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/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? 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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-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. 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! 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-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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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-106) 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-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. 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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)**[.](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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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? 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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-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. 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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… **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. 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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. 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/two-weeks-no-upf-what-i-noticed

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: