August 13, 2025 • 41 mins
The battle against cognitive decline begins long before memory problems appear. Dr. Holly Thacker delivers a fascinating deep dive into the nutrients and supplements proven to protect your brain as you age, with startling revelations about how women's brains age differently than men's.
At the heart of this episode is a treasure trove of practical knowledge about brain-protective nutrients. A newly available over-the-counter supplement called CerefolinNAC Brain Wellness (formerly prescription-only) combines active folate, methylated B12, and NAC to support brain health.
Perhaps most fascinating is the discussion of magnesium's profound impact on brain volume – particularly in women. Despite its vital role in over 300 enzymatic systems, nearly half of Americans consume insufficient amounts.
Beyond supplements, Dr. Thacker emphasizes the critical role of physical activity, social engagement, and cognitive challenges in maintaining brain health. For anyone concerned about maintaining mental sharpness through midlife and beyond, this episode provides the roadmap you've been searching for.
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Episode Transcript
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Speaker 1 (00:05):
Welcome to the Speaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, and I'm back in our sunflower
house for a new podcast, and onthis episode I'm going to be
talking about everything youneed to know about preventing
(00:25):
cognitive decline, with a focuson B12, a lot about magnesium,
omega-3 fats and a newover-the-counter supplement that
is now available that you canavail yourself of.
So some gradual mental declineis considered normal with aging.
(00:50):
The declines due to agingshould not affect your daily
life, though, and activities anda gradual reduction in thinking
ability related to learning,remembering, reasoning and
paying attention can become aproblem.
(01:10):
There's four stages ofcognitive decline.
Number one no impairment, nodecline at all.
Number two, which I see a lotin my practice, is this
subjective decline, but nointerference in daily activities
.
You know, women may complain ofword finding difficulties or
just not being quite as sharp,needing to take more list.
(01:34):
Then there's the number three,which is mild cognitive
impairment, which isn't someimportant memory loss without
loss of being independent interms of functioning, so
forgetfulness, struggling toperform certain self-care tasks
for example, forgetting to takemedications, forgetting to pay
(01:56):
bills but still being able tofunction in life for the most
part without the direct help orintervention of another person.
Then we get to stage four,which is outright dementia,
which can include a loss of notjust memory but language and
other important thinkingabilities that do interfere with
daily life, and research showsthat women may have greater
(02:20):
cognitive brain reserve but afaster cognitive decline than
men.
It's not really known why thisis the case, but it's thought to
be related to female hormonesand we certainly talk a lot
about female hormones.
The whole focus of my career ismidlife and menopause and
hormone therapy.
It appears that estrogen,particularly if taken within the
(02:44):
10 years of menopause, has someneural protective abilities and
that women with brain fogsubjectively report an
improvement in their wordfinding ability with menopausal
hormone therapy.
(03:08):
Recent research has shown thatwomen may have greater cognitive
improvement in their cognitionand improvement in the size, the
volume of the brain if they areat risk because they have the
APOE4E4 phenotype or actuallygenotype, so you can have
different ApoEs, and ApoE4, e4,or even ApoE3, e3 have a three
(03:34):
to four fold to up to a 12 to 15fold increased risk for senile
dementia of the Alzheimer's type, also called SDAT, relative to
women that just have the wildtype ApoE, apoe genotype and
they have generally severalyears earlier age of onset of
(03:55):
dementia.
It seems like ApoE2 is the bestone at protecting the brain and
I have some women who get thistesting done.
In the past I somewhatdiscouraged it, I just focused
on family history because youknow we didn't really have
interventions but increasinglywe do have more interventions.
(04:17):
But I think that every womanand man for that matter at
midlife and beyond should beinterested in protecting brain
function.
So some of the signs andsymptoms of cognitive decline it
can be individual, but thecommon symptoms first include
trouble finding the right wordsto express yourself and people
(04:41):
can get frustrated and say youknow what I mean, as they're
pointing to something but theycan't come up with the word door
or handle or knife or ballReally simple terms.
I remember postpartum, when youof course experience rapid loss
in estrogen after having a wholebunch of estrogen during
(05:02):
pregnancy, when I was writingthank you notes to people having
trouble remembering like reallysimple words how to spell, and
certainly some of it can be justthe whole upheaval and change
in life and also the excitementand the sleep deprivation.
(05:22):
But I was convinced that a lotdid have to do with estrogen and
once I got my estrogen levelsback several months postpartum.
I remember thinking, yep, I wasjust clicking on all those
gears and that personally had alot of impression on myself, as
well as the fact that,personally, my tendons were much
(05:45):
worse in the postpartumtimeframe.
And again, it's individual.
There's lots of women who loseestrogen, who don't notice any
word finding difficulties, whodon't notice any tendon problems
.
But that's one reason why Ireally like to take a good
obstetrical history in mymidlife patients.
Did you develop hypertension ordiabetes?
How did you feel postpartum?
(06:06):
Did you have any postpartummood problems?
I certainly didn't.
I was euphoric, but a lot ofwomen aren't and that's why
we're all individuals andcertainly genetics and
environment and diet andlifestyle play a role in how all
of these interplay.
So, after trouble finding theright words to express yourself,
(06:29):
if you misplace or lose itemsNow I have to admit when I buy
gifts early months in advance Itell my husband okay, I hid this
in this place, don't let meforget.
So again, some word findingissues or some forgetfulness,
especially for women that aremultitasking and so busy.
(06:50):
You don't have to immediatelybe concerned that you're on the
road to dementia, but when youforget dates or appointments,
you feel overwhelmed by tasks,you forget to do things, you're
more hesitant to be out inpublic or to travel.
Those are concerns.
(07:10):
So when should you talk to yourphysician about your memory
concerns?
Well, if you have anyforgetfulness or amnesia for
recent events that is not linkedto medications like anesthesia.
If you always have to writereminders and set alarms If you
start to struggle to performdaily chores and tasks and you
(07:33):
need reminders and promptsregularly.
If other people are concerned, Ialways ask women about their
work productivity.
Are they having any issues oranyone complaining about their
ability to work?
And one thing about menopauseif you look at United States
labor statistics, prior tomenopause women have about a 70%
(07:59):
work participation level.
After menopause, around 51,which is the median age of
menopause, it drops to 30% and alot of that has to do with
brain functioning to 30% and alot of that has to do with brain
functioning.
If there is loss of insight orawareness and poor judgment,
that's another concern.
If there's behavioral problemslike irritability, excessive
worry, anger, agitation,suspiciousness when I do memory
(08:21):
testing questions in the office,I find if someone is trying to
joke or make light of things tohide their cognitive impairment,
that that is a problem.
There are tests that can bedone.
You should first start withyour primary care physician.
You may need to see aneurologist.
There are treatments thatinclude lifestyle modifications,
(08:42):
diet supplements and evensometimes medications.
One of the medicines that Ihave been prescribing for quite
a while to women over 45, andespecially over 50 after we take
care of lifestyle and hormonalstatus and sleep disturbances,
is serifolin NAC.
It's a so-called quote medicalfood and it's formulated to meet
(09:08):
distinctive nutritionalrequirements of patients who
have memory loss, called MCImild cognitive impairment.
It was up until recently onlyavailable by prescription and a
lot of insurances wouldn't coverit because they considered it a
medical food, not a medication.
But I would always tell peoplelet's try this for three months
(09:32):
If you think it's worth it, butyou can't afford it long-term.
Then you could maybe figure outhow to buy the component
separately, and in my podcast Idid in season one in September
of 2023.
I described that in more detail, but it's now available over
the counter, making itconvenient for people who just
(09:53):
want to take one single pill andthey want to treat their mild
cognitive impairment.
So the ingredients in serifoland NAC include active folate
L-methylfolate that supportsmental focus and the
neurotransmitter production,while improving brain metabolism
(10:14):
.
It also has methylated B12,which boosts energy production
to help support overall brainand neurologic function.
And it contains NAC, anacetylcysteine which contributes
to brain health by reducingoxidative stress and boosting
(10:34):
glutathione production.
I have a column on glutathione.
What are the benefits of serifoland NAC?
Well, it's backed by an MRIstudy up to seven years of
clinical data in the samepatient, showing long-term users
help slow cognitive decline andmaintain essential brain
(10:54):
function.
Starting it early can helpprotect your brain cells, slow
the loss of brain function andimprove the quality of your life
.
And as of March 2025, the Idesof March, serifolin NAC is now
over the counter and it'srenamed serifolin brain wellness
(11:16):
.
Now, if you happen to have anMTHFR mutation and half the
population has one mutation, ifyou have two mutations of the C
gene, especially if you haveelevated homocysteine levels,
and that can be up to 10% of thepopulation it means your body
lacks the enzyme to take regularfolate and convert it into the
(11:39):
active isomer L-methylfolate,and that can accelerate brain
oxidation and brain aging.
I describe it the oxidativeprocess like if you cut an apple
and you leave it open to theair, it turns brown.
So with aging there can beoxidative stresses Now gobbling
up a bunch of antioxidants.
(12:01):
If you have too muchantioxidants they can be
pro-oxidative.
So even if you're takingsomething over the counter, it's
important to work with yourhealthcare team and bring that
in.
And just because something'snot a prescription doesn't mean
that it's not effective orpotent.
Supplements B12.
(12:23):
I routinely check B12.
I always did it over age 65,then I started going down to 60.
If someone is on anymedications like metformin or
stomach acid ppi blockers, thatcan affect b12.
If people are strict lacto ovovegetarians and their dietary
survey doesn't include milk andeggs and meat, those are all
(12:45):
reasons I might want to do a B12level.
People with gut issues, crohn's, anyone who's had any ileal
resection generally needs B12shots because their gut can't
absorb it.
And there was a new study inolder adults with low levels of
B12, but still in the normalrange, that showed signs of
(13:06):
neurologic and cognitiveimpairment.
I routinely send messages to mypatients on my chart.
Even if the lab says it's quote, normal, if it's under 300, I
am not happy because there canbe neurologic impairment and so
increasingly I'm trying to shootfor levels of 400 or 500 in
patients, just like vitamin D.
Oh, I go back and forth withpatients.
(13:28):
They say my doctor said my B12,or my vitamin D rather, is too
high at 85 or 95.
And I'm like lifeguards havelevels of 150 and feel great,
it's not even a vitamin.
Now B12 is a vitamin.
It's a very big vitaminphysically, with a long
half-life, and is a very complexvitamin.
Now B12 is a vitamin.
It's a very big vitaminphysically, with a long
half-life, and it's a verycomplex vitamin, but it is water
(13:49):
soluble and so excess isusually excreted out.
There are some cases whereelevated levels may be related
to other conditions, and we havethis information on our
speakingonwomenshealthcom site,but far more often we're
(14:09):
concerned with inadequate lowlevels.
Another nutrient or supplementthat's important for brain
health is omega-3.
Now I've done a podcast onomega-3 fats, we have a column
on it, and so I'm not going torehash all of that, other than
to say that omega-3 is importantfor brain health.
It helps facilitatecommunications in the brain,
boost brain blood flow andsupport brain health, and signs
(14:34):
of omega-3 deficiency caninclude brain fog, poor memory,
trouble concentrating, as wellas skin irritation, dry eyes,
brittle nails, joint pain,insomnia, and I have so many
women complain of those symptomsat midlife.
Some of it's related, of course, to lack of estrogen, but not
all of it.
(14:54):
And another side of low omega-3, apparently, is earwax buildup.
I learned that in researchingfor this column and podcast.
Now magnesium in researching forthis column and podcast, now
magnesium I wanna spend a littletime on magnesium, because some
studies recently suggested thatmagnesium is linked to better
(15:14):
brain function and may helpreduce dementia risk, and after
vitamin D and now probablyomega-3, probably the next most
common, tied with omega-3 forsupplements.
I recommend to women thatthey're not getting in their
diet is magnesium, and women, orpeople, adults who consume more
(15:37):
than 550 milligrams ofmagnesium daily have higher
brain volumes than those whoonly get 300 to 350 milligrams
daily, and, interestingly though, these effects were greater in
women compared to men, and someof this information I'm going to
present is from the NationalInstitute of Health.
There's a nice fact sheet onmagnesium for health
(16:00):
professionals, and magnesium isan abundant mineral in the body.
It's in lots of foods, it'savailable as an over-the-counter
, inexpensive supplement, it'sin certain medicines like
laxatives and colonoscopy prepsand antacids, and magnesium is
very important because it'sinvolved in over 300 enzymatic
(16:22):
systems in our body thatregulate a lot of diverse
biochemical reactions, includingprotein synthesis, muscle and
nerve function, blood sugarcontrol and blood pressure
regulation.
Magnesium is needed for energyproduction, oxidative
phosphorylation and glycolysis,and it contributes to the
(16:45):
structural development of ourbones, and, of course, I'm very
concerned about bones.
One in two women over age 55have osteoporosis and we have a
lot of podcasts on osteoporosis.
If you want more detail abouttherapies, evaluation, calcium,
vitamin D, please go back toprior podcast.
(17:07):
So magnesium plays a role inthe active transport of calcium
and potassium ions across yourcell membranes.
That helps with nerveconduction, which obviously can
help affect brain function,muscle contraction and heart
rhythm.
The average adult body containsabout 25 grams of magnesium and
(17:29):
over half of it is in the bonesand the rest are in the soft
tissue, with less than 1% in thebloodstream.
That are under tight control,and so the normal magnesium
serum concentrations are tightlycontrolled.
If the magnesium level is low,there can be a lot of problems.
(17:49):
The body tries to conserve itby reducing kidney excretion.
Assessing magnesium status,just like assessing calcium
status, can be difficult becausemost of the magnesium is inside
the cells or the bone, justlike calcium.
That's why I have women do24-hour urine calcium
(18:11):
collections if I want to findout about their calcium balance,
and unfortunately half of mypatients don't complete the test
, so the serum levels ofmagnesium don't always correlate
.
You can get an RBC red bloodcell magnesium, which sometimes
I do.
I like to clinically assesspeople and as long as there's
(18:34):
not kidney failure, generallyspeaking, magnesium
supplementation is not going tobe a problem.
If you take too much magnesium,you will get diarrhea.
The recommended daily allowancesfor magnesium are set and
there's different requirementsbased on age and sex, pregnancy,
(18:56):
breastfeeding, and then there'sa tolerable upper intake level
and you can find this in thelinks to our column or on our
website.
We list it.
Obviously, situations withpregnancy and breastfeeding
require more.
In general, it's listed thatthe average male over age 50
(19:21):
needs about 420 milligrams ofmagnesium, where the female's
320.
I really think it's probablymore than that, just from my own
clinical experience with doingdietary surveys and recommending
magnesium supplements.
Magnesium is in lots of foodsbeverages, green leafy products,
spinach, nuts, seeds, wholegrains.
(19:43):
Magnesium is added to somefortified foods, but foods that
are highly processed removes thenutrient-rich germ and bran and
lower the magnesium content.
So I think it's best to getwhole foods.
Tap and mineral and bottledwater might be a source of
(20:04):
magnesium depending, it variesfrom one milligram per liter to
more than 120 milligrams perliter.
About 30 to 40% of the dietarymagnesium consumed is typically
absorbed by the body and thatprobably varies by individuals.
(20:29):
Some foods that are rich inmagnesium pumpkin seeds, 156
milligrams.
Chia seeds, which are rich inomega-3, 111 milligrams per
serving.
Almonds, also rich in omega-3,80 milligrams.
Spinach, 78.
Cashews, which are rich incopper, 74.
Peanuts a quarter cup 63.
Soy milk, plain or vanilla aone cup is 61.
(20:53):
Black beans 60 and tamami,shelled and cooked, a half a cup
50.
Peanut butter two Peanut butter, two tablespoons, 49.
Potato baked with the skin 43.
Brown rice a half a cup, 42.
Plain yogurt, low fat, eightounces, 42.
(21:15):
Yogurt's, also rich inphosphorus, which is important
for muscles.
Halibut, cooked, three ounces.
Rich in omega-3 is is, uh, 24milligrams.
Avocado cubed, which is a hearthealthy fat, 22.
Chicken breast three ounces 22.
(21:39):
Beef ground 90, just threeounces is 20 grams of magnesium,
actually milligrams, 20milligrams of magnesium.
A medium apple you know, anapple a day keeps the doctor
away is just nine milligrams.
(22:02):
A carrot, one medium, is sevenmilligrams of magnesium and of
course that's very rich invitamin A, which is a true
vitamin, unlike vitamin D, whichis a pro-sterile hormone, hard
to overdose on.
Vitamin A you can overdose on,so a lot of times dietary
supplements might be recommendedand you can get the oxide which
(22:25):
is more irritating to the gut.
So for constipation women, Imight recommend that Magnesium
citrate I might recommend ifsomeone has had a calcium
oxalate stone and you're tryingto get more citrate in the diet.
There is potassium chloride.
(22:46):
Absorption of magnesium fromdifferent salts vary.
It seems like magnesium thatdissolves well in liquid are
more completely absorbed thanless soluble forms and some
small studies show thatmagnesium in the aspartate,
citrate, lactate and chlorideforms are absorbed better and
more bioavailable than magnesiumoxide, the cheaper one that I
(23:11):
tend to recommend withconstipation, and better than
magnesium sulfate.
One study found that very highdoses of zinc can interfere with
your magnesium absorption anddisrupt your magnesium balance
in the body your magnesiumabsorption and disrupt your
magnesium balance in the bodyand certainly I've been finding
more zinc deficiency and sincethe age of COVID, where we knew
(23:31):
that vitamin D was veryimportant and zinc is important
in terms of helping enzymes thatfight off respiratory viruses,
I've done more zinc levels andI'm surprised at finding low
levels.
I think just in general, thenutritional status of Americans,
(23:51):
who have a lot of wide accessto food.
Sometimes that quality of thefood is not optimal and if you
missed my column or podcast onfood freedom and banned foods
and substances in our foodsupply that are not optimal and
that are banned in othercountries, please go back and
listen to that one.
Now, in terms of magnesium inmedicines, it's in lots of
(24:16):
laxatives, like milk of magnesia.
For instance, there's 500milligrams of elemental
magnesium per tablespoon and theadvice is up to four
tablespoons per day foradolescents or adults, but such
a dose is well above the safeupper limit on a daily basis and
(24:37):
some of that magnesium is notabsorbed because of the laxative
effect.
So it's not to be doneregularly.
And again, this podcast is notmedical advice.
It's just to empower you to bestrong, be healthy and be in
charge and be prepared tointeract with your healthcare
team in the most efficient andproductive way.
(24:59):
And you have been listening tothe Speaking of Women's Health
podcast I'm your host, dr HollyThacker, in the Sunflower House.
We're talking a lot aboutmagnesium.
We started off by talking aboutsupplements that help with
cognitive decline, including nowthe available over-the-counter
without a prescription, serifoland Brain Wellness.
(25:20):
We're talking also not justabout B12, but omega-3 and
magnesium and the magnesiumstatus and, unfortunately,
dietary surveys in the US findthat many people consume less
than the recommended amounts ofmagnesium, finding that 46 or
(25:42):
48% of all Americans ingest lessmagnesium from their food and
beverages than they should, andthat adult men 71 years and
older, and adolescent males andfemales are the most likely to
have low intakes.
And again, that can lead toconstipation.
(26:04):
It can lead to migraine,headaches, leg cramps, insomnia.
So if you're suffering fromthose symptoms, take a look at
your diet and count up.
Go on our website and see thelist of foods that are magnesium
rich and see if you'reingesting those.
If you're very low in magnesium,your kidneys try to limit
(26:25):
excretion of this, buthabitually low intakes or
excessive loss of magnesium dueto certain health conditions
that also include poor nutrition, chronic alcoholism or the use
of medicines that can lead tomagnesium deficiency can cause
loss of appetite, weakness,numbness, tingling, even
(26:48):
seizures, muscle cramps,personality changes, coronary
heart spasm, and severemagnesium deficiency can lead to
low potassium, low calciumlevels, low serum calcium or
potassium levels, because thewhole mineral balance is
disrupted.
So we talked about some of thegroups of people that we're
(27:12):
concerned with.
That also includes those thathave GI gastrointestinal
problems, like gluten-sensitiveenteropathy.
We have a great column andpodcast on celiac disease.
Regional enteritis Crohn's canlead to magnesium depletion If
the ileum has been resected.
(27:32):
That not only leads to low B12levels, requiring B12 shots, but
also magnesium loss.
Those people that have type 2diabetes can have magnesium
deficits, and those with insulinresistance or type 2 diabetes
have more loss of magnesium intheir urine, probably because of
(27:54):
higher concentrations of sugarin the urine, which increase the
output.
Alcohol dependence isassociated with GI problems,
poor nutrition, possible liverdysfunction, pancreatitis,
kidney problems.
Liver dysfunction, pancreatitis, kidney problems and most
(28:18):
people that have alcoholproblems are very low in
magnesium.
We talked about older adults,and older adults by age are also
associated with a higher riskof cognitive decline, which
we've been talking about tryingto prevent.
The statistic that one in twowomen by age 85 will have
dementia is terrifying.
People do not want to outlivetheir brain.
(28:40):
Magnesia may also affect bloodpressure, and uncontrolled high
blood pressure is associatedwith a higher risk of dementia
and heart failure and kidneyfailure.
(29:00):
Now, besides having a good diet,taking selected supplements
with your healthcare team'sadvice, whether that's serifolin
, brain wellness or magnesium.
Hopefully you can get youromega-3s from your diet.
That's best for your heart.
But some people if they cannottolerate fish, if they don't
(29:22):
like the chia seeds, flax seed,seaweed, almonds, walnuts to add
to their diet, may need to takea supplement.
And sometimes those people withvery high triglycerides or very
dry eyes may be recommended bytheir cardiovascular and
(29:43):
ophthalmologic physicians totake fish oil supplements.
But it's important to have thismonitored and measured, because
too much omega-3s are not good.
You want a four to one omega-6to omega-3 ratio.
(30:04):
Migraine headaches, and the moremigraine headaches you have,
the less blood flow do you haveto the brain and the more white
lesions you have.
If you haven't heard my podcaston migraine headaches and if
you suffer from migraineheadaches, that's a good one to
go back to.
I pretty much will recommend amagnesium supplement and
riboflavin to all of my patientswith migraine.
(30:27):
Half the population hasmigraine and the more migraines
you have, the more insults toyour brain.
And just like we want to avoidtrauma to the brain, we want
good nutrition.
We want good brain stimulation,using the right side creative
side of the brain and the leftside, more detailed,
(30:48):
mathematical oriented side ofthe brain.
You want to use both sides.
You want to learn newactivities.
Physical activity learning fromdoing Tai Chi to even ballroom
dancing has been shown to helpbrain health.
Now you do not want to doexcessive doses of magnesium,
(31:13):
excessive doses of B12,excessive doses of omega-3,
which is a fat, which iscalories.
Ladies, and weight is a bigproblem and a big concern.
The biggest concern no punintended for midlife women and
women in general.
It's not a menopausal symptom.
I have a lot of womenpresenting to my practice for
(31:35):
weight concerns, but nothormonal concerns, and they're
sent to our weight managementprogram.
Now, getting back to some ofthe interactions with magnesium,
it's interesting that magnesiumrich supplements can decrease
the absorption of oralbisphosphonates like alendronate
(31:56):
, fosamax, residronate, actonel.
We use these medicines to treatosteoporosis and, generally
speaking, any magnesium-richsupplement or medication should
be separated by at least twohours.
They also form insolublecomplexes with antibiotics like
doxycycline, fibromycin that weuse for acne and we use for
(32:20):
different infections, includingendometritis, uterine infections
, as well as democlocycline,which is a tetracycline, as well
as quinone antibiotics likeciprofloxacin-cipro or
levofloxacin-levoquin.
And so there has to be at leasta two hour before or four to
(32:44):
six hour after amagnesium-containing supplement
is done.
Supplement is done.
If you're on diuretics, it'simportant to discuss with your
physician or healthcare team themagnesium status, because
(33:06):
different types of diureticsmight increase the loss of
magnesium, such ashydrochlorothiazide.
In contrast, potassium-sparingdiuretics like spironolactone,
aldactone, which we might usefor hair thinning, androgenic
alopecia we have two podcasts onhair so far June of 2023 and
(33:29):
June of 2024, and June of 2024,as well as a 2025 podcast on
biotin those potassium-sparingdiuretics actually reduce
magnesium excretion, so youmight need less magnesium if
you're starting on one of thosemedicines.
The proton pump inhibitors, ppidrugs, when taken for prolonged
(33:54):
periods of time, can affect thebone negatively and can cause
low magnesium levels.
Now it's best again to focus ongetting your magnesium in your
diet, but not everyone can dothat.
(34:14):
It's also important to limitalcoholic beverages.
Certainly, alcohol is aneurotoxin and is not required,
and so if you're really tryingto protect your brain, also
reduce cancer risk of the mouthand throat and pancreas and
breast, ditch the alcohol.
(34:36):
It also will help you save alot of calories.
I know a lot of people don'tlike to hear it, but it is true
information.
So, wrapping up this podcast oneverything cognition and those
selected supplements which wethink have some pretty important
effects on the brain.
The lifestyle changes of eatinga whole food, plant-based,
(34:59):
heart-healthy Mediterraneanolive oil-rich diet or the MIND
diet, which incorporates thatplus beans which are high in
fiber and focusing onunprocessed foods and whole
foods, is very important.
Physical exercise the morephysical exercise and activity,
(35:20):
the lower the risk of cognitivedecline.
That's one reason that Iencourage those who are hesitant
to have major orthopedicsurgery to those needing a joint
replacement, like a knee or ahip replacement, because they're
very concerned about such majorsurgery or major back or spine
surgery to really stronglyconsider having their orthopedic
(35:43):
problem or neurologic problemfixed so that they can maintain
physical activity for brainfunction.
Social interaction Communicationstimulates and engages
different parts of the brain.
Social isolation after age 65is a modifiable risk factor for
dementia.
So include your older relativesin your events and, as you get
(36:09):
older, make younger friends.
I always like to laugh when Ithink about my uh sons telling
me that, uh, one of my friendswho's actually younger than they
are, who I love to golf withand do things socially, that she
can't be your friend, mom,because she's too young.
Well, she's an adult and she'snot too young and I think it's
(36:32):
good to, as you get older, haveyounger friends to keep you
active and, sadly, the olderthat you get, the more life
celebrations and funerals thatyou attend.
So you want to have a widesocial network as much as
possible.
Wide social network as much aspossible.
(36:53):
Learn new things, challengingthings.
Every time I have to dosomething that I might not want
to do, that's like a new project.
I'm not one for liking to putthings together, for instance, I
realize this is challenging apart of my brain that maybe I'm
not so good at, and it's a goodthing to do Working or
(37:15):
volunteering.
I also think about this thingwhen I'm doing a lot of extra
work.
Well, I'm using my brain.
We just had to learn a newsoftware program for artificial
intelligence, and the thing thatbothers me about artificial
intelligence is well, it's onlyas good as the information
(37:36):
inputted.
So that's an issue.
But also, if it makes thingstoo easy for us that we're not
using our critical thinkingskills, it's a problem.
You know, I marvel at somepeople who've never looked at a
map or a compass, because theyjust have their phone.
Tell them where to go.
You know what if you lose yourphone?
(37:56):
What if you don't haveelectricity?
So sometimes relying on allthese extra assists are not good
not so good.
So learn new things, work andvolunteer.
Anytime you have to think orreason or communicate, organize
or problem solve, it's a goodthing.
(38:18):
So remember, be strong, behealthy and be in charge.
And bookmark our website,speakingofwomenshealthcom, to
read new things, to learn aboutbreaking health news, to follow
us on social media, to deep diveinto some long, complex columns
(38:42):
that aren't just short snippetsof fast social media.
You want to vary your readingand not just do the quick social
media snippets.
Thank you so much for listeningto the Speaking of Women's
Health podcast.
Don't miss a future episode.
Hit, subscribe or follow.
(39:03):
It's free and you can subscribewherever you listen to podcasts
Apple, itunes, tunein, spotify.
We're also on YouTube andRumble.
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share it with others.
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(39:23):
Please leave a five-star reviewand a rating.
Thanks again and I'll see younext time in the Sunflower House
.
Remember, be strong, be healthyand be in charge.
Welcome to the Speaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, and I'm back in our sunflower
house for a new podcast, and onthis episode I'm going to be
talking about everything youneed to know about preventing
(00:25):
cognitive decline, with a focuson B12, a lot about magnesium,
omega-3 fats and a newover-the-counter supplement that
is now available that you canavail yourself of.
So some gradual mental declineis considered normal with aging.
(00:50):
The declines due to agingshould not affect your daily
life, though, and activities anda gradual reduction in thinking
ability related to learning,remembering, reasoning and
paying attention can become aproblem.
(01:10):
There's four stages ofcognitive decline.
Number one no impairment, nodecline at all.
Number two, which I see a lotin my practice, is this
subjective decline, but nointerference in daily activities
.
You know, women may complain ofword finding difficulties or
just not being quite as sharp,needing to take more list.
(01:34):
Then there's the number three,which is mild cognitive
impairment, which isn't someimportant memory loss without
loss of being independent interms of functioning, so
forgetfulness, struggling toperform certain self-care tasks
for example, forgetting to takemedications, forgetting to pay
(01:56):
bills but still being able tofunction in life for the most
part without the direct help orintervention of another person.
Then we get to stage four,which is outright dementia,
which can include a loss of notjust memory but language and
other important thinkingabilities that do interfere with
daily life, and research showsthat women may have greater
(02:20):
cognitive brain reserve but afaster cognitive decline than
men.
It's not really known why thisis the case, but it's thought to
be related to female hormonesand we certainly talk a lot
about female hormones.
The whole focus of my career ismidlife and menopause and
hormone therapy.
It appears that estrogen,particularly if taken within the
(02:44):
10 years of menopause, has someneural protective abilities and
that women with brain fogsubjectively report an
improvement in their wordfinding ability with menopausal
hormone therapy.
(03:08):
Recent research has shown thatwomen may have greater cognitive
improvement in their cognitionand improvement in the size, the
volume of the brain if they areat risk because they have the
APOE4E4 phenotype or actuallygenotype, so you can have
different ApoEs, and ApoE4, e4,or even ApoE3, e3 have a three
(03:34):
to four fold to up to a 12 to 15fold increased risk for senile
dementia of the Alzheimer's type, also called SDAT, relative to
women that just have the wildtype ApoE, apoe genotype and
they have generally severalyears earlier age of onset of
(03:55):
dementia.
It seems like ApoE2 is the bestone at protecting the brain and
I have some women who get thistesting done.
In the past I somewhatdiscouraged it, I just focused
on family history because youknow we didn't really have
interventions but increasinglywe do have more interventions.
(04:17):
But I think that every womanand man for that matter at
midlife and beyond should beinterested in protecting brain
function.
So some of the signs andsymptoms of cognitive decline it
can be individual, but thecommon symptoms first include
trouble finding the right wordsto express yourself and people
(04:41):
can get frustrated and say youknow what I mean, as they're
pointing to something but theycan't come up with the word door
or handle or knife or ballReally simple terms.
I remember postpartum, when youof course experience rapid loss
in estrogen after having a wholebunch of estrogen during
(05:02):
pregnancy, when I was writingthank you notes to people having
trouble remembering like reallysimple words how to spell, and
certainly some of it can be justthe whole upheaval and change
in life and also the excitementand the sleep deprivation.
(05:22):
But I was convinced that a lotdid have to do with estrogen and
once I got my estrogen levelsback several months postpartum.
I remember thinking, yep, I wasjust clicking on all those
gears and that personally had alot of impression on myself, as
well as the fact that,personally, my tendons were much
(05:45):
worse in the postpartumtimeframe.
And again, it's individual.
There's lots of women who loseestrogen, who don't notice any
word finding difficulties, whodon't notice any tendon problems
.
But that's one reason why Ireally like to take a good
obstetrical history in mymidlife patients.
Did you develop hypertension ordiabetes?
How did you feel postpartum?
(06:06):
Did you have any postpartummood problems?
I certainly didn't.
I was euphoric, but a lot ofwomen aren't and that's why
we're all individuals andcertainly genetics and
environment and diet andlifestyle play a role in how all
of these interplay.
So, after trouble finding theright words to express yourself,
(06:29):
if you misplace or lose itemsNow I have to admit when I buy
gifts early months in advance Itell my husband okay, I hid this
in this place, don't let meforget.
So again, some word findingissues or some forgetfulness,
especially for women that aremultitasking and so busy.
(06:50):
You don't have to immediatelybe concerned that you're on the
road to dementia, but when youforget dates or appointments,
you feel overwhelmed by tasks,you forget to do things, you're
more hesitant to be out inpublic or to travel.
Those are concerns.
(07:10):
So when should you talk to yourphysician about your memory
concerns?
Well, if you have anyforgetfulness or amnesia for
recent events that is not linkedto medications like anesthesia.
If you always have to writereminders and set alarms If you
start to struggle to performdaily chores and tasks and you
(07:33):
need reminders and promptsregularly.
If other people are concerned, Ialways ask women about their
work productivity.
Are they having any issues oranyone complaining about their
ability to work?
And one thing about menopauseif you look at United States
labor statistics, prior tomenopause women have about a 70%
(07:59):
work participation level.
After menopause, around 51,which is the median age of
menopause, it drops to 30% and alot of that has to do with
brain functioning to 30% and alot of that has to do with brain
functioning.
If there is loss of insight orawareness and poor judgment,
that's another concern.
If there's behavioral problemslike irritability, excessive
worry, anger, agitation,suspiciousness when I do memory
(08:21):
testing questions in the office,I find if someone is trying to
joke or make light of things tohide their cognitive impairment,
that that is a problem.
There are tests that can bedone.
You should first start withyour primary care physician.
You may need to see aneurologist.
There are treatments thatinclude lifestyle modifications,
(08:42):
diet supplements and evensometimes medications.
One of the medicines that Ihave been prescribing for quite
a while to women over 45, andespecially over 50 after we take
care of lifestyle and hormonalstatus and sleep disturbances,
is serifolin NAC.
It's a so-called quote medicalfood and it's formulated to meet
(09:08):
distinctive nutritionalrequirements of patients who
have memory loss, called MCImild cognitive impairment.
It was up until recently onlyavailable by prescription and a
lot of insurances wouldn't coverit because they considered it a
medical food, not a medication.
But I would always tell peoplelet's try this for three months
(09:32):
If you think it's worth it, butyou can't afford it long-term.
Then you could maybe figure outhow to buy the component
separately, and in my podcast Idid in season one in September
of 2023.
I described that in more detail, but it's now available over
the counter, making itconvenient for people who just
(09:53):
want to take one single pill andthey want to treat their mild
cognitive impairment.
So the ingredients in serifoland NAC include active folate
L-methylfolate that supportsmental focus and the
neurotransmitter production,while improving brain metabolism
(10:14):
.
It also has methylated B12,which boosts energy production
to help support overall brainand neurologic function.
And it contains NAC, anacetylcysteine which contributes
to brain health by reducingoxidative stress and boosting
(10:34):
glutathione production.
I have a column on glutathione.
What are the benefits of serifoland NAC?
Well, it's backed by an MRIstudy up to seven years of
clinical data in the samepatient, showing long-term users
help slow cognitive decline andmaintain essential brain
(10:54):
function.
Starting it early can helpprotect your brain cells, slow
the loss of brain function andimprove the quality of your life
.
And as of March 2025, the Idesof March, serifolin NAC is now
over the counter and it'srenamed serifolin brain wellness
(11:16):
.
Now, if you happen to have anMTHFR mutation and half the
population has one mutation, ifyou have two mutations of the C
gene, especially if you haveelevated homocysteine levels,
and that can be up to 10% of thepopulation it means your body
lacks the enzyme to take regularfolate and convert it into the
(11:39):
active isomer L-methylfolate,and that can accelerate brain
oxidation and brain aging.
I describe it the oxidativeprocess like if you cut an apple
and you leave it open to theair, it turns brown.
So with aging there can beoxidative stresses Now gobbling
up a bunch of antioxidants.
(12:01):
If you have too muchantioxidants they can be
pro-oxidative.
So even if you're takingsomething over the counter, it's
important to work with yourhealthcare team and bring that
in.
And just because something'snot a prescription doesn't mean
that it's not effective orpotent.
Supplements B12.
(12:23):
I routinely check B12.
I always did it over age 65,then I started going down to 60.
If someone is on anymedications like metformin or
stomach acid ppi blockers, thatcan affect b12.
If people are strict lacto ovovegetarians and their dietary
survey doesn't include milk andeggs and meat, those are all
(12:45):
reasons I might want to do a B12level.
People with gut issues, crohn's, anyone who's had any ileal
resection generally needs B12shots because their gut can't
absorb it.
And there was a new study inolder adults with low levels of
B12, but still in the normalrange, that showed signs of
(13:06):
neurologic and cognitiveimpairment.
I routinely send messages to mypatients on my chart.
Even if the lab says it's quote, normal, if it's under 300, I
am not happy because there canbe neurologic impairment and so
increasingly I'm trying to shootfor levels of 400 or 500 in
patients, just like vitamin D.
Oh, I go back and forth withpatients.
(13:28):
They say my doctor said my B12,or my vitamin D rather, is too
high at 85 or 95.
And I'm like lifeguards havelevels of 150 and feel great,
it's not even a vitamin.
Now B12 is a vitamin.
It's a very big vitaminphysically, with a long
half-life, and is a very complexvitamin.
Now B12 is a vitamin.
It's a very big vitaminphysically, with a long
half-life, and it's a verycomplex vitamin, but it is water
(13:49):
soluble and so excess isusually excreted out.
There are some cases whereelevated levels may be related
to other conditions, and we havethis information on our
speakingonwomenshealthcom site,but far more often we're
(14:09):
concerned with inadequate lowlevels.
Another nutrient or supplementthat's important for brain
health is omega-3.
Now I've done a podcast onomega-3 fats, we have a column
on it, and so I'm not going torehash all of that, other than
to say that omega-3 is importantfor brain health.
It helps facilitatecommunications in the brain,
boost brain blood flow andsupport brain health, and signs
(14:34):
of omega-3 deficiency caninclude brain fog, poor memory,
trouble concentrating, as wellas skin irritation, dry eyes,
brittle nails, joint pain,insomnia, and I have so many
women complain of those symptomsat midlife.
Some of it's related, of course, to lack of estrogen, but not
all of it.
(14:54):
And another side of low omega-3, apparently, is earwax buildup.
I learned that in researchingfor this column and podcast.
Now magnesium in researching forthis column and podcast, now
magnesium I wanna spend a littletime on magnesium, because some
studies recently suggested thatmagnesium is linked to better
(15:14):
brain function and may helpreduce dementia risk, and after
vitamin D and now probablyomega-3, probably the next most
common, tied with omega-3 forsupplements.
I recommend to women thatthey're not getting in their
diet is magnesium, and women, orpeople, adults who consume more
(15:37):
than 550 milligrams ofmagnesium daily have higher
brain volumes than those whoonly get 300 to 350 milligrams
daily, and, interestingly though, these effects were greater in
women compared to men, and someof this information I'm going to
present is from the NationalInstitute of Health.
There's a nice fact sheet onmagnesium for health
(16:00):
professionals, and magnesium isan abundant mineral in the body.
It's in lots of foods, it'savailable as an over-the-counter
, inexpensive supplement, it'sin certain medicines like
laxatives and colonoscopy prepsand antacids, and magnesium is
very important because it'sinvolved in over 300 enzymatic
(16:22):
systems in our body thatregulate a lot of diverse
biochemical reactions, includingprotein synthesis, muscle and
nerve function, blood sugarcontrol and blood pressure
regulation.
Magnesium is needed for energyproduction, oxidative
phosphorylation and glycolysis,and it contributes to the
(16:45):
structural development of ourbones, and, of course, I'm very
concerned about bones.
One in two women over age 55have osteoporosis and we have a
lot of podcasts on osteoporosis.
If you want more detail abouttherapies, evaluation, calcium,
vitamin D, please go back toprior podcast.
(17:07):
So magnesium plays a role inthe active transport of calcium
and potassium ions across yourcell membranes.
That helps with nerveconduction, which obviously can
help affect brain function,muscle contraction and heart
rhythm.
The average adult body containsabout 25 grams of magnesium and
(17:29):
over half of it is in the bonesand the rest are in the soft
tissue, with less than 1% in thebloodstream.
That are under tight control,and so the normal magnesium
serum concentrations are tightlycontrolled.
If the magnesium level is low,there can be a lot of problems.
(17:49):
The body tries to conserve itby reducing kidney excretion.
Assessing magnesium status,just like assessing calcium
status, can be difficult becausemost of the magnesium is inside
the cells or the bone, justlike calcium.
That's why I have women do24-hour urine calcium
(18:11):
collections if I want to findout about their calcium balance,
and unfortunately half of mypatients don't complete the test
, so the serum levels ofmagnesium don't always correlate
.
You can get an RBC red bloodcell magnesium, which sometimes
I do.
I like to clinically assesspeople and as long as there's
(18:34):
not kidney failure, generallyspeaking, magnesium
supplementation is not going tobe a problem.
If you take too much magnesium,you will get diarrhea.
The recommended daily allowancesfor magnesium are set and
there's different requirementsbased on age and sex, pregnancy,
(18:56):
breastfeeding, and then there'sa tolerable upper intake level
and you can find this in thelinks to our column or on our
website.
We list it.
Obviously, situations withpregnancy and breastfeeding
require more.
In general, it's listed thatthe average male over age 50
(19:21):
needs about 420 milligrams ofmagnesium, where the female's
320.
I really think it's probablymore than that, just from my own
clinical experience with doingdietary surveys and recommending
magnesium supplements.
Magnesium is in lots of foodsbeverages, green leafy products,
spinach, nuts, seeds, wholegrains.
(19:43):
Magnesium is added to somefortified foods, but foods that
are highly processed removes thenutrient-rich germ and bran and
lower the magnesium content.
So I think it's best to getwhole foods.
Tap and mineral and bottledwater might be a source of
(20:04):
magnesium depending, it variesfrom one milligram per liter to
more than 120 milligrams perliter.
About 30 to 40% of the dietarymagnesium consumed is typically
absorbed by the body and thatprobably varies by individuals.
(20:29):
Some foods that are rich inmagnesium pumpkin seeds, 156
milligrams.
Chia seeds, which are rich inomega-3, 111 milligrams per
serving.
Almonds, also rich in omega-3,80 milligrams.
Spinach, 78.
Cashews, which are rich incopper, 74.
Peanuts a quarter cup 63.
Soy milk, plain or vanilla aone cup is 61.
(20:53):
Black beans 60 and tamami,shelled and cooked, a half a cup
50.
Peanut butter two Peanut butter, two tablespoons, 49.
Potato baked with the skin 43.
Brown rice a half a cup, 42.
Plain yogurt, low fat, eightounces, 42.
(21:15):
Yogurt's, also rich inphosphorus, which is important
for muscles.
Halibut, cooked, three ounces.
Rich in omega-3 is is, uh, 24milligrams.
Avocado cubed, which is a hearthealthy fat, 22.
Chicken breast three ounces 22.
(21:39):
Beef ground 90, just threeounces is 20 grams of magnesium,
actually milligrams, 20milligrams of magnesium.
A medium apple you know, anapple a day keeps the doctor
away is just nine milligrams.
(22:02):
A carrot, one medium, is sevenmilligrams of magnesium and of
course that's very rich invitamin A, which is a true
vitamin, unlike vitamin D, whichis a pro-sterile hormone, hard
to overdose on.
Vitamin A you can overdose on,so a lot of times dietary
supplements might be recommendedand you can get the oxide which
(22:25):
is more irritating to the gut.
So for constipation women, Imight recommend that Magnesium
citrate I might recommend ifsomeone has had a calcium
oxalate stone and you're tryingto get more citrate in the diet.
There is potassium chloride.
(22:46):
Absorption of magnesium fromdifferent salts vary.
It seems like magnesium thatdissolves well in liquid are
more completely absorbed thanless soluble forms and some
small studies show thatmagnesium in the aspartate,
citrate, lactate and chlorideforms are absorbed better and
more bioavailable than magnesiumoxide, the cheaper one that I
(23:11):
tend to recommend withconstipation, and better than
magnesium sulfate.
One study found that very highdoses of zinc can interfere with
your magnesium absorption anddisrupt your magnesium balance
in the body your magnesiumabsorption and disrupt your
magnesium balance in the bodyand certainly I've been finding
more zinc deficiency and sincethe age of COVID, where we knew
(23:31):
that vitamin D was veryimportant and zinc is important
in terms of helping enzymes thatfight off respiratory viruses,
I've done more zinc levels andI'm surprised at finding low
levels.
I think just in general, thenutritional status of Americans,
(23:51):
who have a lot of wide accessto food.
Sometimes that quality of thefood is not optimal and if you
missed my column or podcast onfood freedom and banned foods
and substances in our foodsupply that are not optimal and
that are banned in othercountries, please go back and
listen to that one.
Now, in terms of magnesium inmedicines, it's in lots of
(24:16):
laxatives, like milk of magnesia.
For instance, there's 500milligrams of elemental
magnesium per tablespoon and theadvice is up to four
tablespoons per day foradolescents or adults, but such
a dose is well above the safeupper limit on a daily basis and
(24:37):
some of that magnesium is notabsorbed because of the laxative
effect.
So it's not to be doneregularly.
And again, this podcast is notmedical advice.
It's just to empower you to bestrong, be healthy and be in
charge and be prepared tointeract with your healthcare
team in the most efficient andproductive way.
(24:59):
And you have been listening tothe Speaking of Women's Health
podcast I'm your host, dr HollyThacker, in the Sunflower House.
We're talking a lot aboutmagnesium.
We started off by talking aboutsupplements that help with
cognitive decline, including nowthe available over-the-counter
without a prescription, serifoland Brain Wellness.
(25:20):
We're talking also not justabout B12, but omega-3 and
magnesium and the magnesiumstatus and, unfortunately,
dietary surveys in the US findthat many people consume less
than the recommended amounts ofmagnesium, finding that 46 or
(25:42):
48% of all Americans ingest lessmagnesium from their food and
beverages than they should, andthat adult men 71 years and
older, and adolescent males andfemales are the most likely to
have low intakes.
And again, that can lead toconstipation.
(26:04):
It can lead to migraine,headaches, leg cramps, insomnia.
So if you're suffering fromthose symptoms, take a look at
your diet and count up.
Go on our website and see thelist of foods that are magnesium
rich and see if you'reingesting those.
If you're very low in magnesium,your kidneys try to limit
(26:25):
excretion of this, buthabitually low intakes or
excessive loss of magnesium dueto certain health conditions
that also include poor nutrition, chronic alcoholism or the use
of medicines that can lead tomagnesium deficiency can cause
loss of appetite, weakness,numbness, tingling, even
(26:48):
seizures, muscle cramps,personality changes, coronary
heart spasm, and severemagnesium deficiency can lead to
low potassium, low calciumlevels, low serum calcium or
potassium levels, because thewhole mineral balance is
disrupted.
So we talked about some of thegroups of people that we're
(27:12):
concerned with.
That also includes those thathave GI gastrointestinal
problems, like gluten-sensitiveenteropathy.
We have a great column andpodcast on celiac disease.
Regional enteritis Crohn's canlead to magnesium depletion If
the ileum has been resected.
(27:32):
That not only leads to low B12levels, requiring B12 shots, but
also magnesium loss.
Those people that have type 2diabetes can have magnesium
deficits, and those with insulinresistance or type 2 diabetes
have more loss of magnesium intheir urine, probably because of
(27:54):
higher concentrations of sugarin the urine, which increase the
output.
Alcohol dependence isassociated with GI problems,
poor nutrition, possible liverdysfunction, pancreatitis,
kidney problems.
Liver dysfunction, pancreatitis, kidney problems and most
(28:18):
people that have alcoholproblems are very low in
magnesium.
We talked about older adults,and older adults by age are also
associated with a higher riskof cognitive decline, which
we've been talking about tryingto prevent.
The statistic that one in twowomen by age 85 will have
dementia is terrifying.
People do not want to outlivetheir brain.
(28:40):
Magnesia may also affect bloodpressure, and uncontrolled high
blood pressure is associatedwith a higher risk of dementia
and heart failure and kidneyfailure.
(29:00):
Now, besides having a good diet,taking selected supplements
with your healthcare team'sadvice, whether that's serifolin
, brain wellness or magnesium.
Hopefully you can get youromega-3s from your diet.
