The High-Maintenance Body In Practice : The Body

Hydration and Blood Viscosity

Lisa Lehwalder — Tue, 11 Aug 2026 15:01:19 GMT

Photo by Daniele Levis Pelusi on Unsplash

Hydrate, hydrate, hydrate!

We’ve all heard this advice over and over again: “Drink more water,” “stay hydrated,” “refill your water bottle often.” There are water bottle refill stations at the airport. A multi-million dollar industry exists around making hydration more enjoyable. Cute water bottles to buy.

Hydration is a health goal for most of us, keep the systems working, keep the flow flowing.

Almost nobody explains why it matters more specifically for someone with Hereditary Hemochromatosis. No one ever mentioned it to me.

But there’s a real, important reason for those of us with HH to pay close attention to our hydration levels and keep them sufficiently topped off.

Here’s why…..

The Actual Science Behind “Thicker Blood”

Thicker blood.

Research on hemochromatosis patients has found real, elevated blood values, higher hemoglobin, higher hematocrit, and larger red blood cells compared to people without the condition. Hematocrit specifically is the percentage of your blood volume made up of red blood cells, a direct, literal measure of how “thick” or concentrated your blood actually is. The same research found these elevated levels dropped after iron depletion treatment, but stayed higher than average even afterward.

That’s not dramatic description. Hemochromatosis patients show measurably higher blood values in real research.

Why Hydration Matters More Here Than It Would Otherwise

Hydration status affects blood viscosity for everyone. Water makes up the plasma, the liquid portion of your blood that carries the red blood cells through your veins. When you’re dehydrated, plasma volume drops, which means a higher concentration of red blood cells packed into less fluid. Less water in your blood means your blood gets thicker, harder for your heart to pump, and slower to circulate efficiently.

Layer that on top of blood that’s already running more concentrated due to iron overload, and the effect compounds. For us, “just drink more water” is countering a real, physical mechanism already working against us. More water means more plasma, and more plasma means your blood gets diluted back toward a normal, easier-flowing concentration, even while the iron itself is still being addressed separately.

This is why I came up with the phrase “super hydration” in my article “What I Eat in a Day,” and why it fits so well here: the goal isn’t just healthy hydration for its own sake, it’s specifically about diluting blood volume for easier flow through our veins.

The Good-to-Know Moment

Being even mildly dehydrated has a variety of negative impacts on our bodies, from disrupting healthy digestion to causing cardiac symptoms that can mimic a heart attack. When I found myself in a hospital, hooked up to heart monitors, exploring the possibility that my heart had suffered some kind of issue due to a hormone produced by a heart under stress, the idea that it could be something as simple, but massively impactful, as dehydration seemed almost too simple to believe. But after my tests came back clear, my follow-up visit with a cardiologist landed on the most likely explanation: dehydration.

It’s more common than you’d think, cardiac symptoms turning out to be dehydration rather than an actual cardiac event. His advice: drink a tall glass of water an hour before bed, and again first thing in the morning.

Something I still do to this day.

The Practice | 3 Things Worth Knowing

Tea Compounds the Need, It Doesn’t Replace It | Tea does count toward your fluid intake, despite the old myth that caffeine cancels it out, but the sheer volume required for both tea-with-every-meal and genuine 'super hydration' adds up fast. Water still needs to be its own deliberate, separate habit, not something you assume tea is already covering.
Makes Blood Draws Easier | Thicker blood can make blood draws sluggish and less productive. It can also prevent a full, successful donation when your numbers depend on getting the full 500mL. Hydration, before and after, is a real part of a successful draw.
Your Body Adjusts Faster Than You’d Expect | Yes, drinking more water means more bathroom trips at first. But in my experience, the body regulates within a few weeks, and those trips space back out on their own. Don’t let the first week discourage you from staying the course.

Super-hydration is how I think about my increased need to drink water each day. It’s about diluting the thickness of the blood flowing through your veins, not just hitting a daily number. It’s a piece of information we rarely get with this diagnosis, but it’s a vital key to maintaining healthy veins and blood flow.

So find a way to dress up your water. Frozen fruit in mineral water is my favorite way to make drinking this much more pleasurable.

Hydrate, hydrate, hydrate, and keep that blood flowing smoothly.

In practice,

Lisa

OVER TO YOU | What’s your secret to staying hydrated? Give me your best tips and tricks below. I’d love to know.

The 3PM Wall

Lisa Lehwalder — Tue, 04 Aug 2026 15:02:58 GMT

Photo by Poonam on Unsplash

You’re working away when suddenly you realize that you’re tired. You look over at the clock on your desk and see that it’s nearing 3 PM. That tracks.

We’ve all heard about the 3 PM slump. It’s a common experience for many people. Science says we have two circadian dips each day - one early in the AM and the other in the afternoon - between 1-4 PM.

I’ve never been a napper or someone who has ever really been bothered by this afternoon lag, but I wasn’t peri-menopausal or dealing with an active chronic condition then.

Lately, one minute I’m mid-sentence, mid-task, thinking clearly enough and the next, it’s like someone flipped a switch. My eyes are heavy, my thoughts go thick and slow, and I can’t seem to string together two intelligent sentences.

And this isn’t the ordinary afternoon slump everyone jokes about. This isn’t ‘tired’ - it’s different. Sharper. Harder to talk myself out of. And for me, it wasn’t part of my life before menopause & HH. That timing tells me something real is going on. If you’re navigating menopause, a different chronic condition, or simply a body that’s changed on you without much explanation, you may know a version of this same wall even if the cause behind it looks nothing like mine.

And this is becoming a daily ‘event.’ I become the sort of tired I pray for at bedtime each night, but seldom comes. It’s the type of tired that feels concerning in its concentration.

What Might Be Happening

I’m guessing here, not stating facts, and I’d encourage you to bring your own version of this pattern to your own care team rather than take my guesses as answers.

