Explore all emails from Today’s Ajenda

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6a22e613-5b7d-45a5-b350-37db89ad902f/1200x630_OD_banner_blue__new_.jpg?t=1783970755) [In a World of Noise, Here's the Signal | TODAY'S AJENDA By Dr. Jen Ashton] Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cc5d4841-1341-4243-83f1-c85ccc0afc6d/dose-_data-88.jpg?t=1784681385) [Your Dose of Honesty | The Antidote to Toxic Perfectionism | Woman surrounded by graphs and charts] Caption: I said something on Instagram recently that struck a nerve in the best way: Health shouldn't be this hard. That we've turned it into a dissertation exercise, with tracking and statistics and trials and data inputs stacked so high that most people can't see the actual goal underneath them anymore.  The response was immediate and, frankly, cathartic to watch. Hundreds of comments, all essentially saying the same thing: thank you for giving me permission to put the spreadsheet down. But a statement that resonates that widely deserves more precision than a caption allows, so let me clearly say what I meant, and just as clearly what I didn't. **Data Is Not the Enemy** I have three degrees and built my entire professional life on the belief that science and evidence matter more than opinion. But data is supposed to be a means and, for a lot of smart, well-intentioned people, it has quietly become the end. The tracking stopped serving the goal and started replacing it. That's the actual definition of toxic perfectionism in a health context, not caring too much, but mistaking the measurement of health for the experience of it. The overwhelming majority of what actually predicts how long and how well you live traces back to these three inputs done consistently, not perfectly: Move your body, fuel your body, rest your body. That's not a dumbed-down version of health science, it's the foundation underneath nearly all of it. Resistance training and daily movement. Adequate protein, enough fiber, whole foods most of the time. Sleep that's protected rather than sacrificed. Everything else — the continuous glucose monitor, the HRV ring, the twelve-supplement stack, the biomarker panel — is meant to fine-tune those three things. It was never supposed to become a full-time occupation that sits on top of them. **Dedication Still Matters** Here’s the clarification that matters most, because I think it's the part most likely to get lost. This is not permission to coast. It’s not an argument for giving in to cravings, skipping workouts because you don't feel like it, or calling any of that "intuitive." Intuitive eating and movement, done well, still require structure and consistency. What I'm describing isn't the absence of effort. It's the absence of white-knuckling — the exhausting, joyless grip it seems like so many people have on their own health, where every meal is a test they're afraid of failing and every missed workout feels like a moral failure rather than a Tuesday. **How Do You Know if Something Is Working?** You don’t need a dissertation’s worth of data to find the answer. My genuinely useful, low-tech rule of thumb: How do you feel and how do you look? Not in a superficial sense, but an honest, embodied, and even clinical one. Do you have energy in the afternoon? Does your clothing fit the way you want it to? Are you sleeping through the night? Can you carry your own groceries, play with your grandchildren, get up off the floor without narrating the effort? Are your clinical blood tests and screening tests normal or optimized? These are not vanity metrics. They are, in aggregate, a remarkably reliable proxy for whether your fundamentals are actually in order. If the answer is yes, something is working, and you have my full permission to stop interrogating it. If the answer is no, that's useful information too, and it usually points back to one of the three fundamentals — not to a fourth supplement or pricey device you haven't tried yet. I’d argue that this is the real wellness flex. Not the longest testing panel or the most optimized morning routine, but arriving at genuine strength and vitality without needing an advanced degree in your own biology to get there. Sustained simplicity over years outperforms sustained intensity over weeks every time. **The Bottom Line** Data still matters enormously to me, and it always will. But its job is to occasionally check your work, not to become the work itself. Move. Fuel. Rest. Notice how you feel and how you look. Adjust what needs adjusting. That's the North Star, and it was always meant to be simple enough to actually live by. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/301ba008-d768-4258-a4f0-9b8c73533e46/_ss_m4_vitamin_d_options_update_2-1.jpg?t=1784670651) [Symptom Solutions | The Vitamin D Conversation We're Not Having | This Week: Symptom Solutions is sponsored by JSHealth Vitamins | Dr. Jen Ashton holding a bottle of JSHealth Vitamins' Vitamin D3] Follow image link: (https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly) Caption: Every conversation I have about vitamin D starts in the same place: bones and immunity. Sometimes heart health comes up. What’s rarely mentioned, and what I think deserves far more airtime for women over 50, is metabolic health. That’s a real gap. The data on vitamin D and metabolic health, specifically glucose regulation and insulin resistance, is actually the strongest, most consistent evidence we have for this nutrient — even stronger than the cardiovascular case most people assume is the headline. **What the Research Shows** A 2023 meta-analysis of randomized controlled trials in postmenopausal women found that vitamin D supplementation meaningfully reduced fasting glucose, HOMA-IR (a standard insulin resistance marker), fasting insulin, and HbA1c, with the strongest fasting glucose benefit at doses of 1000 IU per day or less, sustained over more than six months. A separate trial in vitamin D-deficient postmenopausal women found that 1000 IU daily for nine months reduced insulin levels by 14%, HOMA-IR by 18%, and lowered the odds of metabolic syndrome by more than half. For women carrying extra weight, this matters even more: A 2026 meta-analysis specifically in patients with obesity-associated metabolic syndrome found vitamin D3, not D2, meaningfully reduced visceral fat, the metabolically active fat around our organs that drives so much of midlife metabolic risk. That D3-versus-D2 distinction is worth remembering the next time you're reading a label. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cf2b1325-40aa-4d9f-a0d0-1463a7bd21f3/vitamin_d_stat_quote.jpg?t=1784670649) [A separate trial in vitamin D-deficient postmenopausal women found that 1000 IU daily for nine months reduced insulin levels by 14%, HOMA-IR by 18%, and lowered the odds of metabolic syndrome by more than half.] Follow image link: (https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly) Caption: **The Honest Caveat** The 2024 Endocrine Society guideline formally recommends vitamin D for adults with prediabetes, and that recommendation is real and significant. The musculoskeletal and cardiovascular claims you hear most often are the ones with the weakest support, unless you're actually deficient (which is estimated to be 18-25% of women over the age of 50 if using the threshold of less than 20 ng/mL). Deficiency rises substantially in women with obesity, in Black and Hispanic women, and in women during the winter months, so basically, a large number of women are thought to be frankly deficient.  Large trials have not shown that vitamin D prevents cardiovascular events or meaningfully changes body weight in a _general_ population. The metabolic benefit is concentrated in a specific group: women who are vitamin D-deficient, prediabetic, or carrying extra weight, particularly around the midsection. If that's not you, the evidence for high-dose supplementation is far less compelling. **Don’t Skip This Step** Get your serum 25(OH)D level tested before you decide on a dose. This simple blood test is the only way to know whether you’re deficient, insufficient, or already sufficient. I recommend asking about the cost of the blood test beforehand, as at some labs (such as Quest Diagnostics) it can run several hundred dollars depending on your insurance plan.  Once you have your number, here's how to read it (according to most labs and the major endocrine guidelines): * Below 20 ng/mL = Deficient * 20 to 29 ng/mL = Insufficient * 30 ng/mL or above = Sufficient, meaning adequate for general health Some of the metabolic research cited above found the strongest benefit in women starting below 20 ng/mL, and the largest diabetes-prevention effect in those under 12 ng/mL. This suggests the people most likely to feel a real difference are the ones who are genuinely low, not the ones already in a healthy range. Levels above 100 ng/mL are generally considered a ceiling worth avoiding without medical supervision. Supplementing blindly, without knowing where you start, means you're either wasting money or, at higher doses, approaching a threshold worth respecting. The generally recognized upper daily intake for most adults is 4000 IU, and I wouldn’t recommend going meaningfully above that without medical supervision and lab monitoring. **My Vitamin D3 Supplement of Choice** If your labs show you're low, a well-formulated D3 supplement, like _[JSHealth Vitamins' ](https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly)__[Vitamin D3](https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly)_, is a reasonable, evidence-supported choice for the metabolic benefit specifically — not just the bone, immune, and cardiovascular story you've heard a hundred times. Sourcing is worth a mention here too, since not all D3 is created the same way. Most D3 supplements are derived from lanolin, a byproduct of sheep's wool. _[JSHealth Vitamins’](https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly)_[ ](https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly)version is a vegan alternative, cholecalciferol sourced from lichen, a naturally occurring organism found on rocks and trees that produces D3 without any animal input. Each capsule (the recommended daily dose), delivers 25 micrograms, or 1000 IU, which lines up closely with the dose used in several of the studies above showing meaningful metabolic benefit over six to nine months. The guidelines regarding maximum safe daily dose are 4000 IU per day, so more is NOT better! For anyone avoiding animal-derived ingredients for dietary or ethical reasons, that sourcing distinction matters without requiring any tradeoff in the form of vitamin D you're actually getting. As always, get tested, know your number, and talk to your doctor before starting any new supplement, especially if you're managing blood sugar, take other medications, or have a history of kidney or calcium-related conditions. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a7d8e676-e3d6-4657-8ae6-4758706bf0d0/shop_js_health_button_update_22.png?t=1784671301) Follow image link: (https://us.jshealthvitamins.com/pages/drjen-bundles?utm_source=Newsletter&utm_medium=DrJenAshton&utm_campaign=AjendaJuly) Caption: _Receive Up to 20% Off JSHealth Vitamins_ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ea2ca739-25e0-4cdf-a393-d9a7025fcd0c/com-4_questions_2.jpg?t=1784670651) [Community | 4 Questions to Ask to Treat Your Analysis Paralysis | Headshot of Dr. Jen Ashton] Caption: I talk to women every day who are exhausted before they even start. Not from their workouts, not from their jobs, but from the sheer volume of health information they're expected to sort through just to make one decision. Should I take this supplement? Should I try that protocol? Should I be worried about this headline? By the time most women get to me, they're not undernourished on information, they're drowning in it, and they've stopped trusting their own judgment entirely. I want to name what's actually underneath that exhaustion, because I don't think it's really about the information at all. It's fear. Fear of aging faster than you're supposed to. Fear of missing the one thing that would have made the difference. Fear of losing the version of yourself you recognize, physically, in the mirror, and mentally, in your own head. And underneath all of it, a quieter fear that's harder to admit: not knowing who to actually trust anymore. Everyone has a protocol. Everyone has a study. Some are even validated and worthwhile, but very few people are willing to say plainly what we know, what we don't, and what actually matters for you. That's the role I want to play. Not another voice adding to the noise, but the calm inside it. The person who's willing to be the decider, so you don't have to make every single call alone. Someone you can actually trust, because I'll tell you when the evidence is strong and I'll tell you when it isn't, even when that's a less exciting answer. Here’s the tool I gave my patients, and still give my own family and friends when they come to me frozen, staring down a new supplement, a new trend, or a new fear-based headline. Four questions. Ask them in order every time, before you spend another dollar or another ounce of mental energy. **1. Why Am I Interested in This?** Be honest with yourself here. Is this solving a real problem you actually have — or a problem someone else suggested, or a feeling that you're falling behind? Those are very different motivations, and only one of them deserves your time and attention. **2. What Am I Actually Trying to Fix? ** Get specific. Not "I want to be healthier," but the actual symptom, goal, or concern. Vague goals invite vague, endless solutions. Specific problems have specific, findable answers, and specific answers are how you know when something is working. **3. Who Am I Taking This Advice From?** This is the question that filters out the vast majority of noise, because most of what's competing for your attention today fails this test the moment you ask it out loud. Credentials matter. Track record matters. Financial incentive actually matters less for me, because ultimately the only person who should be deciding what I spend money on is me. When we go into a doctor’s office or a restaurant or a store, we are paying for expertise, service, food, or products. That’s life. So, I factor in finances as part of the equation rather than the whole equation. And, as always, sunlight fixes everything: Full disclosure and transparency are mandatory on all levels, at all times.  **4. Is This Easy or Hard, and How Heavy Is the Lift?** This one gets skipped constantly, and it shouldn't. I'm not suggesting easy is always the right answer. Some of the most worthwhile things you'll do for your health are genuinely hard, and the effort is exactly why the payoff is real. But effort is a legitimate factor in the decision, not an afterthought, and it cuts both ways. A big lift with a big potential payoff might be worth committing to fully. But something low-effort is also worth a fair trial, precisely because the downside of trying it is so small. I use a red light mask for six minutes a day. If it turns out to do nothing, I've lost six minutes. That asymmetry, low cost of trying versus real potential upside, is its own reason to say yes to something, separate from how strong the evidence is. Plus, it makes heavy choices seem a little lighter, which is always nice! **The Whole Mantra** Why am I interested in this? What am I trying to fix? Who am I taking this advice from? Is this easy or hard, and is the lift worth it? It's simple on purpose, because clarity, not more information, is the actual antidote to fear. You don't need to know everything. You need four questions, asked honestly, every time the noise gets loud or the fear creeps in. 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) ["I'll never send you in circles!" –Dr. Jen Ashton] Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-122

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6a22e613-5b7d-45a5-b350-37db89ad902f/1200x630_OD_banner_blue__new_.jpg?t=1783970755) [In a World of Noise, Here's the Signal | Today's Ajenda by Dr. Jen Ashton] Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b2634c35-3e54-40ee-8857-e231ccedd413/Dose-_GLP-1_s_and_inflammation-_a_new_benefit__8_high_rez.jpg?t=1784071758) Caption: There’s a particular irony in watching "wellness" become the umbrella term for a practice that has almost nothing to do with being well. Right now, that practice is injectable peptides. Here’s why I think this is the most unwell trend in an industry that already has a low bar for unwell trends. **What Peptides **_**Actually**_** Are** Peptides are short chains of amino acids, smaller than proteins, that act as signaling molecules in the body. Some peptides are legitimate, FDA-approved medications, such as semaglutide, tirzepatide, and tesamorelin. These drugs went through years of trials, dose-finding, safety monitoring, and stringent manufacturing standards. Then, there’s everything else. BPC-157. TB-500. Thymosin beta-4. GHK-Cu. Ipamorelin. CJC-1295. PT-141. Retatrutide. Though often labeled “for research purposes only,” these peptides are sold directly to consumers, who then inject them at home for everything from tendon healing and muscle growth to fat loss and “performance.” **Most Have Never Been Studied in Healthy Humans** …Not in a small trial, not in a large one. There is no short- or long-term safety data in the population using them (which remember, are HEALTHY people, seeking even more health!). What we do know is based on animal research, cell-culture research, and anecdotal evidence. That’s not enough to justify putting a needle in your body. Even if you set aside the question of whether these peptides do what they claim, the second problem is far more urgent: you don’t know what’s actually in your vial. **What the Data Shows** A recent independent analysis looked at 6,441 gray-market peptide samples across 14 commonly used compounds, including several of the ones I named. Researchers applied two quality frameworks, one modeled on the standards used for compounded 503A pharmacy preparations, and a stricter one modeled on the standards required for FDA-approved peptide drugs. Depending on which standard was used, between 41.6% and 71.1% of samples _**failed to meet basic quality benchmarks**_. Additionally, 15% of samples showed measurable endotoxin contamination, meaning bacterial byproducts that can trigger fever, inflammation, sepsis, or a serious immune reaction when injected. So I’m saying it louder for the people in the back: Up to three-quarters of what's being sold doesn't meet basic quality standards. Roughly one in seven vials tested carries contamination that should never be in something you inject. **Why Are People Choosing Gray-Market Peptides?** The same analysis found gray-market peptides were consistently cheaper than their FDA-approved counterparts, though by wildly different margins. For a clinically relevant course of tirzepatide, the approved version cost about 73% more than the gray-market alternative. For PT-141, the price gap was almost incomprehensible. The approved product cost roughly 39 times more. When the price difference is that dramatic, of course it’s tempting. But cost savings mean very little if what you’re buying isn’t reliably labeled, sterile, or tested in a single human trial for the purpose you're using it for. **Testing Alone Isn’t Enough** Consumer-facing lab testing is a good step toward transparency, and it’s certainly better than no testing at all, but it can’t replace a clinical trial. Third-party testing services can only tell you whether a vial contains roughly what it claims and whether it's free of one category of contamination. A clean purity report is not the same thing as a safety profile, and I worry that testing services are creating a false sense of security about a practice that remains fundamentally unstudied. And lastly, there’s the financial motivation: Ask yourself how much the person/center/website you are buying from is making off of your purchase, and then estimate their total sales revenue… follow the money trail. It’s often very different than the science trail. **My Position** If a peptide is FDA approved, it went through the process I trust, and I have no issue with patients using it under medical supervision. If a peptide is _not_ FDA approved, I don’t think it’s worth the risk. Actually, I think it’s crazy. You’re running an uncontrolled experiment on yourself with a compound that has no established human safety data, using a supply chain that fails basic quality checks nearly half the time. That's not wellness. That's the opposite of it. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/44d3a66f-ad47-44eb-87e2-f7d8da394be4/_SS_m4_skincare__alloy_health_add.jpg?t=1784071782) [Symptom Solutions | A Closer Look at M4 Skincare: Estriol Meets Peptides for the Skin You Actually Live In | This Week: Symptom Solutions is sponsored by Alloy Health] Caption: If you read my newsletter, you know I don't recommend just anything. So, when a product combines a topical hormone with a genuine peptide delivery system, and backs it with an actual clinical study rather than a testimonial page, it has my attention. That's the case with _[Alloy's ](https://alloy.sjv.io/0GXY2J)__[M4](https://alloy.sjv.io/0GXY2J)_^_[®](https://alloy.sjv.io/0GXY2J)_^_[ Body Treatment Rx](https://alloy.sjv.io/0GXY2J)__*_, a prescription body treatment built around estriol and two specific peptides. **What’s Actually in It?** This is where credibility lives or dies. The active hormone is estriol at 0.2%, the mildest of the three estrogens the body produces naturally, the one most often used in topical, localized formulations. Alongside it are two peptides, Palmitoyl Pentapeptide-4 and Acetyl Hexapeptide-8, both of which have been shown to support collagen signaling and skin firmness when applied topically. The rest of the formula is a fairly standard, well-tolerated emollient base: glycerin, squalane, shea-adjacent esters, and preservative systems that are common across dermatology-grade products. In other words, they are the workhorses of most skin products. **On the Data** Alloy cites a 2026 independent clinical study in which 97% of users agreed their skin felt more hydrated, 95% felt smoother skin, 84% saw firmer skin, and 79% reported improvement in crepiness. These are obviously subjective reports, but still, these are respectable numbers, and I want to be transparent about what they mean and don't mean. This is a single manufacturer-cited study, and I have not independently reviewed its full methodology, sample size, or duration. I'd treat these as promising, self-reported outcomes rather than the equivalent of a multi-year, peer-reviewed, placebo-controlled trial. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0d398342-0b73-44a6-852a-f0af560de0d5/alloy_stats_bigger%2B.jpg?t=1784062823) [Alloy cites a 2026 independent clinical study: 97% of users agreed their skin felt more hydrated, 95% felt smoother skin, 84% saw firmer skin, 79% reported improvement in crepiness] Caption: **Why This Matters for Midlife Women** Topical estriol at this concentration is formulated to act locally, on the skin, rather than systemically. According to Alloy, “_[M4](https://alloy.sjv.io/0GXY2J)_ does not impact blood estrogen levels, does not require progesterone, and can be used alongside HRT, vaginal estrogen, or other M4 products.” For women managing skin laxity and crepiness, particularly through perimenopause and beyond, a well-formulated, non-systemic option carries a meaningfully different risk profile than an oral or systemic hormone therapy. **What Don’t We Know?** As with most newer topical hormone-peptide combinations, we don't have decades of long-term data on this exact formulation, and every body responds differently to any active ingredient. That's not a red flag specific to _[M4](https://alloy.sjv.io/0GXY2J)_ — it's simply true of most dermatology innovations at this stage of their life cycle. **My Honest Read** For a topical, localized, non-systemic approach to visible skin changes tied to estrogen decline, _[M4](https://alloy.sjv.io/0GXY2J)_ is a reasonable and evidence-informed option to discuss with your physician. Not a miracle in a tube, but a legitimately formulated product with a real mechanism and real, if early, data behind it. Finally, remember that this is a prescription treatment. Always follow the prescribing physician's instructions, and consult your doctor if you have any medical concerns, especially if you're currently on hormone therapy or have a personal or family history of hormone-sensitive conditions. Your prescription also includes access to Alloy's board-certified, menopause-trained physicians, so you can ask questions and receive expert guidance at no additional charge. _Clinical results based on Alloy's 2026 independent study; individual results may vary._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/447d6f91-181b-4f4a-a2ad-8c1950e79105/SHOP_alloy_BUTTON_update3.jpg?t=1784044716) [SHOP ALLOY!] Follow image link: (https://alloy.sjv.io/0GXY2J) Caption: Use code **AJENDA20** for $20 off sitewide! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/71cd0e89-4501-4f2d-b561-68dd71f1d664/COM-vitality_2.jpg?t=1784044718) [Community | What Happens When We Make “Longevity” the Endpoint] Caption: Longevity is having a moment, and I understand why. For the record, I absolutely despise the word “longevity.” In my opinion, it’s a marketing term, not a medical one, and it isn’t even accurate. What we should really care about is _vitality_: living in a way that is healthy and vibrant, not just long. This week may have given us a case study in what happens when longevity itself becomes the goal, rather than a byproduct of good medicine. Bryan Johnson, the 48-year-old tech entrepreneur who spends an estimated $2 million a year measuring and re-engineering his own biology in pursuit of longevity, announced he has autoimmune gastritis. He bluntly described this chronic condition as his stomach “eating itself,” but, in clinical terms, it’s the immune system attacking the acid-producing cells lining the stomach. He was diagnosed in May, after years of low ferritin — the protein that reflects the body's iron stores — that his own extensive testing had failed to explain. This isn’t really surprising to me because, while he is quite knowledgeable, he isn’t a physician. “His own testing” may be akin to saying he Googled it. **How Did This Happen to Bryan Johnson?** Given that I don’t have Johnson’s full chart, I want to be careful and respectful of his situation. I have zero desire to ever blame a patient for their condition. Autoimmune gastritis is not rare. It's estimated to 2 to 5% of people, and it often develops silently over years or decades before anyone catches it, biohacker or not. This is not a fatal diagnosis, but it isn’t curable. Current medicine can only manage the condition, not reverse it, and it carries a long-term risk of vitamin B12 deficiency, anemia, and stomach cancer. Autoimmune disease can arise for a number of reasons, including genetics and environmental exposures. Sometimes it happens with no identifiable trigger at all. It would be irresponsible for me to tell you that his supplement stack, his experimental protocols, or any single piece of his regimen caused this. Maybe it did, maybe it didn’t. **Why This Matters for You** Here’s what I do want to say plainly: A body is not a spreadsheet of independent variables or a set of dials to be endlessly turned. Interventions interact. Immune systems are neither simple nor infinitely tolerant of manipulation. Something introduced to optimize, protect, or enhance one area can provoke an entirely different, unintended response somewhere else in the system. That's just how physiology works when you're pushing on it from many directions at once, especially with tools that don't have long safety track records in humans. I commend Johnson for making his diagnosis public and for openly acknowledging that his own extraordinarily monitored body still hid this condition for years. It’s a useful reminder for the rest of us. You can’t data your way to certainty about your own biology. No amount of tracking replaces actual clinical evaluation, and no protocol is risk free simply because part of it might be doing some good. **The Bottom Line** The endpoint you choose matters. If the goal is health and vitality, decisions get filtered through a fairly conservative question: _Does the evidence support this, and does the risk profile make sense for me?_ If the goal is longevity as an abstraction, an ever-receding target of maximal lifespan, the filter changes. More becomes better almost by default, because doing more, trying more, and measuring more feels like progress toward the goal, even when the underlying evidence for any single piece is thin or entirely absent. Before adding anything to your regimen, ask what the evidence says specifically about people who look like you, not just about a mechanism that sounds promising. “Longevity” is not a finish line. It's what tends to happen when the boring, well-evidenced things (sleep, movement, nutrition, appropriate medical monitoring) are actually done consistently. Everything stacked on top of that needs to earn its place, not just plausibly help. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6a30522c-5dea-42ef-a933-861bd7ccee7c/youtube_video_soup_for_NL.jpg?t=1784047056) [Video thumbnail with text reading Doctor Approved | High-Protein. Zero Excuses.] Follow image link: (https://www.youtube.com/watch?v=STXNNte0Wn4) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c475e0c6-6f3d-4c75-8a07-bb0c01c9259b/carrot_and_ginger_soup_update.jpg?t=1784047854) [Recipe for Carrot-Ginger Soup] Caption: ——————————————————————————— Carrot-Ginger Soup 232.93 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/edc5d007-a93c-45a0-9933-176027549c1a/RECIPE%20full%20carrot%20soup%20AR2.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260715%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260715T110043Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=9290d0b4f8aae20426bdb30668e94c83a7870446ad593cc06034e2f88b8f3183 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Come join us inside **[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer)**. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) ["I'll never send you in circles!" –Dr. Jen Ashton] Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-121

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [GLP-1’s and Inflammation](#dose) | [My Skin Protocol](#ss) | [The Wellness Economy](#community) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f20664f3-2441-43bf-ace0-09866fb30db3/Dose-_GLP-1_s_and_inflammation-_a_new_benefit__c.jpg?t=1783457680) Caption: **GLP-1s and Inflammation: What We Know and What We Think We Know** Here is a sentence I did not expect to write five years ago: the same medication your endocrinologist prescribes for diabetes—and your insurance company increasingly balks at covering for weight loss—is also quietly turning down the volume on the inflammation running through your body. And for women over 50, whose estrogen decline triggers what researchers at Harvard have called an "inflammatory event," that distinction matters more than we may think. Let's separate what's solid from what's still being researched. **What we know.** GLP-1 receptor agonists, the drug class that includes semaglutide and tirzepatide, were built to manage blood sugar and, later, weight. But a growing body of research shows they do something else at the same time: they lower inflammatory markers like C-reactive protein, interleukin-6, and TNF-alpha, the same molecules your rheumatologist or cardiologist watches when assessing your risk for heart disease, joint pain, or metabolic syndrome. A 2025 review in the Journal of Clinical Investigation found that some of these anti-inflammatory effects occur within hours of a single dose, far too fast to be explained by weight loss alone.  Other research estimates that only 20 to 60 percent of the reduction in C-reactive protein seen with these drugs can be attributed to weight or glucose changes. The rest appears to come from something else, a direct effect on immune cells themselves. **What we think we know.** The mechanism is still being mapped. Researchers believe GLP-1 receptors sit on macrophages and other immune cells, and that activating them dampens the inflammatory cascade directly,_ independent of any change on the scale_. Animal studies support this. Human data is accumulating but not yet definitive, and head-to-head trials designed specifically to isolate inflammation as the outcome, rather than weight or blood sugar, are still in progress. So when I say "may help with inflammation," I mean exactly that. Promising, mechanistically plausible, not yet proven as a standalone indication. Now, the part nobody wants to say out loud: this won't be covered by your insurance at this point or in the near future. Insurers pay for GLP-1 medications when there's an FDA-approved indication, like type 2 diabetes or obesity, sitting behind the prescription. "I want it for my inflammation, independent of my weight" is not currently an indication anywhere, and that means you're looking at a cash-pay conversation, often running several hundred dollars a month. You should also expect some/many doctors to say no. Not because they're being difficult, but because prescribing a medication for inflammation alone, off-label, with incomplete human trial data, is a real clinical dilemma / question for a physician, and a fair one. If your doctor isn't ready to write that prescription based on where the evidence currently stands, that's not gatekeeping. That's understandable caution, especially from doctors who may not be current with the latest literature. Ideally, however, your doctor will be current with the latest science AND be able to individualize the risk/benefit decision for and with you.  So where does that leave you if you're 58, dealing with joint stiffness, brain fog, or labs that keep creeping in the wrong direction, and a GLP-1 isn't a realistic option at this time? You are not without tools.  The Mediterranean pattern, heavy on omega-3s from fatty fish, olive oil, and fiber, is one of the most consistently evidence-backed anti-inflammatory approaches we have, and it doesn't require a prior authorization. Strength training does real, measurable work too, lowering inflammatory markers independent of whether the scale moves at all.  Sleep matters more than most women over 50 are told. Poor sleep alone elevates inflammatory cytokines, so if you're waking at 3 a.m. with your mind racing, that's not just exhaustion, it's a measurable physiological cost.  And if hot flashes, joint pain, or brain fog are affecting your quality of life, it's worth having a direct, unhedged conversation with your doctor about menopause hormone therapy. Estrogen has well-established anti-inflammatory effects, and those benefits decline as our hormone levels do. The honest version is this: GLP-1s may become an important tool against chronic inflammation.The early signals are encouraging, but "may" is doing a lot of work in that sentence. Until the science catches up, the rest of your anti-inflammatory toolkit still matters.   View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9dcc9470-4b44-4f78-9adb-78ad6df3cbf6/_SS_honest_take_on_pique_bt_2.jpg?t=1783435578) Caption: I get asked constantly what I actually do for my skin. This is a relatively new experience for me, as I never had great skin before. So here is an honest answer, with the caveats a doctor is obligated to give you, even in her own newsletter. I've started almost every morning for the last year with _[Pique’s Radiant Skin Duo Protocol](https://piquelife.com/ajendarsd)_: a packet of Sun Goddess Matcha, and a packet of BT Fountain, both mixed into water. I am absolutely convinced this combination is a big reason my skin looks as good as it does. The Sun Goddess Matcha is ceremonial-grade matcha (meaning it’s pure, high-quality matcha) and it has literally replaced my morning coffee. But today I want to focus on the BT Fountain. It's not a medication. It's a clean electrolyte, built around hyaluronic acid and ceramides. Here's the science, stripped of marketing language. Hyaluronic acid is a molecule your skin naturally produces to hold onto water, but its concentration declines with age, contributing to the dryness and thinning many of us notice in our 50s and beyond. For years, researchers assumed oral hyaluronic was too large a molecule to survive digestion and have any meaningful effect. We now know that’s not true. A randomized, double-blind trial of 150 healthy adults found that oral sodium hyaluronate significantly improved skin hydration, elasticity, and reduced wrinkle depth at the eye area compared to placebo, while also increasing epidermal thickness. A separate trial of 129 women found measurable improvements in hydration within two to eight weeks, with increased epidermal thickness showing up by twelve weeks. A 2025 meta-analysis pooling seven randomized trials confirmed the same pattern: statistically significant gains in hydration, elasticity, and wrinkle depth. Ceramides work differently, and the evidence is newer and thinner, so let me be honest about that distinction. Ceramides are the fats that physically hold your skin's outer barrier together, keeping moisture in and irritants out. Early studies suggest oral ceramides can improve hydration, strengthen the skin barrier, and even soften fine lines. That’s encouraging, and the science makes sense, but the research is still much less robust than it is for hyaluronic acid. I'd like to see larger, more rigorous trials before calling it settled. So why have I kept drinking it for over a year, past the point where novelty alone would explain it? Honestly, because my skin feels different, and at this stage in my life I've learned to pay attention when something simple actually delivers. I'm not going to pretend a powder replaces sunscreen, sleep, or a dermatologist. It doesn't. But as one small, low-effort addition to a morning routine that already includes the basics, this is one I've personally stuck with, not because the company sent it to me, but because I bought it myself and kept buying it. (Actually, my daughter Chloe introduced me to _[Pique](https://piquelife.com/ajendarsd)_ because she loved it so much!) One disclosure, because I am always about transparency: [_Pique_](https://piquelife.com/ajendarsd) is a trusted sponsor of Today’s Ajenda newsletter, and/but it’s also one of my favorite products. I'm not telling you this will erase a decade off your face. I'm telling you what I actually do, why the underlying science is more credible than I expected, and where that science still has real gaps. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3676efa4-27ad-4908-9a6f-517cdd177722/SHOP_Pique_BUTTON_upate.jpg?t=1779126492) Follow image link: (https://piquelife.com/ajendarsd) Caption: Use the Pique links above, and you can get 20% off and try it risk-free for 90 days! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5a69191f-0639-4c63-8163-505b79be9533/COM-vitality4.jpg?t=1783436161) Caption: Let me ask you something, and I want you to answer honestly. When was the last time you ate a meal without thinking about its macros, slept without checking a score in the morning, or walked outside without wondering whether the air quality justified an indoor workout instead? If you had to pause to think about it, you are not alone, and I'd argue you're not doing anything wrong. The system around you was built to make that pause necessary. The global wellness economy is now valued at more than $6 trillion and the biohacking segment alone—the wearables, the supplements, and the continuous glucose monitors worn by people who do not have diabetes—is projected to roughly double by the early 2030s. That is not a grassroots movement. It is an industry, and industries need you to believe the next product is the one that finally fixes you. Here is my honest, slightly self-deprecating confession: I have fallen for some of this too. I have stood in my kitchen reading the ingredient list on a water filter pitcher as though I were defusing a bomb. I own supplements I never take, and devices that I barely use. I understand the pull, because I feel it. But somewhere between the red light masks, the cold plunges, the mouth tape, the sleep scores, and the air purifiers in every room, I think we crossed a line from caring for our health into something else. Call it vigilance without end. Call it anxiety wearing the costume of self-care. When wellness requires a dashboard, multiple subscriptions, and a constant low hum of self-monitoring just to feel like you're doing it right, it has stopped being wellness. It has become a second, unpaid job, and the qualifications for that job change every six weeks depending on which influencer just discovered a new villain in your bloodstream. (You can probably tell that I despise fear-mongering!) I think this hits women over 50 particularly hard, and for a specific reason. This is the decade when your body genuinely is changing, often in ways that feel disorienting, and the wellness industry has learned exactly how to monetize that disorientation. Feeling foggy, tired, or different in your own skin is real. Too often, though, the answer being marketed to you isn’t "this is a normal, well-documented part of a hormonal transition," but rather "buy this $200 device and we'll measure exactly how broken you are." That's not protective. That's exploitative, and you deserve better than being treated as a permanent diagnostic project. So let me say the unglamorous thing, the thing that doesn't sell a device. Research on the longest living populations have made an observation worth sitting with: those communities have no biohacking at all. Their lifestyle is the intervention. Community, purpose, daily movement, real food, and enough sleep, done consistently, for decades, without a sensor in sight. That is genuinely the whole protocol, and I say this as someone with three medical degrees. Sleep enough. Eat real food, mostly plants, without needing a scoring app to tell you it was a good meal. Move your body most days, in a way you don't dread. And when you need medication, whether that's a statin, a thyroid prescription, or hormone therapy, take it, because medicine when it's appropriate is not a failure of wellness. It _is_ wellness. You do not need to detoxify your water, your skin, and your air on the same Tuesday to be a person who takes her health seriously. You need the basics, done consistently, and the confidence to ignore whoever is selling the next miracle. That confidence, not another gadget, is the actual upgrade. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b7987bd4-7ee6-439f-82e6-a234e100c16e/summer_salad.jpg?t=1783438503) Caption: ——————————————————————————— Summer Salad Click the button below to download the print-friendly version! 885.76 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/a50d411b-b7e3-4ec9-93d1-a83e8be18e1f/RECIPE%20full%20summer%20salad.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260708%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260708T110030Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=6d74705c8a492aca2be55ac4c7873dd7a7b533f49c01eb7c6fdaf9678210dae7 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Come join us inside **[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer)**. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-120

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Lessons from Sardinia](#dose) | [Need a Deload Week?](#ss) | [Blue Zone 101](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7625b5dc-dfdb-4815-b2ea-e62fefdd8bb3/image.jpeg?t=1782679574) Caption: Sardinia has been held up for two decades as one of the five original Blue Zones, regions where people supposedly live measurably longer than the rest of us. So when my husband suggested we go to Sardinia this summer, I was all in! The narrative is seductive: elderly shepherds walking mountain terrain, eating pecorino cheese, drinking Cannonau wine, surrounded by family, unbothered by modern stress, living past 100. And I thought the pictures of the water and the island's history were romantic! Apparently, others agree because Sardinia (and other Blue Zones) have been packaged into bestselling books, a Netflix series, branded food products, and an entire longevity industry. And parts of it are real. But some of the most important parts appear to be wrong. **The Data Problem** Dr. Saul Justin Newman, a demographer at University College London, has spent years examining the records behind Blue Zone longevity claims. His research, which won the first-ever Ig Nobel Prize in Demography in September 2024, revealed that the regions with the highest concentrations of supposed centenarians and supercentenarians consistently overlap with regions characterized by high poverty, a lack of birth certificates, and poor vital statistics record-keeping. Newman found that the introduction of state-specific birth certificate requirements was associated with a 69 to 82 percent decrease in supercentenarian records in those areas. In other words, once you could actually verify someone's age, the extraordinary longevity claims largely disappeared. In countries with Blue Zones like Japan and Greece, Newman discovered that pension fraud and reports of "missing" centenarians were common. As he put it: "They were getting older on paper, but they were already dead." Family members continued collecting pension payments, and the deceased remained alive in government databases. Sardinia's Ogliastra region, the mountainous interior where the Blue Zone was identified, fits this pattern precisely: historically rural, relatively impoverished, and characterized by the kind of civil registry infrastructure where errors and fraud would be difficult to detect. **What's Actually Supported by Evidence ** Here's where I want to be careful, because dismissing the lifestyle patterns observed in Sardinia would be throwing out genuinely valuable data along with the questionable longevity statistics. The traditional Sardinian diet closely mirrors a Mediterranean dietary pattern: abundant vegetables, legumes, whole grains, olive oil, moderate dairy (particularly sheep's milk cheese), fish, and modest red wine consumption. The evidence supporting this dietary pattern is robust and has nothing to do with Blue Zone branding. _[A systematic review](https://pmc.ncbi.nlm.nih.gov/articles/PMC12196460/)_ analyzing the PREDIMED and CORDIOPREV trials found that higher adherence to the Mediterranean diet is associated with a significant reduction in cardiovascular events, including stroke. A study published in _Nutrition, Metabolism and Cardiovascular Diseases_ found that Mediterranean diet adherence was associated with better cardiometabolic health specifically in middle-aged women, with more substantial improvements than those seen in men. The daily physical activity patterns in traditional Sardinian life, walking steep terrain, manual labor, and constant low-level movement rather than structured exercise, align with what the exercise physiology literature supports about the metabolic benefits of consistent non-exercise activity thermogenesis (NEAT). The multi-generational family structures and strong social integration mirror extensive evidence linking social connection to lower all-cause mortality, reduced inflammation, and better cardiovascular outcomes. So the lifestyle works. It's the longevity math that doesn't hold up. **Why This Matters For Women Over 50 ** The Blue Zones narrative has been enormously influential in how women in midlife think about aging. It's comforting. It suggests that if you eat the right foods, walk enough, maintain community, and drink a glass of red wine at sunset, you can live to 100. And the lifestyle components of that message are genuinely health-promoting. But the specific claim that these behaviors produce extraordinary longevity, that Sardinian shepherds are routinely living to 110, appears to be built on a foundation of unreliable data. Why does this distinction matter? Because it changes what you optimize for. If the goal is "live to 100," you're chasing a number that may have been artificially inflated. If the goal is "live well for as long as possible with functional independence, metabolic health, and cardiovascular resilience," then you're making decisions based on evidence rather than mythology. And those decisions, for women over 50, include resistance training (not just walking), adequate protein (not just vegetables and legumes), managing hormonal transitions (not just eating cheese and drinking wine), and addressing cardiovascular risk directly (not assuming a Mediterranean diet alone is sufficient). The Sardinian lifestyle has real lessons. Eat whole foods. Move your body daily. Stay connected to people who matter. Don't eat alone. And live in and near beautiful nature and that spectacular ocean water! Those things are supported by decades of independent research that has nothing to do with whether a 97-year-old shepherd's birth certificate is accurate. **What I Found: ** But the longevity fairy tale? The one that says you can eat your way to 110 in a picturesque mountain village? That story is, at minimum, built on shaky ground. What I did find, though, is worth searching for: being active, eating fresh food, enjoying strong social connections and interactions, and being in beautiful nature…THAT will yield solid endpoints every time. Real evidence that is tailored to you. Not romance. That's what the Gray Zone is for. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/bfc4a41e-5b00-4c5d-9f84-7e9ec976d337/image.jpeg?t=1782679574) Caption: If you train hard, you need to recover hard. That's not a throwaway line; it's the whole premise behind a deload week, and it's also exactly why so many women skip it. We've been conditioned to treat rest as the opposite of progress, when physiologically, it's the mechanism that allows progress to happen at all. **Here's the Science** Strength and endurance gains don't happen during the workout itself; they happen during the repair window afterward, when muscle protein synthesis rebuilds tissue stronger than it was before. That process needs time and resources. Train hard week after week without a break in the loading pattern, and you start accumulating fatigue faster than you can repair it, what exercise physiologists call non-functional overreaching. Cortisol stays elevated, sleep quality drops, and connective tissue, tendons and ligaments, which adapt more slowly than muscle does, fall further behind the load you're asking it to handle. A deload week is a planned, deliberate reduction in training volume or intensity, typically every four to eight weeks, that lets your nervous system, your hormones, and your connective tissue catch up to the work you've already done. This matters more, not less, as we move through our 50s and 60s. Estrogen has a real role in collagen synthesis and tendon stiffness, so as levels decline, recovery from mechanical stress takes longer than it used to. Add in the natural decline in growth hormone and the higher baseline cortisol many women experience during this transition, and the math changes. The training stimulus that built your fitness in your 30s can become the training stimulus that injures you in your 50s, if you never give your body a structured chance to adapt. Deloading isn't a concession to aging. It's how you keep training hard without your body sending you the bill in the form of a tendon injury or six weeks on the sidelines. **What People Get Wrong ** A deload week is _not_ a week off. This is the misconception I most want to correct, because skipping training entirely for a week can actually cause small losses in strength and cardiovascular conditioning, and it does nothing to support the connective tissue adaptation you're trying to support. A _real_ deload usually means cutting your training volume by 40 to 60 percent, fewer sets, fewer total reps, a shorter workout, reducing intensity, lighter loads at a higher percentage of reps in reserve, while keeping movement patterns and frequency relatively intact. You still show up. You still move your joints through full range, still do some loaded work, still get your heart rate up. You're just not chasing a personal record or grinding out your last rep that week. **A Practical Way To Structure It ** Keep your usual training days, but drop weights by roughly a third and stop every set two to three reps before failure. If you've been doing five sets, do three. If your week includes high-intensity intervals, swap one or two for zone two cardio instead. Sleep and protein intake stay non-negotiable; if anything, this is the week to prioritize them most. **The Bigger Mindset Shift ** A deload week isn't something you do when you're already injured or burned out; it's something you schedule before you get there. Recovery, done well, is not the absence of training. It's a part of training, with its own purpose and its own science. If you're serious about lifting heavy, running hard, or pushing your conditioning in your 50s and 60s, building in deliberate recovery isn't optional. It's the strategy that lets you keep doing the hard part for years, not just weeks. _PS: Tired of guesswork when it comes to your fitness, nutrition, and weight loss? Get the proven system that works all-in-one: _[__The Wellness Experiment__](https://www.joinajenda.com/experiment?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-112)_! _ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ea4026db-28db-400a-897d-a13a79f9568c/image.jpeg?t=1782679574) Caption: ** ****What We Know (and Don't) About the Mediterranean Diet** Every few months, a new diet ranking lands, and the Mediterranean diet sits at or near the top almost every time. I'm not going to argue with that. The _[PREDIMED trial](https://pubmed.ncbi.nlm.nih.gov/28684083/)_ followed over 7,400 people for nearly five years and found roughly a 30 percent reduction in major cardiovascular events, with no calorie counting required. A meta-analysis pooling data from more than 722,000 women found 24 percent lower cardiovascular disease incidence and 23 percent lower total mortality in the highest adherence group. The cognitive numbers are just as striking: an 18 percent reduction in cognitive impairment, and a 30 percent reduction in Alzheimer's risk, across pooled prospective studies. This is some of the most extensive evidence we have for any dietary pattern. But I want to be honest with you about what that evidence actually means, because the way these rankings get reported does you a disservice. Here's the problem nobody puts in the headline: we cannot cleanly separate the food from the person eating it. PREDIMED was conducted in Spain, in people already living a Mediterranean lifestyle, with Mediterranean genetics, Mediterranean food matrices, and decades of epigenetic exposure we can't replicate in a lab. When researchers try to extract "olive oil" or "fish three times a week" as if those are interchangeable inputs you can drop into any life, they're stripping out everything else that travels with that diet: more walking, denser social ties, different sleep patterns, a food supply that hasn't been engineered for shelf life. _[As per the American Heart Association](https://www.ahajournals.org/doi/10.1161/CIR.0000000000001146)_, “ there is the potential for oversimplification and misinterpretation of the defining features. With the Mediterranean pattern, some patients may focus solely on olive oil consumption, increasing total calorie intake and missing out on many of the other important features of the diet.”  The American Heart Association rates the evidence for the Mediterranean diet's effect on LDL cholesterol, HDL, and triglycerides as low, and blood pressure reductions in trials have been modest, six to seven points systolic at best. Several intervention trials outside Mediterranean countries have shown smaller or inconsistent benefits, and researchers increasingly suspect that carbohydrate quality and degree of weight loss may matter more than the pattern itself. That's not a reason to dismiss the diet. It's a reason to be skeptical of anyone who tells you a list of foods alone is the whole mechanism. **Relevance For Women Over 50 ** _[In PREDIMED](https://pubmed.ncbi.nlm.nih.gov/26365989/)_, women aged 60 to 80 who followed the Mediterranean diet supplemented with extra-virgin olive oil saw a 62 percent relative reduction in invasive breast cancer, with each additional 5 percent of calories from olive oil tied to a 28 percent lower hazard. Other data show women in the highest tier of Mediterranean diet adherence reporting 80 percent lower odds of severe hot flashes and 83 percent lower odds of severe sexual symptoms compared to women in the lowest tier. Those numbers are genuinely compelling. They're also observational, which means they show association, _not proof of cause_. We don't yet have the large randomized trials in menopausal women that would let me tell you with certainty that the diet itself, rather than something correlated with who eats this way, is driving those results. I'd rather tell you that plainly than oversell it. **The Nutrition Factor** This matters even more once you factor in our food supply. A tomato in Crete and a tomato shipped to a Texas grocery store in February are not nutritionally equivalent, even if the label says "tomato." Produce loses nutrient density the longer it sits between harvest and your plate. Affordability compounds this: extra-virgin olive oil, wild fish, fresh produce- these aren't cheap, and "eat Mediterranean" is a very different ask depending on your zip code and your grocery budget. I don't think it's fair to hand you a diet built in one food system and expect identical results from a different one, without saying so out loud. **Does Organic Matter?** For pesticide exposure, the evidence leans toward yes, modestly. For nutrient content, the differences are small and inconsistent across studies. If organic fits your budget, it's a reasonable choice. If it doesn't, conventional produce still beats no produce, and I will not let perfect be the enemy of good in your kitchen. Now, the controversial stuff. Beef tallow and raw milk have become culture-war shorthand for "real food," and I understand the instinct, since processed seed oils and ultra-pasteurized everything don't feel like progress. But here's what I won't do: pretend there's good methodology behind either as a wellness upgrade. We don't have quality human trials on beef tallow's health effects, and raw milk carries documented infection risk without offsetting evidence of superior nutrition. Strong opinions on both sides, thin data underneath. That gap is worth naming. I avoid both, personally. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e49388de-a6a8-4d33-a806-dc97bf403c08/image.jpeg?t=1781039996) Caption: _So where does this leave you?_ Not as someone on the receiving end of a diet ranking, scrolling through a list wondering if you're doing it right. You're the one whose genetics, food access, budget, and history actually determine whether any of this works, and that's worth remembering every time a headline tells you what "the science says." The Mediterranean pattern is, genuinely, one of the best-supported frameworks we have. But it's not a guarantee, it's not magic, and it sure wasn't built with your grocery store in mind. So take the principles that make sense for your life, and don't feel guilty about the parts that don't translate. That's not settling. Honestly, that's just what good medicine has always looked like, taking something real and making it fit the person in front of you. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-119) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-119

