Can Alzheimer’s Disease Be Prevented? 14 Modifiable Risk Factors That May Reduce Dementia Risk

Can Alzheimer’s Disease Be Prevented? 14 Modifiable Risk Factors That May Reduce Dementia Risk

by | Jun 12, 2026 | Brain Health, Naturopathic Medicine, Prevention

Nearly Half of Dementia Risk May Be Modifiable—What I Share With Patients

When patients ask me about Alzheimer's disease, the question is often some version of:

"Is there anything I can actually do to prevent this?"

For many years, Alzheimer's disease was viewed largely through the lens of age and genetics. While those factors remain important, research over the past several decades has expanded our understanding of the lifestyle, health, and environmental factors that may influence cognitive decline.

According to the 2024 update from the Lancet Commission on Dementia Prevention, Intervention, and Care, approximately 45% of dementia cases worldwide may be attributable to modifiable risk factors across the lifespan.

That's a powerful statistic—but it's one I think is important to interpret thoughtfully.

Because this is not about eliminating risk or getting everything "right." It's about understanding how the environment your brain lives in over decades may influence its resilience and function as you age.

What "45% Modifiable Risk" Actually Means in Practice

This number comes from something called Population Attributable Fraction, which estimates how many cases of a condition might be reduced if certain risk factors were improved at a population level.

That's helpful from a public health perspective, but in practice, I'm looking at something slightly different:

How are these patterns showing up in the individual sitting in front of me?

Because this doesn't mean Alzheimer's disease is fully preventable, and it doesn't mean any one factor causes the disease. What it does mean is that there are meaningful ways to support brain health over time—and that those efforts are not insignificant.

The 14 Modifiable Risk Factors for Alzheimer's Disease and Dementia

The Lancet Commission organizes these risk factors across the lifespan, which is a helpful way to think about timing and opportunity.

Early Life and Cognitive Reserve

Lower levels of formal education are associated with increased dementia risk. This relates to cognitive reserve—the brain's ability to adapt and compensate over time.

While we can't go back and change early education, we can continue to build cognitive reserve through learning, engagement, and mental stimulation throughout life.

Midlife Risk Factors: Where I Often See the Greatest Opportunity

Midlife is often where I focus clinically because this is where many of the highest-impact, modifiable drivers emerge—particularly those tied to metabolic and vascular health.

These include:

  • Hearing loss
  • High blood pressure
  • Obesity
  • Traumatic brain injury
  • Excess alcohol use

In practice, this is often where I see patterns begin to cluster—changes in blood sugar regulation, shifts in weight, rising blood pressure, or early signs of sensory decline. These are rarely isolated issues and often influence one another.

Later Life Risk Factors

In later life, we're often seeing the cumulative effects of long-term patterns.

These include:

  • Smoking
  • Depression
  • Social isolation
  • Physical inactivity
  • Diabetes
  • Air pollution exposure
  • Vision impairment
  • High LDL cholesterol

At this stage, the goal is less about perfection and more about supporting function, quality of life, and continued engagement.

The Common Thread: The Brain Reflects the Whole System

What stands out to me clinically is how much these risk factors overlap in their underlying physiology.

Many of them converge on a few key themes:

  • Blood sugar regulation and insulin resistance
  • Vascular health and circulation to the brain
  • Chronic, low-grade inflammation
  • Sensory input through hearing and vision
  • Social and cognitive engagement

This is why I rarely think about brain health in isolation. In practice, we're often working on metabolic health, inflammation, cardiovascular function, sleep, and nervous system support—and the brain benefits as a result.

If you'd like to learn more about how I approach this in practice, you can learn more about my Well Aging & Senior Care services.

Alzheimer's Disease and Whole-Body Health

One reason these risk factors matter is that Alzheimer's disease is increasingly understood as a condition influenced by processes occurring throughout the body—not solely within the brain.

Many of the same factors that contribute to cardiovascular disease and metabolic dysfunction—including insulin resistance, vascular changes, chronic inflammation, and reduced physical activity—also appear to influence cognitive decline and dementia risk.

This is one reason I often focus on foundational aspects of health such as blood sugar regulation, cardiovascular health, sleep quality, physical activity, and inflammation. Supporting these systems benefits overall health and may also help support long-term brain health.