A few things I’ve read and suspect might be part of it, for me specifically: iron plays a real role in cellular energy production, and when the system is managing overload, that process may not run as efficiently as it should. There’s also the simple fact of that natural afternoon circadian dip, which is something most people experience mildly. But for me it’s compounding with whatever else is already taxing my system, whether that’s inflammation, hormonal shifts during menopause, or the general load of managing a chronic condition. Blood sugar patterns through the day may also be interacting with that same afternoon window in a way that makes the crash heavier than it might otherwise be, so learning to manage this during the day is a major tool.

I don't actually know which one is causing this for me, let alone for you. I just know the wall shows up, reliably, and for me it showed up only after it became harder to manage my iron.

What You Can’t Just Push Through

My old instinct was to fight it with more coffee or more willpower to just grit my teeth through a meeting or a task. That doesn’t work here like it used to with just tiredness, but fatigue is another matter altogether. This is the same lesson “Rust in the Gears” and “The Cooling Protocol” both taught me the hard way. That when the system is already working overtime, whatever the underlying reason, trying to just push through isn’t strength, but avoidance.

The Practice | 3 Things Worth Trying

Preempt It, Don’t Just React to It | First, pay attention. Keep a log of your symptoms, including fatigue events. Identifying any patterns can help you craft your plan. A protein snack 30 minutes before an expected slump can help to ease the impact or severity. Even using an essential oil blend of rosemary or peppermint can help train the brain to stay more alert. And hydration is key. Drinking a tall glass of water is always a good practice because dehydration can make fatigue worse, so staying ahead of it helps.
Legs-Up-The-Wall, Even for Five Minutes | The same restorative reset from “The Gravity Shift” of a few minutes in this position when the wall hits does more for me than another cup of coffee ever has. Eye shade, ear plugs or headphones with a great afternoon meditation or just soothing music can help calm the nervous system and reset your system.
A Short Walk Instead of a Stimulant | Even five minutes outside, away from the screen, tends to shift the fog faster than fighting to stay at the desk through it. A slow walk outside can help to increase endorphins, oxygen, and energy. And if a walk is not available due to location or even weather, standing on the front porch doing some deep fresh air breathwork exercises while moving your limbs to increase blood flow can be highly effective.

I don’t have this fully solved. Some days that wall of fatigue still wins regardless of what I try. But I’ve stopped treating it as something I have no control over and have started treating it as a way to show up for myself. Listening the same way I’ve learned to listen to everything else this last year has asked of me.

In practice,

Lisa

OVER TO YOU | Do you have a version of the 3pm wall? What have you tried that’s actually helped, even a little? Drop your thoughts below.

Uncomfortably Cool

Lisa Lehwalder — Tue, 28 Jul 2026 16:05:12 GMT

Originally published February 26, 2026. This is part of my "Second Look" series, published on the last Tuesday of each month, where I revisit and update an older piece with what I've learned since.

Photo by Robbie on Unsplash

I am not a fan of being cold, I am known for this. I’m not warm until the temperature outside is nearing 84. I don’t like ice cubes…

Sit. Stand. Repeat. No Hands.

Lisa Lehwalder — Tue, 14 Jul 2026 15:02:05 GMT

Photo by Vitaly Gariev on Unsplash

Can You Still Get Up Off the Floor?

I mean, without using your hands to help you up? I was sitting on my living room floor last week, untangling a mess of yoga strap, and when I went to stand back up, I did something I don’t think I’d ever consciously noticed myself doing before - I planted a hand down first. Just one hand, just a quick brace, barely a thought.

I know what this could mean.

And then I couldn’t stop thinking about it.

You Can Do This Test Right Now

Here’s something worth trying before you continue reading:

Sit down on the floor, cross-legged or however feels natural.
Now stand back up without using your hands, no knees touching down, no furniture grabbing.
Just your body, doing what it already knows how to do.

Were you able to do it? Did you have to use your hands to get going? Or grab something to steady yourself?

That’s called the Sitting-Rising Test, and it turns out, it’s not just fun to know if you can do it. It’s actually pretty serious.

Why a Floor Test Predicts More Than It Should

A 2024 study followed over 4,000 adults for more than a decade, scoring each person on exactly this test. The people who scored lowest, those who needed the most support to get up, were four to six times more likely to die of cardiovascular causes over that period than the people who did it cleanly.

Four to six times. Indicated by if they could get up off the floor with any assistance.

This test is quietly measuring something real: strength, balance, mobility, and coordination, all firing together, the same combination your body needs for basically everything else it does. A body that can’t do this one thing easily is often a body that’s lost more than just this one thing.

This Can Be a Starting Point

Here’s what I actually believe, as someone who spends her days teaching bodies to do things they didn’t think they could do anymore (mine included) this test isn’t a definitive you’re done for. It’s measuring where you are right now, which is a completely different thing. And where you are right now is trainable.

The same weight-bearing poses I’ve written about before, like Chair, Warrior II, Tree Pose, aren’t just bone-density work. They’re helping build the strength to hold your own weight, the balance to trust your own two feet, the coordination to move through a change in position without needing to brace against something else. You don't need a special program to start training beyond this test. And some of it, you may already be doing.

The Practice | 3 Ways to Build Toward It

Practice the test itself, safely. Try it near a couch or chair you can lightly touch if needed - be honest- no leaning on it, just there in case. Do it a few times a week, not to master it immediately, just to let your body start learning the pattern. Our bodies typically have great muscle memory that learns and remembers quickly.
One weight-bearing hold, daily. Chair pose, held for five slow breaths. This is the same strength the floor test asks for, just broken into a smaller, safer piece.
A single-leg balance moment. Brushing your teeth, waiting for the coffee to brew, washing dishes, stand on one foot for thirty seconds. Balance is trainable in stolen moments, not just on a mat. Switching from foot-to-foot to ensure both legs are benefitting and those stability muscles are activating and strengthen.

