Discussion/support regarding "Next Level" by Simms & Yeager

[Zutroy]

.5 seems super low. I weigh 54-55 kilos which would mean 27 grams of protein a day. I aim for at least 100 grams a day. It’s so hard sometimes. I am allergic to eggs and avoid artificial sweeteners, erythitrol and xylitol which rules out most protein powders and bars. I have yet to find anything that I like without those additives.

I use Tailwind Recovery mix that has 10g of protein in it after a run. It makes a decent shake and you can get more protein if you add milk, but I’m just too lazy to clean the blender

Whoops, it’s .5 grams per pound of body weight. That’s what I get trying to use the metric system. Body builders usually consume ~1 gram per pound, but higher protein intake is tough on the kidneys.

 

[avondale]

This sounds very similar to the “anabolic window” bro-science in the weight lifting world. I would see guys at the gym eating cans of tuna and drinking protein shakes after a workout because they believed they had 30 minutes to get gains. The science suggests that the window is actually 5-6 hours post workout, so don’t force feed yourself unnecessarily. If your daily protein intake is around .5 grams to 1 kg of body weight, you’re probably hitting your macros.

https://lewis.gsu.edu/2021/10/13/fact-or-fiction-the-anabolic-window/

Ok, so this is why you need to read the book. The point the authors make is that for MOST people who are NOT female and around menopause (i.e., having their hormones go crazy), the window for protein intake is a lot longer. However, they are showing that the recent science regarding menopausal women is that the effective window is significantly shorter. Because of the significant decreases and/or swings in estrogen and other hormones around menopause, the body isn't as good at maintaining muscle and efficiently using the protein coming in. The window closes a lot faster.

This is sort of the point of the whole book: most of the guidance out there on exercise, nutrition, etc. is not WRONG, per se, but it's based on and aimed at average adults (or even younger adults) and becomes more inaccurate for the special case focused on in this book.

I'm not saying everyone needs to do this - it's the target audience the authors are going for.

 

[avondale]

This past week, I had my well-woman exam and had some relevant things to share.

I've noticed in the past couple of months that I'm having what I term "hot waves". They aren't as extreme as hot flashes are usually described, but I'm definitely warmer overall and I have times where I do get unusually warm. More evidence of perimenopause. At any rate, I mentioned this to my PCP as part of the discussion. Those of you who have read my training log know that I've had chronic, constant headaches for years. In the past few months, pain reprocessing therapy has helped resolve those (yay!), so I've been going off the various meds I'd been taking for them. One of those was gabapentin. My PCP says that gabapentin is a non-hormonal med that's often used to treat symptoms like hot flashes - so I've probably been noticing them more because I went off that. A bit ironic.

At any rate, they don't bother me enough to want to do anything about them right now.

I also wanted to talk to her about switching from my BCP to HRT possibly - now or in the future. She pretty much said my BCP was like a form of HRT (because I take it continuously), and so I can just stay on it for quite awhile. Nice!

Another downside of aging: cholsterol. My mother has high cholesterol (I think my father did, too). Keeping my weight in a healthy range plus lots of exercise kept my cholesterol low until about 2021...now my LDL is getting higher and higher into the bad range.

A reinventory of my eating habits says that I'm eating around what the FDA recommends as an upper limit for women on saturated fat (20g). I don't eat transfats or artificial sweeteners. I get lots of fiber. So I don't have a lot of room for improvement on this. Since my LDL was lower, I have gained 5 - 10 lbs, so I could stand to lose that, I guess. I'm going to try to cut down a bit on chocolate (an achilles heel of mine) and a number of well-regarded sources suggested supplements of plant sterols, so I'm waiting for those to arrive from Amazon.

Does anyone else have anything that helped him?

 

[The Expert]

BCP was like a form of HRT

It is, but it is also synthetic. My doc just took me off BCP and put me on a patch/pill combo as she didn't like me on the synthetic hormones. YMMV but something to keep an eye on.

Does anyone else have anything that helped him?

The biggest initial difference came for me when I got a full blood panel and starting taking the right vitamins. I had been on a multivitamin for years, but was still deficient in a few things (D3 and B12 specifically) even though my diet was pretty well optimized.

 

[PrincessV]

@avondale I started quoting and lost half of your post, so I’m just going rogue now lol!

Gabapentin… anecdotally, I started taking 100mg of it most nights to deal with the pain from nerves being pinched by my messed up back… and have seen a noticeable decrease in both frequency and severity of hot flashes. It sadly hasn’t eliminated them, and they’re oddly much, much worse in cold weather, but it’s the difference between waking up 20-30 times a night feeling like I’m literally on fire and 1-2 times a night feeling too warm, but not actually cooking. It’s not quite a miracle, but it’s close!