Why Hearing Loss is SO Important (and Often Overlooked)

One of the most surprising findings for many people is that hearing loss is consistently among the most significant modifiable risk factors for dementia.

In practice, this makes sense.

When hearing declines, the brain receives less input. Social interaction often decreases. The brain must work harder to interpret sound, increasing cognitive load.

Over time, this can contribute to withdrawal, fatigue, and reduced stimulation—all of which may influence cognitive health.

Addressing hearing changes early is one of the more straightforward—and often underutilized—interventions we have.

What This Looks Like in Practice

When I'm working with patients, I'm often looking at the broader patterns that influence brain health and healthy aging.

Instead, I'm looking at patterns such as:

  • Blood sugar variability or insulin resistance
  • Lipid patterns and cardiovascular risk
  • Inflammatory markers
  • Nutrient status
  • Sleep quality
  • Stress and nervous system load

Often, patients come in for concerns such as fatigue, weight changes, cardiovascular risk, or metabolic health challenges, and we begin addressing these patterns. Over time, we're also supporting many of the systems that influence how the brain ages.

What This Research Doesn't Fully Capture

The Lancet model provides one of the strongest evidence-based frameworks currently available for dementia prevention, but it doesn't address every factor that may influence cognitive health.

In practice, I may also consider areas such as:

  • Gut health and the microbiome
  • Environmental exposures, including mold and heavy metals
  • Mitochondrial function
  • Individual nutrient needs, including vitamin B12 and omega-3 fatty acids

Research in these areas continues to evolve. While they are not currently included among the established modifiable risk factors identified by the Lancet Commission, they may provide additional context in selected patients.

These considerations do not replace the foundational risk factors identified in the research—they simply add another layer of personalization.

A More Grounded Way to Think About Prevention

Rather than asking whether Alzheimer's disease can be prevented, I often guide patients toward a different question:

How can we support your brain's resilience over time?

Because the goal isn't perfect control—it's building capacity.

The capacity to adapt, repair, and maintain function even as the body changes.

Where I Typically Suggest Patients Start

For many people, this work becomes especially relevant in their 40s and 50s—when many of these patterns are still highly modifiable.

Foundational Areas to Support Brain Health

A few foundational areas I tend to focus on include:

  • Stabilizing blood sugar
  • Supporting cardiovascular health
  • Maintaining regular physical activity
  • Addressing hearing or vision changes
  • Supporting sleep and mood
  • Maintaining social connections

These are not quick fixes, but they are meaningful—and they add up over time.

Final Thoughts

The idea that nearly half of dementia risk may be modifiable is not a guarantee.

But it is an invitation.

An invitation to pay attention to the patterns that shape how the brain ages and to make steady, thoughtful changes that support long-term health.

Because in practice, it's rarely one big intervention that makes the difference.

It's what is done consistently, over time.

Concerned About Brain Health?

If you're concerned about cognitive decline, have a family history of dementia, or want to identify modifiable factors that may influence healthy aging, a comprehensive evaluation can help uncover opportunities to support long-term brain health before significant symptoms develop.

Learn more about my Well Aging & Senior Care services to explore a personalized approach to healthy aging, cognitive wellness, and long-term vitality.

References

  1. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet Commission. The Lancet. 2024.
  2. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. 2020;396(10248):413-446.
  3. Alzheimer's Research UK. Dementia risk factors and prevention resources.
  4. Alzheimer's Disease International. Global dementia reports and statistics.

Photo by David Matos on Unsplash 

About the Author

Dr. Sarah Giardenelli, ND, MSOM, LAc, is a naturopathic doctor and licensed acupuncturist in Leesburg, Virginia. She has a special interest in healthy aging, metabolic health, hormone balance, cognitive wellness, and chronic inflammatory conditions. Through her work at Collective Health Center, she helps patients identify modifiable factors that influence long-term health, resilience, and quality of life.

She combines naturopathic and East Asian medicine with evidence-informed care, focusing on personalized strategies that support healthy aging and long-term well-being.

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

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Perimenopause Isn’t a Problem to Fix—It’s a Phase to Support

Perimenopause Isn’t a Problem to Fix—It’s a Phase to Support

by | May 10, 2026 | Endocrine/Hormone Health, Naturopathic Medicine, Women's Health

We only just start to feel like we understand our bodies… and then things begin to shift again.