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [3-Steps to Sleep](#dose) | [Hair Help 411](#ss) | [Hair Dye Safety](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3180d218-b51b-4423-813a-e80c80da9104/image.jpeg?t=1782235573) Follow image link: (https://www.eventbrite.com/e/glp-1s-hormones-and-midlife-weight-what-actually-works-tickets-1992439769987?aff=oddtdtcreator) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/236074fc-01c6-468c-877b-06df8b93c740/image.jpeg?t=1782235573) Caption: I want to teach you something that takes 10 minutes, requires nothing but a pen and a piece of paper, and has more clinical evidence behind it than most of the supplements in your medicine cabinet. It's called constructive worry, and it's one of the most underutilized components of cognitive behavioral therapy for insomnia (CBT-I), the gold standard treatment for chronic sleep problems. But first, let me give you a few numbers that might surprise you. _[A 2023 meta-analysis](https://pubmed.ncbi.nlm.nih.gov/38231522/)_ of 241 randomized controlled trials involving over 31,000 participants, published in _Annals of Internal Medicine_, found that the cognitive and behavioral components of CBT-I, including constructive worry, produced sustained improvements in insomnia that outlasted the effects of prescription sleep medications. The medications worked faster. CBT-I worked longer. And unlike medication, the skills don't stop working when you stop using them. In another study in the journal _Behavior Research and Therapy, _it was found that pre-sleep cognitive arousal, the racing mind you experience when your head hits the pillow, is a stronger predictor of insomnia severity than somatic arousal (physical tension, heart rate, muscle tightness). In other words, it's not your body keeping you awake. It's your brain. And women over 50 are disproportionately affected. _[Data from the SWAN study](https://pmc.ncbi.nlm.nih.gov/articles/PMC3185248/)_ showed that women in the menopausal transition are two to three times more likely to report insomnia symptoms than premenopausal women, and that difficulty staying asleep, not falling asleep, is the most common complaint, often driven by exactly this kind of middle-of-the-night cognitive activation. **Why Your Brain Does This** Your prefrontal cortex, the part of your brain responsible for planning, problem-solving, and future-oriented thinking, doesn't have an off switch. During the day, it's occupied. You're working, managing, caring for people, making decisions. But the moment you lie down and remove every external demand, your prefrontal cortex does what it's designed to do: it scans for unresolved problems. Not because something is wrong with you. Because that's its job. The issue is that 11 PM is a terrible time to solve problems. You have no resources, no capacity to act, and no ability to resolve anything. So the thoughts loop. And the looping itself generates cortisol, which lowers your sleep threshold, keeping you awake and giving your brain more time to loop. It's a cycle that feeds itself. Constructive worry breaks the cycle by giving your prefrontal cortex what it wants, a plan, before you ever get into bed. **The Formula** Do this every evening, ideally 60 to 90 minutes before bed. Not in bed. Not in the bedroom. At a table, with the lights on, treating it like a brief task, not a bedtime ritual. **Step one:** Set a timer for 10 minutes. Write down every worry, concern, or unfinished thought that's on your mind. Don't filter. Don't judge. Don't try to be rational about it. If it's in your head, put it on paper. "Did I pay the electric bill." "Mom's doctor appointment is on Thursday." "I haven't called Sarah back." "My knee hurts, and I'm ignoring it." All of it. **Step two: **Next to each worry, write one concrete action step you will take tomorrow. Not a solution. Not a resolution. Just the next single thing you can do. "Check autopay settings." "Confirm appointment time with Mom." "Text Sarah in the morning." "Call orthopedist and schedule evaluation." The action step doesn't have to be brilliant. It has to be specific and doable. **Step three: **Close the notebook. Physically close it. Put it in a drawer or turn it face down. This is not a metaphor. The act of closing it signals to your brain that the problems have been externalized, acknowledged, and assigned a next step. They are no longer items your working memory needs to hold. **Why This works** Constructive worry works because it addresses the actual mechanism of pre-sleep cognitive arousal rather than trying to suppress it. Telling yourself to "stop thinking" doesn't work because thought suppression paradoxically increases the frequency and intensity of the unwanted thoughts. This is called the ironic process theory, and it's well-documented in cognitive psychology. Constructive worry doesn't ask you to stop thinking. It asks you to finish thinking, at least enough to give your brain permission to stand down. The research also shows that the act of writing, physically externalizing thoughts onto paper, reduces their emotional intensity. A study published in the _Journal of Experimental Psychology_ found that participants who wrote a specific to-do list for upcoming tasks before bed fell asleep significantly faster than those who wrote about tasks they had already completed. The directionality matters: it's the unfinished, forward-looking concerns that drive pre-sleep arousal, and the written plan is what neutralizes them. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3f8a7389-1f9d-4fe4-8311-be84be0c31a4/image.jpeg?t=1782235573) Follow image link: (https://youtu.be/qBw9_uDfL3E) Caption: **What I'd Add For Women Over 50 ** If you're in menopause, your baseline arousal system is already elevated for reasons that have nothing to do with your thoughts. Rising cortisol, declining progesterone (which is a natural sedative), and estrogen-mediated changes in brainstem sleep-wake centers all lower your threshold for waking. You're already starting from a more activated place. That means the cognitive layer, the worry loop, doesn't have to be dramatic to push you over the edge into wakefulness. Even low-level rumination that might not have disrupted your sleep at 40 can be enough at 55. That's why this technique isn't optional for you. It's not a nice-to-have. It's removing the one layer of sleep disruption you have complete control over, so the interventions addressing the biological layers, whether that's hormone therapy, a DORA, or an NK3 receptor antagonist, can actually do their job. Ten minutes. A pen. A piece of paper(not a phone or laptop). Close the notebook. Your brain doesn't need you to solve everything tonight. It just needs to know there's a plan for tomorrow. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/98a0f797-5aaa-409c-ba77-31167189d31c/image.jpeg?t=1782235573) Caption: Earlier this month, when I was on GMA, so many of you commented on how healthy and vibrant my hair looked. Thank you. Those messages meant more than you might realize. If you've been part of this community for a while, you know I've always been honest about the fact that my hair affects how I feel. Not because it's the most important thing about me, but because it is part of how I recognize myself. And I know I'm far from alone in that. For so many women, hair isn't just hair. It's identity. It's expression. It's the quiet confidence that comes from catching your reflection and feeling like yourself. When that begins to change, whether through thinning, shedding, or shifts in texture, it can feel surprisingly personal. And before we talk about solutions, I think it's important to acknowledge that reality. What I've come to appreciate more and more as both a physician and a woman navigating midlife is that confidence is not superficial. It is deeply connected to how we move through the world. ### **The Biology Behind Midlife Hair Changes** Women in perimenopause and menopause are already navigating significant hormonal shifts that affect hair density and growth. As estrogen and progesterone decline, the active growth phase of the hair cycle shortens. More follicles move into a resting phase, shedding increases, and the thickness and fullness many of us have relied on for decades can begin to change. Layered onto that are nutritional factors, stress, sleep quality, and the broader metabolic recalibration that midlife often brings. The good news is that while these changes are common, they are not something women simply have to accept. Understanding the physiology is the first step toward supporting the body through it. ### _[Why I'm Talking About Wellbel Women+](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_***** I want to be transparent, as I always am, especially when there's a sponsorship involved. _[Wellbel Women+](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_ was physician-formulated specifically for women navigating perimenopause and menopause. What appealed to me is that it acknowledges the hormonal reality of midlife rather than treating women as an afterthought in the hair-growth conversation. I did some research into their brand, and after speaking with their co-founder, Dr. Dan Yadegar, about the inspiration and formulation of this supplement, I was impressed. A few aspects of the formula stand out. The biotin dose is 500 micrograms, far lower than the mega-doses commonly found in many hair supplements. That's important because biotin alone is rarely the primary issue for women experiencing hair changes, despite what marketing often suggests. In addition, higher doses of Biotin can actually harm, more than it can help, as it can affect important blood tests regarding heart health. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c543d6e4-c75e-453f-8a5c-693d5a7fa760/new_hair_growth.jpg?t=1782251800) Caption: Look at all this NEW GROWTH! Thank you, Wellbel! The formula also includes saw palmetto to support healthy DHT balance, MSM to support collagen and keratin production, zinc and copper for healthy cell regeneration and protein synthesis, stinging nettle leaf for additional DHT support, and vitamin K2, which plays a role in both bone health and hair follicle vitality during the postmenopausal years. In other words, it approaches hair health through the lens of whole-body physiology rather than a single ingredient solution. The results reported by Wellbel's community (and our Ajenders) are very encouraging. Among women who had taken the product for six months or longer, 94% reported healthier-looking hair and 83% reported visible new growth. Personally, I tested this supplement for 3 months before even considering sharing it with you.[ ](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)Once I saw my results, _[I couldn't wait to share Wellbel with you](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_! While everyone’s results can and will vary, this is a hair helper that ‘checks all my boxes.’ The outcomes align with what we would expect from a thoughtful nutritional intervention given enough time and consistency. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e49388de-a6a8-4d33-a806-dc97bf403c08/image.jpeg?t=1781039996) Caption: Hair changes in midlife are common. But they do not define you, and they are not necessarily your new normal. I believe every woman deserves to feel at home in her own reflection. Not because appearance is everything, but because there is something powerful about recognizing yourself again.  While there are many possible causes of hair changes in midlife (ranging from menopause to GLP-1 use and more), there are also numerous ways to manage or treat them. As a nutritionist and a physician, I strongly believe in working from both the inside out and the outside in. _[This supplement is worth trying, in my personal and professional opinion](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_. Remember that it generally takes at least 3 months for any change in hair to become noticeable, so patience is key. And if you see a positive change, continue! Maybe it will be shinier or more growth, or thicker/fuller hair. It doesn’t have to be the hair we had at age 25. It should, however, be hair that makes you smile.  That's the ripple effect I'm interested in. Not perfection. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0bc07003-de5f-49c1-a8fb-0fb005721777/image.jpeg?t=1782235572) Follow image link: (https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) Caption: ==Use the code AJENDA15 for 15% off any Wellbel order with free shipping.== View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a1ca47dc-6283-45a4-9e5d-92e03f09f2b4/image.jpeg?t=1782235573) Caption: **What Hair Dye Actually Does to Your Hair and Scalp** Most of us (myself included) have been coloring our hair for decades without thinking much about what the chemistry is actually doing. That’s not a criticism. When something works, you use it. But I get asked about this constantly, especially by women who are noticing more breakage, scalp sensitivity, or just want to understand what they are putting on their heads every six weeks or so, so I did some research for you. The short version: not all hair dye is created equal, and the risks, both to your hair structure and your scalp, are almost entirely concentrated in one category. **The Type of Dye Matters Enormously ** Permanent dye, which accounts for roughly 70 to 80 percent of what is sold, is the category that does the most work and the most damage. It has to be. To permanently change your hair color, the chemistry has to open the hair shaft, bleach your natural pigment, and deposit new color molecules deep enough that they cannot wash out. That process, repeated every four to eight weeks for years, takes a structural toll. Semi-permanent dye partially penetrates the hair but does not use the same oxidative chemistry, lasts about 24 washes, and causes substantially less damage. Temporary color sits on the surface of the hair and washes out within a week or two. Those two categories have a much cleaner safety profile across the board. If you have options, they are worth considering. **What Permanent Dye is Doing To Your Hair Shaft** Even a single application of permanent dye causes visible changes to the cuticle, the outermost protective layer of the hair shaft, detectable under electron microscopy. With three or more consecutive treatments, the damage compounds. The cuticle scales begin to roughen, lift, and eventually erode, leaving the inner cortex of the hair increasingly exposed. Once the cuticle is compromised, the hydrogen peroxide in the dye penetrates deeper and begins breaking down the disulfide bonds that give hair its tensile strength and elasticity. This is why repeatedly colored hair feels different over time and breaks more easily. It is not imaginary, and it is not just dryness. It is cumulative structural degradation at the protein level. _One finding worth knowing: research using atomic force microscopy shows that after a single permanent dye application, cuticle damage peaks at around six hours to one day, then gradually recovers, with near-complete restoration by about eight weeks. That is meaningful if you are trying to calibrate how frequently you can color without significant cumulative harm._ **What It’s Doing To Your Scalp** The most common scalp reaction is allergic contact dermatitis, and the main culprit is a compound called PPD (p-phenylenediamine), which is present in most permanent dark dyes. About 6.8 percent of hair dye users report adverse skin reactions, with women and frequent users being more affected. Most reactions are on the milder end, itching, eczema, scalp irritation, but severe cases do occur, and repeated sensitization can escalate over time. If you have noticed your scalp becoming more reactive to dye as you have gotten older, that pattern is real and documented. **The Cancer Question** This is where I want to be honest about what the science actually shows, without either dismissing it or overstating it. For blood cancers like lymphoma, a large meta-analysis published in JAMA found a pooled 15 percent higher risk among ever-users of permanent hair dye. That sounds alarming in isolation, but 15 percent above a baseline low risk is a relatively modest absolute increase. The risk appears higher with dark-colored permanent dyes and with formulations used before 1980, when the chemical composition was considerably more carcinogenic than what is on the market today. For breast cancer, _[the data are more nuanced and more concerning](https://pmc.ncbi.nlm.nih.gov/articles/PMC5862263/)_, specifically for Black women, with one major study finding a 45 percent higher risk in that group compared to 7 percent in White women, a disparity that warrants more research and more attention than it has gotten. Semi-permanent and temporary dyes have not been associated with increased cancer risk in most analyses, which is consistent with the fact that they do not use the oxidative chemistry that drives the concern. **The Practical Takeaway** This is not an argument for stopping hair color. For most women, the absolute risks remain relatively low, and the evidence is not definitive enough to issue a clinical directive. What it is an argument for: spacing out permanent color treatments as much as your schedule allows, taking scalp reactions seriously rather than pushing through them, and knowing that semi-permanent options have a meaningfully different risk profile if you have flexibility in your routine. You deserve the real information. What you do with it is yours to decide. Personally, I still get my hair highlighted every 10-12 weeks, and I plan to continue that.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a4aa46f8-ed4a-43c6-8812-53055431f4e5/image.jpeg?t=1782235573) Caption: ——————————————————————————— Grilled Steak and Broccoli Click the button below to download the print-friendly version! 1007.75 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/87498ff4-38f0-481a-a0fc-97de736b86d7/RECIPE%20full%20page%20steak%20%20%281%29.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260624%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260624T110154Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=7b446f018e2e5a4d0c14507463a00a19e3f20077ca1a7baf318f6ecf15038a23 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: ---------- Get the most out of Today’s Ajenda by answering _[this short survey!](https://todays-ajenda.beehiiv.com/forms/7203dad7-02c8-4d24-898d-7f33e9bab15e)_ ---------- Take the Survey (https://todays-ajenda.beehiiv.com/forms/37362e78-f665-494b-973c-53a67bc26882) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Become an AJENDER inside _**[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-112)**_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-117) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-118

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Fiber Facts](#dose) | [Optimize Your Shower](#ws) | [3AM Wake-ups](#ss) | [Giveaway Winner](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d8fe6f81-490f-486c-8c8e-1c7866b7c3fe/image.jpeg?t=1781640011) Caption: Most women know fiber is "good for you." Fewer know that it could be one of the most powerful — and most underused — tools for protecting their hearts, bones, and longevity after 50. Here's what the science actually says, including the nuances that rarely make it into headlines. **You're Almost Certainly Not Getting Enough** The recommended fiber intake for women over 50 is about 21 grams per day. The average postmenopausal American woman gets roughly 15 grams, and only about 5 percent of the population meets the target. That gap matters more than most people realize, because the biggest health benefits come from simply moving out of very low intake — not from becoming a fiber overachiever. A study of nearly 8,000 postmenopausal women found that those with the highest fiber intake had a 15 percent lower risk of dying from any cause and a 31 percent lower risk of dying from heart disease (Guo et al., _Maturitas_, 2025). The most striking finding? The steepest benefit came from getting above roughly 8 grams per day. Even modest increases — an extra apple and a half-cup of lentils — can move the needle. **The Cholesterol Connection Most Women Underestimate** Heart disease is the leading killer of women over 50, and fiber is one of the most effective (and underused) dietary tools for managing cholesterol. _[A meta-analysis](https://pubmed.ncbi.nlm.nih.gov/31897475/)_ of 28 clinical trials found that roughly 10 grams per day of psyllium fiber reduced LDL cholesterol by about 13 mg/dL. To put that in perspective: _[research has shown](http://sciencedirect.com/science/article/pii/S0002914918313328?__cf_chl_tk=.WgA82aHY7lHhHSZEAxQy0JoCaujfj161AIRQEm2hrI-1781189859-1.0.1.1-MaapDeJxON5FfR9_m7So.s6lrHBS12qrEHnjX2ZcIYg)_ that adding psyllium to a statin lowers cholesterol as much as doubling the statin dose. For women who experience the common complaint of muscle aches at higher statin doses this is a practical, evidence-based alternative worth discussing with a doctor. But the benefits go beyond LDL. Psyllium also reduces non-HDL cholesterol and apolipoprotein B, both of which are increasingly recognized as better predictors of cardiovascular risk than LDL alone. The American Heart Association's 2026 dietary guidance statement identifies fiber-rich dietary patterns as consistently associated with lower cardiovascular disease risk. **The Bone Benefit Nobody Talks About** Here's the nuance that surprises even many doctors: certain types of fiber can improve calcium absorption and support bone health — a critical concern for every postmenopausal woman. When prebiotic fibers reach the colon, gut bacteria ferment them into short-chain fatty acids. These acids lower the pH in the intestine, making calcium more soluble and easier to absorb. _[A clinical trial](https://pubmed.ncbi.nlm.nih.gov/27465372/)_ in postmenopausal women found that 20 grams per day of soluble corn fiber improved bone calcium retention by 7 percent — the equivalent of absorbing an extra 50 milligrams of calcium daily without taking another supplement. _[A longitudinal study](https://pmc.ncbi.nlm.nih.gov/articles/PMC13016812/)_ of 223 early postmenopausal women confirmed that higher fiber intake was positively associated with trabecular bone structure, mediated by specific short-chain fatty acids produced by gut bacteria. The best food sources of these prebiotic fibers include garlic, onions, leeks, asparagus, bananas, and chicory root. You don't need a supplement. A diet rich in these foods feeds the gut bacteria that help your bones hold onto calcium. **It Lowers Breast Cancer Risk** _[A meta-analysis ](https://pmc.ncbi.nlm.nih.gov/articles/PMC2728649/)_of 20 prospective studies found that women with the highest fiber intake had an 8 percent lower risk of breast cancer, with the association holding for both premenopausal and postmenopausal women. The mechanism likely involves fiber's ability to help the body clear excess estrogen more efficiently, reducing the circulating hormone levels that can fuel hormone-driven tumors. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ddf49dcd-efc7-4ecb-b2cd-7f5b7e528f1a/image.jpeg?t=1781639753) Caption: For bone-supporting prebiotic fiber specifically, focus on garlic, onions, leeks, asparagus, bananas, artichokes, and chicory root — these are the foods that feed the gut bacteria responsible for improving calcium absorption. **The Practical Playbook** Start low and go slow. Increasing fiber too quickly causes bloating and gas, which is the number one reason people quit. Add about 3 grams every two weeks. Drink plenty of water with every increase; without adequate fluid, fiber can make constipation worse, not better. And if you take thyroid medication, blood thinners, or other daily prescriptions, take your fiber supplement at least two hours apart to avoid interfering with absorption. The bottom line: fiber is not glamorous, but for women over 50, it may be one of the simplest, cheapest, and most evidence-backed investments in long-term health. The bar is low, and that's exactly why the payoff is so high. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/401485d8-da88-4065-b3c6-14fb6f0fa239/image.jpeg?t=1781639753) Caption: Challenge: Take something we do every day and ponder whether there is a way to improve it, in some way. I love this exercise because it checks several boxes: curiosity, scientist, wellness enthusiast, and, yes, overall Type A individual. For me, one of those things is the shower. Ironically, it wasn't a dermatologist who first got me thinking about my shower water — it was a hairstylist. She told me that one of the biggest factors in maintaining vibrant color, reducing frizz, and keeping hair looking and feeling healthy isn't necessarily another product — it's the water we use to wash every day. I'll admit that wasn't something I had really considered. Like most people, I assumed great hair came down to genetics, good products, and a solid haircare routine. But once I started looking into the role water quality can play, I went down a bit of a research rabbit hole. That's how I discovered _[Vitaclean](https://vitacleanhq.com/DRJASHTON26)_*, and specifically their newest wall-mount model, the [Vitaclean Ultra](https://vitacleanhq.com/DRJASHTON26), which recently received a design patent. What I like about the Ultra is that the filtration system makes sense. First, it filters out particles down to .005mm. Things like dirt, rust, and sediment that cause your hair to feel (and look) dingy, even after you just washed it. After the first time I changed my Vitaclean filter, I was shocked to see how dirty the filter had become! Who knew?! In addition, the ceramic and Vitamin E beads help condition the water. And finally, Vitamin C helps remove chlorine by up to 99% while Vitamin E and essential oils are infused into the water. The result is a conditioned shower that actually cleans your hair. I absolutely love it! The gross stuff comes out, and some good stuff goes IN!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/90197fdc-7a28-446a-9645-4cc5376584eb/vitaclean-ultra-shower-head-starter-kit.jpg?t=1781647153) Caption: And I know what you might be thinking, “How’s the water pressure after all that filtration?” _[Vitaclean Ultra’s](https://vitacleanhq.com/DRJASHTON26)_ design ensures the shower pressure stays strong throughout, which earned them a spot in Oprah's Bath Awards in 2025, and which matters to me because a trickle is not a reset, it's a punishment (I said what I said). The water feels cleaner, and my skin feels softer and less irritated after showering. I've also noticed that my hair is easier to manage, looks less frizzy, and feels more hydrated. If you color your hair, maintaining vibrancy is always a goal, and anything that helps support that is a welcome bonus.  We spend a lot of time and money choosing products for our skin and hair, but then we stand under water that can contain chlorine, sediment, rust, and mineral buildup every single day. Especially as our skin and hair change with age, that feels worth paying attention to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e49388de-a6a8-4d33-a806-dc97bf403c08/image.jpeg?t=1781039996) Caption: I’m not telling you this will transform your hair and skin overnight, because that's not how biology works, and I won't overhype something to you. What I will say is that if your shower is also your sanctuary, the quality of the water running through it is worth thinking about. I’m certainly glad I did!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2b9f4f36-9afd-4b39-9dd1-22cdb2ce49b9/image.jpeg?t=1781639753) Follow image link: (https://vitacleanhq.com/DRJASHTON26) Caption: Save 10% with code [**DRJAshton26**](https://vitacleanhq.com/DRJASHTON26) at checkout.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fd149e43-037a-4a89-b57a-7cf4808c1ca2/_SS_3am_final.jpg?t=1781649248) Caption: It is 3:14 a.m. You are wide awake (again). Your heart is racing slightly, your skin is hot, and your brain has already moved on to the grocery list and the things you need to do before Tuesday. You’re not anxious. And you generally are not a light sleeper. Your body’s internal thermostat just blew, and you are the collateral damage.  This is thermoregulatory instability, and if you are a postmenopausal woman, you need to understand what it is, why it is happening, and why it is specifically wrecking your sleep, because this doesn’t get discussed enough. What it is Your hypothalamus is your brain's built-in thermostat. For most of your adult life, it operated with something called a thermoneutral zone, a comfortable temperature buffer of roughly 0.4 degrees Celsius within which your body made small, quiet adjustments to keep you stable. You could walk into a warm room, eat spicy food, or pull up an extra blanket and your hypothalamus would handle it silently, no alarm, no response.  Firing on all cylinders. In the menopausal years, coincidental with a drop in estrogen levels, that thermoneutral zone essentially disappears. The buffer is gone. Even a half-degree increase in core body temperature can now trigger a hot flash in a menopausal woman, compared to the one-to-two degree change required to trigger a response in a premenopausal woman. Your thermostat did not just get sensitive. It lost its margin of error entirely.  Why it happens The mechanism is more specific than "low estrogen." Thermoregulatory instability during menopause has been linked to overactivity in a specific cluster of hypothalamic neurons called the KNDy system, which stands for kisspeptin, neurokinin B, and dynorphin. When estrogen levels decline, these neurons become hyperactive, firing signals that inappropriately trigger your body's heat-dissipation response. The result is sudden cutaneous vasodilation, sweating, and a spike in skin temperature, what you experience as a hot flash or a night sweat.  Norepinephrine and serotonin are also implicated, which is why medications that modulate these neurotransmitters can reduce hot flash frequency even without altering estrogen levels. This is not a hormonal problem with a single hormonal fix. It is a neurological dysregulation with multiple entry points for intervention.  Who it affects and when Sleep disturbances affect an estimated 40 to 69% of women across the menopausal transition, and terminal insomnia, waking in the early morning hours unable to return to sleep, is one of the most common presentations. Polysomnographic studies have confirmed that objectively measured hot flashes are temporally linked to awakenings and increased nocturnal wakefulness. You are not imagining the timing. The thermoregulatory event wakes you first. The racing thoughts come second.  What to actually do about it Good news, because there are more treatment options than ever! There are four categories of intervention, and the evidence supports using more than one simultaneously. Your sleep environment. This is the most underutilized tool, and I believe in this strongly. Set your bedroom between 65 and 67 degrees Fahrenheit. Use moisture-wicking, lightweight layers you can shed without fully waking. A cooling mattress pad is worth serious consideration: a crossover trial in 98 peri- and postmenopausal women found a 56% reduction in nocturnal hot flashes when sleeping on an active temperature-regulation mattress pad, with effects appearing within one week. That is a meaningful intervention with no side effects and no prescription required.  Behavioral approaches. CBT-I, cognitive behavioral therapy for insomnia, targets the arousal cycle that keeps you awake after thermoregulation wakes you up. The two most relevant tools: get out of bed if you cannot return to sleep within 20 minutes (lying awake in bed teaches your nervous system to associate bed with wakefulness), and actively challenge the catastrophic thought, "I'm never going to function tomorrow," because that thought spikes cortisol and guarantees you won't fall back asleep. Non-hormonal pharmacology. This is where the science has genuinely moved. Fezolinetant and elinzanetant are both FDA-approved neurokinin receptor antagonists that work by interrupting the overactive KNDy signaling directly, reducing hot flash frequency without the use of estrogen. Clinical trials showed fezolinetant (sold under the brand name, Veozah) reduced hot flash frequency by approximately 60% and elinzanetant by approximately 74%. These are not workarounds. They address the root mechanism. They are worth a conversation with your doctor, particularly if you are not a candidate for hormone therapy, but note that blood tests for monitoring liver function are necessary before and during treatment. Hormone therapy. For women who are appropriate candidates, estrogen remains the most effective intervention for thermoregulatory instability, full stop. The decision involves your personal health history and needs a real clinical conversation, not a Google or ChatGPT search. Do not let old, outdated fear keep you from having it. You are not a bad sleeper; it’s just that your thermostat lost its buffer. Now you know what broke it, and what can actually fix it. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9b277cc8-ce09-4c95-b827-4e2ab3c01af2/image.jpeg?t=1781639753) Caption: _“I have been using the mushroom chocolate that Dr. Jen recommended, and it has really helped me get to sleep and stay asleep.” _- Joy B.  **Ajenda: Before you started prioritizing sleep, what was your biggest sleep challenge and how was it affecting your daily life?** Joy: My biggest problem was staying asleep. I would wake at 2 or 3 and struggle to get back to sleep. **Ajenda: Walk us through your typical evening routine. What are the key habits that help you get a good night's sleep?** Joy: I take my chocolate at 9 pm and then watch TV for an hour. I have an alarm on my phone so I don't forget. At 10, another alarm goes off, reminding me to go to bed. I get ready and read in bed for about 10 minutes and am usually asleep by 10:30. **Ajenda: Of all the changes you've made, which one has had the biggest impact on your sleep quality?** Joy: Definitely the Alice chocolate. I tried a lot of things, and nothing helped until I added that in. **Ajenda: What differences have you noticed in your energy, mood, health, or daily life since improving your sleep?** Joy: I have so much more energy and want to do things again. I was so sluggish and just wanted to be home, wear cozy things, and sit around. Now I have the energy and desire to get out and do the fun things around town. **Ajenda: How did Alice Chocolates help you?** Joy: Alice's helped me by putting me right to sleep and staying asleep until 5 or 6 am. It's still early, but compared to 2 or 3, it's great. My smart watch really showed the difference as well, with better, less restless sleep. **Ajenda: If you could share one piece of sleep advice with another woman who is struggling to get enough rest, what would it be?** Joy: Keep trying new things. If one thing doesn't work, try something else. Find people you trust (like Dr. Jen) and try everything they suggest because someday one of those things will work and the difference is amazing. Thanks for sharing your sleep tips, Joy. We’re so glad you’ve found good rest with a little help from our favorite chocolate! _[Alice Mushrooms Nightcap](https://alicemushrooms.com/AJENDA)_ combines reishi mushrooms for long-term sleep cycle regulation with faster-acting nutritional ingredients like magnesium, L-theanine, zinc, and chamomile to help support more immediate relaxation.[ ](https://alicemushrooms.com/products/nightcap-x-open) Reishi is an adaptogenic mushroom that works by down-regulating the nervous system over time. This means the effects build gradually rather than hitting all at once. Chamomile contains apigenin, a compound that binds to receptors in the brain associated with sleepiness and stress reduction. Zinc and magnesium support the body's own melatonin production rather than introducing synthetic melatonin directly, which may explain why Joy doesn't mention feeling groggy in the morning, a common complaint with traditional sleep aids.[ ](https://alicemushrooms.com/products/nightcap) Note: this is not a prescription medication. It is a nutrient- packed tiny square of dark chocolate, so it should not interact with any pharmaceutical-grade medication. It is an easy, low-risk, potentially high-benefit addition to your nighttime routine.  The smartwatch data she references is worth noting, too. Better sleep isn't just about hours logged; it's about quality. Less restlessness and more time in deeper sleep stages is where the real restoration happens, and where the energy, mood, and motivation Joy describes start to make a lot of sense. Sweet dreams! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0ea04ff7-9474-4fcc-b0ef-08275509c470/image.jpeg?t=1781639753) Caption: ——————————————————————————— Savory Oatmeal Recipe Click the download button below to get the print-friendly version. 500.94 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/8e98d6e3-de29-4247-ae14-b94efd7d240e/RECIPE%20full%20page%20mushroom%20oatmeal.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260617%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260617T110033Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=ac298880d6691cde0aeda65f24bc455f504f883ffbdb947b40950a2ff810e8af ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: We want to know what you do (and don’t) appreciate about Today’s Ajenda. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-116) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-117

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Why you wake at 3 AM](#dose) | [7 Sleep Solutions](#ss) | [Magnesium For Workouts](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/90de4121-e73e-4149-b422-bf7dff0812f7/red_sox.jpg?t=1781040747) Caption: Last week, I partnered with CPR and the MLB to bring you a first-ever health special ON THE FIELD.  I had the privilege of joining the Red Sox Foundation and the American Heart Association during National CPR and AED Awareness Week, where we trained more than 400 people in hands-only CPR. Learning this simple skill can have a profound impact. When someone experiences cardiac arrest, immediate bystander CPR can nearly double their chances of survival. In cases where cardiac arrest is witnessed, and CPR is started right away, survival to hospital discharge is approximately 13%, compared to just 7.6% for unwitnessed arrests. Every person trained is another potential lifesaver in our communities. I am very grateful to have been part of an effort that empowers people to act when seconds matter most. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3bb759c9-9259-47ca-b2be-988636843949/image.jpeg?t=1781039996) Caption: If you are a woman over 50 and you find yourself wide awake at 3 AM, staring at the ceiling with your mind suddenly racing despite the fact that you fell asleep just fine, I want you to know something important: there is a real physiological explanation for this, and it is not anxiety, it is not a character flaw, and it is absolutely not something you should simply accept as the new normal. There are actually **five distinct biological mechanisms** driving that specific window of wakefulness, and what makes this so frustratingly hard to fix is that all five are happening simultaneously. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/316454b2-a3f1-421a-aa97-3571340818df/image.jpeg?t=1781039996) Caption: ##### **Your cortisol is already climbing.** Cortisol, your body's primary stress hormone, follows a predictable 24-hour rhythm. It hits its lowest point between midnight and 2 AM, then begins a steep preparatory climb toward waking, and research shows that this rise reaches a critical inflection point at approximately 3:40 AM regardless of whether you are actually awake or asleep. As cortisol rises, your brain's arousal threshold drops, which means that any small disturbance — a sound, bladder pressure, a flash of heat — is far more likely to pull you into full consciousness than it would have been two hours earlier. In postmenopausal women, this system compounds itself in a way that I think is genuinely underappreciated: sleep fragmentation itself raises nighttime cortisol by approximately **27%** and blunts the normal morning cortisol surge by roughly **57%**, according to published research. So the more your sleep breaks apart, the more your cortisol rhythm flattens, and the more your sleep breaks apart. It is a self-reinforcing cycle, and once you understand it, the relentlessness of those wake-ups starts to make a lot more sense. ##### **Your internal thermostat has been destabilized.** Your core body temperature reaches its nadir between 4 and 6 AM, but the transition leading up to that point — roughly 2 to 4 AM — is when your body is actively dissipating heat, and in postmenopausal women, that process has been significantly disrupted. A group of neurons in the hypothalamus called **KNDy neurons** becomes hyperactive when estrogen declines, releasing excessive neurokinin B that inappropriately triggers heat dissipation responses. (Yes, that is the hot flash you know so well.) What is less commonly discussed is that even when you do not perceive a full hot flash, these subclinical thermoregulatory shifts can still trigger cortical arousals that pull you out of sleep entirely, which is precisely why newer non-hormonal medications like fezolinetant — and hormone therapy itself — can meaningfully improve sleep: they quiet those overactive neurons at the source. ##### **You have lost your body's built-in sedative.** This one is underappreciated and frankly under-discussed in most menopause conversations. **Progesterone is not just a reproductive hormone.** It is metabolized in the brain into a compound called allopregnanolone, which acts on the same GABA-A receptors targeted by medications like benzodiazepines. (Think Xanax or Valium, but endogenous — meaning your body made it naturally.) It is, in effect, your built-in sleep aid, and after menopause, when ovarian progesterone production drops dramatically, you lose it. The impact is most pronounced in the second half of the night, when your homeostatic sleep pressure — the biological drive to sleep that builds throughout your waking hours — has already partially dissipated and your brain is relying more heavily on that GABAergic tone to keep you under. Without allopregnanolone reinforcing it, the door to wakefulness swings open much more easily, and this is one more reason, independent of hot flash prevention, why micronized progesterone as part of hormone therapy can make a real difference for sleep. ##### **Estrogen loss disrupts sleep architecture directly.** Data from the landmark SWAN study — one of the most comprehensive longitudinal studies of women's health through the menopausal transition — showed that lower estradiol and higher FSH levels are independently associated with more nighttime awakenings, even after controlling for hot flashes and mood. What this tells us is that the hormonal environment of menopause is disrupting sleep through pathways that have nothing to do with thermoregulation. Estradiol modulates serotonin, norepinephrine, and acetylcholine signaling in the brainstem centers that regulate sleep and wake states, and when it declines, sympathetic arousal increases and stress reactivity rises, both of which lower your threshold for waking in the second half of the night. ##### **Your sleep is naturally lighter at this hour.** Normal aging reduces slow-wave sleep — the deepest, most physically restorative stage — and what slow-wave sleep remains is concentrated in the first half of the night. By 3 AM, for most women, you are predominantly cycling through lighter Stage N2 and REM sleep, which carries a naturally higher vulnerability to arousal. Now layer that lighter architecture on top of rising cortisol, active thermoregulatory instability, absent GABAergic tone, and direct estrogen-mediated arousal signaling, and what you get is a perfect storm converging at precisely the same hour every single night. That is not a coincidence, and it is not in your head. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ee3cff19-a91c-4a5e-8e35-e9687fe6485a/image.jpeg?t=1781039996) Caption: Because this is a multi-mechanism problem, no single intervention fully resolves it, and I want to be clear with you that anyone who tells you otherwise is oversimplifying. The evidence supports a **layered approach**, and what that looks like will depend on your individual health history and goals. Cognitive behavioral therapy for insomnia, known as CBT-I, addresses the conditioned hyperarousal and racing thoughts that perpetuate the cycle. Menopausal hormone therapy with estradiol and micronized progesterone — for appropriate candidates — restores both the estrogen-mediated sleep architecture support and the progesterone-to-allopregnanolone sedative pathway. NK3 receptor antagonists like fezolinetant target the thermoregulatory circuit directly and offer a meaningful option for women who cannot or choose not to take hormones. And dual orexin receptor antagonists (DORAs) reduce the wake-promoting orexin signal that becomes relatively unopposed when GABAergic tone is diminished. (These are FDA-approved for insomnia, available by prescription, and importantly, they do not carry the risks of tolerance, dependence, or rebound insomnia that older sleep medications do.) If you were my patient, here is what I would tell you: bring this list to your doctor, because knowing which of these mechanisms is most dominant in your situation is the starting point for a targeted, effective plan. Next week in Today's Ajenda, we are going to go deep on the behavioral and lifestyle practices that work alongside these interventions, because the sleep piece of this puzzle is too important — and too solvable — to leave on the table. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e49388de-a6a8-4d33-a806-dc97bf403c08/image.jpeg?t=1781039996) Caption: _[Waking at 3 AM](https://youtu.be/fk49SWpkPJI)_ is not random, not a weakness, and not something you are simply stuck with. It is biology, and biology responds to targeted intervention when you understand what you are actually dealing with. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e487d0cd-9672-4749-b16f-8f0b719fb69a/image.jpeg?t=1781039996) Caption: You've heard the list: Dark room. Cool temperature. No screens before bed. Limit caffeine after 2 PM. These are sleep hygiene recommendations, and they're fine, they’re important, but they're just the tip of the iceberg. They're also the equivalent of telling someone with a broken leg to wear comfortable shoes. Technically not wrong, yet wildly insufficient. If you're a woman over 50 dealing with real insomnia, not a bad night here and there, but a persistent pattern of lying awake, waking at 3 AM, or dreading bedtime because you know what's coming, sleep hygiene alone will not fix it. The gold standard treatment is cognitive behavioral therapy for insomnia (CBT-I), and it involves a set of specific, structured techniques that most people have never been taught. _[A 2024 component network meta-analysis in Annals of Internal Medicine](https://pubmed.ncbi.nlm.nih.gov/39504928/)_ analyzed the individual elements of CBT-I across dozens of randomized trials and confirmed that the behavioral and cognitive components are what drive the results, not the general hygiene advice. Here are the methods that actually move the needle, translated into what you can start doing tonight. 1. **Keep a sleep diary** Before you change anything, you need data. For two weeks, track what time you got into bed, how long it took you to fall asleep, how many times you woke up, what time you got up, and how you'd rate your sleep quality from 1 to 10. This sounds tedious. It is. But every technique that follows depends on knowing your actual sleep patterns, not your perception of them, which is almost always worse than reality. 2. ** Restrict your time in bed** This is the most counterintuitive and most effective technique in CBT-I. If your sleep diary shows you're averaging six hours of actual sleep but spending eight hours in bed, you are spending two hours lying awake, training your brain to associate the bed with wakefulness. The fix: limit your time in bed to your average sleep duration plus 30 minutes. If you're sleeping six hours, your window is six and a half hours. That might mean getting into bed at midnight and setting your alarm for 6:30 AM. It will feel terrible for the first week. Then your sleep will consolidate, your efficiency will climb above 85%, and you will gradually extend the window by 15-minute increments. This works because it rebuilds sleep pressure and breaks the association between bed and frustration. 3. **Retrain your brain** Your bed should cue two things: sleep and sex. That's it. No reading, no scrolling, no watching television, no lying there thinking about tomorrow. If you're not asleep within roughly 20 minutes, get up. Go to another room. Do something quiet and boring in dim light. Go back to bed only when you feel genuinely sleepy. This is not punishment. It's reconditioning. Your brain has learned that bed equals anxiety and alertness. You're teaching it something different. 4. **Recreate what you believe about sleep** This is the cognitive piece, and it's more powerful than most people expect. CBT-I asks you to identify the beliefs that are fueling your insomnia: "If I don't get eight hours, I can't function," "My insomnia is going to destroy my health," "I've always been a bad sleeper, and nothing will change." These thoughts feel true. They are also distortions that increase pre-sleep arousal, which makes insomnia worse. The technique involves writing down the thought, evaluating the evidence for and against it, and replacing it with something more accurate. Not positive thinking. Accurate thinking. 5. **Write down your worries before bed** If you're the type who gets into bed and immediately starts solving tomorrow's problems, this one is for you. Before you get into bed, take five minutes with a pen and paper. Write down every worry. Next to each one, write one concrete next step you can take tomorrow. Then close the notebook. You're not solving the problems. You're externalizing them so your brain doesn't feel compelled to hold them in working memory while you're trying to sleep. This technique is called constructive worry, and it is remarkably effective for the ruminators among us. 6. **Relaxation training** Not the vague "just relax" advice. Structured exercises: progressive muscle relaxation, where you systematically tense and release muscle groups from your feet to your forehead. Abdominal breathing, where you extend your exhale to twice the length of your inhale, directly activates the parasympathetic nervous system. These techniques reduce the physiological arousal that keeps your body in a state incompatible with sleep onset. 7. **Try to stay awake** I know this sounds counterintuitive, but the science behind this tactic is called paradoxical intention. It may sound absurd, but when you get into bed, instead of trying to fall asleep, try to keep your eyes open and stay awake as long as possible. No screens, no stimulation, just lie there with the goal of not sleeping. What happens is that you remove the performance anxiety around falling asleep, the "trying" that creates the tension, and your body's natural sleep drive takes over. It doesn't work for everyone, but for women whose insomnia is driven by anxiety about insomnia itself, it can break the cycle. **Why this matters for women over 50** Menopause introduces at least five distinct physiological mechanisms that disrupt sleep, from cortisol rhythm changes to thermoregulatory instability to the loss of progesterone's natural sedative effects. CBT-I doesn't eliminate those mechanisms, but it addresses the behavioral and cognitive layers that sit on top of them, the layers that turn a biological vulnerability into a chronic condition. Menopausal hormone therapy can help with the hormonal drivers. CBT-I handles everything else. And unlike a sleeping pill, the effects of CBT-I persist long after treatment ends because you've changed the patterns, not just masked the symptoms. Sleep hygiene is where the conversation starts. This is where it actually goes somewhere. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/27e8847d-3a35-438e-8156-56915c15aa3d/youtube_video_2__sleep__rev.jpg?t=1781049756) Follow image link: (https://youtu.be/fk49SWpkPJI) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/238f8400-b356-4950-8791-70f74683a849/image.jpeg?t=1781039996) Caption: Your questions and enthusiasm around magnesium genuinely lit up our inbox last week, and I have to say, I was not surprised — because if there is one nutrient that I think the majority of us are quietly underserving, it is this one. Magnesium is involved in[ ](https://www.sciencedirect.com/science/article/pii/S2352364621000079)_[over](https://www.sciencedirect.com/science/article/pii/S2352364621000079)_[ ](https://www.sciencedirect.com/science/article/pii/S2352364621000079)_[600 biochemical reactions](https://www.sciencedirect.com/science/article/pii/S2352364621000079)_ in the human body, which means that when you are feeling foggy, sleeping poorly, waking up unrested, or dragging through your afternoons, low magnesium is a very real and very common culprit worth considering before you assume something more complicated is going on. Which brings me to something I have been using myself and wanted to share with you:[ ](http://piquelife.com/ajenda)_[Pique's R•E Fountain](http://piquelife.com/ajenda)_*. Long-time readers of Today's Ajenda know that I have been a fan of Pique for a while now, and R•E Fountain continues to earn that appreciation — not because of the branding, but because of what is actually in it. (And yes, that stunning blue hue from the organic spirulina is a genuinely nice bonus. I will not pretend otherwise.) What makes this formulation worth paying attention to is the combination of three distinct forms of magnesium, each doing something a little different in the body. **Magnesium Glycinate** is bound to glycine,[ ](https://www.healthline.com/health/magnesium-glycinate)_[an amino acid](https://www.healthline.com/health/magnesium-glycinate)_ that research suggests may support relaxation and more restful sleep — which, given everything we covered this week about sleep architecture and why the second half of the night is so vulnerable, feels particularly relevant right now. **Magnesium Taurate** combines magnesium with taurine, which may[ ](https://www.health.com/magnesium-taurate-8546934)_[support healthy heart rhythm](https://www.health.com/magnesium-taurate-8546934)_ and help modulate the parasympathetic nervous system, the branch of your autonomic nervous system responsible for the rest-and-digest state we are all trying to access more consistently. And **Magnesium Malate** — paired here with malic acid — has been studied for its role in[ ](https://www.healthline.com/nutrition/magnesium-malate)_[cellular energy production](https://www.healthline.com/nutrition/magnesium-malate)_ and muscle recovery, which makes it particularly useful if fatigue and physical tension are part of what you are navigating.  I use _[R•E Fountain](http://piquelife.com/ajenda)_ before bed on most nights and especially when I am traveling heavily, which is when my magnesium levels are most likely to take a hit, and my sleep is most likely to suffer. The formula is completely free of sugar, artificial flavors, and maltodextrin, which matters to me both clinically and personally. (I am not interested in adding ingredients to my body that I am actively advising patients to reduce.) Let me be clear: this is not a magic bullet. If your magnesium deficiency is significant, a single nightly sachet may not be sufficient on its own, and that is a conversation worth having with your doctor. But as a practical, low-barrier, genuinely clean way to support your magnesium levels, your hydration, and your wind-down routine all at once, it earns a spot on the list. **Bottom line:** Magnesium is not a trend. It is a fundamental nutrient that most of us are not getting enough of, and the form it comes in actually matters. If you are looking for a low-risk option, this is a reasonable one. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/bec75065-dbec-4527-9ea6-20aa69724064/image.jpeg?t=1781039996) Follow image link: (https://Piquelife.com/ajenda) Caption: ==Use the Pique links above, and you can get 15% off your Pique orders for life!== View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b8c5b9e8-1732-48a2-81d2-03092af4d455/image.jpeg?t=1781039998) Caption: If there’s one thing I believe is foundational to our health, longevity, mood, metabolism, and overall wellness, _it’s sleep._ Quality sleep supports brain health, hormone balance, recovery, stress management, immune function, energy levels, and overall well-being. Yet for many women, especially during midlife and beyond, getting restorative sleep can feel harder than ever. During Sleep Month, we’d love for our community to focus on better sleep habits, more consistency, and creating routines that help us wake up feeling our best. Whether it’s getting morning sunlight, creating a calming bedtime routine, limiting screen time before bed, tracking your sleep, prioritizing recovery, or simply committing to an earlier bedtime, it all counts. **To celebrate, we’re giving away a 3-month supply of Alice Mushrooms throughout June!** **TO ENTER:** 1. Subscribe to our _[YouTube channel ](https://www.youtube.com/@drjashton)_ 2. Follow _[@joinajenda on Instagram](https://www.instagram.com/joinajenda/?hl=en)__ _ 3. Follow Jen on Instagram [_@drjashton_](https://www.instagram.com/drjashton/?hl=en) 4. Share your favorite sleep tip, bedtime routine, sleep win, or healthy sleep habit in the comments of this post.  5. Share your photos throughout the month and tag **@joinajenda** We’d love to see your cozy bedtime routines, morning sunlight, sleep-tracking wins, relaxing evening rituals, and anything that’s helping you prioritize better sleep. Your story may inspire someone else in our community. Remember this isn’t about perfection. It’s about consistency, recovery, and taking care of yourself one night at a time. Xx,  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7537758c-f195-496f-bf34-89cf7ea20af6/Jen_signature_3__3%2B_.jpg?t=1771982636) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/021a0bc0-dfe1-4167-bde8-6acd0066d125/pink_smootie_recipe___3_.jpg?t=1781049802) Caption: ——————————————————————————— Pink Protein Smoothie Recipe Click the link below to download the print-friendly version! 517.90 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/ea626ea5-fb50-4e73-9e6e-0b1e17b106b3/RECIPE%20full%20page%20pink%20smoothie.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260610%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260610T110047Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=ff4707b277f90d4019d6d44276fb8434456bc70d70e565a8419f854841c854b5 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-115) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-116

