In her second report on biological ageing, beauty editor Ingeborg van Lotringen, 50, tries switching up her hormone prescription, her supplements and her workouts to bring her stress levels, and her inner age, down
When author and beauty director Ingeborg van Lotringen took a ‘Real Age’ DNA test , she was shocked to find out that she was 56 on the inside; despite the fact that she had only 50 years on the clock and looked closer to 40.
The test measured the length of telomeres, genetic markers of internal ageing. According to the telomere theory, shorter telomeres equal shorter life, and Inge's were more diminutive than expected for her age. So, knowing that (roughly) 25 per cent of overall ageing was genetic while a rather whopping 75 per cent depended on lifestyle, she opted into hormone and integrative medicine specialist Dr Sohere Roked’s ‘Reduce My Internal Age’ full body package.
Now, after a battery of blood, urine and saliva tests to determine what was causing her internal ageing, she charts the next step of her journey towards what she hopes will be a better result. Can a bespoke programme of supplementation, medication and lifestyle tweaks effectively extend her life? This week, her stress test result come back.
"I was a glossy magazine beauty director for most of my career, never prone to Devil Wears Prada tantrums, and am now a time-poor freelance writer. Stress is part of the job, but I’ve rarely felt that it overwhelmed me. The truth is, I like to think of myself as relatively relaxed. I’ve always worked my arse off, but I did and do it with pleasure and with the solid support of great colleagues, bosses and mates.
"So when my ‘comprehensive adrenal stress profile’ test reveals that my cortisol levels are out into the stratosphere, it’s an unwelcome surprise. According to the test (for which I had to spit into a test tube at various times of the day to measure the stress hormones in my saliva) this stress hormone severely elevated in my system throughout the day, indicating that I’m always in a state of stress). Not only that, but my level of the hormone DHEA, which acts as a buffer to the effects of stress, is awfully low. To make matters worse, my ‘secretory IgA’ (me neither) is way too high, showing that my immune system is under constant strain from my stressy surges. Surges that I’m well aware of each time I shout 'oh for God’s sake!' and throw myself into a bout of hurried problem-solving while feeling exasperated about the other 10,000 things I have to do. I just didn’t know they were that physically detrimental. Isn’t a mild state of panic and broken sleep just what life is like for everyone?
Isn’t a mild state of panic and broken sleep just what life is like for everyone?
“That’s the problem,” says Roked. “You’re not an exceptional case among my patients, who do tend to be high-achieving, busy individuals. But just because constant high stress is rife doesn’t mean it’s normal. You can live quite successfully with stress, but doing so consistently is not okay. The greatest risk, as we can see from your tests, is that it undermines the immune system. That means your body is chronically besieged by low-level inflammation, which over time leads to issues such as gut problems , joint pain and even degenerative disease.”
"It sounds like the warnings enthusiastic smokers and drinkers (neither of which I am) get – and that’s in line with Roked’s assessment that stress is literally as bad for our bodies as smoking is. I could wave it away – after all, I don’t feel exceptionally stressed, and, frustratingly, my lifestyle, replete with good food, copious exercise and plenty of love and fun, is already pretty exemplary in the stress-busting stakes. But then I remember why I’m doing this programme in the first place: my shortish telomeres. They are proof positive that something is undermining my health, and Roked has hypothesised from the start that it’s inflammation, likely caused by, among other things, stress. So what on earth can be done to manage it beyond all the ‘right’ practices I’m already committed to? Roked writes me an anti-stress plan consisting of three things - dialling down my high-intensity training, taking supplements and coming off the pill and on to HRT .
The anti-stress plan
1. Stop with the intense cardio and resistance training
"I do a good five hours of running and resistance training a week and tend to feel I’ve wasted my time if I don’t end up beet-red and soaked in sweat.
"Roked advises dialling down the drill sergeant in my head and focus on more yoga and meditation. Cardio is not the best option for the already-stressed as it raises the hormone while you’re in the sweaty throes of thumping the pavement, even though you might feel less stressed after you’ve exercised. Substituting it with yoga, which consistently dampens cortisol, makes total sense to me, except that previous to the last yoga-less year, I used to practice it very regularly (admittedly, I’ve always favoured ashtanga and vinyasa flow classes, at the more aerobic end of the yoga spectrum) and I still have truncated telomeres. Nonetheless, I understand the benefits of it and of simple, regular breathing exercises .
Did it work?
"How to slot relaxed workouts in between my deadlines or prioritise them over my head-clearing, endorphin-boosting runs is another question and has so far proved harder than it should be. Or to be precise: I haven’t really made any changes at all. My gym’s yoga schedule is still sorely lacking in the wake of Covid, I don’t like practising yoga on my own, I’ve got a piece to write, I want to go for a run... Overall, finding a new regular yoga class I want to commit to is a project that requires time and headspace, which I don’t have. Which I realise is ironic.
