Hey friends,

Last week I curated a stage of 30 speakers covering longevity topics ranging from sleep, breathwork, and women’s health to consciousness and cryopreservation.

It was my first full day event that I’ve curated and it was a huge success, overcapacity with standing room only. Barely anyone left because they didn’t want to give up their seats. Highly engaged audience!

Some feedback that just melted my heart:

“Really brilliant day Nina! You put together such a great event and I loved alllll the talks.”

“Incredible event. I wish I could have stayed the whole day. All of the speakers were so good.”

“Longevity day was the place to be in Lisbon last week.”

“Part of me wishes we could turn back time and do it all over again today, tomorrow, and the day after. Thank you once again for creating such a special experience.”

Cheers,

Nina

💬 In this note:

• 🫩 The Exhaustion No One Is Diagnosing Correctly

• 📚 Yellowface

• ⚡️ Fart Sensor

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#185: The Root Cause of Exhaustion No One is Diagnosing Correctly

I have one colleague that I meet with multiple times a week and every time we open the video chat, the conversation starts with a “this week is AHHHHH” followed by the breakdown of why the days have been insane, the meetings back-to-back, and the impossible volume of work.

This isn’t one bad week or a deadline that got away from him.

This is every week.

This is normal.

Another friend of mine only had time to have a catch-up call with me on her way to the airport because she is flying from Boston to SF multiple times a month now for work.

Another texted me at 9pm telling me she is wrecked.

Meanwhile, my calendar is also full. Podcast interviews, events, writing, ceramics, padel, dance, calls I said yes to. I worry about fitting things in. But I’m not exhausted the way they are.

My calendar has the same density, but something is different.

A packed calendar can lead to exhaustion or it can be fulfilling.

Something is wrong with how we are talking about what occupies our time, and how we feel after that time is spent.

When we look at the calendar, we think we have too many meetings, too much screen time, too much stimulation.

The story we tell ourselves is we’re doing too much. So the answer is subtractive.

The advice is cancel the meetings that don’t need to exist. Do a digital detox. Try a dopamine fast. Block your calendar. Say no more often. Take the vacation you’ve been putting off.

Some of this is good advice. Some of it works for a week.

But none of it solves the thing.

Most of us experience the Sunday Scaries.

The day you’re supposed to be recovering. You rest, you do the slow morning, you take the walk, you don’t check your email. And by Sunday night the dread is there anyway. Monday looms ahead of you. You’re so anxious about the week ahead that you start making the to-do list on Sunday night, just to “get ahead.”

You trade your last hours of the weekend for the illusion of control over the next day coming.

Or you try having an early night mid-week.

You finally have an evening with nothing on it, no work dinner, no call, nothing you said yes to three weeks ago and now regret. You think okay, this is it.

I’ll go to bed at ten. I’ll get the full eight hours. I’ll wake up actually rested for once. The alarm goes off and you’re just as wrecked as every other morning. Because one good night doesn’t undo the twenty before it. You’re exhausted from the last six months, and a single early bedtime can’t pay down that kind of debt.

And vacation doesn’t even seem to fix it. My colleague went to Morocco for his birthday and he didn’t bring the laptop.

He did it right, the actual disconnection. But then the first call we had after he got back, the conversation opened the same way it always does. “This week is AHHHH.”

A week back at his desk and the vacation was already gone. Whatever it refilled, it wasn’t what was actually empty.

So if it’s not too many meetings, and it’s not too little sleep, and it’s not the missing vacation, what is it?

Self-Determination Theory

When I really started to dive into it, I realized that the reason for the exhaustion is not from doing too much. It’s from doing too little of your own choosing.

There’s a framework from psychology called self-determination theory (SDT). It says humans have three basic psychological needs we have to meet to function, and autonomy is one of them. Not autonomy in the grand sense of running your own life. Autonomy in the granular sense: being the one who decided what you’re doing right now.

Chronic low-autonomy environments produce a specific kind of depletion that looks like tiredness but does not respond to rest. You can’t nap your way out of it.

This is also why I’d be just as exhausted as my colleagues if I spent a week doing things I didn’t pick.

The shape of the week matters less than the ownership of what fills your time.

There is an obvious objection here…”But I chose my job. I chose to have kids. I chose this life. So why am I exhausted?”

All true, but choosing the container isn’t the same as choosing what fills it day to day.

You picked the job, but you didn’t pick the 6am meeting.

You picked parenthood, but you didn’t pick that you need to bring homemade muffins to school tomorrow morning.

Macro-autonomy doesn’t substitute for micro-autonomy.

The depletion happens in the small moments. The meeting you didn’t schedule, the muffins you didn’t volunteer for, the Slack message that pulls you off the thing you were actually choosing to do.

Each one is too small to protest but the accumulation is the whole game.

If you’ve been wondering why you can’t seem to rest your way out of this, it’s because the problem was never how much you were doing. It was how little of it was yours.

So, What Actually Refills The Tank?

Side quests, hobbies, and weird small projects that nobody asked you to do. The thing you are doing because you want to, not because it’s on your to do list.

These replenish, because they are self-directed.

This is why the couch fails at being rest. Sitting there scrolling isn’t lazy, your body genuinely needs something, and something with a low cognitive load. The couch/scrolling is a reasonable guess at that.

But the deficit was never inactivity, it’s again the ownership of the tasks.

And unfortunately, scrolling doesn’t supply that ownership. It just supplies cheap dopamine.

Wellness coaches often frame this as a novelty problem. It makes hobbies sound like a brain hack, pull the lever and get the reward.

Essentially saying, “do new things because dopamine.”

But it actually is “do chosen things because your nervous system is starving for evidence that your life is yours.”

Doing side quests is a way to reclaim your autonomy.

Therefore, your hobby, your padel game, the side project you’ve been pushing away for months, they all have a deeper purpose. These aren’t novelty-seeking or dopamine-chasing or productivity-coded self-improvement. They are evidence-gathering for your nervous system.

Your nervous system needs proof that your life belongs to you.

And the only thing that supplies proof is actions that you chose to do actively.

The chosen action is the only thing that shows your nervous system that you are in charge.

That’s why a nap you chose to take can refill the tank, but a vacation your boss prescribed to you doesn’t.

The Biggest Villain is both Work Culture and Wellness Culture

Work culture is the obvious villain in this story and wellness culture is its sidekick.

Both are about optimization, and both promise that if you tune your schedule correctly, you’ll feel better.

Some of this has real science behind it. Meeting timing, morning routines, sleep windows, these things do affect how you feel. The wellness industry didn’t invent the underlying research.

But it took the research and wrapped it in a prescription, and the prescription asks you to perform optimization inside a structure you didn’t design.

Sleep needs are individually determined. Some people are wired to wake at 5am and some at 9am, but the underlying biology is well-established and it’s called your chronotype.

Nonetheless, wellness culture has decided that 4:30am is virtuous and 9:00am is lazy, causing some people to spend years trying to force themselves into a schedule their biology was never going to accept.

But you didn’t choose any of it. You inherited that structure from a wellness influencer, whose body, schedule and life happen to work that way, and now you’re trying to fit yourself into their container.

The core of this problem is actually due to a demanding work culture. Most people don’t have enough autonomy in their schedules to discover what their body actually needs in the first place.

So they fail, and they’ll conclude they lack discipline. Discipline was never the problem. The prescription was wrong for them, and the prescription was never theirs to begin with.

Even worse, many people now again have to force themselves into a schedule that doesn’t fit their biology with the return to office mandates.

After years of working from home, and being more productive by nearly every available metric, millions of people are now back at desks, commuting, sitting through meetings that could have been emails, available in a way that’s mostly about being seen as available.

With the return to office, what changed is the granularity of choice.

When working from home, you decided when to make coffee. When to take a walk. When to step away to think. When to answer Slack and when to leave it.

In the office, those micro-decisions get absorbed by the environment. You don’t choose when you’re interrupted. You don’t choose when to be reachable. You can’t even choose to be in a quiet place in some offices.

Each loss is too small to protest. But each loss of choice wears you down, and the accumulation leads to exhaustion.

Performative availability is more important to companies now than ever. However no one is realizing that this is what causes exhaustion.

The expectation that you’re reachable at all times means your attention is never fully yours, even when no one’s contacting you. You’re holding a slot open. The waiting leads to the feeling of depletion.

Both cultures use the same trick. They give you the appearance of choice inside a structure you didn’t choose. The morning routine looks like authorship. So does the open-plan office with the unlimited PTO. The wrapping is autonomy. The contents are someone else’s blueprint.

The next time you feel the exhaustion that rest doesn’t touch, the question to ask yourself is how much of this week did you actually choose.

Not the job, not the city, not the life, the container is already chosen. Reflect on the hours. The meetings. The morning. Tuesday afternoon between 2 and 4. The thing you’re doing right now.

If the honest answer is “I did not choose much of this,” you don’t need a vacation. You need a side quest. Something small, chosen, slightly pointless and entirely yours.

Your nervous system needs proof that your life still belongs to you.

That’s the antidote to exhaustion. Not less of your time, but more of it spent the way you decided it should be.

📘 Thinking of Diving Deeper? Check Out My Guidebooks.

You can download all 9 and more at ninapatrick.xyz/guidebooks. Or if you want everything in one place, the guidebooks, the full deep dives, and early access to events, just upgrade to a paid subscription. Paid subscribers get the complete guidebook library included.

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📚 Book of the Week

Yellowface by R. F. Kuang

Rating: ★★★★★

I’ve seen this book over and over as a bestseller and definitely waited too long to pick it up.

I didn’t know what to expect, from the title I assumed a white woman impersonating an Asian woman...and while there is some of this going on, it’s more subtle than I originally thought.

The story is about a famous Asian writer Athena, and her supposed best friend and struggling writer June Hayward, the cutthroat publishing industry, cancel culture, and how far a woman will go to obtain the fame and fortune she thought she wanted.

What surprised me most about this book is that I hated all of the main characters. It’s rare to read a book and not relate to a character in some way, empathize with them, or at least find them somewhat endearing.

But this batch of characters, they are all terrible people! June is the worst of them all, but Athena is not innocent either. At moments you really want to jump into the book, grab June and tell her to do the right thing, which does make for an entertaining read.

The novel is fast paced, exhilarating, and I found many evenings when I couldn’t put it down because I really needed to read my characters out of bad situations, only to be surprised when the next situation was worse than the one before.

Great beach read or one for a long plane ride.

⚡️ Check This Out

Scientists have invented underwear that measures your farts.

Researchers at the University of Maryland built a tiny wearable sensor that attaches to underwear and tracks gas production around the clock, measuring hydrogen, methane, and hydrogen sulphide released by gut microbes as they break down your food.

As lead researcher Professor Brantley Hall put it, we don’t actually know what normal fart production looks like, and without that baseline it’s hard to know when someone’s gas output is truly excessive.

Apparently, the team has found that healthy adults fart an average of 32 times per day - around double the previous estimate.

However their findings also show that daily farts can range from as few as 4 to as many as 59.

This data could help unlock new insights into food intolerances, IBS, and other digestive conditions.

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on YouTube, Spotify, Apple Podcasts, and Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

📰 Wednesdays: Nina’s Notes in your inbox with interviews, deep dives on longevity & neuroscience

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Edited by Wright Time Publishing

Dr. Axel Schumacher spent 25 years at the forefront of genomics and epigenetic clock research and says your social life is a more powerful longevity biomarker than anything in your bloodwork.

In this episode, he walks through the Social Connectivity Value (SCV): a framework he developed to map your social network, identify the relationships that drain your energy, and turn your social health into a number you can actually track.

What you’ll learn:

• Why loneliness can cost 12–20 years of healthy life (men are hit harder than women) and why the “smoking 15 cigarettes a day” statistic doesn’t change behavior without a way to measure it

• How to build a sociogram using Dunbar’s three layers, assign energy values to every person in your life (including the ones dragging you down), and calculate your SCV score

• Why looking for a romantic partner through your close friends almost never works, and the “super connector” strategy that statistically gives you access to 150 new people from a single introduction

What’s the link between loneliness, AI companions, and living to 150? We get into all of it.

Timestamps

• 00:05 – Intro

• 01:35 – Meet Dr. Axel Schumacher

• 02:21 – From Genomics to Social Science (The Pivot)

• 04:28 – How Loneliness Affects Your Health Span

• 06:36 – The Loneliness Epidemic & Declining Birth Rates

• 07:47 – Why Is Social Health So Hard to Measure?

• 09:56 – The Holt-Lunstad Meta-Analysis Explained

• 10:47 – Introducing the Social Connectivity Value (SCV)

• 12:44 – The Sociogram: Mapping Your Social World

• 13:13 –Building Your Sociogram: Mapping Social Connections

• 14:54 – The Dunbar Layers: Your 3 Social Circles

• 15:22 – The Invisible Load: Identifying Energy-Draining Relationships

• 17:03 – The Invisible Load of Toxic Relationships

• 20:09 – The Role of Family and Close Connections

• 22:38 – What Is Your SCV Score?

• 24:51 – How Your Nervous System Responds to Others

• 28:08 – Tracking Your Social Life Like a Biohacker

• 30:44 – Introverts vs Extroverts & Social Energy

• 31:49 – AI Companions & The Future of Connection

• 35:31 – Should Your Partner Be Everything?

• 37:34 – Weak Ties & Super Connectors

• 41:37 – The Mathematical Magic of Super Connectors

• 42:57 – Rapid Fire: Social Media — Net Positive or Negative?

• 43:51 – SCV vs Epigenetic Clocks: Which Matters More?