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Magnesium](#doh) | [Late Night Cravings](#ss) | [Misogi Challenge](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d32d3363-e63a-4b90-89bd-8ec6d3aa5b6a/image.jpeg?t=1779993320) Caption: Magnesium is one of those supplements that gets talked about constantly and understood rarely. It's been positioned as the answer to everything from insomnia to anxiety to leg cramps to bone loss, and while some of that is supported by evidence, a lot of it has been inflated well beyond what the data actually shows. So let me give you the real picture, specifically for us women over 50, where this mineral genuinely matters. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a3578726-367b-470e-b772-a45b2adedd65/bone_health_more_upate2.jpg?t=1780441647) Caption: Roughly 30 to 40% of postmenopausal women have low magnesium levels, and about 20% of the general population chronically consumes less than the recommended daily amount of 320 mg. But it's not just about what you eat. Several things converge after 50 to drain your magnesium stores: if you take a proton pump inhibitor for reflux, that alone causes magnesium deficiency in approximately 20% of long-term users by reducing intestinal absorption. Thiazide and loop diuretics, commonly prescribed for blood pressure, cause the kidneys to waste magnesium. Type 2 diabetes impairs magnesium reabsorption. And **your gut simply absorbs less magnesium as you age**. So even if your diet hasn't changed, your magnesium status probably has. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f13877df-a1da-4d2c-bbbe-7709584084da/bone_health_more_upate6.jpg?t=1780441662) Caption: **Blood pressure.** A 2025 meta-analysis of 38 randomized controlled trials found that magnesium supplementation reduced systolic (the top number) blood pressure by about 2.8 mmHg and diastolic (the bottom number) by about 2 mmHg, with larger effects in people who already had hypertension or documented low magnesium. That's modest, but clinically meaningful as an adjunct to medication, not a replacement for it. **Glucose metabolism.** This is where the data gets genuinely compelling for women over 50. Studies have found that higher magnesium intake is associated with a 22% lower risk of developing type 2 diabetes, with about a 6% risk reduction per additional 100 mg per day. In people with type 2 diabetes, a dose-response meta-analysis of 18 RCTs showed that 500 mg/day elemental magnesium reduced HbA1c by 0.73%. Supplementation for four months or longer also improved insulin resistance in both diabetic and non-diabetic subjects. Given that menopause itself increases insulin resistance, this connection deserves more attention than it gets. **Sleep.** A meta-analysis of three randomized controlled trials in older adults found that magnesium reduced the time to fall asleep by about 17 minutes compared with a placebo. That's real, but the effect on total sleep time was not statistically significant. A large observational study found that people with the highest magnesium intake had 36% lower odds of sleeping less than seven hours. The mechanism makes biological sense: magnesium modulates GABA-A receptors and blocks NMDA receptors, both of which reduce neuronal excitability and promote deeper sleep. But I want to be honest: the overall quality of the sleep RCT data remains low. Promising, biologically plausible, but not definitive. **Bone Health.** The Women's Health Initiative, which studied over 73,000 postmenopausal women, found that hip bone mineral density was about 3% higher in women consuming more than 422 mg per day than in those consuming less than 206 mg per day. _But here's the important nuance: no randomized controlled trial has ever evaluated magnesium's effect on fracture risk as a primary endpoint_, and if your magnesium stores are already adequate, supplementation does not further increase bone density. More is not better here. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/bbb27805-1f9e-4a9e-8834-c9873415982d/bone_health_more_upate5.jpg?t=1780441671) Caption: The most common side effect is dose-related diarrhea. If you've experienced loose stools from magnesium, you may have been taking too much at once or using a poorly absorbed form (magnesium oxide is the most common culprit). Splitting your dose and choosing magnesium glycinate or citrate typically helps. More importantly, if you have kidney disease, particularly stage 4 or 5 with an eGFR below 30, magnesium supplementation can be genuinely dangerous. Your kidneys are responsible for clearing excess magnesium, and when that clearance system is compromised, magnesium can accumulate to levels that cause low blood pressure, nausea, and cardiac conduction problems. If you have CKD, do not supplement without your nephrologist's guidance. There's also a paradox worth knowing: while low magnesium is harmful to bone, very high magnesium levels have been associated with reduced bone density in postmenopausal women. This suggests a U-shaped relationship in which both too little and too much can be problematic. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ac46b266-1348-4e6c-880c-797aaa7defcf/bone_health_more_upate4.jpg?t=1780441679) Caption: Before we talk about which form to take, I want to be transparent about something that's often skipped: serum magnesium is an imperfect marker. Only about 1% of total body magnesium circulates in your blood, which means a normal serum level does not exclude tissue depletion. If you're on a PPI plus a diuretic — a combination that dramatically increases hypomagnesemia risk — it's worth asking your doctor about checking RBC magnesium or a 24-hour urine magnesium, which are more informative in borderline cases. And if you have chronic kidney disease with an eGFR below 30, please do not supplement without your nephrologist's guidance, because your kidneys are responsible for clearing excess magnesium, and when that clearance is compromised, accumulation can affect cardiac conduction. This is one of those rare situations where a supplement can be genuinely dangerous. Form is where most people go wrong. NEJM's review of magnesium disorders makes it clear that organic salts — glycinate, citrate, aspartate, gluconate — are more effectively absorbed than inorganic salts like magnesium oxide. Oxide has the highest elemental magnesium per tablet, which looks good on a label, but only about 4% of it is actually absorbed, making it primarily useful as a laxative. The forms I recommend for most women are **glycinate** and **citrate**: glycinate because the amino acid chelate allows efficient absorption with minimal GI side effects, and citrate because it has excellent bioavailability with the added benefit of mild laxative properties if constipation is part of your picture. _(And if you're postmenopausal and taking calcium supplements, odds are fairly good that it is.)_ Timing matters too: evening dosing, separated from levothyroxine, bisphosphonates, and tetracycline antibiotics by at least two hours, maximizes both absorption and the sleep benefit.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d7589eb2-e194-43a9-b63f-c6d59d6d923f/bone_health_more_upate3.jpg?t=1780441696) Caption: This is where things get murky, and I want to be straight with you about it. The FDA does not assess supplements before they come to market, which means quality standards vary widely across brands and price points. Numerous independent analyses of random supplement samples have found that significant percentages either don't contain the dose claimed on the label or contain contaminants we have no business putting in our bodies, and spending more money does not guarantee you're getting a better product. That reality doesn't mean you throw your hands up — it means you do your homework about where something is made, what's actually in it, and whether third-party testing backs up what the label promises. I have high standards for supplements, and you should too. When I came across[ ](https://us.jshealthvitamins.com/products/advanced-magnesium-formula?utm_source=Newletters&utm_medium=DrJenAshtonJune&utm_campaign=DrJenAshtonJune)_[JSHealth](https://us.jshealthvitamins.com/products/advanced-magnesium-formula?utm_source=Newletters&utm_medium=DrJenAshtonJune&utm_campaign=DrJenAshtonJune)_*, I spent real time investigating and tracking changes before I agreed to a partnership. Once it passed my litmus test, I agreed to share it with you.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b68617a5-6bdf-484e-9e3d-540b00392eca/bone_health_more_upate.jpg?t=1780441702) Caption: JSHealth was developed by **expert nutritionist** Jessica Sepel and is manufactured in **NSF GMP-certified **facilities with **ISO/IEC-accredited testing**, formulated with **minimal fillers **and **non-GMO**, sustainably sourced ingredients, and certified by the **Clean Label Projec**t for purity and safety. That combination of third-party testing, transparent sourcing, and meaningful quality standards is exactly what I look for. Most magnesium supplements use a single form, often oxide, because it's cheap and allows a high-looking number on the label. _[JSHealth Advanced Magnesium+](https://us.jshealthvitamins.com/products/advanced-magnesium-formula?utm_source=Newletters&utm_medium=DrJenAshtonJune&utm_campaign=DrJenAshtonJune)_ uses **three** bioavailable forms: magnesium glycinate, magnesium citrate, and magnesium amino acid chelate. From a clinical standpoint, this approach makes sense: different forms have different absorption pathways and different tissue affinities, so a combination formula is more likely to address varied physiological needs than any single form alone. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5898a769-0411-44a8-94cd-d87a8edee34a/love_about_it_rev.jpg?t=1780357199) Caption: From my own experience, this is a supplement you can actually feel the difference with. That matters to me because I'm skeptical of anything I can't notice working. I sleep better. I feel more physically settled in the evenings. That's not a marketing claim; it's just what I've observed, and it's consistent with what the biology would predict given the forms and dose involved. (If you try it and notice the same thing, I'd genuinely love to hear from you.) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbdbed92-d9a5-4298-a086-5cfbb2894f06/image.jpeg?t=1779993342) Follow image link: (https://us.jshealthvitamins.com/products/advanced-magnesium-formula?utm_source=Newletters&utm_medium=DrJenAshtonJune&utm_campaign=DrJenAshtonJune) Caption: Use code AJENDA at checkout to save 15% off any order! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/403f73ee-19f9-463d-a957-8b00cecb75af/image.jpeg?t=1779993342) Caption: Magnesium is one of the most evidence-supported supplements for women over 50, but the form, dose, and your individual health profile matter more than any headline or social media recommendation. Aim for 350 to 400 mg per day total, choose a well-absorbed form, take it in the evening if sleep is your primary concern, and talk to your doctor if you have kidney disease or take medications that affect electrolyte balance. Evidence-supported does not mean take as much as you want. Nuance applies here, as it does everywhere. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fe5224e1-bd69-444e-8ad6-d0772eeb41d5/image.jpeg?t=1779993342) Caption: I hear this from women constantly: "I'm good all day and then I blow it at night." And I get it, because the evening is when willpower is lowest, routines dissolve, and the couch-to-kitchen pipeline is dangerously short. But before I give you my three go-to strategies, let me explain why eating at night is particularly counterproductive for women over 50. **Why Nighttime Eating Is Working Against You** Your body processes calories differently depending on when you eat them. Insulin sensitivity follows a circadian rhythm, peaking in the morning and declining as the day progresses. By evening, your body is less efficient at clearing glucose from the bloodstream, which means the same food eaten at 9 PM produces a higher glycemic response than the same food eaten at 9 AM. A study published in _The Journal of Clinical Endocrinology & Metabolism_ found that late-evening calorie intake was associated with higher fasting glucose, impaired insulin metabolism, and increased fat oxidation disruption. For women in menopause who are already dealing with increased insulin resistance from declining estrogen, adding calories during the window when your metabolism is least equipped to handle them compounds the problem. There's also the sleep angle. Eating close to bedtime, particularly foods high in sugar or refined carbohydrates, can disrupt sleep quality by causing blood sugar fluctuations during the night. And as we've discussed before, sleep disruption in menopause is already a multi-mechanism challenge. You don't need to add a dietary one. **My Three Strategies** **1. Go to bed earlier.** This sounds almost too simple to count, but it's the most effective intervention I know. You cannot eat if you're asleep. Every hour you stay up past dinner is an hour of exposure to the kitchen, the pantry, and the part of your brain that's decided you deserve something. Closing the kitchen at 8 PM and moving your bedtime up by even 30 minutes eliminates the window where most evening damage happens. Bonus: you get more sleep, which independently helps regulate appetite hormones like ghrelin and leptin. **2. Cheese and a cracker.** If you genuinely need something after dinner, this is my go-to recommendation. A small piece of cheese (an ounce or so) with one or two whole-grain crackers gives you protein and fat from the cheese, which promotes satiety, and the cracker satisfies the crunching urge that so many women describe as the real craving. It's not the calories they want; it's the texture. The combination lands at roughly 150 to 180 calories; it feels like a snack rather than a deprivation strategy, and the protein helps stabilize blood sugar rather than spiking it. **3. Eat an apple.** This one is underrated. A medium apple has about 4.5 grams of fiber, roughly 95 calories, and here's the part that matters most: it takes a while to eat. You have to chew it. You can't inhale it the way you can a handful of chips or a row of cookies. The mechanical act of chewing and the time it takes to finish an apple gives your brain a chance to register satisfaction. The fiber slows gastric emptying, which means you feel fuller longer. And the natural sweetness can take the edge off a sugar craving without sending your blood glucose on a roller coaster. **For Sweet Cravings Specifically** If what you really want after dinner is something sweet, try a cup of herbal tea, something naturally sweet like cinnamon apple or vanilla chamomile. The warmth, the ritual of making it, and the flavor can satisfy the craving without adding meaningful calories. A few frozen berries eaten slowly work well too. The cold temperature forces you to eat them one at a time, and the natural sugars are buffered by fiber. What I'd encourage you to resist is the "just a small bowl of ice cream" rationalization, because we both know that a small bowl has a way of becoming a less small bowl, and the sugar and fat combination late at night is precisely the metabolic hit your body handles worst at that hour. The goal isn't perfection. It's closing the gap between what your body needs at 9 PM (very little) and what your brain is telling you it wants (everything). These three strategies work because they're realistic, not because they're heroic. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9338e87b-93d4-4c86-bf7b-46e8aa8aa82c/image.jpeg?t=1779993343) Caption: I’ve been researching Misogi and am excited to share this with you. My friend from medical school, Marty Clark, who is an orthopedic surgeon and former professional squash player, brought this up to me, and I am considering that a sign! I decided to do it: I'm committing to a misogi, that is, one challenge. One thing that genuinely scares me. Something I'm not sure I can finish. And I'm telling you about it now so I can't back out. But before I get to mine, let me tell you where this concept comes from, because the history is part of what makes it powerful. **The Origin** Misogi is a Japanese Shinto purification ritual that dates back centuries. The word translates roughly to "water cleansing," and the traditional practice involved standing beneath a freezing waterfall while chanting sacred texts. It was designed to purify both body and spirit, to strip away what's unnecessary and reconnect with something essential. It was never meant to be comfortable. It was meant to be transformative. The modern Western interpretation of misogi was adapted by Dr. Marcus Elliott, a Harvard-trained physician and sports performance scientist who runs P3, one of the most advanced athletic performance labs in the country. Elliott distilled the ancient ritual into a contemporary framework with two rules: **it has to be extraordinarily hard, and you can't die**. The challenge should be something where, even after months of preparation, you have roughly a 50% chance of completing it. Not 90%. Not 80%. Fifty. That uncertainty is the point. NBA sharpshooter Kyle Korver was one of the first high-profile athletes to adopt the practice, completing a 25-mile paddleboard crossing from the Channel Islands to Santa Barbara. Entrepreneur Jesse Itzler helped popularize the concept further, describing it this way: do something so hard one time a year that it has an impact on the other 364 days. **Why You Should Care** I want to reframe this for our demographic, because most of the Misogi content online features 30-year-old men carrying rocks underwater or running 100-mile ultramarathons. That's fine for them. But the Misogi framework isn't about replicating someone else's challenge. It's about finding the thing that tests _your_ limits, in _your_ body, at _your_ stage of life. A Misogi might look like completing a sprint triathlon for the first time. Hiking a fourteener. Swimming a mile in open water. Doing your first unassisted pull-up. Running a half-marathon after never having run more than a 5K. Completing a multi-day backpacking trip. Learning to rock climb. The specifics matter less than the criteria: it must scare you, it must require preparation, and you must not be certain you can do it. This is not about fitness performance in the conventional sense. It's about what the psychology literature calls self-efficacy, the belief in your own capacity to execute a behavior or accomplish a goal. A 2020 meta-analysis in _Psychological Bulletin_ confirmed that self-efficacy is one of the strongest predictors of sustained health behavior change, including exercise adherence, dietary modification, and chronic disease self-management. For women in midlife, when so many messages are about decline, limitation, and "being careful," a misogi is a direct counter-narrative. It's evidence, created by you, that you are not fragile. That you are still becoming. There's also a physiological argument. Acute exposure to hard physical challenges triggers a hormetic stress response, the same adaptive mechanism behind the benefits of sauna, cold exposure, and high-intensity interval training. Short-term physiological stress, followed by adequate recovery, produces resilience at the cellular level. Your body doesn't just survive the hard thing. It adapts to it and comes back more capable. **Why I’m Doing This** Here's the thing: I have always done hard things. I've done triathlons. I completed a 77-mile bike race in Colorado. I went through medical school, surgical residency, two board certifications, a master's degree, live national television for 12 years, and a very public personal life that tested me in ways no race ever could. When I look back honestly, I think I've always treated my whole life as a kind of rolling mini-misogi, one hard thing after another, each one proving to myself that I could handle what came next. So when I learned about the formal Misogi framework, my first reaction wasn't "that sounds terrifying." It was "oh, there's a name for what I've been doing." And that recognition is exactly why I want to do it intentionally now, with a structure and a purpose, rather than just letting life throw the hard things at me and reacting. At 57, I have a temperamental Achilles, so a marathon is off the table. That's a real limitation, and I've accepted it. But accepting a limitation is not the same as accepting a ceiling. There are plenty of challenges that don't require 26.2 miles of running, and the Misogi framework doesn't prescribe a specific type of suffering. It prescribes uncertainty. It prescribes the honest question: Can I actually do this? I don't know yet what mine will be, and when I decide, I'll share it _[here](https://www.joinajenda.com/off-duty-with-dr-jen?utm_source=email-beehiiv&utm_medium=Evergreen&utm_campaign=newsletter&utm_content=misogi&utm_term=ta115)_ in Off Duty. But I wanted to tell you the concept first, because I think it's one of the most important things a woman over 50 can give herself: proof that she is not done surprising herself. You don't have to be an elite athlete. You don't have to be 30. You just have to be willing to be uncertain about the outcome and try anyway. If you take on a Misogi, I want to know! Post it on Social Media with the hashtags ==#ReclaimMisogi #AjendaStrong== One thing. One year. Fifty percent chance you make it. That's the Misogi. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3a3bc916-ac42-42c4-ab0c-04738770bb9b/turkey_burger_recipe_rev.jpg?t=1780357221) Caption: ——————————————————————————— Turkey Burger Click the download button below for the print-friendly version. 28.37 MB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/17cc228a-471e-45d1-910b-6991e3bbc337/RECIPE%20full%20page%20turkey%20burger.jpg.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260603%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260603T110110Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=b5f6e9021bd7bb287cab9bc233cceb0b33685c8e1b3422852a6b05c3b0734cee ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: I've been thinking about you as I look ahead at the next 6 months. You signed up for Today's Ajenda at some point, which tells me you care about your health, your body, and getting information you can actually use (not just more noise). But the reality is I've been sending the same newsletter to everyone, and that means some of what lands in your inbox probably feels more relevant than other parts. [_I want to change that._](https://todays-ajenda.beehiiv.com/forms/7203dad7-02c8-4d24-898d-7f33e9bab15e) Our team put together a short, 60-second survey so we can understand where you actually are in your health journey, what questions keep you up at night, and what topics you want me to go deeper on. Whether you're navigating menopause, managing a chronic condition, trying to make sense of conflicting nutrition advice, or just trying to feel more like yourself again, we want to know. Because here's what I've learned after nearly 20 years as a physician and medical correspondent: the most powerful thing I can do for you isn't to broadcast at you — it's to actually listen first. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2e46a8a0-a58d-4d73-83c2-94eebaadda0e/image.jpeg?t=1779993342) Follow image link: (https://todays-ajenda.beehiiv.com/forms/7203dad7-02c8-4d24-898d-7f33e9bab15e) Caption: Your answers will shape how I curate content going forward, which topics I prioritize, and how we can make Today's Ajenda feel less like a newsletter and more like a conversation with someone who actually knows your situation. Thank you for being here, and thank you in advance for helping me serve you better. Xx, View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7537758c-f195-496f-bf34-89cf7ea20af6/Jen_signature_3__3%2B_.jpg?t=1771982636) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Microdosing GLP-1](#doh) | [EAAs & Inflammation](#ss) | [On Berberine](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c06a8dcb-67a1-4360-b145-993bf68ec257/_dose_microdose.jpg?t=1779375732) Follow image link: (https://dos) Caption: Most people using that word don’t know what it means.  If you've been on social media in the last six months, you've probably seen someone talk about "microdosing" their GLP-1 medication. It sounds precise, scientific, cutting-edge. It sounds like someone who's really done their research. And it sounds like someone who is afraid of societal push-back for saying simply ‘I’m on a GLP-1.’ (think about the parallel for depression: would someone say, I’m on medication, but just a micro-dose, so it’s not THAT bad?!) In most cases, what it actually means is: they're taking a low dose. And those are not the same thing. **What Microdosing **_**Actually **_**Means** In pharmacology, microdosing refers to administering a drug at a fraction of the therapeutic dose, typically below the threshold at which the drug exerts its intended pharmacological effect. The concept originated in early-phase drug development, where sub-therapeutic doses are given to study a drug's behavior in the body without producing clinical effects. When people on TikTok say they're "microdosing" semaglutide at 0.25 mg per week, they are, in many cases, simply taking the FDA-approved starting dose of Ozempic. That's not microdosing. That's the labeled titration protocol designed to minimize gastrointestinal side effects while your body adjusts. The manufacturers built that ramp-up for a reason. True microdosing of GLP-1 receptor agonists would mean taking doses below 0.25 mg of semaglutide or below 2.5 mg of tirzepatide, often as low as 0.05 to 0.1 mg. There is no peer-reviewed scientific evidence demonstrating that GLP-1 receptor agonist microdosing is effective or safe. The American Association of Clinical Endocrinology has stated that it does not support routine microdosing and recommends adherence to FDA-approved dosing guidelines. **Why It’s Trending** Four reasons: cost, side effects, stigma, and marketing. GLP-1 medications are expensive, and many patients either can't afford or can't tolerate full therapeutic doses. The appeal of getting "some benefit" at a lower dose and a lower price is understandable. But as researchers at Yale have pointed out, patients pursuing unvalidated microdosing protocols are essentially **serving as their own test subjects** on both efficacy and safety. Several telehealth companies have launched microdosing programs using compounded semaglutide, which is **not FDA-approved**, at prices that undercut branded medications. The marketing is compelling. The clinical evidence behind it is not. And, as I mentioned above, some people use this term for **fear of social pushback**, for being on this medication if they don’t have overweight or obesity.   **What the Published Data Shows ** The STEP trials, which _[established semaglutide's efficacy for weight management](https://pmc.ncbi.nlm.nih.gov/articles/PMC10092086/)_, studied the drug at 2.4 mg weekly. A STEP 1 subanalysis did show that participants taking 1 mg of semaglutide lost an average of roughly 16% of their body weight over 64 weeks, which was close to the results at 2.4 mg. **That's a genuinely interesting finding, but 1 mg is **_**not**_** a microdose**. It's the standard maintenance dose for Ozempic's diabetes indication. _[A 2025 case series](https://pmc.ncbi.nlm.nih.gov/articles/PMC12210098/)_ found that patients who reduced their injection frequency to every two to four weeks after reaching their weight loss goal were able to maintain most of their results, which suggests there may be a role for lower-dose maintenance. (I am a big advocate of spacing out doses for people who have reached their goal weight, OR who are taking GLP-1’s primarily for a possible metabolic/anti-inflammatory benefit, and who want to keep their weight neutral.) But maintenance dosing after achieving a clinical response is a completely different concept from starting at a sub-therapeutic dose and hoping it works. **Why This Matters More For Women in Mid-Life ** Women in menopause and beyond face a specific metabolic landscape: declining estrogen, increasing insulin resistance, accelerating visceral fat accumulation, and anabolic resistance. If you need a GLP-1 medication, and many women do, **the therapeutic dose exists for a reason**. It was calibrated in clinical trials involving tens of thousands of patients. Taking a fraction of that dose to save money or avoid side effects may mean you're getting the cost and the injection without the clinical benefit, and there is currently no rigorous evidence to tell you otherwise.   There may be a future where low-dose GLP-1 protocols are validated for specific populations. _[A 2025 letter in Diabetes Care](http://understanding)_ acknowledged that microdosing could play a role in optimizing therapy around challenges like availability, affordability, and tolerability. But that's a hypothesis, not a conclusion. **My Position** If you're working with a board-certified obesity medicine physician or endocrinologist who is thoughtfully adjusting your dose based on your clinical response, your labs, and your tolerance profile, that's personalized medicine. That's appropriate. But if you're buying compounded semaglutide from a telehealth app at a fraction of the proven dose because an influencer said it worked for her, you're not microdosing. _You're underdosing_. And those are two very different things with very different consequences.   The language matters. The dose matters. And you deserve a prescriber who knows the difference. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a8b8204e-2189-49d6-9a96-67474480511e/youtube_video_2__stigma_near_final.jpg?t=1779375853) Follow image link: (https://youtu.be/Ers_H1wTiB4) Caption: I just launched a GLP-1 deep dive that’s really worth the time if you’re considering GLP-1s. You can watch it at your own pace, or press play and listen while you go about your day. [_Click here to watch the GLP-1 Deep Dive. _](https://youtu.be/Ers_H1wTiB4) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3c2ed245-4bb3-4df5-b563-a280e76073f2/image.jpeg?t=1779292393) Caption: **What Are Essential Amino Acids?** Essential amino acids (EAAs) are nine protein building blocks that your body cannot make on its own — you must get them from food or supplements. These include leucine, isoleucine, valine, lysine, methionine, phenylalanine, threonine, tryptophan, and histidine. Think of them as the "master keys" that unlock muscle protein synthesis, the process by which your body builds and repairs muscle tissue. Unlike complete proteins from food, EAA supplements contain only these nine critical amino acids in concentrated form, without the extra calories, carbohydrates, or fats found in whole protein sources. This makes them particularly valuable for women over 50 who may struggle with appetite, calorie management, or digestive issues. **Why Women Over 50 Need More Protein — and Why EAAs Help** After menopause, women face a perfect storm of muscle-threatening changes: declining estrogen, increased inflammation, and "anabolic resistance" (meaning your muscles become less responsive to protein). Research shows that while younger adults can stimulate muscle protein synthesis with 15-20 grams of protein per meal, **women over 50 may need 25-35 grams to achieve the same effect**. This is where EAAs shine. Studies demonstrate that just 1.5-3 grams of leucine-enriched EAAs can stimulate muscle protein synthesis as effectively as 40 grams of whey protein in older women. _[A landmark 2018 study](https://pmc.ncbi.nlm.nih.gov/articles/PMC6295981/)_ found that 1.5 grams of leucine-enriched EAAs provided the same muscle-building stimulus as much larger protein doses, highlighting that composition matters more than quantity. **The Calorie Advantage** For women managing their weight, EAAs offer a significant calorie advantage. A typical 15-gram EAA supplement contains about **60 calories**, compared to **150-200 calories** in an equivalent muscle-building dose of whole protein. This allows you to meet your muscle protein synthesis needs without exceeding your calorie goals, which is particularly valuable during weight loss, when protein needs actually increase to preserve muscle mass. **Resistance Training: The Essential Partner** While EAAs can stimulate muscle protein synthesis on their own, the magic happens when combined with resistance training. _[A 2026 randomized trial](https://pubmed.ncbi.nlm.nih.gov/41863133/)_ of 96 healthy women over 65 found that combining resistance exercise with EAA supplementation (5.5 grams twice daily) produced superior results compared to either intervention alone. The combination group showed the greatest improvements in muscle mass, strength, and functional fitness tests. The resistance training component doesn't need to be intimidating. The most effective programs in research studies typically involve 2-3 sessions per week, focusing on major muscle groups with 8-12 repetitions at moderate intensity (about 70% of your maximum effort). **Anti-Inflammatory Benefits** Chronic low-grade inflammation, often called "inflammaging," accelerates muscle loss and increases disease risk in older women. The good news: both resistance training and protein supplementation fight inflammation, and the combination is particularly powerful. Research shows that resistance training alone reduces inflammatory markers like IL-6, TNF-α, and C-reactive protein. When combined with adequate protein intake, these anti-inflammatory effects are enhanced. A 2014 study of elderly women found that combining resistance training with higher protein intake (1.3 grams per kilogram of body weight) reduced IL-6 levels by 16% more than exercise alone. **Pros and Cons of EAA Supplementation** **Advantages:** - Low calorie content (about 60 calories per effective dose) - Rapid absorption and muscle protein synthesis stimulation - Non-satiating, so they can be added to meals without affecting appetite - Particularly effective for overcoming age-related anabolic resistance - Can be taken between meals or with lower-protein meals to boost their effectiveness **Potential Drawbacks:** - More expensive per gram of protein than whole food sources - Lack the additional nutrients (vitamins, minerals, fiber) found in whole foods - May have an unpleasant taste - Don't provide the satiety benefits of complete proteins **Whole Food Protein Sources: The Foundation** While EAA supplements can be valuable tools, whole food proteins should remain your foundation. Complete protein sources that contain all essential amino acids include: - **Animal proteins:** Eggs (6 grams per egg), Greek yogurt (15-20 grams per cup), chicken breast (25 grams per 3.5 oz), salmon (22 grams per 3.5 oz), cottage cheese (14 grams per half cup) - **Plant proteins:** Quinoa (8 grams per cup cooked), soy products like tofu (10 grams per 3.5 oz) and tempeh (15 grams per 3.5 oz), hemp seeds (10 grams per 3 tablespoons) - **Dairy:** Milk (8 grams per cup), cheese (6-7 grams per ounce) **Practical Recommendations** For women over 50 engaging in resistance training, aim for 1.6 grams of protein per kilogram of body weight daily, distributed across meals. EAA supplements can be particularly useful: - As a post-workout supplement (10-15 grams containing at least 2.5 grams leucine) - To boost the protein content of lower-protein meals - During calorie restriction to preserve muscle mass - When appetite is poor or digestive issues limit whole protein intake **The Bottom Line** EAA supplements represent a scientifically-backed tool for women over 50, particularly when combined with resistance training. While they shouldn't replace whole food proteins entirely, they offer unique advantages for overcoming age-related anabolic resistance while managing calories. The combination of resistance training, adequate protein intake (including strategic EAA supplementation), and the resulting anti-inflammatory effects creates a powerful strategy for maintaining muscle mass, strength, and overall health during and after menopause.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9429c361-b1af-4a96-aee2-8bc93a9a5264/COM-berberine_1_final.jpg?t=1779375755) Caption: Berberine has exploded in popularity on social media, often called "nature's Ozempic" or "nature's metformin." But what does the published research actually show — and what should women over 50 know before trying it? **What Is Berberine?** Berberine is a plant compound found in goldenseal, barberry, and Oregon grape. It has been used for centuries in traditional Chinese medicine, primarily as an antimicrobial for gut infections. Today it is sold as a dietary supplement, typically in 500 mg capsules. **What the Research Supports** The strongest evidence for berberine involves blood sugar and cholesterol. _[A 2023 meta-analysis](https://pubmed.ncbi.nlm.nih.gov/37598753/)_ of 20 randomized trials (1,761 participants) found that berberine modestly lowered fasting blood sugar, HbA1c, and insulin resistance — with potentially larger effects in women than in men. A separate 2023 meta-analysis of 18 placebo-controlled trials (1,788 participants) found that berberine reduced LDL cholesterol by about 18 mg/dL, total cholesterol by about 19 mg/dL, and triglycerides by about 30 mg/dL. Women in these studies also saw a small increase in HDL ("good") cholesterol that was not seen in men. For weight loss, the results are more modest. _[A 2025 meta-analysis](https://pubmed.ncbi.nlm.nih.gov/41310257/)_ of 23 trials found berberine reduced body weight by less than 2 pounds and BMI by about half a point — statistically significant but far less dramatic than prescription weight-loss medications. A 2026 randomized trial published in JAMA Network Open found that berberine (1 gram daily for 6 months) did not reduce body fat in people with obesity, though it did lower LDL cholesterol and inflammation. **The Cons** Berberine is not without drawbacks. The most common side effects are gastrointestinal: diarrhea, constipation, bloating, and abdominal discomfort, reported in up to 23% of users in clinical trials. At high doses, it has been associated with low blood pressure and, rarely, cardiac effects. Perhaps the most important concern for women over 50 — who are often on multiple medications — is drug interactions. Berberine inhibits several liver enzymes (CYP3A4, CYP2D6, CYP2C9) that metabolize common drugs. This means it can raise blood levels of statins (increasing the risk of muscle damage and cardiac toxicity), blood thinners like warfarin, certain diabetes medications like sulfonylureas, and immunosuppressants like cyclosporine. Anyone taking prescription medications should consult their doctor before starting berberine. Additionally, berberine is a dietary supplement, meaning it is not regulated by the FDA for purity, potency, or consistency. Quality varies widely between brands. **How It Compares to Alternatives** For blood sugar control, metformin remains the gold standard — with decades of large-scale safety data and proven cardiovascular benefits that berberine lacks. For cholesterol, statins are far more potent (reducing LDL by 30–50% versus berberine's roughly 10%). For weight loss, GLP-1 receptor agonists like semaglutide produce 15–20% body weight reduction, dwarfing berberine's effect. For women over 50 seeking evidence-based natural approaches to metabolic health, lifestyle interventions remain the most strongly supported: regular aerobic exercise (150–300 minutes per week), a Mediterranean-style diet rich in fruits, vegetables, whole grains, fish, and olive oil, and maintaining a healthy weight. Phytoestrogen-rich foods like soy (50–80 mg/day of isoflavones) have shown benefits for both menopausal symptoms and metabolic markers. And no, soy does not cause breast cancer. **The Bottom Line** Berberine has real, published evidence supporting modest improvements in blood sugar, cholesterol, and inflammation — benefits that may be particularly relevant for women. However, the effects are small compared to prescription medications, the risk of drug interactions is real, and it should never replace proven therapies for diabetes or heart disease. If you are considering berberine, talk to your doctor first — especially if you take any prescription medications. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/af1d4180-f945-4791-9109-a13b21c2071f/icecreawm_recipe_5_27-3.jpg?t=1779397665) Caption: ——————————————————————————— Jamaican Chocolate Ice Cream 746.02 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/8e18d0aa-222d-4f51-81b3-3a2f786d585d/RECIPE%20full%20page%20choc%20icecream%20revise.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260527%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260527T110103Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=71f5d7dc5b7ff46d201ecb0ff19b681d6e2ac9796729c9bb211e26e4e44ac433 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-113) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-114

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [On Wellness Influencers ](#doh)| [Collagen Supplements](#ss) | [Walking Challenge](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/22897531-4902-44a0-a0de-eeecc3f068ea/_dose_I_Spent_20_Years_in_Training___Practice._She_Spent_20_Minutes_on_Canva.__1_.jpg?t=1779123928) Follow image link: (https://DOH) Caption: I saw a graphic from Pew Research this week that I haven't been able to stop thinking about. They analyzed nearly **7,000 health and wellness influencers **with over 100,000 followers who regularly post on Instagram, TikTok, or YouTube. The breakdown of who these people actually are stopped me cold. **Only 41%** identified themselves as any kind of health professional. And within that 41%, only 17% specified conventional medicine. The rest were allied health, complementary and alternative practitioners, dietitians, or mental health professionals. Meanwhile, 31% called themselves coaches. 28% said entrepreneur. 16% listed no credentials at all. None. Not a certification, not a license, not a degree. Just a ring light and an opinion. I want to be careful here because I don't think credentials are the only thing that matters in life. I've learned valuable things from people who never went to medical school. Lived experience is real. Perspective is real. But when we're talking about health advice, about what to put in your body, how to interpret your lab work, whether that supplement is safe with your medication, whether that symptom is normal or a red flag, we are talking about stakes that are genuinely life and death. And the person answering those questions for millions of women may have gotten their expertise from a weekend webinar and a PDF certificate. This is where I get frustrated, and I want to be candid rather than dancing around it professionally. I have three Ivy League degrees. I completed a four-year residency in obstetrics and gynecology. I am double board-certified in OB-GYN and obesity medicine. I have a master's degree in nutrition. I spent two decades in clinical training and practice at the same time as I spoke to millions of people on television about health. And I am not saying that to list my resume. I'm saying it because **there is a difference between educating yourself and having a formal education** and clinical experience, and that difference matters most precisely when the stakes are highest. "Educating yourself" means reading, being curious, and staying informed. I'm all for that. **I want every woman who follows me to feel more informed**, not less. But there's a reason medical training takes a decade or more. It's not just about learning facts. It's about learning clinical judgment, having clinical experience with real humans, understanding risk stratification, knowing when a study applies to you and when it doesn't, and recognizing when something that sounds logical is actually dangerous. You cannot get that from a highlight reel. You cannot get that from a 60-second video with text overlays and trending audio. You can get confidence from those things. **But confidence without competence is where people get hurt.** And the people most likely to get hurt? Women over 50. Us. We. Me. My audience. Your demographic is actively targeted by wellness influencers selling hormone protocols, supplement stacks, detox programs, and peptide regimens with zero clinical oversight. You're in a phase of life where hormonal shifts are real, where medication interactions are more complex, and where a missed diagnosis can accelerate a disease trajectory that might have been caught early by someone who actually knew what they were looking at. The margin for error is thinner, and the people offering you advice have never had to carry the weight of a wrong call. I've carried that weight. Every physician has. We've had patients whose labs scared us, whose biopsies came back wrong, whose symptoms didn't fit the textbook. I’ve had patients die. I’ve been in an operating room where the 50-year-old patient with end-stage ovarian cancer asked for a fellow Catholic to say the ‘Our Father’ before she went under anesthesia. _That_ experience, the weight of consequence, is part of what makes a clinician different from a content creator. Not better as a person. Different in **the gravity of what we've been trained to hold**. I'm not asking you to distrust everyone who doesn't have an MD. I'm asking you to look at who's giving you advice and ask one simple question: what are they risking if they're wrong? If the answer is nothing, if the worst that happens to them is a deleted post, please weigh that advice accordingly. Pew just showed us the data. **Nearly 60% of the people shaping public health beliefs online are not health professionals**. That's not an opinion. That's a number. And it should change how all of us consume what we scroll past every day. Your health is not content. It's your life. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5a8f922f-da92-4855-a157-295d2c87af3b/SS-Collagen_Supplements-_What_Women_Over_50_Should_Know__1_.jpg?t=1779197738) Follow image link: (https://ss) Caption: _[Last week, I asked what supplements you take (or plan to add) to your routine](https://todays-ajenda.beehiiv.com/p/today-s-ajenda-112)__. _Nearly **40% **of you said **collagen**. That number didn't surprise me, but it did tell me this topic deserves a real, thorough conversation. Because like so many things in the wellness space, not all collagen supplements are created equal — and the differences actually matter. **What Are Type I and Type III Collagen?** Collagen is the most abundant protein in your body and can be considered the "scaffolding" that gives structure to your skin, bones, joints, and blood vessels. Type I collagen is the main type found in skin, bones, and tendons, providing strength and firmness. Type III collagen works alongside Type I, adding flexibility to skin, blood vessels, and organs. After age 50, your body produces less of both types, which contributes to wrinkles, joint stiffness, and bone loss. Most collagen supplements on the market contain Type I, Type III, or a combination of both. They are typically sold as "hydrolyzed collagen" or "collagen peptides," meaning the protein has been broken down into smaller pieces that are easier to absorb. **What the Research Shows: Potential Benefits** Several studies have found that taking 2.5 to 10 grams of hydrolyzed collagen daily for 8 to 12 weeks may improve **skin hydration** and **elasticity**, and reduce the appearance of fine **wrinkles**. Some research also suggests benefits for **joint pain** and stiffness, particularly in people with osteoarthritis, and modest improvements in **bone density**. However, there is an important catch. A large review published in 2025 in The American Journal of Medicine looked at 23 clinical trials and found that the positive results came almost entirely from studies funded by supplement companies. When only independently funded, high-quality studies were analyzed, collagen supplements showed no significant improvement in skin hydration, elasticity, or wrinkles. This does not necessarily mean collagen is useless — but it does mean the evidence is not as strong as marketing materials suggest. **Your Options** Collagen supplements come in several forms: - **Powders** (unflavored, mixed into coffee, smoothies, or water) — typically provide 10–20 grams per serving - **Capsules/tablets** — convenient but usually provide a lower dose (1–3 grams) - **Liquid shots** — pre-mixed drinks, often combined with vitamins C and E - **Bone broth** — a food source, though research shows it provides inconsistent and generally lower amounts of collagen-building amino acids compared to supplements Sources include bovine (cow), porcine (pig), and marine (fish) collagen. Marine collagen is primarily Type I, while bovine sources typically contain both Type I and Type III. There is no strong evidence that one source is superior to another. **Side Effects and Safety** Collagen supplements have a strong safety record in clinical trials. Most studies report no significant adverse events. When side effects do occur, they are mild and uncommon: - A feeling of fullness or bloating - Mild digestive upset (occasional diarrhea or constipation) - An unpleasant aftertaste People with allergies to fish, shellfish, or eggs should check the source of their collagen supplement carefully, as allergic reactions are possible. Collagen supplements are not regulated by the FDA the way prescription drugs are, so quality and purity can vary between brands. Look for products that have been third-party tested. **Does Collagen Count Toward Your Daily Protein?** This is an important question, especially for women over 50 who need adequate protein to maintain muscle mass. Technically, collagen is a protein, and the grams listed on the label do contribute calories and amino acids. However, collagen is considered an "incomplete" protein — it is very high in the amino acids glycine, proline, and hydroxyproline, but it is missing or very low in tryptophan and is low in leucine, the amino acid most important for building and maintaining muscle. (Personally, I view it as ‘extra’ in the protein category, distinct from the protein I am eating in food form.) A recent clinical trial in older adults found that supplementing with 50 grams of collagen protein per day did not increase muscle protein synthesis, while the same amount of whey or pea protein did. This means collagen should not be relied upon as your primary protein source. Think of it as a supplement on top of — not a replacement for — high-quality protein from foods like eggs, fish, poultry, dairy, beans, and soy. **What I Use** When it comes to collagen, not all formulas are created equal — and after trying more than I can count, I've found one worth staying loyal to. _[Pique's Carrara Marine Collagen Peptides](https://piquelife.com/ajendacararra)_*** **is the one I use and trust daily. Here's what most collagen supplements won't tell you: the majority rely on a single Type I peptide, make brand-stated claims with zero clinical backing, and if you see results at all, you're waiting months. Carrara is built differently, and the research proves it. It features a rare dual-collagen system, which is clinically studied Type I _and_ Type II marine collagen with **visible results starting in as little as 2 weeks**. Every claim is **backed by double-blind, placebo-controlled RCTs**, not marketing copy. VISIA® analysis showed skin appearing 3.7 years younger, something conventional collagen hasn't come close to studying. And while most formulas stop at skin, **Carrara also supports a more youthful immune profile**. **That’s a longevity benefit you simply won't find anywhere else on the shelf.** Beyond the collagen itself, USP-grade biotin enhances **hair shine, volume, and nail strength,** while micronized pearl powder awakens a bright, luminous glow at the cellular level. Pure organic coconut cream rounds it out, supporting collagen absorption while making every serving genuinely luxurious to take. 30 servings, shelf-stable, no refrigeration needed, and it even comes with the Carrara Scoop, a precision-dosing tool designed to deliver the perfect serving every time. Simple and backed by real research. That's exactly what I want in my routine. I know getting in all the right supplements in a day can feel like a challenge, that’s why I try to simplify and incorporate my powders into water/smoothies whenever possible. I know friends who love to put _[Pique’s Carrara Collagen Peptides](https://piquelife.com/ajendacararra)_ in their morning latte or matcha and love the creaminess it adds. The best part, you’ve given your body a boost first thing in the morning. I will either add mine to my creatine, protein, fiber smoothie in the morning, or sometimes even mix it with some yogurt. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3676efa4-27ad-4908-9a6f-517cdd177722/SHOP_Pique_BUTTON_upate.jpg?t=1779126492) Follow image link: (https://piquelife.com/ajendacararra) Caption: Get 15% off plus receive a free gift! **The Bottom Line** Collagen supplements are safe for the vast majority of people and may offer modest benefits for skin, joints, and bones, though the strongest evidence comes mostly from industry-funded research, and independent studies have been less convincing. If you choose to try collagen, a dose of 2.5 to 10 grams daily for at least 8 to 12 weeks is what most studies have used. _[This is what I take personally](https://piquelife.com/ajendacararra)_. Just remember: collagen does not replace the complete proteins your body needs to maintain muscle strength and overall health. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9b757a52-42ea-407f-94f1-89b02889c65f/COM-_walking_2.jpg?t=1779129424) Follow image link: (https://community) Caption: This might irritate some of you, and I want you to hear me out before you decide I'm being dismissive: I don't consider walking exercise, I consider it _activity._  Before you come for me, let me be clear about what I'm not saying. I'm not saying walking doesn't count. I'm not saying it isn't beneficial. **The data on walking is enormous and overwhelmingly positive**. [A 2022 meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC11725191/) in _JAMA Internal Medicine_ (Paluch et al.) involving nearly 47,500 adults found that higher daily step counts were significantly associated with lower all-cause mortality, with the biggest reduction in risk occurring between 6,000 and 8,000 steps per day for adults over 60. [A large 2023 study](https://pubmed.ncbi.nlm.nih.gov/37555441/) in the _European Journal of Preventive Cardiology_ (Banach et al.) analyzing over 226,000 participants confirmed that even modest increases in **daily steps were associated with reduced cardiovascular and all-cause mortality**, with benefits beginning at roughly 4,000 steps per day. Walking lowers blood pressure, improves mood, supports metabolic health, aids digestion, and reduces stress. If you are currently sedentary, walking is one of the best things you can do for your body. I will never argue against that. But here's where I need to draw a line. ---------- Walking at a comfortable pace does not produce progressive overload. It does not generate the mechanical stimulus needed to build or even maintain skeletal muscle mass. It does not reach the intensity thresholds required for meaningful cardiovascular adaptation beyond a baseline. It does not meet the criteria for high-intensity interval training or sprint interval training. For women over 50 who are facing anabolic resistance, declining estrogen, accelerating bone density loss, and increased sarcopenia risk, **walking alone is not a sufficient exercise prescription**. It is a foundation, not the structure. -------------------- The American College of Sports Medicine recommends that older adults perform **moderate-to-vigorous aerobic activity** (at 64 to 95% of maximum heart rate) plus resistance training targeting all major muscle groups **at least twice per week**. Walking at a conversational pace typically reaches about 50 to 60% of max heart rate in most adults. That's below the moderate threshold. It's movement. It's valuable. But it's not building the muscle, bone density, or cardiovascular reserve that women in midlife critically need. -------------------- **The step count debate** -------------------- You've probably heard 10,000 steps per day cited as a goal. That number has no scientific origin. It came from a 1965 Japanese pedometer marketing campaign. The actual evidence suggests diminishing returns above 7,000 to 8,000 steps per day for mortality benefit in older adults, per the Paluch data. So if you're chasing 10,000 as a magic number, you can let that go. But I'd also challenge the framing entirely. Counting steps measures the volume of low-intensity movement. It tells you nothing about whether you challenged a muscle, elevated your heart rate into a training zone, or loaded your skeleton in a way that stimulates bone remodeling. You can walk 12,000 steps a day and still be losing muscle mass. Those two things are not in conflict. ----------**What I actually recommend** Walk daily. I genuinely mean that. It's one of the best things you can do for your mental health, your metabolic health, and your longevity. But do not let it be the only thing you do, and do not let it substitute for resistance training and higher-intensity cardiovascular work. Think of walking as the floor, not the ceiling. It's the baseline movement your body needs every day, just as hydration and sleep are baseline. But you wouldn't say drinking water is the same as nutrition, and you shouldn't say walking is the same as exercise. The prescription is clear: walk for your health, lift for your muscles and bones, and push your heart rate into uncomfortable zones two to three times a week for your cardiovascular system. If you love walking, try Japanese Walking, Nordic Walking, or incline walking: all are more strenuous than the ‘walk your dog walking.’ Bottom line: walking is the beginning of the conversation. It was never meant to be the whole answer. The health enthusiasts we affectionately call “Ajenders” are currently taking part in National Walking Month, doing meetups and posting motivation inside the Wellness Experiment Community!  ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2c599364-12c1-4e91-a931-1fd0af4a3a53/COM-_walking_11_ajenders_9.jpg?t=1779126552) Caption: ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0e70d6f3-eda5-44bf-9356-d91ec98e1b76/image.jpeg?t=1779043795) Caption: ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/77b51ab4-5331-44ce-9f43-50b792cbbc07/image.jpeg?t=1779043795) Caption: ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0475d722-0142-4bf8-84c6-2781591a13a0/cevichi_recipe_520_rev_3.jpg?t=1779120110) Caption: ——————————————————————————— Shrimp Cevice Click the download button the print-friendly recipe! 2.78 MB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/de536b91-bb7c-44ae-ab0e-6a8150eef83f/RECIPE%20full%20page%20shrimp%20ceviche.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260520%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260520T110034Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=1ec8e12c9952780ee3979bf2b09bc7fad2e4d60a45b1f38e081d960541d2ebc1 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/41d95c80-0b14-4a1e-83b4-2ab052e80641/newsletter_JEN_POLL_slug_.jpg?t=1742840813) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Become an AJENDER inside _**[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-112)**_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-113

