely talk about. You know, that’s my, that’s my favorite area to get into. On how that can help. How you can decrease blood pressure or improve blood pressure markers, improve blood sugar management, and then, in turn, decreases stress on your body and can support your immune system.

Dr. Wendy Ellis

Yeah, and I think there’s a lot too. There’s a lot to be said about, you know, we’re working on things like a vaccine, right? But viruses, they mutate. So when they go into the cell, they start to replicate and they replicate at a very rapid pace. And then mistakes get made in the, in the RNA to, to would that replication. And so with this virus, it’s actually a slow, a slower mutation. So a vaccine will be helpful for us. However, I always tell patients that, you know, this year it’s the Covid-19  virus. In the next coming years, there will be other viruses that were not vaccinated against because they’re new. And so vaccines, although are very important, just like flu vaccines, can be very important. We can’t predict what viruses are going to come in the future. And so we need to prepare our bodies as best we can to help our bodies innately fight that off instead of trying to think of all the vaccinations that we could possibly need. Cause we just don’t know.

Stasi Kasianchuk

Yeah, absolutely. And what a great way just to be more proactive than reactive. So we’re setting ourselves up for success. Yep, exactly. Well, let’s start talking with some of those supplements that can help with that. I know I’ve received questions from clients just tell me what supplements to take, what should I be buying? And it looks like the supplement industry is doing very well right now. So it’s kind of interesting to see what’s marketed out there. It would love to hear how you approach this as a credentialed, experienced practitioner with training and expertise around supplements. How do you approach this with your patients and what would you recommend right now?

Dr. Wendy Ellis

Well, when this first rolled out in March in the state of Washington I put a newsletter out that really was trying to help patients know which supplements are the best for this. And this was independent of any health condition that someone might already have. And so for those of us in the Pacific Northwest, actually, you know, most of the US, we’re low in vitamin D. Most of us are low in vitamin D because we have jobs that have us working inside most of the time. And even when we’re out in the sun, I mean, in Washington, read a latitude that even when we’re out in the sun, we don’t get a whole lot of vitamin D except for a few months of the year. And so because of that, and, and even when we’re outside, we’re covering ourselves with sunscreen because we’re trying to avoid skin cancer.

So we’re basically at risk of having low vitamin D levels. And I think that people who have darker skin pigment or even at more a higher risk of having vitamin D deficiency. And then as we’re, we’re a society with a lot of obesity and obesity also decreases our vitamin D levels. We just automatically, you know, are, have reduced vitamin D and so we have a lot of risk factors that are innately built-in. So vitamin D. If there was one supplement that I would recommend taking across the board, it’s vitamin D and vitamin D is a very important antiviral. It’s anti-inflammatory. Again, vitamin D is not, you know, you can’t get a virus and just take a bunch of vitamin D and expect that it’s going to cure everything. But it’s a really important vitamin for our immune system, for mental health, for our bones.

There is just so much that vitamin D does for us. There’s a lot of information about vitamin D and cancers and how it reduces cancer risk. And again, you can’t get cancer and take a bunch of vitamin D and expect it to go away. But if you have a long history, or a longer history, of taking vitamin D that is protective for you and then the dose of how much to take. Of course, this depends on how old you are, what your skin color is, whether you are overweight, whether you’re pre- or post-menopausal. And it’s not so much, I think a lot of the data, it makes me a little crazy because it says, well, you know, it used to be 400 IUs, which was definitely not enough to get us up to a healthy blood level. So it really depends on your blood level more than it depends on the dose that you take. So when it comes to vitamins like vitamin D, it is a fat-soluble vitamin. You can take too much of it, which can be detrimental. But the sort of one of the most stringent it’s the, it used to be, let’s see. Oh my gosh, I can’t believe this is my perimenopause moment. It makes her participants feel better.

But the endocrine society used to recommend like, you know, 400 units. And then it was like, well, our vitamin D levels in the blood need to be at least at 30. But they’re safer. The upper limit is 4,000 units and that’s across the board. And so most of my patients, I do recommend that they take 4,000 units per day. And what this does is it gets the blood level up to a point where usually around 40 to 50, which is a level that is sort of going to help our immune system help our bone density, reduce association with certain cancer risks. So I’d say 2000 to 4,000 I use depending on, you know, depending on the patient, but you can test your vitamin D in the blood. It tends to be a more expensive test. Insurance companies are very stringent on what health conditions it will pay vitamin D for. And so a lot of doctors just won’t order it. So I would say that two to 4,000 units would be recommended, not only for longterm general health but also for helping avoid viruses.

Stasi Kasianchuk

Excellent. That’s a good recommendation. And gives, it gives a range for people to work with. We have a couple of questions on vitamin D. So one is that the accumulation of taking vitamin D is what matters. So should we start taking it now or for not if we leave that…

Dr. Wendy Ellis

Definitely. Absolutely. And you know, if you’re a post-menopausal female, vitamin D is one of the best things for your bone density as well. And there are pretty good studies on reducing breast cancer risk with adequate vitamin D intake. Of course, as with any health condition, it’s never just one thing. And so you always have to consider all the contributing factors that play into that.

Stasi Kasianchuk

Okay. So vitamin D is a piece of the puzzle. It’s not the be-all and end-all. Exactly. Another question here on vitamin D is, is there a supplement that you should not take with vitamin D at the same time if there are any counter counteractive effects?

Dr. Wendy Ellis

Not off the top of my head. It’s a, it’s a pretty well-known supplement that’s very safe. I do recommend women take it in the morning because it can interfere with sleep if taken at night for certain individuals.

Stasi Kasianchuk

That’s good to know. Alright, well vitamin D sounds like an important one to be starting with. And taking starting vitamin D if you aren’t looking at your dose if you are. And then considering getting your blood levels tested, if you can if that works with your physician. And once we’re able to go back to doctor’s offices and do lab tests, what else are there? Are there other vitamins, supplements, minerals, herbs that you think?

Dr. Wendy Ellis

And again, there are so many and so I chose my favorites. So the other one that I am using a lot of is vitamin C. There’s a lot of really good evidence for vitamin C as an antiviral. And so vitamin C is one of these nutrients that’s readily available. It’s easy to take if you take too much, you can get loose stools. There’s actually a website that I really encourage patients to check out. It’s the Linus Pauling Institute at Oregon state university. And what I really like about it is that it’s really well-referenced and you can type in on the search at the top of the, at the top of the page and type in any nutrient and it gives you probably more than you ever wanted to know about every vitamin and mineral that we use.

And so vitamin C is, is being recommended generally below 2000 milligrams per day. They recommend that you should consult a doctor before taking any higher doses than that. Okay. There are some doctors that are using vitamin C, an IV form, for patients who are actively fighting the virus. And in IB form, you can use much higher values like 25 to 50 grams. However, most of us should be taking somewhere between 502,000 grams of vitamin C or milligrams of vitamin C per day. It’s, you know, we also have to think about all of those underlying some systems. Like we want it to be anti-inflammatory, we want it to be an antioxidant and we also want it to be antiviral. So vitamin C is another really great, really safe over the counter supplement that it’s really good at fighting viruses. There’s also a lot of research on zinc and you know, if we think about all of the things that you would take if trying to avoid a cold or flu, you know, we think vitamin C, vitamin D, we think zinc and zinc is one of those minerals that is very well-tolerated by people.

There’s one study that people developed a copper deficiency from taking too much zinc. It was actually people who were using Polident for putting their dentures in really high doses of zinc. But I’d say most multivitamins have 15 to 30 milligrams of zinc and usually they have one or two milligrams of copper. And zinc is also a very good antiviral. And then people who actually pulled some studies and it, it actually inadequate levels of zinc limited the individual’s response to fight infection. But when actually given oral supplementation in the study and actually found that it reduces the incidence of acute respiratory tract infections, of course, we’re worried about, we’re worried about lung health right now. It reduced it by 5% and it shortened the recovery. Wow. so, and again, a lot of these things I pulled from the Linus Pauling website and you can have, you can find references there. But zinc is one of those minerals that can really upset your stomach if you don’t take it with enough food. And so that is a big caveat for that is you have to take it with food.

Stasi Kasianchuk

All right. Good reminder there. And we’ll make sure to link that Linus Pauling in the followup email to all of our participants. So thank you for providing that resource.

Dr. Wendy Ellis

Yeah, it’s an excellent resource. And that’s, that’s the other thing, you have to be really careful about reading blogs and you have to know like, you know, just like we want good supplements and we can talk about how you find good supplements. You have to be really careful online. You know, what you read and where the data is coming from and you have to make sure it’s referenced. And for every study that supports something, there’s two studies that, that don’t support that. And so, fortunately, we have an epidemiologist on staff Dr. Rebecca, and so she’s really helpful in helping us determine, you know, is this a good study or is this not a good study? So that’s an important thing.

Stasi Kasianchuk

Yeah, I like that you pointed that out, that we’re here to support you. And when you’re working with your patients, I’m working with my clients. I want you to have information that’s going to help you. And that is really going to be reputable cause it can be easy to get bogged down by all the information that’s out there. And if you don’t have the background in health-related fields or the training that you and Dr. Rebecca have, you can get taken advantage of. And that’s not fair either.

Dr. Wendy Ellis

Right? Exactly. Exactly. The other supplement that I have been using not only for my family but recommending for patients is vitamin A. Vitamin A is found in fish. Which, you know, we also, we, we see Cod liver oil is generally a good way to get your vitamin an in there if you want it to also get your Omega-three fatty acids. But vitamin a is really important for the health of the nasal pharynx as well. And so the mucosal membrane actually produces retinoic acid and we know that it’s very antiviral and anti-inflammatory. You just like vitamin D, vitamin a is a fat-soluble vitamin and so you can overdose on that. So you don’t want to use high doses of that for long periods of time. There are some studies and recommendations that recommend taking like 50 to 100,000 units of vitamin a, but that’s something that a doctor should prescribe for you and something that you should be monitored for.

And the other thing is if you, obviously we’re dealing with mostly peri and post-menopausal women who are not trying for pregnancy, but vitamin A can be very dangerous and high doses for fetuses. So you want it. So generally what I recommend is 10,000 units, which is very safe across the board of vitamin a supplementation just as further immune support to, to aid in the immune system that you mentioned that we already have. We’re trying to, we’re not trying to replace something, we’re trying to give the nutrients to the body that it uses to actually improve and work our new system.

Stasi Kasianchuk

Excellent. Yeah. No, it’s such a good point of theirs. Again, balancing and that there’s not one pill that works. It’s how, how does this work in conjunction, and what is it looking to support? Exactly. Exactly. What question I get with my clients is, Oh, well especially with vitamin C actually, well if, if a thousand milligrams is good, then why do I stop at 2000? I was, should I take more? Is it okay to take 5,000? I hear it’s water-soluble. I’ll just pee it out. With the things you’ve mentioned with each of them, I heard vitamin C and the zinc and vitamin A more does not necessarily equate to better. Exactly. Is there a parameter or risk, an awareness that people should be?

Dr. Wendy Ellis

Yeah. And, and, and the thing is, if it’s water-soluble, you’ve urinated out with magnesium or vitamin C, it can give you very loose stools. And so obviously that’s a negative side effect. But some vitamins like vitamin a can be toxic to the liver if you take too much. And so we worry about toxicity and clinical studies actually, you know, there’s, there’s a threshold to when things are helpful. And so, you know, there’s a lot of research that hasn’t been done on supplements. And so, you know, it’s, if you, if you go to any major medical journal and you try to look up studies on nutrients, a lot of the studies will say, well, it’s thought to do this, but we’re really not sure. It’s the same with pharmaceuticals. And so if we look at what we typically take in a diet, supplements are above and beyond that, but we want to make sure that we’re not taking something that’s going to damage our kidneys or our liver or create a nutrient deficiency, like the zinc thing. If you take too much, think you can deplete copper. And so too much of one thing can absolutely create tissue damage but also create other nutrient deficiencies.

Stasi Kasianchuk

Okay, good to keep in mind that more is not always better and there’s a reason for those limitations. And then also from a cost standpoint, you don’t want to be taking more than you need, that’s going to cost more money and you’re going to run out of those supplements.

Dr. Wendy Ellis

Exactly. And I will say that I spend a lot of time talking people off supplements because we read things and we want to avoid Alzheimer’s or we want to avoid all these things. And so people take them presumptively, but your kidneys have to process those, your liver has to process those. And so I actually have seen liver enzymes or kidney issues secondary to people taking too many supplements. Yeah, that’s it.

Stasi Kasianchuk

Great reminder. About some of those risks there. Are there any, if anything else that you would recommend, are those the three main favorites right now?

Dr. Wendy Ellis

Yeah, so there was some press about melatonin. And so I felt like I needed to bring up melatonin cause I thought someone would ask that. And melatonin is obviously what our bodies produce to help us sleep. And so our bodies are triggered to make melatonin when our rooms are dark. And so if you’ve gone through any of the, of the genetic programs especially the ones pertaining to sleep, we talk about melatonin, we talk about sleep habits and having lights off in your room and trying to go, go to bed, you know, when it’s nighttime and wake up in the morning and get as much daylight as we can. And so melatonin is something that I think we’re lacking because we’re living in a society where our rooms are often not that dark and people are sleeping less or they’re not sleeping enough because they’re having hot flashes.