Then try the Sitting-Rising Test again to see if you’ve made improvements. Is it easier, harder, the same? No matter where you land on your next attempt (and landing is hopefully just a metaphor here - always be extra careful) use it as nothing more than data and keep at the strengthening and balancing exercises. Even if you ace it, this will be a practice you’ll want to keep up for the rest of your life. In fact, for me, I now include 10 Sitting-Rising moves in my daily workout.

This isn’t about becoming the most flexible person in the room, or the strongest. It’s about being able to get up off your own floor, on your own terms, for as long as possible.

In practice,
Lisa

Over To You | Try the test. How’d you do easy, one hand down, or couch-assisted? No judgment, just curious where everyone’s actually starting from. Drop it below.

Perimenopause & Yoga

Lisa Lehwalder — Tue, 05 May 2026 18:36:14 GMT

Photo by Zen Bear Yoga on Unsplash

I’m almost 58 years old and STILL have not reached post menopause yet. It’s not typical for most people my age and there are (finally!) signs it’s not too far off, but here I am the only gal in my friends group still having to stop by the store on my way to the girls weekend away to grab “supplies”.

Let’s face it, mid-life is a bit of a mixed bag for each of us. There are definitely some upsides (hello, wisdom!) but also a few things that can start to feel… well, more challenging. Whether it’s your body not following the average menopausal milestones, or it aching a little more than it used to, or your mind struggling to remember why you walked into the kitchen just now, it’s clear that this phase of life asks us for a little extra self-care.

And that’s where yoga comes in.

If you’ve ever been curious about yoga, but felt like it was just for the super bendy, super fit, super thin, super young types, I get it. But let me tell you yoga is for everyone, especially as we get older. It’s one of the best things you can do for your mind, body, and spirit during this chapter of your life. In fact, a regular yoga practice can actually help you feel more you than ever before!

Here’s how yoga has helped me maintain my personal balance - mind, body, and spirit - during perimenopause.

1. Yoga for Your Body: Flexibility, Strength, and Comfort

As we age, our bodies change. Maybe you’re noticing some tightness in your lower back or your knees don’t love going up stairs as much as they used to or bending over to tie your shoes feels super risky these days. Yoga is a wonderful way to keep your body feeling strong, flexible, and honestly, less creaky.

The thing with yoga is that it’s all about meeting your body where it’s at. You don’t have to be able to touch your toes or do a handstand to benefit from it. As a matter of fact, I don’t teach or recommend handstands to my yoga clients. Simple poses like Downward Dog and Cat-Cow can stretch your spine, open up your hips, and release a lot of that stiffness that creeps up from sitting too long or lifting heavy things. And don’t even get me started on how good it feels to end your day with some leg stretches or legs-up-the-wall to help with fluid movement and vein health.

Plus, the strength-building poses, such as Warrior or Tree Pose, are perfect for boosting your balance and core stability. This is key as we get older, strong muscles and good balance reduce your risk of falls and injuries. So, yoga isn’t just about being flexible it’s about staying strong, stable, and comfortable in your own body.

2. Yoga for Your Mind: Calm, Clarity, and Focus

If you’re anything like me, your mind might be a bit busy these days. Between work, family, and just life in general, it can feel like there’s always a million things bouncing around in your head. That’s where yoga’s magic comes in.

Yoga is all about bringing you into the present moment. The slow, deep breathing and mindful movements help quiet the mental chatter and give you a chance to just breathe - literally. It’s like hitting the reset button for your brain.

A simple breathing exercise like box breathing (inhale to the count of 4, hold 4, exhale 4, repeat) can immediately calm your nervous system, lower your stress, and clear your mind. Even just five minutes of breathing can help you feel more focused and grounded. And let’s be honest who doesn’t need a little more of that?

And yoga isn’t just physical. It trains your mind to be more aware and present. When you’re focused on your breath and movement, there’s less room for worries and distractions. It’s a great way to give your mind a break, especially in the middle of a busy, stressful day.

3. Yoga for Your Spirit: Connection, Growth, and Peace

When we were young our thoughts were occupied a great deal of the time with what we wanted to be when we grew up. However, in this phase of life, it’s time to consider who we became or are still becoming. Mid-life is a time of deep reflection. Maybe you’re thinking about your purpose, what’s next, or what truly brings you joy. Yoga is such a beautiful way to connect to your spirit and nurture your inner growth.

Yoga philosophy invites you to be present with yourself, to honor your body, your thoughts, and your feelings without judgment. The practice encourages acceptance and contentment, which is such a gift, especially as life brings changes.

If you’re feeling disconnected or unsure of where you’re heading, yoga can be a powerful tool to get back in touch with your true self. And it’s not all about deep philosophical thinking; it can be as simple as feeling a sense of peace in your body or being grateful for the time you take for yourself. The beauty of yoga is that it’s a journey that’s uniquely yours.

Plus, let’s not forget the community aspect. If you join a yoga class or practice with friends, it can be such a lovely way to bond with others who are also on a path of growth and self-discovery. Yoga has this magical ability to bring people together and create a sense of connection both with yourself and with others.

The Takeaway: Yoga as a Practice

It’s never too late to start. Even better than that, it’s especially beneficial to start a yoga practice in this wonderful phase of transition. No movement practice seems to offer such a comprehensive range of benefits for our ever changing bodies. If you’re thinking, “I’m too stiff for yoga” or “I don’t have the time,” trust me there’s a style and pace for everyone. You can start small with a gentle class, or even practice in the comfort of your own living room. Youtube has a wealth of free yoga classes of every type and experience level. No judgment, no pressure, just you and your mat.

Yoga is a gift you can give yourself, not just for your body’s strength, flexibility & stability, but for your mind’s peace and your spirit’s connection. Whether you’re looking for relief from physical aches, a way to calm your mind, or a deeper sense of purpose, yoga meets you exactly where you’re at.

And the best part? It’s a practice that grows with you.