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment) Caption: [Essential Aminos](#dose) | [HIIT Over 50](#ss) | [A Safe Community](#comm) | [Financial Health](#worth) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e942c09d-43a9-4a71-a2ac-1d89d9d146e6/_dose_Your_Muscles_Are_Asking_for_Something__More_Specific_Than__More_Protein__rez.jpg?t=1778626746) Caption: I say this all the time: protein matters. You've heard me [break down the math](https://www.joinajenda.com/article/the-missing-link-in-your-protein-routine), the absorption windows, the leucine threshold. But here's where I think most women over 50 are getting tripped up, and it's not about _how much_ protein they're eating. It's about what's actually in it. Let me explain. **What essential amino acids actually are** Protein is made up of 20 amino acids. Your body can manufacture 11 of them on its own. The other nine, it cannot. Those nine are called essential amino acids (EAAs), and they must come from food or supplementation. Period. There is no workaround, no hack, no alternative pathway. If you don't eat them, you don't have them. The nine EAAs include leucine, isoleucine, valine (those are the three branched-chain amino acids, or BCAAs, you may have seen on supplement labels), along with histidine, lysine, methionine, phenylalanine, threonine, and tryptophan. Each plays a distinct role, but collectively they are the raw materials your body requires to build and repair muscle tissue. **Why this matters more after 50** As we age, particularly after menopause, our muscles become increasingly resistant to the signals that tell them to grow and repair. This is called **anabolic resistance**, and it means that even if you're eating the same amount of protein you ate at 35, your muscles aren't responding to it the same way. The machinery is there. It just needs a louder signal. EAAs, particularly leucine, are that signal. They activate the mTOR pathway, which is the primary molecular switch for muscle protein synthesis.  **Think of it this way:** eating a chicken breast gives you protein, and that protein contains EAAs. But the concentration and ratio of those EAAs matters. A 4-ounce chicken breast has roughly 2.5 grams of leucine, which is close to the threshold needed to trigger muscle protein synthesis. But **not all protein sources are created equal**, and not all of them deliver EAAs in the proportions your aging muscle needs most. Supplemental EAAs allow you to hit those targets precisely, without the extra calories, volume, or digestive burden of eating yet another piece of chicken. This is not about replacing whole food protein. It's about precision. **A new study that caught my attention** _[A randomized controlled trial](https://www.tandfonline.com/doi/full/10.1080/15502783.2026.2646626)_ published in the _Journal of the International Society of Sports Nutrition_ in March 2026 looked at 76 healthy women aged 65 and older, none of whom had insulin resistance. The researchers divided them into four groups: a control group, resistance exercise only, EAA supplementation only (11 grams daily), and a combination of resistance exercise plus EAAs. After 12 weeks, the combined group was the only one that significantly increased muscle mass. Not exercise alone. Not EAAs alone. **The combination**. But what really struck me were the molecular findings. The combined group showed a 114% increase in their follistatin-to-myostatin ratio, which is essentially a measure of how strongly your body is favoring muscle building over muscle breakdown. They also had significant reductions in three key inflammatory markers: IL-6, IL-1β, and TNF-α. The exercise-only group lowered two of those three. The EAA-only group didn't significantly lower any. So the combination didn't just build muscle. It **changed the inflammatory environment** in a way that neither intervention achieved on its own. This is incredibly important, especially for us over 50. **What I'd actually do with this information** First, keep lifting. I will not stop saying this: **resistance training is non-negotiable for women over 50**, and this study reinforces that. Second, if you're already strength training and you're struggling to hit adequate protein and EAA intake through food alone, particularly if appetite, digestion, or simply the volume of food is a barrier,** targeted EAA supplementation is worth discussing with your doctor**. The dose used in this study was 5.5 grams twice a day, which is modest and well-tolerated. I want to be clear about the limitations. This was a 12-week study in Korean women over 65 who were already metabolically healthy. The researchers used BIA rather than muscle biopsy to measure muscle mass, and they didn't track participants' diets with precision. These are real caveats. But the direction of the evidence is consistent with what we're seeing across the literature: for women in midlife and beyond, the combination of resistance exercise and strategic amino acid intake creates a metabolic environment that's more favorable for preserving muscle and tamping down the chronic low-grade inflammation that accelerates aging. And because I know the question is coming, since hundreds of you have already asked: _what brand do I use?_ I'll only share that in _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=newsletter&utm_term=ta-112)_, because I have zero financial association with any EAA brand, and recommending one by name here would imply I believe it's better than all the others. I can't say that. I've had my personal brand independently tested for heavy metals, and it came back clean, but that doesn't mean other brands aren't equally good. If you want to supplement EAAs, which I do recommend, do your research, look for third-party testing, and aim for about 11 grams a day. I mix mine in my water, which has the added benefit of encouraging me to drink more water (always a win). **Finally, the ‘real food is better’ argument. ** The reality is that just because you _**eat**__ _enough protein doesn't mean you _absorb_ what you eat. Absorption declines with age, with changes in gut health, and with medications. That's another reason targeted EAA supplementation can be so valuable. You're delivering the building blocks** in a form your body can actually use**. Calories are also an issue. Here's where the math gets practical. To reach approximately 11 grams of EAAs from whole food, you'd need to eat roughly 5 to 6 ounces of chicken breast, which comes with about 230 to 280 calories. That's reasonable for one meal. But if you're trying to hit that threshold two or three times a day, which is what the research suggests older adults need to overcome anabolic resistance, you're looking at 15 to 20 ounces of animal protein daily. That's a lot of food, a lot of calories, and for many women over 50, a lot of digestive effort. A typical EAA supplement delivers 10 to 11 grams of essential amino acids in roughly 40 to 50 calories. That's the same functional building blocks with a fraction of the caloric load. For women managing weight, dealing with reduced appetite, or simply finding it difficult to eat that volume of food three times a day, that tradeoff matters. I know it does for me. **Bottom line**: think of this as a tool, and likely a possible daily practice (I definitely drink my essential aminos every day mixed in my water). The risks are exceedingly low (cost of the supplement, possible trace heavy metal contamination in random brands), and the benefits are likely significant.   View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6e35f6e8-e20a-4f14-b7ac-582d42bc7d42/image.jpeg?t=1778584104) Follow image link: (https://youtu.be/w1MNoLpLnvE) Caption: _[NEW YouTube video](https://youtu.be/w1MNoLpLnvE)_ on Protein and EAAs just dropped!! Be the first to get the scoop on protein and leave a comment to let me know your big takeaways.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/83f873d0-de6f-43e6-9f00-f7d318111b83/Screenshot_2026-05-12_at_7.09.24_PM.png?t=1778627375) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b928a275-3fa1-4551-9fe1-88bc82272c60/_SS_HIIT_rez.jpg?t=1778626733) Caption: After my _[May 8th reel on women and cardio](https://www.instagram.com/drjashton/reels/)_ and a recap of a study I recently read, my DMs turned into a full Q&A session. So let me get specific, because "do HIIT" is not a prescription. It's a bumper sticker. Here's what it actually means in practice. **What HIIT is (and isn't)** High-intensity interval training means alternating short bursts of all-out or near-maximal effort with periods of lower-intensity recovery. The keyword is intensity. If you can comfortably hold a conversation during your "hard" interval, it's not HIIT. It's closer to cardio with enthusiasm. **True HIIT means working at 80 to 95% of your maximum heart rate during the effort intervals.** **How to calculate your target** A simple estimate of your max heart rate is 220 minus your age. So for a 55-year-old woman, that's 165 beats per minute. Your HIIT work intervals should land between roughly 132 and 157 bpm (80 to 95% of 165). Your recovery intervals should bring you back down to about 99 to 115 bpm (60 to 70%). A chest strap heart rate monitor (like a Polar H10) is the most accurate way to track this in real time, but you can count your pulse in your wrist or neck too. Wrist-based monitors are less reliable at high intensities, but they're better than guessing. **What a HIIT session actually looks like** Here are three protocols you can use with zero equipment (and all examples of exercises can be used interchangeably with every ‘protocol.’ The important thing is to get your heart rate up): View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3129959d-a236-482c-967b-ff166737aac9/protocol_headlines_1-3.jpg?t=1778593736) Caption: 30 seconds of work, 90 seconds of recovery, repeated 6 to 8 times. Total time: about 15 minutes. Work intervals could be fast-paced bodyweight squats, stair climbing, or brisk uphill walking on a treadmill at max incline. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b8a8bfe2-ad3a-485f-b2c1-76abb8966090/protocol_headlines_1-32.jpg?t=1778593720) Caption: 40 seconds of work, 60 seconds of recovery, repeated 8 to 10 times. Total time: about 18 minutes. Work intervals could be cycling sprints on a stationary bike, jump squats, or rowing. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ec2601a8-115b-406c-ac9c-6ee9549b2fd2/protocol_headlines_1-33.jpg?t=1778593726) Caption: 20 seconds all-out effort, 10 seconds rest, repeated 8 times (this is the classic Tabata format). Total time: 4 minutes per round, with 2 to 3 rounds separated by 2 minutes of active recovery. Work intervals could be burpees, kettlebell swings, or assault bike sprints, OR you could work in high-intensity 30-60 seconds moves within your resistance workout (as I’ve been doing with Korey Rowe for the past nearly 2 years, and as is a key part of the fitness program in our _[Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=Evergreen&utm_campaign=newsletter&utm_content=&utm_term=ta112)_.) Any modality works as long as you can push to true high intensity safely: a bike, a rower, a set of stairs, a pool, a hill. _The tool matters less than the effort._ **How often** Two to three HIIT sessions per week, with at least 48 hours between sessions. This is not a daily protocol. Recovery is where the adaptation happens. On non-HIIT days, walk, do yoga, do steady-state zone-2 cardio, and lift weights. More is _not_ better here. More is how you get hurt or overtrained. **The cortisol myth** I hear this constantly: "HIIT raises cortisol, and cortisol makes you store belly fat, so women shouldn't do HIIT."  Let me correct this. Yes, a single HIIT session acutely elevates cortisol. That's a normal, healthy stress response. It's supposed to do that. Cortisol levels, like many hormones,  go up and down every single day, and it is critical to keeping us alive. Social media hype is all about ‘lowering cortisol,’ which really means (in my interpretation) that we should be paying as much attention to stimulating our parasympathetic nervous system as we do our sympathetic nervous system.  In other words, we need to push hard and then recover hard. In terms of exercise, here's what the research actually shows: **consistent HIIT training over time results in lower resting basal cortisol levels**. A _[2021 meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC12736704/)_ in the _Journal of Science and Medicine in Sport_ (Qian et al.) found that regular high-intensity exercise training significantly **reduced baseline cortisol concentrations** compared to sedentary controls. Your body adapts to the stress by becoming more efficient at regulating it. Avoiding HIIT because of cortisol is like avoiding lifting weights because it causes temporary muscle inflammation. The acute stress is the stimulus. The adaptation is the benefit.  And yes, HIIT is pretty unpleasant while you’re doing it. That’s the point, and that is how you know how effective it is.  Stop fearing the tool and learn how to use it to your benefit.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/86fb235a-7ee4-4142-ab70-28571657b09f/COM-_The_Comment_Cleanse2.jpg?t=1778626715) Caption: _[On May 4th, I posted a video about the AI-generated "jello diet" that's been circulating online](https://www.instagram.com/drjashton/reel/DX6zq2jOlAh/)_, and I used Kathy Hilton as an example of someone who had shared it. The point of that post was to highlight how sophisticated AI-generated health misinformation has become, how convincing it looks, and how easily it can fool anyone.  But some people missed that entirely. And the comments some made about Kathy were, frankly, ugly. "She's so dumb." "What do you expect from her?" "Not the sharpest tool in the shed." I read them. I read all of them. And I need to say this clearly: **I will not tolerate that on my platforms**. Not toward Kathy Hilton, not toward anyone. Let me give you some context. Kathy and I are Instagram “friends.” We follow each other. We DM each other. We’ve never met in person. She is a real woman reading real comments written by real people who seem to forget that. But even if I had never exchanged a single message with her, my response would be exactly the same, because this isn't about whether I‘m in contact with her. **It's about how we treat people.** The entire reason I made that video was to show how good AI-generated content has become at mimicking legitimate health information. It looks real. It cites fake studies that sound real. It uses medical language that sounds authoritative. Kathy Hilton is not "dumb" for believing it. She's human. Millions of people are falling for this kind of content every single day, including people with advanced degrees, including physicians, including, I guarantee you, some of the people who left those comments. The whole point of AI-generated misinformation is that it's designed to be believed. That's what makes it dangerous. If it were obviously fake, we wouldn't need to talk about it. What pains me most is watching women tear other women down with such ease. Such speed. Such confidence in their own superiority. We do this constantly, and it is one of the most self-defeating patterns I see, not just online but in life. It actually makes me sick to my stomach. We are so quick to call another woman stupid, or vain, or out of touch, as if cruelty is a form of intelligence. It's not. It's just cruelty with a keyboard. If we can't try to give people the benefit of the doubt, if we can't look at a situation where someone was deceived by deliberately deceptive content and respond with empathy instead of mockery, then we are screwed. I mean that. Because the same grace you refuse to extend to someone else is the grace you will desperately want when you're the one who gets fooled. And you will get fooled. We all will. That's the landscape we're living in now. I built this platform to inform, not to humiliate. I built it to help women, not to give them a place to perform superiority at another woman's expense. If that's what you're here for, this isn't the right space for you. And for the mean women who lash out at anyone on my platforms, that rudeness will not be tolerated. (Read: you will be blocked, the very first time I notice it.) There’s enough nastiness in the world; I want my platforms to be places of support, positivity, good information, perspective, and occasionally, humor.  I will keep calling out health misinformation. I will keep naming examples when I see them. And I will keep insisting that we can do that without being rude and nasty.  We’re better than those comments. I know we are.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/381f1d66-1eb3-4c57-83be-f1056162b1da/_worth_sharing_roadmap_1.jpg?t=1778608673) Caption: Financial health is one of the most underrated pillars of overall well-being, and it is something I've come to feel strongly about the more I watch women in midlife navigate the particular stress that comes from feeling behind financially. So let me introduce you to Haley Sacks, known to most of the internet as Mrs. Dow Jones, who has spent years doing something that very few people manage to do well: making personal finance actually feel approachable without dumbing it down or making you feel ashamed for not having figured it all out already. Haley and I met a few years ago on set at Good Morning America, and recently have been in touch on social media because she started doing Korey Rowe workouts too! She’s a very cool and very smart person, and she gives great financial information!  Her debut book, _[Future Rich Person](https://www.mrsdowjones.com/book)_, JUST hit shelves yesterday from Penguin Random House, and from everything I've seen of her work, it's the kind of resource that meets you exactly where you are and gives you a real roadmap forward, whether you're just starting to get serious about building wealth or you've been meaning to for longer than you'd care to admit. **(And let's be honest, most of us have been "meaning to" for a while. No judgment.)** What I appreciate most about her approach is that she doesn't traffic in jargon or shame, which, as a physician, I find refreshing, because that's exactly how I try to approach health information too: strip away the noise, get to what actually matters, and trust that the person you're talking to is smart enough to handle the truth once it's presented clearly. For Today’s Ajenda readers like you, _[when you order the book](https://www.mrsdowjones.com/book)_, you also get exclusive access to 10+ digital bonuses, including the Debt Payoff Planner, the Dead Folder, and the Emergency Fund Calculator. (Thank you, Haley!) These tools are genuinely useful for anyone thinking about the long game, whether you have kids now, plan to, or simply want to think about how wealth compounds across a lifetime rather than just within one. The guide covers three things that I think of as foundational: understanding how compound interest actually works and which vehicles (529 plans, Custodial Roth IRAs, index funds) give your money the most runway over time; how to start building credit for a child before they turn 18, which is one of those strategies that sounds complicated but is far more accessible than most people realize; and how to become the kind of financial role model who passes on not just assets, but the knowledge and habits that make those assets grow. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dccf4301-8f74-4021-bc91-010c244b36e2/image.jpeg?t=1778584104) Follow image link: (https://www.mrsdowjones.com/book) Caption: Get 10+ FREE Digital Bonuses With Purchase! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f3a7a5bc-cb48-402c-9340-987d1ed811a1/pancake_recipe_4_23_rev.jpg?t=1778608746) Caption: ——————————————————————————— Protein Pancakes Click the button below for the print-friendly version. 1.18 MB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/7880f04b-3d2d-4376-869d-c8c68721b5b9/RECIPE%20full%20page%20pancakes.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260513%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260513T110033Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=36f4471900618c824c2a2659ad53c693b1e23b6b12080447bda7c34cb5978bcf ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4bbb04fa-a920-4b25-a5e0-5dc9d601c0c7/off_duty_BUTTON.jpg?t=1761072727) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) Caption: $7 monthly subscription View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5d3ab75f-a171-43fb-acc6-7eb34732c5f1/join_the_experiment.jpg?t=1778608926) Follow image link: (https://www.joinajenda.com/experiment?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-112) Caption: Ready to start a proven plan built for women in this season of life? Come join us inside _**[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-112)**_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-111) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-112

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [Red Light Therapy](#doh) | [Hair & GLP-1s](#ss) | [Community Hair Experiment](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/aa65cfd1-0b55-449a-8e6f-902685c9af9c/image.png?t=1777989630) Caption: Hair thinning is one of those topics that sounds cosmetic until it happens to you. Then suddenly it is not cosmetic at all. It’s emotional, and it’s personal. It’s the ponytail that feels smaller, the part that looks wider, the shower drain that looks more dramatic than it should, and the tiny internal panic of, “Wait, is this just aging, and when will this stop?” For women over 50, hair thinning is common, but that does not mean it is simple. Female-pattern hair loss increases with age and is influenced by genetics, hormones, health conditions, nutrition, medications, stress, and time. Menopause can absolutely be part of the story, because estrogen has effects on the hair cycle, but we should be careful not to reduce every strand of hair on our head to “hormones.” Sometimes it is androgenetic alopecia. Sometimes it is telogen effluvium after illness, surgery, stress, weight loss, or a medication change. Sometimes it is iron deficiency, thyroid disease, inflammatory scalp disease, or a combination of all of the above. So before we talk about red light therapy, let me say the unsexy doctor thing first: **if your hair loss is sudden, patchy, associated with itching, pain, scaling, scarring, or major shedding, get evaluated**. A board-certified dermatologist can help identify the type of hair loss, and that matters because the treatment depends on the diagnosis. Now, red light therapy. Also called low-level light therapy, or LLLT, this is not the same as sitting under a red bulb and hoping for the best. Medical-grade devices use specific wavelengths of red or near-red light, often in caps, helmets, combs, or bands, intended to stimulate follicles. The proposed mechanism is that light may influence mitochondrial activity, increase blood flow around the follicle, reduce inflammation, and help shift follicles into the anagen, or growth, phase. That sounds very science-y, and it’s plausible. _The question is whether it actually works._ The best answer is: yes, there is evidence it can help, especially for androgenetic alopecia, including female-pattern hair loss, but the effect is usually modest and requires consistency. _[A 2025 systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/39404126/)_ of low-level laser and LED therapy in alopecia included 38 studies with more than 3,000 patients and found **significant improvement** in hair density compared with placebo or sham treatment, especially in androgenetic alopecia. Earlier randomized, sham-controlled trials also found increases in terminal hair density in both men and women using low-level laser devices, **with no serious adverse events** reported in those studies. _[A 2021 systematic review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8675345/)_ of FDA-cleared home-use devices similarly found a significant increase in hair density with LLLT compared with sham, although the authors noted that the number of trials was limited and, importantly, **devices varied widely**. This is not a miracle. It’s not regrowing hair on a completely bald scalp. It’s not a replacement for diagnosing the cause of hair loss.   Most protocols require using the device several times per week for months. Some people may start to see changes around 12 to 16 weeks, but more meaningful results often take six months or longer. The real-world and trial data suggest that consistency matters. This is one of those treatments where buying the device and leaving it in the closet is, unfortunately, not considered a protocol. **For women over 50, the pros are real**. Red light therapy is noninvasive, generally well tolerated, doesn’t have known systemic drug interactions, and can be used with other therapies like topical minoxidil. In fact, some studies suggest combination treatment with LLLT plus minoxidil may outperform either approach alone in female-pattern hair loss. For women who can’t tolerate minoxidil, don’t want oral medications, or want an adjunctive option, it can be reasonable. **But the cons are also real**. Good devices are expensive, often hundreds to more than a thousand dollars. Insurance usually doesn’t cover them. The treatment schedule can be annoying, the results vary, and while the safety profile is reassuring, minor side effects such as scalp itching, tenderness, tingling, headache, or temporary shedding have been reported. **The bigger issue isn’t danger; it’s expectation management.** There is also a regulatory nuance worth understanding. Many of these devices are FDA-cleared, not FDA-approved like a drug. FDA clearance through the 510(k) pathway generally means the device is considered substantially equivalent to a legally marketed predicate device. It doesn’t mean the FDA has evaluated it with the same efficacy standard used for prescription medications. FDA device summaries do list cleared indications for promoting hair growth in women with androgenetic alopecia, but that is not the same as saying every red light cap on the internet is equally effective.  **My bottom line: red light therapy for hair thinning is not nonsense**. It has biologic plausibility, published evidence, and a favorable safety profile. But it’s also not magic, not fast, not cheap, and not specifically proven for “menopausal hair loss” as its own distinct category. The evidence is mostly extrapolated from broader studies of pattern hair loss in men and women. For a woman over 50, I would think of it as a reasonable adjunct, not the whole plan. First, know what type of hair loss you have. Second, address the basics: protein intake, iron and ferritin if indicated, thyroid status, medications, scalp health, stressors, and recent weight loss or illness. Third, discuss proven treatments like minoxidil with a dermatologist. And then, if you want to add red light therapy and can commit to the time and cost, I think it’s a fair, low-risk option. _[It’s not a miracle helmet](https://go.shopmy.us/p-48475668)_*, and not a scam by definition. More like **a potentially useful tool**, as long as we do the very boring, very grown-up thing first: diagnose the problem before buying the gadget. I personally use one, not terribly consistently, because it falls under the ‘may help and is very unlikely to hurt’ umbrella.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2b0fc930-5562-48e7-bec8-78c2a306e9c3/image.png?t=1777989630) Caption: If you've started a GLP-1 medication and noticed more hair in your brush, on your pillow, or circling the shower drain, you're not imagining things, and you're not alone. **More than 1,000 spontaneous cases** of hair loss in patients on semaglutide, tirzepatide, liraglutide, and dulaglutide** have been reported** to the FDA's Adverse Event Reporting System.[ ](https://pmc.ncbi.nlm.nih.gov/articles/PMC12997224/)_[A large real-world cohort study](https://pmc.ncbi.nlm.nih.gov/articles/PMC12997224/)_ presented at the 2025 European Academy of Dermatology and Venereology Congress, looking at data from nearly 548,000 adults, found that GLP-1 receptor agonist use was independently associated with increased incidence of **telogen effluvium and androgenetic alopecia**. So this is not anecdotal. There is a signal. But the more important question is _why_, because the answer is probably not as simple as "the drug causes hair loss." **Your body doesn't know the difference between intentional weight loss and a famine**. When you lose weight rapidly, and GLP-1 medications can produce significant weight loss in a relatively short window, your body interprets that caloric deficit as physiological stress. The hair follicle is one of the most metabolically active structures in the human body, and it is exquisitely sensitive to systemic stress signals. When the body perceives a threat, it triages. It shunts resources toward essential organs and away from things it considers expendable, ie: hair. **The result is telogen effluvium**, a condition where a disproportionate number of hair follicles prematurely enter the resting phase and then shed, typically showing up 2-3 months after the triggering event. In a normal cycle, about 10% of your follicles are in the resting phase at any given time. In telogen effluvium, that number can spike to 30% or more. **Layered on top of that stress response **_[is the micronutrient problem](https://www.joinajenda.com/article/5-overlooked-topics-about-glp-1-medications)_**, **and this is significant. GLP-1 medications suppress appetite, which is their primary mechanism for weight management. But reduced food intake means reduced nutrient intake, and several nutrients are non-negotiable for hair follicle cycling. Iron is probably the most significant: ferritin levels below 30 ng/mL have been consistently associated with increased shedding. Zinc plays a critical role in keratin synthesis. Vitamin D receptors are expressed directly in the hair follicle. B12 and biotin matter too. _[A 2025 U.S. database study](https://pmc.ncbi.nlm.nih.gov/articles/PMC12205620/)_ of over 461,000 adults on GLP-1 medications found that **12.7% were newly diagnosed with a nutritional deficiency **by six months, and 22% by twelve months, with vitamin D deficiency being the most common. Here is where it gets particularly relevant for women over 50: you may have two things happening at the same time. Telogen effluvium from the rapid weight loss and nutrient depletion, and the unmasking or acceleration of androgenetic alopecia, the hormonally driven, genetically influenced hair thinning that **affects approximately 40% of women by menopause**. The decline in estrogen that accompanies menopause shifts the androgen-to-estrogen ratio, and follicles that were already genetically susceptible begin to miniaturize. Add a metabolic stressor like rapid weight loss on top of that hormonal shift, and you can get both conditions running concurrently, one temporary, one progressive, each making the other look worse. **So, what should you do about a hair issue? ** 1. Don't wait for the shedding to start. Get your labs checked before or early in treatment: ferritin, zinc, vitamin D, B12.  2. Prioritize protein, even when your appetite is suppressed, aiming for at least 1.2-1.6 g/kg of body weight daily. 3. Talk to your prescriber about titrating your dose more gradually if weight loss is happening very quickly.  4. Ask a dermatologist to evaluate whether what you're seeing is telogen effluvium, androgenetic alopecia, or both, because the treatment strategies are different. And know that telogen effluvium, while distressing, is almost always reversible once the trigger resolves and nutritional status is restored.  Your hair will come back, but you do have to feed it. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/61e8bfb2-92a9-4e86-86c4-a4c010867e7b/IMG_7287.png?t=1778008687) Follow image link: (https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) Caption: So many of you have been asking about my hair resuscitation journey and which products have worked for me, and so I want to tell you what I've been using and, more importantly, explain the biology behind why it works. Let’s do a little mini-med school on hair supplements because you deserve more than "trust me, it's great."  The brand is _[Wellbel](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_*, and the reason I find it worth talking about isn't marketing — it's the formulation logic. Let me break it down. ### **The Inside Story: The Supplements** Hair loss is almost never one single thing. Most of us are dealing with some combination of hormonal shifts, nutritional gaps, inflammation, and just the biology of getting older. What I appreciate about Wellbel's physician-formulated supplement line is built with that complexity in mind rather than ignoring it. Their supplement, _[women +](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_, was specifically formulated for perimenopausal and post menopausal women There's **MSM**, which is one of Wellbel’s hero ingredients. MSM works to strengthen hair and reduce breakage, and specifically helps improve blood flow to the scalp, nourishing dormant hair follicles and promoting healthier growth. Blood flow to the scalp is one of those things that sounds almost too basic to be meaningful, but follicles that aren't being adequately perfused simply cannot function at their best.  Saw palmetto works by helping to prevent DHT formation, the hormonal byproduct of testosterone that shrinks hair follicles over time, and it becomes increasingly relevant for women during perimenopause and beyond when our sensitivity to androgens shifts.  **Betaine HCl** rounds out the formulation by improving the breakdown and absorption of the very nutrients the other ingredients are trying to deliver, because even the best supplement is only as good as your gut's ability to actually absorb it. That's elegant formulation thinking, not filler. On **biotin** — I know you've seen (and maybe even tried) the 5,000 and 10,000 microgram doses and wondered if more is better. It isn't. High doses of biotin can contribute to breakouts and interfere with blood work results, including thyroid and cardiac markers — which is exactly why Wellbel uses 500 micrograms, a clinically reasonable dose rather than a megadose. This is the kind of restraint that reflects actual medical thinking. If you're getting routine labs done while taking a high-dose biotin supplement and haven't disclosed it to your physician, please do — it can genuinely skew results.[ ](https://wellbel.com/products/wellbel-women-plus-bundle) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c1515a0f-1887-4565-b211-dc93dafb2da7/image.jpeg?t=1777989629) Caption: ### **The Outside Story: The Shampoo and Conditioner** **I'll be direct: no topical product can regrow hair the way a clinical intervention can**. But that's not what good topical care is trying to do. What it can do is create and maintain the scalp environment in which follicles have the best possible chance to function. [_**The Wellbel Gelée Detox Shampoo**_](https://wellbel.com/products/gelee-detox-shampoo-restorative-conditioner?rfsn=8807655.ec75ef&variant=51296407781649) uses encapsulated salicylic acid, and the encapsulation matters as much as the ingredient itself. The encapsulated delivery system gently exfoliates to remove buildup, impurities, and excess oil without stripping natural moisture, which supports a balanced, healthy scalp environment. A clogged, inflamed scalp is not a hospitable place for hair growth — and traditional clarifying shampoos often overcorrect, stripping the barrier they're supposed to support. This shampoo is pH-balanced and physician-formulated to reset the scalp microbiome while providing a clean feel without that stripped, tight sensation that tells you the product went too far.[ ](https://wellbel.com/products/gelee-detox-shampoo-restorative-conditioner) [_**The Restorative Conditioner**_](https://wellbel.com/products/gelee-detox-shampoo-restorative-conditioner?rfsn=8807655.ec75ef&variant=51296407781649) then picks up where the shampoo leaves off. Encapsulated hyaluronic acid, copper tripeptide-1, and ceramides work together to deeply hydrate, strengthen, and soften strands — with the encapsulation technology _ensuring these actives actually penetrate_ rather than just coat the surface. The encapsulation enables peptides, ceramides, and copper tripeptide to penetrate deeper into the strand, delivering hydration where your hair needs it most. Copper tripeptide in particular supports scalp health at a structural level, and ceramides help seal and fortify the cuticle, which is critical for anyone dealing with breakage or color-treated hair that's more prone to damage.[ ](https://wellbel.com/blogs/journal/why-wellbel-s-wash-day-duo-is-the-equivalent-of-a-juice-cleanse-for-your-scalp) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d82cfcf8-c0e7-4421-bbf5-d29ae5b739a8/image.jpeg?t=1777989629) Caption: ### **The Bottom Line** Hair health is a system, not a single intervention. Hormones, nutrition, inflammation, and scalp environment are all talking to each other, and the most effective approach acknowledges that. What I find compelling about Wellbel is that their product line was built with that whole-system thinking in mind — the supplements address what's happening internally, and the topicals address what's happening at the surface level, with physician formulation behind both. The key is consistent use because real change takes time. _[I’ve been using Wellbel](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_ for over 9 months, and it only continues to bring impressive results. That's not a guarantee of results, and I'll always tell you that individual response varies. But it's a scientifically coherent approach, and in a space full of noise and overpromising, coherence is something I genuinely value. If hair thinning has been on your mind, it's worth starting the conversation with your doctor to understand what's driving it — hormonal? nutritional? inflammatory? — and building from there. And in the meantime, this is the kind of support I'd point you toward. Wellbel has kindly extended a 15% discount to all Ajenda readers. _[Use the code Ajenda15 for 15% off any Wellbel order with free shipping](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)_. And if you decide to do a quarterly subscription, you’ll get another 20% off.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9035565b-4fe7-447d-84b1-0bb5578dbe3b/SHOP__welbell_BUTTON.jpg?t=1767730000) Follow image link: (https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) Caption: Use code: AJENDA15 for special savings Dozens of women in the Wellness Experiment are thrilled with their personal results with Wellbel. Here’s a glimpse of what they’re sharing in our community: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/83ef1b6d-b94a-4c99-87c9-095b35ef8f14/testimonials_2_addition_1_rev10.jpg?t=1778025799) Follow image link: (https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9035565b-4fe7-447d-84b1-0bb5578dbe3b/SHOP__welbell_BUTTON.jpg?t=1767730000) Follow image link: (https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) Caption: Use code: AJENDA15 for special savings ——————————————————————————— ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e7d49423-a199-4787-bee3-be2d41713bd1/IMG_7286.png?t=1778008192) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=ta110&utm_term=mothers-day-2026) Caption: Mother’s Day special: 6 months of The Wellness Experiment for $119! -------------------- Mother’s Day is almost here, and I’m offering a gift that keeps on giving. Unlike flowers, what doesn’t fade is the way we feel in our own bodies, the strength we carry into our days, the confidence we walk into a room with, and the energy we have for the people we love most. That is exactly why I created The Wellness Experiment. It’s a science-backed, structured program that brings nutrition, fitness, and wellness together in one place so we can actually see what’s possible for ourselves and what we are capable of when we commit to it. So whether you are treating yourself, your mother, or your daughter this Mother’s Day, this is the kind of gift that keeps showing up long after the flowers are gone. _[This week, you can join or gift 6 months of the Wellness Experiment for an additional 20% off](https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=ta110&utm_term=mothers-day-2026)_! Happy Mother’s Day to all of you out there doing the work to feel your best! Xx ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ff4c052d-ada0-49f0-bff2-02f693e04861/protein_bowl_recipe_5_6_rev3.jpg?t=1778024902) Caption: ——————————————————————————— Garden Protein Bowl Click the download button below for the print-friendly version! 1000.44 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/31f74b29-d3db-453c-a3de-6a651953d56c/RECIPE%20full%20page%20PORTEIN%20BOWL.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260506%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260506T110046Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=602b826e968c80ce50309304126187358c1f560055f4e9beca3effbf7245ad07 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/94ac17ee-4edd-4522-9554-beec5f6f6b23/image.jpeg?t=1777671605) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: Mother's Day always brings me back to my kids. Not just to the love which is, of course, enormous, but to the question that quietly sits underneath so much of what I do: _what am I modeling_? What do they see when they watch me move through the world, navigate my health, my aging process, and decisions about my body? This is especially true for Chloe, and **the blueprint I am drawing for her as a woman**.  For a long time, health culture gave us one answer to that question, and it looked like _endurance_. Push through fatigue. Override the signals. Stay consistent, no matter what your body is asking of you. I followed versions of that script myself. And for a while, it seemed to work — until it didn't, and I had to take an honest look at what I'd been teaching myself, and by extension, what I'd been teaching her. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f051b963-1413-47db-ba1c-856c51c8a285/image.png?t=1777671608) Caption: What I've come to understand, both as a physician and as a mother, is that real, sustainable strength comes from something more intelligent than force. It comes from paying attention to what your biology is telling you, to how your habits are actually serving you, to the difference between discipline and depletion. That understanding is what I want Chloe (and Alex) to grow up watching. Not a woman who pushes past her limits to prove something, but a person who knows her body well enough to work with it. That, to me, is a far more powerful inheritance. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1d3d4eeb-5d6c-4742-b8c5-6609715de381/image.png?t=1777671607) Caption: This isn't a soft idea. It's actually the more rigorous approach. One that requires real self-knowledge, real adaptability, and the willingness to build something sustainable rather than something spectacular in the short term. It's what I mean when I talk about reconnecting with the feminine in your wellness. Smarter. More self-trusting. The kind of intelligence that doesn't get enough credit in a culture that still romanticizes burnout. And it's what I want to pay forward to Chloe, and to every woman reading this who is trying to figure out how to achieve better vitality without losing herself in the process. _[The Wellness Experiment](https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026)_ was built around exactly this principle: a structured, science-backed framework for building strength, energy, and resilience — without the trendy all-or-nothing cycles that leave so many of us starting over, season after season. If there's ever a meaningful moment to invest in how you show up — for yourself, and for the people watching you — this is it. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c7c3980c-4295-4de3-af78-56f4def88fe8/image.jpeg?t=1777671605) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: ### WHAT YOU GET  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/609881a5-b18f-404e-8be3-33d70afcd31b/womens_community_3_rex_quad_nutrition_spelled_right_.jpg?t=1772383607) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: ### **But you’re not doing this alone… ** You’re stepping into a safe space where women are sharing that they showed up for a workout they did not feel like doing, that they increased their weights for the first time in years, that their energy is steadier, that their sleep is improving, and that their confidence is quietly returning. You will see someone celebrating her first push-up and someone else celebrating a thirty-five-pound weight loss, and both are met with the same response: **encouragement, respect, and genuine excitement.** And perhaps most powerful of all, there is consistency. When you surround yourself with women who are logging in, lifting weights, asking thoughtful questions during live sessions, and recommitting even when life gets messy, something shifts. Motivation stops being something you have to manufacture on your own and becomes something you absorb. #### **Plus, there’s my favorite part: Weekly LIVE ZOOM calls with Korey and me! ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c729c79f-b084-4728-a56b-6a718b3b88f5/weekly_zooms_4-63.jpg?t=1772373483) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: Imagine the difference when you have a board-certified physician and an elite trainer **answering your questions in real time**. Plus, a tribe of pro-aging women who have your back, judgment-free. No more wondering, no more excuses, no more lack of motivation — just inspiration and momentum! At[ ](https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026)_[less than $1 a day](https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026)_, I priced this to be accessible while still requiring commitment, because transformation requires participation. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b3e668ae-9e37-443b-897f-631a590ac4e1/image.jpeg?t=1777671650) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: ### **THE GIFT THAT KEEPS ON GIVING** Have someone in mind you want to start the Wellness Experiment with?! _[We’ve set up a NEW gifting feature for Mother’s Day](https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026)_, making this simple to give and seamless to receive!  To your wellness, Xx Dr. Jen View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fe0043ff-d92f-4fcd-aaec-59f5d387a7ed/banners_for_NL_4.jpg?t=1772318719) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fab6e887-ef83-4c77-96b7-8ec55d36598b/Screenshot_2026-05-04_at_6.56.55_AM.png?t=1777892227) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/be63f884-fd23-402a-a4de-9e8eaeb45132/Screenshot_2026-05-04_at_6.56.50_AM.png?t=1777892238) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ed412f94-3740-474e-9cd7-57553c466174/Screenshot_2026-05-04_at_6.56.43_AM.png?t=1777892247) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/75b65017-647f-487d-b868-be44955e6385/Screenshot_2026-05-04_at_6.56.37_AM.png?t=1777892362) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d57ff466-dca1-4fa7-97ed-e292b14b0e7d/for_promo_20_.jpg?t=1772304041) Follow image link: (https://www.joinajenda.com/mothers-day-gift?utm_source=email-beehiiv&utm_medium=Promo&utm_campaign=newsletter&utm_content=&utm_term=mothers-day-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: ### ABOUT DR. JEN In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton, ”Dr. Jen”**, has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/mother-s-day-2026

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [Micronutrient Deficiencies](#dose) | [Night Sweat Tips](http://ss) | [The Biggest Fitness Myth](#comm) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ada03543-5a06-4736-b158-e60a5c3d8861/IMG_7140.png?t=1777435146) Caption: If you're currently taking a GLP-1 medication, or seriously considering one, this is a direct conversation to you about something that almost never comes up in the prescribing process. Not because it's obscure, not because the evidence is thin, but simply because the protocols for managing these medications have not kept pace with how widely and quickly they're being prescribed. That gap concerns me, and it's why I want to address it here. We talk a lot about macronutrients when GLP-1s come up, and that conversation matters. Adequate protein intake to protect lean muscle mass is genuinely important, particularly for women over 50 who are already navigating the muscle and bone changes that come with perimenopause and beyond. **But there is an equally important conversation that's barely happening at all: micronutrient deficiencies.** Here's the basic physiology:  GLP-1 medications work in part by slowing the emptying of your stomach, which is precisely why they reduce hunger and extend feelings of fullness. The downstream effect is that you eat less. And when you eat less, you are by definition consuming fewer vitamins and minerals, including essential ones like vitamin B12, magnesium, zinc, calcium, and vitamin D. Reduced food intake also means reduced gastric acid production, which in turn affects your body's ability to break down and absorb certain nutrients, B12 being a primary example. This is not theoretical. _[We have meaningful data from the bariatric surgery literature](https://pmc.ncbi.nlm.nih.gov/articles/PMC12913018/)_ showing significant micronutrient deficiencies following procedures that produce a similar physiological effect, and emerging evidence now points to the same concern in long-term GLP-1 users. What makes this particularly worth paying attention to is how slowly some of these deficiencies reveal themselves. **Vitamin B12** depletion, for instance, can take months to years before it surfaces clinically, and by the time you feel it, fatigue, cognitive changes, peripheral nerve issues, or, in some cases, anemia, you have likely been running low for a long time. **Magnesium **deficiency tends to show up more quickly, often as muscle cramps, disrupted sleep, or what I'd describe as a low-grade increase in anxiety that doesn't have an obvious explanation. Hair thinning, which so many women on GLP-1s report, is frequently attributed to rapid weight loss, but inadequate **zinc** and protein intake are important contributors that deserve equal attention. (More on hair loss in another issue.)  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6cc6082f-6e78-49c4-b9f1-244696ae2855/image.jpeg?t=1777404612) Follow image link: (https://youtu.be/ViENDAw0ab0) Caption: None of this is meant to alarm you or discourage you from a medication that may be genuinely helping you. GLP-1s have real and meaningful value, and I say that as someone who takes the full picture of evidence seriously. What I am saying is that these medications require monitoring, follow-up, and attention to your nutritional status that goes well beyond what most people are currently receiving. Ask your provider about baseline and follow-up bloodwork that includes B12, Iron, Folate, Vitamin D3, and magnesium. Think about whether a prenatal vitamin, ANY prenatal vitamin, which tends to contain slightly higher amounts of key micronutrients than a standard multivitamin, might be appropriate for you, regardless of whether you're pregnant or even female. And recognize that a multivitamin alone may not be sufficient if a true deficiency is already developing. The most important thing I can offer you here is not a supplement protocol but a framework: **these medications affect your whole body, and caring for yourself on them means thinking in terms of total body health, not just the number on the scale**. You deserve providers who are having this conversation with you, and if they aren't yet, I hope this gives you the language to start it yourself. I just launched a new deep dive video on micronutrients and GLP-1s on YouTube. If you’re taking a GLP-1, it’s worth a watch.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/577c4e6c-792c-4841-b010-8f0202875c15/image.jpeg?t=1775522366) Follow image link: (https://youtu.be/ViENDAw0ab0) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5a766dd1-411c-4017-8f5f-90096eedb43c/image.png?t=1777404880) Caption: Most sleep problems have a straightforward explanation. Night sweats during menopause are one of them. Too many women spend months assuming they're just stressed, or running warm, or coming down with something, before anyone connects the dots to what's actually driving it. By the time the pattern becomes undeniable, the sleep debt has already accumulated, the irritability has set in, and the frustration of feeling like your own body has become unpredictable is very real. Here's what's actually happening: as estrogen levels decline during perimenopause and menopause, the hypothalamus, which is your brain's internal thermostat, becomes significantly more sensitive to even small changes in core body temperature. The result is a vasomotor response, meaning your blood vessels dilate rapidly, your heart rate increases, and your body essentially tries to cool itself down by producing sweat, often intensely, without warning, and in some embarrassing situations. This isn't a minor inconvenience for many women. Research suggests that up to 80% of women experience vasomotor symptoms during the menopause transition, and for a meaningful percentage, those symptoms are severe enough to fragment sleep night after night, contributing to fatigue, mood changes, cognitive fog, and more. So let's talk about what you can actually do. **Start with your sleep environment, because it matters more than most people realize, and it can be one of the easiest variables to correct/modify.** **One of the most evidence-informed adjustments you can make is** **reducing the thermal load in your immediate sleep environment**, and that means being thoughtful about what you're sleeping _on_ and _under_. The thermal environment in which you sleep is directly relevant to the physiology driving your symptoms. This is where _[temperature-regulating bedding](https://my.cozyearth.com/drjashton)_* earns its place in the conversation: **What it's made from:** Responsibly made and sourced viscose derived from bamboo, a material specifically designed to respond to body heat rather than trap it. **Why that matters physiologically:** When your hypothalamus triggers a heat-release response at 3 am, sheets and a duvet that wick moisture and allow airflow can be the difference between a brief wake-up and a full hour of lying in damp, uncomfortable misery. **Where to start:**  Bamboo sheets and temperature-regulating duvets are both worth looking at as genuine first-line environmental interventions, not an indulgence. **How to get it:** I’ve collaborated with _[Cozy Earth](https://my.cozyearth.com/drjashton)_ to bring you their great products for **20% off, this month only**! I tested them myself, they meet my (very high) standards, and I use them. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fe4fe850-bcc4-4ea6-b4a3-5d1d8860b93e/image.jpeg?t=1777404805) Follow image link: (https://my.cozyearth.com/drjashton) Caption: _Offer Expires May 31, 2026 _ **Layer your approach, because no single solution does everything.** Beyond your bedding, there are several strategies worth building into your routine. **Keeping your room cool, ideally between 65 and 68 degrees Fahrenheit**, supports your body's natural overnight temperature drop and gives the hypothalamus less to react to. (I sleep at 67 degrees exactly!) **Wearing lightweight, moisture-wicking sleepwear**, **staying well-hydrated** through the day, and **limiting alcohol** **and spicy foods** in the evening can all reduce the frequency and intensity of night sweats for many women. None of these is a cure, but together they form a genuine support system for your body during a real transition. For women whose night sweats are severe, persistent, and meaningfully affecting quality of life, I want to be clear that hormone therapy remains the most clinically effective treatment we have for vasomotor symptoms, and it's worth a thoughtful, individualized conversation with your physician about whether it's appropriate for you. Other options, including _[certain non-hormonal prescription medications](https://www.joinajenda.com/article/cant-take-hormones-other-good-options-for-menopause-symptoms)_, such as fezolinetant, have also shown real efficacy in clinical trials. The goal isn't to push through or simply manage; it's to understand what's available and make informed decisions in partnership with someone who knows your full medical picture. What I want you to take away from this is that night sweats are not something you simply have to endure in silence, and they are not a sign that something is catastrophically wrong. They are a physiological response to a hormonal shift that your body is navigating, and with the right environmental setup, lifestyle adjustments, and medical support when needed, most women find meaningful relief. Start with what you can control tonight, including your sleep environment, and build from there. And I really don’t care if your husband, boyfriend or partner gets cold as a result. That’s what blankets are for! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b902fa0b-276a-457f-a213-2110ecd02946/image.png?t=1777404957) Caption: There is a fitness myth I keep seeing everywhere, and it makes me nuts because it sounds so believable. **It’s the idea that there is one perfect workout**. One class, one machine, one method, one “secret” that is going to solve everything after 50. And to be fair, I understand why we want that to be true. We are all busy. We are tired of being told we need to do more and just want a clear answer. We want someone credible to say, “This is the thing. Do this, and you’re good.” Walking. Pilates. Strength training. Yoga. Zone 2 cardio. HIIT. Barre. Pickleball. Whatever the current favorite fad happens to be… But here’s the problem: almost every one of those things is good for you, BUT actually none of them is enough by itself. That’s the part the fitness industry does not love to say out loud, because “do this one thing” is much easier to package and sell than “your body is complex and needs different types of stress, challenge, and recovery.” But over 50, this really matters. Variety is not just nice to have, it is physiological. Your body is not one system; it is many systems working together. Your muscles need resistance. Your heart needs endurance and intensity. Your joints need mobility. Your tendons and ligaments need gradual loading. Your bones need impact or force. Your nervous system needs balance and coordination. Your brain needs novelty and challenge. And your body needs recovery, which, somehow, still feels like the least glamorous wellness advice ever, even though it may be one of the most important. This is where I think a lot of very disciplined, very health-conscious women get frustrated. They are active, consistent, and they are doing “the right thing.” But often, the right thing they’re doing is actually one thing done over and over again. A woman who walks 10k steps every day is wonderful, but she never lifts enough weight to truly challenge her muscles. Another woman lifts weights, but avoids cardio because she hates it or because someone convinced her cardio was “bad for cortisol” (which is not true by the way).  Someone else does Pilates three times a week and has a beautiful core, but never trains her heart rate. Another does high-intensity cardio, but never stretches, never works on balance or strength, and wonders why her hips feel like they belong to someone else. And then there is the woman who plays tennis or pickleball and thinks that counts as everything, until her calf, Achilles, shoulder, knee, or lower back files a formal complaint. I say this with love because I have done versions of this myself. We all have. We find what we like, what we’re good at, what fits into our schedule, what makes us feel competent, and then we cling to it. **The problem is that after 50, the body becomes much less tolerant of missing categories**. That is not meant to be depressing. It is meant to be clarifying.  In our 20s and 30s, many of us could get away with doing random exercise and still feel pretty good. A run here, a yoga class there, a few weeks of being “good,” and our bodies responded. But in midlife and beyond, especially around menopause and after it, the margin changes.  * Muscle becomes harder to build and easier to lose.  * Power declines faster than we think.  * Balance can slip quietly.  * Tendons become less forgiving.  * Cardiovascular fitness can fade unless we train it deliberately.  * Range of motion gets smaller if we don’t keep asking for it. So the question is not, “What is the best workout for women over 50?” The better question is, “What am I missing?” **That one question can change everything**. A smart fitness routine after 50 needs strength training, ideally three times a week, because muscle is not just about looking toned. Muscle is metabolic tissue. It helps with glucose regulation, joint stability, posture, bone health, and independence. It is what helps you lift your suitcase into the overhead bin without making a noise that scares the person in 12C. It also needs **cardiovascular training**, and not just one speed. Easy cardio matters. Walking matters. Zone 2 matters. But if it is safe and appropriate for you, your heart also needs higher-intensity work. You need enough to remind your cardiovascular system that it can work hard and recover. This means the assault bike, treadmill sprints, rower sprints, any sprint interval training, stuff that feels super unpleasant but delivers extraordinary results. Then there is **mobility** and **flexibility**, which I used to think of as the thing you do at the end if there is time, which of course means never. But hips, shoulders, ankles, and the spine all need attention. Strength without range of motion is limited. Mobility without strength is also limited. We need both. **Balance** deserves its own category, even though it is probably the least sexy fitness word in the English language. But balance is strength, coordination, brain training, and fall prevention all rolled into one. And it is much better to train it in your living room than to find out you needed it while stepping off a curb in cute shoes. And finally, **recovery** has to be part of the plan. Not because we are fragile, but because adaptation happens when the body has a chance to repair. Sleep, protein, hydration, rest days, easier movement days, all of that counts. Recovery is not the opposite of training. It is part of the training. So no, I am not here to tell you that walking is bad, or Pilates is overrated, or strength training is the only thing that matters, or cardio is the enemy, or yoga is not enough. That is not the point. The point is that any one of them, alone, leaves gaps and is definitely not enough. If you love walking, please keep walking. Just add strength. If you love lifting, keep lifting. Just add cardio and mobility. If you love Pilates, keep doing Pilates. Just add heavier resistance and some heart-rate work. If you love yoga, keep doing yoga. Just add load and power. If you love pickleball, I am thrilled for your social life, but stretch your calves and train your balance. **This is not about doing more for the sake of doing more**. It is about being more complete and more holistic in how we care for the body we have now. Over 50, the goal is not just to be thinner, smaller, or “good” at exercise. **The goal is to be strong enough, steady enough, mobile enough, and fit enough to live your life with confidence**. To carry things, climb the stairs, play on the floor with babies and small children, travel, recover from setbacks, avoid preventable injuries, and feel capable in your own body. **There is no single magic workout**. Not Barry’s, not Bar Method, not Hot Yoga, not SLT or PVOLVE, or SoulCycle or Orange Theory… It’s not either/or. It’s EVERYTHING. Which is why I want us all to have the wisdom to stop giving a complex system only one overly simplistic answer. ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771950279) Follow image link: (https://www.joinajenda.com/experiment) Caption: -------------------- Ready to start a proven plan built for women in this season of life? Come join us inside _[The Wellness Experiment](https://www.joinajenda.com/experiment)_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4bb3bcd0-a38d-47c8-8344-eb0d8d4bc15f/cotttage_cheese_scrample_recipe_4_28__1_.jpg?t=1777404969) Caption: ——————————————————————————— Berry-Chia Cottage Cheese Bowl Click the button below to download the print-friendly version. 781.99 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/f78a2ce6-d59d-40c0-bc67-b803bcedb939/RECIPE%20full%20page%20cottage%20cheese.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260429%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260429T110032Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=20e4c8cfc872dd67ce6009c056ceb29fb80d2283bc1eb86a9bfe313d4194a7fc ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4bbb04fa-a920-4b25-a5e0-5dc9d601c0c7/off_duty_BUTTON.jpg?t=1761072727) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) Caption: $7 monthly subscription View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-110