2. Take stress-busting supplements
"B vitamins are important for managing stress and my levels are low, so a daily B-complex is a shoo-in. Having at this stage not actually measured my blood levels of vitamins, Roked puts me on a one-a-day average-strength Methyl-B Complex by Biocare , £16.30 for 60 capsules. She also recommends a daily 500mg of ashwagandha , an adaptogenic herb with reams of research behind it showing it helps regulate cortisol levels. It’s such a trendy supp (I seem to get several PR emails a week about it) that I can’t help but feel a bit cynical, but many physicians such as Roked are convinced by the research and take the herb themselves, so there has to be a point to it.
I often lie awake feeling constant cortisol surges as panicky thoughts besiege me; in the night, everything seems like a crisis.
"I’ve suffered from insomnia for more than a decade and this is likely my main source of stress. I often lie awake feeling constant cortisol surges as panicky thoughts besiege me; in the night, everything seems like a crisis. Knowing, as I now know, how elevated cortisol puts the body in a state of inflammation, I can just imagine what marinating in it on such a regular basis does to my health.
"Roked recommends taking magnesium nightly, because it quiets down nerve activity and acts on the sleep-regulating hormone melatonin (and magnesium levels deplete with age). It should be taken in the form of glycinate or citrate, not other compounds such as magnesium oxide as these don’t affect sleep. Roked puts me on 200mg magnesium glycinate nightly by a brand called Nutri Advanced, and when that runs out I try Solgar magnesium citrate tablets.
Did it work?
"A month or so of supplementing this has no discernible effect on my sleep, but it’s Roked’s other strategy that does (see point three)
"I take to popping my pills with ease, experiencing no issues bar neon-yellow wee , which a friend tells me must be due to a high intake of B12. All in all, a good two months of taking these supplements regularly yields no major difference in how I feel – but then, as I said, I didn’t feel outrageously stressed at the outset. Perhaps, in time, I will find out that under the surface, things are improving? “That’s what I expect,” says Roked. “You came in and said you felt very well to begin with, so noticing a marked difference would be hard. But what we’re doing here is largely preventative and designed to prevent illness later in life.”
3. Rebalance your hormones
"There are two more types of pill to swallow, this time on prescription. One is DHEA, a hormone that is a precursor to testosterone, made by the adrenal glands. “It can drop with age but also through stress, both of which could explain your low levels,” says Roked. DHEA pills can be obtained over the counter in the US and are available online, but Roked stresses that they are unlicensed here and you must seek medical guidance to take the hormone. “Too much of it in your system is as bad as too little. Only balanced levels give resilience against stress, which is why it is important for you to supplement it. But getting the dosage right may be a bit hit and miss at first.”
"The second part of my inflammation-busting age-prolonging hormone plan is coming off the Pill. At the age of 50, I’m still on a low-oestrogen combined Pill (Mercilon) as a means to regulate nasty periods. “That means your body has completely stopped producing its own progesterone , and the synthetic version in the Pill (called progestin) is not at all equivalent,” says Roked.
“It has none of the mood-calming benefits the female sex hormone progesterone has. A lack of it in the body can lead to increased anxiety and insomnia.” That’s a bit of an eye-opener. I was labouring under the illusion that the Pill was keeping both my progesterone and oestrogen topped up, rather than hampering their levels. After so many sleepless years, could progesterone supplementation be the answer?
Did it work?
"First the DHEA. No kidding about hit and miss. Roked warns that DHEA can give you oily breakouts and certainly, every time I take a ten mg capsule (initially every other day) I suffer something between an oily breakout and an allergic rash that takes days to calm down. “That’s a sign the dosage is too high, so take it less regularly,” advises Roked. I dial things down from once every three days to taking one pill a week, but the rashes keep coming. Let’s just say I’m not sure about this one – although, now I know it is important, the fact that I at this point have stopped using it altogether is stressing me out. Which doesn’t help.
"Part of Roked’s telomere-stretching plan from the off was to help me transition from the Pill to HRT (hormone replacement therapy). I’ll talk more about that in the next article, but I can confirm that taking body-identical progesterone (as a pill, which is the only form that gives you the sleep benefits), derived from wild yams and soy, has improved my sleep, and did so within days of starting to take it. I still wake up at all hours, but then fall asleep again, which certainly wasn’t the case before. For me it’s a significant win, and hopefully the first clear sign that my live-longer programme is bearing fruit."
Ingeborg van Lotringen is author of Great Skin: secrets the beauty industry doesn’t tell you , £10.19). Follow her story by signing up to our newsletter .
Dr Sohere Roked’s Real Age (Telomere) Test , including an in-depth consultation to assess the results, is £750.
Reduce My Internal Age test costs vary (different tests may be needed for different people), but is typically around £2,500 for all the tests and two consultations per month over six months. The medication and supplements are extra. For more information, go to www.drsohereroked.co.uk