So, grab a mat (or a towel if you’re just getting started) and give it a try. You’ll be amazed at how yoga can help you feel stronger, calmer, and more connected, no matter if you already have some yoga experience or are brand new to the practice.

Are you ready to get started? Take it one breath at a time. You’ve got this!

In practice,

Lisa

AVAILABLE NOW: The Restaurant Edit: How to Order with Iron-Overload (HH)at Lisainpractice on Gumroad

AVAILABLE JUNE 1ST: The Plate: A Guide on How to Think About, Use, and Love Food Again After Diagnosis available on lisainpractice on Gumroad.

The Cooling Protocol

Lisa Lehwalder — Thu, 26 Mar 2026 15:01:47 GMT

Photo by Klara Kulikova on Unsplash

Have you ever felt like your internal thermostat is just... broken? Like there’s a low-grade hum of heat or vibration under your skin, even when the room is cool?

Iron is a pro-oxidant. In the simplest terms, it burns. When our saturation levels are high, our bodies are working overtime to deal with that oxidative stress, which often results in systemic inflammation. It’s why our joints can feel rusty and why we often feel restless and hot in our own marrow. It’s an invisible fever that doesn’t show up on a thermometer, but you can feel it in every cell.

For a long time, I treated this restlessness as something to be worked out. I thought if I just did a harder vinyasa flow or a longer walk, I could burn off that excess energy. But when the engine is already redlining, you don’t add more RPMs. You don’t push a body that is already fighting an internal fire.

Being High-Maintenance on Purpose means we don’t just suck it up and keep moving through that heat. It means recognizing that our movement needs to be a Cooling Protocol, not a calorie-burning one. When I feel that internal hum now, I don’t reach for more activity; I reach for the yield. I’ve traded the sweaty, high-impact push for a series of deliberate, quiet choices designed to bring the temperature down. We are giving our liver and our nervous system a much-needed break from the burn, allowing the body to find its way back to a neutral, sustainable baseline.

We aren’t just resting; we are strategically cooling the system so we can stay in the game for the long haul.

Your High-Maintenance Challenge:

The Hydration Flush: Swap one dehydrating drink for room-temperature mineral water with a sprig of fresh mint. Mint is naturally cooling and helps the body feel fluid rather than stagnant and heavy.
The Legs-Up-The-Wall: This is my non-negotiable ritual. Spend 5 minutes before bed with your legs up the wall (Viparita Karani). It encourages lymphatic drainage and signals to your hot internal engine that it’s time to cool down and rest.
The Lukewarm Rinse: If you’re feeling that internal hum, try a lukewarm (not hot) shower before bed. Lowering your external temperature helps signal to your nervous system that the burn of the day is over.

When we lower the heat, we find the clarity to make the next right choice. It’s not about doing less; it’s about doing what is required for the version of us we want to be thirty years from now.

Life is the practice,

Lisa

COMING MAY 1st: The Plate: A Guide on How to Think About, Use, and Love Food Again After Diagnosis. Because a high-maintenance body deserves a high-quality manual.

Rust in the Gears

Lisa Lehwalder — Thu, 12 Mar 2026 15:02:42 GMT

Photo by Margaret Young on Unsplash

In my years as a Vinyasa teacher, I lived for the sweat and flow. But let’s be real: when you’re living with iron overload, there are mornings when your joints feel less like a flow and a lot more like a rusty garden gate.

It’s that creaky, stiff sensation that makes you want to crawl back under the covers. For a long time, I thought the answer was to grind it out and move faster to get things working again. But here’s the secret I’ve learned: You can’t bully your joints into feeling better.

When our bodies are working overtime to manage iron, they are essentially running hot. Pushing through a high-intensity workout during a flare is like revving an engine that’s low on oil. Instead, I’ve started looking at my movement through the lens of Joint Preservation.

The Magic is in the Yield

This is where Yin Yoga comes in. Think of it as the chilled-out sister of the yoga world. Instead of pushing, we yield. Instead of sweating, we cool down. By holding simple, supported shapes for a few minutes, we aren’t just stretching muscles we are giving our fascia and ligaments (the hinges of our body) a chance to hydrate and release that rusty pressure.

Yin is not the “resting” yoga we often see it marketed as, but rather its focused on the joints, fascia, ligaments, and tendons. Creating space and room for smoother and healthy movement.

It’s not about being a patient; it’s about being a high-maintenance manager of your own vitality. It’s about choosing the movement that makes you feel smoother tomorrow, not just exhausted today.

Your Rust-Reset Challenge

Ready to try a different kind of movement? Here are 3 simple ways to oil the gears this week:

The 5-Minute Dangle: If your low back or hips feel rusty, simply stand with soft knees and fold forward, letting your head and arms hang heavy like a ragdoll. Hold for 2 minutes. Breathe into the back of your heart. Feel the gravity do the work for you.
The Cooling Breath: If you feel that internal HH (or menopausal) overheating, try Sitali breath. Curl your tongue (or purse your lips) and inhale slowly through the mouth as if through a straw and exhaling through your nose. It’s like an internal air conditioner for your nervous system.
The Yield Test: Next time you feel the urge to push through a workout while feeling heavy, try doing 50% less. Observe how your joints feel the next morning. Sometimes, less really is more.

Movement is medicine, but only if we’re taking the right dose.

Life is the practice,

Lisa

COMING MAY 1st: The Plate: A Guide on How to Think About, Use, and Love Food Again After Diagnosis. Because the best way to support your movement is to master your fuel.

Uncomfortably Cool

Lisa Lehwalder — Thu, 26 Feb 2026 16:00:40 GMT

Photo by Hannah Xu on Unsplash

To tell you that I am not a fan of being cold, I really mean it. I’m not warm until the temperature outside is upwards of 80. I don’t like ice cubes in my beverages. I don’t like to eat ice cream in the shade. My happy place is standing in front of the open oven door after removing whatever food I’d just cooked. I have a sweatshirt that says: “Always Cold” across the front.

I’m the first to admit that turning the shower dial towards cold is the last thing I ever want to do. But I’ve started doing it anyway. Not because I’m trying to be some cold plunge enthusiast, but because the health benefits this simple practice offers are huge.

The Reality of the Cold

It’s a strange feeling, turning the dial away from that comfortable heat, but there’s a real mechanical reason to do it. When that cool water hits your skin, your body immediately reacts. Your blood vessels constrict, and your nervous system takes a giant reset breath, that involuntary gasp.

For those of us managing the systemic load of Hemochromatosis or the unpredictable internal thermostat of menopause, those 90-120 seconds are a chance for some actual maintenance.

The Vascular Pump & Lymphatic Drainage: Unlike the heart, the lymphatic system doesn’t have its own pump; it relies on movement and pressure. Cold water provides a manual version of this. That rapid shunting of blood acts like a pump, flushing stagnant fluid out of the tissues and supporting the liver and kidneys. It’s a straightforward way to keep fluid moving through joints where iron-related stiffness likes to settle.
The Vagus Nerve & Mood: The shock triggers the vagus nerve, which is essentially an off switch for the stress response. It forces the nervous system out of a high-cortisol state and triggers a steady release of dopamine. This isn’t a quick spike; it’s a prolonged lift that helps with focus and mood for hours.
Thermostat Training: Regular exposure to cooler temperatures acts as exercise for your internal thermostat. By intentionally practicing the cooling response, you’re training your body to handle those sudden, involuntary spikes of hot flashes with more efficiency later in the day.
Immune & Metabolic Support: The cold shock actually signals the body to increase the production of white blood cells (leukocytes) and can stimulate mitochondrial health. It also activates brown fat, which the body uses to burn energy and generate heat, helping to regulate metabolism from the inside out.
Inflammation Control: By down-regulating pro-inflammatory cytokines, the cold acts as a natural anti-inflammatory. This is huge for dampening the systemic inflammation that often tags along with HH and hormonal shifts.

The Protocol

Maintenance should be sustainable, so this doesn’t have to be a miserable, ice-cold ordeal. I call it uncomfortably cool because that’s exactly what it should be: just enough to trigger that gasp reflex.

The Transition: Start with your regular warm shower. Towards the end, move the dial down. You don’t need an arctic plunge; you just need a significant enough difference between your body temperature and the water to cause a reaction.
The Target: Focus the water on the back of your neck and your chest. These areas have the most direct impact on the nervous system, but I do make it a point to soak my entire head (because it’s also good for your hair!).
The Breath: This is the actual practice. As the water hits, your body will want to panic-breathe. Focus on slow, controlled exhales/inhales. This signals to your brain that the stress is controlled and that you are safe. It’s mindset mastery as much as a physical training. It’s not about grit, but rather self-control.
The Clock: Start with 30 seconds, building towards 90-120 seconds. Anything beyond two minutes provides diminishing returns for this daily habit.

The Finish

Extreme temperature shifts are great for the vessels, but they can be taxing on the skin’s lipid barrier, especially as it thins and becomes more sensitive with age. To keep from feeling itchy or extremely dry, you have to seal moisture in immediately while you're still damp. I go straight for Jojoba oil because it mimics the skin’s natural sebum, followed by a rich barrier cream. It's a non-negotiable step, especially in the winter.

The truth is, I still hate the cold. Every morning, there is a split second of hesitation before I turn that dial where I try to talk myself out of it. But I do it anyway because I’ve weighed the 120 seconds of shivering against the hours of feeling heavy and stagnant, and the facts don’t lie.

It’s a small price to pay for a system that actually functions. In the end, the temporary discomfort of the water is nothing compared to the long-term benefit of feeling clear, mobile, and regulated. It’s not a ritual I do because I enjoy it; it’s a ritual I do because I enjoy how I feel for the rest of the day once it’s over. I enjoy how this simple, yet uncomfortably cool practice, does a huge amount of systemic work in just under 2-minutes.

And that’s what being in practice is all about.

Lisa

Disclaimer: I am not a doctor or a medical professional. The information shared here is based on my personal experience with Hereditary Hemochromatosis and my own research. It is for entertainment and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

The Non-Negotiables

Lisa Lehwalder — Tue, 17 Feb 2026 16:02:42 GMT

Photo by kike vega on Unsplash

There comes a time when we all reach a fork in the road: active aging or passive aging. When you receive a diagnosis, that choice becomes a mandate.

I’ve opted for a high-maintenance lifestyle. On purpose!

I want to be clear: how I handle my Hereditary Hemochromatosis (HH) isn’t a universal prescription. I’m not preaching “The Way.” But I do know that the gap between diagnosis and treatment for HH is a wide canyon of nothing. Lifestyle recommendations are sparse, under-tested, or simply not encouraged.

Faced with that silence, I decided to go my own way: active aging and aggressive condition management. Active aging is a full-time job on its own; when you layer a genetic mutation on top of the complexities of menopause, the workload increases a hundredfold.

High-maintenance, for me, means I treat self-care like a CEO job description. My schedule for eating, movement, and recovery is non-negotiable. It is the framework that allows me to manage hormone balance, inflammation, and iron levels simultaneously.

My Non-Negotiables:

Sleep as a Pillar: I treat sleep as a sacred recovery window. Same time every day, supported by magnesium and an inclined pillow to assist with circulation and respiratory ease.
The Morning Launch: I walk before sunrise to clear mental space. I follow it immediately with hydration, adding lemon and cayenne to “prime” the liver and stimulate metabolic fire.
The Movement Menu: I don’t just “exercise.” I utilize rebounding, vibration plates, and jumping to stimulate the lymphatic system, which, unlike the heart, has no pump of its own and relies entirely on manual movement to flush toxins. I balance this with yoga, Pilates, and weights to maintain bone density and joint integrity.
Strategic Nutrition & Supplementation: Every meal is nutrient-dense and low-iron. I leverage iron inhibitors -like dairy or the tannins in black and green tea to physically block iron absorption during digestion. I have built a protocol of proven iron-impacting supplements, taken throughout my day, to aid in iron management.
The Contrast Finish: Finishing showers with a 2-minute cold water blast isn’t just a grit test; it’s a tool for vasoconstriction and vasodilation, which aids cardiovascular efficiency and boosts immune function.
Lymphatic Mastery: I use dry brushing and lymphatic massage to manually move lymph fluid. This is crucial for HH management, as it assists the body’s natural detoxification pathways and reduces the “sluggish” feeling of systemic inflammation.
Breathwork for Longevity: I maintain a dedicated practice to improve lung capacity and down-regulate the nervous system, keeping cortisol (the enemy of hormonal balance) in check.
Administrative Wellness: In January, I schedule every annual appointment with my wellness providers. While phlebotomy needs can be unpredictable, the rest of my calendar is set in stone.

My health is a full-time job now, and I am high-maintenance on purpose.

This diagnosis threw me for a loop. I had been working so hard to counter a complex gene pool, only to find myself exactly where I didn’t want to be: a patient. It felt like a kick in the butt. But because the risks of severe illness are higher now, my commitment must rise to meet them.

I’m choosing this path to get to the end of the journey upright, vibrant, and strong. I’m not just aging; I’m managing my vitality with the seriousness it deserves.

And that is the practice.

Lisa

The Negotiation

Lisa Lehwalder — Thu, 05 Feb 2026 16:02:46 GMT

Photo by Vladislav Muslakov on Unsplash

When you have Hemochromatosis, your blood work is a constant negotiation.

In the beginning, my goal was just to get the numbers down. Lower the iron, lower the ferritin, and find some relief. But once you start making progress, you realize it’s a fine balance between the two and not easily achieved.

Right now, I’m in a difficult spot. My Ferritin is low, but my Saturation is high.

The Ferritin (storage) - think of this as your backup. When it’s low, your internal battery is essentially dead. Because my body has no healthy amount of stored iron, there is nothing to draw from when I need even a small burst of energy. I am running on empty.

The Saturation (circulation) - this is the iron currently moving through your veins. When this is high, the iron is free and unbound, when it’s not supposed to be. And unbound iron can be dangerous because it is looking for places to land like your joints, your organs, and your tissues where it can cause permanent damage. It’s like a room packed full of people with no chairs; because they have nowhere to sit, and the room is too crowed, and they are constantly pushing on and damaging the walls.

The Conflict - this is where the frustration lives. You can be depleted and overloaded in the same body. There is no easy fix for the fatigue because while you feel empty, your blood is already too full and you can’t just “push through” because your internal battery is at zero.

The Strategy - when the unbound iron is high and the storage is low, the protocol changes. It’s no longer about aggressive moves; it’s about management.

It’s about using tannins (think green tea) to keep that unbound iron from landing.
It’s about radical rest to let the “crowd” in your blood calm down.
It’s about accepting that “healthy on paper” doesn’t mean “functional in life.”

Because while we are listening to our body, navigating the numbers, and finding the appropriate ways to raise or lower them, we are also learning to accept the misalignments of our biology as space to rest and reflect and nurture and accept.

And that is definitely a practice.

Because life is the practice,

Lisa

The Empty Overflow

Lisa Lehwalder — Tue, 03 Feb 2026 16:03:11 GMT

Photo by Kelly Sikkema on Unsplash

My latest labs tell a contradictory story: My Ferritin is low, yet my Iron and Saturation levels are high. In the language of this journey, it means I am empty, yet I am overflowing. My stores are depleted, but my circulation is under constant, unmanaged pressure. And I’m a kind of tired I’ve never experienced before.

The last few years found me slowly creeping towards this exhaustion, little by little, and it was easy to assign the reason to peri-menopause. I felt both justified, but also guilty, of the need to sit down while brushing my teeth or skipping the workout, only to push harder for longer on other things to “make up” for the laziness.

Iron-overload is a specific, extreme fatigue that defies the usual remedies. It’s not a heaviness I can just carry; it’s sometimes a total absence of strength. It’s the type of exhaustion where even sitting upright feels like a demand on the body, a state where you feel almost too tired to even lie down. When the body is this out of balance, the fatigue isn’t just in the muscles; it’s in the marrow.

The truth? The thoughts of “pushing through” or “doing it anyway” seem valiant, but can be, in actuality, promoting damage. And when you’re lucky enough to be starting out with no organ damage or iron buildup in the tissues, taking rest seriously seems the least I can do at this point to maintain the baseline health I’m fortunate enough to have.

The frustration though is deepened by a baffling contradiction: all my scans and tests say I am healthy. A strong heart, a clean liver, a perfect pancreas. My other blood work is great, yet I’ve never felt so terrible in my life. This disconnect between being "clinically healthy" and physically too exhausted to function has led to a mild feeling of hopelessness and an unusual, unhealthy relationship with food. I feel as though my life was pulled out from under me and flipped upside down. Being "healthy" on paper while being afraid of every bite of food you take is an exhaustion of its own kind.

So because my saturation level is high and my iron stores are low, my protocol this week is simple: I’m choosing rest over resistance. In recognizing that my body is struggling to process the load, I am cultivating healing, joint and organ preservation, and easing the mental weight of a condition that has changed the dynamic of my life. It’s a practice of self-care and it’s non-negotiable.

Because life is the practice,

Lisa

The Weight of the Load

Lisa Lehwalder — Thu, 29 Jan 2026 17:00:40 GMT

Photo by Anton Shuvalov on Unsplash

I’m six months into this now, and if there’s one thing I’ve learned, it’s that this isn’t a straight line. Some days the “High-Maintenance Body” feels manageable, like I’ve got a handle on things. Then there are days like today, where I can just feel the weight of the load.

The fatigue is deep, and the mental fog is so thick it’s hard to focus. I even feel light-headed, a blunt reminder that when my iron saturation is this high, my blood is literally heavy. It’s a sluggish feeling that hits my brain the second I try to get moving.

My recent labs explain why I feel this way. I have another round of bloodwork coming up this next Wednesday, but I’m trying to be realistic. It’s only been 18 days since my last check and while I’m hopeful to see some movement, I’m not expecting a miracle turnaround in less than three weeks just from my daily habits alone. Change takes time, and right now, the numbers are still high.

Why I’m Not “Pushing Through”

The old version of me would have tried to grit my teeth and just power through the exhaustion. But I’m learning that with high iron, that’s a bad move. When my saturation is peaking, my body is under a massive amount of internal stress. Pushing myself right now doesn’t make me stronger; it just adds more inflammation to my heart and my joints. In this practice, resting isn’t being lazy. It’s a tactical choice to stop the damage before it gets worse.

Beyond the Curated Fantasy

I see so much on social media that feels like a curated fantasy of people acting like once you have a protocol, every day is a win. But the reality of the maintenance is that some days the load is just too much. I don’t want to only post when I’m feeling great, because that’s not the whole story. Being a Practitioner means managing the heavy days just as much as the good ones.

What Today Looks Like

Since the load is heavy today, I’ve stripped my to-do list down to the bare minimum. I’m not looking for progress today; I’m just looking for maintenance and that means:

Water: Lots of it, to help my system flush out the waste.
Tea: Using tannins to help neutralize the oxidative stress in my system, even between meals (while being careful not to overdo it on an empty stomach).
Pacing: Breath work, meditation, restorative yoga, and lots of reading or just a little binge-watching is the only agenda. I’m at my limit and actually stopping to self-care is a major part of my long-term strategy. This is a NO JUDGEMENT activity, because it’s good science.

We don’t just manage the numbers on a page; we have to manage the reality of how we feel in the moment.

Bio-awareness is actually a super-power we often overlook. It’s the ability to stop guessing and start listening. Today, my body is speaking loud and clear, and the most powerful thing I can do is respect what it’s saying.

Because life is the practice,

Lisa

My Protocol

Lisa Lehwalder — Wed, 26 Nov 2025 18:01:12 GMT

“Just get phlebotomy, you’ll be fine.”

That’s the most common recommendation people report getting after being diagnosed with HH. And right after I found out I had the C282Y gene mutation, I got that recommendation too.

My PCP told me I’d have to get comfortable with the fact that for the rest of my life, I’d need regular phlebotomy.

My hematologist told me we wouldn’t need to do anything at all until my iron numbers showed I needed phlebotomy.

Then, I was on my own. No further directions. No plan.

I’m not a passive patient.

I want the details—what are we going to do, what are our options, why are we moving in the direction we’re discussing, and how does that look for my healthcare team, myself, and my life directly?

As I started to learn more about HH and how it works in the body, I realized that the “phlebotomy is the only treatment” statement wasn’t exactly accurate.

Phlebotomy is the only treatment for iron overload—not the condition itself.

What’s commonly conflated in the conversation about HH is the condition(Hereditary Hemochromatosis) and the result of the condition (iron overload). Or, put another way: managing the condition versus treating the symptoms of the condition.

And the question I kept coming back to was: Why is the entire conversation about treatment, but never about what we might be able to do to manage it?

If the result of HH is iron overload, that suggests there’s a period of loading that feels wholly unaddressed in any recommendations or outlines of the condition.

To me, this felt like a terrible oversight.

Because it all comes down to one thing: the food we eat.

Of course, you can get hemochromatosis as a result of over-supplementation, extreme lifestyle habits, or as a result of another disease—and those are completely different matters. But we’re focusing specifically on the hereditary version here.

So if this is about the food we eat, how our body pulls iron from that food, and what happens to that iron once it’s in our body—why was I not hearing more conversations about diet modifications?

We all know that most foods have some iron in them. But what I didn’t know before this was that there are different types of iron:

Heme iron (from meat) – easily absorbed by the body
Non-heme iron (from plants) – not as easily absorbed by the body

That difference suggests we might be able to exercise a little bit of control here.

In the upcoming weeks, I’ll share more specifics about the protocol I’m building to create a management plan using food combinations and rules, supplementation (some supplements have been shown to aid in iron control), and other aspects of overall health foundation building that have been shown to help manage iron overload.

If there’s a code to eating in a way that lessens my iron absorption, eases the symptoms, and reduces the need for regular phlebotomy—it would make sense to do it.

My Personal Protocol:

Here’s what I’m building with the help of my naturopath and based on research from two books on HH that I highly recommend (you can find the titles of those books at the end of this article):

Diet Modifications – Food combinations, rules, and choices that reduce iron absorption
Meditation – Stress management is vital (stress can impact iron overload)
Movement – Iron can be excreted through sweat; movement is a must
Microbiome Management – Gut flora uses iron as food; supporting gut health matters
Supplementation – There are supplements that help with iron management
Products – Things I find that may help in my protocol

I’ll be diving deeper into each of these in future posts—what I’m doing, why I’m doing it, what’s working, and what’s not.

This is my approach. It may not be yours—and that’s okay.

But if you’re looking for a way to take control of HH beyond just phlebotomy, I hope this gives you a starting point.

Life is the practice,
Lisa

P.S. - The books I recommend:

Ironbound by Shelly Manning
The Iron Curse by Christy Sutton

The Treatment I Fought For

Lisa Lehwalder — Tue, 25 Nov 2025 18:01:48 GMT

I had to do my research. I had to understand the pros and cons of this treatment. And in the end, I had to demand my doctor order it.

I’m a self-titled “proactive patient,” which simply means I don’t subscribe to the belief that my doctor “knows everything” about medicine—or my body. I make sure I’m not only informed, but actively participating in my healthcare.