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [Honest look at peptides](#peptides) | [Drinkable Skincare](#ss) | [Non-Hormonal Remedies](#non-hormone-therapy) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/791e3c2f-3c32-4957-b879-1f341ad1c1ff/image.jpeg?t=1776788243) Caption: If you spend even five minutes in the wellness corners of the internet right now, you could be forgiven for thinking IV peptides are the next great shortcut to healing, fat loss, muscle gain, recovery, anti-aging, or some glamorous combination of all five. The marketing is slick, and the promises are broad. **The science, at least for the peptide cocktails being pushed to healthy people in med spas and online clinics, is not there yet.** To be clear, this is not because peptides are biologically meaningless. **Peptides can be extremely powerful**. For example, insulin is a peptide, and GLP-1 medications are peptide-based drugs. And precisely because they act on real physiology, they can also cause real side effects, from hypoglycemia with insulin to pancreatitis, gallbladder disease, and serious hypersensitivity reactions with semaglutide. **When something is biologically active, it deserves evidence, not enthusiasm**. So when I see casual, unsupervised enthusiasm around IV or injectable peptides being sold to otherwise healthy people, my concern is not that they do nothing. My concern is that they _actually DO work_, and we may not fully understand the downside. This is the nuanced point that is getting completely ignored in this discussion, and it is definitely the most important one. In medicine, the standard is simple: **first, do no harm**. Before I recommend that a healthy person put a biologically active compound into their bloodstream, I want evidence from well-designed human trials showing what it does, what it does not do, what the side effects are, how it should be dosed, who should not get it, and what happens over time. The most reputable published peer-reviewed data on peptide use at this time come from the fields of _[orthopedic surgery](https://pmc.ncbi.nlm.nih.gov/articles/PMC12313605/)_ and _[clinical nutrition](https://peptidings.com/peptides/bpc-157/?)_, and those studies are limited to very specific patient populations and focus on specific peptides.  For many of the peptides now being marketed for recovery, metabolism, inflammation, “cellular repair,” or body composition, that level of evidence in healthy humans is thin to nonexistent. _[A recent review in the orthopedic literature](https://pmc.ncbi.nlm.nih.gov/articles/PMC12313605/)_[ ](https://pmc.ncbi.nlm.nih.gov/articles/PMC12313605/)noted that BPC-157, one of the best-known peptides in this space, has potential based largely on preclinical data, but remains largely unvalidated in human trials. Part of the way in which this  peptide works is by stimulating new blood vessels to grow.  **(One of the unknowns/concerns is whether or not these new blood vessels can help feed or stimulate tumor growth at the same time as stimulating repair.) ** This does not mean the future is empty here; it means it’s still being written. Some peptides may _eventually_ prove useful in tightly defined medical settings; that is how medicine works. We identify a target, test it carefully, characterize benefits and risks, and then decide whether it belongs in practice. There are even early signals with certain peptide-related agents in very controlled research settings, which is exactly where they belong for now. But “promising” is not the same as “ready,” and “mechanistically interesting” is definitely not the same as ‘safe to drip into healthy people on a Tuesday afternoon between Pilates and a blowout.’  Then there is **the scam factor**, and yes, I am using that word deliberately. Many of these products live in the gray zone of compounding, concierge wellness, and direct-to-consumer marketing.  The FDA states plainly[ ](https://www.fda.gov/drugs/human-drug-compounding/understanding-risks-compounded-drugs#:~:text=Compounded%20drugs%20are%20not%20FDA,serious%20patient%20injury%20and%20death.)_[that compounded drugs are not FDA-approved](https://www.fda.gov/drugs/human-drug-compounding/understanding-risks-compounded-drugs#:~:text=Compounded%20drugs%20are%20not%20FDA,serious%20patient%20injury%20and%20death.)_, meaning the agency does not verify their safety, effectiveness, or quality before marketing. The FDA has also flagged multiple peptide substances used in compounding (including CJC-1295, ipamorelin, MOTS-c, AOD-9604, and thymosin alpha-1) for concerns such as immunogenicity, peptide-related impurities, limited human safety data, and, in some cases, serious adverse events. Also, let’s remember that many ‘medi-spas’ are administering these peptides in settings that make it impossible for the user/patient to know where the substance is coming from, how it’s been stored, what is actually in it, how it is being injected (often by non-medical personnel), etc., etc., etc.  So where do I land? **Curious, but unconvinced. Interested, but not recommending it at this time**. This is not a moral objection to peptides. It is a medical one. When evidence in healthy humans is limited, quality control is uncertain, and marketing gets ahead of the data, that is a bad combination. Anecdotes that people “feel amazing” are not enough to outweigh that, especially when we know the placebo effect alone can drive meaningful perceived benefit 30% of the time. **My thumbs-down, for now, is NOT because these compounds cannot work. It is because biologically active things do work, and that is exactly why they require rigor, respect, and restraint**. Until that standard is met, IV peptides are not ready for primetime, certainly not in the wellness or spa setting. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2b9b5900-4401-4140-b5a9-c2935a1a8335/image.jpeg?t=1776788243) Caption: The idea of ‘skincare you can drink’ is showing up everywhere right now. Marketed as a simple, inside-out approach to skin health in drinkable powder form. The idea is to support skin from within using antioxidants and compounds that may influence hydration, elasticity, and inflammation. At the core of these formulations are polyphenols, particularly those derived from tea, which have been studied for their antioxidant properties and their potential role in reducing oxidative stress, one of the key contributors to skin aging, including collagen breakdown, pigmentation changes, and loss of elasticity. There is some evidence suggesting that tea-derived compounds, such as catechins, may offer photoprotective benefits and help mitigate UV-induced damage at a cellular level, although this does not replace the need for sunscreen or other protective measures. In addition to polyphenols, ingestible skincare products often include ingredients like **ceramides**, **hyaluronic acid precursors**, and other **bioactive compounds **that have been explored in small clinical studies, with some data indicating modest improvements in skin hydration, barrier function, and overall appearance when taken consistently over time. However, it is important to note that much of this research is limited in scale, varies in quality, and is not always conducted on the exact formulations being marketed, which makes broad claims difficult to fully substantiate. What makes this category interesting is that it aligns with a growing body of research in dermatology and nutrition that recognizes the **skin as an organ influenced by systemic factors**, including diet, inflammation, and metabolic health, but translating that concept into a single product or even a “duo” that delivers visible, reliable results across a broad population is still a bit of a leap beyond the current evidence. ### **Here’s the real ‘tea.’** The ingredients in _[Pique’s Skincare Duo](https://piquelife.com/drashton20)_* are not random. The formulas center on polyphenols, including compounds found in tea and botanicals, which have been studied for their potential to reduce oxidative stress, a primary driver of skin aging. There is some interesting science here. _[Early research on tea polyphenols ](https://pmc.ncbi.nlm.nih.gov/articles/PMC3390139/)_suggests they may help protect against UV-related skin damage and support collagen pathways. Other ingredients often included in similar blends, like ceramides or hyaluronic acid precursors, have data demonstrating improvements in skin hydration when taken orally. _[Pique’s B·T Fountain](http://piquelife.com/drashton20)_ (found in the Duo) acts as a daily hydration reset. This refreshing beauty electrolyte is powered by clinically studied ceramides to support the skin barrier and hydrate at a cellular level. I’ve read some of these studies and was impressed by their methodology and findings. Together, these formulas may help restore balance, support hydration, and nourish the body from within, helping to create a strong foundation for spring, without sugar, fillers, or artificial flavors. This duo is not a miracle. Most of the evidence is small-scale or indirect. You are not going to replace sunscreen, retinoids, or a solid skincare routine with a drink, sadly! **Think of this as an add-on, not a swap**. If you are already investing in your skin, this could be a reasonable layer. If you are looking for a shortcut, this is not it.  Like many things, consistency matters. If there is a benefit, it is likely subtle and cumulative, meaning weeks, not days. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/df0099b6-8056-4a39-951d-c488e67dce1c/image.jpeg?t=1776788243) Caption: ### **My personal experience:** I have generally replaced my morning coffee on most days with _[Matcha Green Tea](http://piquelife.com/drashton20)_, and I add [_BT Fountain_](http://piquelife.com/drashton20) in my water bottle. And yes, it may be a placebo, but I really do notice a ‘glow’ in my skin. Of course, it may be due to the consistent use of my favorite topical products, in a synergistic manner, but I do like the fact that my morning matcha not only tastes good but DOES good for my body/skin too.  You can save up to 20% off Pique’s Skincare Duo using the button below. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c16f3885-32cf-4822-bb0d-3210485ad577/image.jpeg?t=1776788243) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/ab8f686b-6e14-464e-b95e-97242c377a15/image.jpeg?t=1776788243) Caption: Let me start with something I say regularly: the goal for menopause management isn’t all about taking hormones or not taking hormones; **the goal is to make an informed decision**. I personally take HRT, but I recognize that hormones are not for every woman, despite what the loud Instagram menopause community seems to suggest. And for the millions of women who can't use hormone therapy, or who choose not to, there's a growing, and genuinely promising, non-hormonal toolkit worth understanding clearly. ### Older, non-hormonal options — what the data actually supports SSRIs and SNRIs (paroxetine, venlafaxine, escitalopram) have the most published evidence behind them, after fezolinetant, the new kid on the block for non-hormonal treatment. Low-dose paroxetine salt (Brisdelle) is actually FDA-approved specifically for hot flashes. In clinical trials, these drugs reduced hot flash frequency by roughly 25-60%, which is much less than HRT, but clinically meaningful for many women. The trade-offs include potential sexual side effects, nausea, and, critically, drug interactions. Paroxetine, for example, inhibits tamoxifen metabolism, so that combination is off the table for women on tamoxifen. **Gabapentin** has modest evidence, mostly from smaller trials, showing reductions in hot flash frequency and improved sleep. It's sedating, which is either a side effect or a feature depending on the patient. The data is less robust than SSRIs and more variable across studies. **Clonidine**, an older blood pressure drug, has weak and inconsistent evidence for hot flashes. I have never prescribed this in my career, and don’t know any Gyns who have either. It has significant risks, especially when discontinuing it, and has largely fallen by the wayside in the ‘menopause museum’ of modern-day usage. ### The new standard-bearer: Fezolinetant In 2023, the FDA approved Fezolinetant (Veozah), the first non-hormonal drug specifically designed for menopausal hot flashes. It works by blocking neurokinin B receptors in the brain, targeting the thermoregulatory pathway that goes haywire during perimenopause. This is not a repurposed antidepressant. It's a mechanism-specific treatment, and that matters. Clinical trial data showed **statistically significant reductions in the frequency and severity of moderate-to-severe vasomotor symptoms** compared with placebo, with effects observed as early as week one. The side effect profile is generally mild, with headache and insomnia being the most commonly reported, although a small percentage of women actually reported hot flashes when on the drug. It’s unclear whether that was a new side effect or a continuation of a symptom they had before starting the medication. The one flag worth knowing: there's a liver enzyme monitoring requirement for women with pre-existing liver conditions, and it's contraindicated with certain CYP1A2 inhibitor medications. It is necessary to check liver function with blood tests before and during treatment. It's not the right fit for everyone, including women with kidney or liver disease, but for appropriately selected patients, it's a meaningful option. ### Behavioral and non-pharmacologic approaches **Cognitive behavioral therapy (CBT)** has stronger evidence than most people realize. Multiple randomized trials, including the _[MENOS studies out of the UK](https://pmc.ncbi.nlm.nih.gov/articles/PMC11773179/)_, showed CBT significantly reduced the _problem rating_ of hot flashes, meaning the degree to which they interfered with daily life,  even when it didn't always reduce the raw frequency. This is important because _how_ we experience a symptom is as clinically relevant as the symptom itself. CBT isn't "just therapy" here; it's a validated intervention. **Clinical hypnosis **has a smaller but real _[evidence base](https://pmc.ncbi.nlm.nih.gov/articles/PMC3556367/)_, with one well-designed randomized controlled trial showing a significant reduction in hot flash scores. I find this underused. **Mind-body approaches** such as yoga, mindfulness, and paced breathing show benefits in some studies, but the quality of evidence is inconsistent. They're low-risk, potentially helpful for sleep and anxiety, and worth recommending alongside other strategies. I put them in the ‘use WITH’ category, rather than the ‘use on their own category.’ ### What we don't yet know We need longer-term data on fezolinetant so that we can look at the incidence of other medical endpoints, such as cardiovascular disease, various cancers, and quality of life issues. We need head-to-head trials comparing non-hormonal options to each other, not just to a placebo. We have almost no data on many of the supplements and botanical options women are already using, such as black cohosh, phytoestrogens, and magnesium, with studies that are largely underpowered, short-duration, and often industry-funded. The absence of evidence isn't evidence of absence, but it does mean I can't confidently tell you they work. ### The bottom line Non-hormonal treatment for menopause symptoms has moved well beyond "just deal with it”. Fezolinetant is a genuine clinical advance. SSRIs and SNRIs have real data behind them. CBT is underutilized and undervalued. **None of these are perfect substitutes for hormone therapy in all patients, but for many women, they're effective, appropriate, and sometimes exactly right.** The conversation isn't (as many influencers suggest) hormones versus nothing. It's about understanding the full menu — and making a decision that fits your history, your risk profile, and your life. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/decb8154-d545-44e4-810a-ace18f256c79/chicken_souvlaki_recipe_4_23_rev.jpg?t=1776804088) Caption: ——————————————————————————— Chicken Souvlaki Click the button below to download the print-friendly version! 1.05 MB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/5a9e901d-d195-443e-aa8a-62be1acddec6/RECIPE%20full%20page%20chicken%20rev.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260422%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260422T110026Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=d9472941586c3fb4cb078d871b8ea64f56a515d89cd006183fd551535386c3d0 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771950279) Follow image link: (https://www.joinajenda.com/experiment) Caption: -------------------- Ready to start a proven plan built for women in this season of life? Come join us inside _[The Wellness Experiment](https://www.joinajenda.com/experiment)_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-108) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-109

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [Sauna Bathing Benefits](#sauna) | [5 Important GLP-1 Topics](#5-overlooked-topics-about-glp-1-med) | [‘The Menopause 10’](#men-10) | [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3a388df6-d541-4932-a867-ae22209fae87/_dose_sauna_rev.jpg?t=1776212780) Caption: For most of my career, I filed sauna under "feels good, probably fine" and moved on. I was busy cataloging the interventions with hard outcomes data — the medications, the labs, the evidence-backed protocols. A hot wooden room felt more spa than science. Recently, I’ve changed that thinking, big time.  Here’s why. **What the research actually shows** The most compelling evidence comes from Finland, which makes sense given that the country has roughly 3 million saunas for 5.5 million people. _[A landmark prospective study published in JAMA](https://pubmed.ncbi.nlm.nih.gov/25705824/)_ in 2015 followed over 2,300 middle-aged men for an average of 20 years and found that those who used a sauna 4 to 7 times per week had a 63% lower risk of sudden cardiac death compared with those who used it once a week. AND cardiovascular disease mortality was reduced by 50%. More recent work has extended these findings to women and to broader outcomes. _[A 2018 meta-analysis in the Mayo Clinic Proceedings](https://pmc.ncbi.nlm.nih.gov/articles/PMC6262976/)_ found consistent associations between regular sauna use and reduced risk of cardiovascular events, hypertension, and all-cause mortality.  _[There is also emerging data on brain health](https://pmc.ncbi.nlm.nih.gov/articles/PMC7560162/)_. Regular sauna use has been associated with reduced risk of dementia and Alzheimer's disease in observational studies, though the causal pathway is still being worked out. Researchers hypothesize that heat shock proteins produced during exposure may play a neuroprotective role — interesting, worth watching, not yet conclusive. A small but well-designed Japanese study found that twice-weekly far-infrared sauna sessions over three months improved walking speed, cardiovascular fitness, depression scores, and overall quality of life in older adults classified as pre-frail or frail, with no adverse events reported. Notably, the improvements were most pronounced in women, who showed significant gains in walking speed, peak oxygen uptake, and peak power output that their male counterparts did not. _[The study](https://pmc.ncbi.nlm.nih.gov/articles/PMC7590093/)_ also found that reducing the cumulative burden of common aging symptoms — cold extremities, chronic pain, skin problems, leg swelling — was independently associated with improvement in frailty scores, suggesting the sauna's benefits may work through whole-body symptom relief rather than any single mechanism. The findings are preliminary, and the study had no control group, but they add to a growing body of evidence that regular heat exposure may be a low-barrier, accessible tool for supporting physical resilience in older women who may not tolerate conventional exercise programs. **Two types of heat, one underlying biology** Traditional Finnish-style saunas operate at 80 to 100 degrees Celsius, heating the air around you. Infrared saunas work differently: they use light energy to warm the body more directly, producing a gradual rise in core temperature at lower ambient temperatures. The physiological experience feels less intense, but the downstream effects overlap considerably. **Both types trigger vasodilation and improve circulation**. In clinical studies, repeated _[infrared sauna sessions have been associated with improvements in cardiac function](https://pubmed.ncbi.nlm.nih.gov/19602651/)_, including better blood flow and ejection fraction in patients with heart failure, and moderate evidence of blood pressure normalization. The mechanisms are biologically plausible and consistent with findings from traditional sauna research, even if the infrared-specific evidence base is thinner. **The cellular explanation: heat as a form of stress** Here is where things get genuinely interesting. Both exercise and sauna exposure trigger the production of heat shock proteins, particularly HSP70 and HSP90. These function as the body's cellular quality-control system, acting as molecular chaperones that refold damaged or misfolded proteins, prevent protein aggregation, and protect cells under stress. Regular activation of this pathway is associated with improved cellular resilience, reduced inflammation, and potentially neuroprotection. **Saunas MAY stimulate some of the effects of exercise** Before you erupt in elation and excitement, there are similarities between what happens to the body during exercise and during sauna bathing.** This**** does NOT mean we don’t have to exercise**, but it does suggest some interesting cellular effects of heat exposure.  **What we're still working out** This is important: when you hear or see quotes about the benefits of sauna use, most of the strong data remains observational, showing association rather than causation. People who sauna regularly may differ in other health behaviors. The associations are compelling; the causal story is still being built, though the mechanisms are physiologically plausible. We also lack meaningful head-to-head comparisons between traditional and infrared modalities. The strongest cardiovascular data comes specifically from Finnish dry saunas. Infrared sauna research is growing, but marketing in that space has frequently outpaced the evidence. That gap matters when making decisions. But if you weigh risks vs benefits, the risks are low, and the benefits are likely there with IR saunas as well.  **A word about your hair** This one is non-negotiable, and I say it as someone who has learned the hard way. Repeated heat exposure degrades the keratin structure of hair, strips moisture from the cortex, and, over time, contributes to brittleness, breakage, and frizz. If you sauna (either type) regularly, protect your hair. A towel wrapped around dry hair before you enter, or a heat-protective product on the ends, is not vanity. It is maintenance. The scalp itself also benefits from protection against direct dry heat. Make it part of the ritual, not an afterthought. **Safety concerns** According to Sunlighten, “it's true some products produce EMFs and smart consumers are concerned about minimizing exposure. Sunlighten aims to eliminate the concern about EMFs in our saunas and has made mitigation a top priority. As a result, Sunlighten saunas produce almost no EMFs, a fact validated by the world’s foremost EMF testing experts. Their report shows that Sunlighten heater panels measure 0.5 mG, **less than 1 mG**! That is **lower than 95% of the most common household devices**. It’s the latest and most current testing, so you can rest assured your infrared sauna is safe from EMFs. In addition, while you relax and enjoy the warmth of your Sunlighten sauna, behind the scenes, our SoloCarbon heaters are working safely and efficiently with a proprietary blend of FDA-approved materials that are heat-sealed to withstand temperatures above and beyond the operating temperature, **ensuring no unhealthy gases are released during heating**. It is reassuring to have third-party testing verify claims, and Sunlighten is committed to providing that as part of our safety process and quality control.” This protection is important to me, and it’s worth looking for.   **The bottom line** We lack robust, large, randomized controlled trial data, with most sauna research being observational and showing association rather than causation. The stress reduction data is solid. The sleep improvement data is promising. The vascular benefits have a plausible causative mechanism. The neurological data is early but interesting. And the ritual of it, the deliberate pause, the heat, the quiet, turns out to matter too. I absolutely love the way I feel after every time I pop into a sauna. It is a combo of relaxed, warm, and invigorated all at once. And this is important because, well, wellness activities should actually be pleasurable, and sauna use definitely is!  The infrared sauna I’ve been using recently is the _[Sunlighten mPulse Smart Sauna](https://www.sunlighten.com/partner-savings/?utm_source=DrJenAshton&utm_medium=Partner&leadsource=DrJenAshton&utm_campaign=DrJenAshton)_*. (You can save up to $1,600 + FREE shipping + FREE Red Light Mask with [_this special link_](https://www.sunlighten.com/partner-savings/?utm_source=DrJenAshton&utm_medium=Partner&leadsource=DrJenAshton&utm_campaign=DrJenAshton)!) This infrared sauna combines **all three infrared wavelengths** with built-in red light therapy, and what I appreciate most is how customizable it is. Depending on what I need that day, whether it’s relaxation, muscle recovery, or just a mental reset, I can tailor the sauna session to match. It is a health investment I am glad I made, because prioritizing recovery is critical.  For me, this isn’t about chasing every wellness trend or overpromising results. It’s about layering in tools that support the body’s natural physiology, especially for recovery, circulation, and stress regulation. And sometimes, the simplest interventions, sitting, sweating, and slowing down, are exactly what the body has been asking for all along. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e6332bfb-f6ad-40d4-921f-d0b01196d2b2/SS-_glp-1__high_rez.jpg?t=1776211223) Caption: GLP-1 medications are dominating the conversation right now, but much of what you are hearing is either oversimplified or missing critical context. _[In today’s video](https://youtu.be/_MRrK4F7oMs)_, I walk through 5 important topics that are not getting the attention they deserve, especially if you are currently taking one of these medications, or thinking about starting.  1. **Micronutrient deficiencies** When appetite drops, and you eat less, your intake of essential vitamins and minerals declines too. This can show up as fatigue, hair changes, immune issues, and more. I explain why this happens, what to watch for, and the simple lab tests that can help you stay ahead of it. 2. **Muscle loss** This has been widely reported but often misunderstood. Weight loss is never purely fat, but with GLP-1 medications, a higher percentage can come from lean mass. That is not a reason to avoid these medications, but it is a reason to be strategic. I break down how to protect your muscles with adequate protein and resistance training, and why this matters far beyond aesthetics. 3. **Hair thinning/loss** Something many people notice but do not always connect to changes in nutrition and caloric intake. This is less about the medication itself and more about what is happening in your body as a result of eating less. Understanding which micronutrients are critical for hair when taking a GLP-1  can help you prevent this and respond appropriately. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c3251ccb-7958-4ede-861d-c73d952cfc5e/youtube_video_2__five_things_.jpg?t=1776211243) Follow image link: (https://youtu.be/_MRrK4F7oMs) Caption: 4. **Long-term metabolic and overall health** This one is a positive effect that is not getting nearly enough attention. GLP-1 medications appear to reduce systemic inflammation, in some cases independent of weight loss. This opens the door to potential benefits that go far beyond the scale and into long-term metabolic and overall health. 5. **For peri/menopause** Finally, we look at what this means for women in perimenopause and menopause. This is an area of active research, but early insights suggest these medications may play a meaningful role in managing weight, body composition, and metabolic health during this transition. I explain what we know so far and how to think about it in a practical, informed way. The goal here is not hype or fear. It is clarity. These medications can be powerful tools, but only if you understand how to use them to support your overall health. Get the full breakdown, including exactly what to monitor, how to adjust your nutrition and training, and how to think about these medications in the bigger picture of your health. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/577c4e6c-792c-4841-b010-8f0202875c15/image.jpeg?t=1775522366) Follow image link: (https://youtu.be/_MRrK4F7oMs) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f1b4ed30-7539-46b7-b014-c1c70b1cacf7/Comm-changing_body_1__1_.jpg?t=1776211290) Caption: Let me tell you what I hear more than almost anything else. It’s not "I have no idea what to do." It's "I've tried everything, and I don't know what to try _next_." Most women over 50 who are carrying an extra 10-15 pounds are not uninformed. They are exhausted, misled, and working against a biology that has genuinely shifted underneath them. So let's start there, with the biology, and then get practical. ### Why 10 pounds feels like 50 after menopause * Estrogen decline changes where fat is stored.  * The subcutaneous fat that used to distribute around the hips and thighs migrates inward, becoming visceral fat around the abdomen.  * Visceral fat is metabolically active in the worst way, driving insulin resistance, low-grade inflammation, and cardiovascular risk.  * Meanwhile, muscle mass is declining at roughly 1% per year after 40 without deliberate intervention, and muscle is your primary metabolic currency.  * Less muscle means a lower resting metabolic rate, which means the same food choices that maintained your weight at 38 now don't at 52.  This is not a willpower problem. It is a physiological problem, and it has real solutions. ### A direct word about what does _not _work. I want to be blunt here, because the internet has made this worse, not better. The CBD gummies and other products using my name/likeness/AI-generated videos promising to "melt belly fat," the collagen gelatin capsules, the so-called miracle metabolism boosters flooding your social media feed… **they do not work**. Not a little. Not for some people. They are totally fraudulent, not regulated, not evidence-based, and designed entirely to extract money from women who are doing everything right and feeling desperate for something to tip the balance. The only thing they reliably reduce is your bank account. Worse, they distract from the interventions that actually move the needle, and every week spent on a scam supplement is a week not spent building the habits that compound over time. I have pursued and will continue to pursue legal action against these fraudulent companies, but they are impossible to stop. One shuts down, and another pops up. They do not have actual business addresses that can be tracked down. If you see my face, voice, name, or video next to ANY product that you don’t see on MY platforms (my Instagram, Facebook, YouTube channel, or my _[joinajenda.com](https://joinajenda.com)__ _website), you should assume they are fraudulent.  This said, I understand the appeal. When you're doing the work and the scale isn't moving, a capsule that promises to fix it overnight is a seductive idea. But you deserve better than that. You deserve the truth, which is that the tried-and-true methods are tried and true for a reason. ### What actually works **Resistance training is the single highest-yield intervention available to you right now.** Not because it burns the most calories in the gym, it doesn't. Because it rebuilds the muscle tissue that keeps your metabolism running between workouts, improves insulin sensitivity, protects bone density, and shifts body composition even when the scale moves slowly. Two to three sessions per week of progressive resistance training is supported by extensive evidence and should be non-negotiable. _[Protein intake needs to go up, not down](https://www.joinajenda.com/article/the-missing-link-in-your-protein-routine)_. The dated advice to eat less applies far less than the evidence-backed guidance to eat more protein. Current research supports 1.6 grams per kilogram of body weight daily for women in midlife, prioritizing leucine-rich sources like eggs, Greek yogurt, fish, and lean poultry. Protein preserves muscle during a caloric deficit, reduces appetite, and has the highest thermic effect of any macronutrient.  **Sabotage alert**: make sure that as you consume more protein, you are consuming LESS carbs and fat; otherwise, the number on the scale will go up rather than down. It’s about the pie chart of macronutrients and how they compose your overall energy intake, rather than expanding the pie itself.  **Sleep is not optional.** Poor sleep elevates ghrelin, suppresses leptin, drives cortisol, and directly impairs the metabolic processes that regulate fat storage. Seven to nine hours is not a luxury. It is a clinical lever that is worth using. For some/many women, _[GLP-1 receptor agonists](https://www.joinajenda.com/article/new-glp-1-guidelines-just-dropped---the-who-what-where-when-why-and-how-of-weight-loss-drug-management)_ are legitimate, physician-supervised options worth discussing, particularly when metabolic dysfunction or insulin resistance is present. These are not shortcuts. They are medical tools that work best alongside the behavioral foundations above. ### Where to start Pick one thing. If you are not resistance training, start there. If your protein is low, address that first. If you are sleeping five hours, that is your most urgent variable. The temptation is to overhaul everything simultaneously. The research on behavior change suggests the opposite: one anchor habit, executed consistently, creates the platform for the next. If you’re feeling stuck, like you’ve tried everything and still cannot figure out why the same 10 to 15 pounds will not budge after 50, you are not alone, and the reality is it’s often less about willpower and more about having the right, _[evidence-based strategy](https://www.joinajenda.com/experiment)_ for this stage of life. Ten pounds is not your destiny. It is a speed bump in the course of midlife. ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771950279) Follow image link: (https://www.joinajenda.com/experiment) Caption: -------------------- Ready to start a proven plan built for women in this season of life? Come join us inside _[The Wellness Experiment](https://www.joinajenda.com/experiment)_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6da4cb7f-06a1-4e88-bf6f-20b396e2806b/avocado_egg_recipe_4_15.jpg?t=1776131520) Caption: ——————————————————————————— Avocado, Egg & Tomato Salad Click the button below to download the print-friendly version! 889.58 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/8fffdab0-333d-47ca-92ef-72a1cece4630/RECIPE%20full%20page%20tomato%20and%20egg%20salad%2025.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260415%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260415T110046Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=1c6dd067af2b29f9a4712daefb2d5b96cad246ef948805be75936332fd01cc73 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-107) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-108

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Follow image link: (https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=header&utm_term=107) Caption: [Protein Intake](#protein) | [Midlife Healthcare Upgrades](#alloy) | [BIG News For GLP-1s ](#glp-1)| [Recipe](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0b595cc0-07b4-42bc-bd4c-30960c12d938/image.jpeg?t=1775522366) Caption: Everyone on your feed is telling you to eat more protein. And honestly? They're not wrong, but how much more do you _really_ need? This is where the advice is often either vague, overwhelming, or (and _[I saw this recently on a Forbes Instagram](https://www.instagram.com/reel/DVzI2r4yv14/)_ post that made me cringe) just flat-out incorrect. There are two big issues with protein: You probably aren’t eating enough, AND even if you are, you aren’t absorbing it all. The science-backed formula I use to calculate daily grams of protein is this: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/923c18cc-eefb-4f72-a0dd-01a01cae6d9b/image.jpeg?t=1775522366) Caption: That's it. Run the numbers for a 150-pound woman, and you land around 109 grams, not 200. Not "as much as possible." A real, achievable number rooted in evidence. Now here's the part most influencers skip entirely: **consuming protein and absorbing protein are not the same thing. ** You can eat 130 grams in a day, but you generally absorb only 10-30 percent of what you consume. So your body may only use a fraction of it, **which can be a huge issue for women already struggling to hit protein targets each day.** This is why intentional **pacing matters** more than the total. And this is also where I hear the same thing from women constantly: _"I just can't eat that much. It feels like so much food. Should I really be eating when I'm not even hungry?"_ I get it. I've said versions of this myself. But **here's the reframe**: protein-forward eating isn't about volume, it's about **density and distribution**. Greek yogurt, eggs, cottage cheese, a palm-sized piece of fish — these aren't massive meals, they're _strategic_ ones. You're not eating more food. You're eating _smarter_ food. Spread your intake across three to four meals, aiming for roughly 25-35 grams per meal. Think of it less like hitting a daily quota and more like making consistent deposits into an account that only accepts so much at once. As for eating when you're not hungry: yes, sometimes you should. Especially at breakfast, when appetite is lower, but the window for muscle protein synthesis is wide open. Your hunger cues and your biological needs don't always align. That's not a flaw. That's just physiology. **One more thing worth knowing**: protein needs don't decrease as we age — they _increase_. Muscle synthesis becomes less efficient after 50, meaning your margin for error shrinks. Getting this right isn't vanity, it's vitality. One scientific discovery I am VERY excited about is an enzyme that can be activated by stomach acid and effectively doubles the absorption of the protein we consume. This enzyme, discovered at the University of California, Davis, builds on Nobel Prize-winning research and has the potential to change metabolic endpoints, such as blood glucose, and overall physical metrics, such as body composition. I will have more on this supplement in future issues! Stay tuned!  So yes, eat more protein, but spread it out, choose dense sources, and please — check the math before you trust the post. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9b7c1f8d-9678-400c-8c69-badd7c5da9a4/IMG_6484.jpeg?t=1775567747) Caption: There’s a version of midlife healthcare most of us have become accustomed to. You call your doctor, wait a few weeks for their next available appointment, get seven rushed minutes, and leave with more questions than answers. And if you still have a relationship with your OBGYN (who may have delivered your babies decades ago), there is a good chance when/if you do get an appointment, that somehow you feel ‘less important’ than the pregnant woman sitting next to you in the waiting room. I’ve felt it too! And then there’s the version that actually works in terms of high-level, convenient access for busy women like us. That’s why I was excited when _[**Alloy**](https://alloy.sjv.io/xJJ1xd)_* approached us to sponsor this newsletter!  Not as a product, but as a system that actually makes sense for this stage of life. Instead of trying to squeeze menopause, hair changes, skin, libido, and weight all of it into fragmented appointments, _[**Alloy**](https://alloy.sjv.io/xJJ1xd)_ brings dedicated care under one virtual roof, with doctors who specialize in this phase. All of the doctors at Alloy follow the protocols set by The Menopause Society and the American College of Obstetricians and Gynecologists. **How it works:** You fill out a quick intake, connect directly with a menopause-trained physician, and get a plan that feels tailored to you, not something pulled from a standard playbook. Plus, Ajenda readers get [**$20 off their first order**](https://alloy.sjv.io/xJJ1xd), with code [AJENDA20](https://alloy.sjv.io/N9Ja0V). **Why I love it:** What stands out to me is the continuity and the accessibility. You are not just handed a prescription and sent on your way. With _**[Alloy](https://alloy.sjv.io/xJJ1xd)**_, you can follow up, ask questions, and adjust as things change for no additional costs or fees. And things do change, because this phase of life is not static, and your care shouldn’t be either. When you have a question, you deserve a timely answer, rather than a ‘we can see you in 2 months’ response. [_**Alloy**_](https://alloy.sjv.io/xJJ1xd) providers cover a wide range of issues and treatments, from hormone therapy to skin, hair, sexual health, and even weight support, **vetted through clinicians **who are actually trained in menopause care. And it is not trying to reinvent medicine or push anything fringe. It is grounded in evidence-based, FDA-approved treatments, just delivered in a way that feels more human and a lot less rushed. It feels a lot more ‘according to YOUR schedule’ rather than someone else’s. When you zoom out, the real value is not just what they prescribe. It is the access, the consistency, and the feeling that someone is actually looking at the full picture instead of one symptom at a time. And for many women, that alone is a pretty meaningful shift. **Join me:** Alloy is sponsoring a** **[_**live Webinar**_](https://www.eventbrite.com/e/the-doctor-who-goes-there-midlife-weight-hormones-and-what-actually-work-tickets-1986648756911)** **with me and Liz Plosser, former Editor and Chief of Women’s Health, next Wednesday, April 15th, at 12 pm EST. We will discuss fitness, food, midlife health, GLP-1’s, and hormones! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d51e02b6-ca37-44c7-89bc-35119cbfacf4/click_button.jpg?t=1775522396) Follow image link: (https://www.eventbrite.com/e/the-doctor-who-goes-there-midlife-weight-hormones-and-what-actually-work-tickets-1986648756911) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9a50abbc-0028-419e-997b-b23239a3264e/Comm-glp-1_-3.jpg?t=1775605565) Caption: You know I have been talking about incretin therapy and GLP-1 medications for years. This week, the news genuinely got me excited. [_I had the rare chance to sit down with Dave Ricks, CEO of Eli Lilly, and what he shared is too important to miss._](https://youtu.be/OPuWRsiUMgQ)[ ](https://youtu.be/OPuWRsiUMgQ)Let’s break it down because complex health topics deserve more than a 75-second soundbite. The big headline is that the FDA just approved **Foundayo**™, a new once-daily** oral GLP-1**. That is right, a _pill_, not an injection. [_**The details on how it works, who can use it, and what it actually costs**_](https://youtu.be/OPuWRsiUMgQ) are even more interesting than the headlines suggest. Here is what you need to know: * The current FDA approval is for **adults with overweight or obesity**, with or without type 2 diabetes, for **weight loss**. Approval for **blood sugar control** is expected later this year or early next year. * In clinical studies, Foundayo™ lowered **HbA1c** (a key diabetes marker) by about **2 points**. As a physician, I can tell you that it is a remarkable result for an oral medication. * Participants lost an **average of 11 percent of their body weight** over about a year. Most people lost some weight, and many lost a significant amount. There is more to this story. We talked about why this pill behaves differently than other oral options, the background on the “expedited” FDA approval process, and why there is nothing to worry about, and what is next for this class of medications. It goes well beyond weight loss. I also asked the questions that matter most to me as a doctor: **access for seniors, the risks of compounded knockoffs, and whether women’s health is finally getting the attention it deserves, in the form of specific research and development**. Some of his answers genuinely surprised me. And I want to be clear on one important point that many people raised on my brief Instagram post last week with Lilly’s CEO: the cost of these drugs is PART of the picture, not the whole picture. I asked questions, and the CEO gave answers. How you think after hearing them is up to you, not me.  ---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/925a4210-0c5a-4beb-ade9-5b8714de3017/youtube_video_9.jpg?t=1775603317) Follow image link: (https://youtu.be/OPuWRsiUMgQ) Caption: ----------**I am not pro-pharma or anti-pharma.** I live in the real world, where it costs $2-3 billion to develop a new drug. Pharmaceutical companies are not non-profits, and I don’t think they should be. I actually WANT them to make money so they can afford to research and develop new drugs that can help many people. I think the blame rests more with insurance company coverage of these and other medications than with the industry that makes them. To address the cost issue, my personal POV is that in a country where 70% of the population could benefit from these drugs, the government should be subsidizing them for those whose insurance doesn’t cover them or who can’t afford them. (Perhaps work on people’s health rather than build missiles or spend $200B on a war that was elective- but I digress.)  Regardless of any societal or political view, this is a complex issue, and many of the people, myself included, commenting on the pros and cons of big pharma are not expert enough to make definitive statements, so I hope you watch and read with an open mind. The full conversation is live now on my [_**Ajenda YouTube channel**_](https://www.youtube.com/@drjashton). Go check it out. You do not want to miss this one. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/577c4e6c-792c-4841-b010-8f0202875c15/image.jpeg?t=1775522366) Follow image link: (https://youtu.be/OPuWRsiUMgQ) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/0a723658-5459-4548-a8a7-60cbdd8e0526/Gut-Nurturing__Green_Smoothie__recipe_4_8.jpg?t=1775522940) Caption: ——————————————————————————— Gut-Nurturing Green Smoothie Click the button below to download the print-friendly version! 876.13 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/145016ec-2047-44e7-92d9-0c4478009875/Today%27s%20Ajenda%20107%20Recipe%20Green%20Smoothie.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260408%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260408T110104Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=0153b919fbd1ee44c98d21a1b1464c09272942d4e191550bc46d342e5e5fc88f ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Come join us inside _**[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=footer&utm_term=107)**_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? 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As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-107

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278492) Caption: [Calcium Risks](#Dose) | [Hair Loss](#Hair loss) | [The Oscars ](#Hair loss)| [Chicken Wrap ](#recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/28452346-28d9-4bb3-bf72-68c6e1f1253b/image.jpeg?t=1774974814) Caption: For decades, women over 50 have been told the same thing: take your calcium supplement. It's good for your bones. Your doctor recommended it, the pharmacy shelves are full of it, and it feels like responsible, proactive health behavior. I'm here to clarify that narrative. The science on supplemental calcium has quietly shifted over the last fifteen years, and I think a lot of women — and frankly, a lot of physicians — haven't caught up with it yet. A landmark [2010 study published in the BMJ by Bolland and colleagues](https://pubmed.ncbi.nlm.nih.gov/20671013/) found that **calcium supplements, taken without vitamin D**, were associated with a **significantly increased risk of myocardial infarction** (i.e., heart attacks). [A follow-up meta-analysis in 2011](https://pubmed.ncbi.nlm.nih.gov/21505219/) extended those findings and suggested the risk persisted even when vitamin D was added. We're not talking about small signals. We're talking about data that should have changed the conversation. **The working theory is this: **when you swallow a calcium supplement, you get a sharp spike in serum calcium levels. Your body isn't built to handle that kind of bolus delivery. That spike may promote arterial calcification, stiffen blood vessels, and increase the risk of clotting. The result, in vulnerable women, can be cardiovascular. **Whole food calcium doesn't behave the same way**. When you get calcium from food, it enters your system slowly, in doses your body recognizes and can actually use. The cardiovascular signal we see with supplements? It largely disappears with food sources, and this distinction matters enormously. Here's what hitting 1,200mg of calcium actually looks like on a plate:  * A cup of Greek yogurt gives you roughly 200mg.  * A cup of fortified almond milk adds another 400mg. * Three ounces of canned salmon with bones contribute about 180mg.  * A cup of cooked kale brings in around 180mg.  * A serving of ricotta or a couple of string cheese sticks adds another 200mg or so.  * A small glass of fortified orange juice rounds things out with another 350mg.  With intention, it’s entirely doable to get there without opening a single pill bottle. I can hear you asking, “[So what about AlgaeCal](https://www.joinajenda.com/article/low-bone-density-and-algae-derived-calcium-what-does-the-science-show)”, the plant-based calcium supplement derived from South American algae that's been heavily marketed as a safer alternative? The honest answer is: maybe, but the evidence is thin. The existing studies are small, industry-funded, and not yet independently replicated at scale. I'm not dismissing it, but I wouldn't call it _proven, _and so, until data consistently looks at plant-based calcium supplements and heart attack risks specifically, it is prudent to err on the side of caution and assume that the risks may be the same. In addition, emerging data suggest that Vitamin K2 can help direct calcium into bones rather than into blood vessels. K2 may improve bone mineralization and may reduce some fracture risk (but this has been inconsistently shown in large studies), but broad clinical guidelines on its use have not yet been developed. I would, therefore, put **K2** in the category of: **maybe helpful**, but not yet definitive data for or against. **My clinical recommendation, and what I personally do: aim for 1,200mg daily from food first.** If you genuinely cannot hit that target through diet, have a real conversation with your doctor about whether supplementation makes sense for you, at what dose, and what your individual cardiovascular risk profile looks like. Bone health matters, but so does the heart that keeps those bones moving. Know what you’re talking about and have the data to make informed decisions.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1cf1af8a-afd1-4f2c-92ed-8b01c50c315d/SS-_hariline_revised_images5.jpg?t=1774987137) Caption: If you've found yourself angling your phone camera slightly higher lately, or parting your hair differently than you did five years ago, you're not imagining things. And you're not alone. I am living the thin-hair journey myself and have been for the past 5 years! Hair thinning along the frontal hairline and crown is one of the most common and least discussed changes women experience after 50. It has a name: female pattern hair loss, or **androgenetic alopecia**. And the reason it tends to accelerate after menopause is straightforward. Estrogen and progesterone help keep hair in its growth phase longer. When those hormones decline, the growth phase shortens, the resting phase extends, and hair follicles miniaturize over time. What you're left with is hair that grows back finer, shorter, and less dense than before. This is biology, not neglect. The other thing worth knowing: the frontal hairline is particularly vulnerable because follicles in that region tend to be more sensitive to androgens, specifically DHT, the testosterone derivative that shrinks follicles over time. After menopause, with estrogen's protective effect reduced, DHT has more room to operate. _So what actually works?_ Topical minoxidil remains the most evidence-backed option we have. But there's a newer conversation happening around **topical retinol**, and the science is genuinely interesting. A study published in the _Journal of the American Academy of Dermatology_ [found that tretinoin, a prescription-strength retinoid, enhanced minoxidil absorption and improved hair regrowth outcomes when the two were used together](https://pubmed.ncbi.nlm.nih.gov/3771854/). The theory is that retinoids upregulate growth factors in the scalp and improve cellular turnover around the follicle, creating a more receptive environment for regrowth. **At-home retinol use: ** If you want to try topical retinol at home, **start low and go slow**. A 0.025% to 0.05% retinol applied to the scalp two to three nights per week is a reasonable starting point. **How to do it: ** Apply it to a dry scalp, use sparingly along the hairline, and expect some initial dryness or irritation. Give it at least three to four months before drawing conclusions. **Other options: ** Beyond retinol, the options worth discussing with your dermatologist include** low-level laser therapy (LLT), **which has solid trial data behind it, **platelet-rich plasma injections**, which are promising but still evolving, and oral minoxidil at low doses, which is gaining traction as an option for women who don't respond to topical treatment. (_Note: I’m doing a deeper dive into red light therapy for thinning hair in an upcoming issue. Stay tuned!) _ One thing I want to be direct about: hair loss in this population is under-treated because it's under-reported. Women don't mention it at appointments because they assume it's just aging. And physicians don't ask because it's not on the acute problem list. Bring it up, it's worth the conversation. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9f41bc5b-9d6f-4db6-9d6a-44676d46ba07/image.jpeg?t=1774974814) Caption: I watched the Oscars this year the way I imagine a lot of you did: appreciating the fashion, admiring the talent, and then finding myself stopped cold by something harder to name. It wasn't envy. It wasn't admiration; it was _concern._ The ultra-thin silhouette was back on that red carpet in a way we haven't seen since the early 2000s. And this time, we know what's likely behind it. I want to be careful here, because this topic deserves it. I am not commenting on any individual's body, their personal choices, or their medical history. I don't know what any specific person is taking, struggling with, or navigating privately. **What I am commenting on **is the collective image that got beamed into millions of homes that night, and what it communicates to women, particularly women over 50, who are already fighting hard enough against a culture that makes them feel invisible. GLP-1 medications are genuinely remarkable. [I've written about this before](https://www.joinajenda.com/article/new-glp-1-guidelines-just-dropped---the-who-what-where-when-why-and-how-of-weight-loss-drug-management), and I'll say it again: **for the right person, they are a serious and legitimate medical tool**. But a medication designed to treat obesity and metabolic disease (and possibly even provide some healthspan long-term benefits that are independent of weight loss for people without overweight/obesity) is increasingly being used as an aesthetic accelerant by people who were never candidates for it clinically. The result, on a stage as visible as the Oscars, is a beauty standard quietly recalibrated in a way that concerns me deeply as a physician. **Here is the medical reality that often gets lost in the cultural conversation: being significantly underweight carries serious health risks of its own.**  * Bone density loss * Muscle wasting * Cardiac arrhythmias * Hormonal disruption * Immune suppression.  Let me be clear: after 50, when we are already fighting to preserve muscle mass and bone integrity, excessive thinness isn't a health achievement; it's a liability. It actually INCREASES the risk of all-cause mortality, death from everything and anything. The research is consistent on this. Mortality risk follows a U-shaped curve: it rises at both extremes. We talk constantly about the dangers of obesity, as we should. We almost never talk about the other end of that curve with equal seriousness. **Every woman gets to decide what she does with her own body. Full stop. That is not a negotiable principle for me.** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4412c6de-a453-4584-83cf-c7370f388d72/image.jpeg?t=1774974814) Caption: But individual choices, when amplified on a platform that size, stop being purely individual. They become a signal. And the signal this sent, intentionally or not, was that smaller is better, that visible is desirable, that a body that takes up less space is a body worth celebrating. For women over 50 who are already navigating menopause, body composition changes, and a culture that has never been particularly kind to aging female bodies, that signal lands hard. It lands in the way that makes someone skip a meal, reconsider their medication, or look in the mirror with a new and unnecessary hostility. We can hold two things at once: We can support access to GLP-1 medications for their plethora of benefits _and_ still ask hard questions about what happens when powerful tools migrate from medicine into aesthetics or are overdone/used to an extreme. This is where one of my favorite lines about health and wellness raises its hand: most things in MODERATION. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/396a3094-9ade-4990-b27f-5011f0781656/image.jpeg?t=1774974814) Follow image link: (https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=community-oscars&utm_term=106) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/488c0587-84a8-484b-8f5d-e1cb1de13e7b/image.jpeg?t=1774974814) Follow image link: (https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=community-oscars&utm_term=106) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/062d81c2-1f79-45b0-b90e-2c81f239c7f0/image.jpeg?t=1774974814) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88890076-b874-4209-8805-898b50ac26a8/chicken_wrap_recipe_final.jpg?t=1774987073) Caption: ——————————————————————————— Grilled Chicken Hummus Wrap Click the button below to download the print-friendly version of the recipe! 753.51 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/120ebd2e-84c3-40b1-aed1-69963f5c0193/chicken%20wrap%20recipe%201.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260401%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260401T110008Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=28520eefd0cd3a16ee5a879b22adf1e2ab32d9ef3f3a7a6d197aac759a39b21e ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4bbb04fa-a920-4b25-a5e0-5dc9d601c0c7/off_duty_BUTTON.jpg?t=1761072727) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) Caption: $7 monthly subscription View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1efe3eaf-1302-420f-a9e4-584ec75eb2ff/black_rule.jpg?t=1773360952) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771950279) Follow image link: (https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) Caption: Ready to start **a proven plan built for women** in this season of life? Come join us inside **[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer)**[.](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly live Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-105) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-106