Cholesterol… mine is always right over the edge of high and has been since my 20s. It’s hereditary from both sides of my family, so it is what it is. I’m mostly vegetarian, the only meat I do eat is white meat chicken in small amounts, I eat a ton of vegetables and good grains, plenty of good fats and virtually none of the bad, run marathons for fun, do aaaaaalllll the things that are supposed to lower it… nothing. Good cholesterol is always high and bad is regularly *just* over the line into the high zone, punching the whole thing up. My doctor doesn’t see a reason to put me on meds because it’s steadily just into the high range and only changes by a point or two each year, sometimes up, sometimes down. So apologies that I offer no useful recommendations, but solidarity, at least!

 

[michigandergirl]

Just thought I'd give an update, to keep the conversation going...because women our age need to talk about these things!!

Last week I was referred to a Women's Health Center and a PA that specializes in perimenopause/menopause. She was a great listener and I found her very helpful. We talked a lot about sleep. I've not been sleeping well at all, the night sweats waking me up multiple times a night, almost every night. She said lack of sleep alone can cause weight gain, not to mention all the other hormonal stuff going on. She put me on the estrogen patch with progesterone pill. We are hoping that will help with better quality sleep. She also said it may help lower my blood pressure, which has been creeping up the last 2 years. She mentioned it might help with weight gain, but to keep my expectations low on that front. So fingers crossed, it will at least help me sleep better.

The other thing I wanted to mention is that I've been working with both a gastroenterologist and an allergist. Long story short, through a series of elimination diets, we've discovered I have a gluten sensitivity. The gastro confirmed it is not celiac, thankfully, but he's bouncing me back to the allergist because I've had a couple of episodes of hives after eating wheat products. Whether it's gluten sensitivity or wheat allergy, I'm avoiding it because I feel sooooo much better!!!

So I'm hoping these things will help me feel less like a zombie/lunatic and I can get back to focusing on running. I'll try to give an update in a couple of months.

 

[flav]

Just thought I'd give an update, to keep the conversation going...because women our age need to talk about these things!!

Last week I was referred to a Women's Health Center and a PA that specializes in perimenopause/menopause. She was a great listener and I found her very helpful. We talked a lot about sleep. I've not been sleeping well at all, the night sweats waking me up multiple times a night, almost every night. She said lack of sleep alone can cause weight gain, not to mention all the other hormonal stuff going on. She put me on the estrogen patch with progesterone pill. We are hoping that will help with better quality sleep. She also said it may help lower my blood pressure, which has been creeping up the last 2 years. She mentioned it might help with weight gain, but to keep my expectations low on that front. So fingers crossed, it will at least help me sleep better.

The other thing I wanted to mention is that I've been working with both a gastroenterologist and an allergist. Long story short, through a series of elimination diets, we've discovered I have a gluten sensitivity. The gastro confirmed it is not celiac, thankfully, but he's bouncing me back to the allergist because I've had a couple of episodes of hives after eating wheat products. Whether it's gluten sensitivity or wheat allergy, I'm avoiding it because I feel sooooo much better!!!

So I'm hoping these things will help me feel less like a zombie/lunatic and I can get back to focusing on running. I'll try to give an update in a couple of months.

Thanks for sharing. I will try to be attentive to my sleep patterns because, I feel like having a bad night is becoming more frequent.

Which brings me to the following question: What are you all tracking and how?
Physical activity?
Food intake?
Weight?
Measurements?
Symptoms?
Sleep?

 

[avondale]

I can definitely understand the sleep issues. I feel like all last fall I was short on sleep. Oddly lately I have been sleeping better (both feeling like it and my Garmin telling me), but I am not sure why.

Fortunately hot flashes are still hot waves for me and haven't hit me too much at night. But I have taken a blanket off the bed in the past six months - previously I was always too cold for that.

Fingers crossed that the new meds help you! Please report back!

 

[PrincessV]

@flav I guess I track anything that’s a departure from the norm at this point - hot flashes, pain increase/decreases, mood, exercise tolerance/intolerance, along with any changes in supplements/meds. Nothing formal, just notes in a little notebook. It’s taken 3 years of that to find any kind of pattern, and the pattern is that EVERYTHING is better when I use OTC progesterone cream, and everything is horrible to the point of intolerable without it. Rx progesterone capsules were truly horrific, interestingly. I seem to be very, VERY sensitive to hormones and it took a long time to get the OTC cream dosage just right. I genuinely thought the stuff was snake oil until I started tracking and saw the connection!

 

[avondale]

@flav I guess I track anything that’s a departure from the norm at this point - hot flashes, pain increase/decreases, mood, exercise tolerance/intolerance, along with any changes in supplements/meds. Nothing formal, just notes in a little notebook. It’s taken 3 years of that to find any kind of pattern, and the pattern is that EVERYTHING is better when I use OTC progesterone cream, and everything is horrible to the point of intolerable without it. Rx progesterone capsules were truly horrific, interestingly. I seem to be very, VERY sensitive to hormones and it took a long time to get the OTC cream dosage just right. I genuinely thought the stuff was snake oil until I started tracking and saw the connection!

This may be a dumb question, but where is the cream applied? And why a cream versus pill?

 

[PrincessV]

This may be a dumb question, but where is the cream applied? And why a cream versus pill?

