As men cross the threshold of 40, the conversation about health invariably takes a new turn. It's no longer just about staying fit or avoiding the common cold. The focus shifts towards long-term wellness, and an integral part of this journey is optimizing one's diet. But why does diet become such a central piece in the health puzzle past the age of 40?
Firstly, it's important to understand that the body undergoes significant changes as it ages. These changes are not just superficial; they are profound, affecting everything from metabolism to muscle composition, bone density, and even the way our bodies process nutrients. For instance, after the age of 40, men start to experience a natural decline in muscle mass. Studies show that by 50, a man may lose about 10% of his muscle mass, escalating to 15% by 65, and a staggering 50% by 80. This loss of muscle mass not only impacts physical strength and endurance but also has a significant effect on the body's metabolic rate.
As muscle mass decreases, so does the body's resting metabolic rate, meaning fewer calories are burned at rest. This change can lead to weight gain, particularly around the midsection, and can increase the risk of various health issues like Type 2 diabetes and cardiovascular diseases. Furthermore, the aging process also affects bone health, posing a threat to independence and mobility in later years.
Given these changes, the dietary needs of a man in his 40s and beyond differ markedly from those of his younger self. A diet that once suited a 30-year-old may no longer be appropriate or sufficient for a 40-year-old. This is where diet optimization comes in – it's about adapting to the body's evolving needs, ensuring the intake of essential nutrients to maintain muscle and bone health, managing weight effectively, and ultimately, preserving overall health and vitality.
The goal of this article is to provide a comprehensive guide on how to optimize diet for men over 40. We'll explore the necessary dietary adjustments, the key nutrients required for this age group, and how to effectively integrate these changes into daily life. The focus will be on practical, sustainable dietary strategies that not only cater to the body's changing needs but also contribute to long-term health and well-being.
Understanding the Aging Body
As men enter their forties, their bodies begin a process of change that significantly impacts their nutritional requirements. Understanding these physiological changes is crucial for optimizing diet and maintaining health.
One of the most notable changes is the decline in muscle mass, known as sarcopenia. This gradual loss begins as early as the 30s but becomes more pronounced after 40. By the time a man reaches 50, he may have lost about 10% of his muscle mass, with the figure rising to 15% by 65, and by 80, it could be as much as 50%. Muscle is metabolically active tissue, so this loss directly impacts the body's metabolic rate, leading to a decreased caloric need. Consequently, without adjusting dietary intake, weight gain, especially around the midsection, becomes a significant risk.
Moreover, aging affects bone density. Along with muscle, bone mass also declines, increasing the risk of fractures and osteoporosis. This combination of muscle and bone loss can significantly impact mobility and independence in later years.
Another crucial aspect is the body's efficiency in nutrient absorption and utilization. As men age, their bodies may become less efficient at absorbing certain nutrients. For example, the absorption of B12, crucial for nerve function and blood cell production, can decline. Thus, a diet rich in vitamin B12, found in meat, poultry, fish, and dairy, becomes essential.
Additionally, the need for other nutrients like Vitamin D, magnesium, and potassium increases. Vitamin D is vital for bone health and immune function, while magnesium plays a crucial role in muscle and nerve function, blood glucose control, and blood pressure regulation. Potassium is essential for proper cell function and reducing the risk of hypertension.
Understanding these physiological changes is fundamental to dietary optimization for men over 40. A well-planned diet can mitigate the effects of muscle and bone loss, adjust to the body’s reduced caloric needs, and ensure adequate intake of essential nutrients. This understanding forms the foundation for the subsequent sections, where we'll delve into specific dietary recommendations and strategies to address these changes.
The Importance of Caloric Intake
For men over 40, one of the most critical aspects of diet optimization is understanding and managing caloric intake. As the body ages, its metabolic rate slows down due to a decrease in muscle mass. This reduction in metabolism means that the body burns fewer calories at rest, leading to a decrease in the overall caloric needs.
While the exact caloric requirement can vary based on activity level, size, and overall health, general guidelines suggest that men in their 40s require fewer calories than they did in their younger years. The U.S. Department of Health and Human Services provides a breakdown of daily caloric needs by age group, suggesting that men aged 41 to 55 typically need between 2,200 to 2,800 calories per day. This range shifts downward as men age, with those 56 to 60 needing 2,200 to 2,600 calories, and those 61 to 75 requiring 2,000 to 2,600 calories daily. Men older than 75 may need between 2,000 to 2,400 calories per day.
The decrease in calorie needs is further influenced by the level of physical activity. Sedentary men should aim for the lower end of the calorie range, while those who are more active can consume towards the higher end. However, it's not just about reducing calories; it's also about ensuring that the calories consumed are from nutrient-rich sources. A diet dense in nutrients but moderate in calories can help maintain weight and support overall health.
Incorporating a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats can provide the necessary vitamins, minerals, and other nutrients without excess calorie intake. This balance is crucial because while overeating can lead to weight gain and associated health problems, under-eating can lead to nutritional deficiencies, loss of muscle mass, and decreased energy levels.
Therefore, understanding and managing caloric intake is essential for men over 40. It's not just about eating less; it's about eating smart. By choosing nutrient-dense foods and being mindful of portion sizes, men can meet their body's changing needs and maintain a healthy weight and lifestyle.
Key Nutrients for Men Over 40
As men age past 40, their nutritional needs evolve, making certain nutrients increasingly important for maintaining health and vitality. This section delves into these essential nutrients, explaining their significance and suggesting food sources to incorporate into the diet.
Vitamin D: Often dubbed the 'sunshine vitamin', Vitamin D is crucial for bone health, immune function, and muscle function. The body's ability to synthesize Vitamin D from sunlight decreases with age, making dietary sources and supplements more important. The recommended daily intake for men over 40 is about 600 international units (IU) per day. Rich dietary sources of Vitamin D include fatty fish like salmon, egg yolks, fortified dairy products, and mushrooms.
Vitamin B12: Vital for nerve function and the production of DNA and red blood cells, Vitamin B12 absorption can decline with age due to reduced stomach acid production. Men over 40 should ensure a daily intake of 2.4 micrograms. Animal products such as meat, poultry, fish, eggs, and dairy are excellent sources of Vitamin B12. For those following a vegetarian or vegan diet, fortified cereals and plant-based milk, or B12 supplements, may be necessary.
Magnesium: This mineral plays a pivotal role in over 300 enzyme reactions in the human body, including those involved in protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. The recommended daily intake is 420 milligrams. Foods rich in magnesium include pumpkin seeds, almonds, spinach, cashews, and whole grains.
Potassium: Essential for cell function, nerve signaling, and blood pressure regulation, potassium becomes increasingly important for men over 40, who are at a heightened risk for hypertension. The daily recommended intake is 4,700 milligrams. Excellent food sources include bananas, oranges, potatoes, and avocados.
Vitamin B6: After the age of 50, the need for vitamin B6 slightly increases from 1.4 milligrams per day to 1.7 milligrams. This vitamin is important for immune function, which tends to weaken with age. Foods like wild salmon, potatoes, poultry, and avocado are good sources of vitamin B6.
Fiber: While not a vitamin or mineral, fiber is crucial for digestive health, which can become more sluggish with age. It also plays a role in managing blood sugar levels and maintaining a healthy weight. High-fiber foods include whole grains, fruits, vegetables, beans, and legumes.
Omega-3 Fatty Acids: Essential for heart health and cognitive function, omega-3 fatty acids become increasingly important as men age. They help combat inflammation, which is linked to many chronic diseases. Sources of omega-3s include fatty fish like salmon and mackerel, flaxseeds, chia seeds, and walnuts.
Incorporating a variety of these nutrient-rich foods into a balanced diet can help address the specific nutritional needs of men over 40. This approach not only supports physical health but also plays a vital role in maintaining mental sharpness and overall well-being. Remember, it's not just about what you remove from your diet, but what you add to it that counts.
Combating Muscle and Bone Loss
As men age, particularly after 40, they face a significant challenge in maintaining muscle and bone health. This section focuses on dietary strategies to combat these age-related losses, which are crucial for preserving strength, mobility, and overall quality of life.
Understanding Muscle Loss: Muscle loss, or sarcopenia, accelerates with age. By the age of 50, men can lose up to 10% of their muscle mass, increasing to 15% by 65, and as much as 50% by 80 years of age. This decline not only affects physical strength and endurance but also impacts metabolism, as muscles are vital for burning calories.
Dietary Strategies for Muscle Maintenance
- Protein: Adequate protein intake is essential for muscle maintenance. As the body becomes less efficient in protein synthesis with age, older men need more protein compared to their younger counterparts. Good sources of protein include lean meats, poultry, fish, eggs, dairy, legumes, and tofu. Aim for a varied protein intake throughout the day to maximize muscle synthesis.
- Amino Acids: Leucine, an amino acid found in whey protein, dairy products, and meats, is particularly effective in stimulating muscle growth. Including foods rich in leucine can help counteract muscle loss.
- Vitamin D and Calcium: These nutrients are crucial for bone health. Vitamin D aids in the absorption of calcium, which is essential for maintaining bone density. Dairy products, green leafy vegetables, and fortified foods are excellent sources of calcium, while Vitamin D can be obtained from sunlight exposure, fatty fish, and fortified foods.
Understanding Bone Loss: Alongside muscle, bone density also declines with age, increasing the risk of osteoporosis and fractures. This loss can be exacerbated by a lack of calcium and Vitamin D in the diet.
Dietary Strategies for Bone Health
- Calcium-Rich Diet: Dairy products like milk, cheese, and yogurt are high in calcium. For those who are lactose intolerant or vegan, alternatives include fortified plant-based milks, green leafy vegetables, and tofu.
- Vitamin D: Essential for calcium absorption, Vitamin D can be obtained from the sun, but with aging, the skin's ability to synthesize Vitamin D diminishes. Therefore, dietary sources or supplements become important.
Balancing Macronutrients: It's not just about increasing protein or calcium; a balanced diet is key. Carbohydrates, especially complex ones like whole grains, are essential for energy. Healthy fats from sources like avocados, nuts, and olive oil are important for overall health.
Hydration: Adequate hydration is vital for all bodily functions, including muscle and bone health. Water helps transport nutrients, supports metabolic processes, and aids in joint lubrication.
Exercise: While focusing on diet, incorporating strength training and weight-bearing exercises can significantly enhance muscle and bone health.
Maintaining muscle and bone health after 40 requires a multifaceted approach that includes a balanced diet rich in protein, calcium, Vitamin D, and other essential nutrients, combined with regular physical activity. By adopting these strategies, men can significantly mitigate the effects of aging on muscle and bone health, maintaining their strength, mobility, and independence well into later life.
Managing Weight and Metabolism
Weight management and maintaining a healthy metabolism are central concerns for men over 40. As the body ages, various factors, including a slowing metabolism and changes in muscle mass, make weight control more challenging. This section will delve into effective strategies for managing weight and boosting metabolism, emphasizing the role of diet and lifestyle adjustments.
Understanding Metabolic Changes: As men age, their metabolic rate naturally declines. This decrease is partly due to the loss of muscle mass, as muscle burns more calories than fat, even at rest. The reduction in metabolic rate means that the body requires fewer calories to maintain its current weight. Without adjusting caloric intake or increasing physical activity, weight gain, especially around the abdomen, becomes a significant risk.
Dietary Adjustments for Weight Management
- Control Caloric Intake: It's crucial to adjust caloric intake to the body’s changing needs. Men over 40 should aim for a nutrient-dense diet that provides enough calories to maintain energy but not so many that it leads to weight gain.
- Increase Protein Intake: High-protein foods can increase the feeling of fullness and reduce overall calorie consumption. Additionally, protein is essential for maintaining muscle mass, which in turn helps keep the metabolism active.
- Incorporate Fiber: High-fiber foods, such as fruits, vegetables, whole grains, and legumes, can also increase satiety. Fiber aids in digestion and can help manage blood sugar levels, preventing spikes and crashes that can lead to overeating.
- Choose Healthy Fats: Incorporating healthy fats, like those found in avocados, nuts, seeds, and olive oil, can promote satiety and provide essential fatty acids that support overall health.
Lifestyle Factors Influencing Weight and Metabolism
- Regular Exercise: Physical activity is a crucial component in managing weight and boosting metabolism. A combination of aerobic exercises, like walking or cycling, and strength training can help increase muscle mass and, consequently, metabolic rate.
- Adequate Sleep: Poor sleep can negatively impact metabolism and is linked to weight gain. Men over 40 should prioritize getting enough quality sleep each night.