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/006812db-14e1-4dda-a493-33dcda48c2f1/NEW_banner_for_newsletter_with_TOC_heading.jpg?t=1774278454) Caption: _[Creatine](#lets-examine-creatine)_ | _[Sleep](#ss)_ | _[A Note On Aging](#community)_ | _[A Healthy Alcohol Alternative](#vesper)_ | _[Spring Recipe](#recipe)_ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f2a66a89-3edc-4443-9335-c8fd3fadea61/image.jpeg?t=1774368155) Caption: ## **Introducing the series you've been asking for: ‘**_**Worth it or Waste?’**_ I get hundreds of great questions every week. And to be honest, the one category that comes up more than almost any other isn't about a specific diagnosis, nor is it even about a specific symptom. It's some version of this: _"Is this worth it? Or am I wasting my money?"_ Creatine, red light therapy, collagen peptides, mushroom coffee, magnesium glycinate, GHK-Cu. The list grows every week, and so does the confusion. And here's the thing: that confusion is not your fault. The wellness industry generates billions of dollars by making women feel like they're always one product away from feeling better. They offer big promises of being “just one supplement away from sleeping through the night, and one device away from reversing ten years…” It's exhausting, and a lot of it is nonsense. So today, I'm launching this recurring series where I cut through exactly that noise. Every installment, I'll take a product, ingredient, supplement, or wellness trend you're actually asking about, and give you the honest, evidence-based breakdown. Not what the brand says. Not what the influencer is paid to say. _What the data shows, _and what I _actually_ think. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/03b3c59c-f6e3-4d20-8326-622b4c9738be/newsletter_worth_it_A__1_.jpg?t=1774387281) Caption: # **Let’s Examine Creatine** This is by far **the number one supplement you’re asking about right now**, and that makes sense. Creatine has migrated from gym culture into mainstream women’s wellness conversations seemingly overnight. But here’s the thing: the research behind it isn’t new at all. Let’s break it down properly. ### **What It Is** Creatine is a** naturally occurring compound **that your body synthesizes from amino acids, and you get small amounts through your diet, mainly from red meat and fish. Its central job?** Energy production**. Creatine helps replenish ATP, the molecule your muscles use for short bursts of intense effort. Most of your body’s creatine is stored in skeletal muscle, and supplementing increases those stores beyond what diet and your body alone provide. ## **What the Research Shows** ### **Safety** Creatine monohydrate is well-tolerated in healthy adults. The most common side effect is **temporary water retention**, which can cause a slight increase on the scale in the first few weeks. Women with kidney disease should check with their physician before supplementing, as creatine affects creatinine levels, a key marker used to monitor kidney function. ### **Dosage** Most research uses 3–5 grams of creatine monohydrate per day, although emerging data suggest that higher doses may be needed to achieve the cognitive benefits associated with creatine. (I take 4-5 grams a day personally.) There’s no need for “loading” unless you’re an athlete trying to saturate stores quickly. Consistent daily use at a moderate dose achieves the same benefits over time. ### **Muscle Strength & Power** This is where creatine really shines. Decades of research show that when combined with resistance training, creatine improves muscle strength and lean mass more than training alone. For midlife women, this is crucial. From age 30-70, we _[lose about 1-2 percent of muscle every year](https://pmc.ncbi.nlm.nih.gov/articles/PMC6124840/#:~:text=Aging%2DRelated%20Muscle%20Decline,to%20about%203%25%20per%20year.&text=Thus%2C%20the%20primary%20aging%20process,include%20disuse%20and%20disease%20states.)_ in a process called sarcopenia. Preserving muscle isn’t just about aesthetics; it’s essential for **metabolic health, vitality, and maintaining independence**. ### **Bone Health** Emerging research suggests creatine _[may support bone resorption](https://pmc.ncbi.nlm.nih.gov/articles/PMC12878991/)_ when paired with exercise. The data is promising, though more studies are needed before we can draw firm conclusions. ### **Cognitive Function** Small trials have indicated that daily creatine supplementation helps combat perimenopausal symptoms such as brain fog, accelerates cognitive processing, and improves mood stability. While it’s not a cure, the early evidence is very intriguing. ## **The Verdict: Worth It, With Specifics** If you are doing resistance training, creatine monohydrate is one of the few supplements I can confidently say is backed by strong evidence for **midlife women**. The muscle-preserving and potential cognitive benefits align perfectly with what this stage of life demands. If you’re **not yet strength training**, creatine is not a substitute. Prioritize establishing a resistance routine first, then add creatine as a supporting tool. **One practical note:** Quality matters. Stick to **creatine monohydrate**, not “fancy” forms like creatine HCl or ethyl ester, which haven’t shown superior results in research. Look for brands that use **third-party testing**. I personally recommend [Thorne](https://www.joinajenda.com/article/the-honest-truth-about-alcohol-and-what-i-actually-do-about-it?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=symptom-solution&utm_term=105)*, which has been independently tested for heavy metals and comes back clean. NSF Certified for Sport or Informed Sport certification is a good benchmark for any brand you consider. As always, run this by your physician if you have **kidney concerns** or take medications that affect renal function (though your doctor may not be current on the extensive creatine literature, sadly). View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/460629cc-a1d5-47b2-9204-da399769df4e/image.jpeg?t=1774367852) Caption: Most sleep advice for women over 55 is written for someone else. The standard recommendations of limiting caffeine, keeping a consistent bedtime, and avoiding screens at least two hours before bed aren’t wrong, but they aren’t sufficient for a woman whose sleep architecture has been fundamentally reorganized by hormonal changes. If you’re waking at 3 a.m. with a racing heart, lying awake for two hours and then crashing before your alarm, or sleeping eight hours and still feeling exhausted, this is not a discipline problem; it’s a physiological problem. You are not alone. Sleep disturbances are reported by **40 to 60 percent of menopausal women**, making this one of the most common and least adequately treated symptoms of the menopause transition. Before menopause, around 30 percent of women report sleep problems more than three times a week. During the transition, that rate _doubles_. ### **Understanding Sleep** Sleep is not one uniform state; it’s a sequence of stages: light sleep, deep sleep, REM, each cycling through the night in a specific pattern. **Estrogen and progesterone** play active roles. Estrogen helps regulate body temperature and REM cycling, while progesterone acts on GABA receptors and has a natural sedating effect. When both hormones drop, sleep architecture doesn’t just shift slightly; it can fragment significantly. ### **What’s Happening at 3 a.m.** Early-morning waking is often linked to cortisol. Cortisol should rise gradually in the early morning to help you wake, but low estrogen and a dysregulated stress response system can cause the spike to come earlier and be stronger than intended. Add a hot flash, and you may find yourself fully awake in the middle of the night. It’s not your body working against you. It’s your body operating without the hormonal scaffolding it once had. ## **Where to Focus Clinical Attention:** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/927d6c53-df0d-40ae-a0b8-6608fded86e4/image.jpeg?t=1774367852) Caption: If you’re not on HRT and sleep disruption is significant, this is a conversation to have with your provider. Oral micronized progesterone has strong evidence supporting sleep: one randomized, double-blind, placebo-controlled study found women taking it had 53 percent less time awake after sleep onset and nearly 50 percent more slow-wave sleep. Subsequent reviews indicate that estrogen combined with progesterone improves sleep quality, whereas estrogen alone does not. Micronized progesterone, not synthetic progestins, is the formulation with the strongest data. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/67451a3d-021f-4477-aa47-12f6f6e90a56/image.jpeg?t=1774367852) Caption: Wearables like the _[Oura Ring](https://go.shopmy.us/p-48471015)_* can help track this. Research shows nearly 50 percent of women meeting criteria for insomnia had less than six hours of total sleep on objective measures, even if they believed they were sleeping more. Eight hours of fragmented sleep is not eight hours of rest. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7aaedac5-1c8e-492b-ab17-28c8bde12299/image.jpeg?t=1774367852) Caption: Even low doses (roughly two drinks)  can disrupt REM sleep and delay REM onset by an average of 18 minutes. You may fall asleep faster, but your sleep quality suffers. If sleep is poor and you drink regularly, addressing alcohol should come before supplements or devices. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f5d88183-da15-4bfb-b7f9-7f25ceccf418/image.jpeg?t=1774367852) Caption: Chronic stress, under-eating, and over-exercising can elevate cortisol and directly disrupt sleep. Many high-functioning women who exercise intensely and eat clean still struggle to sleep. Sometimes the solution is to reduce intensity, not increase it. ### **Supplements** Supplements can support sleep, but they **cannot reconstruct sleep** if the hormonal foundation is missing. **Magnesium glycinate** is my starting point because it’s well-tolerated, supported by reasonable evidence, and carries a low risk. Melatonin is often misused; most women take too much (5–10 mg) when evidence supports lower doses (0.5–1 mg) for sleep onset. Ashwagandha has emerging data for cortisol regulation and may help indirectly.  ### **On Ambien or Xanax** These prescription medications **can be safe and effective, **but only in the short term. They have **not been approved for nightly use for years**. Using them this way carries a real risk of **altering your brain chemistry in ways we don’t fully understand**, and that’s not something any of us wants. If you’ve been taking one for years, now is the time to consider a **medication holiday**, carefully. This doesn’t mean stopping abruptly. Instead, the safest approach is to **gradually reduce the dose** and adjust the frequency: every other day, every 2-3 days, or only when truly needed, such as for long-distance travel. We’ll dive deeper into safe tapering strategies in a future issue. You deserve more than a pamphlet or a quick fix. You deserve a **real, personalized workup** to get to the root of the problem, not just temporary relief. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/61fa4762-c98b-4e76-bef3-5e6d5d324e7c/image.jpeg?t=1774367852) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4f6a8b3e-ce69-494b-93e6-853666c90e35/image.jpeg?t=1774367885) Caption: I’ve been doing a deep dive on the questions you’ve sent over the past several months. And I don’t mean skimming, but really _reading _them. What struck me wasn’t the volume, or even the complexity of the medical questions (though both are real). It was the emotional undertone running beneath almost every single one. You are asking about HRT timing, about whether it’s too late, about what happens if you stop. You’re asking about hair loss in a way that makes clear this isn’t about vanity; it is about **recognition**. You are asking about GLP-1 maintenance, long-term safety, and what comes next after initial results. You want to know if your fatigue is normal or whether something is actually wrong. On the surface, these questions are all different. But underneath, they’re circling the same thing: _**Am I going to be okay? And is anyone going to tell me the truth?**_ I feel that — deeply. And here’s what I know from 19 years in clinical medicine, 26 years as a doctor, and as a 56-year-old woman navigating this same terrain: **the medical system was not designed with us in mind.** It wasn’t designed for the complexity of midlife female physiology. It wasn’t designed for the woman who is already informed, already in treatment, already doing the work,  and still not getting straight answers or the results she wants. **That gap is exactly why I built **_[Ajenda](https://www.joinajenda.com/?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=community&utm_term=105)_**.** Not to give you more information… because you already have access to plenty. But to help you think through it. To take a position when the evidence supports one. To say, “for most women in this situation, here’s what I’d actually do” _and mean it._ Yes, I am a doctor, but I am also a real person. I ask the same questions about my own body; I feel the same uncertainty when the guidelines don’t quite fit my situation; and I’ve sat in the exam room on the other side of the table, feeling stressed and nervous. So when you write to say that something I’ve shared made you feel seen, helped you walk into your doctor’s appointment with more confidence, or finally gave you language for something you’ve been feeling for years, that is not small to me. That is the whole point, and why I do what I do! Thank you for being here. Thank you for asking the hard questions. Thank you for refusing to settle for “that’s just aging.” Because it’s not ‘just aging’. And you deserve to know the difference. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/90d7f8c9-1674-4bb4-926a-6dd68c2aa864/image.jpeg?t=1774367885) Caption: _[If you read last week’s issue on my recommendations around alcohol,](https://www.joinajenda.com/article/the-honest-truth-about-alcohol-and-what-i-actually-do-about-it?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=vesper&utm_term=105)_ you know that the goal was not restriction or judgment. It was creating space for something that actually makes us feel better. For me, that’s _[Vesper](https://www.piquelife.com/JENNIFERASHTON)_*.  It’s what I consider to be a great option when I want the elevated feeling of a delicious cocktail, a signal that the day is done. But with Vesper, there is no negative impact on sleep and nothing to contribute to a guilty feeling the next morning. And this isn’t just a placebo effect. _[Research from Brown University (among others)](https://sph.brown.edu/news/2025-12-03/dry-january)_[ ](https://sph.brown.edu/news/2025-12-03/dry-january)shows that even taking a short break from alcohol can improve sleep, mood, energy, and key markers of metabolic and cardiovascular health. And what I appreciate about Pique is that it is actually formulated with intention. This isn’t just a non-alcoholic drink trying to imitate something else; it’s built to make you feel a certain way. ### **What it actually feels like** I’ve been enjoying Vesper after dinner or before a pre-bedtime bath. It makes these things feel more intentional (and even healthier!). And this is the part that surprised me: it doesn’t feel like you’re “missing” anything. Each glass may support or provide: • A subtle release of tension at the end of the day • A positive shift in mood, without feeling altered • That social ease you want if you’re out with people • A calm, present feeling instead of that wired-tired edge No haze, no sleep disruption, no next-day drag. I feel like myself, but better! ### **Why it works** The formulation is thoughtful from a nutritional science standpoint: • **L-theanine, tart cherry, and lemon balm **to support relaxation and nervous system balance •** Gentian root **for a subtle sense of uplift • **Damiana** to support a slightly more open, social feeling • **Elderflower** for a bright, celebratory finish It’s sparkling, slightly tart, a little herbaceous, and tastes like a real drink, not a substitute. Honestly, it’s one of the few alcohol alternatives I’ve tried that doesn’t feel like a compromise. If you’re experimenting with drinking less, or even just being more intentional with it, this is an easy swap that still feels good. I partnered with Pique to offer you [**10% off **](https://www.piquelife.com/JENNIFERASHTON)[**Vesper for life **](https://www.piquelife.com/JENNIFERASHTON)if you’re interested in trying it.   View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5b8a450d-dbfb-4235-8edb-40bb917bb5d2/Pique_BUTTON_B.jpg?t=1769550871) Follow image link: (https://www.piquelife.com/JENNIFERASHTON) Caption: _Offer available for a limited time._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9891b944-9751-407b-bdbb-222fbe3f11fd/egg_scrample_recipe_3_25__1_.jpg?t=1774300645) Caption: ——————————————————————————— Spring Spinach & Egg Scramble Click the button below to download the print-friendly version! 1.68 MB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/11464854-e1df-4ff5-82ed-f3b19ce718e5/Today%27s%20Ajenda%20105%20Recipe%20Spring%20Egg%20Scramble.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260325%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260325T110033Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=cd0a465eef244ac87d57cc79ac06787aeb5887cd16d7ba641269200e51cb1bb1 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter _[Off Duty](https://todays-ajenda.beehiiv.com/upgrade)_, where I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4bbb04fa-a920-4b25-a5e0-5dc9d601c0c7/off_duty_BUTTON.jpg?t=1761072727) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer) Caption: $7 monthly subscription View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1efe3eaf-1302-420f-a9e4-584ec75eb2ff/black_rule.jpg?t=1773360952) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771950279) Caption: Ready to start **a proven plan built for women** in this season of life? Come join us inside _**[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer)**_. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-103) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-105

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: ## Table of Contents * [“I’m over 60. Am I too late for HRT?”](#im-over-60-am-i-too-late-for-hrt) * [The Honest Truth About Alcohol (And What I Actually Do About It](#the-honest-truth-about-alcohol-and-) * [Vibration Plates: Helpful or Hokey?](#vibration-plates-helpful-or-hokey) * [Seared Ahi Tuna Bowl](#seared-ahi-tuna-bowl) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cdb4d70a-7656-4ac7-a438-94b30f8fa3aa/_dose_hrt_over_60.jpg?t=1773591984) Caption: If you’re over 60 and still experiencing hot flashes, sleep problems, mood changes, or a general sense that your body has shifted in ways you don’t fully recognize, these symptoms can persist for years after menopause. Many women deal with this, and it can feel isolating, but it is a recognized and treatable pattern. We know that these symptoms can persist for **10 or more years** in women AFTER they officially enter menopause; that’s a lot of time spent suffering! The bright side is you’re definitely not “too late” to ask about hormone therapy. The key is that you _are_ in a category where the conversation has to be more individualized, more risk-aware, and frankly, more grown-up. Despite what is shown on social media, there is no one ‘hook’ or answer that is right for everyone. The reality is that there is a huge gray zone when it comes to this issue, and that often doesn’t fit well on an Instagram reel or a Facebook post. Here’s the core evidence-based idea: **age and time since menopause matter.** The North American Menopause Society (NAMS) states that for women who start hormone therapy **under 60 or within 10 years of menopause**, [the benefit-risk balance is generally favorable ](https://pmc.ncbi.nlm.nih.gov/articles/PMC6683316/#:~:text=There%20is%20general%20agreement%20among,cardiac%20mortality%20and%20CHD%20events.&text=Nevertheless%2C%20despite%20accumulating%20evidence%20and,and%20expertise)%20of%20the%20authors.)for bothersome symptoms and bone protection. For women who start **over 60, or more than 10 years from menopause**, that balance becomes **less favorable** because absolute risks (heart disease, stroke, blood clots, dementia) rise with age.  If you’re over 60 or past the 10-year threshold, that doesn’t mean “no.” It means “let’s do this thoughtfully.” ## **What HRT can still help with after 60** **Pros** * **Vasomotor symptoms (hot flashes and night sweats)** If these symptoms are still disrupting your life, hormone therapy remains the most effective treatment we have. * **Sleep and overall quality of life** For many women, better sleep follows once nighttime hot flashes improve, which can have a ripple effect on mood, energy, and daily functioning. * **Bone health** Systemic estrogen helps slow bone loss and reduce fracture risk while you are taking it. That said, for many women in their 60s, it is not considered first-line treatment for osteoporosis, but it may still play a supportive role depending on the situation. * **Genitourinary symptoms** Vaginal dryness, painful intercourse, and recurrent urinary tract infections often respond very well to local vaginal estrogen therapy. This form is low-dose and works primarily in the local tissues, which gives it a different safety profile from systemic hormone therapy. ## **The real potential downsides we have to respect** **Cons** * **Blood clots and stroke** Risk increases with age, and it also varies depending on the type of hormone therapy used. Route matters here: transdermal estrogen (patches or gels) and lower doses may carry a lower clotting risk than oral estrogen in some women. * **Heart disease** This is one of the most misunderstood areas. Hormone therapy is **not** prescribed to prevent cardiovascular disease. In the Women's Health Initiative, combined estrogen-progestin therapy was associated with an increased risk of coronary heart disease early in treatment, particularly among women who started therapy later in life. * **Dementia** Some research suggests that starting systemic hormone therapy later in life, particularly well beyond menopause, may be associated with a higher risk of dementia. That concern is part of why timing is emphasized in current guidelines. At the same time, the research landscape is not completely uniform. Some studies have suggested potential cognitive protection, while others show the opposite. The reality is that brain health, like most aspects of medicine, cannot be explained by a single variable. ## **Special note for women and heart disease** Heart disease is the **#1 killer of women**, and the menopausal transition is often a time when cardiometabolic risk quietly accelerates. Blood pressure, cholesterol, visceral fat, and insulin resistance can all shift during this period. Researchers have proposed what is called the **“timing hypothesis,”** which suggests that estrogen may have more favorable vascular effects when it is started closer to menopause, and less benefit — or potential harm — when initiated later. The [ELITE Trial](https://www.imsociety.org/2016/06/27/cardiovascular-results-from-the-elite-study/) provides some biological support for this idea, showing slower progression of subclinical atherosclerosis when estrogen therapy was started earlier rather than later. Guidance from the [American Heart Association is consistent with this perspective](https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061559): hormone therapy may be appropriate for symptom relief in selected women, but it should not be used as a strategy to prevent cardiovascular disease. ## **So… are you too late?** No, but you may be in what many clinicians think of as the **gray zone**, where the best approach typically involves: * using the lowest effective dose * choosing the safest formulation and route for your individual risk profile * being clear about the symptoms or goals being treated * reassessing periodically as your health evolves That’s the framework that tends to produce the most thoughtful decisions. And ultimately, that’s the more useful question to ask. Not “can I take hormone therapy after 60?” but rather: **What problem are we trying to solve, what risks do I personally carry, and what is the safest path to feeling better?** Those answers rarely come from a generalized chart; they come from a** careful conversation with a physician **(sometimes more than one) who understands your health history, your priorities, and your tolerance for risk. Because when it comes to menopause care after 60, the goal is not to follow a rule. It’s to make a decision that actually fits **you**. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d84ed380-69cd-4001-ae3e-37436cd5448c/SS-_alcohol_1-55.jpg?t=1773592401) Caption: Let me be straight with you: this is one of the topics I find most challenging to write about. Not because the science is complicated, it isn't, really, but because it sits right in the middle of something that is deeply psychosocial. And that makes it tricky. Here's what the data says, plainly: there is no truly "safe" level of alcohol consumption. The research has shifted meaningfully over the past decade. What we once called the "French paradox" and the cardioprotective benefits of a glass of red wine? Largely artifacts of flawed study design. The most current evidence, including a [landmark global analysis](https://oncodaily.com/oncolibrary/group-1-carcinogen) published in _The Lancet_, concludes that alcohol is a Group 1 carcinogen, linked to at least seven cancers, and that the risks begin with the first drink. Full stop. I know. I didn't love reading that either! **Why it hits differently after menopause:** This isn't just about quantity — it's about biology. After menopause, estrogen levels drop, and with them goes a meaningful layer of metabolic protection. Your liver enzymes that process alcohol become less efficient. Body composition shifts toward less muscle and more fat, and since fat retains alcohol longer than muscle does, blood alcohol concentration rises higher and stays elevated longer — even if you're drinking exactly what you always drank. Add to that: alcohol raises estrogen metabolites in ways that matter for breast cancer risk, disrupts the sleep architecture that's already under siege during menopause, and accelerates cortisol dysregulation. It is, in the most clinical sense, a different substance in a post-menopausal body than it was at 35. And the skin piece is real and worth naming: alcohol is profoundly dehydrating, degrades collagen synthesis, and promotes systemic inflammation. These three things show up directly on your face. It's not vanity to factor that in; it's data. **What it specifically does to us.** For women over 50, the targeted concerns are: * **Breast cancer:** Even moderate drinking — one drink daily — is associated with a 7–10% increased risk. That number matters more when your baseline risk is already climbing with age. * **Bone density:** Alcohol interferes with calcium absorption and suppresses the bone-building cells your body is already struggling to maintain post-menopause. * **Cardiovascular health:** The supposed heart-protective benefits have been largely debunked. What remains is evidence of increased blood pressure and triglycerides with regular use. * **Cognitive function:** Alcohol is neurotoxic. For women already concerned about brain aging, it works directly against you. * **Sleep:** It may help you fall asleep, but it will absolutely degrade the quality of that sleep, suppress REM, fragment deep sleep cycles, and leave you more fatigued than rested. **So what do you actually do with this?** Here's what worked for me — and I offer it not as a prescription, but as a practical starting point. I cut from roughly four drinks a week to four drinks a month. That's an 80% reduction, not perfection. I made that shift not because someone told me to, but because when I looked at the evidence as a physician, not as someone who wanted to keep drinking, I couldn't unsee it. Practically speaking: * **Default to sparkling water with lime or bitters.** It sounds too simple. It works. Your hands are occupied, your glass looks social, and no one asks questions. * **Try quality mocktails.** The non-alcoholic beverage space has genuinely improved. Brands like Ghia, Seedlip, and Lyre's produce complex, satisfying drinks that don't taste like a punishment. Just watch the calories. * **Make your one drink count.** If you're going to drink, choose intentionally — something you actually love, with people you actually want to be with. Not out of habit or social anxiety. * **Delay the first drink.** At any gathering, wait an hour before ordering alcohol. You'll often find you don't want it as much as you thought you would. (I find that this happens to me a LOT.) * **Track it for two weeks.** Not to judge yourself — just to see clearly. Most of us are drinking more habitually than intentionally. Here's the cultural complication I want to acknowledge: alcohol is woven into almost everything we do as social adults. Celebrations, grief, first dates, book clubs, the Saturday night that actually _feels _like Saturday night. Telling women over 50 to simply "eliminate alcohol" without acknowledging that reality isn't medicine, it's judgment wearing a white coat. The goal isn't abstinence evangelism. It's an informed choice, which means you actually have to look at the information first, even when it's inconvenient and slightly painful. That part is non-negotiable. Everything after it is yours to decide.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/606327fb-537e-4781-aba2-0f0520d1809e/Comm-gym_1_with_handles.jpg?t=1773701580) Caption: You asked (genuinely, a lot of you asked), and I get why.  You've seen them in gyms, in influencer content, in wellness spaces that charge $40 a session to stand on one. (I have tried one in my gym, and honestly, the first time it made me laugh out loud just imagining how ridiculous I looked on that thing!)  The underlying question is always the same: _is this worth my money and my_ _time, or is it just another trend or fad that doesn't actually do anything?_ Let me give you the honest answer: **The science is more real than I expected.** Whole-body vibration (WBV) therapy has been studied legitimately, and the findings are nuanced in ways that actually matter for women over 50. Here's what holds up: * **Bone density:** Several randomized controlled trials show modest but measurable improvements in lumbar spine and hip bone density with consistent use. For post-menopausal women already concerned about osteoporosis, _this is not nothing._ * **Balance and fall prevention:** This is arguably the strongest evidence base. Vibration plate training improves neuromuscular coordination and postural stability, both of which decline with age and are directly tied to fall risk. * **Muscle activation:** It creates involuntary muscle contractions that can complement, not replace,  traditional strength training. Think of it as an add-on, not a shortcut, especially if you are squatting while vibrating. * **Circulation and lymphatic flow:** Plausible mechanisms exist, though the clinical evidence here is thinner. I wouldn't lead with this claim.   **What it won't do.** It will not spot-reduce fat. Nor will it replace resistance training or deliver the metabolic benefits of actually lifting weights. If someone is selling you a vibration plate as a passive weight loss solution, that's noise. Tune it out. **My actual take.** This lands in the "worth it if you'll use it" category… with a caveat. The research-backed benefits are real but modest, and they require consistency and correct usage (specific stances, frequencies, duration). A $50 under-desk model from Amazon is not the same as a clinical-grade plate. And if your budget has to choose between a vibration plate and a good strength training program? _Choose the program every time_.  But if you have access to a clinical-grade plate, you're already weight training, and you're thinking about bone health and balance (which I hope you are), then adding it to your routine is a reasonable, evidence-informed choice. Not magic. Not a scam. Somewhere in the useful middle, which is honestly where most good medicine lives. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cd306c11-176f-41c5-84d6-c38523300917/tuna_recipe_3_183.jpg?t=1773701722) Caption: ——————————————————————————— Seared Ahi Tuna Bowl Click the button below to download the print-friendly version! 838.58 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/790d73c7-eb8c-4b70-ad95-0fcbdc11ab82/RECIPE%20full%20page%20ahi%20tuna.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260318%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260318T110023Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=c96f43207cc7277317ce3461136979f07408c599c3c0221ad261ff701161891f ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: In my paid newsletter [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), I share the real-life things I’m wearing, eating, buying, loving, and truly swearing by — the kind of insider details I usually only share with close friends. 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Come join us inside **[The Wellness Experiment](https://www.joinajenda.com/experiment?utm_source=email-beehiiv&utm_medium=todays-ajenda&utm_campaign=evergreen&utm_content=button&utm_term=footer)**. It’s where strength training meets smart nutrition, real accountability, and a community of women aged 50, 60, 70+, doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/57651dd6-7db4-4793-861e-a6a608585d75/newsletter_red_heads2.jpg?t=1773701907) Caption: Forwarded this email? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/654a6f04-fb65-4145-9aa7-966c7941fe29/click_here_BUTTON.jpg?t=1742832491) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe?utm_source=todays-ajenda.beehiiv.com) Caption: I want to hear from you! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Caption: Miss last week’s issue? View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/cbfeb741-eb5f-42ce-8fc7-3193bb1a8f67/Read_it_here_BUTTON__2_.jpg?t=1745278785) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-103) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/484c3938-2af1-438f-a4de-138e8b3b5a68/newsletter_red_heads.jpg?t=1773701917) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ _*Note: This newsletter may include affiliate links. Sponsors may earn a commission if you purchase._ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-104

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/4ea2212f-70ff-44ca-a0fc-5f8f0caaae01/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762364753) Caption: ## Today's Ajenda: * [The Hidden Cost of “Just to Be Safe” Testing](#the-hidden-cost-of-just-to-be-safe-) * [Steady Energy for the Season Ahead](#steady-energy-for-the-season-ahead) * [Invitation: Smart Human Health Summit ](#invitation-smart-human-health-summi) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/20cc3450-629d-4165-9e4f-cc6dcfbcd412/_dose_The_Hidden_Cost_of__Just_to_Be_Safe__Testing_6.jpg?t=1773101119) Caption: ## **The Hidden Cost of “Just to Be Safe” Testing** I’m suddenly on the other side of the conveyor belt I know so well professionally — this time, as the patient. Recently, a large thyroid nodule was found incidentally, and now I’m staring down the familiar sequence: more imaging, more interpretation, biopsy discussions, the phrase “it may be nothing,” followed quickly by the implication that it also may _not_ be nothing. Here’s how it started. I recently switched to a new doctor, who also happens to be my husband’s physician. I made the change because I’ve been genuinely impressed with the care he’s given my husband (and trust me when I tell you my standards are HIGH). At my first visit, as part of getting established in the practice, he ordered a thyroid ultrasound. I had never had one before and, honestly, hadn’t thought much about my thyroid. I’ve never had symptoms that suggested a problem. During the scan, I could see the screen as the technician moved the probe across my neck. Years of looking at medical images have trained my eyes in a way that’s hard to turn off. And pretty quickly, something caught my attention. There it was: a large thyroid cyst, also called a nodule — _and it wasn’t subtle._ In that moment, I felt the quiet shift that so many patients experience: the realization that a routine check can suddenly open the door to a whole new set of questions. **And there’s a very specific kind of psychological whiplash that comes from going in search of reassurance — and instead being handed uncertainty**. This is the part of modern medicine we do not talk about enough. We love the language of “proactive”; we praise vigilance; we celebrate early detection as if more information is always _better_ information, and more testing is always better care. Sometimes that is true, and sometimes it is lifesaving. But sometimes what starts as a non-standard scan, a “just to check,” or a body-peeking expedition uncovers an incidental finding that is real enough to demand follow-up, but ambiguous enough to disrupt your peace, your sleep, your concentration, and frankly, your identity. That gray zone is expensive, not only financially, but _psychologically._ Let me be very clear: I am not anti-testing or anti-imaging, and I am certainly not anti-medicine. I am deeply pro-evidence, pro-good judgment, and pro-using the right test for the right patient at the right time. My motto is: don’t do a test unless you know what you will do with the RESULTS of that test. But I am also increasingly aware of the hidden cost of testing that is not truly standard, not clearly indicated, or marketed more as emotional insurance than sound medical strategy. Because here is what can happen: You feel fine, then you get a ‘procedural’ test, something is seen (which it often is), now you are no longer “fine.” Not because you are necessarily sick, but because you have now entered a new category: person under evaluation. **That is not a small shift.** A thyroid nodule is actually a perfect example of this. Thyroid nodules are common, very common, and most are benign. Although many are found accidentally, once they are discovered, they often trigger a cascade of ultrasounds, recommendations, measurements, surveillance, sometimes biopsies, and an unavoidable question hanging in the air: _could this be cancer?_ Even when the statistical odds remain reassuring, the emotional experience is anything but.  In my case, several features are suspicious for malignancy: its size, appearance, and shape. Last week, I had an FNA (fine needle aspiration) with four relatively painless needle aspirations of this nodule, and now I await the results. The endocrinologist did not love the way it looked, and because I understand the correlation between ultrasound characteristics and malignancy risk, I am trying to prepare myself for whatever the pathology report may show.  But this is where I think the conversation needs to get more sophisticated. We tend to talk about testing in binary terms: good or bad, responsible or neglectful, early detection or dangerous avoidance._ Real life is messier. _Some tests save lives, some tests create noise. Some findings matter urgently, some create months of medical theater before ultimately meaning very little. And some findings fall into that maddening middle where follow-up is reasonable, but **the psychological toll starts long before the pathology report does. ** It’s the late-night Googling, the sudden awareness of your body and your mortality. It is the bizarre emotional speed with which the brain can go from “routine” to “what if this is the beginning of something terrible?” And the part that’s worth sitting with is the loss of innocence that comes from becoming a patient, even temporarily. Because one of the hidden costs of incidental findings is that **they can change the way you relate to your own body**. A body that felt familiar and trustworthy on Monday can feel suspect by Wednesday. You start listening, interpreting, and watching differently. And that shift, even before any diagnosis, is real, powerful, and sometimes all-consuming. Sometimes the most medically intelligent question is not “what else can we scan?” but rather “was this test truly necessary in the first place, and if it reveals something incidental, am I prepared for the emotional and medical cascade that may follow?” That is not fear-mongering. That is informed consent. And frankly, I think we deserve a lot more of it. So this is where I am landing, at least for now: more testing is not automatically better care, more detection is not automatically better health, and more information is not automatically more wisdom. Sometimes, additional testing can detect something dangerous before it produces symptoms or causes harm, and only time will tell if that will ultimately be my story. For now, I’m staying anchored in the grounding practices that help steady me. This experience has changed me in ways I am still processing, but it has also sharpened my gratitude for every moment and experience I get to have. I’m not perfect at it, and I still feel the pull toward rabbit holes and overwhelming worst-case-scenario thinking, but I am trying, as intentionally as I can, to focus on joy and strength rather than fear of the uncertain. (With the understanding that doctors tend to swing from overt denial to full-blown emergency mode)! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/23d4c5a4-1f6b-430b-8589-e890b9be9fe5/SS_pique_7.jpg?t=1773189148) Caption: I can feel spring knocking at the door, and I am so ready! The days are getting a little longer, and a quiet momentum is building excitement for the summer of ‘26. This transition is a perfect time to focus on **small rituals that support steady energy** and grounded clarity rather than **overstimulation**. Spring is a season of transition, and transitions often call for habits that feel supportive and sustainable. Spring is also a season when many people return to more consistent movement routines or increase their workouts, and having energy that feels clean and balanced can make those efforts feel more sustainable. **Energy that feels steady** matters whether you are tackling a morning strength session, a brisk walk, or simply staying focused through a busy day. Coffee works well for many people, but it can sometimes cause spikes and crashes, or a jittery edge that does not pair well with exercise. This is where I turn to matcha tea, which offers a different approach to energizing the body. (Plus, I really get a powerful reaction to its green color, which is synonymous with health…for me!)  **What gives matcha its clean energy: ** Matcha is a finely ground powder made from specially grown green tea leaves. Unlike regular green tea, where the leaves are steeped and then discarded, matcha involves consuming the entire leaf in powdered form. **That means you get a more concentrated dose of nutrients and antioxidants **compared to traditional brewed tea. Matcha has become popular worldwide as a daily beverage and ingredient in smoothies, lattes, and baked goods. Because you consume the powdered leaves rather than an infusion, matcha contains higher levels of certain compounds, including catechins like **EGCG**, which are studied for their **antioxidant properties**.  **Matcha for post-workout recovery: ** Uniquely, the tea plants used for matcha are typically shaded for several weeks before harvest. This shading process **increases chlorophyll** levels and boosts amino acid production, **including ****L-theanine**, which promotes calm focus and sustained alertness. This synergy allows you to feel awake and energized without the sharp highs and lows that can interfere with concentration or post-workout recovery. According to analysis from Harvard Health Publishing, [the combination of caffeine and L-theanine may encourage a gentler form of stimulation that supports mental clarity](https://pubmed.ncbi.nlm.nih.gov/21040626/), which can be helpful when you are preparing for movement or tackling challenging tasks. **Matcha and your metabolic health: ** Spring is also a time when many people think about metabolic health and **cellular renewal**. Matcha is **rich in antioxidants** called catechins, including **EGCG**, which are [studied for their role in supporting oxidative balance](https://pmc.ncbi.nlm.nih.gov/articles/PMC12348855/?utm_source=chatgpt.com). While no single beverage is a substitute for medical care or a comprehensive nutrition plan, antioxidant-rich foods and drinks complement a lifestyle that prioritizes resilience. They work alongside hydration, movement, and adequate sleep to support the body’s natural ability to adapt and recover.  That recovery piece matters for workouts as well. Exercise works by creating beneficial stress on the body, and proper recovery allows muscles to rebuild and grow stronger. A beverage that provides steady energy without excessive stimulation can fit neatly into that recovery cycle. One ritual that aligns with this approach is [_**Sun Goddess Matcha from Pique Tea**_](https://www.piquelife.com/JENNIFERASHTON?q=subs-collection)__***.**___** **_I have one every single day, and it now occupies a different ritual in my day than my early-morning coffee. This matcha is ceremonial-grade and organic, crafted using traditional stone-grinding methods that preserve the tea's vibrant green color and nutrient profile. These qualities make it **a supportive option for morning routines, pre-workout energy, or an afternoon reset** when you want focus, without overstimulation. **Should you make the switch? ** I view matcha as a simple tool for clean, steady energy that can complement an active lifestyle. It is not a replacement for medical care or personalized nutrition guidance, and it does not solve every symptom or challenge. But it can support workouts by providing sustained alertness and hydration-friendly energy, and it can support daily life by offering a moment of calm focus. There is something centering about preparing a cup, whisking the powder into a smooth, bright green liquid, and taking a brief pause before the day begins or a workout session starts. It is a small ritual that honors both the science of nutrition and the human need for moments of presence and care. While Spring invites forward movement, it also invites intention. Choosing habits that support the nervous system and provide sustainable energy can make this season feel more balanced and manageable. Movement, nutrition, and recovery work together to build strength and vitality, and Pique’s Sun Goddess Matcha is a practical daily addition with many benefits for everyday wellness that meets you where you are and helps you move forward with clarity and resilience. **To celebrate the shift into spring, Pique is offering Ajenda subscribers a special, limited-time seasonal offer: up to 20% off + free gifts! ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9865d1af-59a5-4257-a25e-76ffb3270051/image.jpeg?t=1773101187) Follow image link: (https://www.piquelife.com/JENNIFERASHTON?q=subs-collection) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fccfaedb-9a1e-449d-a270-717b7a675466/Comm-summit4.jpg?t=1773101561) Caption: If you’re interested in a deep, evidence-based conversation about women’s health right now, I wanted to share an event I’ll be part of next month. On **April 25, 2026**, I’ll be speaking at the **Smart Human Health Summit 2026**, a full-day integrative women’s health conference taking place **in person in Princeton, New Jersey, and virtually** for those joining from elsewhere. The focus this year is **women’s health across the lifespan** — and the goal is simple: bring together physicians and experts who are doing meaningful work in this space and create room for the thoughtful, science-driven conversations women deserve to hear. **What I’ll be discussing** My session will focus on **menopause and hormone therapy**, a topic that continues to generate a lot of questions and confusion for many women.Specifically, I’ll be covering: * What the **current evidence actually tells us about hormone replacement therapy (HRT)** * Why the conversation around menopause treatment **became so complicated over the past two decades** * Who may benefit from hormone therapy, who may not, and **how physicians think about risk versus benefit** * The broader health implications of menopause — including **bone health, cardiovascular health, and sleep** My goal is always the same: to help women understand the science well enough to make **informed, confident decisions about their own health**. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b556978e-f406-436c-a669-68f9937e583d/image.png?t=1773101501) Caption: The summit is hosted by **Dr. ****Aly Cohen**, who wrote the book DETOXIFY, and the speaker lineup includes [an exceptional group of experts](https://thesmarthuman.learnworlds.com/course/summit-2026#:~:text=Academy%202026%20Summit-,SPEAKERS,-Click%20on%20each), including: * **Tieraona Low Dog** on integrative and herbal medicine * **Gayatri Devi** on Alzheimer’s and dementia in women * **Adi Benito-Herrero** on thyroid disease and Hashimoto’s * **Vivian Kominos** on women’s heart health * **Ashley Koff** on weight management and GLP-1 medications There will also be a panel discussion on the **current state of women’s healthcare**, featuring OB-GYNs **Maria Sophocles** and **Christopher Naraine**, moderated by health journalist **Meghan Rabbitt** and author **Deborah Copaken**. The summit is designed for **both healthcare professionals and anyone who wants a deeper understanding of women’s health**, with expert presentations, panel discussions, and opportunities for questions and conversation. If this is a topic that interests you, you can **learn more about attending the event and register here**. Whether you attend in person or virtually, it should be a thoughtful and informative day focused entirely on women’s health, and I’d love to fill the room with incredible ‘Ajenders’ like you!  Space is limited, especially for in-person attendance. We encourage you to register soon to secure your spot. I would love to see you there! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1e7a2701-9f76-41c7-89ee-e41639c8ca23/image.jpeg?t=1773101500) Follow image link: (https://thesmarthuman.learnworlds.com/course/summit-2026#:~:text=Academy%202026%20Summit-,SPEAKERS,-Click%20on%20each) Caption: Use code **TSH10 **for 10% off View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/9bb2f123-675a-4786-8e13-380f2e28ba4b/quinoa_recipe_3_10_pdf___2_.jpg?t=1773189075) Caption: ——————————————————————————— Mexican Quinoa Salad Click the button below to download the print-friendly recipe! 990.92 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/f74cc899-ad7c-40e3-a398-050c78adf90f/Today%27s%20Ajenda%20Mexican%20Quinoa%20Salad%20Recipe.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260311%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260311T110011Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=fe0e2789d74883b99fdd04d2a73780963fadc2d05323264ccc20bf2a236253ec ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### ABOUT DR. JEN View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986178) Follow image link: (https://www.joinajenda.com/about) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OBGYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/today-s-ajenda-102) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/today-s-ajenda-103

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/55fea009-b7b4-45ae-8493-60ddc3e90fb2/womens_community_4pst.jpg?t=1772415317) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=banner) Caption: When was the last time you felt genuinely strong? Not _“fine for your age.”_ Not “_doing your best.”_ I mean, steady on your feet, supported in your joints, able to lift, carry, move, and wake up with energy that felt reliable rather than fragile. If you’re struggling to remember, you’re not alone. I’ve been there. But here’s the shift I need you to make: **aging well doesn’t have to be a struggle. ** ### **THE REAL PROBLEM**  Most fitness and nutrition programs were built around male physiology and male hormone patterns. Then they were handed to women with completely different biological realities and life demands.  Layer on perimenopause, menopause, packed schedules, aging parents, growing children, careers, and the constant noise of conflicting advice online, and it becomes very easy to assume that _you _are the problem.  **And I get it… ** You feel like you’ve been here before, starting a program only to burn out weeks later. You’ve tried the diets and the fads and watched the scale barely move, and followed guides designed for a 30-year-old man and wondered why your 55-year-old body didn't respond the way you were promised it would. Then, at some point, **you decided that this is just what getting older feels like.** I've heard it from thousands of women, _and _**I've lived it myself.**** **But last year, I decided to change the trajectory and to **age my way**.  ### **I RAN AN EXPERIMENT** Exactly one year ago, I didn’t know if this would become what it is today. I just knew I wanted to test something on myself first. I wanted to see what would happen if I trained differently. If I aligned my nutrition with science instead of trends or extremes. If I treated my health like a medical experiment and not a 30-day challenge. So I partnered with [Korey](https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=korey). We documented the workouts, the nutrition, the data, the setbacks, and the results with the same rigor I would apply to any medical question. What happened over the next 6 months changed more than my body composition: * I became **measurably stronger** * My **biometrics shifted** in meaningful ways * My **energy stabilized** * My relationship with my body moved from criticism to **collaboration** * I started to treat food as a **longevity plan** I was no longer chasing a smaller version of myself, or the body I had at 30.** I was building a stronger, more resilient one at 55.** When I shared that process, women did not ask how much weight I lost. They asked how I built strength, how my bone density improved, how my skin started glowing, how my energy returned, and whether it was possible for them, too. **That question is what brings thousands of women together tonight to celebrate the 1-year anniversary of **[**The Wellness Experiment**](https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight)**. ** ### **WHAT THE WELLNESS EXPERIMENT IS** This is not a quick fix, a detox, or a challenge you white-knuckle for eight weeks then abandon. It is a physician-designed, trainer-led, science-backed strength and nutrition system built specifically for women over forty who want **durability, stability, and longevity**. ### WHAT YOU GET  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/609881a5-b18f-404e-8be3-33d70afcd31b/womens_community_3_rex_quad_nutrition_spelled_right_.jpg?t=1772383607) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight) Caption: **But you’re not doing this alone… ** You’re stepping into a safe space where women are sharing that they showed up for a workout they did not feel like doing, that they increased their weights for the first time in years, that their energy is steadier, that their sleep is improving, and that their confidence is quietly returning. You will see someone celebrating her first push-up and someone else celebrating a thirty-five-pound weight loss, and both are met with the same response: **encouragement, respect, and genuine excitement.** And perhaps most powerful of all, there is consistency. When you surround yourself with women who are logging in, lifting weights, asking thoughtful questions during live sessions, and recommitting even when life gets messy, something shifts. Motivation stops being something you have to manufacture on your own and becomes something you absorb. ### **Plus, there’s my favorite part: Weekly LIVE ZOOM calls with Korey and me! ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c729c79f-b084-4728-a56b-6a718b3b88f5/weekly_zooms_4-63.jpg?t=1772373483) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight) Caption: Imagine the difference when you have a board-certified physician and an elite trainer **answering your questions in real time**. Plus, a tribe of pro-aging women who have your back, judgment-free. No more wondering, no more excuses, no more lack of motivation — just inspiration and momentum! At** **[**less than $1 a day**](https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=inline&utm_term=korey), I priced this to be accessible while still requiring commitment, because transformation requires participation. SAY YES TO THE EXPERIMENT 20% off with code: ONEYEAR (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=button) **JOIN US TONIGHT: Our one-year anniversary celebration is happening live on ZOOM**!!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c61424b8-d929-4439-9483-80bf895c2101/womens_community_4pst2.jpg?t=1772415366) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight) Caption: I want you to see what’s possible when you say YES to the Experiment. In this room, you will hear women share what has changed for them over two months, six months, or a year. Not just weight, but strength, numbers, balance improvements, confidence shifts, and measurable health markers. If you have been waiting for the right time, **this is the moment** to stop observing and start participating. You need a set of dumbbells, a mat, and a decision on how you want aging to look on you. Lock in your membership, join us tonight on ZOOM, and [begin the Experiment](https://www.joinajenda.com/experiment). **Your strongest self is not behind you**; she is built deliberately, one supported week at a time. See you inside, Dr. Jen SAY YES TO THE EXPERIMENT 20% off with code: ONEYEAR (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=button) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fe0043ff-d92f-4fcd-aaec-59f5d387a7ed/banners_for_NL_4.jpg?t=1772318719) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5a8d9a49-7220-4332-bbc5-1b5ef6dce7ac/image.png?t=1772303944) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=becky) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/46242f9a-5f81-4653-9603-a24a87d0ecfb/1.jpg?t=1772374333) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=testimonial) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/76a4335c-66ce-44c2-b224-6d4a67c81d07/image.png?t=1772304002) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=testimonial-kendra) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/091d25d1-015b-48fe-8ee6-c7c5a150f706/2.jpg?t=1772374350) Follow image link: (https://V&utm_term==testimonial) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/bf20324e-5a8d-4b8d-bc20-6807d52e44cb/image.png?t=1772304009) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d57ff466-dca1-4fa7-97ed-e292b14b0e7d/for_promo_20_.jpg?t=1772304041) Follow image link: (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight) Caption: _Discount code:_**_ONEYEAR_** LEARN MORE ABOUT THE WELLNESS EXPERIMENT (https://www.joinajenda.com/experiment?utm_source=Email-Beehiiv&utm_medium=Promo&utm_campaign=HMS&utm_content=see-you-tonight&utm_term=button) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986179) Caption: ### ABOUT DR. JEN In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton, ”Dr. Jen”**, has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/see-you-tonight

