In case you missed it, in my last newsletter released on 5/27/22, I shared two new articles:
Contents of this Issue:
I am now the proud owner of a freshly minted California Medical License #179649
Californians are warmly welcomed into my medical practice.
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New Article: The Wealth of Selection
In the industrialized world, calorically dense foods are cheap, plentiful, and palatable. Thus, many struggle to limit their caloric intake. However, some people struggle with the opposite problem, excessive restriction. It’s now recognized that competitive female athletes are prone to be over-restrictive as a result of internal and external influences. Restricting calories below what’s needed to maintain physiologic functions can harm performance, hamper recovery, and lead to serious medical conditions such as amenorrhea and osteoporosis.
Thanks to sports-medicine doctors, researchers, and outspoken athletes like Mary Cain, Sarah Sigmundsdottir, and Emma Abrahamson, the phenomenon of energy-deficiency in female athletes is now appreciated by more coaches, trainers, and athletes. Despite this, many female athletes still make the mistake of under-nutrition and under-recovery. Few know that this is also a problem that afflicts male athletes, military personnel, and even people who exercise for recreational or aesthetic purposes. Performance, short-term, and long-term health all depend on proper energy balance. Too much energy is bad and so is too little. This article explores the problem of “too little,” how to recognize it, and how to avoid it.
Trisha is a healthcare real estate advisor whose interests include a wide range of medical and real estate topics. In episode 108 we discussed the following topics:
Video discussion with Danielle Miller, MD, fertility wellness expert, on functional hypothalamic amenorrhea.
Several years ago, I documented the diagnosis and treatment of one of my clients who suffered from three years of amenorrhea (the lack of a menstrual period), as well as anxiety, fatigue, decreased exercise tolerance, fragmented sleep, and other signs and symptoms of energy deficiency.
This individual was a former college athlete, an avid CrossFit practitioner, and had a fastidious and restrictive approach to nutrition. After a period of diagnostic testing and clinical evaluation, we confirmed the diagnosis of functional hypothalamic amenorrhea (FHA) and relative energy deficiency in sport (RED-S). In her case, the cause of the amenorrhea was multifactorial. By decreasing her training volume and intensity, by increasing her energy intake, and by focusing on adequate sleep and stress management, my client regained her menstrual period and her overall health and wellbeing.
In managing this case, I consulted closely with a colleague of mine who specializes in fertility wellness, Dr. Danielle Miller, MD, founder and physician of Luz Medicine. Recently, I connected with Danielle to discuss this case in more detail. We recorded our conversation and shared it publicly to bring high-quality information on this topic to interested individuals.
In the video, Danielle and I do a deep dive on FHA and how it’s differentiated from polycystic-ovary syndrome, another common cause of secondary amenorrhea. We have a detailed discussion of the clinical approach to amenorrhea, ultrasound features, laboratory findings, and what it takes to recover.
The Objective Standard Conference 2022 (TOS-Con)
I attended TOS-Con 2022 in beautiful Westminster, CO. TOS-Con is a conference whose theme is “philosophy for freedom and flourishing.” The conference is a four day event which attracts productive and creative individuals from all over the world who are interested in the ideas that cause freedom and flourishing. I was able to connect with old friends and to make new ones. I left feeling reinvigorated but wishing for more of the benevolent buzzing atmosphere that permeates these conferences.
Some highlights of the conference were:
Westminster is roughly 20 minutes from Boulder, so I had an opportunity to visit the Flatirons and to drive into the mountains. This was a stunning drive which I highly recommended.
Credit: Intricate Explorer on Unsplash
I also had the opportunity to briefly drive through the Rocky Mountain Arsenal National Wildlife Refuge, which is 15,988 acres of protected land 8 miles northeast of downtown Denver. The refuge is on the land that was formerly the Rocky Mountain Arsenal, a US Army chemical weapons manufacturing and testing location. Now it’s home to multiple species of deer, bison, and birds. It’s a beautiful wide open space where one can see for miles with mountains in one direction and plains in the other.
Credit: My photo from our visit at the wildlife refuge