- Stress Management: Chronic stress can lead to weight gain, particularly abdominal fat. Practices such as meditation, yoga, or even regular leisure activities can help manage stress levels.
Monitoring and Adaptation
- Regular Health Check-Ups: Regular check-ups can help monitor weight, metabolic health, and overall wellness, allowing for timely adjustments in diet and lifestyle.
- Be Adaptive: As the body continues to change, it’s essential to be adaptive in dietary and lifestyle choices. What works at 40 may need adjustment at 50 and beyond.
Managing weight and metabolism after 40 requires a holistic approach that includes a balanced, controlled-calorie diet rich in protein, fiber, and healthy fats, combined with regular exercise, adequate sleep, and stress management. By being mindful of these aspects, men can effectively manage their weight and maintain a healthy metabolism as they age.
Dietary Adjustments and Recommendations
As men cross the 40-year mark, making specific dietary adjustments becomes imperative to address the body’s changing needs. This section offers detailed recommendations and strategies to optimize diet for men over 40, focusing on maintaining health, preventing age-related issues, and enhancing overall well-being.
- Increase Nutrient-Dense Foods:
- Fruits and Vegetables: Emphasize a variety of colorful fruits and vegetables. They are rich in vitamins, minerals, antioxidants, and fiber, which are essential for good health and can help prevent chronic diseases.
- Whole Grains: Replace refined grains with whole grains like brown rice, quinoa, whole wheat, and oats. Whole grains provide necessary fiber, B vitamins, and minerals.
- Lean Proteins: Include lean protein sources such as chicken, turkey, fish, beans, lentils, and tofu. These foods help maintain muscle mass and keep you feeling full.
- Opt for Healthy Fats:
- Omega-3 Fatty Acids: Foods rich in omega-3s, such as salmon, mackerel, flaxseeds, and walnuts, are important for heart health and may help reduce inflammation.
- Monounsaturated Fats: Incorporate sources of monounsaturated fats like avocados, nuts, and olive oil, which are beneficial for heart health and may help control weight.
- Mindful Eating:
- Portion Control: Be mindful of portion sizes to avoid overeating. Using smaller plates and checking serving sizes can help control calorie intake.
- Eat Slowly: Eating slowly and without distraction allows for better digestion and can prevent overeating by giving the brain time to register fullness.
- Stay Hydrated:
- Water: Ensure adequate hydration by drinking plenty of water throughout the day. Water is essential for digestion, nutrient absorption, and maintaining energy levels.
- Limit Certain Foods and Beverages:
- Reduce Salt: High sodium intake is linked with increased blood pressure. Limit processed and packaged foods, which are often high in sodium.
- Limit Sugary Foods and Beverages: Excess sugar can lead to weight gain and increase the risk of type 2 diabetes and heart disease.
- Moderate Alcohol Consumption: Excessive alcohol can contribute to weight gain and various health issues. Moderation is key.
- Regular Meal Times:
- Consistent Eating Schedule: Eating at regular intervals helps regulate blood sugar levels and prevents overeating.
- Consult a Healthcare Provider: Consider supplements, especially for nutrients that might be difficult to obtain in sufficient amounts through diet alone, such as Vitamin D or B12. However, always consult a healthcare provider before starting any supplements.
Incorporating these dietary adjustments and recommendations into daily life can significantly impact men's health over 40. A balanced, nutrient-rich diet, coupled with healthy lifestyle choices, lays the foundation for maintaining vitality and preventing age-related health issues.
Exercise and Physical Activity
In addition to dietary changes, exercise and physical activity play a pivotal role in optimizing men's health after the age of 40. Regular exercise not only aids in weight management but also contributes significantly to overall well-being, including mental health, cardiovascular fitness, and muscle and bone strength. This section outlines the types of exercises beneficial for men over 40 and how to integrate them into daily routines.
- The Importance of Regular Exercise: As men age, they experience a natural decline in muscle mass and bone density, a process that can be significantly slowed down with regular physical activity. Exercise helps maintain muscle strength, enhances metabolic rate, and supports cardiovascular health. Additionally, it plays a crucial role in mental health, helping to reduce stress and improve mood.
- Types of Exercise:
- Strength Training: Vital for maintaining and building muscle mass, strength training exercises include using weights, resistance bands, or body weight (like push-ups or squats). Aim for at least two strength training sessions per week, focusing on major muscle groups.