---------- View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: ----------_Thousands of new friends are joining us this week! Sending a big, heartfelt welcome to all of you! A quick reminder: you can catch up on past issues, share this newsletter with a friend, and even join our insiders list, Off Duty. Links are at the bottom of this email. Now, let’s get into it. We’ve got a lot to cover!_ ## Today's Ajenda: * [Statins Reduce Inflammation?](#statins-reduce-inflammation) * [Tackling the #1 Killer of Women](#tackling-the-1-killer-of-women) * [Your FRAX® Score And Why It Matters](#your-frax-score-and-why-it-matters) * [My Winter Metabolism Hack](#my-winter-metabolism-hack) * [Recipe: Nutty Banana Oat Bowl ](#recipe-nutty-banana-oat-bowl) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/99342234-c78b-4703-8df3-661e5816bcf3/image.jpeg?t=1771980576) Caption: If you’re a woman over 50, you’ve probably had this moment: your cholesterol panel pops up in your patient portal, your LDL is “borderline,” or maybe around 120, and suddenly you’re staring down the Statin question like it’s a referendum on your lifestyle choices. The problem is, we’ve all been trained to talk about statins as if they’re _just_ cholesterol-lowering medications. That’s the _noise_. **The **_**science signal**_** is this: **statins are also anti-inflammatory drugs in the way that matters most for midlife women, meaning inflammation inside the blood vessel wall that drives plaque, rupture, heart attack, and stroke. And the menopause transition is a perfect storm for this because cardiometabolic risk shifts quickly, even when your habits haven’t changed. As estrogen levels drop around menopause, systemic inflammation rises, and that can affect everything from your joints to your arteries. #### **North Star lens: risk is a story, not a single lab value** One of the biggest decision-fatigue traps in women’s health is being asked to make a major medication decision based on one number (LDL) in one moment of time (a single lab draw). **A better North Star approach is pattern recognition**: _What is your overall trajectory?_ Family history, blood pressure, A1c or fasting glucose, waist circumference, sleep, exercise capacity, smoking history, pregnancy history (preeclampsia, gestational diabetes), and inflammatory markers like hs-CRP…these all belong in the conversation. That’s exactly why the JUPITER trial matters. #### **The JUPITER trial: the “inflammation” statin trial hiding in plain sight** [JUPITER](https://www.jacc.org/doi/abs/10.1016/j.jacc.2010.09.082) (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) studied people who **did** **not** have high LDL by traditional standards (LDL <130 mg/dL) **but did** have elevated inflammation (hs-CRP ≥2 mg/L). Rosuvastatin 20 mg significantly reduced major cardiovascular events, with a similar relative risk reduction in women and men.  **That’s the headline for women**: you can have “meh” cholesterol and still have meaningful vascular risk if inflammation and overall risk context are pointing in the wrong direction. JUPITER helped normalize a more modern frame: statins don’t just lower LDL, they lower risk. #### **Statins as anti-inflammatory agents: the underappreciated benefit** Statins reduce inflammatory signaling and markers like CRP, and this effect is not always tightly linked to the amount of LDL reduction. A 2024 review of lipid-lowering therapies reported that statins significantly reduce CRP concentrations, supporting the idea that the benefit profile is not “cholesterol only.” A[ 2025 ACC scientific statement ](https://www.sciencedirect.com/science/article/pii/S0735109725075552)on inflammation and cardiovascular disease also highlights that some of the earliest evidence linking inflammation to improved outcomes came from statin trials showing reduced inflammation alongside reduced events.  This matters for women over 50 because our risk often shows up as a cluster: rising blood pressure, creeping insulin resistance, visceral fat gain, sleep disruption, and a subtle uptick in inflammatory tone. If your North Star is “reduce my chances of being the woman who has her first symptom as a heart attack,” inflammation belongs in your plan. #### **The diabetes question: yes, the risk is real, and yes, context matters** Here’s the con that deserves grown-up attention: statins cause a **moderate, dose-dependent increase in new diagnoses of type 2 diabetes**, largely reflecting a small upward shift in blood sugar. A major [2024 meta-analysis](https://www.sciencedirect.com/science/article/pii/S2213858724000408?) in _The Lancet Diabetes & Endocrinology_ quantified this effect and reinforced that it’s real and dose-related, meaning the higher the dose of statin, the higher the risk of elevated blood sugar levels/ diabetes. #### **What to do with this info: ** Think like a doctor: don’t throw out a cardiovascular risk-reducer because it nudges glucose in a predictable subset. Instead, identify who is most vulnerable (prediabetes, metabolic syndrome, higher baseline A1c, central adiposity) and monitor intentionally. If you start a statin and your A1c rises, that’s not a moral failure. It’s a physiologic signal to tighten the basics: protein-forward meals, resistance training and cardio exercise, sleep, and maybe medication adjustments if needed. #### **Muscle pain: the myth, the reality, and the nocebo effect** This is where fear has wildly outpaced data. Randomized, blinded trials show that **most muscle symptoms reported on statins are not actually caused by the statin**. In a large individual-participant meta-analysis, statin therapy caused only a small excess of mostly mild muscle pain, and **more than 90%** of reported muscle symptoms in people assigned to statins were not due to the drug.  Even more recently, a 2024 [meta-analysis](https://www.thelancet.com/article/s0140-6736(22)01545-8/fulltext?) of double-blinded RCTs found **no meaningful difference** in reported muscle symptoms between statin and placebo groups across tens of thousands of participants. And in February 2026, a large _Lancet_ [analysis](https://pubmed.ncbi.nlm.nih.gov/41655587/) of adverse effects attributed to statins concluded that most label-listed side effects are not supported by blinded randomized trial data (only a small number showed any association, and the risks were small).  Practical translation: if you get muscle symptoms, we take you seriously, we check for other contributors (thyroid, vitamin D, training changes, drug interactions), and we problem-solve (dose, timing, switching statins, alternate-day dosing). But we don’t let misinformation make the decision for us. #### **So, should a woman over 50 take a statin?** The honest answer is, many absolutely should, some absolutely shouldn’t, and a lot are in the “let’s personalize this” middle.  What I want women to _stop_ doing is using cholesterol alone as the decision-maker. (Also, this is where a CAC CT scan is key.) A Coronary artery calcium CT scan to see if plaques in the coronary arteries have calcified, reflecting Stage 4 Atherosclerosis. Newer ultra-fast, ultra-low dose CT scans can detect Stages 1-3 Atherosclerosis even BEFORE calcification occurs. **Your North Star is in the outcomes: ** * Fewer heart attacks * Fewer strokes * A lower chance of you becoming another heart disease statistic * More good years.  Statins can be a powerful tool toward that goal, partly because of their LDL-lowering effects and partly because vascular inflammation is a target, whether we admit it or not. Sometimes a drug can be preventative, rather than therapeutic, and we are starting to see statins slide into this role. And yes, _I know_, adding a daily medication can feel like crossing a line. But sometimes the most feminist, self-respecting thing you can do at 55 is prevent the crisis you never saw coming. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3b713f47-f7f7-46bc-8f1c-2699a0392b17/image.jpeg?t=1771980744) Caption: This week, I appeared on The View to talk about two topics that directly affect us all: heart disease and hormones. I am the daughter of a cardiologist, and thus, an interest in and awareness of cardiovascular disease is literally in my blood. **Here’s a fact I need you to know: one in three women will die of heart disease. ** I want you to really sit with that for a second, because most women I talk to have absolutely no idea that is the reality. **Heart disease is our biggest risk.** Not breast cancer. Not a stroke. Heart disease is the number one killer of women in this country, accounting for roughly one death every 80 seconds. And yet it remains one of the most underfunded, underdiagnosed, and undertreated conditions in women's health. As an OBGYN, I’ve always believed that some of the most important windows into a woman’s long-term health happen in those exam rooms. Pregnancy complications, menopause symptoms, and blood pressure changes are not isolated events. They are clues to disease states and _opportunities to improve health. _But too often there’s a big gap: cardiologists don’t understand OBGYN conditions, and OBGYNs often don’t know how best to screen for heart disease. That gap has always bothered me, which is why I am so proud to share that my husband, Tom, and I have joined a new initiative specifically aimed at closing it through continued education and better access to cardiovascular care for women by including their OBGYNs. This work feels deeply personal to me, and I want to bring you along for it. So let's talk about what is actually going on, because the conversation around women and heart disease is far more nuanced than most people realize. #### **Why Women Are Different (and Why That Matters)** For decades, cardiovascular research was almost exclusively conducted on men. The symptoms we learned to recognize, the treatments that were developed, the risk thresholds that were established, all of it was built around the male body. Women often present differently. We are far more likely to experience atypical symptoms like jaw pain, nausea, back pain, or profound fatigue rather than the dramatic chest-clutching image we have all seen on television. Because of that, women get missed. We get sent home from emergency rooms. We get told it is anxiety. We are underscreened, under tested, undertreated, and understudied. The consequences of that are fatal. What changes after menopause is significant, too. Before menopause, women actually have a lower risk of cardiovascular disease than age-matched men. Estrogen appears to play a genuinely cardioprotective role, supporting healthy cholesterol levels, insulin sensitivity, and arterial function. Once estrogen drops, that protective advantage disappears, and CVD risk climbs sharply. This is not a coincidence. #### **The HRT Conversation We Need to Have** I want to talk about [hormone replacement therapy](https://www.joinajenda.com/article/7-little-known-facts-about-hormone-replacement-therapy-hrt) (HRT) here, because the research is nuanced, the history is complicated, and too many women are making decisions based on fear rather than facts. Most of the confusion traces back to 2002 and the Women's Health Initiative study, which for years led both doctors and patients to believe that HRT was dangerous for the heart. What we _now_ understand is that the timing of when HRT is initiated matters enormously. The Women’s Health Initiative enrolled women with an average age of 63, many of whom already had subclinical cardiovascular disease. [When researchers went back and looked ](https://pmc.ncbi.nlm.nih.gov/articles/PMC3107840/#:~:text=WOMEN'S%20HEALTH%20INITIATIVE%20FINDINGS%20AND,hormone%20treatment%20in%20clinical%20practice.)specifically at women who started HRT closer to menopause, the picture looked very different. In other words, the risks involved for a woman of 46 or 50 are much different than the risks involved for a woman of 63 or 70. [A large meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9178928/) showed that women who initiated HRT before age 60, or within 10 years of menopause onset, had a statistically significant 32% reduction in coronary heart disease events and meaningful reductions in all-cause mortality compared to placebo. This is what researchers now call the "window of opportunity," and[ another landmark analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC3046231/) confirms that the earlier you act within that window, the more pronounced the benefit. The data is consistent across both randomized controlled trials and observational studies. Then there is the question of how HRT is delivered, and this is where things get really important for the decisions you are making with your doctor. A[ major 2024 Swedish study published in the BMJ](https://pubmed.ncbi.nlm.nih.gov/39603704/), drawing on data from over 900,000 women, found that transdermal forms of estrogen (meaning patches, gels, and creams) did not carry the same cardiovascular risks as certain oral combined hormone therapies, which were associated with a modestly increased risk of ischemic heart disease. Transdermal estrogen showed no clear increase in any cardiovascular outcomes, and in fact suggested a borderline _reduction _in both heart attack and composite CVD risk. That is a meaningful distinction and one that is not making its way into enough conversations between women and their doctors. (The lowered heart risk is likely a result of the fact that when a hormone is delivered through the skin, metabolism by the liver is bypassed, which LOWERS the risk of clotting that is seen with all hormonal formulations- including birth control pills.)  _None of this is a blanket endorsement of HRT for everyone._ Route of administration, type of progestogen, dosage, timing, and your individual health history all factor in. This is not a one-size-fits-all conversation, which is exactly why you need to be having it directly with your physician rather than relying on what you heard from a friend or read online from a menopause influencer.  But I do want you to walk into that appointment informed, because the science is moving in a direction that is far more favorable than the fear-based messaging of the early 2000s suggested. #### **What You Can Do Right Now** Whether or not HRT is right for you, there are foundational habits that move the needle on cardiovascular health significantly, and they are things you have control over starting today. Remember: 80% of heart disease can be prevented with behavioral modification. The key is knowing what to modify!  1. **Know your numbers**. Blood pressure, fasting blood sugar, and a full cholesterol panel, including LDL, HDL, and ideally lipoprotein(a), which is sometimes called the heart's quiet killer and is significantly underscreened in women. Knowing cholesterol particle size is also important and is really just beginning to be considered in risk assessment. These are not just numbers on a lab report. They are your early warning system. 2. **Move your body consistently**. Resistance training in particular is one of the most underutilized tools for cardiovascular health in women (and it is something we work on directly inside The Wellness Experiment.) Aerobic exercise is needed too; it’s not either / or. 3. **Prioritize sleep and manage chronic stress**. Inflammation is a very real cardiovascular risk factor that does not get nearly enough attention in women's health conversations. Sleep helps reduce inflammation, as do prescription medications like statins and GLP-1’s. More on this in next week’s newsletter! 4. **Eat in a way that supports metabolic health**. Blood sugar stability, adequate protein, fiber-rich meals, all of it feeds back into your heart health in ways that compound over time. And please, **advocate for yourself at every single appointment**. Ask about your cardiovascular risk. Push for a full workup. Ask if you can get a CAC CT scan to check for calcium deposits in your coronary arteries. Do not accept "you're fine" without the data to back it up. This is the work. And this is exactly why Tom and I said yes to supporting this initiative. I believe deeply in continued education, not just for myself but for our entire field. Medicine evolves, science evolves, and if we are not actively learning, we are falling behind for the women we are here to serve.  This initiative is rooted in that commitment to staying current, connecting specialties, and ensuring that OBGYNs and Cardiologists are equipped with the most up-to-date cardiovascular and menopause knowledge so we can identify risk earlier, intervene sooner, and ultimately save lives and truly change the trajectory we’re on. In short, if we reach women sooner and connect these dots sooner, we can prevent heart disease, and improve, _and save _lives.  This is the work that keeps me thinking at night and gets me up in the morning. And I’m so grateful to have you here for it! More to come, but I hope this is a starting point for a conversation you carry into your next doctor's visit. From my heart to yours, thank you.  Xx View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7537758c-f195-496f-bf34-89cf7ea20af6/Jen_signature_3__3%2B_.jpg?t=1771982635) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d2cd634a-d059-457f-806d-e44aaac6b239/image.jpeg?t=1772004730) Caption: If you’ve ever had a bone density scan — the DXA that gives you a T-score — you may have walked away with two questions: _Is this “bad,” and what do I actually do about it?_ The truth is, **the T-score is just one piece of the story**. For women over 50, understanding _your FRAX® score_ — that ten-year fracture risk calculator — can be far more meaningful than obsessing over yet another number. Let’s talk about what it is, why it matters, and how it helps you take action. #### **The problem with measuring bone density alone** A DXA scan measures bone mineral density (BMD) and compares it to a healthy young adult reference population. A **T-score ≤ –2.5 defines osteoporosis**, and between **–1.0 and –2.5 defines osteopenia (low bone mass)**, [according to the World Health Organization](https://iris.who.int/bitstream/handle/10665/39142/WHO_TRS_843.pdf?sequence=1) diagnostic criteria. But here’s the catch: **bone density alone does not capture true fracture risk**. Most fragility fractures occur in people with osteopenia, rather than osteoporosis, because that population is much larger. And once you start treatment, the [T-score becomes less useful](https://pubmed.ncbi.nlm.nih.gov/25182228/) in isolation to assess ongoing risk. That’s where FRAX® comes in.  #### **What exactly is a FRAX® score?** FRAX® stands for _Fracture Risk Assessment Tool_. It was developed by researchers at the University of Sheffield, UK in 2008 and calibrated using outcomes data from large international cohorts. It estimates your 10-year probability of breaking a bone — specifically, a hip fracture or another major osteoporotic fracture (like a spine, forearm, or shoulder break).  Rather than telling you how “bad” your bones are, FRAX® tells you how _likely_ it is you’ll end up with a fracture over the next decade based on: ✔ age, weight, and height ✔ history of fractures ✔ parental hip fracture ✔ smoking status ✔ glucocorticoid (steroid) use ✔ rheumatoid arthritis ✔ other risk factors such as alcohol use or certain medical conditions …and it can include your hip bone density from DXA if available to improve accuracy.  That’s what makes FRAX® so powerful: it’s not just _bone strength_. It’s _contextual bone risk_. #### **So why does FRAX® matter?** If knowing your FRAX® score feels like getting assigned a prognosis, that’s because it helps you see the forest instead of the trees. Instead of treating a number on a scan, you’re assessing your _overall fracture probability_. This has three practical implications: 1. It **identifies women who might benefit **from treatment even without osteoporosis-level T-scores. Most fragility fractures occur in women with osteopenia, not full-blown osteoporosis. FRAX® helps catch that.  2. It **guides treatment decisions**. U.S. consensus guidelines often recommend considering medication if your 10-year risk of major osteoporotic fracture is ≥20% or your hip fracture risk is ≥3%.  3. It gives you **a conversation starter **with your clinician, not a prescription slip. Whether you decide to address bone health with medication, lifestyle changes, or both, FRAX® lets you personalize your plan. In other words, the FRAX® tool can be used to guide treatment decisions in people who meet the following three conditions: 1. Postmenopausal women or men age 50 and older 2. People with low bone density (osteopenia) 3. People who have not taken an osteoporosis medicine #### **What the numbers mean (in plain speak)** Let’s imagine two women of the same age and DEXA T-score. One has a history of wrist fracture and a parent who broke a hip; the other doesn’t. Their bone density alone might look the same, but their fracture risk — as captured by FRAX® — will be very different. That’s because FRAX® integrates _clinical risk factors_ with bone density, giving a more complete picture.  A higher FRAX® score doesn’t mean you _will_ fracture a bone. It means your _probability_ of doing so over the next decade is higher than that of someone with a lower score. And that probability is not fixed — it’s modifiable with targeted interventions. #### **Action over anxiety** If your FRAX® score is elevated, it doesn’t mean resignation. It means opportunity. Here’s why: * You can strengthen bones with the right treatment plan. * You can improve balance and reduce fall risk with exercise and physical therapy. * You can optimize nutrition, vitamin D, and calcium intelligently. * You can engage with medications when appropriate in a way that aligns with your values and risk profile. FRAX® doesn’t tell you to _be afraid_. It tells you to _act with information_. #### **Personalizing risk, not generalizing fear** Your bones don’t live in a vacuum, and neither should your fracture prevention strategy. The FRAX® score gives you a personalized 10-year risk estimate that accounts for your clinical history and lifestyle, not just a snapshot of bone mineral density. In doing so, it helps you and your doctor make informed decisions about therapy and prevention.  And for women over 50, whose fracture risk accelerates after menopause, it’s one of the most actionable tools we’ve got. **Keep it in your toolkit**. Not as a verdict, but as a guide toward stronger bones and fewer surprises down the road.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/23c10e89-e02c-47b1-a88f-482ebba3bb1f/image.jpeg?t=1771980948) Caption: The recent ‘snowpocalypse’ on much of the East Coast reminded me of what happens every winter: my energy dips, I move a little less, and I start craving cozy, comfort foods. In the past, I’d sometimes ‘cave’ and satisfy my cravings whenever they arose while telling myself I’d deal with it in the spring. **But now I do things differently, **supporting my metabolism through winter with structure and intermittent fasting while still prioritizing protein and strength training during my eating window.  Done thoughtfully, intermittent fasting (IF) can improve insulin sensitivity and lower inflammation (which is exactly why the first week of [The Wellness Experiment](https://www.joinajenda.com/experiment) includes [autophagy](https://www.joinajenda.com/article/i-did-a-32-hour-broth-fast-heres-what-happened) and curated recipes). Instead of waiting to “fix” things later, during the Winter I lean into small, consistent habits now so Spring feels like a continuation and not a correction. While there is interesting data that makes the question of whether or not women do well with IF a bit murky, let me be clear: there is no right or wrong answer here. If IF works for you, do it. If it doesn’t, don’t do it. Personally, I cycle through periods when I practice time-restricted eating and other times when I don’t, _and I like both approaches! _ **My no-sacrifice-secret: **[Pique Fasting Teas](http://piquelife.com/drashton20)* _formulated by Dr. Jason Fung_. The matcha and electrolyte sachets have earned their place in the front of my kitchen cupboard, but for cold winter evenings, the Cinnamon Herbal Fasting Tea is my go-to. I use this ritual not only to support my metabolism, but also as a signal to wind down, offering warmth and subtle sweetness without sugar while supporting healthy blood sugar levels and calming digestion at the end of the day.  I trust the products from Pique because they are  * USDA Organic  * Triple toxin screened * Sugar-free * Dissolve instantly (read: no prep required!) #### **Ready for Your Winter Reset?** If you’re feeling the winter slump and want a reset that feels supportive rather than extreme, this might be the shift your body needs. And, I just got word that Pique’s Fasting Teas are now back in stock!  As a subscriber of Today’s Ajenda, you can order your winter fasting teas for **20%off**! Click the button below to shop & save! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e2838150-b1c0-486c-a28a-1c011bb1be6d/image.jpeg?t=1771980948) Follow image link: (http://piquelife.com/drashton20) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e5b72a05-1ed1-4cb7-9b90-5315a3237baf/Cinnamon-Herbal-Fasting_1.jpg?t=1771984070) Caption: An important note on intermittent fasting: IF is not about eating less just to eat less. It’s about leveraging your digestive circadian rhythms and becoming more mindful about eating, often the same amount of food, compressed into an 8-hour time window. A fast-mimicking diet that triggers autophagy is different and usually involves eating 900 calories a day for no more than 7 days consecutively. _But both come with some cautionary criteria: _If you have a history of disordered eating, are on a GLP-1 medication, or take other medications that should be taken with food, or have medical concerns, please talk with your doctor first. IF is not for everyone, and it does not have to be forever. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a09f8432-4c6a-4675-8391-b6d7ec4f27ef/Nutty_Banana_Oats_recipe_update__1_.jpg?t=1771982564) Caption: ——————————————————————————— Nutty Banana Oats Bowl Click the button below to download the print-friendly recipe! 732.74 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/8e1e7324-97ab-4026-a668-9875a4b75b65/Ajenda%20Recipe%20%23101%20Banana%20Oat%20Nut%20Bowl%20.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260225%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260225T120017Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=c511a99df6b4ab98068a4920468a2603022d5d51b39f7c077ecface47fe05642 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade) Caption: ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f71e7e5f-a83d-4414-86b0-80c08b6cf22f/join_the_experiment.jpg?t=1771948714) Follow image link: (https://www.joinajenda.com/experiment) Caption: ——————————————————————————— Ready to start **a proven plan built for women** in this season of life? Come join us inside [The Wellness Experiment](https://www.joinajenda.com/experiment). It’s where strength training meets smart nutrition, real accountability, and a community of women 50, 60, 70+ who are doing this together. No extremes. No fads. Just proven strategies that help you feel strong, capable, and confident again. Plus weekly LIVE Q&A sessions with me and pro-trainer Korey Rowe. Click the button below to start your transformation today! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/086fda23-24ba-4d57-9804-a2d3024135db/JOIN_button5.jpg?t=1771951573) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### ABOUT DR. JEN View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/dc473b89-28fd-46c9-b70f-db57b61681c5/Screenshot_2026-02-24_at_9.18.44_PM.png?t=1771986178) Follow image link: (https://www.joinajenda.com/about) Caption: In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OBGYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/todays-ajenda-100) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/todays-ajenda-101

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: ## Today's Ajenda * [Dose of Honesty: I wish I didn't have to write this](#dose-of-honesty-i-wish-i-didnt-have) * [Symptom Solutions: The Biggest Myth About Menopausal Hair Loss](#symptom-solutions-the-biggest-myth-) * [Community: Sometimes the Strongest Move is Rest](#community-sometimes-the-strongest-m) * [Chicken Pick-Me-Up Recipe](#chicken-pick-me-up-recipe) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/b1a932e6-153b-4d0e-bcd3-0279a18d5dd8/image.jpeg?t=1771355936) Caption: My (long) fuse got lit last week.  [Learning what was happening within my own professional community](https://www.instagram.com/drjashton/reel/DUZLsILErbd/?hl=en) left me angry, repulsed, and deeply disillusioned. If you’re feeling some version of that too, that reaction is valid and appropriate.  Part of me wanted to unread[ ](https://www.justice.gov/epstein/files/DataSet%209/EFTA00833985.pdf)what I learned about [Peter Attia and his involvement with Epstein](https://www.justice.gov/epstein/files/DataSet%209/EFTA00833985.pdf), to shield this precious community from something so disturbing. There’s a balance we have to hold. We need to protect our energy and be mindful of what and how much we consume. Our brains aren’t wired to process information this way. At the same time, there are moments when silence isn’t neutral. Though I am a big believer in ‘staying in our lane(s)’, I finally felt that I had an obligation to use my platform and my voice to speak about something critically important, not just for women, but for medicine, and for all of us.  Even though I am no longer under contract with the #1 network in the country (ABC), having a national platform for nearly two decades carries real responsibility, **especially when the issues at hand directly affect your health and trust in medicine.** I take that responsibility seriously, and I would never jeopardize the trust you have placed in me. Having a public platform for so long changes you. It gives you reach, yes, but it also gives you a kind of moral responsibility you don’t get to opt out of. And this particular event makes staying quiet feel like a betrayal of everything I’ve spent my career standing for. I’m not trying to be loud or dramatic. I’m trying to be honest. Medicine, at its best, is about humility, respect, and care for real people —_ not branding, not power, not proximity to fame._ Watching those values get chipped away, normalized, or waved off as “not a big deal” has been genuinely painful. **What I want is simple:** for people to pause before they outsource their trust. To remember that influence isn’t the same thing as integrity, and credentials alone don’t equal character. I want the profession I love to feel worth defending again, and for patients to feel protected, not marketed to. Speaking up isn’t comfortable. It’s not fun. But silence feels worse. And I’d rather be clear about where I stand than make peace with something that doesn’t sit right in my bones. That’s why I’m saying something and hoping to empower you with things to look for before you put something as valuable as your health in anyone else’s hands.   **The important lessons: ** 1. **Credentials matter.** Taking medical advice from someone who never completed residency or earned board certification is inherently risky. Training and certification exist to protect patients, not to pad résumés and pockets. 2. **Ethics are fundamental.** Medicine requires a moral compass grounded in respect for all people and, as outlined in the Hippocratic Oath, a commitment never to let financial gain drive care. When that standard is violated, especially through degrading language or conduct, trust in the profession erodes. 3. **Morality clauses matter.** Network contracts include them for a reason. When behavior that undermines professional integrity is tolerated, it sends a troubling message about what standards are actually being upheld. Referring to women’s body parts in vulgar and defamatory language reveals a side of a person that should not be tolerated when that person is a physician.  A higher standard should be applied, and behavior and language should be professional ALL THE TIME, not only when people are watching.  I feel so strongly about this and Peter Attia’s repulsive demonstrations of the exact opposite that I will not appear on any CBS or Paramount platform while he is still under contract with CBS News. 4. **Professionalism is demonstrated, not declared.** For nearly 18 years, I’ve cared for patients across the socioeconomic spectrum, providing treatment because it was needed, not because it was lucrative or advantageous. That is what medicine is meant to be. When influence replaces integrity, the profession itself begins to erode. **Bottom line:** do your homework before you take anyone’s advice. Popularity is not proof of ethics. Followers are not credentials. And when someone shows you who they are, _believe them._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/653d2468-4449-49bf-8e6e-a43f0fa51446/image.jpeg?t=1771355936) Caption: You see it in the mirror. You feel it in the shower. You notice it on your sweater,  _Hair loss._ In midlife, it’s rarely just one thing causing your part to widen, hairline to recede, or your volume to thin out. For me, it was a perfect storm: menopause, stress, not eating enough protein, years of heat styling, and decades of highlighting. The thinning, breakage, dullness, and slower growth felt like something I was supposed to accept (and my faux-po felt like my only solution).  But I wasn’t ready to just accept it.  Once I understood what my hair _actually needed_, starting with nutritional support felt like the most logical next step. And for most well-meaning (and perhaps a little desperate) women, turn to hair supplements. **Here’s what most people get wrong: more biotin is not better.** The fact is, most women are not biotin-deficient. And once your needs are met, taking more biotin does not equal more hair growth. Biotin (vitamin B7) supports keratin production and helps convert food into energy. The National Institutes of Health [recommends just 30 mcg per day for adults](https://ods.od.nih.gov/factsheets/Biotin-Consumer/). Many hair and nail supplements have over 3,000 mcg of biotin.  ## **Why this matters: ** High doses of biotin can backfire. The U.S. Food and Drug Administration has [warned](https://www.fda.gov/medical-devices/in-vitro-diagnostics/biotin-interference-troponin-lab-tests-assays-subject-biotin-interference) that** **megadoses of **biotin can interfere with lab tests**, including thyroid panels and even cardiac troponin tests used to diagnose heart attacks. High doses have also been linked to **breakouts, cystic acne, **and **digestive discomfort** in some people.  ## **What I use: ** [Wellbel](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)* was the first thing that really moved the needle for me. Last August, I was convinced to try it after spending time with Wellbel’s founder, Dr. Daniel Yadegar, a cardiologist with advanced fellowships in functional medicine. I was impressed by Wellbel’s formulations, which replace biotin megadoses (and their side effects) with thoughtfully crafted supplements just for perimenopausal and menopausal women. Wellbel has a [conscious, plant-based formulation](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) with a low dose of 500 mcg of biotin, formulated with 3 key ingredients, for optimal hair growth, fullness, and shine. The part I love most: it’s made specifically for perimenopausal and post menopausal women experiencing hair loss. 1. Methylsulfonylmethane (OptiMSM®): A natural anti-inflammatory precursor of keratin and collagen; strengthens the structure and resilience of hair, skin, and nails. 2. Saw Palmetto: Helps reduce hair follicle shrinkage and shedding by mitigating the impact of DHT. 3. Betaine HCl: Optimizes nutrient absorption by supporting stomach acid levels, critical for breaking down and utilizing hair-healthy vitamins and minerals. [Wellbel’s Women+](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) formula also includes a few additional targeted ingredients for overall hair health from the inside out.    * **K2**: supports metabolic bone health and scalp health. * **Vitamin A (Beta-Carotene)**: Supports scalp and skin health by promoting normal cell turnover and mucous membrane integrity. * **Vitamin D3 (Cholecalciferol)**: Helps maintain healthy hair follicles through cell regulation and immune function. * **Folate (L-5-Methyltetrahydrofolate)**: Aids in cell division and new tissue formation, essential for active hair follicle growth. * **Vitamin B12 (Methylcobalamin)**: Promotes red blood cell production and nutrient delivery to hair follicles, working with folate for cell regeneration. * **Selenium (Selenium Glycinate Complex)**: Offers antioxidant protection and supports normal hair and nail maintenance through cellular defense. Wellbel’s hair, skin, and nail supplements are a comprehensive approach that gives aging hair exactly what it needs, without additional fluff and harmful fillers.  ## **My results: ** Six months ago, I committed to taking Wellbel daily and being consistent. No panic buying, no supplement hopping, just a steady, easy routine. I also decided to discontinue my prescription Minoxidil, because, while it was effective, it does come with some side effects like water retention that I don’t love. The first thing I noticed was short hairs sticking out near my hairline. I assumed it was breakage. But then seeing the same growth pattern at the top of my head made it clear it was new hair, and that was a moment of real joy. * Less shedding * Fewer hairs on my clothes, brushes, and in the shower * Visible new growth along my hairline and crown * My hair feels stronger and more hydrated View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/fd101711-1a96-4293-84fd-2cf0b5681c5c/image.jpeg?t=1771355937) Caption: SO happy with my results so far! And maybe the biggest shift? _I’ve stopped being depressed over it._ This isn’t about chasing perfect hair or quick fixes.  Hair supplements can take 3-6 months to see meaningful results, and while I saw changes after just one month, I know that consistency is key for me!  [Wellbel Women+](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129) was my game-changer.  If you know me, you know that I can tend towards the, um, melodramatic, at times. So I want to share some comments from Ajenda Wellness Experiment members that tell it like it is (without drama or hyperbole!). View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/053dc8a2-3b73-473b-a887-49be7ec2999f/wellbel_quotes_smaller_size_combined__1_.jpg?t=1771375776) Caption: Wellbel has kindly extended a **15% discount **to all Ajenda readers. Use the code [Ajenda15](https://wellbel.com/products/menopause-hair-skin-nails-supplement?rfsn=8807655.ec75ef&variant=49390178042129)** **[for 15% off](https://wellbel.com/collections/supplements?rfsn=8807655.ec75ef) plus **FREE shipping**. Or, sign up for a quarterly subscription to take an **ADDITIONAL 20% **off!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/e5c961cf-7bef-4776-b029-35e55ac21f34/image.jpeg?t=1771355935) Follow image link: (https://wellbel.com/collections/supplements?rfsn=8807655.ec75ef) Caption: _Note: If you already take another supplement, take caution before just adding Wellbel (or any supplement. Supplement stacking has a risk of getting too much of a good thing. Take one hair supplement at a time. _ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5f779906-a19f-4d80-b305-41d90a96be06/community-rest-2_18_select.jpg?t=1771374129) Caption: This week I’m (finally) recovering from RSV, which has been a humbling reminder that even when you prioritize sleep, strength training, and nutrition, you’re still human. There was no “powering through” this illness; in fact, I haven’t been so sick since my first round of COVID. So instead, I’ve been leaning into rest, fluids, and patience, and thinking a lot about how best to support my body. Although exercise was out of the question for me for a full week (which is torture for me personally), I still think it’s important to understand if you should exercise when sick, or when to return to it after illness. Here’s what the science actually says about working out when sick. There _are_ peer-reviewed studies on exercise and immune function. Decades of research, including a well-known review in [Medicine & Science in Sports & Exercise,](https://journals.lww.com/acsm-msse/fulltext/2002/08000/moderate_to_vigorous_physical_activity_and_risk_of.3.aspx) describe what’s often called a **“J-shaped curve.”** Moderate, regular exercise is associated with a _lower_ risk of upper respiratory infections. But very intense or prolonged exercise can temporarily suppress certain aspects of immune function, especially in already stressed or fatigued individuals. A systematic review in the [Cochrane Database](https://www.cochrane.org/evidence/CD010596_exercise-versus-no-exercise-occurrence-severity-and-duration-acute-respiratory-infections) looked at randomized trials comparing exercise vs. no exercise during acute respiratory infections (like the common cold). The evidence was considered low certainty, but moderate aerobic exercise did **not appear to worsen illness** and may slightly reduce symptom severity or total sick days in some cases. **The big picture: ** While there’s no definitive yes or no answer to this question, science gives us parameters we can follow.  ​​If your symptoms are mild and “above the neck” (think runny nose, mild sore throat, nasal congestion), then light to moderate movement (like walking, mobility work, easy cycling) is generally considered reasonable if you feel up to it. But if you have: • Fever • Significant fatigue • Chest congestion or productive cough • Body aches • Vomiting or diarrhea That’s your cue to rest. Fever, in particular, is a hard stop, and exercising while febrile can increase the risk of dehydration and cardiovascular strain and delay recovery. The bigger picture? Regular moderate exercise supports immune health over time. But when you’re acutely sick, your body is already doing hard work. Sometimes, the most physiologically smart training decision is recovery. When in doubt, scale it down. And if you wouldn’t want the person next to you at the gym coughing like that, stay home. (Note: there is an RSV vaccine that is recommended for everyone 65 years of age and over. When I tested positive, my husband rushed out to get his, as it had fallen through the cracks this year. Yes, that happens even to doctors’ families!)  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c303baa3-91c9-4f6d-a89f-c635729e0bfa/High_Protein_Chicken____White_Bean_Salad_300_alt__1_.jpg?t=1771373801) Caption: ——————————————————————————— Chicken Pick Me Up Salad Recipe.pdf Download this Recipe! This high-protein and nutrient-dense salad is the perfect pick-me-up when you need a reset. Click the button below to download the recipe! 929.03 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/7306fc94-4c32-4425-932a-8b53f93d8bfa/Ajenda-Chicken%20Pick%20Me%20Up%20Salad%20Recipe.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260218%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260218T120010Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=dfeb98f6bd978442b1d1490f8a9c22be98645e08ca14c25b839382311c735d91 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### _ABOUT DR. JEN_ In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton**— **”Dr. Jen”**— has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/todays-ajenda-february-11-2026) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: _We’ve got thousands of new friends joining us this week, so a big, warm welcome! If you’re an OG, thank you for being part of this community. Your support truly means the world to me._ _A quick reminder: you can catch up on past issues, share this newsletter with a friend, and even join our insiders list, Off Duty. Links are at the bottom of this email. Now, let’s get into it. We’ve got a lot to cover!_ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/eb803ba0-b5cb-479d-8fb4-2d28956d9283/DOSE_Why_I_Think_the_Term__Longevity__is_BS_final.jpg?t=1770755359) Caption: I’m going to say the quiet part out loud: I think the way we use the word longevity right now is mostly BS. Not because living longer isn’t a good thing. Of course it is. But the way that longevity is marketed to women over 50 has drifted far from reality and very close to fantasy. And fantasy is expensive, exhausting, _and not especially helpful._ **Here’s the core problem. ** Much of the longevity conversation asks women to do uncomfortable, restrictive, expensive or time-consuming things today for a hypothetical payoff 40 or 50 years from now. Now, that framing might work if you’re 28 and optimizing a spreadsheet version of your future. It lands very differently when you’re 50 and over, juggling work, family, sleep disruption, joint stiffness, and a body that already feels different than it used to. Most women I talk to aren’t asking, “_How do I live to 110?”_ They are asking, _“How do I feel better this year?”_ _“How do I wake up with energy?”_ _“How do I move without pain?”_ _“How do I think clearly and enjoy my life now?”_ **Longevity culture often skips right over that.** It’s also become a magnet for marketing hype. Supplements, stacks, gadgets, biohacks, peptide protocols that sound scientific but rest on very thin evidence.  There’s a lot of talk about pathways, molecules, and mechanisms, and far less honesty about what’s actually been proven in real humans over meaningful periods of time. Much of what gets labeled “longevity science” is either extrapolated from animal models, short-term surrogate markers, or observational data that can’t tell us what actually causes what. That doesn’t mean the science is useless. (I find it interesting and potentially exciting, but I also often find it ‘not ready for primetime.’)  It means it’s being oversold. I also have a huge issue with health influencers who speak in absolutes. Science is _**almost never **_an absolute. It is nuanced, dynamically evolving, and ultimately may be slightly different for you than it is for a ‘study population.’  And here’s the other thing we don’t say enough: longevity without quality is not a win. Living longer while feeling weaker, foggier, more medicated, more restricted, and less joyful is not some gold medal outcome. It’s just more years. **This is why I prefer the terms "health span" or "vitality.”** Health span asks a better question: _How many of your years are lived with strength, mobility, cognitive clarity, independence, and resilience?_ Vitality is even more grounded. It asks: _How do you feel in your body today?_ _Do you have energy?_ _Do you recover well?_ _Can you do the things you love without fear?_ Ironically, when you focus on vitality and health span, longevity often improves as a side effect.  • **Exercise and physical activity improve healthspan** by enhancing cardiovascular, metabolic, and musculoskeletal function, preventing or delaying many chronic diseases. [Scientific reviews](https://pubmed.ncbi.nlm.nih.gov/35269492/) highlight exercise as the core of healthy aging and chronic disease prevention. • [WHO recommends](https://www.who.int/initiatives/behealthy/physical-activity) even moderate daily activity, which is associated with **lower mortality risk** and fewer cardiovascular events. • Research summaries note that maintaining muscle (“musclespan”) correlates with **lower risks of chronic illness and premature death**.  **But that’s not the sales pitch. It’s the byproduct.** The problem with the longevity obsession is that it can pull people away from what actually works: boring, unsexy fundamentals. Strength training. Protein. Walking. Sleep. Stress regulation. Purpose. Community. Social interaction. These don’t come with sleek branding or elite club vibes, and many of them cost nothing,  but they have the deepest evidence base we have. I’m not interested in shaming anyone for wanting to live a long time. I’m interested in reality checks. If a recommendation makes your life smaller today in the name of a distant, uncertain future, it deserves scrutiny. And, if something sounds too good to be true, it usually is.  For women over 50, the goal isn’t to optimize for a theoretical version of yourself at 95. _(Though, full transparency: I am formulating my 80’s and 90’s style now, and I’m kind of excited about it! It involves platinum blonde hair or a faux-po, cool glasses, swaggy footwear, and oversized button-down shirts over cool leggings or pants!)_  **The goal is to feel capable, clear, and alive now, and to stack enough of those good years together that you don’t need to chase the word longevity at all.** Call it vitality. Call it health span. Call it living well. Just don’t let marketing convince you that suffering today or the latest trend is the admission price for a future that isn’t guaranteed. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/80a03cba-5b04-4770-adb2-d5dc25f8c74f/image.jpeg?t=1770753863) Caption: **What GLP-1 Medications Are:** GLP-1 medications (brand names such as Wegovy, Zepbound, Mounjaro, Ozempic) are prescription drugs that mimic a natural gut hormone to regulate blood sugar, reduce appetite, and slow stomach emptying, helping many people manage diabetes and weight when used properly.  If you’re a woman over 50 thinking about a GLP-1 medication for weight management (or even for prevention, though this is off-label at this time) and your doctor won’t prescribe it, you’re not alone. And before we turn this into a story about “a doctor who doesn’t get it,” it helps to know there are a few very real reasons clinicians say no. Some are appropriate. Some are fixable. Here is the calm, practical roadmap for requesting GLP-1 medication:  ## **Why a doctor might say no (and what it **_**usually**_** means)** 1. **You don’t meet FDA-labeled criteria (or they think you don’t).** For chronic weight management, both trizepatide (Zepbound) and semaglutide 2.4 mg (Wegovy) are indicated for adults with a BMI ≥30 or a BMI ≥27 with at least one weight-related condition (such as hypertension, dyslipidemia, type 2 diabetes, sleep apnea, or cardiovascular disease).  Off-label use for women who have gained 10-20 lbs during menopause, or for people at a normal body weight who want it for the brain/heart/kidney protective effects, is a much harder situation. 2. **They’re worried about your safety or contraindications.** These medications have [known risks and boxed warnings](https://pmc.ncbi.nlm.nih.gov/articles/PMC12549488/#:~:text=Gallbladder%20Side%20Effects,in%20the%20post%2Dmarketing%20setting.), and some clinicians are appropriately cautious. I was too, before speaking with Dr. Anne Peters (the world-renowned LA endocrinologist who has been prescribing these medications for 20 years and told me she has NEVER seen a case of thyroid cancer associated with GLP-1’s and that that risk was found only in lab rats. ) For example, if you have a family history of medullary thyroid carcinoma or MEN2, those would be a **hard stop** for this drug class. 3. **They don’t have the time or the workflow for follow-up.** GLP-1s are not a “hand someone a prescription and wave” medicine. They require titration, management of side effects, and ongoing monitoring. Some doctors just simply don’t have the time to commit to proper patient management with this drug. It’s a good thing if your doc knows their limits.    4. **They aren’t current or comfortable.** Some clinicians simply haven’t incorporated obesity medicine into routine practice yet. That’s not a moral failure. It’s a systems issue, and I respect it. Tackling barriers to weight-related medications is often more about communication, documentation, insurance, and logistics than it is about your body. Here’s a practical step-by-step approach that empowers you without guesswork.  ### **1.) Politely ask for the **_**reason**_** for “no” in writing** Don’t allow a vague “I don’t prescribe that” to be the end of the conversation. Ask your clinician to email or note in your record the _specific barrier_: eligibility criteria, safety concerns, experience, insurance, etc.  **Why it matters: **Clear documentation enables you and your care team to address the real issue, rather than relying on assumptions. ### **2.) Bring a one-page safety snapshot to your visit** Make it easy for your clinician to assess appropriateness by providing them with the necessary clinical context to quickly evaluate eligibility and safety.  **Include:** * Your current weight, height, and BMI. ([Calculate your BMI here.](https://www.cdc.gov/bmi/adult-calculator/index.html)) * Weight-related diagnoses (Blood pressure, prediabetes, type 2 diabetes, lipids, sleep apnea, fatty liver disease, cardiovascular history) * Prior weight-loss attempts (your lifestyle, nutrition, medications, structured interventions) * Relevant medical history (pancreatitis, gallbladder disease, severe GI motility disorders, personal or family history of medullary thyroid cancer or MEN2, pregnancy, or plans for pregnancy)  **Why it works:** GLP-1 medications are indicated for adults with a BMI ≥30, or a BMI ≥27 with at least one weight-related condition. Summarizing this upfront helps your doc apply guidelines efficiently.  ### **3.) Clinician consideration** Studies show that clinician comfort and training strongly influence whether evidence-based obesity treatments are offered. Some clinicians are uncomfortable [managing obesity pharmacotherapy](https://pubmed.ncbi.nlm.nih.gov/29570250/), particularly dose titration, side effects, and long-term maintenance. _If these are the issues, switch the clinician, not the goal._ **What to look for:** * [Providers with Obesity Medicine training ](https://obesitymedicine.org/about/find-a-provider/)(check [ABOM.org](https://ABOM.org) to find one near you) * Endocrinologists or cardiometabolic specialists * Primary care clinicians who focus on obesity care **Why this matters: **Provider comfort with dose titration, side-effect management, and long-term follow-up [improves care quality and outcomes. ](https://obesitymedicine.org/about/obesity-consensus-statement/) ### **4.) Treat insurance like a benefits problem** Coverage for anti-obesity medications varies widely across plans and often requires prior authorization with documentation of your medical history and comorbidities. This is important because denials are often overturned on appeal when prior attempts are clearly documented. **Why it matters: **Insurance decisions are documentation-driven, not based on personal preference.  **Practical steps: ** * Ask if the office routinely submits prior authorizations.  * If denied, appeal using documented comorbidities and previous weight-loss efforts.  * If you have established cardiovascular disease and meet criteria, note that [semaglutide has evidence for cardiovascular risk reduction](https://www.nejm.org/doi/full/10.1056/NEJMoa2307563) in people with overweight/obesity without diabetes. * Consider paying out of pocket (OOP); the prices for these meds have come way down recently. While not cheap, paying OOP could save you money long-term by improving your overall health. ### **5.) Understand “off-label” use** An off-label use means prescribing an FDA-approved medication for something not listed on the official label.  **Examples:** * Using **Ozempic (semaglutide) **for weight loss is off-label * Zepbound is the FDA-approved version specifically labeled for obesity **Why this matters: **Off-label prescribing can be appropriate, but it may affect insurance coverage and requires careful follow-up and monitoring. ### **6.) Be cautious with compounded or “unapproved GLP-1” products** [The FDA has raised specific concerns](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss) about unapproved GLP-1 drugs, including the use of unapproved salt forms (semaglutide sodium/acetate), and reports of dosing errors and adverse effects, including hospitalization, linked to compounded semaglutide.  While I understand that cost and access concerns drive people toward compound products, it's crucial to understand that safety issues are real.  **Why this matters: **Since compounded products may vary in quality, potency, and dosing, they are not interchangeable with FDA-approved medications. Discuss risks and benefits with your clinician if considering any non-approved option. ## **What Good Follow-Up Actually Looks Like (Non-Negotiable)** Starting a GLP-1 is not a DIY situation. Obesity and the condition of being overweight are chronic conditions. Stopping medication without a plan often leads to weight regain. High-quality care includes an ongoing plan, clear guardrails, and proactive monitoring and/or maintenance. **At a minimum, a good follow-up should include: ** * A clear dose-escalation plan * Defined nutrition targets, especially protein * Monitoring for known risks * **A long-term maintenance strategy ** ## **Bottom line** You deserve an evidence-based care plan that is clearly documented and tailored to your health goals. If your doctor won’t prescribe a GLP-1, don’t default to panic or to sketchy workarounds. Instead, get clarity on _why_, document eligibility, and, if needed, transfer your care to someone trained and current in obesity medicine. That’s the safest, highest-return path for women over 50 who want results without chaos. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/8d4e4b26-0a3c-48c6-861c-e041569ce08d/worth_sharing-__great__image_from_alloy_site__1_.jpg?t=1770757265) Caption: February is all about the heart, yes, but sexual health deserves some love, too. It’s a meaningful part of overall wellbeing, connection, and quality of life.  **Intimacy matters, especially in midlife.** Yet for many women, the hormonal shifts of perimenopause and menopause can quietly disrupt it.  As estrogen levels decline, vaginal tissues can become thinner, drier, and less elastic. This can lead to discomfort or pain with sex, vaginal irritation, and recurrent infections.  **The not-so-sexy facts: **Research suggests that [up to 50–80% of perimenopausal and postmenopausal women](https://www.uhhospitals.org/Health-Talks/articles/2023/12/menopause-and-vaginal-dryness-common-causes-and-what-you-can-do-about-it?utm_source=chatgpt.com) experience these symptoms at some point. _NOT fun!_ Add in hot flashes, fatigue, weight changes, and anxiety, and it's no wonder sex slips to the bottom of your to-do or wish list! Alongside these physical changes, thanks to declines in estrogen and testosterone, many women notice shifts in libido, arousal, and natural lubrication. When sex becomes more uncomfortable and arousal is harder to achieve, desire drops naturally. These changes can erode confidence and pleasure, and they are still not discussed openly or honestly enough. _But this does not mean you're doomed to unpleasant sex the rest of your life!_ Too often, women are told this is just “normal” and something to endure. But normal does not mean inevitable, and it certainly does not mean untreatable. Caring for your sexual health is an act of self-respect and self-care. While sexual health is integral to overall well-being, studies also show that treatment has a positive effect on women who are not sexually active, too. [Menopause.org](https://Menopause.org) suggests that treatment should be offered to anyone with symptoms, whether engaging in sexual activity or not, stating that _“normalizing use of local low-dose estrogen therapy should be a thing.”_ Feeling comfortable in your body, connected to pleasure, and supported in intimacy matters at every stage of life. In fact, regular sexual activity itself increases blood flow and helps maintain tissue health. _Sounds intimidating? _Do not worry. **Amazing sex in menopause is possible. **[You just need the right support](https://www.myalloy.com/blog/why-is-intercourse-painful-during-menopause?utm_medium=affiliate&utm_source=impact&utm_term=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0). That’s why I love and partner with Alloy Health. Alloy offers doctor-led, evidence-based care and [sexual health treatments](https://www.myalloy.com/sexual-health?afsrc=1&clickid=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0&irgwc=1&irpid=5875479&sharedid=&utm_campaign=5875479&utm_content=1935047&utm_medium=affiliate&utm_source=impact&utm_term=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0)* designed specifically for women navigating midlife changes. And because midlife health goes beyond one concern, Alloy also offers evidence-based solutions across skincare, hormone therapy, weight care, and more. Their prescription-based sexual health treatments, including _vaginal estradiol_ and the _O-mazing bundle_, are clinically proven options that help [restore vaginal tissue health and improve comfort during intimacy](https://alloy.sjv.io/xJELVy), even in as little as 4 weeks!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2043ba74-571d-4293-9c0a-f35ad1d1ee3f/alloy_save_burst_2-32.jpg?t=1770762499) Caption: Research shows that local low-dose vaginal estrogen therapy is safe and highly effective at alleviating bothersome symptoms that contribute to pain and avoidance of intercourse. [These products](https://www.myalloy.com/sexual-health?afsrc=1&clickid=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0&irgwc=1&irpid=5875479&sharedid=&utm_campaign=5875479&utm_content=1935047&utm_medium=affiliate&utm_source=impact&utm_term=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0) are designed to help you feel comfortable, confident, and connected again without waiting for an in-person doctor’s visit _(because who has 8-12 weeks to wait to see a Gyn when her vagina is dry, and she can’t have sex?!)_ What I appreciate most is that Alloy treats sexual health as healthcare, not as something frivolous or embarrassing. They make great sex and expert doctor guidance accessible. Their approach centers on dignity, science, and individualized care because they believe **women deserve comfort, pleasure, and fulfillment in their bodies at every age.** **Alternatives to vaginal estrogen therapy: ** This depends on the severity of symptoms, but may include a natural oil (like coconut or sunflower) as a lube, or other prescription medications. For some women, this may be all that is needed, but these options don’t treat the root cause (which is low or depleted estrogen). Anything other than estrogen is like putting ice on top of a cracked driveway.  It might be slippery, but it is still cracked at its foundation/surface.  So, don’t be afraid to look into treatment options in general, and vaginal estrogen therapy specifically. You deserve to have whatever level of physical intimacy you want, without pain! And there’s **nothing** sexier than that. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7a3a2444-b797-4c72-a0e2-2208380bebe1/image.jpeg?t=1770753863) Follow image link: (https://www.myalloy.com/sexual-health?afsrc=1&clickid=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0&irgwc=1&irpid=5875479&sharedid=&utm_campaign=5875479&utm_content=1935047&utm_medium=affiliate&utm_source=impact&utm_term=QbUUtI0XBxyZTFs1tHxlJ2MGUku0ZZ1JQyODXs0) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3c909f12-5d72-45a9-9863-e266d67b05bd/image.jpeg?t=1770753864) Caption: I am a huge fan of **Lindsey Vonn**. Her talent, her drive, her willingness to come back from setbacks, and the discipline required to compete at the level she has for so long are inspiring. She is extraordinary. Full stop.  And precisely because she is extraordinary, moments like the one that happened in Cortina at the Olympics last weekend matter beyond the individual athlete. **Here is the perspective that no one is talking about:** When a world-class athlete competes with a known significant injury, especially something as fundamental to knee stability as an ACL tear, the message absorbed by millions of young (and pro) athletes is simple and dangerous: **push through, suck it up, toughness equals worth, pain is weakness, don’t sit out**. We have spent decades in sports medicine trying to undo precisely that mindset. We teach kids, parents, coaches, and professionals that **playing injured changes mechanics, delays healing, increases the chance of additional injury, and can put others at risk**. We try to create cultures where reporting pain is seen as intelligent, not soft. Where recovery is part of training, not an interruption of it. Then a superstar shows up and does the opposite, on the biggest possible stage. I understand the counterarguments. Elite sport is not normal life. The Olympics are once every 4 years. Athletes assume risk. Comebacks are part of legacy. Competitive fire is real. I respect all of that.  I know that Alpine Skiers have very specific training teams, and that it is intrinsically a dangerous sport. But inspiration cuts both ways. A recreational skier, a high school soccer player, a weekend warrior watching from home, doesn’t see that nuance. They see: _she did it, so I should too._ **As a physician (and an avid sports fan), that makes me uneasy.** In medicine, we think in probabilities, not absolutes. When the margin for error is razor-thin, any impairment becomes relevant.** **Could the injury have contributed to the crash? We cannot know that with certainty, and in fact, Vonn herself said her torn ACL had nothing to do with her hooking her arm by getting too close to the gate.  Ski racing is inherently dangerous. Catastrophic falls happen even to perfectly healthy athletes. It would be irresponsible to claim direct causation, and Vonn herself said her torn ACL had nothing to do with her arm hooking the gate, and her practice runs were actually putting her in medal contention (unbelievably)! But it is also very fair to say that ligament instability can alter proprioception, reaction time, and confidence in micro-moments that matter at high speeds (100 mph). Compensation for her torn ACL could have been subconscious, and could have affected the way her arm went into that gate, hooking it at high speed, and causing a horrible crash that led to a complex fracture of her tibia (among other serious injuries). Even Vonn may not have been aware that her ACL may have contributed in some way to her body mechanics, etc.  There’s another layer here, particularly for women over 50 watching this story unfold. Part of high-level athletics, just like part of life, is **knowing when the cost of continuing exceeds the benefit**. Retirement is not failure. It is often wisdom. It is an acknowledgment that the body has carried you brilliantly and deserves protection. That doesn’t erase ambition or competitive identity. It reframes them.   **I worry** **that what looked like courage may also have been denial**. I wonder what the conversations were like with her personal training team. What did her orthopedist and sports psychologist advise her? Did they have the courage to say what she didn’t want to hear (that she shouldn’t race with a torn ACL)? Either way, the world lauded her for her toughness and courage and ability to ‘push through pain’ and race.  I am not an orthopedic surgeon, a certified athletic trainer, an Alpine skier, or any of HER professional team. But I do know anatomy and physiology. And I covered stories like hers for 18 years as a medical correspondent, so I am familiar with the layers of complexity that lie within. Also, this has nothing to do with sex discrimination, at least for me. I would be thinking the same thoughts if she were an NFL quarterback playing in the Super Bowl with a known TBI, or traumatic brain injury/concussion. **Multiple Truths** None of these theories or issues diminishes what she has achieved. **Lindsey Vonn is generally considered to be the GOAT of skiing. **Her resilience, spirit, and athleticism have inspired countless people, including me. She is a massive role model for recovering from setbacks, injury and ‘falling down.’ Her mantra is _‘chase your dreams,’ _and I am FULLY behind that. _And_… I can hold admiration and concern simultaneously. One feeling or thought does not negate the other. **Why discuss this?** To start, it is a global sports/medical story. She was airlifted off the mountain, had emergency surgery (and will need more), and was placed in the ICU. Also, it’s a ‘women power’ story, which you know I love. Vonn is an incredible figure of resilience, ambition, dedication, fortitude, and stamina. She gave her all, and I admire that. But because she is a celebrity, her decisions will always be scrutinized and debated, and that’s fine – that is the norm in sports. As long as there is respect, I am all for it.  **Uphill From Here ** I wish Lindsey a smooth and complete recovery, physically and mentally. I am heartbroken for her dreams and her severely damaged leg. I hope she is surrounded by people who support healing, and speak to her with respect, and also have the courage to tell her what she may not want to admit to herself.  **The message behind the spectacle.** Strength is not only the ability to endure pain or the ability to get back up after being knocked down.  Sometimes strength is the ability to step back before something worse happens, and listen to the body saying no, even when the mind is saying yes. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1b8a0223-bdae-4dfe-930a-70887cdf565c/image.jpeg?t=1770753864) Caption: ---------- ——————————————————————————— Download this Recipe! These Valentine's worthy truffles deliver deep chocolate flavor with nourishing ingredients. Click the button below to download the recipe! 700.56 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/a29e1130-ab95-4f69-9439-439724230e41/Ajenda%20Recipe%20Chocolate%20Protein%20%20%E2%80%9CTruffles%E2%80%9D.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260211%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260211T120025Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=86431b53bd21cffe04c3b02f7194a8fe540c04e1b9b8be1ad0c8fa56bc0f485f ——————————————————————————— ----------View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d2704d8c-8345-4a55-9960-3cf0f7a97656/image.jpeg?t=1770753864) Caption: Last week, I asked whether you feel comfortable taking nutrition advice from your GP, who is not a certified Nutritionist. The results are in, and I was a little surprised, if I’m being honest. The minority of you replied _“yes,”_ and almost half of you, (42%) replied _“it depends.”_ I wonder what it depends on. So few doctors have ANY formal education or credentials in Nutrition. **Nutrition is foundational to long-term health**, yet many people are left unsure who to trust or where to turn for practical guidance. That’s exactly the gap we aim to fill by offering delicious, genuinely nutritious recipes curated by me, even though I really hate to cook!  No guesswork, no extremes. Just food that’s evidence-based, good fuel for your body, and designed to support real life. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/85247ecb-933c-4b7c-99bf-7c39a11dc0c0/image.jpeg?t=1770753863) Follow image link: (https://www.joinajenda.com/recipes) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. Join now for $7/month, or send it as a gift to your Gal-entine! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://todays-ajenda.beehiiv.com/upgrade) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### _ABOUT DR. JEN_ In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/?close_draft_preview=true) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/todays-ajenda-february-11-2026