• 44:59 – The Best City for Human Connection

• 47:12 – One Weekly Habit to Protect Your Social Health

ABOUT DR. AXEL SCHUMACHER: Longevity scientist and epigenetics researcher with over 25 years of experience, believes the most powerful biomarker for how long you live isn’t in your blood it’s in your relationships. After decades at the forefront of genomics and biomarker discovery, he now focuses on quantifying human connection, developing the Social Connectivity Value (SCV), a first-of-its-kind framework to measure your social network as a health metric and longevity tool.

RESOURCES MENTIONED:

• Website: https://www.grailmaster.com

• YouTube ‘Inside the Dating Mind’: https://bit.ly/4s2U2i4

• Axel’s Longevity Protocol: https://bit.ly/4qIL0pZ

• Sociogram Preprint with DOI: https://doi.org/10.31235/osf.io/m6h58_v1

• X: https://x.com/TheGrailmaster

• Instagram: https://www.instagram.com/the_grailmaster/

• LinkedIn: https://www.linkedin.com/in/draxelschumacher/

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

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A weekly, digestible, non-technical read on health & science.

By Nina Patrick

LinkedIn: https://www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz

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Hey friends,

On June 4th. I’m curating a dedicated longevity stage inside NFC Summit. One of Europe’s largest Web3 and emerging tech conferences 2,000+ attendees from 59 countries!

Longevity Day is a full day of talks, panels, and conversations about where the science and the money are actually going. 26 speakers across longevity biotech, DeSci research infrastructure, and the companies building what comes next.

The theme is ‘From Ancestral Wisdom to Radical Life Extension’. We will cover three pillars: Past, Present, Future.

I have a discount code for the first 20 people to sign up! Use code: NINASNOTES20

Get Your Ticket Here

Cheers,

Nina

💬 In this note:

• ⚠️ 40% of Women with PMDD have Suicidal Ideation

• 📚 Big Swiss

• ⚡️ The Egg Chooses

Subscribe now

#183: ⚠️ 40% of Women With PMDD Have Suicidal Ideation

Last month was a very very stressful month for me.

I was dealing with two separate situations where I felt responsible for a lot of unhappy people. It was the kind of stress that gets under your skin, has you playing back decisions and conversations, and sticks with you for a while.

And somewhere in the thick of it, in the week before my period, I had a strange thought.

What if I just...disappeared? What would happen to all of this?

Not dramatic. Not scary at the moment.

More like my brain doing a weird stress calculation: if I remove me from the equation, what changes?

It passed quickly. And when my period came, those thoughts lifted completely.

I looked back on it afterward and thought: that was odd. Why did I think that?

So I started asking questions.

What’s Actually Happening In Your Brain During PMS

The week before your period is the late luteal phase. Progesterone and estrogen both start to decline as the body prepares for menstruation.

As women, we all know this…

What we don’t talk about is the cascade of neurochemical events happening in a woman’s brain, that most women have never been told about.

In the late luteal phase when progesterone drops, so does a metabolite called allopregnanolone (ALLO).

ALLO binds to GABA receptors in the brain. GABA is your main inhibitory neurotransmitter. Think of it as the brake pedal.

GABA prevents your nervous system from going into overdrive by blocking specific chemical messages, effectively slowing down brain activity to induce calmness, focus and sleep.

Therefore, you become more reactive, more sensitive to stress, and find it harder to regulate.

At the same time, falling estrogen reduces serotonin and dopamine activity, which are the neurotransmitters most closely associated with mood, happiness and motivation.

The prefrontal cortex, the region responsible for emotional regulation and rational decision-making, becomes less responsive during the luteal phase.

So to recap, in the late luteal phase, we lose the protections of estrogen, progesterone and GABA, which makes every emotion hit harder.

Other people’s moods can feel like your own. The interpersonal friction that you could easily brush off in the follicular phase, like their thoughts are theirs, not mine, now lands like a verdict.

The good news is that this is not a personality flaw.

This is pharmacology happening in your brain. Every. Single. Month.

And no one explains it to you. Until now.

The Thoughts No One Names

Most women know about PMS.

We’ve been told about the usual symptoms. You know, bloating, cramps, irritability, crying at ads for insurance.

What nobody told us, is that for some women, the luteal phase can also bring darker thoughts.

Intrusive ones.

The kind you don’t mention at dinner.

Things like: What if I weren’t here? What if I just stopped?

Not necessarily thoughts of self harm.

More like a morbid ‘what if…?’ that your brain serves up when it’s overwhelmed.

What I learned when I started diving into this is that there is a clinical spectrum in regards to these kinds of thoughts.

Clinicians distinguish between passive suicidal ideation (a wish to disappear or not exist, without intent to act), active ideation, and active planning with intent.

What I experienced, and what I suspect many women experience in the luteal phase under stress, sits somewhere in the gray area before and below the clinical threshold.

It’s not nothing.

And it’s not a crisis.

More like the mind reaching for extreme metaphors when it’s under heavy load.

For women that may experience these darker thoughts, it is possible they could have Premenstrual Dysphoric Disorder (PMDD), which is a severe, chronic form of PMS.

It causes debilitating emotional and physical symptoms during the two weeks before menstruation, which disappear shortly after a period begins.

PMDD is highly disruptive to daily life and requires targeted treatment.

For clarity, this experience is not a one time thing. This is something that happens monthly, for decades of a woman’s life.

And when I dug deeper I found out that researchers have actually looked at this. (T God!)

In a clinical sample of 110 women with confirmed PMDD, 39.1% reported suicidal ideation during the late luteal phase.

That’s nearly 40% of the women with PMDD experiencing suicidal ideation!!!

And no one is talking about it.

The silence problem isn’t the only stigma.

It’s that we’ve built a mental health vocabulary organized solely around crisis, and it skips over everything in the vast gray zone.

Women having these thoughts, can feel disturbed or ashamed, they may not even mention them to anyone.

And the worst part is that they may never learn that the menstrual timing is the cause.

PMS vs. PMDD: Where’s the Line?

PMDD affects around 5.5% of menstruating women.

And you may read that stat and think..oh 5.5% - that is not that bad.

*PAUSE*

Let me elaborate.

There are approximately 1.8 Billion menstruating women globally.

1.8 billion × 5.5% = ~99 million people with PMDD globally

Equalling roughly 100 million women.

100 MILLION!

That’s more than the entire population of the UK and France combined.

That’s more people than the population of Germany.

*picks jaw back up off the floor*

Despite that scale, no mainstream app tracks the darker symptom vocabulary!

And suicidality isn’t even in the diagnostic criteria yet.

grrrrr.

Anyway, what happens in the PMDD brain is fundamentally a neuroendocrinological condition, not a mood disorder in the traditional sense, but a sensitivity condition.

The body produces normal hormonal fluctuations, but the brain responds to them abnormally.

Research published in 2024 showed that people with PMDD don’t just have reduced ALLO during the luteal phase. They have altered sensitivity to ALLO itself.

In these women, normal allopregnanolone levels can paradoxically trigger anxiety and mood disturbances rather than calm. For them, the receptor is calibrated differently.

The key diagnostic signal for PMDD is that symptoms must lift in the follicular phase.

The stark contrast of feeling like a completely different person across the cycle, is not just anecdotal. It is actually the diagnostic data.

For years, many women with PMDD were misdiagnosed with bipolar disorder or borderline personality disorder because no one tracked the cyclical pattern.

Can you believe that?!? We are women, with cycling hormones and no one thought to check the menstrual cycle with symptoms!!!

The International Association for Premenstrual Disorders published a paper in 2025 arguing that suicidality should be formally investigated for inclusion in the PMDD diagnostic criteria, noting that major depressive disorder (MDD) and bipolar II already list it in the DSM-5.

I agree that clearer recognition could prevent exactly this kind of misdiagnosis. And it would help doctors and medical professionals recognize the seriousness of PMDD.

I’ve wondered recently if some of what I’ve experienced in particularly bad luteal phases might qualify as PMDD, or at least sits closer to it than I thought.

It’s possible, but as I thought this, I realized I’m someone who knows what PMDD is. I have a pharmacology background and even with that knowledge, I only learned PMDD existed as an adult.

No one told me when I might have most needed to know.

It Doesn’t Stop at Reproductive Age

…or should I say, and more bad news…

A 2025 review found that 84% of studies showed some association between the menopausal transition and increased suicidality.

One study found that perimenopausal women were seven times more likely to report suicidal thoughts compared to pre- or post-menopausal women.

Suicide rates among women aged 45–55 are notably elevated, which maps almost exactly onto the typical perimenopause window.

Perimenopause involves years of erratic estrogen swings before levels finally settle.

It is not a smooth descent.

And the women most affected are often those who already had significant luteal-phase symptoms earlier in their reproductive years. Which means perimenopause symptoms are a continuation of ones they may not have even known they had.

We talk about hot flashes.

We don’t talk about this.

The Tools Gap

I use Clue to track my cycle.

I like Clue because it has strong data protection. It’s a German company and the women behind it coined the term “FemTech”.

Overall, I’ve found it useful. But when I tried to think about logging something like “had a dark thought this week,” there’s no option for it.

There’s an option for “mood swings.”

There’s an option for “sad.”

There’s a redirect to an external resource if you select anything that sounds serious. That’s it.

They offer 13 emotions which cover a range of feelings, but it is definitely lacking.

And when you go to search for a feeling and it isn’t there, you don’t feel heard.

Clue App I love you! I really do…but reducing feelings to a group of just 13… downplays our emotions.

And women’s feelings are already downplayed 24/7.

I also found a study which confirmed what I suspected, that there is currently no menstrual and mood tracking app with the full capability to accurately capture PMDD symptoms to aid with diagnosis

There’s no normalized, non-alarming language for darker luteal experiences.

No way to log “felt like a burden today” or “I want to disappear” without it feeling like you’re flagging a serious crisis.

So women don’t log it. The pattern never becomes visible. The symptoms are never connected to the calendar.

The irony is that the research is ahead of the tools.

The IAPMD paper calling for suicidality to be included in PMDD diagnostic criteria was published in 2025

Meanwhile, the apps millions of women use to track their cycles still redirect you to a hotline rather than help you track a pattern.

Awareness is the Protection

When I had that dark thought last month, I was genuinely stressed.

But because I’m a scientist who’s a big nerd, I rigorously track my cycle.

And luckily for me, I thought I’m in the luteal phase. I’ve had a brutal few weeks. This is probably just my brain reaching for extreme scenarios because the chemical brake is off. It will pass.

And it did.

The knowledge that this is temporary, that there’s a pharmacological explanation, that it lifts, is itself protective.

This is not a replacement for treatment when treatment is needed.

But it can be a first layer of protection for the potentially millions of women who are in the normal-to-mild range and have no framework for what they’re experiencing.

Tracking your cycle, including the emotional and cognitive symptoms, along with the physical ones, can turn a confusing experience into a pattern.

Once you have a pattern, you can prepare for it. You can take steps and preventative measures with added awareness.

And eventually not feel ambushed by it.

Women deserve that framework.

We should have been given it years ago.

Does This Resonate?

I’ve never written about this before, partly because it’s personal territory and partly because I wasn’t sure how to frame it. I’m still not sure I’ve got it right.

But I think it’s one of the most underserved topics in women’s health, because the cultural permission to talk about it hasn’t been granted yet.

Quick Poll - Would love your answers 🙏🏽

📚 Book of the Week

Big Swiss by Jen Beagin

Rating: ★★★★★

Finally a 5 star book! I’ve been reading some mediocre books this year. Apologies dear readers, but now we have a clear 5 star, no excuses, brilliant read that had me cackling.

Big Swiss is hilarious, awkward, cringe and honest.

The story follows Greta, a transcriptionist for the local sex therapist, who goes by the name of Om, in the small town of Hudson.

Om’s newest client, who Greta knows from her initials FEW, captivates Greta with her traumatic past and sexual repression and she dubs her “Big Swiss”.

One day at the dog park, Greta recognizes Big Swiss’ voice and decides to approach.

Loaded with intimate details of Big Swiss’ life, while Big Swiss is completely unaware, the two become friends and lovers…and chaos ensues.

Pick this one up, you won’t regret it.

⚡️ Check This Out

The egg chooses.

For centuries, the story of fertilization was framed as a race.

Millions of sperm, one winner, fastest takes all.

Turns out that’s…WRONG!

A study out of Stockholm University found that eggs actively release chemical signals, called chemoattractants, that don’t only attract sperm but also select which ones get through.

Different eggs release different signals.

Different signals attract different sperm.

The egg can even ignore the first sperm to arrive if the chemical compatibility isn’t right.

This study was published in 2020.

It’s now circulating Instagram like breaking news.

Which raises the real question, why did it take six years to go viral?

Why wasn’t this the headline everywhere the moment it was published?

We’ve had this information. We just weren’t talking about it.

Probably because the title of this paper, no offense to the authors, is “Chemical signals from eggs facilitate cryptic female choice in humans”.

Cryptic female choice in humans = what does that even mean!!??

Thank you to the journalists that extracted “the egg chooses” from “cryptic female choice” you’re doing the lords work 🫡

Human sexual reproduction builds an entire narrative around sperm…the speed, the competition, the conquest…making it all sound powerful, while female choice is “cryptic” and that the egg is passive in the process.

When it was the egg calling the shots the whole time!

The egg had the power and scientists just weren’t looking for it. That…in addition to the main article in today’s newsletter…is something worth sitting with.