- Cardiovascular Exercise: Activities such as brisk walking, running, cycling, or swimming improve heart health and endurance. Cardio exercises also aid in burning calories and managing weight. It's recommended to get at least 150 minutes of moderate-intensity or 75 minutes of high-intensity cardio exercise per week.
- Flexibility and Balance Exercises: Activities like yoga or tai chi enhance flexibility, improve balance, and reduce the risk of falls, which becomes more important as men age.
- Functional Fitness: These exercises focus on training the body for daily life activities, helping to maintain independence. They include movements like bending, lifting, climbing stairs, and balance.
- Creating a Balanced Routine: A well-rounded exercise program for men over 40 should include a mix of strength training, cardiovascular exercises, and flexibility training. The key is to find activities that are enjoyable and sustainable. This could mean joining a gym, taking up a sport, or simply incorporating more physical activity into daily life, like taking the stairs instead of the elevator.
- Listening to Your Body: It's essential to listen to your body and avoid pushing too hard, especially when starting a new exercise regimen. Pay attention to any signs of pain or discomfort, and consult a healthcare professional if necessary.
- The Role of Recovery: Adequate rest and recovery are crucial components of an exercise routine. Ensure you are getting enough sleep and giving your muscles time to recover between workouts.
- Staying Motivated: Staying motivated can be challenging. Setting realistic goals, tracking progress, and mixing up routines can help maintain motivation. Joining a group or finding an exercise partner can also provide a supportive environment and accountability.
Incorporating regular exercise and physical activity into daily life is essential for men over 40. It complements dietary changes and is key to maintaining physical strength, preventing chronic diseases, and enhancing overall quality of life. By adopting a balanced and consistent exercise routine, men can significantly improve their health and well-being in the long term.
Overcoming Common Dietary Challenges
Navigating dietary changes after 40 can be challenging for many men. This section addresses common obstacles faced when trying to optimize diet at this age and offers practical solutions and alternatives to maintain a healthy diet.
- Changes in Appetite and Digestion: As men age, they often experience changes in appetite and digestive efficiency. This can lead to eating less or opting for foods that are easy to digest but may not be the most nutritious.
- Solution: Focus on nutrient-dense foods that provide more nutrition per bite. Incorporate smoothies or soups that are easier to digest and can be packed with fruits, vegetables, and lean proteins. Eating smaller, more frequent meals can also help manage appetite changes.
- Busy Lifestyle and Lack of Time: A demanding career, family responsibilities, and social commitments can make it challenging to maintain a healthy diet.
- Solution: Meal planning and preparation can be a game-changer. Dedicate a few hours each week to preparing healthy meals in advance. Opt for simple recipes with minimal ingredients to save time. Consider healthy meal delivery services if budget allows.
- Changes in Taste Preferences: Taste buds can change with age, leading to different food preferences or a decreased sense of taste.
- Solution: Experiment with herbs, spices, and seasonings to enhance the flavor of food without adding extra salt or sugar. Try new foods and cuisines to keep meals interesting and appealing.
- Dietary Restrictions Due to Health Conditions: Health issues such as diabetes, high blood pressure, or cholesterol can impose restrictions on diet.
- Solution: Work with a dietitian or nutritionist to create a meal plan that accommodates these health conditions while still being enjoyable and nutritious. Educate yourself about which foods to limit and which to include more of.
- Weight Management Issues: Managing weight can become increasingly difficult due to a slower metabolism and reduced physical activity.
- Solution: Focus on portion control and mindful eating. Avoid distractions while eating, such as watching TV or using a phone, to prevent overeating. Incorporate regular physical activity into your routine.
- Social Eating and Peer Pressure: Social events often revolve around food and alcohol, which can make sticking to a healthy diet challenging.
- Solution: Plan ahead when attending social events. Eat a healthy snack beforehand to avoid overindulging. Choose healthier options from the menu, and don’t feel pressured to eat or drink just because others are.
- Lack of Motivation or Knowledge: Many men may want to eat healthier but lack the motivation or knowledge to make lasting changes.
- Solution: Seek information from reliable sources, join health-focused groups or forums, or consider working with a health coach. Setting specific, achievable goals can also help maintain motivation.
By acknowledging and addressing these common dietary challenges, men over 40 can successfully navigate the path to a healthier diet. Adaptability, planning, and a willingness to seek help and information are key to overcoming these obstacles and maintaining a nutritious and enjoyable diet.
Questions and Answers
In this section, we will address the top 10 frequently asked questions about optimizing men's health and diet after the age of 40. These questions and answers aim to provide clarity and guidance for those seeking to improve their dietary habits and overall health in their 40s and beyond.
As you age, your metabolism slows down, and your body becomes less efficient at absorbing certain nutrients. You may need fewer calories due to decreased muscle mass but require more of specific nutrients like Vitamin D, Vitamin B12, and Omega-3 fatty acids to maintain muscle, bone health, and cardiovascular health.
Focus on nutrient-dense foods like fruits, vegetables, whole grains, lean proteins, and healthy fats. Reduce intake of processed foods, excessive sugars, and unhealthy fats. Increase hydration, and consider adding supplements if you're deficient in specific nutrients.
Protein needs depend on your weight, activity level, and overall health. Generally, aim for at least 1.2 to 2.0 grams of protein per kilogram of body weight, particularly if you're active or trying to maintain muscle mass.
Exercise is crucial for boosting metabolism, maintaining muscle mass, and improving overall health. A combination of cardiovascular, strength training, and flexibility exercises is recommended to enhance the benefits of your dietary changes.
Focus on a balanced diet rich in whole foods, control portion sizes, and incorporate regular physical activity. Strength training can help build muscle mass, which boosts metabolism. Also, manage stress and get adequate sleep as they can impact weight.
Depending on your diet and health, you may benefit from supplements like Vitamin D, Omega-3 fatty acids, or magnesium. It's essential to consult with a healthcare provider before starting any supplements.
Risk of cardiovascular diseases increases with age. Focus on heart-healthy foods like whole grains, fatty fish, nuts, and seeds, and limit saturated fats, salt, and processed foods. Regular exercise and avoiding smoking also contribute to heart health.
Include sufficient protein in your diet and engage in regular strength training exercises. Protein-rich foods like lean meat, fish, dairy, beans, and legumes are essential for muscle maintenance.
Increase your intake of fruits, vegetables, whole grains, and legumes. These foods are rich in fiber, which is beneficial for digestion, heart health, and managing blood sugar levels.
Yes, diet plays a significant role in mental health and cognitive function. Foods rich in Omega-3 fatty acids, antioxidants, and B vitamins can support brain health. Staying hydrated and maintaining a balanced diet are also crucial for mental well-being.
These answers provide a starting point for men over 40 looking to optimize their diet and health. It's always recommended to consult with healthcare professionals for personalized advice and to address any specific health concerns.
As we conclude this comprehensive guide on optimizing men's health and improving diet past the age of 40, it's important to recognize that this journey is as much about making informed choices as it is about adapting to the natural changes that come with aging. The aim has been to provide practical, actionable advice that men over 40 can integrate into their daily lives to enhance their health and well-being.
The key takeaway is the importance of understanding and embracing the body's evolving needs. As men age, their dietary requirements change, and so should their approach to food and nutrition. Emphasizing nutrient-dense foods, controlling caloric intake, and ensuring adequate intake of essential vitamins and minerals become pivotal. Equally important is the role of physical activity, not only as a means of weight management but also as a crucial factor in maintaining muscle mass, bone density, and overall vitality.
Moreover, addressing common dietary challenges, whether they stem from changes in metabolism, lifestyle, or health conditions, is essential. Adaptability, planning, and a willingness to seek support and information can make a significant difference in successfully navigating these challenges. Hormone therapy may be a consideration for patients seeking a low testosterone clinic near me.
The Questions and Answers section aimed to address common concerns and provide clarity on how to manage diet and health effectively after 40. Remember, individual needs may vary, and it's always beneficial to consult with healthcare professionals for personalized advice.
In summary, optimizing men's health after 40 through dietary improvements is a proactive step towards a healthier, more fulfilling life. It's about making conscious choices that not only cater to the body's changing needs but also contribute to long-term health and happiness. By adopting the strategies outlined in this guide, men can look forward to not just adding years to their life, but more importantly, adding life to their years. Online TRT therapy may be appropriate for some patients. Hormone replacement for men should only be considered after blood work and a proper evaluation by a Doctor.