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/398c3bf1-1e2c-4af3-a5bc-7a48b7a40dd5/_DOSE-Why__Just_Drink_More_Water__Isn_t_The_Whole_Story_2A__1_.jpg?t=1770154063) Caption: We’re taught that water is the one thing we can inherently trust.  It’s what our bodies are made of. It’s what we’re told to drink more of when we’re pregnant, exhausted, sick, or trying to “glow.” But there’s a widening gap between what we **expect** from our water and what the system actually **delivers**.  ### **An Old Water Infrastructure System ** The backbone of US water safety, the [Safe Drinking Water Act](https://www.govinfo.gov/content/pkg/CPRT-106SPRT67528/pdf/CPRT-106SPRT67528.pdf), was passed in 1974. While it was a triumph for public health at the time, that infrastructure system was **not** designed to address the contaminants we’re now aware of.  From “forever chemicals” (PFAS) to microplastics, our water is now filled with **thousands** of contaminants. These contaminants act as endocrine disruptors, interfering with our hormones, even at very low levels.  * **Zoom In:** There are currently **no federal standards** that limit PFAs or microplastics in either tap or bottled water.  To be clear, municipal water utilities aren’t the “bad guys.” They do the best they can with the tools they have. But they’re often constrained by aging infrastructure, limited funding, and outdated regulations.  ### **The Bottled Water Paradox** **“What if I just stick to bottled water?”** While bottled water is regulated differently (and in some cases less stringently than municipal tap water!), brands are **not** legally required to test for many of these contaminants. As a result, many simply don’t. If a company wants to use terms like “spring,” “artesian,” or “natural,” they are legally limited in how much they can purify the water. The appeal is in the “naturalness,” but that also means they can’t filter out everything.  And since these sources are subject to changes in rainfall, geology, and surrounding land use, even the best springs can carry naturally occurring trace contaminants from season to season.  On the other hand, if a company **does** go the purification route, it won’t get credit for its source. This means most purified waters start with municipal tap water, then rely on filtration to improve quality and consistency. **“What about modern filtration?”** It helps…but it isn’t magic. Modern membrane systems are effective at reducing many contaminants, yet no single method addresses everything under all conditions. The quality of the starting source still matters. ### **Bottled Water Container: Glass vs. Plastic** Then there’s the container. Glass used to be the standard for bottled water. The industry moved away from it because glass is heavy, more expensive, and slower to run through a bottling line. Plastic lines run faster. Aluminum cans run even faster. Today, most bottled water is packaged in some form of plastic, whether that’s PET bottles, plastic-lined aluminum cans, or cartons lined with plastic. Under normal supply chain conditions, including heat, storage time, and transport, those materials can degrade. None of this means our water is universally unsafe. But it does mean that consumers are often operating with incomplete information about something they consume every single day. ### **What Changed My Thinking ** After months of reading studies and reviewing test results, I came to a conclusion. Truly clean, consistent water depends on both a **high-quality source** and equally high-quality **filtration**, **mineralization**, and **bottling** practices. That realization is what led me to invest in [Loonen](https://loonen.com/ajenda). I met the founder, [Clara Sieg](https://www.linkedin.com/in/clarasieg/), last year, and spent a lot of time speaking with her, hearing the evolution of how [Loonen](https://loonen.com/ajenda) was developed, and looking into the world of bottled water myself. I was not only impressed with [Loonen](https://loonen.com/ajenda), but I felt compelled to help them with their mission and their launch, and to help them get their story out about the ways in which they are different.  The [Loonen](https://loonen.com/ajenda) Way:  1. Loonen starts with **pristine spring water** – not municipal water – and then uses a non-chemical, physical membrane filtration process to further purify the water. 2. Then they **remineralize** using the highest-quality, lab-tested minerals (like Celtic sea salt instead of refined table salt) to restore a balanced taste and hydration profile. It’s crisp and refreshing. 3. All Loonen water is transported in **stainless steel tankers and piping** to avoid exposure to plastic along the way. Then, they bottle exclusively in **glass** with microplastic-free caps/seals. 4. Most importantly, **Loonen tests every batch** for microplastics, forever chemicals, and hundreds of other contaminants. The results are **third-party certified, shared publicly**, and available via QR code on every single bottle.  It’s slower, harder, and more expensive. But in comparison to the other few brands of “clean” water, [Loonen](https://loonen.com/ajenda) is a fraction of the cost and has already sold out during its debut on Amazon!  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/bd97956b-229b-43bd-ac6e-193d174719db/IMG_9851.JPG?t=1770154090) Follow image link: (https://loonen.com/ajenda) Caption: And yes, hydration really does help you glow and is good for your body from your brain to your kidneys. I can confirm this after aggressively testing the theory on myself. And as you probably know about me by now, I don’t recommend anything to my friends, patients, followers, readers, or viewers that I don’t do, wouldn’t do, or haven’t done myself.  You can now find Loonen in retailers throughout California and nationwide on Amazon.   View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6c330056-a083-4ce7-8049-fcde9ab50ea3/sip_button.jpg?t=1770154129) Follow image link: (https://loonen.com/ajenda) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a7113bd1-13a8-4742-846e-f78ba1a659e0/_SS__Breathwork-__The__Exercise__You__Should_Be_Doing_.jpg?t=1770154178) Caption: Being told to "just take a deep breath" can feel a bit patronizing, can’t it? But intentional breathing is a direct remote control to your nervous system. I’m making breathwork a major focus of mine in 2026, and I’d love for you to join me.  Between caregiving, work, and unpredictable hormonal shifts, we often get stuck in the [sympathetic drive](https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-flight): that “always-on” state of high alert. Our goal is to shift towards a [parasympathetic state](https://my.clevelandclinic.org/health/body/23266-parasympathetic-nervous-system-psns). This is the branch of your nervous system that focuses on rest, digestion, and sleep.  Breathwork helps us make that shift. Here’s how:  ### **The Physiology in Plain English** Think of your heart, lungs, and brain as being in constant conversation through the [vagus nerve](https://en.wikipedia.org/wiki/Vagus_nerve). When you breathe slowly and extend your exhale, you’re sending a “calm down” message to that nerve. This signal tells your heart to relax and reassures your brain that your environment is safe.  * **Zoom In: **You can actually measure this through [Heart Rate Variability](https://my.clevelandclinic.org/health/symptoms/21773-heart-rate-variability-hrv) (HRV), which tracks how regulated your nervous system is.  Breathing at about **six breaths per minute** (roughly a 4-second inhale and a 6-second exhale) is the “sweet spot.” This rhythm, called **Resonance Frequency Breathing**, can increase [cardiac vagal activity](https://pmc.ncbi.nlm.nih.gov/articles/PMC8656666/) and [improve HRV](https://pmc.ncbi.nlm.nih.gov/articles/PMC8924557/). ### **How Breathwork Combats Stress and Anxiety ** When you’re anxious, your breathing becomes shallow and fast, triggering your sympathetic system. Slow breathing helps **disrupt** that pattern and get you back to a calm state.  * **Science Says**: A [Stanford study](https://pmc.ncbi.nlm.nih.gov/articles/PMC9873947/) found that just five minutes of daily breathwork significantly reduced anxiety, improved mood, and was an effective stress management exercise.  ### **The Beginner’s Guide to Breathwork** Start here: * Sit comfortably with your feet on the floor * Inhale gently through your nose for **4 seconds** * Exhale slowly through your mouth for **6 seconds** * Repeat for **3–5 minutes** That’s about 6 breaths per minute. If you prefer to go by feel, think: longer exhale than inhale. It should feel soft and easy (if you’re dizzy, that’s not good!).  **“When should I do this?”** Whenever works best for you! I like to do this first thing in the morning while watching the sunrise, but you can do it before bed, meals (which can improve digestion), after a stressful day, or even in the middle of the night if you wake up wired.  ### **Are There Any Cons to Breathwork? ** Most people feel calmer after breathwork, but it’s not for everyone. If you have panic disorder, fixating on your breath can feel uncomfortable. Start with just 30 seconds and work up gradually.  And if you breathe too forcefully, you may feel lightheaded. It's not dangerous, but your body is telling you to breathe more gently.  Some people find that movement-based stress relief works better for them, and that's completely fine.  ### **How To Stick To Breathwork ** You don’t need a meditation cushion or a timer. You need a cue. Many women find it easiest to link this to something they already do: brushing teeth, getting into bed, waiting for coffee to brew. For me, it’s right after waking up.  Three to five minutes. That’s it. ### **The North Star Takeaway** You don’t have to outthink stress. You can outbreathe it. Slow breathing is one of the rare tools that is simple, evidence-based, and under your control. For women over 50, who often feel pulled in a dozen directions, it’s a way to reclaim a sense of internal steadiness without adding another rule. If you have time to spiral, you have time to exhale. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/7d96ab54-897e-45a2-a95a-7801c86d1b14/Community-_The_3_Cooking_Oils_I_d_Recommend_For_Skin_Moisturizer__.jpg?t=1770154200) Caption: Last week, I shared [on Instagram](https://www.instagram.com/p/DUJs-aLkhHk/?hl=en) that olive oil is my go-to body moisturizer of choice, and received **hundreds** of questions! It seems we’re all looking for ways to navigate skincare as we age without needing a chemistry degree or second mortgage.   This is one of those things that requires a mix of science, skincare, shopping savvy, and common sense to decide if or how to incorporate it into your daily routine. But to start, here’s a miniature guide to using cooking oils on your skin. **How Skin Changes After 50 ** After 50, our skin becomes thinner, drier, and far less forgiving. This is why I’ve spent the last 20 years recommending three simple, budget-friendly staples: olive oil, coconut oil, and good old baby oil.  While they’re all straightforward, they actually behave quite differently on the skin.  My journey with this started in 2004, when I read a book written by a wonderful Ayurvedic physician. One of the basic principles of Ayurvedic health is: “don’t use anything on your skin that is not pure enough to eat.”  While it’s a sweeping generalization, the point is a valid one. As our body’s largest organ, our skin absorbs what we give it into our bloodstream, so choose wisely. This saying is one I’ve never forgotten.  ### **Olive Oil: The Kitchen Staple That Behaves Like Skincare** [Olive oil](https://www.joinajenda.com/article/is-there-really-a-difference-between-extra-virgin-and-regular-olive-oil) is rich in monounsaturated fats and antioxidants like vitamin E and polyphenols. These act as a natural emollient to soften and smooth the skin by filling in microscopic gaps between skin cells. It’s a wonderful, minimally processed option that’s free from the fragrance and preservatives found in most lotions.  **Cons** * Heavy or greasy if overapplied * Not ideal for acne-prone areas like the chest or back * [Some studies](https://www.researchgate.net/publication/6831298_Occupational_allergic_contact_dermatitis_from_olive_oil) suggest it may disrupt the skin barrier in people with eczema or very sensitive skin if used excessively * It definitely has a “salad” smell initially, but I find it rapidly dissipates within minutes. **Best use**: damp skin after a shower, a small amount warmed in your hands and pressed in, not rubbed aggressively. I use it on my hair (ends only) too. ### **Coconut Oil: The Tropical Favorite With Mixed Reviews** Coconut oil is a rich emollient with a unique fatty acid profile. Unlike olive oil, it contains lauric acid, which has antimicrobial properties. It forms a thicker, more occlusive layer on the skin, which is great for trapping moisture in stubborn areas like shins, elbows, and feet.  But it’s also more comedogenic, meaning it can clog pores for some people. Many dermatologists caution against using coconut oil on the face or upper chest for this reason. Coconut oil can also be used as a vaginal lubricant (internally and externally), as can olive oil, but coconut oil tends to be slightly more optimal because of the lack of smell. **Cons** * Can clog pores and trigger breakouts * Feels heavy in warm weather * Can stain clothing or sheets if overused **Best use**: targeted application to dry areas, especially in winter. ### **Baby Oil: The Misunderstood Classic** Baby oil is typically mineral oil with fragrance. Mineral oil is an **occlusive**, meaning it forms a barrier on the skin that prevents water loss. Unlike olive or coconut oil, it doesn’t nourish the skin with fats or antioxidants. Mineral oil is also non-comedogenic and very stable, which is why it’s long been used in dermatology.  **Cons** * Contains fragrance unless you buy fragrance-free * Does not provide nutrients to the skin * Feels slippery and can transfer to fabrics **Best use**: immediately after showering, on damp skin, in small amounts. ### **Bottom Line: Which Oil Is Right For You? ** Dry skin at this stage of life is often more about a weakened barrier from low estrogen, not lack of moisture. Emollients (olive and coconut oil) add softness. Occlusives (baby oil) seal water. But honestly, the “best” oil matters less than how you use it.  The secret is just a small amount, applied to damp skin consistently. This beats a large amount applied sporadically every time.  None are glamorous, but they all work. And they’re MUCH less expensive than a typical body lotion and more pure, due to the lack of other chemical ingredients.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f25bba14-fd17-40c4-8eea-f438794ad0c8/yogurt_with_chocolate_and_raspberries_recipe__1_.jpg?t=1770154037) Caption: ——————————————————————————— Greek Yogurt Chocolate Bowl PDF Recipe Here's the PDF version of this recipe so you can easily print it out at home for your reference! We hope you enjoy. ❤️ 741.95 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/58ee1010-4693-4b9e-bab5-1fbd8e036320/RECIPE%20full%20page%20yogurt.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260204%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260204T120048Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=e488e9a34d70cfcc567a6039ddc4e9b24f59dd232d19bf4675423bb67019b975 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://www.joinajenda.com/off-duty-with-dr-jen), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://www.joinajenda.com/off-duty-with-dr-jen) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### _ABOUT DR. JEN_ In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/is-this-the-ultimate-muscle-builder-for-women-over-50) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/the-cooking-oil-to-use-as-body-moisturizer

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ecf2ded-ce9d-42da-826a-9a448a7503ac/_DOSE-Do_Essential_Amino_Acids_Really_Beat_Protein_After_50___1_.jpg?t=1769553451) Caption: **“The ultimate muscle builder.” “Anti-aging superfood.”** If you’ve spent five minutes on social media lately, you’ve seen the hype. [Essential Amino Acids](https://www.joinajenda.com/article/do-essential-amino-acids-actually-help-with-muscle-recovery) (EAAs) are being touted as the “missing link” for muscle growth and staying strong as we age.  But are these tubs of powder the real deal…or just clever marketing? Let’s break down the differences between EAA supplements and protein, specifically for women over 50 who don’t want to waste time on fluff. ### **EEAs From Food Versus Supplements ** Protein is made up of amino acids. Of the 20 amino acids we use, your body can only synthesize **11**. The other nine have to come from foods or supplements.  * **Zoom In: **Essential amino acids are called “essential” **not** because they’re “more important,” but because you must get them elsewhere.  When you eat whole protein (such as fish, eggs, or chicken), you’re getting all nine essential amino acids packaged inside a “protein matrix” of calories and nutrients.  **EAA supplements are different. **They deliver those nine amino acids in an isolated, pre-digested form that hits your system instantly.  ### **How This Impacts Women After 50 ** After midlife, women face “[anabolic resistance](https://pubmed.ncbi.nlm.nih.gov/36018750/),” which is when muscles become “stubborn” and less responsive to exercise and protein. To overcome this and prevent muscle loss, women over 50 need more protein (roughly [1.6g per kilogram](https://lifestylemedicine.stanford.edu/protein-needs-for-adults-50/) of body weight) spread throughout the day. It isn’t just about hitting a total protein number, though. It’s about what’s **in** that protein and how much of that protein is actually absorbed. Cue: [leucine](https://en.wikipedia.org/wiki/Leucine). This essential amino acid is the “Queen” of protein synthesis and **turns on** the muscle-building process.  ### **How Much Protein is in EAAs? ** **Side bar:** People always ask me how much protein is in a scoop of essential amino acids. Since leucine makes up about **8-10% **of high-quality, complete protein (like animal proteins and soy), we can use it as a benchmark.  * **By The Numbers:** If your EAA scoop has 1.25 grams of leucine, you’re getting roughly 12-16 grams of high-quality protein.  **The big difference is efficiency**. If you mix it in water, you’re consuming only about 25 calories, compared to at least 64 calories from a whole-food protein source containing 16 grams of protein.  ### **The Pros and Cons of EEA Supplements ** #### **The Pros: Efficiency ** The main advantage is **caloric efficiency**.  EEA supplements trigger muscle repair with almost zero caloric “overhead.” This is useful in specific scenarios: short-term appetite suppression, a workout boost when a full meal feels too heavy, and a way to protect muscle during illness when your appetite is gone.  #### **The Cons: Missing The Foundation ** The trade-off is that EEAs provide the “spark” but not the “fuel.” They lack the full nutritional package of whole foods, and you miss out on micronutrients like calcium, iron, zinc, and B vitamins.  * **Zoom In: **Because they are isolated aminos, they also lack the fiber that keeps you satiated.   **Plus? **There isn’t enough long-term research data in women over 50 that proves these powders perform better than simply eating enough protein.  ### **My Rx For You** For most women over 50, your goal should be getting **30-35 grams** of protein per meal, spread across the day, from high-quality sources (dairy, lean meats, fish, and eggs). EAAs can be helpful, but they’re a tool, **not** a replacement.  I personally add a scoop of EAAs into my water bottle first thing in the morning to check two boxes: 1) to stay hydrated, 2) to hit my protein target with fewer calories.  If nutrition feels overwhelming, simplify. Lift weights. Get 30-35g of protein in your meals. Use supplements selectively, not as a reflex. That approach is the one that actually aligns with the physiology of aging and the evidence we have. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a1f89d7e-1c86-40ad-aac4-e1efcc5d2510/_SS__Low_Bone_Density_and_Algae-Derived_Calcium-_What_Does_The_Science_Show___1_.jpg?t=1769553467) Caption: Algae-derived calcium is having a major moment. It’s being marketed as the “gentler,” more “natural” alternative to traditional calcium supplements, with claims that it’s easier on the stomach and more “body-friendly.”  **It sounds perfect**. But as a doctor, I’ve learned to look past the “plant-based” halo. We need to ask ourselves: Does it actually improve bone mineral density (BMD)? And can it lead to fewer fractures **without** the downsides we worry about with supplemental calcium?  Let’s see for ourselves:  #### **Quick Recap: The Risks of Supplemental Calcium ** Calcium supplements are controversial for two reasons: 1. **Kidney Stones:** Large-scale studies, like the [Women’s Health Initiative](https://pmc.ncbi.nlm.nih.gov/articles/PMC3127502/) (WHI), found that calcium and vitamin D supplements increased the risk of urinary tract stones by **17%. ** 2. **Cardiovascular Risk:** The evidence is a bit of a mixed bag, but there is definitely [some data](https://www.mayoclinic.org/diseases-conditions/heart-attack/expert-answers/calcium-supplements/faq-20058352) that suggests a link between calcium supplements and an increased risk of heart attacks. This is NOT new, and it is why the doctors who have been current with medical literature have advised AGAINST most women taking calcium in supplemental form after menopause. Not only does the data show it doesn’t HELP reduce the risk of osteoporotic fractures, but the data DOES suggest it HARMS cardiovascular and renal health. **Let’s be clear:** algae calcium is still supplemental calcium. It doesn’t sidestep the risks of kidney stones and heart health just because it’s “green.” Until we have safety data, the same caution applies.  Now that we’ve cleared that up, let’s tackle the claim that algae-based calcium improves bone mineral density, which translates to fracture prevention.  #### **BMD is Not The Same as Fracture Prevention ** A [DEXA scan](https://www.joinajenda.com/article/5-different-ways-to-test-your-body-fat-composition) (dual-energy X-ray absorptiometry) measures how strong your bones are. While a higher score of bone mineral density is a good thing, it’s **not** a guarantee that you’re safe from fractures.  The truth is, you can have “dense” bones on paper and still break a hip if you have poor balance, blurry vision, weak muscles, or are on certain medications.  This is why small improvements in a bone scan don't always translate into a real-world fracture reduction. Ultimately, a “BMD claim” on a supplement bottle is not a promise of “fracture prevention.” #### **Do We Have Any Clinical Trials on Algae-Derived Calcium?** The most rigorous data we have comes from a [24-month study](https://aquamin.com/wp-content/uploads/2020/11/Slevin-et-al..-2014-pdf-1.pdf) on postmenopausal women using [Aquamin](https://aquamin.com/) (a common algae-calcium brand) with or without a prebiotic. The research found:  * **No significant improvement **in bone mineral density after two years in either the calcium-only or calcium and prebiotic groups compared to placebo.  * **However**, both calcium groups appeared to **slow bone turnover**, which _theoretically_ could be protective, but didn’t translate to measurable bone mineral density gains.  That distinction matters. As we get older, a good goal for us to have is slowing the rate of bone loss, rather than hoping for a single supplement that will “grow bone.”   **But let’s be crystal clear:** there is a **long** leap between “favorably affecting markers of bone turnover” and “slowing bone loss” to “building new bone” and ultimately “reducing the risk of osteoporotic fractures.” People use them interchangeably, but they are NOT the same thing, and so we have to be cautious with concluding one with the other.  #### **The Honest Framing of Algae-Derived Calcium ** When we strip away the marketing, the honest way to frame algae-derived calcium is this: * **Best Case: **Based on current data, it _may_ help maintain bone mineral density, slow loss, and improve turnover markers in postmenopausal women.  * **Unknown:** It’s still too far of a leap to say it reduces your risk of osteoporotic fractures, nor do we have proof that it sidesteps the kidney and heartrisks associated with traditional supplemental calcium.  #### **What This Means For You ** If you were my patient, here’s what I’d tell you:  * **Start with your plate.** Get your calcium from food (dairy, fortified soy, canned salmon/sardines with bones, calcium-set tofu, leafy greens). These foods come with protein and micronutrients that support bone and muscle.  * **Don’t guess,assess.** If you absolutely cannot reach your needs with food (which is possible), talk to your doctor about smaller supplemental doses at **≤500–600 mg **per dose. While you’re at it, check your Vitamin D levels. Remember, more is **not** better. The theory about why supplemental calcium may be harmful for most women is that it causes an abrupt increase in blood calcium levels, so truly, more is _really_ not better.  * **Focus on the heavy hitters**. If you’re osteopenic or osteoporotic, the real protection comes from resistance training, adequate protein, and FDA-approved osteoporosis medications when indicated. These all have stronger outcome data for fracture risk than any single calcium form. **Bottom line**: algae-derived calcium is an interesting option with some supportive human data for maintenance of BMD, but the leap from “BMD support” to “fracture prevention” is far-fetched. Not to mention, the safety around calcium supplements still applies. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2d663202-bfb8-4359-ad46-65ddb1095653/8_The_Pique_update.jpg?t=1769550816) Follow image link: (https://www.piquelife.com/JENNIFERASHTON) Caption: As you may know, I’ve done dry January (or as I call it dry JEN-uary!) for the past 10 years or so. I’d do it as a personal experiment, and I noticed I’d get brighter skin, lose a pound or two, and sleep better.   But a few Januaries ago, when I was doing a segment on “Good Morning America,” it really sank in how accepted alcohol is in our society despite being classified as a [Class 1 carcinogen](https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health).  Although I’m a minimal drinker (aside from the occasional glass of tequila blanco), I found myself curious for an alternative.  So when Pique launched [Vesper](https://www.piquelife.com/JENNIFERASHTON),* a non-alcoholic adaptogenic aperitif, I was curious. My long-time Ajenda readers know I’m a long-time fan of Pique, and I trust the quality of their ingredients.  Vesper is an alcohol replacement sachet that has:  * L-theanine, tart cherry, elderflower, and lemon balm to melt away tension and ease you into a calmer state * Gentian root to invite a natural sense of happiness and lightness  * Organic damiana leaf extract to support connection (ideal for social settings!)  I’ve been reaching for [Vesper](https://www.piquelife.com/JENNIFERASHTON) when I want to de-stress, and I like that it gives me a relaxed, zen feeling **without** the carcinogen exposure of alcohol. I’m not swearing off alcohol entirely, but having this option feels really good.  **Curious to try it yourself? **The Pique team was kind enough to offer a [10% discount](https://www.piquelife.com/JENNIFERASHTON) **for life** to Ajenda readers when you subscribe.  View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5b8a450d-dbfb-4235-8edb-40bb917bb5d2/Pique_BUTTON_B.jpg?t=1769550871) Follow image link: (https://www.piquelife.com/JENNIFERASHTON) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/d3569cac-4a68-4285-a7f2-d251b2236b45/chicken_recipe_for_NL_smaller.jpg?t=1769539221) Caption: ——————————————————————————— Roast Chicken and Sweet Potato Recipe PDF Here's the PDF version of this recipe so you can easily print it out at home for your reference! We hope you enjoy. ❤️ 1009.79 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/221fe281-b044-47ef-be0d-f2dd5c02f482/RECIPE%20full%20page%20chicken%20full%20page.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260128%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260128T120200Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=238bd5219cce496265adfc3198f277ef6b46d73f8d16d85a590250c601a8cd26 ——————————————————————————— View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://www.joinajenda.com/off-duty-with-dr-jen), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/38b01dac-7c47-4882-8a26-3a63b804f480/off_duty_BUTTON__1_.jpg?t=1765982140) Follow image link: (https://www.joinajenda.com/off-duty-with-dr-jen) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1ead2d84-820a-4410-b15f-c7ab3c369e57/leave_us_a_review_banner____2_.jpg?t=1745881955) Caption: Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/05f3a26e-e94b-49a4-a3e2-06f4b75c51e7/newsletter_JEN_POLL_slug_.jpg?t=1743452739) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### _ABOUT DR. JEN_ In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/two-weeks-no-upf-what-i-noticed) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase._ View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/6b426ece-bf34-4157-807a-c508d2639110/quote_-_end.jpg?t=1743452699) Caption: ^_This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions._^ ——— You are reading a plain text version of this post. For the best experience, copy and paste this link in your browser to view the post online: https://todays-ajenda.beehiiv.com/p/is-this-the-ultimate-muscle-builder-for-women-over-50

View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1247c972-9f2c-4803-80e7-0791efba35a5/NEW_banner_for_newsletter_final_with_Dr_Jen.jpg?t=1762365284) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/39383684-cee8-4aa8-be94-31f22c293caa/_DOSE-What_I_Noticed_After_Two_Weeks_of_No_Ultra-Processed_Foods__.jpg?t=1768950068) Caption: On New Year’s Eve, I shared on [Instagram](https://www.instagram.com/p/DS8YfqykoPt/?hl=en) that I was starting a** 30-Day No Ultra-Processed Food** (UPF) **Experiment**. (Chances are, many of you reading this are doing it with me!).  For the past two weeks, I haven’t counted a single calorie or stepped on a scale. I haven’t tracked macros or worn a glucose monitor or sworn off carbs. I just did one thing: I stopped eating UPFs. Not “mostly.” Not “on weekdays.” Completely. As much as humanly possible. And what surprised me wasn’t what I _lost_, but what I _gained_. Here’s what I observed:  #### **Observation 1) I Had More “Clean” Energy** I’m not talking about the jittery caffeine-induced buzz that has you slumped by 3 PM. This was different. My brain felt clearer. My body felt steadier. And I was less zapped at the end of the day. My theory? When you remove UPFs, your body stops wasting energy trying to metabolize substances it doesn’t recognize as food, such as emulsifiers, artificial sweeteners, flavor enhancers, and stabilizers.  These additives are not neutral passengers. They require immune surveillance and are metabolically expensive. When that burden is lifted, energy can be redirected to processes such as muscle repair, hormone regulation, and brain function. I found myself getting into bed at night just because it was my bedtime, not because I was exhausted.  #### **Observation 2) My Digestion Changed** I noticed slightly fewer bowel movements. Not constipation. No bloating. No discomfort. Just…less urgency. (Sorry if that’s TMI!) This sounds trivial, but it’s actually fascinating.  **UPFs are “pre-digested.”** They’re industrially stripped of fiber and structure, so they melt in your mouth, which tricks your brain into eating more. This is great for the company’s bottom line, but it turns your gut into a high-speed conveyor belt. (Read: more pooping, in general.) **Whole foods are intact. **They engage in chewing, stomach acid, and digestive enzymes. When food is real, the body doesn’t rush to expel it, and it extracts nutrients more thoroughly.   Which brings me to the third and perhaps most striking change:   #### **Observation 3) My Appetite Went Down** My appetite dropped, but not in a suppressed or deprived way. I just wasn’t constantly thinking about food. My meals felt satisfying, and then I moved on with my life. * **The Why: **UPFs are designed to break your “fullness” switch. They combine sugar, fat, and salt in a ratio that doesn't exist in nature. This mix confuses the brain and dulls leptin signaling (your brain’s “I’m full” hormone).  When you switch to whole foods, your brain recalibrates. The satiety signals get louder, and your hunger cues become more accurate. You stop eating because you’re satisfied, not because the bag is empty. #### **Observation 4) I Lost About a Pound ** Honestly, I hesitate to mention this because weight loss is not the headline here. But it is worth noting. When appetite regulation improves and metabolic efficiency increases, body weight often follows.  This experiment was not to “cleanse” or “detox.” (I actually dislike those terms as I find them built on hype and pseudoscience.) Your liver and kidneys already handle detoxification just fine.  This was simply about removing “food” that was never meant to be a daily input. I wanted to see what happened when I gave my body fuel it actually recognized.  #### **What I’m Taking Away From This** The goal here isn’t perfection. There have been times when I don’t really have an option. If faced with starving or eating something awful, I’ll reach for my favorite protein bar. But absent those situations, I plan to continue to minimize eating UPFs. Remember, UPFs don’t just add empty calories. They demand energy, disrupt signals, and create noise in systems that work best when we have “nutritional clarity.”  But when that noise is gone? The body does what it’s designed to do. And that system is incredibly powerful.  **Bottom line:** sometimes, the most powerful experiment isn’t adding something new. It’s taking something **out** and paying attention. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/12f84e5c-dc7f-475c-bf2d-da66a5632f7b/_SS__How_scans_aproved.jpg?t=1768950107) Caption: For almost 20 years, I’ve told people some version of this: “After menopause, the best we can usually do is slow the loss of bone density.” In many cases, that’s true. But I just learned that it’s also incomplete. I recently had a [DEXA Scan](https://my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test) (a test that measures bone strength) on the exact same machine as my scan from one year ago. The result? My bone mineral density (BMD) **increased by 2.4%. **(By the way, the recommendation for a woman with normal BMD is to repeat a DEXA in 2 or more years, not 1 year as I did.) View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/23d9b225-8770-42c0-b2f5-7c10cd7b134a/image.png?t=1768950692) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f8411cfd-5274-4dbb-a69c-d8a9548c4809/image.png?t=1768950696) Caption: This wasn’t a rounding error or a fluke. It was the same equipment. The result was so clear it forced me to say out loud: _Jen, I cannot believe my eyes. Sit down. Your skeleton has notes._ #### **Building Bone After Menopause ** **What happened here?** Let me walk you through what the research says and then what I believe made the difference for me.  First, a reality check. Increasing BMD after 50 is hard. It requires consistent effort and the right interventions. But it’s not some mythical outcome. Research shows two main things move the needle:  1. **Hormone Therapy (HRT):** In [peer-reviewed trials](https://www.sciencedirect.com/science/article/abs/pii/S0301211598003133), menopausal hormone therapy has been shown to preserve and increase BMD and [reduce fracture risk](https://pubmed.ncbi.nlm.nih.gov/11401611/) compared with placebo.  2. **Heavy Lifting: **Resistance training (lifting heavier weights over time) shows [measurable benefit](https://pubmed.ncbi.nlm.nih.gov/8822346/) for BMD in postmenopausal women.  The punchline from more recent reviews is what many of us see clinically: the combination of an estrogen-supportive hormonal environment plus structured loading is generally more effective than either alone.  **That said?** Here are the details on what I’ve done that likely contributed to increasing my bone mineral density:  **1) HRT (five years and counting).** I’ve been on HRT for five years. Estrogen has a documented role in bone remodeling, and randomized trials have shown BMD benefits with hormone therapy.   **2) Heavy resistance training. ** Not “cute little 3-pound weights.” I’m talking [progressive overload](https://todays-ajenda.beehiiv.com/p/the-real-reason-your-workouts-dont-work?utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-issue-49&_bhlid=19e754784d45c83fb325a18a98952a9d56f265bd): lifting heavy enough that my body has to adapt.  If you follow me on [Instagram](https://www.instagram.com/drjashton/?hl=en&utm_source=todays-ajenda.beehiiv.com&utm_medium=newsletter&utm_campaign=today-s-ajenda-issue-46), you know that for the past 18 months I’ve been doing exactly that with professional trainer Korey Rowe. It’s why I’m stronger today at 56 than I was at 36. And my scan shows that his training approach, and my [Wellness Experiment](https://www.joinajenda.com/experiment) pays dividends in truly significant ways. This isn’t just anecdotal. [Research shows](https://pubmed.ncbi.nlm.nih.gov/28975661/) that resistance training is a powerful lever for increasing BMD in postmenopausal women.  It is true that my bones were good before I started training with Korey. In fact, my bone mineral density was in the normal range (not even [osteopenia](https://my.clevelandclinic.org/health/diseases/21855-osteopenia)) because I’ve been lifting weights since high school.  This is your reminder that the window of adolescence and early 20’s is **key** for preventing osteopenia or osteoporosis 30-40 years later! So if you know a teenage girl or young woman in her 20’s, pay it forward and share this key bone-sparing info with her! **3) Getting ~1,200 mg/day of calcium from food.** I’ve been militant about getting 1,200 mg of calcium from food (**not** supplements) every day. The data is clear: calcium in supplement form is **not** a reliable fracture-prevention strategy for most postmenopausal women.  * **Science Says**: [A 2015 review](https://www.bmj.com/content/351/bmj.h4580) found that the evidence that calcium supplements prevent fractures is“weak and inconsistent.”  That doesn’t mean calcium doesn’t matter. It means **how** you get it matters, and food-first is usually the cleanest approach.  Vitamin D3 and Vitamin K2 are part of this, too. Vitamin D is essential for calcium absorption and bone metabolism. Vitamin K2 (menaquinone) [has suggested benefits](https://todays-ajenda.beehiiv.com/p/i-did-a-32-hour-broth-fast-heres-what-happened) for lumbar spine BMD and fracture outcomes in postmenopausal women.  #### **The One Thing I Want You To Hear** Do not wait until you’re 65 to start thinking about your bones. While the [USPSTF recommends](https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening) routine osteoporosis screening with DXA starting at **age 65** for most women, I have never followed these recommendations.  **Why?** Because I was trained to get a baseline DEXA when menopause starts. And in my medical career, I’ve seen numerous cases of osteoporosis in women aged 50. I subscribe to the philosophy of: I would rather catch something sooner rather than later, and since we ALL lose bone density as we age, I would rather know about it at 50 rather than 65! I encourage you to be aggressive about asking your health care provider or doctor about getting a DEXA scan when you go through menopause or at least before age 65.   **The good news?** Your skeleton is a living tissue that can respond to the right inputs. This experience reminded me of exactly why I love medicine and being a physician: the body can do miraculous things! View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/72a3f57a-14c4-4cb0-9f46-e939299237d4/The_Mushroom_Supplement_For_Cognitive_Clarity_After_50_.jpg?t=1768950165) Follow image link: (https://alicemushrooms.com/AJENDA?q=brainstorm-journal) Caption: **The brain fog in midlife is real**. Between hormonal shifts, poor sleep, and stress, our cognitive clarity tends to stretch thin after 50.  I’ve been asked countless times what helps with this. Is there something that can clear the cobwebs that **isn’t** a stimulant? That question is what drew me to [Alice Mushrooms](https://alicemushrooms.com/AJENDA?q=brainstorm-journal)* about three years ago.  I met the founders, Lindsay Goodstein and Charlotte Cruze, at an event. They’d just created Brainstorm, a functional mushroom chocolate (not psychedelic!) designed to enhance focus and energy.  I was skeptical but curious. Mushrooms for brain clarity? As with anything, I had to try it myself. Today, I have [Alice Brainstorm](https://alicemushrooms.com/AJENDA?q=brainstorm-journal) almost every day, usually in the afternoon when I need mental sharpness or a low calorie boost.  Here’s what makes Brainstorm stand out:  * 🍄 **These are not psychedelic mushrooms. **No psilocybin, no hallucinogens.  No tripping. These are functional mushrooms (think food and nutritional science)  formulated to energize your brain.  * 🍄 **They’re not ultra-processed. **Brainstorm is built around whole-food mushroom extracts and botanicals with minimal processing. The body recognizes these inputs as nutrients, not chemical fillers. * 🍄 **The star ingredient is lion’s mane. **[Research has shown](https://pubmed.ncbi.nlm.nih.gov/18844328/) that lion’s mane stimulates nerve growth factor (NGF), a protein involved in learning and memory. In plain terms, this supports brain cell communication and adaptability.  * 🍄 **They have botanicals for stress resilience and neurotransmitter balance.** Instead of forcing your brain into overdrive with stimulants (and the inevitable crash and appetite disruption), Brainstorm helps to support clarity by contributing to reducing inflammation and oxidative stress. This is where I need to be transparent: I’m not just recommending Brainstorm. I’m Alice Mushroom’s medical and nutritional advisor, as well as an investor.  I invested because Brainstorm aligns with how I think about nutrition: to respect physiology, prioritize real and high quality ingredients, and support the system with nutrients. It’s one of the few supplements I stand behind.  If you’re curious about supporting your physical and mental energy from a square of dark chocolate, use the code** AJENDA** for [15% off your order](https://alicemushrooms.com/AJENDA?q=brainstorm-journal). View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/2123a4e7-2970-4e1c-8876-0de453f8021a/Shop__ALICE_Brainstorm_BUTTON.jpg?t=1768950320) Follow image link: (https://alicemushrooms.com/AJENDA?q=brainstorm-journal) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/efb4f780-a735-411e-82a3-abce0669b094/approved_Community_5_Different_Ways_to_Test_Your_Body_Fat_Composition_.jpg?t=1768950388) Caption: Ever stepped on a “smart” scale and watched your body fat percentage jump around like the stock market? I’ve been there. There’s so much happening inside our bodies, from where fat is stored to how much muscle we have to bone strength. It’s never just a number on a scale.  And menopause makes it _that_ much harder to track. More central fat, less total body water, and gradual muscle loss if you’re not strength training. Fortunately, a bathroom scale isn’t the only option. I am asked all the time if these various body composition devices are “worth it.” Let’s go through the major body comp test methods. #### 1) Bathroom “body fat” scales (single-frequency BIA) This is the scale you probably already have in your bathroom. They use [bioelectrical impedance analysis](https://en.wikipedia.org/wiki/Bioelectrical_impedance_analysis) (BIA): a small current travels through your body, and the device estimates fat mass vs lean mass based largely on how water conducts electricity.  Sounds simple. The problem is that almost everything affects water.  Had a glass of wine last night? Different reading. Went for a run this morning? Different reading. Ate salty food, took a hot shower, or flew across the country? All different readings. And after 50, the margin of error gets wider:   * **Zoom In:** Menopause shifts where we store fat and how much water our bodies hold, which means these scales can be even less reliable than they were in our 30s.  [Research shows](https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0200465&) that while BIA scales _can_ track trends, they often diverge from the gold-standard DEXA scan and have meaningful individual-level error and bias.  * **Pros: **cheap, easy, great for trend tracking if you standardize conditions  * **Cons:** not “precise”; day-to-day numbers are often more drama than data  * **Cost:** $30–$200   #### 2) Gym/clinic segmental, multi-frequency BIA (InBody-style) These are the machines you've seen at your gym or doctor's office, where you stand barefoot on metal plates and grip handles while it does its thing (e.g., the [InBody Machine](https://inbodyusa.com/)).  Unlike the scale at home, these devices measure electrical impedance across different body segments (arms, legs, trunk) and different body components (bone, fat, muscle, water) and use multiple frequencies. They’re generally better than bathroom scales, and in older adults, some models show improved agreement with DXA (still not perfect).  * **Pros: **fast, repeatable, useful for tracking muscle distribution over time  * **Cons:** still hydration-sensitive, still an estimate  * **Cost:** often $10–$40 per scan in gyms or wellness settings. The machine itself runs over $6000.  #### 3) DEXA body composition DEXA ([dual-energy X-ray absorptiometry](https://www.radiologyinfo.org/en/info/dexa)) is the “gold standard.” It measures bone, lean mass, and fat mass with high precision. Lost two pounds? DEXA tells you whether it was muscle or fat. Strength training for six months? DEXA shows whether your bones have strengthened.  It’s not perfect (different machines and software can vary), but if you use the same machine, it’s excellent for tracking change. * **Pros: **best balance of accuracy + practicality; also gives bone data * **Cons:** cost and access; low-dose radiation. Also, many technicians flat out refuse to run this (generally because they may not be aware that it can easily be done while testing bone density and it’s just easier for them to say ‘no.’) * **Cost:** roughly $40–$300+ cash-pay depending on setting  #### 4) Bod Pod (air displacement plethysmography) This “egg-shaped” chamber estimates body fat based on body volume and density. It looks futuristic, feels a little claustrophobic, and…isn’t as accurate as you’d hope.  [Research shows](https://pmc.ncbi.nlm.nih.gov/articles/PMC4739294/?) the Bod Pod can over- or underestimate compared to DEXA, with bias depending on your body size and shape.   * **Pros:** quick, noninvasive  * **Cons: **results can differ from DXA; sensitive to protocol and clothing  * **Typical cost:** $30–$100  #### 5) Skinfold calipers The old school pinch test. A technician uses calipers to measure fat at specific spots on your body, plugs those numbers into an equation, and estimates your body fat percentage.  Can it work? Sometimes. But accuracy depends heavily on the measurer and the equation. In older adults, certain equations perform better than others, and some are simply unreliable.  * **Pros:** inexpensive, portable * **Cons:** technician-dependent; less accurate with age-related fat redistribution  * **Typical cost:** ~$20–$75 for an assessment  #### My North Star Takeaway Don’t obsess over a single number on your bathroom scale. Use it for trends only, under the same conditions, and focus on what moves the needle: strength, protein, sleep, and mobility.  And if you want hard data? Go with DEXA. (Or if that's not accessible, find a multi-frequency BIA machine and use the same one every time.) That's how you build your own dataset and use it to make smarter decisions about your health. The number is just information. What you do with it is what counts. View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/f7c091d7-0776-49dc-ac83-9ee837fab3c6/shrimp_stir_fry_take_2.jpg?t=1768953247) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/c2b76a19-b28f-43d8-961c-139d2c4c4688/newsletter_want_more_jen.jpg?t=1765982081) Caption: Subscribe to my paid newsletter, [Off Duty](https://todays-ajenda.beehiiv.com/upgrade), where I step away from the doctor’s desk and television sets and share the info from my real life that nobody else has access to. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/171ba266-41e2-4b21-a40d-ba73987b641f/leave_a_review_BUTTON__1_.jpg?t=1745881921) Follow image link: (https://senja.io/p/experiment/r/newsletter) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: #### _ABOUT DR. JEN_ In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” **Dr. Jennifer Ashton—”Dr. Jen”**—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time._ And she has gone through menopause… **Forwarded this email? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/5fba8aac-dae0-430c-a69f-25e442c9cca1/click_here_BUTTON.jpg?t=1743452475) Follow image link: (https://todays-ajenda.beehiiv.com/subscribe) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: **Missed the last issue? ** View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/81d4c39d-5baf-4341-b255-647dbfa1fb4b/Read_it_here_BUTTON__3_.jpg?t=1745882021) Follow image link: (https://todays-ajenda.beehiiv.com/p/i-did-a-32-hour-broth-fast-heres-what-happened) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/88d5095a-5b58-4c46-b361-5a64b3ea1d27/blue_rule.jpg?t=1743447366) Caption: _*Note: This newsletter includes affiliate links. 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View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/3522583b-4580-40b2-b140-e2cc888a1177/image.png?t=1710466035) Caption: # Welcome to Ajenda! Hey there! Thank you for joining Ajenda! I’m so glad you’re here.  I created Ajenda because women deserve **honest**, unbiased information from credentialed and credible sources on the topics that impact their everyday lives.  Because let’s be real—too often, the medical world makes that information **way** harder to digest than it should be.  Medical jargon. “Miracle cures.” Blanket statements that ignore the nuance of health concerns. Even worse are the way some experts use their platform to **shame women** into feeling “less than” through scare tactics or half-answers that send you in circles.   I refuse to be part of the problem. I don’t motivate people towards better health with melodrama: That’s **not **my job. Instead, I chose balanced and honest communication. As someone who is double board certified in OB-GYN and obesity medicine with a Master’s degree in nutrition—and was the Chief Medical Correspondent for [Good Morning America](https://www.goodmorningamerica.com/author/Dr._Jennifer_Ashton) and ABC News—my job is to give you evidence-based information** **about hormones and hair loss, menopause and metabolism, weight management and women’s health.  (For free. Now and forever.)   Every single day, for almost 18 years, I was trusted to give analysis, perspective, and context to the medical headlines that matter to millions of people. But whether I am speaking to one person or millions, my standard is **always** to present the facts, the pros and cons, the risks and benefits, what’s known and what’s not known, and then (if asked) to give my personal and professional opinion in a no-nonsense, non fear-mongering manner.  Because I trust women—I trust **you**—to make the best decisions for your own health as long as you’re accurately informed and properly advised.  As a thank you for subscribing, here’s your **free science-backed nutrition plan**: ——————————————————————————— Free One-Week Nutrition Plan In this seven-day meal plan, you'll get the exact recipes for high-fiber and high-protein meals that'll help you look and feel you best. 559.26 KB • PDF File Download: https://beehiiv-publication-files.s3.amazonaws.com/uploads/downloadables/f004aea8-5e48-4849-bd2f-990276a8e175/93b567e4-65b6-4656-a8d8-9c235fc2918f/Nutrition%20Plan_Lead%20Magnet.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAQCMHTQSE2JGAGXHJ%2F20260117%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260117T214013Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=b8fbf0054c9cce016535aa9ae507b4617e46b4a00f4c1b73ad56c1059cdda045 ——————————————————————————— This nutrition plan is straight from [The Wellness Experiment](https://www.joinajenda.com/experiment), a program that blends my evidence-based nutritional and medical guidance with personal trainer Korey Rowe’s fitness expertise to deliver a complete, results-driven wellness solution. To access more science-backed recipes, targeted fitness plans, and expert wellness content, you can enroll in the program [here](https://www.joinajenda.com/experiment). As a reminder, here’s what you can expect every **Wednesday** in Ajenda: * **Dose of Honesty**: No-BS insights on a timely medical topic. * **Symptom Solutions**: Tangible steps for common health issues. * **Community**: I answer _your_ questions about anything on your mind. Speaking of which: I’d love to cover **your** favorite topic for an upcoming community section. Answer this poll and tell me: Nothing is off limits. I’ll give it to you straight to help you understand what you need to know and what to do. And one thing's for sure: You’ll never get an answer that sends you in circles (unless we’re talking about a cycling class).  Thank you again for subscribing. Now…let’s do this!  Dr. Jen View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/1b0ea781-6f58-49b7-afa5-94b3c69a0c2e/Dr._Jen_signature.png?t=1710438803) Caption: View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/a4d1ee9d-c14a-4404-8165-e78bd62a66db/Frame_450.png?t=1709844973) Caption: ### About Dr. Jen In her roles as chief medical correspondent for ABC News and on air-cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—shares the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has written several books, including the best-selling _The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time_. And she has gone through menopause… View image: (https://media.beehiiv.com/cdn-cgi/image/fit=scale-down,format=auto,onerror=redirect,quality=80/uploads/asset/file/892da0c2-1f4d-43a5-9f9b-ad3a88ba401f/Ajenda_Guidelines_SiteUpdates__5_.png?t=1709837555) Caption: