Writer, Harvard-trained board-certified gynecologist, yoga teacher, mom. I believe in evidence-based ancient medicine. My specialty: bioidentical hormones + botanicals. I've partnered in, predicted, and personalized healing with women since 1989. For more info, visit www.SaraGottfriedMD.com. Return to balance, naturally™.
Monday, January 31, 2011
Monday Mystic: Menopause Poem by Adair Lara
Adair Lara is our Monday Mystic for Jan 31, 2011. She sent this phresh poem to me today (see below), and got me thinking I need to banish people-pleasing from my life far in advance of menopause. You? And start self basting in this Bulgarian hotel I call my body.
Adair connects me to another time and place - to the refreshingly honest voice of Annie Lamott's Operating Instructions, which I clutched to my bosom like a bible before my kids were born. Finally, a mom who tells the truth. Now the kids are getting older and a new part of the women's life cycle presents itself to me... namely, hormonal chaos. Actually, pregnancy and post-partum was rather hormonally chaotic too, but in a different way. I had a precious new life that kept me focused.
Adair Lara reminds me of the rugged, hilarious, wise and seamed women I love from Alaska who live fully, boldly and without qualification. She is the author of 13 bold books, including the most recent: Naked, Drunk and Writing (Ten Speed Press, 2010).
Menopause
The mother of all wake-up calls
After the hormones wear off like party drugs
The house is rewired
By a blind and maybe drunk electrician
Sparks are flying
The thermostat’s out of whack
It’s like living in a Bulgarian hotel
Still. The craziest hotel has its dance band.
I see you there in your little black dress
And little black mood.
You got back from Bangkok with new eyes,
just in time for your first granddaughter
to be born with your old eyes.
You can now turn your head side to side
Say no in several languages.
Oh, the forgotten pleasure
Of not pleasing.
You who skipped Ivanhoe and parallelograms
take night classes and sit up front.
Making yourself sharp and sure for
that woman in the glass.
The to-do list has changed
Do become self-basting.
Do buy yourself roses
And hang one over an ear.
Don’t finish books if you don’t like ‘em
Don’t examine thighs in tooth-paste flecked glass
Do stroll in the dark up Kilimanjaro
Write books start tea shops paint wild canvases?
-- Adair Lara
Labels:
Adair Lara,
Anne Lamott,
Menopause Poem,
Mystic Monday
Thursday, January 27, 2011
Fried: Why You Burn Out by Joan Borysenko, PhD
I'm loving Joan Borysenko's new book, Fried... except I think I'm fried. I hate it when that happens. I immerse myself, write and teach what I most need to learn.
Joan refers to one symptom of burnout - the desire to take sabbaticals regularly - and that totally rings true for me, like an arrow to the chest. How can we move forward with our work, repair the world, heal others and not be desperate for a sabbatical every other minute?
Here's Joan in the early part of the book, when she was recognizing some of her symptoms of burnout:
I discovered that burnout is very poorly understood. None of the healers whom I consulted - either the traditional or the complementary - understood what the mechanics of burnout are and what is needed for recovery.
I realized that unless the condition is recognized and taken seriously, physicians will keep missing it and handing out antidepressants. While medication can affort temporary relief for some people, it may also short-circuit the process of self-reflection which is ultimately where healing comes from.
Plus we know that anti-depressants probably don't help mild to moderate depression - they are effective for severe depression but side effects (low libido, weight gain) may make them worse than placebo.
Here are some favorite questions she posits.
Joan weaves an interesting new voice in her book - that of her Facebook Friends. Joan writes that one FB friend: "used to think that being burned out was an admission that something was wrong with her. Now she views burnout as an invitation to come into alignment with a more elegant expression of her gifts, relationships, and overall life energy."
More elegant expression of my gifts, relationships and energy? Yes, that is what I'm seeking too.
This is from Joan's Facebook Friend, Shannon Kennedy:
The body is where I would start to deal with burnout so that I wouldn't need to take long sabbaticals to collect my parts and return them to their original location. So often we intellectualize and go to the mind to think things through, jumping right past the physical discussion our body is having right under our nose. My perspective is this: getting to know where you feel contracted in body, thought and emotions and what it feels like to release that holding is the way out of burnout.
We are fluid, flowing beings, and when we are in nonstop mode, we are perpetually in a holding contraction, thinking that we are stabilizing. OUr body is actually working overtime to support our mind's directives, like a loyal canine companion. Because of this contraction, no blood/prana can flow.
Here's to releasing contraction in the way that serves you best, whether that is yoga, meditation, tai chi or some other contemplative practice.
Joan refers to one symptom of burnout - the desire to take sabbaticals regularly - and that totally rings true for me, like an arrow to the chest. How can we move forward with our work, repair the world, heal others and not be desperate for a sabbatical every other minute?
Here's Joan in the early part of the book, when she was recognizing some of her symptoms of burnout:
I discovered that burnout is very poorly understood. None of the healers whom I consulted - either the traditional or the complementary - understood what the mechanics of burnout are and what is needed for recovery.
I realized that unless the condition is recognized and taken seriously, physicians will keep missing it and handing out antidepressants. While medication can affort temporary relief for some people, it may also short-circuit the process of self-reflection which is ultimately where healing comes from.
Plus we know that anti-depressants probably don't help mild to moderate depression - they are effective for severe depression but side effects (low libido, weight gain) may make them worse than placebo.
Here are some favorite questions she posits.
- In what ways do adverse experiences in childhood lead to learned helplessness that increases your chances of burning out as an adult?
- How can you learn to manage your energy and find a dynamic state of balance?
- Once you pinpoint your temperament, how can you match it to the right kind of work?
- emotional exhaustion - deep fatigue and feelings of being emotionally drained and overwhelmed;
- depersonalization - a loss of self and a cynical disregard for the people you serve or live with;
- diminished personal accomplishment - a progressive loss of confidence and competence.
Joan weaves an interesting new voice in her book - that of her Facebook Friends. Joan writes that one FB friend: "used to think that being burned out was an admission that something was wrong with her. Now she views burnout as an invitation to come into alignment with a more elegant expression of her gifts, relationships, and overall life energy."
More elegant expression of my gifts, relationships and energy? Yes, that is what I'm seeking too.
This is from Joan's Facebook Friend, Shannon Kennedy:
The body is where I would start to deal with burnout so that I wouldn't need to take long sabbaticals to collect my parts and return them to their original location. So often we intellectualize and go to the mind to think things through, jumping right past the physical discussion our body is having right under our nose. My perspective is this: getting to know where you feel contracted in body, thought and emotions and what it feels like to release that holding is the way out of burnout.
We are fluid, flowing beings, and when we are in nonstop mode, we are perpetually in a holding contraction, thinking that we are stabilizing. OUr body is actually working overtime to support our mind's directives, like a loyal canine companion. Because of this contraction, no blood/prana can flow.
Here's to releasing contraction in the way that serves you best, whether that is yoga, meditation, tai chi or some other contemplative practice.
Wednesday, January 26, 2011
Beginnings of the Ends: Telomere Storytime
I've been talking up telomeres a lot lately, which are emerging as the key biomarker of biological aging. Think you look younger than your chronological age? Here's your marker. Telomeres are a lot like the plastic tips on the ends of shoelaces - in this case, telomeres keep DNA on the ends of chromosomes from fraying, and help cells divide more crisply (which they typically do 60-100 times before sinking into the hot tub of senescence).
For my friends with attention deficit -- SHORT VERSION -- short telomeres are bad; long telomeres are good. Stress shortens your telomeres (see research on mamas in distress, below) and here's what lengthens them: meditation, whole food, mostly plant-based and a little estrogen.
I'll highlight first some of the studies that I did not mention but you may find interesting, all out the lab of Nobel Laureate Elizabeth Blackburn at UCSF.
Estrogen helps: it lengthens telomeres after menopause. Endogenous estrogen exposure is associated with longer telomeres in postmenopausal women at risk for cognitive decline, as reported last October, 2010.
This is major on depression: telomeres are shorter in depressed folks, and can predict treatment response, published this month in Nature.
Even beginning meditators can lengthen telomeres. A significant change was noted as soon as 3 months after beginning meditation as reported last month.
For men, read how yoga, meditation and eating right can improve your risk of prostate cancer right here along with lengthening your telomeres.
Exercise buffers how chronic stress shortens telomeres in postmenopausal women, as reported last year.
Telomeres lengthen when you eat whole foods, mostly plant-based and meditate. Results of this studyhttp://www.ncbi.nlm.nih.gov/pubmed/18799354 (www.lancet.com), demonstrated that intensively improved nutrition and meditation increases telomerase. Telomerase is the enzyme responsible for maintaining telomere length. Telomeres are the ends of chromosomes that influence how long we live. This is the first time that any intervention, even drugs, has been shown to significantly increase telomerase.
For my friends with attention deficit -- SHORT VERSION -- short telomeres are bad; long telomeres are good. Stress shortens your telomeres (see research on mamas in distress, below) and here's what lengthens them: meditation, whole food, mostly plant-based and a little estrogen.
I'll highlight first some of the studies that I did not mention but you may find interesting, all out the lab of Nobel Laureate Elizabeth Blackburn at UCSF.
Estrogen helps: it lengthens telomeres after menopause. Endogenous estrogen exposure is associated with longer telomeres in postmenopausal women at risk for cognitive decline, as reported last October, 2010.
This is major on depression: telomeres are shorter in depressed folks, and can predict treatment response, published this month in Nature.
Even beginning meditators can lengthen telomeres. A significant change was noted as soon as 3 months after beginning meditation as reported last month.
For men, read how yoga, meditation and eating right can improve your risk of prostate cancer right here along with lengthening your telomeres.
Exercise buffers how chronic stress shortens telomeres in postmenopausal women, as reported last year.
Telomeres lengthen when you eat whole foods, mostly plant-based and meditate. Results of this studyhttp://www.ncbi.nlm.nih.gov/pubmed/18799354 (www.lancet.com), demonstrated that intensively improved nutrition and meditation increases telomerase. Telomerase is the enzyme responsible for maintaining telomere length. Telomeres are the ends of chromosomes that influence how long we live. This is the first time that any intervention, even drugs, has been shown to significantly increase telomerase.
Elizabeth Blackburn also showed that mothers caring for their sick kids have shorter telomeres when they report that their emotional stress is at its greatest. Acute stress actually increases telomere length (via increased telomerase), whereas chronic stress shortens length.
Want to test your telomere length? That'll set you back $350, not usually covered by insurance. Hopefully that fee will reduce as more competitors join the field.
Lots of new data, lots of promise here for those of us trying to slow down the decline of middle and old age. Best news to date: meditate regularly and eat right (Dean Ornish way, according to these data, although I'll take that with a tablespoon of oil, thank you very much) and your telomeres will stay nice and longy.
Want to test your telomere length? That'll set you back $350, not usually covered by insurance. Hopefully that fee will reduce as more competitors join the field.
Lots of new data, lots of promise here for those of us trying to slow down the decline of middle and old age. Best news to date: meditate regularly and eat right (Dean Ornish way, according to these data, although I'll take that with a tablespoon of oil, thank you very much) and your telomeres will stay nice and longy.
Tuesday, January 18, 2011
Sake Bombs or Kale? Vacation Review
At the risk of sounding insufferable, I have to share some thoughts on two side-by-side vacations.
Let me preface our discussion with two disclosures: I have adrenal dysregulation and two young kids. While I'm in adrenal "recovery," as many of you know who are on this path with me -- recovery takes a long, long time.
Vacation #1: Bolinas. We rented a small house on the mesa in late December. We slept a lot and watched deer (here's a YouTube of watching deer as meditation). We ate incredibly food that was picked that day from the local Gospel Hills farm stand, which operates on the honor system. You can see some of the chard and kale in the foreground of the photo I took (above). We did some serious chillaxin'. We hung out. We walked. We did lots of sleeping. We came home after 5 days, tanks full.
Vacation #2: Tahoe. We rented a tiny condo in Northstar Village but double the cost of the Bolinas house. We tried to gather used gear for the kids to ski but could only find weird bits and pieces so we spent 3 evenings before we left spending about $500 to outfit the kids fully. We were worried about taking our little Prius on big mountain passes so we rented an SUV for another $400. We left early because we were worried about traffic (my last trip took 9 hours in traffic on a Friday afternoon from Berkeley). We got up early to haul our semi-reluctant kids to ski school. We stayed out late drinking too much with friends. Sake bombs, anyone? I learned they can ruin a good liver in record time.
Let me preface our discussion with two disclosures: I have adrenal dysregulation and two young kids. While I'm in adrenal "recovery," as many of you know who are on this path with me -- recovery takes a long, long time.
Vacation #1: Bolinas. We rented a small house on the mesa in late December. We slept a lot and watched deer (here's a YouTube of watching deer as meditation). We ate incredibly food that was picked that day from the local Gospel Hills farm stand, which operates on the honor system. You can see some of the chard and kale in the foreground of the photo I took (above). We did some serious chillaxin'. We hung out. We walked. We did lots of sleeping. We came home after 5 days, tanks full.
I kid you not about the honor system. Here's where you put your mula - at $2 for organic dino kale, life is good.