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

📰 Wednesdays: Nina’s Notes in your inbox with interviews, deep dives on longevity & neuroscience

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Edited by Wright Time Publishing

Don’t forget to grab your ticket for Longevity Day

I have a discount code for the first 20 people to sign up!

Use code: NINASNOTES20 for 50% off

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Nina’s Notes is a media partner for Longevity Summit Dublin: June 24–26

Three days in Dublin bringing together clinicians, investors, researchers and founders working on the science of ageing. One of Europe’s leading longevity events and I’ll be covering it directly for Nina’s Notes readers.

If you’re in Europe, this is worth the trip!

→ Grab your ticket

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This week on the Nina’s Notes Podcast, I sit down with Nahid Zokaei, an Oxford researcher, cognitive neuroscientist, and founder of Cerebella, to explore why menopause may be one of the most overlooked neurological transitions in a woman’s life.

We talk about the connection between menopause, brain fog, memory loss, and Alzheimer’s risk, why women are often dismissed when reporting cognitive symptoms, and how hormonal changes can directly affect the brain during midlife.

Dr. Zokaei also shares the science behind estrogen and brain health, the future of non-drug cognitive therapies, and what women can do today to better protect their long-term cognitive health.

KEY TOPICS:

• How hormonal changes during midlife affect memory, focus, mood, and cognition.

• Why menopause-related brain fog is a real neurological symptom, not “just stress.”

• Exploring why women make up the majority of Alzheimer’s patients.

• How estrogen supports memory, cognition, and overall brain function.

• Why women’s midlife health has been historically overlooked in science and healthcare.

• How non-drug cognitive interventions may help support women’s brain health.

• The importance of sleep, exercise, hearing health, and staying mentally active during midlife.

TIMESTAMPS:

• 00:00 – Why 60% of Alzheimer’s Patients Are Women

• 00:39 – Leaving Academia to Build a Women’s Brain Health Startup

• 05:13 – The Menopause–Alzheimer’s Link Explained

• 06:27 – Understanding Menopause and Brain Health

• 13:55 – Brain Fog Is Not Taken Seriously And What Brain Fog REALLY Means

• 17:36 – Women Are Being Gaslit About Menopause Symptoms

• 19:18 – Menopause as a Window to Prevent Alzheimer’s

• 23:34 – Why Most Brain Training Apps Don’t Work

• 29:06 – Building Brain Games for Women in Midlife

• 35:11 – Early Symptoms Women Should NEVER Ignore

• 38:35 – Why Women’s Health Research Is So Behind

• 42:11 – What Women Can Do TODAY for Better Brain Health

• 45:41 – Why So Many Women Quit Their Jobs During Menopause

• 47:21 – The Worst Advice Doctors Give Women
  

ABOUT NAHID ZOKAEI: Nahid Zokaei is a cognitive neuroscientist, Oxford researcher, and Founder of Cerebella, is focused on advancing women’s brain health through science-backed digital therapeutics and non-drug cognitive interventions.

After more than a decade researching dementia, cognition, and aging, she now works at the intersection of neuroscience, menopause, and Alzheimer’s prevention helping redefine how women’s cognitive health is understood and supported during midlife.

RESOURCES MENTIONED:

Website: https://www.cerebella.health/

WhatApp Community: https://chat.whatsapp.com/H5tNvI5LPAE4OmOOeBrHc1

Professor Aimee Spector’s Lab: https://profiles.ucl.ac.uk/1239-aimee-spector

Nahid Zoukaei Linkedin: https://www.linkedin.com/in/nahid-zokaei-b3795563/

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH NINA’S NOTES

Newsletter: https://www.ninasnotes.xyz

LinkedIn: www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz

Thanks for reading Nina’s Notes!

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If you’re going to be in Lisbon this summer, block June 4th.

I’m curating a dedicated longevity stage inside NFC Summit. One of Europe’s largest Web3 and emerging tech conferences 2,000+ attendees from 59 countries!

Longevity Day is a full day of talks, panels, and conversations about where the science and the money are actually going. 26 speakers across longevity biotech, DeSci research infrastructure, and the companies building what comes next.

The theme is From Ancestral Wisdom to Radical Life Extension. We will cover three pillars: Past, Present, Future.

We’ll move from what human biology has always known, through where clinical science stands today, to the genuinely speculative edge of the field.

The people in that room will be founders, investors, clinicians, and researchers who are serious about longevity as a scientific and commercial category.

If that’s your world, or you want it to be, join me. I’ll be on stage and in the room all day. Come find me.

I have a discount code for the first 20 people to sign up!

Use code: NINASNOTES20

Get your ticket here

Cheers,

Nina

💬 In this note:

• ✍🏼 Writing Is Thinking. What Happens When We Replace Writing for Dictation?

• 📚 The Deserters

• ⚡️ Turn Your Spareroom Into A Data Center

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#181: ✍🏼 Writing Is Thinking. What Happens When We Replace Writing for Dictation?

I’ve been using Wispr Flow for a few weeks. It’s an incredible speech-to-text tool that can clean up the raw transcript into texts, emails, anything you need really.

It’s great for remembering a quick thought, and talking to the LLMs.

But I’m noticing I’m using it more and more to replace the effort of actually writing.

It’s nearly replaced journaling for me.

I still sit at my table with my journal open and start to write, but then by some compulsion, I pick up my phone to dictate into Wispr Flow or Claude instead of taking the time to write out the thoughts slowly.

Even as I got ready to write this article, I was tempted to dictate it into Wispr Flow rather than take the time to type it out.

Wispr Flow also does this terrible thing where they tell you your words per minute in the corner of the desktop app home screen. I speak at 181 words per minute. My typing speed is 61 words per minute. (For reference, “A fast typing speed is generally anything above 70 words per minute (WPM)...nowhere close to our speaking speed.)

I speak at 3x my typing speed, and that number glares at me every time I open the Wispr Flow desktop app.

No wonder it seems daunting to stare at a blank Google Doc and think - this is going to take a while.

But, that’s the point.

Writing Is the Cognitive Work

Writing is the art of slowing down.

There is a friction that happens when you write.

You have to choose the next word intentionally.

Even in a stream of consciousness you’re still making micro-decisions, selecting, pausing, reconsidering.

When I dictate, a lot of what comes out sounds like this:

“I guess what I mean is probably…” “I’m thinking, okay, so the thing is...”

Those filler phrases rarely make it into written work because writing focuses you to skip past the throat-clearing and get to the actual thought.

The choosing of the word, the pausing and reflecting while writing is part of the craft.

It is not inefficiency, it’s where clarification happens. It’s where good explanations are made and practiced.

You often don’t know what you think until you’ve done the writing.

Who Wrote This Message?

Are we losing this layer of cognitive work as we all start to leverage the speech-to-text?

Then instead of doing the cognitive work ourselves, we leverage an LLM to make sense of what we mean, and then we send it off to our friends, family and colleagues with barely an edit.

We’re already getting such a flood of AI-slop to read on the internet, and now this is coming into almost every form of online written communications - not just blog posts, newsletters, news media and bad LinkedIn posts - It’s coming into text messages and Instagram messages where people have set up AI agents to reply back to their messages for them.

Forcing us to ask ourselves “Was this written by AI?” and analyze the messages we get.

I’ve definitely found myself wondering if this sort of over-polished, neutral, bloodless prose that sounds like nobody, is actually how my colleagues email people?

Was this text truly written by my friend? Are they too busy, or too lazy, to simply type a quick response?

However there are advantages to using speech to text. For myself, I can get the raw, unedited tone of my voice, the tangents (or ADHD subplots…) and the uncertainties. Speech-to-text can put a spotlight on my tone in the way I think out loud.

I often forget what I said but luckily Wispr Flow keeps the history, so I can go search for it later.

But is this harming my memory?

What the Neuroscience Says About Writing vs. Dictation

There is solid research that shows that information that you produce yourself (the generation effect), even if it’s just restating something you learned in your own words, is retained significantly better than information that you passively receive.

Writing forces that generation.

Dictation, especially if you know it will be cleaned up for you, is much more passive.

You are outputting content, but you aren’t necessarily constructing or crafting it.

When you write, you have to hold an idea in your working memory. When you hold it there, you are evaluating and revising it before it hits the page. Then you do more editing and revising.

This is a metabolically expensive task, and it is cognitively generative.

Speaking and dictation externalize that mental load. It flows through you which feels easier and that’s because it is easier. It is metabolically and cognitively easier.

However, that hard work of compression, understanding and evaluation doesn’t happen.

Or…it gets outsourced to an LLM for editing and clean-up which makes us all sound the same anyway.

There is also research suggesting that the act of writing doesn’t just record an idea, it actually changes the idea.

There is the constraint of needing to convey your message linearly, and having to commit to one word before the next, that forces a resolution of the idea that speaking doesn’t.

You can talk in circles for 20 minutes and feel like you’ve thought something through.

However if you try to read a transcript of that circular talking, you’ll be confused and probably bored.

Now if you instead spend that 20 minutes trying to write down the thought, you’d probably expose the holes in your thinking faster, and come to a consolidation of the idea.

It’s also worth examining that there is a difference between retrieving a thought or idea - which we can do through dictation, and then forming a thought or idea.

Writing, at its best, forms the thought into an idea that can then be communicated clearly.

And that effort of formation of the thought to an idea, expending the cognitive energy to do so, seems to me like a way to sustain and improve our cognitive health.

To be fair, there are real advantages to dictation.

I’m not going to tell you to delete Wispr Flow. I’m still using it.

But, I am going to be more intentional about when I reach for it. Quick thoughts, voice memos, talking to an LLM, fine.

When I sit down to actually think something through, I want to feel that friction. The slowness isn’t the bug. It’s where the thinking happens.

This newsletter took me longer to write than it would have to dictate. I noticed every time I wanted to pick up my phone.

I left the holes in my thinking exposed until I had to actually resolve them on the page and I think I understand what I believe about dictation vs writing now, in a way I wouldn’t have if I’d just talked it out.

Maybe that’s the test worth applying: Is this something I want to retrieve, or something I want to form?

If it’s the latter, put the phone down. Open the doc. Choose the next word intentionally.

Your brain will thank you…and possibly even remember it.

📘 Thinking of Diving Deeper? Check Out My Guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

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📚 Book of the Week

The Deserters by Mathias Enard

Rating: ★★★☆☆

The Deserters follows two parallel timelines, one present-day and one set during a past war, for most of the book though you’re waiting for the moment they converge. That anticipation is either the novel’s greatest tension or its greatest frustration, depending on your tolerance for ambiguity. For me, it was the latter.

The war-era timeline carries a mysterious soldier at its center and I kept reading to find out who he was.

SPOILER ALERT!

That question never gets answered. The two storylines never fully meet, and if you’re the kind of reader who needs narrative resolution, that absence will leave you genuinely unsatisfied.

That said, both timelines are emotionally rich. The writing captures pain, love, and the particular sorrow of lives shaped and broken by conflict. There’s real craft here and clearly a lot of intention behind the structure.

But intention isn’t always enough. A dual timeline story lives or dies by the payoff, and this one left me hanging. I finished it respecting the ambition of the author more than I enjoyed the experience.

⚡️ Check This Out

Oh dear lord.

California startup Span is partnering with Nvidia to turn your home into a mini data center.

The average household uses only about 42% of its allotted power. Span wants to fill that gap by installing “nodes” packed with 16 Nvidia GPUs and roughly $500k worth of hardware, then use that spare electricity to run AI compute.

In exchange, homeowners get their energy and internet bills subsidized.

The startup has outfitted one home so far, with around 100 more rolling out in a pilot program later this year.

Whether you’d actually want a $500k server rack humming away in your spare bedroom is a different question entirely.

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

📰 Wednesdays: Nina’s Notes in your inbox with interviews, deep dives on longevity & neuroscience

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Edited by Wright Time Publishing

I want to highlight another upcoming longevity event, and one that I’d actually clear my calendar for.

Vitalist Bay is May 14–17, at Lighthaven in Berkeley and the lineup this year is serious.

We’re talking 100+ leaders working on aging from every angle: the biology, the biotech, the AI, the policy, the money. Joe Betts-LaCroix (Retro Biosciences), Morgan Levine (Altos Labs), Michael Snyder (Stanford’s Center for Genomics and Personalized Medicine), Jean Hebert (ARPA-H), and that’s just the start of the speaker list.

What I love about Vitalist Bay specifically is the venue. Lighthaven is built for intimate workshops, salons, actual nooks where you can go deep with someone instead of exchanging business cards and moving on.

Register at vitalistbay.com, and use code NFC25 for 25% off your ticket.

Subscribe now

In this episode, I sit down with Dr. Katrin Dreissigacker, a plastic surgeon turned longevity architect and founder of Epigenedit, to explore why hyperbaric oxygen therapy may be one of the most overlooked tools in longevity science.

We talk about her journey from a small village in East Germany to becoming known as the “Queen of Needles,” how she reversed markers of biological aging, improved her VO2 max in midlife, and why oxygen, mitochondria, skin health, resilience, and reinvention are all deeply connected.

Key Topics:

• Hyperbaric oxygen therapy and its role in longevity

• Innovations in aesthetic medicine and needling techniques

• The impact of oxygen saturation on aging and skin health

• Biomarkers of aging and how hyperbaric oxygen influences them

• The use of peptides and biohacking for healthspan extension

Timestamps:

• 00:00 – Reversing Biological Age? The Power of Oxygen

• 00:30 – From East Germany to Elite Medicine

• 02:30 – Why She Chose Medicine (Unexpected Path)

• 04:05 – What Is Aesthetic Medicine (Beyond Vanity)

• 06:30 – “Queen of Needles” & Revolutionizing Fillers

• 09:30 – First Encounter with Hyperbaric Oxygen Therapy

• 12:00 – From Pandemic to Longevity Innovation

• 14:30 – Why She Built Her Own HBOT Chamber

• 16:45 – Can HBOT Really Improve VO2 Max?

• 18:30 – How HBOT Actually Works (Simple Explanation)

• 21:10 – Mild vs Medical HBOT: What’s the Difference?

• 23:45 – What It Improves: Sleep, Recovery & Aging

• 25:00 – How Often Should You Do HBOT?

• 27:30 – Risks, Side Effects & Common Fears

• 30:30 – The Real Benefits (Why You Don’t Feel It Immediately)

• 34:50 – Skin, Collagen & The ‘Glow Effect’

• 37:10 – Who Should NOT Use HBOT?

• 39:00 – Most Underrated Longevity Tool?

• 41:30 – Peptides: Hype or Breakthrough?

• 43:40 – Biggest Misconceptions About HBOT

• 45:30 – Most Overused Aesthetic Treatment Today

• 47:00 – Daily Habits for Longevity & Energy

• 48:15 – What Shows Up on Your Skin the Most?

• 51:00 – Reinvent Yourself at Any Age
  

ABOUT DR. KATRIN DREISSIGACKER: Physician, pioneer in aesthetic medicine and Co-Founder of EpigenEdit, believes ageing is not something to fight but something to design. After three decades at the forefront of aesthetics, she now focuses on longevity science, using tools such as mild hyperbaric oxygen therapy to support cellular regeneration, performance, and vitality from within.

RESOURCES MENTIONED:

• www.epigenedit.com

• Instagram: @epigenedit_europe / @katrin_dreissigacker

• LinkedIn: www.linkedin.com/in/katrin-dreissigacker

• Katrin’s individual practice: www.katrin-dreissigacker.com

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH NINA’S NOTES

Newsletter: www.ninasnotes.xyz

LinkedIn: www.linkedin.com/in/ninapatrick/

Website: www.ninapatrick.xyz

There are a lot of really cool longevity conferences coming up this year

1. Life Summit Berlin is giving away 10 free tickets to the Nina’s Notes community in a raffle. Everyone who participates but does not win, receives a 50% discount. Enter here: lifesummit.berlin/giveaway-nina-patrick

2. Longevity Day at NFC Summit Lisbon — June 4, 2026. Join me as I host a day all about Longevity.

3. Longevity Summit Dublin — June 24–26 at Trinity Business School, Trinity College Dublin, Ireland. Grab your tickets here.

4. Longevity Show — June 26 & 27 in London. My podcast co-host Phil will be part of the event! Grab your tickets here.

5. 2060 Longevity Forum — September 2 & 3, 2026, one of the best conferences dedicated to longevity investment. Use code LONGEVITYDAYXYZ for a special discount (valid until May 15) at forum.2060.life

Cheers,

Nina

💬 In this note:

• 📱 How A Text Message Changed US Drug Policy

• 📚 New To Reads

• ⚡️ IKEA Inflatable Furniture, round 2

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#179: 📱 How A Text Message Changed US Drug Policy

On April 18th, Bicycle Day weekend, no less, the anniversary of Albert Hofmann’s first LSD trip, US President Donald Trump sat in the Oval Office and signed an executive order to accelerate research into psychedelic drugs and expand patient access.

According to Joe Rogan, who was standing right there in the room, here’s how it happened: he texted Trump some information about ibogaine.

Trump texted back.

“Sounds great. Do you want FDA approval? Let’s do it.”

Rogan described it as “literally that quick.” CNN

Policy by text message.

Welcome to 2026.

What The Executive Order Actually Does

The executive order directs $50M from the Department of Health and Human Services to match state investments in psychedelic research.

It also calls for the FDA to give expedited consideration to certain psychedelics that meet specific criteria.

More specifically: the order directs the FDA Commissioner to provide National Priority Vouchers to psychedelic drugs that have received Breakthrough Therapy designations for treating serious mental illnesses.

The National Priority Vouchers essentially fast-track regulatory review to weeks instead of the standard year-long timeline.

It also instructs the FDA and DEA to establish a pathway for eligible patients to access investigational psychedelics, including ibogaine, under the Right to Try Act.

Trump, for his part, seemed genuinely enthusiastic. Before signing, he pointed to early research on ibogaine’s potential, then joked, “Can I have some, please?” “I’ll take it. Whatever it takes.” to which the audience laughed.

Ibogaine, derived from a shrub native to West Africa, is named explicitly twice in the executive order. It has been championed by veteran organizations and psychedelic advocates as a promising treatment for hard-to-treat conditions including opioid addiction, PTSD, depression, and traumatic brain injury.

Why ibogaine, and why now

Ibogaine has been building momentum, quietly, while the rest of the mainstream psychedelic conversation centered on psilocybin and MDMA.

Ibogaine was classified as a Schedule I substance in the United States in 1970. Due to this illegality, in recent years, US veterans have reported benefiting from ibogaine after travelling to clinics in Mexico to access it.

That grassroots pressure, combined with backing from veterans groups and former Texas Governor Rick Perry, who co-founded a group called Americans for Ibogaine and made the case for reducing federal limits on the drug on Rogan’s podcast, twice in two years, led to a law providing $50 million for ibogaine research in Texas.

Trump’s executive order appears designed in part to match and amplify exactly that kind of state-level momentum.

The clinical trials are preliminary and limited on Ibogaine due to the Schedule I classification, which makes it almost impossible to study the compound domestically in the United States.

One of the only recent studies conducted by US researchers was done by a Stanford research group who enrolled 30 veterans who then received Ibogaine in Mexico. They found that veterans treated with ibogaine showed improvements in PTSD, depression, and anxiety symptoms.

Ibogaine is known to cause irregular heart rhythms and has been linked to more than 30 deaths in the medical literature.

That is a significant safety concern that has stalled research for decades. The FDA has resisted ibogaine research partly due to concerns about heart-related risks, and most research has been conducted abroad.

What the executive order does is create the conditions to finally study it properly, in the USA.

Frederick Barrett, director of the Johns Hopkins Center for Psychedelic and Consciousness Research, says: “It’s been incredibly difficult to study ibogaine in the US because of its known cardiotoxicity. If the executive order can pave the way for doing objective, scientific research with this compound, it would help us understand whether it is truly a better psychedelic therapy than others.”

While the executive order is a symbolic act signalling unusual openness to scheduled substances as potential treatments, it doesn’t fundamentally change the evidence on safety and efficacy the FDA would need to see.

There’s also a real risk of moving too fast. And, then there’s the access question.

Even if ibogaine clears FDA approval someday, clinic owners note there will be no insurance coverage, and it will still be considered unapproved, non-covered care.

Access will initially remain a privilege of the wealthy.

The people who need it most, veterans, people with treatment-resistant depression, those without the means to fly to Mexico for treatment, will still be waiting.

Whatever you think of the currently political circumstances, and I have thoughts, the framing shift on psychedelics matters.

The stigma around Schedule I drugs is significant, and this gives political cover for Republican governors and legislatures to step into the ring and fund research programs at their universities. States that might have been fence-sitting may now feel safer moving forward.

For those of us who have spent years watching rigorous psychedelic science get dismissed, defunded, or simply ignored, the idea that ibogaine is being discussed by name in the Oval Office is genuinely surreal.

📘 Thinking of diving deeper? Check out my guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

You can download all 9 and more at ninapatrick.xyz/guidebooks.

Or if you want everything in one place, the guidebooks, the full deep dives, and early access to events, just upgrade to a paid subscription. Paid subscribers get the complete guidebook library included.

Subscribe now

📚 Book of the Week

Alright readers, I’m a bit behind on my reading, but I bought two new books from the bookstore this weekend and can’t wait to read them.

Have you read Big Swiss by Jen Beagin or The Deserters by Mathias Enard?

What did you think?

Drop it in the comments - but, no spoilers please!

⚡️ Check This Out

IKEA is trying inflatable furniture again.

Yes, really.

After their famous 90’s fail - where their inflatable range turned out prone to dust, delation and being destroyed by a passing vacuum cleaning.

Now they’re back, and apparently they’ve cracked it.

The new easy chair, designed with Mikael Axelsson, has a foam cover, a carbon steel frame, and it is…full of air.

But the textile cover means no squeaking, no sliding and actual back support. It looks surprisingly solid.

And honestly, I have to admit, it’s kind of cute.

Subscribe now

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

📰 Wednesdays: Nina’s Notes in your inbox with interviews, deep dives on longevity & neuroscience

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Did you know I’m curating a Longevity Stage within the NFC Summit in Lisbon on June 4, 2026?

It’s going to be 8 hours of dedicated longevity talks, panels and workshops.

I’d love you to join if you are in town.

Grab your ticket here!

Nina

💬 In this note:

• 💪 My Accidental Workout Stack

• 📚 The Hallmarked Man

• ⚡️ Robots Are Running Half-Marathons

Subscribe now

#178: My Accidental Workout Stack

Nobody handed me this workout routine, I ended up building it by following what felt right to my body. And…somewhere along the way, I accidentally ticked almost every box the longevity research says matters.

I’ve been active my whole life, cheerleading and track in high school, cheerleading in college. I fell off when I no longer had a coach pushing me, then found my way back in grad school through CrossFit-style workouts and dance classes.

After that I had to figure out how to sustain it on my own, which took a while. What I learned about myself: I like being told what to do. I want to show up, do the workout, and leave without having to think too hard about it. That’s not laziness, that’s knowing yourself.

So I chased classes. OrangeTheory, hot yoga, power pilates in San Francisco and Berlin, Beat81, Barry’s Bootcamp.

As I learned more about longevity, I got more intentional about balance. The research is clear: you need strength training, cardio, and mobility work, ideally all three, consistently.

Which meant I was trekking all over Berlin or San Francisco to hit different studios for different things.

When I landed in Lisbon in the winter of 2022, I found Amplify. And I’ve been going ever since.

In the beginning of my time in Lisbon in that winter of 2022, I was living in Baixa, so getting to the Amplify studio meant a 20-minute uphill walk. I’d do a bootcamp class and walk back home. Between the walks, the workouts, and eating well, I genuinely think I was the healthiest and happiest version of myself that winter. I came back to Berlin tan and fit, having lost about 10 lbs, and tried to carry that momentum forward.

When I moved to Lisbon permanently in 2023, I signed right back up to Amplify. The bootcamp classes became my anchor - 10 minutes on the treadmill, 10 minutes strength, repeat. I did this three or four times a week, no question.

Resistance training is one of the most important things you can do for longevity. After 40, you lose 1-2% of muscle pass per year if you’re not actively fighting for it.

Muscle is protective, metabolically, structurally and for independence later in life. Bootcamp class is my prescription for that.

Then a friend told me I hadn’t even scratched the surface of Amplify if I hadn’t tried Miki’s cycling class. I went. The man has a gift.

It was the hardest class I’d ever done, the energy was through the roof, and at one point Miki was literally on the ground with his fist down, giving us a full motivational monologue about being in our bodies, becoming our best selves. You walk out of that class feeling like you can do anything. I was hooked.

Cycling at that kind of intensity is exactly what longevity literature calls for.

Your VO2 max, your body’s capacity to use oxygen, is one of the strongest predictors of all-cause mortality. The research shows that moving from “low” to “above average” VO2 max cuts your risk of dying more than quitting smoking.

For me, that means Miki’s cycling class is basically a longevity drug.

After a bad ankle injury eventually took running off the table, I went deeper into cycling and then yoga. A year or two in, Amplify opened a new location in Santos, where they have a bigger studio and added Barre classes.

Now my routine is a mix of everything: two or three bootcamps a week, one cycling class, and barre or yoga on top of that.

Flexibility and stability work isn’t just recovery, it’s core to your longevity too. The ability to balance on one leg for 10 seconds is an independent predictor of survival in your later years. Barre and yoga are my way of working on that.

I’m at Amplify four times a week. I hit 250 classes recently, and I’m still going. One thing nobody tells you about Amplify: people bring their dogs. This is, objectively, one of the best parts of my day.

Post-workout, I grab a smoothie. My order: the Boogie Matcha. Everytime. This helps me get my protein in right after a hard workout. Protein matters more than most people realize, and your muscles are most receptive to protein in that window right after training. Getting protein in after a workout is one of the easiest optimizations you can make.

Beyond Amplify, I dance. Pop dance once a week at Jazzy Saldanha, and high heels dance twice a week, which is as much work as it sounds and connects me to something completely different.

In 2017, researchers found that dance was more effective than traditional exercise at reversing brain volume loss in the hippocampus. This is because dance requires constant new learning, new choreography, new spatial awareness, and new timing.

That’s a cognitive challenge on top of a physical one. High heels specifically trains proprioception and balance in ways that flat-footed dance training doesn’t.

I also play padel once or twice a week for the social aspect. Longevity research has also identified social connection as a strong predictor of a long, healthy life - equally powerful to exercise and diet. Padel is a great way for me to get in extra movement and my social time.

My workout framework, if you want to steal it:

- Amplify is where I build the foundation: strength, cardio, mobility, all under one roof

- Dance is for my brain: neuroplasticity, body awareness, learning something new

- Paddle is for my social health: connection, fun, lateral movement

I designed it by following what I enjoyed. The fact that it maps almost perfectly onto what the research recommends is either a coincidence or proof that your body knows something.