For many women, perimenopause doesn’t arrive all at once. It’s more of a slow awareness over time. A few subtle changes here and there—until one day it becomes clear that something is different.

I’ve felt this myself over the past few years.

For me, it’s shown up as changes in body composition—more weight around the midsection, more inflammation. There are clear hormonal waves now, where only part of the month feels like “myself.” Energy dips more noticeably before and during my cycle. And this past winter, the weight gain was more than I expected. Enough to pause and really take a closer look.

This isn’t surprising. I knew this phase was coming. But knowing and experiencing it are two very different things.

And what I see in my own body is exactly what I see in many of my patients.

This Isn’t Just Hormones

Hormones are shifting in perimenopause—that part is true.

But what often gets missed is that this isn’t just about hormones.

One of the biggest underlying shifts I see—both personally and clinically—is increasing insulin resistance.

Even in women who:

  • Eat well
  • Don’t consume much sugar
  • Have “normal” standard lab results

This is where a tool like the QUICKI score can be helpful. It looks at the relationship between glucose and insulin in a way that can reveal patterns not obvious on standard labs.

In my case, my glucose, insulin, and A1c look normal. But my QUICKI score—and the changes in my body—tell a different story.

There are also other factors at play. Some women, myself included, may have androgen patterns that aren’t always easy to track on standard labs, but can still influence metabolism and insulin sensitivity. Diet matters too—even healthy fats, in higher quantities, may not always work well in the setting of insulin resistance.

All of this is happening alongside shifting and declining hormone levels, which further impacts how the body handles blood sugar, energy, and fat storage.

What I See in Practice

In clinic, the patterns are consistent.

Women in their late 30s, 40s, and early 50s often come in saying:

  • “I don’t feel like myself anymore”
  • Sleep is more disrupted
  • Energy is less predictable
  • Mood feels different
  • Libido is lower or absent
  • Weight is harder to lose—despite doing “all the right things”

There are also changes in the menstrual cycle itself:

  • Shorter cycles
  • Irregular timing
  • Skipped ovulation
  • More noticeable hormonal fluctuations throughout the month

And one important clinical reality:

Hormone testing in this phase can be tricky.

Because levels are fluctuating so much, a single snapshot doesn’t always tell the full story. This is often why women are told their labs are “normal,” even when they don’t feel well.

Why This Feels So Frustrating

For many women, this phase feels confusing—not because they aren’t trying, but because what used to work… doesn’t work the same way anymore.

I also see a common pattern:
Years of calorie restriction, dieting, or pushing through fatigue.

Over time, this can make the body less metabolically flexible—and more resistant to change.

So when perimenopause begins, the margin for error gets smaller.

We all want this to be easy.
But for most women in this phase, it’s not.

Common Mistakes I See

A few patterns tend to make things harder:

  • Undereating or chronic calorie restriction
  • Over-exercising
  • Pushing through fatigue instead of responding to it
  • Assuming everything is fine because basic labs are “normal”

These approaches often come from a place of effort and sometimes desperation—but they can backfire in this phase.

What It Actually Looks Like to Support This Phase

If perimenopause isn’t a problem to fix, then what does support look like?

In my practice, it means shifting the focus toward:

  • Metabolic health, especially insulin sensitivity
  • Nourishment, rather than restriction
  • Balanced movement, not overtraining
  • Supporting stress physiology, instead of pushing through

This is not a one-size-fits-all process.

It’s highly personalized—based on symptoms, patterns, lab markers, and how someone is actually feeling in their body.

A Natural and Integrative Approach

There is a lot we can do to support this phase naturally:

  • Nutrition
  • Lifestyle shifts
  • Targeted supplementation

And at the same time, there is also room for an integrative approach.

In many cases, that’s the sweet spot.

This isn’t about choosing one path or another—it’s about finding what works best for each individual.

A Different Way to Look at Perimenopause

If you’re in this phase and things feel off, you’re not imagining it.

Your body is changing.
Your physiology is shifting.
And there are real reasons behind what you’re experiencing.

Your body isn’t broken.

It’s adapting—and it needs a different kind of support now than it did 10 or 15 years ago.

There is a way to navigate this phase with more clarity, more stability, and more support.