Vacation #2: Tahoe. We rented a tiny condo in Northstar Village but double the cost of the Bolinas house. We tried to gather used gear for the kids to ski but could only find weird bits and pieces so we spent 3 evenings before we left spending about $500 to outfit the kids fully. We were worried about taking our little Prius on big mountain passes so we rented an SUV for another $400. We left early because we were worried about traffic (my last trip took 9 hours in traffic on a Friday afternoon from Berkeley). We got up early to haul our semi-reluctant kids to ski school. We stayed out late drinking too much with friends. Sake bombs, anyone? I learned they can ruin a good liver in record time.
I think you know where this is heading.
I was thinking about a sweet 4-mile hike in Bear Valley with our kids versus the cold, exhaustingly agro-ness of hustling around Tahoe. But it is awfully pretty to be in the mountains.
Let me add that I was super fun to be around while in Tahoe: donning my one organic wool sweater and leggings for 4 days straight and scouring every menu in Northstar for something I could eat that aligns with both my organic experiment and the Gottfried Cleanse I began last Wednesday. Been around folks who are detoxing? One word: I - R - R - I - T - A - B - L - E .
While body weight is an arguable criterion for ranking vacation, it's a great proxy for cortisol: I lost 5 pounds in Bolinas, maintained it for 3 weeks, then gained it all back in Tahoe.
More worry = high cortisol = more sugar cravings = weight gain + muffin tops. More on that this Sunday at our Stress Resilience workshop.
I was thinking about a sweet 4-mile hike in Bear Valley with our kids versus the cold, exhaustingly agro-ness of hustling around Tahoe. But it is awfully pretty to be in the mountains.
Let me add that I was super fun to be around while in Tahoe: donning my one organic wool sweater and leggings for 4 days straight and scouring every menu in Northstar for something I could eat that aligns with both my organic experiment and the Gottfried Cleanse I began last Wednesday. Been around folks who are detoxing? One word: I - R - R - I - T - A - B - L - E .
While body weight is an arguable criterion for ranking vacation, it's a great proxy for cortisol: I lost 5 pounds in Bolinas, maintained it for 3 weeks, then gained it all back in Tahoe.
More worry = high cortisol = more sugar cravings = weight gain + muffin tops. More on that this Sunday at our Stress Resilience workshop.
At the end of the day, I only have two compelling reasons to go to Tahoe: I love to cross-country ski, and I'd love for my kids to be proficient at skiing (or snow-boarding) down a mountain. It's one of those nice sports that adds to your social card and it's a fun way to burn calories.
But I found it also burns out adrenals, at least my adrenals. Yours?
Labels:
adrenal burn-out,
cortisol,
skiing,
stress,
vacation
Thursday, January 13, 2011
Madonna My Thyroid, Please
One comment personal trainers hear daily from overweight, middle-aged women is: "I want Madonna arms." It makes them want to shoot themselves.
While she is controversial, chameleonic and doesn’t always comment wisely on her art, she is arguably looking might fine for age 52. In fact, I think she may have hacked the aging female body.
Here she is at her birthday party last August. Hottie!
Here she is at her birthday party last August. Hottie!
Madonna is the same age as her boyfriend Jesus’ granny, but I’m pretty sure she could kick my ass even though I’m ten years younger.
What am I getting at? I'm convinced that Madge does everything right for her thyroid, and we could all stand to learn from her. This comes not from direct knowledge as her personal physician but from watching her closely for 27 years. She exercises regularly. I saw her in concert in 2008 and she literally danced nearly nonstop for 2 hours. Not just a two-step but high-kicking, anaerobic-threshold type of dancing. While one can never really know what she eats, she seems to follow macrobiotic principles and we don’t hear about her overindulging in drugs or alcohol and spewing epithets like Lindsay Lohan. She says she’s devoted to family and it’s her top priority. That helps cortisol levels.
Oprah, on the other hand, seems to have done everything wrong.
Let me explain.
Oprah likes sugar. Lotsa lotsa sugar. Oprah has owned several aspects of her eating: that she overindulges, eats to soothe, and especially loves bags of potato chips. Her exercise regimen, is, well… “episodic." Is she still with Stedman? Or is Gayle her only family? She states her thyroid function tests are in the normal range, but to my eye, she continues to look puffy, exhausted, hormonally imbalanced, overweight, and while I aspire to have the type of robust synthesis and intuition she deftly reveals on her show, I don’t want to look like her.
Here’s how the good Dr. Oz describes Oprah’s thyroid to her (with thanks to the super shero Mary Shomon for posting this on her blog) and her comment about having cured her thyroid.