I don’t do well with ambiguity. Especially medical ambiguity. I need to know the what’s, why’s, and how’s of an illness or condition in relation to me and the treatments being prescribed. Not only so I can understand what’s going on, but also so I can ensure my full participation in the process for—hopefully—the best outcomes.

After years of cultivating the relationship I have with myself—learning to listen to my body, trust my intuition, and stop giving my personal power away to others because of some perceived deference to title or position—I am now the one in control. My doctors, who are all obviously vastly more educated in medicine than I am, are great. But they work for me. And I think we often forget that part. Yes, they are the professionals, but I am not about to hire a contractor to come and “do whatever they want” to my house, and I feel the same about my healthcare team. My input is just as vital as their expertise.

My ferritin was high. My iron saturation levels were higher. I was getting pretty concerned. If my upcoming liver MRI were to show no damage, what was I going to do to prevent that saturation level from causing damage? Left unchecked, unmanaged, that high iron saturation level could start me on a road to illness and disease.

My doctor wasn’t going to be concerned, he said, until my ferritin was over 1000. But he didn’t mention the extremely high saturation level. By all my research—and speaking to some experienced people in the HH world—this was a gross oversight by him. The fact is though, most doctors only focus on ferritin, to the detriment of a patient’s health.

Then there were the symptoms: overheating, chronic headaches, extreme fatigue. Each day brought more discomfort, pain, and fatigue—to the point of just not being able to function as I was used to. It was getting frustrating especially since each test I went through came back as good. My systems and organs were all strong and functioning properly, without any signs of iron overload or damage. But I had never felt worse in my life.

Finally, during a 2 AM sleepless night—because my joints and head were hurting—I emailed my hematologist, outlining my argument for phlebotomy. I was not willing to ignore the saturation percentage, and I wanted to be proactive with treatment. I needed relief from the worsening symptoms and the anxiety of knowing that ‘free iron’ was circulating through my body.

What is ‘free iron’? When you have too much iron in your body—like with HH—some of it becomes “free iron”: iron that’s not safely stored or bound to proteins. This free iron is toxic because it creates harmful molecules called free radicals that damage your cells, tissues, and organs over time. That’s why managing iron levels through phlebotomy and lifestyle is so critical—you’re literally preventing this free iron from destroying your body from the inside out.

And what happened after that 2 AM email? My hematologist decided to order phlebotomy. A 12-week treatment plan. I haven’t met with him yet to know for sure what changed his mind—the information I shared about the importance of paying attention to the saturation percentage, or just the pushy patient—and frankly, I’m okay with either answer.

Follow along here or over on Instagram at @thehhlife1 for more on my HH journey and my phlebotomy treatment.

The Log Jam Scenario

Lisa Lehwalder — Thu, 20 Nov 2025 18:02:20 GMT

Imagine a bridge over a raging river. On one side, you have your life—your habits, behaviors, beliefs. On the other side, phlebotomy treatment.

The most common recommendation for HH? “Live your life. When your iron gets too high, get phlebotomy to bring it down. Then go back to living your life while your iron builds back up again.“

Rinse. Repeat.

But here’s what’s actually happening:

As you live your life and your iron numbers rise, that excess iron creates free radicals, causing oxidative stress in your body. And it’s that oxidative stress—unchecked, accumulating—that eventually breaks down your health and organs.

Phlebotomy removes iron, but it doesn’t reduce the oxidative stress already damaging your body. And phlebotomy itself comes with its own drawbacks: vein scarring, fatigue, and the physical toll of repeated blood removal.

So back to the bridge.

You’re on the life side, living as you normally do. Your iron climbs. Oxidative stress builds—imagine it as logs piling up under the bridge. You cross the bridge, get phlebotomy, and return to your life. The logs keep piling. Your numbers grow. Your body endures repeated treatments. Until, eventually, because of that log jam, the bridge breaks.

And when it does, you can’t go back. Your body has to rebuild—but the new bridge is weaker. And the cycle starts again, often with new health issues created by the first break.

Now imagine a different scenario:

Same bridge. Same setup. But this time, on your life side, you’re actively managing your iron through lifestyle changes—diet, hydration, stress management. You’re slowing the buildup. The logs pile up slower. The strain on the bridge is less. You need phlebotomy less often.

If you can keep that log jam from happening—or slow it significantly—your bridge lasts longer. Your health stays stronger.

To me, this made total sense.

Why would I carry on as normal when I now know my body doesn’t work the way I thought it did? Maintaining my health has always been a priority, and this new challenge wasn’t going to change that.

Do I love a dirty vodka martini, a glass of merlot, or a perfectly grilled steak? Absolutely. But do I love those things more than my own liver, pancreas, kidneys, or heart? Absolutely not.

When I first thought up the log jam scenario —the oxidative stress building in my body, guaranteed to eventually cause a health crisis —it was a no-brainer. I would find ways to manage this condition, not just treat it.

I wasn’t comfortable with “eat, drink, and live your life“ if it meant setting myself up for pain, suffering, and early decline.

Live now, be sick later? No thanks.

Yes, life is meant to be lived—and lived well.But I want to reach the end of it upright, vibrant, and thriving. I don’t want to trade years now for illness later.

So I opted out of the ONE TREATMENT only plan and built a Management & Treatment protocol instead.

I researched and collected data. I hired a naturopath to help co-create a wellness protocol. I made lifestyle changes, created diet guidelines, and addressed mental stress (which can also impact iron overload). And I realize that this plan may not be the path others might choose, and that’s okay, it feels right for me.

My goal? Maintain normal iron levels consistently. Donate blood twice a year as maintenance and to give back. And inspire others to take control of their health, too.

The worst part about HH—aside from giving up martinis and red wine—is that this condition comes with so little information or recommended tools to empower you to determine the path your HH journey will take.

I want to help you keep that log jam at bay, keep your health in your control, and inspire you to consider your personal care outside of the medical box we’re all told to stay in by sharing my protocol and HH journey and my WTF moments.

Because …. Life is the practice,

Lisa