Either way: it’s a life I love.

📘 Thinking of diving deeper? Check out my guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

You can download all 9 and more at ninapatrick.xyz/guidebooks. Or if you want everything in one place, the guidebooks, the full deep dives, and early access to events, just upgrade to a paid subscription. Paid subscribers get the complete guidebook library included.

📚 Book of the Week

The Hallmarked Man by Robert Galbraith

Rating: ★★☆☆☆

You may have noticed there wasn’t a book of the week the last two weeks. One reason was…I’m still reading this long damn book. Another reason was #176 was an emotional essay that needed to stand alone.

While I’m still not done with this book, I’m ready to rate it, or give it up.

It’s an 18 hour read according to my kindle, and I’ve dragged myself through over 50% and I can say that it’s a frustrating amount of “Cormoran loves Robin, and Robin loves Cormoran” but neither of them have the confidence to say so and are therefore living unfulfilled lives.

The main plot line moves along at a glacial place - Cormoran and Robin are investigating a mysterious body found inside of a silver shop’s vault. Meanwhile, balancing a few other clients and Cormoran has to face a public scandal.

I’ve read all seven books in this series so I feel I owe it to myself to finish this one too, but it’s truly the most boring one thus far, and it only gets 2 stars.

⚡️ Check This Out

A humanoid robot just ran a half-marathon in 50 minutes and 26 seconds, a new robot record.

The human half-marathon record, on the other hand, is ~57min held by Jacob Kiplimo.

The 2025 half-marathon robot winner finished the race in 2 hours, 40 minutes and 42 seconds.

I’m not going to lie. I don’t really want us to make them any faster, it’s starting to feel a little to I, Robot to me.

But although the winning robot from Chinese smartphone manufacturer, Honor, is faster than the humans…another robot started the race by falling on its face.

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: UNLOCKED interviews with leading longevity innovators

📰 Wednesdays: Nina’s Notes in your inbox, personal essays, interviews & deep dives

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity.Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Edited by Wright Time Publishing

I gave a talk at the HotColdClub in Lisbon last week titled “Altered States, Extended Lives” where I gave a recap of all the latest research linking psychedelics as longevity medicines.

Xo,

Nina

💬 In this note:

• #177: 🤖i’ve Been Using Claude Code for 25 Days. Here’s What I’ve Built.

Subscribe now

#177: 🤖 I’ve Been Using Claude Code for 25 Days. Here’s What I Built.

I attended a 4-hour AI intro class and that was all I needed to enter the future.

Now I want to tell you what happened over the next 25 days.

Using Claude Code has been a gift to my ADHD. For the first time in my life, I feel like I can put all the open tabs in my brain into ONETAB.

I can organize all of my work, visualize it in a way that makes sense, and actually execute on it instead of cycling through it at 2am.

If you have ADHD, get ready to supercharge your superpower.

While other AIs have been great to organize my thoughts… Claude Code takes it further. It lets you execute on all those ideas you’ve been hoarding.

I will admit that it is a fine balance between AI enhancing my ADHD superpower versus making my ADHD worse…but my thoughts on that are for another newsletter.

In 25 days, I launched:

• Two cash-generating products (the Women’s Longevity Starter Kit and my proprietary Pitch Deck Analyzer

• Rebuilt three websites

• Built an interactive daily briefing dashboard that pulls my entire business pipeline in one command

• Created tools for better LinkedIn outreach

• Built tools for SEO optimization across the entire Nina’s Notes archive

• Fed Claude my entire knowledgebase and now get ideas for Substack Notes & YouTube short scripts in my daily briefing dashboard

• Built the full Longevity Day event website - with the program and speaker pages.

11 projects. 60 individual files and tools.

And the best part…I am not a developer.

I started on March 20th by taking Nick Sarafa’s LightSchool AI intro class. It was 4 hours long and that was enough to give me the tools to run wild.

Want to join his class?

He offers it in person here in Lisbon and also offers online classes - grab a spot here.

The product I tried to build a year ago and why it failed.

About a year ago I had an idea, take all the pitch deck feedback I’ve given to founders over the years, distill it into core principles and turn it into a product.

I did the first part. I fed transcripts into ChatGPT, extracted the principles, and built a markdown file.

I even tried to make a customGPT, the concept was solid.

But the output was inconsistent. It hallucinated.

The feedback didn’t feel reliable enough to charge money for.

The interface was awkward and I had no idea how to attach payment to it. So it just…sat there.

So when a founder sent me their deck, I would pop it into ChatGPT alongside my Pitch Deck Principles markdown file and ask for an analysis to test it.

Fast forward a year, and 25 days after opening terminal for the first time in ages. I rebuilt it.

I built the landing page, payment processing, PDF upload, AI analysis and PDF download - all of it…in about six hours (try it here: Pitch Deck Analyzer).

The idea didn’t change, but the infrastructure I could use to build it did.

What did I learn over the last 25 days?

Lesson 1: Get over your terminal anxiety.

Claude Code in the terminal is 100x better than Claude Chat or Claude Cowork.

Those interfaces exist for people who want a nice UX and who are scared of the terminal. I was one of those people, and thank god I’m not anymore.

I currently have five terminal windows open at once, different projects running in parallel, and I genuinely love it.

There’s something about the terminal that strips away the pretty and just lets you build.

(However…you can even make your terminal prettier by simply telling Claude - “make my terminal prettier”. It’s ridiculous.)

With Claude Code, I am building real, functional python scripts that live on my computer and run without Claude afterward.

With those scripts, you’re not just getting text replies from Claude, you are creating infrastructure. Personalized tools that work for your workflows.

No biggie guys, I’m just a junior developer over here now.

And it’s a good feeling.

Lesson 2: Connect Everything.

I know, I know…what about data privacy. (AHHH DER DATENSHUTZ!!!)

Here’s my take and maybe it’s the American in me, but these big companies already know everything about us anyway. Stop letting that anxiety keep you disorganized.

I connected my Gmail, Google Calendar, and my CRM.

My morning briefing now pulls live data automatically.

I ask it to look at my last 7 days of emails and look at the week ahead on my calendar. I need this tool to tell me what’s urgent and tell me what needs nudging.

I made it interactive so I can check things off when they are done and Claude automatically updates my CRM and to do list. (exhale, sigh of relief)

I used to hire people to do this coordination work and be the human layer between all my different systems. I needed an assistant to make sure I didn’t drop the ball on something.

Now it’s one click and my briefing reminds me of everything.

This is hours returned to me, every week, FOREVER.

Lesson 3: Claude Code remembers. Claude Chat doesn’t.

This is why I love Claude Code in the terminal.

When you use Claude in Chat or Cowork, it only remembers what’s in that conversation. It has a vague sense of you, but the moment that chat ends and you start a new one, that context is gone. Every new conversation starts cold.

You can amplify this by using projects and loading files in there, but it has memory storage limitations. For example, I tried to load all of my Nina’s Notes markdown files into a Project in Claude last year, and I ran out of memory in the project by #99. And due to the gap of nearly 50+ Nina’s Notes missing, I didn’t use that project as much as I could have.

In the terminal, when I tell Claude to remember something, it writes notes about me into plain text files that live on my computer. My Claude knows my CRM structure, my product strategy, my tone, my goals, my brand guidelines - all of it.

Think of these like notes a good assistant would keep about you between meetings.

Every new terminal session reads those files. So Claude picks up exactly where we left off, every single time.

That’s the biggest reason I live in the terminal now. It’s not just the speed or power, it’s the continuity.

It’s the difference between a young forgetful intern and a brilliant assistant who actually knows you.

And because it’s just files on your computer, you can read them, edit them, and add them yourself.

You are in control of the memories.

Lesson 4: Find the people building with AI.

Last Friday, I hosted a three hour vibe coding session at my flat.

Everyone was working on something completely different.

One friend was building an app to clean up duplicated photos off her phone.

Another person, an actual developer, was trying to load a massive biological dataset into Claude. He hadn’t used Claude Code yet…and he’s a developer (gasp!!). Getting him set up, watching him realize what’s possible with his own dataset, that was super cool.

I launched a product in three hours! While we were talking and laughing and sharing our struggles getting the AI to work out loud.

I want to do that every Friday.

The people using AI to actually write and run code are thinking differently. Not better necessarily, but they are thinking differently.

They are not using AI just to polish emails. They are using AI to build systems, automate the boring parts of their workflows and create things that didn’t exist yesterday.

We are still a small fraction of AI users.

That gap is closing fast.

You don’t need to understand every line of code, but you do need to start thinking like someone who builds. You need to find the people who are building and get in the room with them.

Do you want to build with me?

I’m doing vibe coding Fridays in Lisbon and I’m thinking about what this could look like online.

I’m not ahead of you by much, just by 25 days. And I want to bring you along with me.

I’ve put together a starter kit and am running live vibe coding sessions online.

Count me in

Edited by Wright Time Publishing

I’ve been working on something.

Over the past few weeks, I pulled together the five areas of longevity science where female biology diverges most from the standard advice, and where getting it right actually changes your trajectory in aging.

The result is The Women’s Longevity Starter Kit, a 14-page guide covering estrogen and cognition, creatine, sleep, HRT, and the psychedelic frontier.

All sourced from my archive of 176 Nina’s Notes issues.

Evidence-based, no fluff.

GET THE GUIDEBOOK

Have a great weekend!

xo

Nina

A super special thanks for those of you who upgraded to a paid subscription.

I write these newsletters every week, and maybe you read some, not all. I get it. Inboxes get full. There’s cool info coming from a lot of awesome writers, and of course I write about whatever I want to write about - it’s NINA’S notes after all ;)

There are weeks when I feel like I’m shouting into the void, but when one of you writes me a supportive message, or upgrades to paid - it’s a reminder that you all are out there, enjoying the content.

Thank you! Thank YOU. THANK YOU!

If you still haven’t decided…a paid subscription is $80/year and you get:

• My 9 longevity guidebooks (a $243 value)

• Access to the full Nina’s Notes archive

• Live Q&As with me

• Exclusive deep dives for paid members only

xoxo,

Nina

P.S Before I get into this deeply personal essay - I have a question for you.

💬 In this note:

• 🤕📉 What Having Two Chronically Ill Parents Taught Me About Longevity

  Subscribe now

  ---

#176: 🤕📉 What Having Two Chronically Ill Parents Taught Me About Longevity

First off, my parents had me when they were “older.” I put this in quotes because what was “old” to their generation is the age that most of my friends are even considering having kids today.

My mom was 36 and my dad was 40 when they had me.

Because of this, I am experiencing my parents aging earlier respectively than most of my friends, who have parents in their 60s right now, while mine are 74 and 78.

While they are aging, and with aging comes changes, that’s not when the chronic illnesses began.

I grew up in a smoking household. Both of my parents smoked indoors, windows closed. Smoked in the car, window cracked. We sat in the smoking section of restaurants (back when they used to have that). As I grew up, we would socialize at the bar in the local casino, where you can smoke openly.

Dad smoked cigars. Mom smoked cigarettes.

Mom started smoking at waking, and smoked until bedtime. About 2 packs a day.

Their rule - “We don’t smoke upstairs.”

Our two-story house has very high ceilings but the living room doesn’t have a floor above it…and well…smoke rises.

My bedroom and childhood playroom, which was converted to my office in my teens, are on the second floor. The office doesn’t have a door.

Secondhand smoke was part of my life - no choice in the matter.

I didn’t realize it had an effect on me.

I really thought that was just how life goes.

The times I would notice the effects of secondhand smoke was always when the track season started. The first week of track season we called “hell week” - you THOUGHT you were in shape. Nope - hell week taught you that was a lie. We were out on the track, doing hard workouts, Rounds of sprints with sometimes positive amounts of rest (meaning more rest than the time spent running, ex. 45 sec sprint, 90 sec rest) or sometimes negative rest (less rest than the time spent running, ex. 30 sec rest after a 45 sec sprint).

Always during hell week, I would experience what I can only explain as an asthma attack.

But I would feel my chest tighten to a point where I was wheezing and gasping for air. It would feel scary, but I could calm down after a few minutes.

My coach would ask if I had an inhaler, but I would say no. I was never diagnosed officially.

I thought this was just part of training.

If I worked myself 120%, that’s just what lungs do, they start to panic.

I’d see other teammates very out of breath, but….they didn’t have this.

It never stopped me from being an athlete, and usually after hell week and the first weeks of training, I wouldn’t have any more asthma attacks. It would really only happen if we did something new in training, like a hills day with lots of sprints, or something that really pushed me.

I just thought that asthma attacks came because I was out of shape.

I also never realized how the smoke was affecting my mom.

She had a cough - a smoker’s cough. Deep. Thick. Musousy. Painful to hear.

When she laughed really deeply, it would cause her to cough.

This would happen to me too - I thought it was a character trait.

As the years went on, the coughing became more and more, and that was just…how she was.

Then…I moved out of my parents house to go to college.

I don’t remember exactly how many years it took, but I started to regain my sense of smell.

When I would come home from school to visit, I would notice how smokey the house felt.

I would open windows to get fresh air - only to be met with objections that it was “too cold” and to close the windows.

I would do laundry at my parent’s house, but when I got back to college, I’d open my bag and all my clothes would smell like cigarette smoke, and I had to wash them all again.

I didn’t train as much in college as I did in high school, but I really noticed a difference in myself when I started training again in grad school, 4 years after moving out of my parent’s house.

I signed up for a body-weight CrossFit-type workout with a trainer.

The workouts were HARD. We would do sprints with negative rest, as many reps as possible (AMRAP) and other exercises to get your body to fatigue.