You don’t have to just push through it.

About the Author

I’m Dr. Sarah Giardenelli, a naturopathic doctor and acupuncturist at Collective Health Center. My work focuses on helping patients better understand what’s driving their symptoms—from metabolism and hormone balance to inflammation and nutrient status—so we can take a more personalized, root-cause approach to care.

If you’re navigating changes in your energy, hormones, or overall health and are looking for a more individualized plan, you’re welcome to learn more about working together or schedule a discovery call.

Photo by Myles Tan on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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When a Statin Is Recommended Before the Full Picture Is Clear: A More Personalized Approach to Heart Health

When a Statin Is Recommended Before the Full Picture Is Clear: A More Personalized Approach to Heart Health

by | Apr 5, 2026 | Cardiovascular Health, Naturopathic Medicine, Prevention

Understanding Statin Recommendations and Cardiovascular Risk

Every week, I speak with patients who are trying to make sense of a cardiovascular recommendation they’ve been given.

Sometimes they’ve already been started on a statin.
Sometimes they’ve been told they need one—but haven’t started yet.

And often, they’re left wondering:
“How serious is this really—and how did we get here?”

This is not a conversation about avoiding statins. They absolutely have a role, and in the right context, they can meaningfully reduce cardiovascular risk.

But it is a conversation about context, sequencing, and understanding cardiovascular risk more clearly before committing to a long-term plan.

Where Most Patients Actually Start

Most patients don’t come in with advanced imaging or a clearly defined baseline.

Instead, they come in with:

  • A standard lipid panel
  • A recommendation for a statin
  • Very little discussion of what may be driving their cardiovascular risk in the first place

Occasionally, someone has had imaging—most often a coronary artery calcium (CAC) score—and if that score is zero, they’re reassured that everything is fine.

But that’s not always the full picture.

A CAC score detects calcified plaque, which is generally more stable. What it does not detect is soft, non-calcified plaque, which is often more metabolically active and more closely associated with acute cardiovascular events.

This is one of the reasons why a CAC score of zero does not necessarily mean zero risk—particularly in younger patients and in women.

Why Cardiovascular Risk Calculators Don’t Tell the Whole Story

Most commonly used cardiovascular risk calculators in primary care are based on population-level data—using factors like age, cholesterol, blood pressure, and smoking status to estimate risk over time.

While helpful, these tools don’t account for more individualized factors such as ApoB, lipoprotein(a), metabolic health, or direct visualization of plaque.

As a result, decisions are often made based on statistical estimates rather than a more complete picture of an individual’s actual cardiovascular health.

A Shift Toward Personalized Cardiovascular Risk Assessment

One of the most meaningful shifts happening in cardiovascular care is a move toward more personalized and precise risk assessment.

Newer tools, such as AI-assisted coronary CT analysis (like Cleerly), allow us to go beyond simply identifying whether plaque is present. These technologies can help characterize:

  • The type of plaque (calcified vs non-calcified)
  • The total plaque burden
  • How plaque changes over time

This allows for a much more individualized understanding of cardiovascular disease—and a way to track whether interventions are actually improving risk.

Lipids: More Than Just LDL Cholesterol

Traditional cholesterol panels are helpful, but they don’t always tell the full story.

Markers such as:

ApoB (Apolipoprotein B)

Lipoprotein(a)

are increasingly recognized as more accurate indicators of cardiovascular risk.

ApoB reflects the number of atherogenic particles—particles capable of promoting plaque formation within the arteries. This often provides a clearer picture of risk than LDL cholesterol alone, especially in patients with insulin resistance.

Lipoprotein(a) is largely genetically determined and can significantly influence baseline cardiovascular risk, regardless of lifestyle.

Lifestyle and Cardiovascular Risk Reduction

One of the most important—and often overlooked—truths in cardiovascular care is that lifestyle interventions are foundational, not optional.

Research consistently demonstrates meaningful impact:

Given how strongly insulin resistance contributes to atherosclerosis, these changes are not secondary—they are central to long-term cardiovascular health.

The Statin Conversation: A More Balanced Perspective

Statins have been shown in many studies to reduce cardiovascular risk—often cited in the range of 20–30% relative risk reduction—though the degree of benefit varies depending on the individual and their baseline risk.

