Man Overboard!

Man Overboard! Plot Summary

Introduction

When a man reaches middle age, his body begins sending subtle messages that things aren't quite working as they used to. Unlike women who experience the dramatic hormonal shift of menopause, men face a gradual decline in testosterone and other physical changes that can feel like a betrayal by their once-reliable bodies. These changes affect everything from energy levels and muscle mass to sexual function and sleep quality, often leaving men wondering what's happening and whether it's normal. This science-based guide explores the biological realities of male aging and provides evidence-based strategies for maintaining health and vitality throughout life. We'll examine how hormones influence everything from mood to muscle mass, why sexual health serves as an important indicator of overall wellbeing, and how sleep and nutrition form the foundation for healthy aging. You'll discover why exercise truly functions as medicine for the aging body, learn to recognize your greatest health risks, and understand the often-overlooked importance of mental wellbeing in men's health. By understanding these changes rather than fighting against them, men can adapt their approach to health and continue thriving through middle age and beyond.

Chapter 1: Hormonal Changes: The Science of Male Aging

Male aging involves a gradual hormonal shift that begins surprisingly early in life. Around age 30, testosterone production starts declining at approximately 1-2% per year, a process sometimes called "andropause." Unlike the dramatic hormonal changes women experience during menopause, this decline happens slowly and subtly, manifesting through a constellation of changes including decreased energy, reduced muscle mass, increased body fat (particularly around the abdomen), mood fluctuations, and changes in sexual function. These symptoms can be frustratingly vague and overlap significantly with normal aging, making it difficult to determine whether a man is experiencing normal age-related changes or has clinically significant hormonal imbalances. The medical community remains divided on whether age-related testosterone decline represents a true deficiency requiring treatment or simply a natural part of aging. Blood tests measuring testosterone levels exist, but interpretation is complicated by the wide normal range (typically 250-900 ng/dL depending on the laboratory) and the fact that two men with identical testosterone levels can experience vastly different symptoms. The Testosterone Trials, a major research initiative sponsored by the National Institutes of Health, found that testosterone replacement therapy produced modest improvements in sexual function and slight increases in walking distance for men with low testosterone, but didn't significantly boost energy levels or cognitive function as many hoped. More concerning, it increased atherosclerosis in coronary arteries, raising questions about cardiovascular safety. Testosterone's role in the body extends far beyond stereotypical masculine traits. Both men and women have testosterone and estrogen, albeit in different proportions, and these hormones work together in a complex balance. In men, some testosterone naturally converts to estrogen, which plays important roles including maintaining bone density. When considering the effects of changing hormone levels, it's important to understand that hormones are just the first signal in a cascade of cellular events, with the ultimate impact determined by individual genetic profiles and receptor sensitivity. This explains why hormone levels alone don't perfectly predict symptoms or response to treatment. The connection between hormones and brain function represents another area of significant misunderstanding. While testosterone certainly influences brain development and function, the notion that men "think with their testicles" is scientifically unfounded. Male and female brains show more similarities than differences, and the development of gender-specific traits involves complex interactions between hormones, genetics, and environmental influences through epigenetics—how experiences and exposures can turn genes on or off. Cognitive changes that occur with aging result from multiple factors beyond hormonal shifts, including vascular health, inflammation, and accumulated oxidative stress. When considering treatment for age-related hormonal changes, a cautious approach is warranted. The long-term risks and benefits of testosterone therapy remain incompletely understood, particularly regarding cardiovascular and prostate health. Some researchers suggest that declining testosterone might actually serve a protective function for aging tissues, and artificially maintaining youthful hormone levels could potentially disrupt important biological adaptations to aging. For men experiencing significant symptoms, a comprehensive approach addressing lifestyle factors like sleep, nutrition, physical activity, and stress management often proves more beneficial than focusing exclusively on hormone replacement. These interventions support natural hormone production while simultaneously addressing multiple aspects of health and aging.

Chapter 2: Sexual Health Beyond 40: Function, Risk, and Adaptation

Sexual health remains an important aspect of wellbeing for most men throughout life, though the frequency and nature of sexual activity naturally evolves with age. Research from the National Social Life, Health, and Aging Project reveals that sexual activity continues well into later life, with 84% of men aged 57-64 reporting sexual activity within the past year, declining to 67% for ages 65-74 and 39% for those 75-85. These statistics confirm that sexuality remains relevant for many older adults, though physical changes and health conditions increasingly influence sexual function and satisfaction as men age. Erectile dysfunction (ED) becomes progressively more common with advancing age, affecting approximately 40% of men by age 40 and 70% by age 70. The mechanics behind erections are surprisingly complex, involving a precisely choreographed interaction between the nervous system, vascular system, and hormones. When sexual arousal occurs, the parasympathetic nervous system triggers the release of nitric oxide, causing smooth muscles in the penis to relax and allowing blood to flow into spongy, cavernous tissue. Simultaneously, veins that normally drain the area are compressed, trapping blood and maintaining the erection. This hydraulic system depends on proper nerve function, adequate blood flow, and appropriate hormonal signals—all of which can deteriorate with age, diabetes, cardiovascular disease, or as side effects of medications. The brain plays a crucial role in erectile function, serving as the true primary sex organ that initiates and maintains arousal. Depression, stress, performance anxiety, relationship problems, or excessive alcohol consumption can all interfere with this process, highlighting the inseparable connection between psychological and physical aspects of sexual function. The Sexual Health Inventory for Men (SHIM) questionnaire helps determine the severity of erectile dysfunction, with scores below 22 (out of 30) suggesting some degree of dysfunction. This standardized assessment tool helps healthcare providers determine appropriate treatment approaches, ranging from lifestyle modifications for mild cases to medications or other interventions for more severe dysfunction. Medications like sildenafil (Viagra), tadalafil (Cialis), and similar drugs have revolutionized ED treatment by enhancing how smooth muscle cells respond to arousal signals. These medications work by inhibiting an enzyme called phosphodiesterase type 5, allowing for better blood flow and stronger erections when sexual stimulation occurs. Clinical studies show approximately 78% of users report improvement, though interestingly, about 25% of men taking placebos also report benefits, highlighting the significant psychological component of erectile function. While generally safe for most men, these medications can cause side effects including headache, flushing, upset stomach, and nasal congestion. Rare but serious side effects include prolonged, painful erections (priapism), sudden vision loss, or hearing problems. A common concern among middle-aged and older men is whether sexual activity might trigger a heart attack, particularly for those with existing cardiovascular disease. Research shows that sexual activity does temporarily increase the risk of having a heart attack by approximately 2.5 times during and shortly after the activity. However, this risk is minimal in absolute terms—for a man with average cardiovascular risk having sex once weekly, the annual risk of heart attack increases by just 0.01%. Even for those with higher cardiovascular risk, the annual increase is only about 0.1%. For perspective, anger episodes trigger more heart attacks than sexual activity simply because people experience anger more frequently than sexual encounters. Sexual activity is classified as light-to-moderate exertion, equivalent to walking a mile in 15-20 minutes or climbing two flights of stairs in 10 seconds. If these activities cause chest pain or severe shortness of breath, medical consultation is warranted before engaging in sexual activity.

Chapter 3: Sleep and Nutrition: Foundations for Healthy Aging

Sleep represents a critical but often neglected component of men's health, particularly as they age. Far from being a passive state, sleep is an active restoration process during which the brain and body undergo essential maintenance—clearing biochemical waste products, consolidating memories, repairing tissues, and regulating hormones. The sleep cycle alternates between REM (rapid eye movement) and non-REM phases, with each complete cycle lasting approximately 90 minutes and repeating 4-6 times nightly. Deep sleep, which occurs during stage 3 of non-REM sleep, provides the most restorative benefits and typically happens earlier in the night, making the first few hours of sleep particularly valuable for physical recovery. Most adults require 7-8 hours of quality sleep per night, though individual needs vary. Sleep architecture changes with age, with older adults typically experiencing less deep sleep, more frequent awakenings, and earlier morning waking. Two common sleep disorders disproportionately affecting middle-aged men are insomnia and obstructive sleep apnea. Insomnia involves difficulty falling asleep, staying asleep, or waking too early, while sleep apnea occurs when throat tissues relax during sleep and temporarily block the airway, causing breathing interruptions and oxygen deprivation. Sleep apnea affects approximately 25% of men over 40 and correlates strongly with excess weight, particularly around the neck and abdomen. Beyond causing daytime fatigue, untreated sleep apnea significantly increases risk for hypertension, heart disease, stroke, and diabetes. Nutrition has been subject to conflicting advice over decades, leaving many men confused about what truly constitutes healthy eating. The low-fat movement of the late 20th century led many to replace fats with refined carbohydrates and sugars, inadvertently contributing to rising obesity rates. Current nutritional science recognizes that dietary fat quality matters more than quantity—plant oils (except coconut and palm) contain healthy unsaturated fats that support heart health and hormone production, while most animal fats contain less healthy saturated fats. Trans fats found in partially hydrogenated oils are particularly harmful and have been largely eliminated from the food supply due to their strong association with heart disease. Carbohydrates similarly vary widely in their health effects. Highly refined carbohydrates and added sugars cause rapid spikes in blood glucose and insulin, promoting inflammation and hunger. In contrast, complex carbohydrates from whole grains, fruits, and vegetables provide steadier energy and contain beneficial fiber, vitamins, and phytonutrients. Protein sources like nuts, beans, eggs, and lean meats complete a balanced diet, with protein requirements actually increasing somewhat with age to support muscle maintenance. The Mediterranean diet, featuring abundant vegetables, fruits, whole grains, fish, olive oil, and limited red meat, has consistently demonstrated health benefits in research studies, reducing risk for heart disease, stroke, diabetes, and cognitive decline. Weight management becomes increasingly challenging with age as metabolism naturally slows and muscle mass decreases. About two-thirds of American adults are either overweight or obese, significantly increasing their risk for diabetes, heart disease, sleep apnea, and other conditions. Body Mass Index (BMI) provides a rough guide to healthy weight, though it doesn't distinguish between fat and muscle mass. Excess abdominal fat, measured by waist circumference, is particularly associated with metabolic problems and inflammation. Successful weight management isn't about short-term dieting but sustainable lifestyle changes that create a slight caloric deficit while providing adequate nutrition. Small, consistent improvements in both diet and physical activity yield better long-term results than dramatic temporary changes, particularly as the body adapts to reduced calorie intake by becoming more efficient—a phenomenon called "diet-induced adaptive thermogenesis" that explains why weight loss becomes more difficult over time.

Chapter 4: Exercise as Medicine: Movement for Longevity

The human body evolved for movement, yet modern life has systematically engineered physical activity out of our daily routines. Escalators, remote controls, drive-thrus, and desk jobs have collectively reduced our daily energy expenditure, contributing to the obesity epidemic and related health problems. This sedentary lifestyle runs counter to our evolutionary programming and undermines two cornerstones of human health: the ability to perform physical work and the ability to properly manage caloric intake. The resulting "movement deficit" has profound implications for aging, accelerating the very physical declines that many attribute solely to advancing years. Dr. James Levine, a pioneering obesity researcher, coined the term "non-exercise activity thermogenesis" (NEAT) to describe the energy expended during ordinary daily activities that aren't formal exercise. His research revealed that lean individuals spent approximately 2.5 hours less per day sitting or lying down compared to mildly obese volunteers—a difference of roughly 350 calories daily. This energy expenditure, equivalent to a 45-minute run, accumulates through seemingly minor movements like standing while talking on the phone, taking stairs instead of elevators, or walking to a colleague's office rather than sending an email. Incorporating more NEAT into daily routines represents one of the most accessible ways to counter age-related weight gain and metabolic decline. The aging process brings inevitable changes to physical capacity, though the rate and extent of these changes vary tremendously based on activity levels. Muscle strength typically peaks around age 30 and begins declining more rapidly after age 50, with sedentary individuals losing approximately 15% of muscle strength per decade between ages 50-70. Cardiovascular fitness, measured by VO2 max (the maximum amount of oxygen your body can utilize during exercise), declines 5-15% per decade after age 25. Other subtle changes affect balance, coordination, flexibility, and reaction time, collectively contributing to functional decline if left unchallenged. The remarkable news is that these age-related declines can be significantly mitigated through regular physical activity. Research consistently shows that even in your 70s and beyond, resistance training can increase leg strength by 25-30% and enlarge fast-twitch muscle fibers that provide power for activities like climbing stairs or rising from chairs. Endurance training can improve maximal oxygen consumption by 10-30%, enhancing stamina for daily activities. The key is to challenge your body appropriately—intensity matters more than duration for both cardiovascular fitness and strength training. As the saying goes in exercise physiology, "If you don't use it, you lose it," but the corollary is equally true: what you use, you largely maintain. Current guidelines recommend 2.5-5 hours of moderate-intensity exercise per week (or 1.25-2.5 hours of vigorous exercise), plus muscle-strengthening activities at least twice weekly. Moderate intensity means you can talk but not sing during the activity, while vigorous intensity leaves you able to say only a few words at a time. Balance and flexibility training become increasingly important components of a complete fitness program as men age, helping prevent falls and maintain functional movement patterns. The benefits extend far beyond physical appearance—regular exercise reduces the risk of heart disease, stroke, diabetes, and some cancers; improves joint, bone, and muscle health; enhances cognitive function; reduces depression; and improves sleep quality. Exercise builds physical reserves that help you weather illness or injury and maintain independence through the aging process. Although the mortality benefits of exercise eventually plateau (running 50 miles weekly doesn't provide substantially more longevity benefit than running 15 miles), the functional and quality-of-life benefits continue to increase with higher activity levels. Remember that injuries take longer to heal as we age, so proper form, gradual progression, and appropriate recovery time become increasingly important. The goal isn't to recapture your athletic prime but to maintain function and enjoy life to its fullest. As Dr. Kenneth Cooper, the father of aerobics, observed, "We don't stop exercising because we grow old; we grow old because we stop exercising."

Chapter 5: Heart Disease: Understanding Your Greatest Health Risk

Heart disease, specifically coronary artery disease, becomes the leading cause of death for men after age 45, yet many fundamentally misunderstand its nature. Contrary to popular belief, coronary artery disease isn't simply a plumbing problem where pipes get clogged with cholesterol. Rather, it's primarily an inflammatory condition where factors like smoking, diabetes, high blood pressure, and elevated cholesterol damage the delicate inner lining of arteries, causing inflammation and scarring that we call "plaques." These plaques aren't just passive blockages—they're dynamic, living structures that can become unstable and rupture. When a plaque ruptures, it triggers blood clot formation that can suddenly block an artery completely, causing a heart attack. This inflammation-centered understanding explains why heart attacks often occur in arteries that aren't severely narrowed. In fact, approximately 70% of heart attacks happen in arteries that are less than 50% blocked—too little narrowing to cause symptoms or be detected by traditional stress tests, which typically only identify blockages of 70% or greater. This explains the perplexing phenomenon of patients suffering heart attacks shortly after "passing" a stress test with flying colors. The most dangerous plaques are often not the largest but the most unstable, with thin fibrous caps that can easily rupture. Newer technologies like CT coronary angiograms and intravascular ultrasound have improved our ability to detect these vulnerable plaques before they cause problems. Diagnosing coronary artery disease typically involves stress tests or invasive angiograms. Stress tests assess how the heart performs during increased workload, either through exercise or medication that simulates exercise effects. These tests can detect significant blockages but miss smaller plaques that can still cause problems. Angiograms provide a more detailed view by injecting contrast dye into coronary arteries, but even they have limitations in detecting certain types of plaques. Coronary calcium scans represent a newer approach that detects calcification within arterial plaques, providing a measure of overall plaque burden that strongly predicts future heart attack risk. Treatment options include medications, angioplasty with stents, and bypass surgery. Angioplasty involves threading a catheter into blocked arteries and inflating a balloon to open the blockage, often followed by placing a stent (a wire mesh tube) to keep the artery open. While these procedures can be lifesaving during acute heart attacks, their benefits for stable coronary disease are more limited than many realize. The COURAGE trial and subsequent studies showed that for patients with stable angina, medications often work just as well as stents for preventing serious outcomes like death, heart attack, and stroke. This finding surprised many cardiologists and patients who assumed that fixing blockages would necessarily improve outcomes. Medications play a crucial role in both treating and preventing heart disease. Statins like atorvastatin (Lipitor) don't just lower cholesterol—they also reduce inflammation in arteries and help stabilize existing plaques, making them less likely to rupture. Blood pressure medications, aspirin, and other drugs help prevent arterial damage and blood clot formation. In fact, medications and lifestyle changes accounted for the vast majority of the 50% reduction in coronary disease deaths achieved in the 1980s and 90s, while procedures like bypass surgery and angioplasty contributed only about 7% of this improvement, according to Stanford researchers. Prevention remains the most effective approach to heart disease. The landmark INTERHEART study identified nine risk factors that explain 90% of heart attacks worldwide: smoking, diabetes, high blood pressure, abdominal obesity, elevated cholesterol, physical inactivity, low fruit and vegetable consumption, excessive stress, and lack of moderate alcohol consumption. For men, smoking and elevated cholesterol were the strongest factors, each more than tripling heart attack risk. Addressing these risk factors through lifestyle changes and appropriate medications can dramatically reduce cardiovascular risk—for example, reducing systolic blood pressure by just 10 points can lower heart disease risk by approximately 20%.

Chapter 6: Managing Risk Factors: A Practical Approach to Prevention

When it comes to health risks, humans demonstrate remarkably poor judgment in assessing what truly threatens their wellbeing. We fear shark attacks while texting and driving, worry about rare diseases while ignoring our expanding waistlines, and obsess over minor symptoms while skipping routine check-ups that could detect serious problems early. This cognitive disconnect between perceived and actual risk undermines effective prevention efforts. A rational approach to health requires focusing on the most likely threats rather than the most exotic ones, particularly as men enter middle age when chronic disease risk accelerates. For men over 45, heart disease and cancer consistently top the list of mortality causes, followed by accidents, stroke, and respiratory diseases. Understanding your personal risk factors for these conditions allows you to prioritize prevention efforts where they'll have the greatest impact. The good news is that many risk factors for major diseases overlap, so addressing one often improves several health outcomes simultaneously. For example, regular physical activity reduces risk for heart disease, stroke, diabetes, several cancers, depression, and cognitive decline—a remarkable return on investment for a single health behavior. Smoking remains the single most destructive health habit, causing not just lung cancer but contributing significantly to heart disease, stroke, chronic respiratory diseases, and numerous other conditions. It's not merely a "bad habit" but a powerful addiction to nicotine that hijacks brain reward pathways. Quitting is challenging but highly beneficial at any age—even after decades of smoking, your body begins repairing damage within days of stopping. Whether you choose to quit "cold turkey" or gradually reduce consumption, combining medication (nicotine replacement, bupropion, or varenicline) with behavioral support significantly improves success rates. The temporary discomfort of withdrawal pales in comparison to the long-term suffering caused by smoking-related diseases. Managing metabolic risk factors—diabetes, hypertension, high cholesterol, and obesity—requires a combination of lifestyle modifications and, when necessary, medication. These conditions often cluster together in what's called metabolic syndrome, with each component amplifying the harmful effects of the others. Regular physical activity improves all these conditions while providing independent health benefits. The Mediterranean diet, rich in fruits, vegetables, whole grains, fish, and olive oil, has consistently shown cardiovascular benefits in rigorous studies. Weight management becomes increasingly important with age, as excess abdominal fat drives inflammation and metabolic dysfunction through the release of inflammatory compounds. Sleep quality significantly impacts overall health, with both insufficient sleep and sleep disorders like obstructive sleep apnea increasing cardiovascular risk. Sleep deprivation affects hormone regulation, glucose metabolism, immune function, and cognitive performance. Improving sleep hygiene (consistent schedule, dark and cool bedroom, limiting screen time before bed) can address mild issues, while more serious problems may require medical intervention. Cognitive behavioral therapy has proven particularly effective for chronic insomnia, while continuous positive airway pressure (CPAP) therapy remains the gold standard treatment for sleep apnea. Stress management deserves attention as chronic stress contributes to inflammation, hypertension, and unhealthy coping behaviors like overeating or excessive alcohol consumption. The body's stress response evolved to handle acute physical threats, not the chronic psychological stressors of modern life. Regular exercise, adequate sleep, social connection, mindfulness practices, and when needed, professional mental health support can all help manage stress effectively. The goal isn't to eliminate stress entirely—which would be impossible—but to develop resilience and healthy coping mechanisms. Regular medical check-ups become increasingly important with age. Screening tests like blood pressure measurements, lipid panels, diabetes screening, and cancer screenings can identify problems before they cause symptoms. However, screening should be personalized based on individual risk factors and preferences—not all tests are beneficial for everyone, and some carry risks of false positives or unnecessary treatment. A thoughtful approach to prevention involves discussing with your healthcare provider which screenings make sense for your specific situation, rather than pursuing every available test.