And so they’re, the reason why sleep is beneficial to us is that it restores a lot of things, but we’re making a lot of melatonin that’s helping us sleep. But that melatonin is actually acting as an antiviral as well. So I pulled some data on this because it’s kind of new to me as something that you would use to actually reduce your viral risk. And actually it’s been shown to decrease some of the inflammatory markers that are, have been associated. So interleukin six is one of those cytokines that actually tends to be high and people who have coven and melatonin have been shown to reduce that. It also has been shown to reduce the reactive protein and also tumor necrosis factor, which is another inflammatory marker. So the studies have shown that at six milligrams this actually improved outcomes in people who are suffering from severe multiple sclerosis.

This was something that was 25 milligrams of melatonin. Okay. But also it’s been shown to lower blood pressure. It reduces proinflammatory cytokines. And actually there’s some research about whether it may help blood pressure, but again, too much, it’s not good. And so melatonin has some anticancer properties and so I’ll have, yesterday I had a patient who was self-diagnosing herself and was taking 60 milligrams and our bodies make about 0.3 to 0.8 milligrams when we’re sleeping. And so my tendency is to get that naturally through actually going to bed in a darkened room instead of taking melatonin. If you do take melatonin, it’s recommended to take three milligrams or less. Okay. Yeah. So that’s another one. That has gotten a lot of press. Well thanks for clarifying that. And again, going back to the more may not be better working with what your body has first and then you know, there’s the whole, there’s a lot of antiviral herbs.

And the thing about herbs is that we just haven’t done enough study about them to know what the safe profiles, safety profiles are. So if you go onto the generic website and you look at some of the herbs that we use for hot flashes, we really include the safety parameters. And any drug, drug, drug, herb interactions. Because I think a lot of herbs, we just don’t fully understand the mechanism of action and we don’t know how they interact with other medications. And we’re not sure if we’re taking a good formula though. A lot of herbs come from overseas and the FDA doesn’t regulate supplements. And so it’s, you don’t know whether you’re taking something that has been grown in pesticide, you don’t know whether it’s actually just cellulose in the capsule. A lot of people take [inaudible] other herbs because they have a high potency of berberine, which is you know, we, it’s almost like an antibiotic herb.

And so if we think about immune health and we think about antibiotics, like 90% of our immune systems and the GI tract. And so if you take an antibiotic and you basically decimate your microbiome temporarily, then your immune system is affected because of that. So if you take berberine long term to treat or prevent a virus, then you could be doing damage on the other side, with decreasing urinate and the other day by affecting the microbiome back to that balancing act. So I think the earth question is a really individual one and a hard one. And I think it needs to be discussed with your doctor because of all the potential side effects. Okay. Good reminder there. So the other thing is that certain health conditions or diseases or just living in this environment with depleted soil that we, we tend to have certain nutrient deficiencies as menopausal women not only because of life but also because of certain things that are increased over time secondary to, you know, just the aging female body.

And so some of those nutrients we’ve put together a vitality pack for women which is not a multivitamin. And I think it’s really important to stress that it’s not a multivitamin. It’s really more of a vitamin specific for the clinical nutrient deficiencies that have been noted in women who are approaching or in menopause. So it’s generally, it’s, it’s something that I created because I just kept supplementing th

Middle age and menopause don’t have to mean your sex life is impaired or worse, over. Heck, there are even solutions and treatments for sex after menopause.

But there can be additional challenges such as trying to find vaginal dryness relief, loss of libido or sexless marriage, crashing fatigue in menopause, even embarrassment over body changes that make us feel less than sexy.

Our menopause health clinic’s Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, spends a lot of time at her practice helping women regain their vibrant sex lives, and one thing she does is recommend books by Dr. Laurie Mintz, particularly A Tired Woman’s Guide to Passionate Sex.

In this podcast, Dr. Dunsmoor-Su got to chat directly with Dr. Mintz about all the things that can dampen the spark and how to reignite it.

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If you need help reigniting your sex life, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

Dr. Laurie Mintz is a licensed psychologist in private practice and a tenured Professor at the University of Florida, where she teaches the Psychology of Human Sexuality to hundreds of undergraduate students each year.

Dr. Mintz has published over 50 research studies in academic journals and six chapters in academic books. She has received numerous professional and teaching awards. She is a Fellow of the American Psychological Association, indicating that her work has had a positive national influence on the field of psychology.

Dr. Mintz is also the author of two popular press books””both written with the aim of empowering women sexually: Becoming Cliterate: Why Orgasm Equality Matters and How to Get It and A Tired Woman’s Guide to Passionate Sex: Reclaim Your Desire and Reignite Your Relationship.

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