They can also play a role in stabilizing plaque.

But like any medication, they are not without potential side effects.

Some patients experience:

  • Muscle symptoms
  • Fatigue
  • Changes in blood sugar
  • Neurologic symptoms

One of the more challenging patterns I see is when multiple medications are started at the same time—often a statin alongside something like thyroid support. When new symptoms arise, it becomes difficult to determine what is helping and what may not be tolerated.

When “Worse” Imaging May Not Be Worse

One important concept that is rarely explained to patients:

Interventions that improve cardiovascular risk—whether pharmacologic or lifestyle-based—can sometimes make imaging appear “worse” in the short term.

Statins, for example, are known to:

  • Reduce softer, more vulnerable plaque
  • Promote a shift toward more calcified, stable plaque

This can lead to an increase in coronary artery calcium score over time, even as overall cardiovascular risk is improving.

In other words:
An increase in calcification is not always a sign of disease progression—it may reflect plaque stabilization.

Why Sequencing Matters in Cardiovascular Care

In many cases, a more thoughtful approach to cardiovascular prevention might include:

  • Establishing a baseline
  • Addressing underlying contributors (such as metabolic health or thyroid function)
  • Implementing targeted lifestyle changes
  • Then layering in medication if needed

This allows for better clarity, improved tolerance, and more sustainable long-term outcomes.

Why Time Horizon Matters in Heart Health Decisions

One of the biggest drivers of anxiety is the sense that something must be done immediately.

But cardiovascular disease develops over years to decades.

In many cases, taking time to:

  • Understand your risk
  • Evaluate your response to treatment
  • Make a more informed decision

does not meaningfully change short-term risk—but can significantly improve long-term outcomes.

A More Personalized Approach to Heart Health

This is not about rejecting conventional care.
It’s about expanding the conversation.

It’s about:

  • Using better tools
  • Asking better questions
  • Creating a plan that is both evidence-based and individualized

The goal is not to choose between lifestyle and medication.
It is to understand how they work together—and when each is most appropriate.

The Takeaway

If you’ve been told you need a statin:

  • Take it seriously—but don’t panic
  • Ask what your true cardiovascular risk over time actually is
  • Understand that not all plaque is the same
  • Know that lifestyle changes have measurable impact
  • And if something doesn’t feel right, it’s okay to ask questions

The best preventative care is not rushed.
It is thoughtful, informed, and personalized.

About the Author

Dr. Sarah Giardenelli is a naturopathic doctor and acupuncturist at Collective Health Center in Leesburg, VA. She focuses on a personalized, root-cause approach to care—helping patients better understand their health, interpret lab results in context, and make thoughtful, individualized decisions around prevention and approach to care. Her work often includes advanced cardiovascular risk assessment, metabolic health support, and integrative care for complex conditions.

Photo by Sasun Bughdaryan on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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Chronic Allergic Inflammation, Heart Disease, and a New Path to Lasting Relief with SAAT

Chronic Allergic Inflammation, Heart Disease, and a New Path to Lasting Relief with SAAT

by | Feb 27, 2026 | Acupuncture, Cardiovascular Health, Chinese Medicine, Immune Health, Naturopathic Medicine, Prevention

Chronic Allergic Inflammation May Affect More Than Seasonal Symptoms

Most people associate allergies with sneezing, congestion, and itchy eyes — not heart disease. However, research increasingly shows that chronic allergic inflammation can extend far beyond the sinuses.

Persistent conditions such as allergic rhinitis and asthma correlate with higher rates of coronary heart disease and cardiovascular events. Research highlighted by Downstate Medical Center  identifies a meaningful connection between allergic immune activation and long-term cardiovascular risk.

In long-term population studies, individuals reporting allergic rhinitis showed approximately a 25% higher likelihood of coronary heart disease. Those with asthma demonstrated even greater associations, particularly following recent exacerbations. Rather than viewing allergies and cardiovascular disease as separate issues, researchers now recognize chronic immune activation as a shared inflammatory driver.

How Chronic Allergic Inflammation Impacts the Cardiovascular System

At its core, an allergic reaction activates the immune system.

When the body encounters pollen, pet dander, or certain foods, immune cells release histamine and inflammatory cytokines. These signaling molecules trigger congestion, itching, swelling, and airway reactivity.