Not dumb at al! The cream can be applied anywhere - you’re just not supposed to use the same spot over and over. I rotate day to day with inner arms, thighs behind my knees, spots where skin is thin and it can theoretically penetrate easily. I’m actually not sure if there are OTC pills or not - I never looked! A friend recommended this cream, so that’s that I tried first and liked it, so I’ve stuck to it. It winds up being good, too, because I already take so many things in pill form; I like having one less of them to manage. The Rx pills don’t come in a dosage any lower than 100mg, which is WAY too much for me.

 

[The Expert]

I’m actually not sure if there are OTC pills or not - I never looked!

There are, because I am on them! When I visited my new ob/gyn after we moved, they switched me from a synthetic hormone (birth control pill) to an estrogen patch/progesterone pill combo. GAME CHANGER! YMMV but for me, it alleviated or at least toned down most of my horrible symptoms. At least for now.

 

[Bree]

Not dumb at al! The cream can be applied anywhere - you’re just not supposed to use the same spot over and over. I rotate day to day with inner arms, thighs behind my knees, spots where skin is thin and it can theoretically penetrate easily. I’m actually not sure if there are OTC pills or not - I never looked! A friend recommended this cream, so that’s that I tried first and liked it, so I’ve stuck to it. It winds up being good, too, because I already take so many things in pill form; I like having one less of them to manage. The Rx pills don’t come in a dosage any lower than 100mg, which is WAY too much for me.

If you ever decide to go back to RX pills, you can get compounded capsules at lower doses. That’s what I use. We have a few local mom and pop pharmacies in my area that do it (and take insurance!).

 

[PrincessV]

If you ever decide to go back to RX pills, you can get compounded capsules at lower doses. That’s what I use. We have a few local mom and pop pharmacies in my area that do it (and take insurance!).

My insurance doesn’t cover any compounding pharmacies But I’m happy with the OTC cream and it’s much less expensive than my Rx prices, fortunately!

 

[avondale]

Ok, so another dumb question: I'm not always sure when what I'm feeling (as in physical effects) is related to perimenopause. Or rather, I'm not always sure things should be "better". I'm not suffering through life or anything but sometimes I wonder if I'm not realizing what's going on. Especially since changes can come on so gradually.

 

[PrincessV]

Ok, so another dumb question: I'm not always sure when what I'm feeling (as in physical effects) is related to perimenopause. Or rather, I'm not always sure things should be "better". I'm not suffering through life or anything but sometimes I wonder if I'm not realizing what's going on. Especially since changes can come on so gradually.

That right there is what‘s most frustrating for me. Some things are relatively easy to peg as perimenopause, but most aren’t. And then add in the fact that some ailments might be specific Thing, but that Thing wasn’t as problematic without peri in the mix.

Sadly, I’ve had no real good answers in my situation. An illustration: chronic pain that’s been going on for a long, long time, but was totally manageable until it wasn’t. It started interfering with life not long after 2 major events: 1. I stopped taking BCP, so no extra hormones, and 2. I contracted COVID and wound up with what is assumed to be Long Covid. That those two things happened at about the same time really stinks. I’ve seen 7 different practitioners and the ONLY thing they agreed on is that perimenopause is probably making everything hurt more, and LC isn’t helping. Which is how my primary and I landed at trying HRT, figuring if it helps, then probably peri is contributing, right?

Like I said previously, adding natural progesterone into the mix has helped. It hasn’t completely resolved everything I have going on, but it has greatly reduced most of the worst, so I think I really can say that much of it is thanks to peri. It really took about 2 years of tracking symptoms and trying different things to figure it out, though.

 

[michigandergirl]

That right there is what‘s most frustrating for me. Some things are relatively easy to peg as perimenopause, but most aren’t. And then add in the fact that some ailments might be specific Thing, but that Thing wasn’t as problematic without peri in the mix.

Exactly!

 

[superchime]

Jumping in here because I finally finished the book! I'm definitely looking into adding weight training, although my knees won't allow compound lifting movements so I will need to see what sorts of adaptations I can use, but I'm starting from nothing so it'll be a while before I can actually LHS. Also need to get my nutrition back under control and get back to eating enough protein.

One change I have noticed lately is that I am running hot. Not just hot flashes, but I'm just warmer all the time. Right now my family is freezing and I am in shorts and a t-shirt. Definitely different for me.

 

[flav]

Right now my family is freezing and I am in shorts and a t-shirt.

So, it is hot Kevin united

 

[Desdemona924]

One change I have noticed lately is that I am running hot. Not just hot flashes, but I'm just warmer all the time. Right now my family is freezing and I am in shorts and a t-shirt. Definitely different for me.

I am hot most of the time now. Oddly, it seems to be worse when it's cold out and not so bad in the heat.
I have sometimes wondered what it would have been like to go through natural perimenopause and menopause instead of just being thrown into it. My mom had terrible hot flashes, to the point where that was the only reason she did HRT, but my sister says that she never did.

Meanwhile, seeing this thread pop again reminds me that I need to read the book instead of letting languish and flipping through it sometimes.