BrainStorm
Sleep, Hormones, and the Brain: A Longevity Doctor's Guide to Aging Well
Sleep, Hormones, and the Brain: A Longevity Doctor's Guide to Aging Well
Endocrinologist and longevity expert Dr. Florence Comite joins Meryl Comer to challenge conventional wisdom about aging, hormones, and brain health. Drawing on decades of clinical experience and her new book Invincible, Dr. Comite explains why the fear around hormone therapy is based on outdated, flawed research. She believes testosterone, progesterone, quality sleep, and resistance training can meaningfully improve brain function at any age, even into your 90s. Dr. Comite also stresses that "normal range" lab results can be misleading, and that individualized, detail-oriented care outperforms one-size-fits-all evidence-based medicine. You don’t want to miss this candid, detail-driven conversation about taking control of your own aging process.
Dr. Florence Comite (00:00):
Let me be one of the first to maybe tell you that evidence-based medicine is not evidence for all of us. It's generally a one size fits all with regression to what I call the mean or average and none of us is average. Would you ever think of yourself as average?
Introduction (00:16):
Welcome to BrainStorm by UsAgainstAlzheimer's, a patient centered nonprofit organization. Your host, Meryl Comer, is a co-founder, 24 year caregiver and Emmy award-winning journalist, and the author of the New York Times bestseller, Slow Dancing With a Stranger.
Meryl Comer (00:36):
This is BrainStorm and I'm Meryl Comer. Our guest today is Dr. Florence Comite, endocrinologist and longevity expert who has spent her career challenging the way we think about aging health and prevention. Her new book Invincible: Defy Your Genetic Destiny to Live Better Longer. She'll share what it really takes to protect the brain, preserve independence and change the future of aging before it's too late. Dr. Comedy, I know there are many women who, 50 plus, you ask your doctor whether you can go back on hormone replacement theory, ask them anything and they'll say, "Sorry, we don't have information on women your age. No research."
Dr. Florence Comite (01:26):
The problem arose about 20 years ago when, 25 now, when they did a huge study at the NIH and they found that one particular estrogen Premarin and one particular progesterone Provera, which I never prescribed for any woman I took care of even two, three decades ago, were not good for women. , And they ended up with research that made it very scary. The way the study was designed, the data they found out was basically except for a carve out of women in their 40s who were close to perimenopause, not quite in menopause, they did well, but everybody else did not. Part of that study was compromised not just by the kinds of hormones they used, but also the, the way they designed it. So they took, for example, 65 year young women who are quite young, 65 to me is ne - is like being 40 right now.
Dr. Florence Comite (02:26):
It's not 65 anymore. And I remember seeing women in their 40s 20, 30 years ago and women in their 40s today are like 25 year olds. It is not the same life that we live. But these women in their 60s at that time, 25 years ago, they were already not well. They didn't look for heart disease before starting and stopping hormones. So as a result, they shut down the pipeline to hormones without really looking at what the other factors are. And that's why you're hearing or you were hearing your doctor because it was a whole generation of women who were not given hormones.
Meryl Comer (03:01):
Let me ask you a two part question. , What are the first three changes you've made for a 45 to 55 year old woman worried about brain aging? And I know you don't like being generic, but <laugh>
Dr. Florence Comite (03:17):
Okay. So it is, , it is based on the way they present because obviously if they're presenting and they have poor sleep, which also leads to brain issues, brain fog, as well as diseases. In fact, poor sleep is probably the number one factor is if they're still cycling, I would look at the way they're cycling because in your 40s you could be in perimenopause, you can also be in menopause, you can also get pregnant. There's any one of those kinds of women. And I would make sure they had adequate progesterone because you don't want just estrogen. Progesterone is protective of the brain. It's protective. It's anti-cancer in some of its functions. And it's an amazing hormone. And in women who are still cycling but maybe not ovulating, I'd put them on progesterone, , half of the month, the second half of the month, which is when we usually make progesterone.
Dr. Florence Comite (04:08):
It is a wonderful hormone. If women are complaining about difficulty losing weight and they're having cy - they're cycling or they're, , they've stopped cycling. Testosterone is one of the first hormones I use in women. And I generally use it as a cream, but it is available sublingual. You know, you can use it as a patch. Some people even use injections or pellets. I'm not that rapid to move to injections or pellets because creams work so well and they're easy. We're all used to putting on creams to keep our skin hydrated, right? And so I find that to be the easiest if somebody, if, if somebody feels that it's not, we work with them and do something else. If I was going to pick one hormone that would benefit every single woman in their 30s, 40s, 50s and beyond, it would be testosterone.
Dr. Florence Comite (04:54):
But again, in terms of starting, I would, I would have to know more about their story, but testosterone can't fail. In fact, years ago when I started women's health, I would see a lot of women who were suffering from no hormones because they had breast cancer and the doctors removed every aspect of hormones. And I gave them testosterone and I blocked conversion to estrogen, which is something... I had a protocol for it at Yale, which was a study, which is something is routinely done now at Sloan, years later, decades after I started doing it. , When you talk about some other things women can do at that point in time to ensure brain health and to make sure they protect their brain, it would be to make sure they get enough sleep and they get adequate sleep and sleep changes, sleep patterns change. A lot of women find they can fall asleep easily, but they wake up frequently during the night.
Dr. Florence Comite (05:45):
Is that an issue because of their hormones? Is that an issue because they have bladder issues? Are they eating or drinking too close to bedtime, which also interferes? Are they taking, are they drinking a couple of glasses of wine which would cause their sugar to go up and then drop suddenly? So making sure they have good sleep, which is also a process, not just the quantity of sleep, but the quality of sleep. There's a cleansing process that gets rid of waste and toxicity in the brain. And that alone, fixing sleep, fixing hormones, making sure women understand that resistance training is as important as aerobic or high intensity interval, you know, sprinting. It will all contribute to a woman's health as well as certain supplements that also are important for the brain. Magnesium, vitamin D, which actually isn't even just a supplement. It's a fat soluble steroid hormone.
Dr. Florence Comite (06:39):
I'll stop there because, because there's so much that can be done. Those are only a few starting points.
Meryl Comer (06:46):
I just read that the first, , of the baby boom generation turns 80 this year. Is there hope for women <laugh>? 70 - Of course. I mean, please,
Dr. Florence Comite (07:00):
What? Yes, 1,000%. In fact, my own mother was on hormones and she passed away at 102. And we see patients routinely. Like when I started this, Maryl, I was actually targeting, you know, 30 to 60 thinking, okay, that's the peak time we begin to see this decline. And what I realized is the changes were so dramatic. I have women into, and men into their 90s where we reverse the decline. There's a study recently taking people in their 90s and dividing them up into exercise and resistance training and none. And the ones in resistant training within weeks improved compared to the placebo controlled group. And so at any point in time, hormones are useful. You just have to make sure you weigh risks and benefit. And as a researcher, that's how we're trained to do research. Whether I did research in a child, which I did very early in my career using peptides and reversing early puberty, or it's research in 70, 80 year young men and women, I believe you can climb mountains at 100.
Dr. Florence Comite (08:04):
Like this is something we should support. And most of my, all of my 90 plus year young patients are running around the world, most of them still working, very active families. It's incredible. I'm thrilled to see that because I want to be like that.
Meryl Comer (08:21):
We all want to be like that.
Dr. Florence Comite (08:22):
Exactly. Exactly. So that wasn't hard at all. In fact, if they're on no hormones, I very gingerly, but in an structured way, start giving them hormones. I usually start with testosterone unless sleep is an issue and then I, if they're not having any periods anymore at 80, if they're feeling pretty good and they're doing so - and they're working out and they're eating enough protein, I usually start with, , with testosterone. Unless sleep is an issue and then I might start with progesterone. So I go slow and carefully because I, I don't want to, I want them to adjust because their body has acclimated to no hormones. And now we have to recruit back those cells in the brain to be active again, in the body to be active with the hormones that are so essential. And that's why I think of it as optimal. I don't think of it as hormone replacement therapy.
Dr. Florence Comite (09:12):
I think of it as optimizing hormones because I'm not mother nature. I'm not going to have women cycle in the way they did when we were in the years of life that we would cycle and have menstrual cycles. I am trying to recover optimal function looking at risk benefit. And that's what my studies have shown. So it's been very rewarding to be fair.
Meryl Comer (09:33):
Bear with us because I think it's important to look at, , differences, , for women about their own aging and where does that old male model of aging still mislead us?
Dr. Florence Comite (09:48):
The male model of aging is tied, I think, to conventional medicine and where we're waiting for things to really be bad before we do something about it. And what we hear from doctors and clin - other clinicians is what you heard. And the reason that, like, we don't know anything about it, we don't have research. Well, let me be one of the first to maybe tell you that evidence-based medicine is not evidence for all of us. It's generally a one size fits all with regression to what I call the mean or average. And none of us is average. Would you ever think of yourself as average? 'Cause I don't think of myself as average. Even compared to my twin sister, we're different. So I look, I take that evidence and I say, "What makes sense sitting in front of this patient? What can I do for her so that she can improve day to day?" And I've had many patients who suffered for 10 years or more turn it around in, you know, a few months, a few weeks even.
Dr. Florence Comite (10:44):
So there are, there's tremendous hope. Like the GLP-1s, which is one of the factors out there that I equate to antibiotics of the 20th century, I've been using them in patients for 21 years. They're phenomenal besides testosterone for the brain. They are phenomenal for brain function and body function. The two combined are incredible. And so doing it carefully, looking at risk benefit can optimize where you are.
Meryl Comer (11:10):
So you've written about how women can enter accelerated, , aging long before they realize it. So what are those early sex specific signs that we should be looking at?
Dr. Florence Comite (11:23):
The sex-specific signs would be we're slowing down. We can't do the kinds of things we used to do. We are having trouble with cognition. We are recognizing that we took, we used to take for granted being able to manage multiple things going on in our life and it's become more challenging. , We lose interest maybe in being with friends and family. We tend to isolate ourselves. , We don't keep active. I think the one area that is something that we can all reach for is relationships. Staying with the relationships we have, trying to maintain our friends, our family, playing games, whether it's pickleball or bridge, keeping the brain active, going to events if we can, even getting together with a friend on a regular basis and going for a walk. So if we notice that that's slipping, that we're either not sleeping enough or we're sleeping too much, those are signs that our brain maybe isn't firing on all cylinders and we need a workup.
Dr. Florence Comite (12:25):
We need to be able to explore. I would recommend, of course, I'm completely biased, but I would recommend Invincible defy your genetic destiny because you'll learn so much. I wrote that book to do just that, to have people get their hands on knowledge that isn't, and wisdom that isn't out there.
Meryl Comer (12:43):
I'm so upset having read it that I just trusted the doctor and the detail again is what
Dr. Florence Comite (12:51):
Matters. Exactly. You said it right. If you hear these words, they're the most dangerous words. You're in the normal range. It's quite meaningless. It gives you such a broad range that when you go from a fasting sugar, let's say of 98 to 99, all of a sudden you're, you're pre-diabetic. No, you've been working towards that over decades. No disorder happens overnight unless it's an accident that you step out in front of a bus or something and you don't realize it. But other than that, all of these conditions are brewing under our system and there's so much that can be done. And that's what I really spell out in the book. So for a 30-something, 40-something, 50, 60, 70, 80, 90, there's so much that can be done. And I would al- always recommend starting slow, going slow and introducing one factor at a time. And if possible, consider wearables because I think wearables give us answers about our own body twenty four seven and we can put that to work.
Dr. Florence Comite (13:50):
For example, you might get eight to 10 hours of sleep every night, but what if it's only eight to 10 minutes of deep sleep? You are doing your body a disservice and it's going to be important to figure out how you get deep sleep. What are you missing? Do you need magnesium? Valerium? Should you be taking a bath with Epsom salt? Should you stop eating, you know, or having a third glass of wine at dinner because of what it's doing to disrupt your sleep? , Is the room dark enough? Are you getting light early in the morning? But not to overwhelm, but to say there are ways to try one step at a time and see if they make a difference. I did this with my own family. My son, my youngest son sleeps long hours but never felt rested. He always did even as a child who slept long hours.
Dr. Florence Comite (14:33):
He was the best because I could put him to sleep and he wanted to go to sleep as opposed to the other one who could stay up all night. And we have been one by one looking at why he doesn't get deep sleep and now he's getting deep sleep. It, it was a journey. And so it took him a little while and he's doing it on his own. He's doing it with our help. And we're experimenting with the different ways he can get deep sleep.
Meryl Comer (14:56):
We write some of these things off. I know, , for those of us who have cared for loved ones with dementia, you know, night is day. So you talk about not getting sleep and then trying to recover from that. We have to be able to recover. So I think this, it's all in the detail and that's why your book is really, , quite remarkable. , You
Dr. Florence Comite (15:21):
Wove in quite beautifully the women questions, but I'm always happy because women are the ones that started me on this trail. They're most invested. It's, it's hard sometimes for the guys, even though I now see probably 60% men, 40% women. But when I started seeing men, it was because the women said, "Would you see my partner? Would you... " And, and I trained in men, women and children. So that wasn't an issue. But a lot of times men, although I think it's changing, they graduate college and they don't go to a doctor until they get a heart attack. So for them, it's a little harder.
Meryl Comer (15:54):
If you look back 20 years because first symptoms start 20 years before, , that, that's where you end up in menopause. And I think the studies coming out now are critical.
Dr. Florence Comite (16:07):
There have been long-term studies that show what estrogen does to the brain and cognition and what, and now I've seen it for myself with testosterone because it was very, there was no doctor who was using testosterone when I started it. And I felt bad because the women that I started first were the women who had no hormones. And they really, they felt terrible. They had been through the surgery. They were losing their jobs because they, you know, they, this is, as we know, as women looking a certain way gives you an advantage and they felt like they, their hormones were gone and they looked bad and they felt bad. They didn't want to live actually. And I was using testosterone as a hope for them. And the, the change was dramatic. So it is all in the details. And I would even argue that menopause is a little later than you want to start.
Dr. Florence Comite (16:53):
You really want to look at the 30s. Having said that, the knowledge I, I have from taking care of thousands of people, men and women now show me that it's never too late. That even the '90s, for example, my own mother, when she got urinary tract infections, she would get brain fog. She would get, she would seem like she had, couldn't control and we didn't know what was going on. And it was all due to a urinary tract infection, which is now being reported. I, I just had a patient whose mother-in-law was hospitalized. They thought she had a stroke because her language changed. She, she actually had a urinary tract infection. So there's so many aspects to health that are in the details. And we just have to be vigilant and we have to ask and be proactive ourselves and say, "Well, I've read about these studies.
Dr. Florence Comite (17:39):
Buy the book for your doctor." <laugh>
Meryl Comer (17:41):
Do you know that's exactly what I'm doing for my son, for the doctor, for anyone I know. I have to tell you, , I'm, we're not done. <Laugh> Okay.
Dr. Florence Comite (17:53):
But I will - Well, I, I, I pray for that. Meryl, the book is arranged because I had written a book a long time ago, the first book on precision medicine and longevity for men because there was nothing out there. Keep it up. It was published in 2013, way before Obama mentioned precision medicine in 2015 in the State of the Union. And the reason I have the chapters in the back have, have references because I want the doctors to see that this is documented scientifically. I am not just an influencer who's out there saying, "Do this because I do it. " No, that would be wrong to me. That's not good medicine. So that means a lot to me, you know, that you are doing that. That's exactly what I prayed for.
Meryl Comer (18:33):
Our guest has been Dr. Florence Comite, her new book, Invincible: Defy Your Genetic Destiny to Live Better Longer. At UsAgainstAlzheimer's, our call to action is know your risk, track your brain health and take action early. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.
Speaker 2 (18:57):
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About This Episode
Endocrinologist and longevity expert Dr. Florence Comite joins Meryl Comer to challenge conventional wisdom about aging, hormones, and brain health. Drawing on decades of clinical experience and her new book Invincible, Dr. Comite explains why the fear around hormone therapy is based on outdated, flawed research. She believes testosterone, progesterone, quality sleep, and resistance training can meaningfully improve brain function at any age, even into your 90s. Dr. Comite also stresses that "normal range" lab results can be misleading, and that individualized, detail-oriented care outperforms one-size-fits-all evidence-based medicine. You don’t want to miss this candid, detail-driven conversation about taking control of your own aging process.
Transcript
Dr. Florence Comite (00:00):
Let me be one of the first to maybe tell you that evidence-based medicine is not evidence for all of us. It's generally a one size fits all with regression to what I call the mean or average and none of us is average. Would you ever think of yourself as average?
Introduction (00:16):
Welcome to BrainStorm by UsAgainstAlzheimer's, a patient centered nonprofit organization. Your host, Meryl Comer, is a co-founder, 24 year caregiver and Emmy award-winning journalist, and the author of the New York Times bestseller, Slow Dancing With a Stranger.
Meryl Comer (00:36):
This is BrainStorm and I'm Meryl Comer. Our guest today is Dr. Florence Comite, endocrinologist and longevity expert who has spent her career challenging the way we think about aging health and prevention. Her new book Invincible: Defy Your Genetic Destiny to Live Better Longer. She'll share what it really takes to protect the brain, preserve independence and change the future of aging before it's too late. Dr. Comedy, I know there are many women who, 50 plus, you ask your doctor whether you can go back on hormone replacement theory, ask them anything and they'll say, "Sorry, we don't have information on women your age. No research."
Dr. Florence Comite (01:26):
The problem arose about 20 years ago when, 25 now, when they did a huge study at the NIH and they found that one particular estrogen Premarin and one particular progesterone Provera, which I never prescribed for any woman I took care of even two, three decades ago, were not good for women. , And they ended up with research that made it very scary. The way the study was designed, the data they found out was basically except for a carve out of women in their 40s who were close to perimenopause, not quite in menopause, they did well, but everybody else did not. Part of that study was compromised not just by the kinds of hormones they used, but also the, the way they designed it. So they took, for example, 65 year young women who are quite young, 65 to me is ne - is like being 40 right now.
Dr. Florence Comite (02:26):
It's not 65 anymore. And I remember seeing women in their 40s 20, 30 years ago and women in their 40s today are like 25 year olds. It is not the same life that we live. But these women in their 60s at that time, 25 years ago, they were already not well. They didn't look for heart disease before starting and stopping hormones. So as a result, they shut down the pipeline to hormones without really looking at what the other factors are. And that's why you're hearing or you were hearing your doctor because it was a whole generation of women who were not given hormones.
Meryl Comer (03:01):
Let me ask you a two part question. , What are the first three changes you've made for a 45 to 55 year old woman worried about brain aging? And I know you don't like being generic, but <laugh>
Dr. Florence Comite (03:17):
Okay. So it is, , it is based on the way they present because obviously if they're presenting and they have poor sleep, which also leads to brain issues, brain fog, as well as diseases. In fact, poor sleep is probably the number one factor is if they're still cycling, I would look at the way they're cycling because in your 40s you could be in perimenopause, you can also be in menopause, you can also get pregnant. There's any one of those kinds of women. And I would make sure they had adequate progesterone because you don't want just estrogen. Progesterone is protective of the brain. It's protective. It's anti-cancer in some of its functions. And it's an amazing hormone. And in women who are still cycling but maybe not ovulating, I'd put them on progesterone, , half of the month, the second half of the month, which is when we usually make progesterone.
Dr. Florence Comite (04:08):
It is a wonderful hormone. If women are complaining about difficulty losing weight and they're having cy - they're cycling or they're, , they've stopped cycling. Testosterone is one of the first hormones I use in women. And I generally use it as a cream, but it is available sublingual. You know, you can use it as a patch. Some people even use injections or pellets. I'm not that rapid to move to injections or pellets because creams work so well and they're easy. We're all used to putting on creams to keep our skin hydrated, right? And so I find that to be the easiest if somebody, if, if somebody feels that it's not, we work with them and do something else. If I was going to pick one hormone that would benefit every single woman in their 30s, 40s, 50s and beyond, it would be testosterone.
Dr. Florence Comite (04:54):
But again, in terms of starting, I would, I would have to know more about their story, but testosterone can't fail. In fact, years ago when I started women's health, I would see a lot of women who were suffering from no hormones because they had breast cancer and the doctors removed every aspect of hormones. And I gave them testosterone and I blocked conversion to estrogen, which is something... I had a protocol for it at Yale, which was a study, which is something is routinely done now at Sloan, years later, decades after I started doing it. , When you talk about some other things women can do at that point in time to ensure brain health and to make sure they protect their brain, it would be to make sure they get enough sleep and they get adequate sleep and sleep changes, sleep patterns change. A lot of women find they can fall asleep easily, but they wake up frequently during the night.
Dr. Florence Comite (05:45):
Is that an issue because of their hormones? Is that an issue because they have bladder issues? Are they eating or drinking too close to bedtime, which also interferes? Are they taking, are they drinking a couple of glasses of wine which would cause their sugar to go up and then drop suddenly? So making sure they have good sleep, which is also a process, not just the quantity of sleep, but the quality of sleep. There's a cleansing process that gets rid of waste and toxicity in the brain. And that alone, fixing sleep, fixing hormones, making sure women understand that resistance training is as important as aerobic or high intensity interval, you know, sprinting. It will all contribute to a woman's health as well as certain supplements that also are important for the brain. Magnesium, vitamin D, which actually isn't even just a supplement. It's a fat soluble steroid hormone.
Dr. Florence Comite (06:39):
I'll stop there because, because there's so much that can be done. Those are only a few starting points.
Meryl Comer (06:46):
I just read that the first, , of the baby boom generation turns 80 this year. Is there hope for women <laugh>? 70 - Of course. I mean, please,
Dr. Florence Comite (07:00):
What? Yes, 1,000%. In fact, my own mother was on hormones and she passed away at 102. And we see patients routinely. Like when I started this, Maryl, I was actually targeting, you know, 30 to 60 thinking, okay, that's the peak time we begin to see this decline. And what I realized is the changes were so dramatic. I have women into, and men into their 90s where we reverse the decline. There's a study recently taking people in their 90s and dividing them up into exercise and resistance training and none. And the ones in resistant training within weeks improved compared to the placebo controlled group. And so at any point in time, hormones are useful. You just have to make sure you weigh risks and benefit. And as a researcher, that's how we're trained to do research. Whether I did research in a child, which I did very early in my career using peptides and reversing early puberty, or it's research in 70, 80 year young men and women, I believe you can climb mountains at 100.
Dr. Florence Comite (08:04):
Like this is something we should support. And most of my, all of my 90 plus year young patients are running around the world, most of them still working, very active families. It's incredible. I'm thrilled to see that because I want to be like that.
Meryl Comer (08:21):
We all want to be like that.
Dr. Florence Comite (08:22):
Exactly. Exactly. So that wasn't hard at all. In fact, if they're on no hormones, I very gingerly, but in an structured way, start giving them hormones. I usually start with testosterone unless sleep is an issue and then I, if they're not having any periods anymore at 80, if they're feeling pretty good and they're doing so - and they're working out and they're eating enough protein, I usually start with, , with testosterone. Unless sleep is an issue and then I might start with progesterone. So I go slow and carefully because I, I don't want to, I want them to adjust because their body has acclimated to no hormones. And now we have to recruit back those cells in the brain to be active again, in the body to be active with the hormones that are so essential. And that's why I think of it as optimal. I don't think of it as hormone replacement therapy.
Dr. Florence Comite (09:12):
I think of it as optimizing hormones because I'm not mother nature. I'm not going to have women cycle in the way they did when we were in the years of life that we would cycle and have menstrual cycles. I am trying to recover optimal function looking at risk benefit. And that's what my studies have shown. So it's been very rewarding to be fair.
Meryl Comer (09:33):
Bear with us because I think it's important to look at, , differences, , for women about their own aging and where does that old male model of aging still mislead us?
Dr. Florence Comite (09:48):
The male model of aging is tied, I think, to conventional medicine and where we're waiting for things to really be bad before we do something about it. And what we hear from doctors and clin - other clinicians is what you heard. And the reason that, like, we don't know anything about it, we don't have research. Well, let me be one of the first to maybe tell you that evidence-based medicine is not evidence for all of us. It's generally a one size fits all with regression to what I call the mean or average. And none of us is average. Would you ever think of yourself as average? 'Cause I don't think of myself as average. Even compared to my twin sister, we're different. So I look, I take that evidence and I say, "What makes sense sitting in front of this patient? What can I do for her so that she can improve day to day?" And I've had many patients who suffered for 10 years or more turn it around in, you know, a few months, a few weeks even.
Dr. Florence Comite (10:44):
So there are, there's tremendous hope. Like the GLP-1s, which is one of the factors out there that I equate to antibiotics of the 20th century, I've been using them in patients for 21 years. They're phenomenal besides testosterone for the brain. They are phenomenal for brain function and body function. The two combined are incredible. And so doing it carefully, looking at risk benefit can optimize where you are.
Meryl Comer (11:10):
So you've written about how women can enter accelerated, , aging long before they realize it. So what are those early sex specific signs that we should be looking at?
Dr. Florence Comite (11:23):
The sex-specific signs would be we're slowing down. We can't do the kinds of things we used to do. We are having trouble with cognition. We are recognizing that we took, we used to take for granted being able to manage multiple things going on in our life and it's become more challenging. , We lose interest maybe in being with friends and family. We tend to isolate ourselves. , We don't keep active. I think the one area that is something that we can all reach for is relationships. Staying with the relationships we have, trying to maintain our friends, our family, playing games, whether it's pickleball or bridge, keeping the brain active, going to events if we can, even getting together with a friend on a regular basis and going for a walk. So if we notice that that's slipping, that we're either not sleeping enough or we're sleeping too much, those are signs that our brain maybe isn't firing on all cylinders and we need a workup.
Dr. Florence Comite (12:25):
We need to be able to explore. I would recommend, of course, I'm completely biased, but I would recommend Invincible defy your genetic destiny because you'll learn so much. I wrote that book to do just that, to have people get their hands on knowledge that isn't, and wisdom that isn't out there.
Meryl Comer (12:43):
I'm so upset having read it that I just trusted the doctor and the detail again is what
Dr. Florence Comite (12:51):
Matters. Exactly. You said it right. If you hear these words, they're the most dangerous words. You're in the normal range. It's quite meaningless. It gives you such a broad range that when you go from a fasting sugar, let's say of 98 to 99, all of a sudden you're, you're pre-diabetic. No, you've been working towards that over decades. No disorder happens overnight unless it's an accident that you step out in front of a bus or something and you don't realize it. But other than that, all of these conditions are brewing under our system and there's so much that can be done. And that's what I really spell out in the book. So for a 30-something, 40-something, 50, 60, 70, 80, 90, there's so much that can be done. And I would al- always recommend starting slow, going slow and introducing one factor at a time. And if possible, consider wearables because I think wearables give us answers about our own body twenty four seven and we can put that to work.
Dr. Florence Comite (13:50):
For example, you might get eight to 10 hours of sleep every night, but what if it's only eight to 10 minutes of deep sleep? You are doing your body a disservice and it's going to be important to figure out how you get deep sleep. What are you missing? Do you need magnesium? Valerium? Should you be taking a bath with Epsom salt? Should you stop eating, you know, or having a third glass of wine at dinner because of what it's doing to disrupt your sleep? , Is the room dark enough? Are you getting light early in the morning? But not to overwhelm, but to say there are ways to try one step at a time and see if they make a difference. I did this with my own family. My son, my youngest son sleeps long hours but never felt rested. He always did even as a child who slept long hours.
Dr. Florence Comite (14:33):
He was the best because I could put him to sleep and he wanted to go to sleep as opposed to the other one who could stay up all night. And we have been one by one looking at why he doesn't get deep sleep and now he's getting deep sleep. It, it was a journey. And so it took him a little while and he's doing it on his own. He's doing it with our help. And we're experimenting with the different ways he can get deep sleep.
Meryl Comer (14:56):
We write some of these things off. I know, , for those of us who have cared for loved ones with dementia, you know, night is day. So you talk about not getting sleep and then trying to recover from that. We have to be able to recover. So I think this, it's all in the detail and that's why your book is really, , quite remarkable. , You
Dr. Florence Comite (15:21):
Wove in quite beautifully the women questions, but I'm always happy because women are the ones that started me on this trail. They're most invested. It's, it's hard sometimes for the guys, even though I now see probably 60% men, 40% women. But when I started seeing men, it was because the women said, "Would you see my partner? Would you... " And, and I trained in men, women and children. So that wasn't an issue. But a lot of times men, although I think it's changing, they graduate college and they don't go to a doctor until they get a heart attack. So for them, it's a little harder.
Meryl Comer (15:54):
If you look back 20 years because first symptoms start 20 years before, , that, that's where you end up in menopause. And I think the studies coming out now are critical.
Dr. Florence Comite (16:07):
There have been long-term studies that show what estrogen does to the brain and cognition and what, and now I've seen it for myself with testosterone because it was very, there was no doctor who was using testosterone when I started it. And I felt bad because the women that I started first were the women who had no hormones. And they really, they felt terrible. They had been through the surgery. They were losing their jobs because they, you know, they, this is, as we know, as women looking a certain way gives you an advantage and they felt like they, their hormones were gone and they looked bad and they felt bad. They didn't want to live actually. And I was using testosterone as a hope for them. And the, the change was dramatic. So it is all in the details. And I would even argue that menopause is a little later than you want to start.
Dr. Florence Comite (16:53):
You really want to look at the 30s. Having said that, the knowledge I, I have from taking care of thousands of people, men and women now show me that it's never too late. That even the '90s, for example, my own mother, when she got urinary tract infections, she would get brain fog. She would get, she would seem like she had, couldn't control and we didn't know what was going on. And it was all due to a urinary tract infection, which is now being reported. I, I just had a patient whose mother-in-law was hospitalized. They thought she had a stroke because her language changed. She, she actually had a urinary tract infection. So there's so many aspects to health that are in the details. And we just have to be vigilant and we have to ask and be proactive ourselves and say, "Well, I've read about these studies.
Dr. Florence Comite (17:39):
Buy the book for your doctor." <laugh>
Meryl Comer (17:41):
Do you know that's exactly what I'm doing for my son, for the doctor, for anyone I know. I have to tell you, , I'm, we're not done. <Laugh> Okay.
Dr. Florence Comite (17:53):
But I will - Well, I, I, I pray for that. Meryl, the book is arranged because I had written a book a long time ago, the first book on precision medicine and longevity for men because there was nothing out there. Keep it up. It was published in 2013, way before Obama mentioned precision medicine in 2015 in the State of the Union. And the reason I have the chapters in the back have, have references because I want the doctors to see that this is documented scientifically. I am not just an influencer who's out there saying, "Do this because I do it. " No, that would be wrong to me. That's not good medicine. So that means a lot to me, you know, that you are doing that. That's exactly what I prayed for.
Meryl Comer (18:33):
Our guest has been Dr. Florence Comite, her new book, Invincible: Defy Your Genetic Destiny to Live Better Longer. At UsAgainstAlzheimer's, our call to action is know your risk, track your brain health and take action early. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.
Speaker 2 (18:57):
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