….And I wouldn’t have an asthma attack.

I thought then - I’m just not training hard enough. I can push myself harder.

The asthma attack was my internal signal that I’d reached my limit.

And they…stopped.

I had read that your lungs can heal if you quit smoking. You regain your sense of smell, and you can start to breathe better.

And it was happening to me.

I’m not sure if it took four full years, but it took time and the repair was there the whole time.

My mom quit smoking about 5 years ago, after smoking for most of her life. She quit after she had a really big scare - one that landed her in the ER with oxygen to breathe. And she said - No, this is not how I go. She quit cold turkey.

Since then, she’s regained her sense of smell, and now Dad is forced to smoke his cigars outside.

She has an official diagnosis of Chronic Obstructive Pulmonary Disorder (COPD), which she’s likely had for decades.

And, she uses an oxygen machine to get her O₂ blood levels to something where she can, but she is constantly out of breath. She is constantly fighting to breathe. Her cough persists. It’s loud, it’s hacking. It must be so, so painful.

To add another layer, my mom has scoliosis. This is a curvature of the spine. Her spine is in the shape of an S, which causes her ribs to twist around and causes her a lot of pain. She also has severe disc degeneration.

I remember as a kid she would wear a hard plastic back brace to help correct for the S curve, but I don’t think it helped tremendously and was eventually abandoned. She tried everything from specialized chairs, pillows, back massages, topical medication, physical therapy and cortisone injections.

Then and now, she has always been in a lot of pain, which she managed and numbed with pain killers. Also during this time she was depressed and anxious.

Her coughing, the scoliosis, the depression…all of it is a lot to carry, and she turned inside of herself to cope.

Growing up, I remember that she did not exercise because it would hurt her back. She would spend a lot of time indoors, working, writing, reading. Very solo-focused activities and hobbies.

Dad, on the other hand, was diagnosed with diabetes after spending perhaps a decade or so overweight (~200lbs).

After the diagnosis, and our move from SF to Las Vegas, he set upon a very diligent exercise routine.

Everyday - 3 mile walk, carrying weights. He lost the excess weight, even got down to ~145lbs at his slimmest.

But the diabetes stayed.

At first, the diabetes was manageable with metformin and the other diabetes pills. Unfortunately, diabetes is a progressive disease.

People think we’ve got it figured out. We have insulin - diabetes is fixed! No no no, I truly disagree.

Diabetes is an incredibly debilitating disease. High blood sugar causes nerve damage (neuropathy), retinopathy (which can lead to blindness), chronic wounds, and even kidney disease. The worst cases lead to amputated limbs.

I can’t remember exactly when my dad was diagnosed with diabetes, let’s say I was about 8 years old. I’m now 38.

Over the last three decades, I’ve seen this disease slow my dad down.

Managing blood sugar with pills turned into requiring insulin injections.

He’d have to check his blood sugar several times throughout the day with the old finger prick reader.

He’d have episodes where his blood sugar was 500, and he’d be screaming in pain from the neuropathy in his feet.

Now, he’s lost the sensitivity of touch in the tips of his fingers - making it hard to text with touchscreens and he’s losing his vision due to retinopathy.

He’s lost consciousness several times from taking too much insulin and depleting his blood-sugar to critical levels which required paramedic intervention.

When your brain doesn’t have enough sugar to use as energy - it shuts down.

He reached this level at least 6 times.

He has fallen down on his walks due to low blood sugar and had head injuries. On Christmas day a few years back, he fell while going for his walk, landing him in the ambulance and ER for a fractured orbital lobe and stitches.

Sometimes, it’s not a true loss of consciousness. It’s more like a sitting zombie. Eyes open. But no response or movement if you try to communicate. And unfortunately, you can’t get him to eat or drink at this stage to move the blood sugar up. Injecting him with glucose from a syringe is the only option.

And then, like a miracle - he’s back within seconds. And….now on a sugar high.

Nowadays, he is showing signs of cognitive decline and memory loss. It could be from these low blood sugar moments that did lasting damage to the brain.

These low blood sugar events are preventable. My dad was taking too much insulin. He was listening to his doctor’s recommendation.

I spent a month with my dad traveling through Australia in January, and I fixed these blood sugar crashes by adjusting his diet and insulin accordingly. Read more about that adventure here.

Dad’s also had some major surgeries - he went for a quadruple bypass in January 2023. And recovered incredibly well because it was a proactive surgery - not after a heart attack.

I have to give my dad credit here. His 3 mile walks every day for nearly 40 years, with weights, has made the man incredibly fit, strong and his recoveries are outstanding. Without that muscle and exercise, I can’t imagine what his recovery would look like.

He also shattered his femur from a fall in 2015. He had the surgery to fix the bone with rods and screws and was walking within 2 months because he had strong muscle around the bone to hold it in place.

Also, even though he still smokes cigars daily - maybe just 1 to 3 a day. He’s never developed COPD like my mom. I think the daily walks work his lungs and allow him to fight that long-term exposure to smoke.

Watching my parents, as a kid, as a teen, and even now led me to make very concrete decisions about my health.

I decided very young to never smoke. I think I’ve tried 1 cigarette, and 1 puff of a cigar in my entire life.

In high school, some of my friends were smoking marijuana for the first time. I also passed on that. I didn’t want to smoke anything.

Daily fitness became a non-negotiable. In middle school and high school - always training with my track team, or cheerleading team, dance, and gymnastics.

College was more difficult because for the first time I didn’t have a coach. I fell out of training. I’d try to go to the gym, but I would just run on a treadmill. I was intimidated by the weights, and the gym was arranged in a way where the weight floor was usually only the men, and the women on the second floor with the ellipticals, treadmills and bikes.

I got a bit out of shape over those 4 years. I lost my muscle.

I remember really noticing it once when I wanted to get out of the deep end of a pool. To get out, you basically do a pull up and then an extension to lift yourself to your hips to be able to sit on the ledge…and I couldn’t do it. My arms had gotten so weak that I really struggled to press up my own body weight.

When I got to grad school, I arrived in Tucson four weeks before the term started. I didn’t have many friends then, and Groupon was alive and well. I bought every gym pass I could at a discount and I got back into training 4 days a week, with a better diet, and I regained my strength.

Since age 21, I’ve been exercising about 5 days a week - a combination of HIIT class, running, yoga, pilates, and dance. I walk everywhere as much as I can.

In grad school I studied epigenetics, now a household term, but back in 2010-2015 it was just emerging as linked to longevity.

I never directly thought I’d study epigenetics because of my parent’s health but, looking back now, it connects. We can change our epigenetics when we change our environment, or behavior, or habits.

While I never tested it, I imagine the epigenome of my lungs changed significantly over the years since I was exposed to secondhand smoke.

Watching my parent’s health through my whole life led me to the decision that I do not want my health to decline the way theirs has and is continuing to do.

My parents didn’t have this information. They didn’t have a framework. They had stress, habits, circumstances, and no one telling them that the daily choices they were making would compound, decade over decade, into the bodies they have now.

I don’t blame them. I love them deeply. And growing up with them has been one of the most formative educations of my life.

What I know now, that they didn’t know then:

Chronic disease is largely preventable. And the prevention is not complicated.

Move your body. Every day. Even a walk counts, as my dad has proven for 40 years.

Don’t smoke. Don’t numb. Don’t sit still.

Protect your lungs, your blood sugar, your spine, your mind.

The body keeps score. It keeps a very, very long score.

All of these life experiences led me to study longevity for a living, where I interview scientists, read the papers, and write the notes. But the reason I care so deeply about it isn’t just intellectual curiosity.

It’s personal.

It started in a smoky living room in Las Vegas, watching my mom cough and my dad check his blood sugar.

And it never stopped.

Mom, Uncle Tony, Aunt Kathy, me & Dad (Las Vegas, 2026)

Edited by Wright Time Publishing

Dr. Yi Song has spent her career bridging Eastern and Western medicine.

What she’s found is that most people are already losing the health game before they feel a single symptom.

In this conversation, Dr. Song breaks down why treating symptoms is not the same as healing, what stem cell therapy can actually do (and what the industry gets dangerously wrong), and how meditation and energy flow aren’t just ancient metaphysics - they’re measurable, teachable tools for longevity.

If you’ve ever wondered whether regenerative medicine is real or hype, or how to find a clinic you can actually trust, this episode will sharpen your thinking.

Key Topics:

• Why early prevention is the most overlooked lever in healthcare

• Stem cell types, functions, and what mesenchymal stem cells can treat

• How stem cell production declines with age — and what to do about it

• Navigating the unregulated stem cell clinic landscape safely

• The six principles of natural longevity from The Regeneration Effect

• Meditation, energy flow, and metaphysical states of consciousness

Timestamps:

• 00:00 The Intersection of Eastern and Western Medicine

• 08:05 The Importance of Early Prevention in Healthcare

• 13:19 Exploring Stem Cell Therapy and Its Benefits

• 16:18 Understanding Stem Cells: Types and Functions

• 19:56 Applications of Mesenchymal Stem Cells in Treatment

• 22:39 Preventative Measures for Joint Health and Aging

• 28:05 The Decline of Stem Cells with Age

• 29:17 Skepticism and FDA Approval in Stem Cell Therapy

• 30:58 Quality Control in Stem Cell Treatments

• 33:45 Identifying Reputable Clinics for Stem Cell Therapy

• 35:21 The Importance of Personalized Treatment

• 38:12 The Regeneration Effect: Principles for Longevity

• 40:46 Six Principles for Health and Longevity

• 46:24 Rapid Fire Longevity Questions

• 49:52 Myths and Realities of Stem Cell Therapy

RESOURCES MENTIONED:

The Regeneration Effect Book — https://book.regenerationeffect.com

StemCell Therapy Experts — https://stemcelltherapyexperts.com

Cell Therapy Experts Podcast — https://youtube.com/CellTherapyExperts

Free Regeneration Effect eBook — https://gift.regenerationeffect.com

Connect with Dr. Song: https://regenerationeffect.com

ABOUT DR. YI SONG: Dr. Yi Song is a regenerative medicine physician and author of The Regeneration Effect. Drawing on decades at the intersection of Chinese medicine and modern science, she guides patients through personalized stem cell protocols and holistic longevity frameworks at StemCell Therapy Experts.

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH NINA’S NOTES

LinkedIn: https://www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz

Key Words

holistic health, early prevention, stem cell therapy, meditation, longevity, Chinese medicine, regenerative medicine, energy flow, aging, biohacking

Read more

While I was taking my Dad to visit his cousins in Australia, I was hustling in the shadows.

I launched a second podcast, Longevity.Technology UNLOCKED, with co-host Phil Newman, one of the leading voices in the longevity space.

Now you can hear from me three times a week!

• 🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

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💬 In this note:

• 💪 Creatine: The Supplement Women Should Actually Be Taking

• 📚 The Last Murder At The End Of The World

• ⚡️ FoundMyFitness Creatine Page

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#174: 💪 Creatine: The Supplement Women Should Actually Be Taking

I’ll admit something a little embarrassing.

I spent years covering longevity supplements, NMN, rapamycin, resveratrol, all of it, and somehow I barely touched creatine.

I filed it away mentally as “the thing bodybuilders take.”

A gym-bro supplement.

Not my thing.

Then I started digging into the research on women’s health and muscle loss, and creatine kept appearing.

I saw creatine in the studies on post-menopausal women, in literature on depression, and in papers on cognitive performance under sleep deprivation.

It was everywhere I wasn’t looking.

Turns out, creatine might be the most underrated supplement for women across the lifespan, and the most overlooked.

What Is Creatine?

Creatine is a naturally occurring compound made in the liver from three amino acids: arginine, glycine, and methionine. About 95% of it is stored in your skeletal and cardiac muscle, with the rest distributed in the brain, liver, and kidneys.

Its primary job is energy. Specifically, creatine helps regenerate ATP, adenosine triphosphate, the main energy source in your body.

It’s also the molecule your cells use as fuel during high-intensity activity. Creatine phosphate is a fast-charge battery that kicks in when your cells are burning through energy faster than they can make it.

You get creatine two ways: your body makes it and/or you eat it (mostly in red meat and fish, around 4–5 grams per kilogram of animal weight). Fruits and vegetables provide almost none.

Creatine supplementation has been studied extensively since the 1980s. We’re talking about hundreds of clinical trials. It’s one of the safest and most researched supplements in the world.

And yet, most of that research was done on men. Surprise, surprise.

The Female Creatine Gap

Women have 70–80% lower endogenous creatine stores than men.

Women also consume significantly less dietary creatine than men, largely because they eat less meat.

But, women actually have higher resting levels (~10%) of intramuscular creatine concentrations than men.

This means women start from a lower total pool of creatine but use what they have more efficiently at baseline. The implication is that women may need higher doses to see the same supplementation response as men, or we may benefit differently.

What’s also been largely overlooked is how female sex hormones interact with creatine metabolism throughout the lifespan.

Estrogen and progesterone directly influence creatine kinase activity, the enzyme central to creatine recycling. These fluctuations happen across the menstrual cycle, pregnancy, post-partum, perimenopause, and menopause. At each of these stages, creatine demands shift.

This creates windows where supplementation may be especially useful.

Why Women Might Benefit Even More Than Men

Muscle strength and exercise performance

The evidence for creatine improving muscle strength and exercise performance in women is solid. Multiple studies show improvements in strength, power, and anaerobic capacity, without the dramatic weight gain that gets weaponized as a reason women shouldn’t take it.