Well, just to be clear, your thyroid problems aren't the usual thyroid problems. And by that I mean although the ailment itself is common, there's two issues that can happen with your thyroid. It can underperform—that's hypothyroidism—or it can overperform—hyperthyroidism. But your issue, Oprah, and you're so unique, is you were having a frat party in your thyroid. You were having a bunch of different things happening at once. And so you have these two ailments: One was stimulating the thyroid with antibodies; the other one was actually waging war on the thyroid. And so when those two level out, they actually can bring you into a place of peace—which, interestingly, is where you are right now.
A frat party in my thyroid? No, thank you. Can this be prevented? We don’t actually know if a whole-foods, Paleo or macrobiotic approach is preventative or if regular exercise, like dancing consistently for 45 years as Madge has done (along with the Tracy Anderson Method), directly and clearly steer our TSH to the normal range. But there’s some suggestive data (again, Mary Shomon is our go-to princess here). Or perhaps it’s having a 20-something boyfriend as we age that is the best preventative?
Labels:
autoimmune thyroiditis,
hypothyroid,
Madonna,
Oprah
Wednesday, January 12, 2011
Notes on an Organic Life, Week 2
I'm 2 weeks into my organic experiment of wearing, eating and schmearing only organic. Frankly it's been difficult: cold, my options are rather limited and it's been expensive. Yet I love it.
Let's start with cold. I bought organic wool yarn from a sweet sheep farm in Petaluma last October. I thought I'd pop out some cute shrugs & easy cardigans. Now why did I think there was anything fast about knitting a sweater? A wool tube top - yes. In fact, I had moved on the "4-hour knitting project" some years ago when I diagnosed myself with inability to complete a sweater project (aka Knitting ADD or KADD).
I've been knitting for months and I'm delighted to have some yummy 4-hour product: fingerless gloves, hats, scarves, lotsa lotsa socks. Two half-finished sweaters. Record-low temps in the Bay Area + Half-awake thyroid + organic only = friggin' cold. All. The. Time.
All changed yesterday when my organic, fair-trade sweater showed up in the mail. The world brightened. Slipped it on at the UPS store. Fit gloriously and within seconds I was warm! Take me to Tahoe, Baby!
Next up: limited options. This one is mixed: a blessing and a curse. Blessing because limiting my options is delightfully liberating, the way a single peony in a vase can be so much more satisfying than a huge bouquet.
Packed up my beloved but probably toxic clothes, from my black Sevens to a rather frighteningly large Lululemon collection, last weekend.
Expensive: I'm trying to do this experiment on a reasonable budget. Yet organic cotton and wool are way more expensive (duh!). While the Europeans won't import the nasty cotton laced with DDT from China and South America, we do, and there's a cost differential for the cheap stuff full of pesticides vs the organic variety. I want to be transparent about the cost, so I'll be posting about that.
But for now, I'm warmer and strangely delighted.
Let's start with cold. I bought organic wool yarn from a sweet sheep farm in Petaluma last October. I thought I'd pop out some cute shrugs & easy cardigans. Now why did I think there was anything fast about knitting a sweater? A wool tube top - yes. In fact, I had moved on the "4-hour knitting project" some years ago when I diagnosed myself with inability to complete a sweater project (aka Knitting ADD or KADD).
I've been knitting for months and I'm delighted to have some yummy 4-hour product: fingerless gloves, hats, scarves, lotsa lotsa socks. Two half-finished sweaters. Record-low temps in the Bay Area + Half-awake thyroid + organic only = friggin' cold. All. The. Time.
All changed yesterday when my organic, fair-trade sweater showed up in the mail. The world brightened. Slipped it on at the UPS store. Fit gloriously and within seconds I was warm! Take me to Tahoe, Baby!
Next up: limited options. This one is mixed: a blessing and a curse. Blessing because limiting my options is delightfully liberating, the way a single peony in a vase can be so much more satisfying than a huge bouquet.
Packed up my beloved but probably toxic clothes, from my black Sevens to a rather frighteningly large Lululemon collection, last weekend.
Expensive: I'm trying to do this experiment on a reasonable budget. Yet organic cotton and wool are way more expensive (duh!). While the Europeans won't import the nasty cotton laced with DDT from China and South America, we do, and there's a cost differential for the cheap stuff full of pesticides vs the organic variety. I want to be transparent about the cost, so I'll be posting about that.
But for now, I'm warmer and strangely delighted.
Labels:
DDT,
Lululemon,
organic cotton,
organic gynecologist
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About Me
- Dr. Sara Gottfried, MD
- I'm an organic gynecologist, yoga teacher + writer. I earn a living partnering with women to get them vital and self-realized again. We're born that way, but often fall off the path. Let's take your lousy mood and fatigue, and transform it into something sacred and useful.