That's best for your heart.
But some people if they cannottolerate fish, if they don't
(29:22):
like the chia seeds, flax seed,seaweed, almonds, walnuts to add
to their diet, may need to takea supplement.
And sometimes those people withvery high triglycerides or very
dry eyes may be recommended bytheir cardiovascular and
(29:43):
ophthalmologic physicians totake fish oil supplements.
But it's important to have thismonitored and measured, because
too much omega-3s are not good.
You want a four to one omega-6to omega-3 ratio.
(30:04):
Migraine headaches, and the moremigraine headaches you have,
the less blood flow do you haveto the brain and the more white
lesions you have.
If you haven't heard my podcaston migraine headaches and if
you suffer from migraineheadaches, that's a good one to
go back to.
I pretty much will recommend amagnesium supplement and
riboflavin to all of my patientswith migraine.
(30:27):
Half the population hasmigraine and the more migraines
you have, the more insults toyour brain.
And just like we want to avoidtrauma to the brain, we want
good nutrition.
We want good brain stimulation,using the right side creative
side of the brain and the leftside, more detailed,
(30:48):
mathematical oriented side ofthe brain.
You want to use both sides.
You want to learn newactivities.
Physical activity learning fromdoing Tai Chi to even ballroom
dancing has been shown to helpbrain health.
Now you do not want to doexcessive doses of magnesium,
(31:13):
excessive doses of B12,excessive doses of omega-3,
which is a fat, which iscalories.
Ladies, and weight is a bigproblem and a big concern.
The biggest concern no punintended for midlife women and
women in general.
It's not a menopausal symptom.
I have a lot of womenpresenting to my practice for
(31:35):
weight concerns, but nothormonal concerns, and they're
sent to our weight managementprogram.
Now, getting back to some ofthe interactions with magnesium,
it's interesting that magnesiumrich supplements can decrease
the absorption of oralbisphosphonates like alendronate
(31:56):
, fosamax, residronate, actonel.
We use these medicines to treatosteoporosis and, generally
speaking, any magnesium-richsupplement or medication should
be separated by at least twohours.
They also form insolublecomplexes with antibiotics like
doxycycline, fibromycin that weuse for acne and we use for
(32:20):
different infections, includingendometritis, uterine infections
, as well as democlocycline,which is a tetracycline, as well
as quinone antibiotics likeciprofloxacin-cipro or
levofloxacin-levoquin.
And so there has to be at leasta two hour before or four to
(32:44):
six hour after amagnesium-containing supplement
is done.
Supplement is done.
If you're on diuretics, it'simportant to discuss with your
physician or healthcare team themagnesium status, because
(33:06):
different types of diureticsmight increase the loss of
magnesium, such ashydrochlorothiazide.
In contrast, potassium-sparingdiuretics like spironolactone,
aldactone, which we might usefor hair thinning, androgenic
alopecia we have two podcasts onhair so far June of 2023 and
(33:29):
June of 2024, and June of 2024,as well as a 2025 podcast on
biotin those potassium-sparingdiuretics actually reduce
magnesium excretion, so youmight need less magnesium if
you're starting on one of thosemedicines.
The proton pump inhibitors, ppidrugs, when taken for prolonged
(33:54):
periods of time, can affect thebone negatively and can cause
low magnesium levels.
Now it's best again to focus ongetting your magnesium in your
diet, but not everyone can dothat.
(34:14):
It's also important to limitalcoholic beverages.
Certainly, alcohol is aneurotoxin and is not required,
and so if you're really tryingto protect your brain, also
reduce cancer risk of the mouthand throat and pancreas and
breast, ditch the alcohol.
(34:36):
It also will help you save alot of calories.
I know a lot of people don'tlike to hear it, but it is true
information.
So, wrapping up this podcast oneverything cognition and those
selected supplements which wethink have some pretty important
effects on the brain.
The lifestyle changes of eatinga whole food, plant-based,
(34:59):
heart-healthy Mediterraneanolive oil-rich diet or the MIND
diet, which incorporates thatplus beans which are high in
fiber and focusing onunprocessed foods and whole
foods, is very important.
Physical exercise the morephysical exercise and activity,
(35:20):
the lower the risk of cognitivedecline.
That's one reason that Iencourage those who are hesitant
to have major orthopedicsurgery to those needing a joint
replacement, like a knee or ahip replacement, because they're
very concerned about such majorsurgery or major back or spine
surgery to really stronglyconsider having their orthopedic
(35:43):
problem or neurologic problemfixed so that they can maintain
physical activity for brainfunction.
Social interaction Communicationstimulates and engages
different parts of the brain.
Social isolation after age 65is a modifiable risk factor for
dementia.
So include your older relativesin your events and, as you get
(36:09):
older, make younger friends.
I always like to laugh when Ithink about my uh sons telling
me that, uh, one of my friendswho's actually younger than they
are, who I love to golf withand do things socially, that she
can't be your friend, mom,because she's too young.
Well, she's an adult and she'snot too young and I think it's
(36:32):
good to, as you get older, haveyounger friends to keep you
active and, sadly, the olderthat you get, the more life
celebrations and funerals thatyou attend.
So you want to have a widesocial network as much as
possible.
Wide social network as much aspossible.
(36:53):
Learn new things, challengingthings.
Every time I have to dosomething that I might not want
to do, that's like a new project.
I'm not one for liking to putthings together, for instance, I
realize this is challenging apart of my brain that maybe I'm
not so good at, and it's a goodthing to do Working or
(37:15):
volunteering.
I also think about this thingwhen I'm doing a lot of extra
work.
Well, I'm using my brain.
We just had to learn a newsoftware program for artificial
intelligence, and the thing thatbothers me about artificial
intelligence is well, it's onlyas good as the information
(37:36):
inputted.
So that's an issue.
But also, if it makes thingstoo easy for us that we're not
using our critical thinkingskills, it's a problem.
You know, I marvel at somepeople who've never looked at a
map or a compass, because theyjust have their phone.
Tell them where to go.
You know what if you lose yourphone?
(37:56):
What if you don't haveelectricity?
So sometimes relying on allthese extra assists are not good
not so good.
So learn new things, work andvolunteer.
Anytime you have to think orreason or communicate, organize
or problem solve, it's a goodthing.
(38:18):
So remember, be strong, behealthy and be in charge.
And bookmark our website,speakingofwomenshealthcom, to
read new things, to learn aboutbreaking health news, to follow
us on social media, to deep diveinto some long, complex columns
(38:42):
that aren't just short snippetsof fast social media.
You want to vary your readingand not just do the quick social
media snippets.
Thank you so much for listeningto the Speaking of Women's
Health podcast.
Don't miss a future episode.
Hit, subscribe or follow.
(39:03):
It's free and you can subscribewherever you listen to podcasts
Apple, itunes, tunein, spotify.
We're also on YouTube andRumble.
If you like this episode andyou want to help support us,
share it with others.
You can donate to our nonprofitspeakingofwomenshealthcom.
(39:23):
Please leave a five-star reviewand a rating.
Thanks again and I'll see younext time in the Sunflower House
.
Remember, be strong, be healthyand be in charge.
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