The weight gain question deserves a direct answer: creatine does cause initial water retention inside the muscle cells, which is actually a good thing, it supports performance and recovery.

The rapid weight gain seen in men during bulking is far less common in women. Body weight and body fat percentage remain largely unchanged across the studies.

Post-menopausal muscle and bone

Now this is super compelling!!

The menopausal decline in estrogen accelerates muscle loss (sarcopenia) and bone density loss (osteoporosis). When creatine supplementation is combined with resistance training in post-menopausal women, the research shows meaningful improvements in lean mass, upper and lower body strength, and physical function measures like chair stand tests. Some studies also show benefits for bone mineral density in the hip region.

The key word is combined. Creatine alone, particularly at low doses, doesn’t do much. Muscle contractions from resistance training enhance creatine uptake into cells.

Which is why the combination of creatine and resistance training is where the real benefits emerge.

For my paid subscribers, I go deeper into the creatine dosing strategies, the brain benefits, and the depression data: read it here.

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📘 Speaking of diving deeper? Check out my guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

You can download all 9 and more at ninapatrick.xyz/guidebooks.

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Plus today’s deep dive on creatine, the brain, and dosing strategies.

📚 Book of the Week

Photo by author

The Last Murder At The End of The World by Stuart Turton

Rating: ★☆☆☆☆

This book comes from the author of The 7 ½ Deaths of Evelyn Hardcastle, which I read in 2021 and loved, so my expectations were high.

I’m genuinely not sure I’ve ever given a book one star but, here we are.

Maybe I’m too distracted right now and juggling too many projects, but every time I sat down to read this, my mind wandered. I wasn’t pulled in. I’d stare at the pages and absorb bits and pieces, but nothing landed. I still have no idea what happened.

Is that the book’s fault? Possibly.

Am I just exhausted? Also possibly.

Either way, it deserves a proper read before a proper verdict. So, I’ll be coming back to this one.

Have you read it?

Drop in the comments what you thought.

⚡️ Check This Out

The FoundMyFitness creatine topic page, compiled by Dr. Rhonda Patrick, is one of the most thorough free summaries of the creatine literature I’ve come across. If you want to go even deeper on any of the mechanisms covered in today’s note, it’s a great place to start.

🔮 Cool Job Opportunities

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Edited by Wright Time Publishing

In this episode of the Nina’s Notes Podcast, I speak with Danny and Sarah, founders of Behold Retreats, who have guided more than 1,500 people through plant medicine ceremonies around the world.

Their participants range from professional athletes and high performers to people seeking deep emotional healing.

We explore what actually happens inside a psychedelic retreat, how medicines like ayahuasca, psilocybin, and Bufo are used in ceremonial contexts, and why these experiences are attracting people interested in healing, personal growth, and expanded consciousness.

Danny and Sarah also explain the concept of ego dissolution, the importance of integration after psychedelic experiences, and the difference between using these medicines for healing versus expansion.

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Topics we discuss:

• What happens during a plant medicine retreat
• The meaning of ego dissolution (sometimes called “ego death”)
• The biggest misconceptions about psychedelics
• Why athletes and high performers explore plant medicine
• Healing versus expansion in psychedelic experiences
• Why integration is essential after ceremony

Plant medicines have been used for thousands of years in indigenous traditions. Today, they are becoming part of a growing conversation around mental health, consciousness, and human potential.

Learn more about Behold Retreats: https://bit.ly/4rwJszz

Most longevity conversations focus on labs, supplements, and biomarkers. This week’s guest, Roderick Lambert, goes deliberately upstream of all of that.

After 15 years of struggling with obesity and a doctor warning him at 35 that he could have a heart attack within five years, Roderick overhauled his life, lost 24kg in seven months, and never looked back. Today he coaches people aged 40–60 on the root causes of metabolic decline and accelerated aging.

The calories in, calories out model isn’t just bad advice. It’s physically inaccurate.

You’ll discover:

• Why mitochondrial dysfunction is the root cause of most chronic diseases

• How fat produces up to 6x more usable energy than glucose

• Why the 40–60 window is your last real chance to turn back the clock

• The role of light, circadian biology, and coherence in cellular health

• Why “you can’t get well in the environment you got sick in”

• How to build habits that stick, without willpower

Cheers, Nina

Timestamps:

• 00:00 Roderick’s Journey: 15 Years of Obesity

• 05:30 The Doctor’s Warning That Changed Everything

• 12:00 Why Calories In/Out Is Inaccurate Physics

• 18:00 Mitochondria: Far More Than the Powerhouse of the Cell

• 25:00 Accelerated Aging and the 40–60 Window

• 31:00 Food First: Fat vs. Glucose as Fuel

• 38:00 Light Diet and Circadian Biology

• 44:00 Fasting, Movement, and Building Habits

• 50:00 Accountability as the Missing Link

ABOUT RODERICK LAMBERT: Roderick Lambert is a metabolic health coach and founder of Midlife Metabolic Health. After reversing his own metabolic syndrome in his early 40s, he now works with clients aged 40–60 to address the root causes of accelerated aging through first principles nutrition, light biology, movement, and mindset.

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH RODERICK LAMBERT

Website: https://midlifemetabolichealth.com

Facebook: https://www.facebook.com/MidlifeMetabolicHealth/

LinkedIn: https://www.linkedin.com/in/rodericklambert/

I’m obsessed with sleep.

Recently, my sleep has been suffering - world travel, jet lag, altitude…I’ve been rough on my body.

But now that I’m back in Lisbon - my peaceful sanctuary, my sleep has been some of the best I’ve had in years.

But because I keep coming back to this idea that we are wildly underestimating what happens to the brain during those unconscious hours.

We think of sleep as passive. That our body goes quiet, and the mind goes offline.

But the more I dig into the research, the more I’m convinced that sleep is the most active thing you can do for your brain’s long-term health.

This week I want to take you inside one of the most fascinating and underappreciated systems in the human body: the glymphatic system.

Never heard of it? It’s the brain’s own sewage network!

and…you can hack it.

Enjoy,

Nina

💬 In this note:

• 🧠 The Glymphatic System Hack: How To Detox Your Brain During Deep Sleep

• 📚 Why We Sleep: Unlocking the Power of Sleep and Dreams

• ⚡️Watch The Brain’s CSF Pulses During Sleep

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Or get the individual guidebooks here: Grab the guidebooks.

#171: 🧠 The Glymphatic System Hack: How To Detox Your Brain During Deep Sleep

Every hour you are awake, your brain is accumulating metabolic waste.

Proteins, cellular debris, and neurotoxic byproducts are building up in the space between your neurons, called the neural interstitium, every moment you are awake.

And the only way to flush them out is through deep sleep.

Deep sleep activates your glymphatic system which carries that waste out.

What Is the Glymphatic System?

The glymphatic system is your brain’s waste clearance network.

The name is a mashup of “glial” (the support cells of the brain) and “lymphatic” (the body’s wider drainage system).

The glymphatic system was only identified in 2012 (!!!) by neuroscientist Maiken Nedergaard at the University of Rochester.

Before Nedergaard’s discovery, neuroscientists were puzzled. The rest of the body has a lymphatic system to remove cellular waste. But the brain sits behind the blood-brain barrier, sealed off from that conventional drainage network.

So how was it clearing the cellular waste and garbage from the brain?

It turns out the brain has its own hydraulic system which moves the cerebrospinal fluid (CSF), a clear liquid that surrounds and cushions the brain, along channels formed by astrocytes which fill the spaces between neurons, providing scaffolding and physical support to the brain.

Astrocytes are essential caretakers of the brain and spinal cord.

As the CSF flows through them, it flushes the waste dissolved in the interstitial fluid out of the brain, draining it into the lymphatic vessels that run alongside the neck.

It gives a new definition to “brainwash,” huh?

Why Does It Only Work During Sleep?

When you are awake, your brain is busy.

Neurons are firing constantly, astrocytes are actively supporting neuronal function, and the glymphatic system runs at only about 5-10% of its sleep capacity.

But during slow-wave sleep (the deep, dreamless stages of non-REM sleep), the brain’s glial cells actually shrink up to 60% in size.

This dramatically increases the space between cells, allowing cerebrospinal fluid to flow much more freely and efficiently through the brain tissue.

That means that the glymphatic system kicks turns on full blast. The CSF floods through, waste gets swept up, and the brain is rinsed clean. (ohhhh ahhhh 🧖🏾‍♀️)

One of the key waste products cleared by this process is beta-amyloid, the protein that clumps into the plaques strongly associated with Alzheimer’s disease. Studies in mice show that beta-amyloid clearance is twice as fast during sleep as during wakefulness.

Data like this show us why sleep is not a passive luxury.

It is important and acts as active neurological maintenance.

How to Optimize Your Glymphatic System

So if we know the glymphatic system activates during slow-wave sleep, can we do anything to maximize it?

YES! We can.

Two of the most evidence-backed interventions are surprisingly simple.

Your sleeping position and core body temperature.

Sleeping Position

A 2015 study published in the Journal of Neuroscience led by researchers at Stony Brook University, found that sleeping on your side (lateral position) significantly enhances glymphatic transport compared to sleeping on your back or stomach.

Why is side sleeping the best?

It comes down to gravity and fluid dynamics.

On your side, your brain’s drainage pathways are aligned in a way that maximizes CSF flow and minimizes resistance.

Laying on your right side appears to offer the best glymphatic clearance, though the research is still emerging on whether right vs. left makes a meaningful difference for most people.

Interestingly, many animals that sleep, from dogs to elephants, default to lateral positions. It may be one of the most evolutionarily conserved behaviors for brain health.

Core Body Temperature

Core temperature is a powerful regulator of sleep architecture, and by extension, a powerful regulator of your brain’s glymphatic activity.

Your body’s core needs to cool by roughly 0.5–1.5°C (1–3°F) to initiate and maintain deep slow-wave sleep.

Deep sleep is most abundant in the early part of the night, coinciding with the natural drop in core body temperature that begins a few hours before sleep.

You can support your body’s natural cooling process by keeping your bedroom cool (18–20°C / 65–68°F) to accelerate your core temperature drop and make falling asleep easier.

Taking a warm bath or shower 1–2 hours before bed works because the warm water draws blood to the skin’s surface and accelerates heat loss once you step out, rapidly dropping core temperature.

You can also try cooling mattress pads (like ChiliPad or Eight Sleep) which have shown meaningful improvements in slow-wave sleep in several studies.

There is also emerging interest in deliberate cold exposure earlier in the day (cold showers, cold plunges) as a way to regulate the circadian temperature rhythm and prime deeper sleep at night.

But the key here is that cold exposure needs to happen earlier in the day (before 4pm or so). Cold plunging at night (and this is really my personal experience here) spikes adrenaline too much which makes falling asleep more difficult.

Listen to 40Hz To Hack Your Glymphatic System

Before I get to the full protocol, I have to share something I covered recently on Longevity.Technology UNLOCKED with Phil Newman because it fits this topic almost too perfectly.

The rest of this note, including a breakdown of a brand new PNAS study on sound therapy for brain detox, and the full glymphatic protocol, is for paid subscribers.

Read more

On a roadtrip to Nazaré back in December, yes, to watch humans voluntarily surf 30-metre waves, which is its own kind of madness, a friend turned to me and asked something that’s been stuck in my head ever since.

“Should we migrate like birds and chase the sun, or should we go with the seasons? Is it possible that our bodies are actually optimal in the habitat where we were born?”

I grew up in Las Vegas. 360 days of sun a year. Desert heat. A sun that is trying to kill you.

And every winter when I lived in Berlin, I’ve had the same quiet breakdown when November hits. The light disappears, my mood tanks, and I spend three months wondering why anyone voluntarily lives in the dark.

So yes. Guilty. I chase the sun. (I wrote this from Australia. No regrets.)

But is this just a personal preference, or is there something deeper going on biologically?

Something that predates me, my choices, even my lifetime?

That’s what I wanted to find out.

💬 In this note:

• ☀️ Chasing the Sun

• 📚 Being You

• ⚡️ Do Your Parents Know What You Do For Work?

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#170: ☀️ Chasing the Sun

Photo by Florian D. Bazac on Unsplash

Your body has a blueprint

Humans have spent tens of thousands of years adapting to the specific environments their ancestors called home, extreme cold, high altitude, low light, desert heat.

That creates what you might call a biological blueprint.

Your native habitat is often the environment where your body experiences the least friction, because it’s the one your genes were shaped for.

Take high-altitude populations in the Andes or Himalayas. Their hearts and lungs are genetically adapted for thin air. Move them to sea level and something might feel... off. Heavy. Wrong.

The same principle applies to temperature and light.

Our genes for thermogenesis, the way our bodies generate heat, were sculpted over 30,000 years by the climates our ancestors inhabited.

Populations from colder climates have genetic variations that enhance brown adipose tissue (BAT) function, which plays a key role in metabolism and energy balance.

If someone genetically optimised for cold moves to a tropical climate, it can create a metabolic mismatch, increasing risks for obesity and diabetes, because the body is programmed to store energy in a way that no longer matches its environment.

Unfortunately, your genes don’t update when you buy a plane ticket.

So what are snowbirds actually doing to their biology?

Quite a lot of good things, it turns out.

Longer daylight hours strengthen your circadian signals. Better alertness during the day, deeper sleep at night.

In winter, lower solar angle means less UV-B radiation reaching your skin, and less vitamin D production as a result.

In Berlin in the winter, you synthesize 0% vitamin D.

The figure above plots the sun’s elevation for Berlin for every month of the year.