Chapter 7: Mental Wellbeing: The Overlooked Dimension of Men's Health

Mental health represents one of the most neglected aspects of men's healthcare, largely due to persistent stigma and cultural expectations around masculinity. While men experience mental health conditions at rates comparable to women, they're far less likely to seek help or even acknowledge psychological struggles. This reluctance stems from societal messages equating masculinity with stoicism and self-reliance—the harmful notion that "real men" handle problems independently rather than asking for support. Consequently, many men suffer silently with depression, anxiety, or other conditions until reaching crisis points that could have been avoided with earlier intervention. The manifestation of mental health conditions often differs between men and women, contributing to underdiagnosis in male populations. Depression in men frequently presents as irritability, anger, risk-taking behavior, or increased alcohol consumption rather than obvious sadness or tearfulness. This "masked depression" often goes unrecognized by both men themselves and healthcare providers looking for stereotypical symptoms. Similarly, anxiety in men may appear as controlling behavior, aggression, or physical complaints rather than obvious worry. These gender differences in symptom presentation reflect both biological factors and socialized tendencies in emotional expression. Work-related stress represents a significant mental health challenge for many men who derive substantial identity from their professional roles. The pressure to succeed financially, advance professionally, and support families creates chronic stress that contributes to both mental and physical health problems. Research shows that job insecurity, long working hours, and poor work-life balance significantly increase risk for depression, anxiety, and burnout. The traditional male provider role, while evolving in modern society, still creates expectations that many men internalize as measures of their worth and success. Developing healthy boundaries between work and personal life, along with stress management techniques, can help mitigate these effects. Social connection plays a crucial role in mental wellbeing, yet many men struggle to maintain meaningful relationships, particularly as they age. Research consistently shows that social isolation increases risk for depression, cognitive decline, and even premature death. Men typically have fewer close friendships than women and are less likely to maintain social networks after major life transitions like retirement, divorce, or widowhood. The quality of relationships matters more than quantity—having even one or two people with whom you can share thoughts and feelings honestly provides significant protection against mental health problems. Cultivating relationships through shared activities, community involvement, or support groups provides vital social connection. The relationship between physical and mental health works in both directions. Physical health problems increase risk for depression and anxiety, while mental health conditions can worsen physical symptoms and interfere with self-care behaviors like medication adherence, healthy eating, and physical activity. Regular exercise has been shown to reduce depression symptoms as effectively as medication for mild to moderate cases, likely through multiple mechanisms including increased endorphin release, reduced inflammation, improved sleep, and enhanced self-efficacy. Similarly, adequate sleep, proper nutrition, and stress management all support both mental and physical wellbeing. Effective mental health maintenance requires a multifaceted approach including regular physical activity, adequate sleep, stress management techniques, meaningful social connections, and professional help when needed. Just as men wouldn't hesitate to see a doctor for a broken bone, seeking help for mental health challenges should be viewed as a sign of strength and self-awareness rather than weakness. The growing number of male public figures openly discussing their mental health struggles is helping shift cultural attitudes, making it increasingly acceptable for men to acknowledge psychological difficulties and seek appropriate support. This cultural evolution represents an important step toward comprehensive men's health that addresses both physical and mental dimensions of wellbeing.

Summary

The journey through male aging involves navigating a complex interplay of hormonal, physical, and psychological changes that affect every aspect of health and wellbeing. While certain aspects of aging are inevitable, the rate and impact of these changes can be significantly influenced through evidence-based lifestyle choices and appropriate medical care. The most powerful insight from current research is that the foundations of healthy aging—regular physical activity, proper nutrition, adequate sleep, stress management, and social connection—work synergistically to maintain function and prevent disease, offering far greater benefits than any single intervention or medication could provide alone. As you apply this knowledge to your own life, remember that perfect adherence to health recommendations isn't necessary or realistic. Small, consistent improvements in key areas yield significant benefits over time. Consider which aspects of health most directly impact your quality of life and focus initial efforts there, whether that means improving sleep, increasing physical activity, addressing stress, or strengthening social connections. The goal isn't to fight against aging but to adapt intelligently to its realities, maintaining function and vitality throughout life's journey. For those seeking deeper understanding, fields like exercise physiology, nutritional science, and preventive cardiology offer expanding knowledge about optimizing health through the middle and later years.

About Author

Loading...

Craig Bowron MD FACP

Read more