The data reveals a hard truth that Berlin is a Vitamin D dead zone in the winter.

When the sun sits low on the horizon, like in winter,the sun’s rays travel a long diagonal path. The light travels through a thicker part of the ozone which absorbs 99.9% of UVB radiation.

You see visible light, of course, but the beneficial biological signals are filtered out. No matter how much time you spend outside in December (or even March) in Berlin, your Vitamin D synthesis is effectively 0.

Vitamin D deficiency weakens your immune system. And the expanded darkness of northern winters is linked to increased inflammation, fatigue, and higher risk of seasonal affective disorder (SAD).

Chasing the sun doesn’t just feel good.

For many people (like me!), it genuinely prevents these seasonal declines.

Want to read the rest?

Upgrade to paid to get the full breakdown including: why constant migration might actually hurt your biology, the concept of “circadian load,” how to figure out if you’re fighting your own genetics, and tools to track your circadian alignment.

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I just got back from a month in Australia with my dad and I have a story I need to share with you.

It’s personal. It was stressful. And it completely changed how my 78-year-old dad manages his type 1 diabetes.

As a pharmacologist, I’ve spent my career understanding how drugs work in the body. But this was the first time I applied that knowledge to someone I love, in real time, on the road, with no safety net.

The results blew us both away.

💬 In this note:

• 🩸 How I Fixed My Dad’s Diabetes Crashes in 4 Weeks

• 📚 Men Explain Things To Me

• ⚡️ Year of the Rabbit, or Cat?

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#169: 🩸 How I Fixed My Dad’s Diabetes Crashes in 4 Weeks

My dad is 78 years old and has type 1 diabetes.

He started as a type 2 diabetic, which eventually developed into insulin dependence.

He does multiple insulin injections a day and wears a continuous glucose monitor (CGM).

I got him on a CGM about a year and a half ago, and that alone was hugely transformative.

Before that, he was doing finger pricks, giving himself way too much insulin, and going into diabetic comas, episodes where his blood sugar would drop so low that his brain essentially stopped functioning.

This. was. terrifying.

He wouldn’t fall asleep exactly.

He’d be in this zombie-like state, kind of there, processing information, but nothing really working.

It’s similar to watching someone who’s had way too much alcohol.

We’ve had to call the paramedics multiple times. They give him a glucose injection and he snaps back. Then he’s on a sugar high because he was just given a ton of glucose. And the roller coaster starts again.

Getting him on the Abbott Libre 3 continuous glucose monitor (CGM) relieved a lot of stress for my mom, for him, and for me.

It sends his blood sugar reading to his phone, my phone, and my mom’s phone in real time.

I absolutely love this device. It is brilliant, easy to use app.

(@Abbot if you want to sponsor my newsletter, please reach out! 🤩)

But it was only step one.

The Deal

Before we left for Australia, I set a rule:

“We’re not going unless you haven’t had a diabetic coma in the last six months. It’s too high risk, something could happen on the plane.”

He was managed that. No crises in a year and a half.

So we went.

And on the flight from Las Vegas to LA before our long-haul to Brisbane, I sat my dad down and said:

“Will you do an experiment with me? Everything we try on this trip, we can change. We can go back to how you were doing things before. But will you be on board and try some of the things I suggest so we can better manage your blood sugar?”

He said yes.

The Roller Coaster Problem

Before our experiment, my dad’s daily blood sugar reading looked like a stock market crash, spike to 300, crash to 60, back to 300, down to 60. A violent roller coaster.

I imagine the feeling was horrible.

What I wanted to see instead was slow, rolling hills as his readings from the CGM.

A flat line would be nearly impossible, but something stable, that was the goal.

His doctor had prescribed 14 units of slow insulin in the morning, 14 at night, and 3 units of fast insulin with every meal.

Based on what I had seen, the crashes, the paramedic calls, the collapses on his walking trail and as a pharmacologist who understands pharmacokinetics, I knew he was taking too much insulin.

⚠️ Disclaimer: I am a pharmacologist, not a medical doctor. This is not medical advice. This was an experiment with an N of 1, my dad, and the results we saw. If you’re going to change medications, you absolutely need to talk to your doctor. I told my dad the same thing: when we get home, we talk to the endocrinologist about every change we made.

The First Test: A 13-Hour Flight

We sat down for a bowl of ramen before the flight. I watched his blood sugar start to skyrocket. We did some fast insulin and brought it down.

Then I said: no more insulin for the rest of the flight. And we’re not eating anything on the plane.

My dad, who has been doing this routine for decades, pushed back.

“I need to do my slow insulin.”

I said, “

Why don’t we just wait and see?”

What happened over those 13 hours was beautiful.

We saw a slow, steady curve decreasing from about 200 down to 100. The fast insulin caught up with the food. The slow insulin from the morning was still working.

No crash.

No panic.

No emergency.

I had proved my first point: the slow insulin lasted longer than he thought.

What 9 Things I Changed (And Why It Worked)

1. Eliminating the Nighttime Insulin Dose

Here’s what I discovered: my dad’s 14 units of slow insulin taken in the morning lasted a full 24 hours.

When he was doing that second dose of 14 units at night, he was stacking insulin

…and crashing in the middle of the night.

He’d wake up stressed, sweaty, disoriented, fumbling around for a soda to bring his blood sugar back up.

That meant terrible sleep, which affected his stress levels, which affected his blood sugar the next day. A vicious cycle.

I said, let’s try just the 14 units in the morning and see what happens.

We did it for the entire month. According to the CGM, how he felt, and how he was sleeping, it was perfect. No more middle-of-the-night crashes.

2. Reducing the Fast Insulin Dose

His doctor recommended 3 units of fast insulin per meal.

I said, let’s be cautious, let’s try 2 units and see what the CGM tells us.

Two units worked for most of the meals we were eating. We avoided those terrifying straight-down arrows on the CGM that signal a rapid blood sugar drop.

3. The Golden Rule: Never Take Insulin Without Eating

This was a non-negotiable.

Before the experiment, my dad would sometimes skip breakfast, take his fast insulin, and go for a three-mile walk carrying weights.

He believed exercise was bringing his blood sugar down. But it was actually the fast insulin on an empty stomach.

This is why he had collapsed on his walking trail, more than once. People found him and had to contact us to get him to the hospital.

New rule: insulin always, always, always goes with food.

Food with slow insulin and fast insulin. No exceptions.

Want to read the rest of this story?

Upgrade to a paid subscription to get the full breakdown of the 9 specific interventions with the science behind them, the insulin adjustments, the diet overhaul, the “emergency bedside banana,” and the dramatic results (reducing 85 blood sugar alerts to only 6 alerts, 15 lbs lost) after 4 weeks and the actionable takeaway summary.

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Want this newsletter in podcast form? Find it on Spotify or Apple Podcasts.

It’s also on my YouTube channel. If you like it, please subscribe and I’ll keep making videos :)

Xo,

Nina

P.S. I recorded this episode on my YouTube Channel, watch it here:

💬 In this note:

• ☀️ Your Joyspan vs Your Lifespan

• 📚 Joyspan: The Art and Science of Thriving in Life’s Second Half

• ⚡️ ChatGPT Psychosis

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#168: ☀️ Your Joyspan vs Your Lifespan

Photo by Robert Collins on Unsplash

How much you like living your life has a huge impact on your quality of life in your later years.

Lifespans are getting longer, and a long life isn’t always a happy one.

Dr. Kerry Burnight, a professor of geriatric medicine and gerontology at the University of California, Irvine School of Medicine, explains this in her book Joyspan: The Art and Science of Thriving in Life’s Second Half.

Your Joyspan - the years you spend liking your life, may matter just as much, if not more, than your healthspan (years in good health) or lifespan (years of life).

Some people hold the belief that aging is a downhill slide with accumulating health problems and challenges.

But I believe, and so does author Dr. Burnight, that we are in control of how we react to the changes that aging brings.

Dr. Burnight argues that “how we step up to those challenges can be the difference between thriving and suffering.”

Some older adults become immobilized by the realities of aging, while others find creative ways to navigate their new normal.

Fortunately, you can lengthen your joyspan through everyday choices regardless of your age or physical condition.

Dr. Burnight suggests focusing on four “nonnegotiable” actions:

1. Grow

2. Adapt

3. Give

4. Connect

A sense of curiosity and willingness to learn helps older adults maintain cognitive function and mental health.

Being able to adapt to your circumstances later in life is key. Dr. Burnight’s patients who are aging well approach life changes “as a normal part of the human experience.”

People with a robust joyspan find ways, even if they’re small, to give to others. They shift their mindset from “how can you help me” to “how can I help you.”

Social isolation can harm your physical and mental health, it’s important to stay connected and put time into new and existing relationships as you age.

How To Continue To Grow As You Age

1. Write down anything that has captured your interest, no matter how esoteric. For example, Renaissance fairs, learning to play the drums, or watercolor painting.

2. Then set a “curiosity goal. Challenge yourself to explore a few activities from the list of things that captured your interest.

As you age, embrace a learner’s mindset.

Some colleges or universities like the California State University System and the state universities and colleges of Ohio, offer a tuition waiver for residents age 60 and older allowing elderly people to continue education free of charge..

How To Adapt As You Age

1. List things that have gotten better as you’ve gotten older. For example, do you care less about what others think of you? Do you have greater experience when it comes to problem solving? Are you less reactive?

2. When a challenge is looming, brainstorm ways to adapt. For example, some of Dr. Burnight’s patients that were losing their vision, switched to audiobooks when traditional reading became too difficult and less enjoyable.

How To Give More When You Are Aging

1. Everyone has something to give, whether it’s time, attention, patience, wisdom or kindness.

2. If you are skilled at organizing, help a friend who is overwhelmed by a life change. If you are good at chess, teach someone to play.

3. If you are still unsure, you can sign up for AARP’s Create the Good program, which matches volunteers with service opportunities in your area, such as being a foster grandparent.

How To Stay Connected As You Age

1. Ask people questions, research suggests that people who ask questions are perceived as more likable. The same study found that asking follow-up questions builds rapport.

2. When the conversation is over, write down topics you want to check back on if you’re afraid you will forget. When you follow up, people are often pleased that you remembered the details of their life

3. Host family game nights in person, or on Zoom. Have watch parties with friends where you all watch the same show or movie together.

Addressing Dr. Burnight’s four “nonnegotiable” actions - grow, adapt, give and connect, can set you apart from your colleagues and friends with a foundation for a great joyspan.

Today’s Challenge

Spend some time today reflecting on your life and how joyful you find it. Journal for 10 minutes with the following prompts:

• What are five things that caught my attention recently?

• What are some things that I used to like to do that I stopped doing?

• What are some ways that I can explore doing those things again, even if it looks a little different? (i.e. You like golfing, but now walking the course seems daunting - maybe you can book extra time on the course, and leverage a golf cart with a driver to take you from hole to hole).

You can take Dr. Burnight’s quizzes here to get a baseline understanding of your current joy in life.

I hope this helps you start to undersrtand how to improve your life so that you not only have a long lifespan, but you spend just as many of your years feeling joy.

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📚 Book of the Week

Source: Hachette Book Group

Photo by Author

Joyspan: The Art and Science of Thriving in Life’s Second Half by Dr. Kerry Burnight

Rating: ★★★★☆

I listened to this book in audio form. Don’t do this. Instead, I recommend reading the text, as Dr. Burnight has nice quizzes and questionnaires throughout the chapters and it is much nicer to engage with these in the text form, rather than trying to remember the questions and write down answers while listening to the audio.

This book is a great resource with strategies to shift your mindset when life throws you specific challenges of aging, such as caregiving, dementia, isolation, and death or divorce.

Dr. Burnight has many questionnaires in the book to assess your current joyspan, with helpful suggestions on how to improve it.

Although it is written for those in the later years of their life, I believe we can consider our joyspan at any age.

Being 38, I was thinking about my own mindset when it comes to adapting, and adjusting to the changes in my life.

I tend to think that younger people are more flexible than older people as I see so many older adults as “stuck in their ways.”

But what I’m also seeing is that my peers are getting stuck in their ways even at 37!

We must challenge ourselves to continue to learn and grow at any age. This is an absolute necessity to improve our joyspan.

It’s also great for your neuroplasticity. Overcoming challenges, adapting, and navigating new environments helps your brain to stay flexible and form new connections.

If you are living the same routine life for decades, it can make it harder for your brain to become flexible again.

But the brain is a muscle and it can be trained, at any age!

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⚡️ Check This Out

There are frightening cases where AI chatbots are inspiring delusional behavior with awful consequences.

What this tells me is that people are desperate for connection.

ChatGPT is always available, and people are using it for more connection than we expected.

Not only do we need stronger mental health safeguards for these AI tools, we also need to encourage IRL human-human connections.

Tech entrepreneur Joe Braidwood shut down his AI therapy startup Yara AI after concluding chatbots are unsafe for vulnerable mental health users.

While AI may help with everyday stress, he found it dangerous for crisis, trauma, or suicidal ideation.

Limits in detecting risk over time, legal pressures, and rising evidence of harm convinced him the space was too risky for a startup to responsibly navigate.

What this ultimately reveals is a boundary we haven’t reckoned with yet.

AI can simulate care, but it cannot carry responsibility. It cannot track a human psyche over time, sense when someone is quietly unraveling, or intervene with the moral weight a real person can.

Until we build systems that understand those limits, and a society that doesn’t outsource intimacy to machines, we risk mistaking availability for care.

AI may support mental wellness.

Mental health still requires humans.

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Edited by Wright Time Publishing