Yet this response does not always remain localized.

Over time, repeated immune activation elevates systemic inflammatory markers. Chronic inflammation contributes directly to vascular stress, endothelial dysfunction, and plaque development. The American Heart Association identifies inflammation as a key factor in atherosclerosis and coronary artery disease progression.

As a result, unmanaged allergic triggers may add to overall inflammatory burden — not just seasonal discomfort.

Why Symptom Suppression Alone Falls Short

Conventional allergy treatment typically focuses on three strategies:

  • Blocking histamine with antihistamines

  • Reducing localized inflammation with steroid sprays or inhalers

  • Avoiding triggers

These tools can provide relief, especially during acute flares. However, they address the downstream reaction rather than the upstream immune misidentification.

In other words, they reduce symptoms without retraining the immune system.

For individuals who experience recurring or worsening allergies year after year, this distinction matters. Long-term immune regulation requires a different strategy.

Where Allergy Immunotherapy Fits Into the Picture

Allergy immunotherapy — commonly delivered through shots or sublingual drops — works by gradually desensitizing the immune system through repeated allergen exposure.

For many patients, this method proves effective. However, immunotherapy typically requires months to years of structured treatment, regular office visits, and ongoing dose adjustments.

Because of this time commitment, not every patient finds it practical.

Soliman Auricular Allergy Treatment (SAAT) offers a different model. Instead of repeated allergen exposure, SAAT uses precise auricular stimulation to influence nervous-system-mediated immune regulation.

Rather than escalating exposure, SAAT encourages recalibration.

Importantly, SAAT does not replace emergency asthma care or cardiovascular management. Instead, it serves as a complementary option for individuals seeking a lower-frequency, minimally invasive immune-modulating approach.

Soliman Auricular Allergy Treatment (SAAT): A Targeted Immune Recalibration Strategy

At Collective Health Center I use Soliman Auricular Allergy Treatment (SAAT) to support patients with chronic allergic inflammation.

SAAT leverages the dense neurovascular network of the ear, which reflects whole-body physiology. By stimulating specific auricular points that correspond to identified allergens, the treatment signals the nervous system to reduce immune overreaction.

A tiny semi-permanent needle remains in place for several weeks. During that time, gentle continuous stimulation supports immune recalibration without daily medications or repeated office visits.

Many patients report substantial and lasting reductions in allergic reactivity — sometimes after a single targeted session.

How SAAT Works in Practice

  1. We identify specific allergens through detailed intake and clinical assessment.
  2. I locate precise auricular points corresponding to each trigger.
  3. I place a tiny semi-permanent needle to encourage immune recalibration.
  4. The patient continues normal daily activities while the stimulation works gradually over several weeks.

SAAT remains minimally invasive and drug-free. Clinicians have used it to address environmental allergies, food sensitivities, histamine intolerance, Alpha-Gal syndrome, and mast cell activation patterns.

Allergic Inflammation and Long-Term Health

When allergic inflammation persists year after year, it elevates systemic stress. Over time, that inflammatory load can influence vascular health and metabolic resilience.

Therefore, addressing allergic triggers may support more than symptom relief. It may reduce cumulative inflammatory burden.

By shifting from suppression to immune recalibration, patients often experience a meaningful change: instead of managing reactions indefinitely, they reduce the reactivity itself.

Learn More About SAAT and Immune Regulation

If persistent allergies, sensitivities, or inflammatory symptoms affect your quality of life, a targeted immune-regulation strategy may offer a new path forward.

Dr. Sarah Giardenelli, ND, LAc, works with individuals seeking a root-focused approach to immune imbalance. At Collective Health Center, care prioritizes long-term immune regulation rather than temporary symptom control.

To learn more about Soliman Auricular Allergy Treatment (SAAT):
https://www.collectivehealthcenter.com/services/soliman-auricular-allergy-treatment-saat/

To explore integrative naturopathic and acupuncture services:
https://www.collectivehealthcenter.com

Photo by Kier in Sight via Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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The Year of the Horse: Moving Forward Without Burning Out

The Year of the Horse: Moving Forward Without Burning Out

by | Feb 5, 2026 | Acupuncture, Chinese Medicine, Herbal Medicine, Naturopathic Medicine, Prevention, Stress Management

A Chinese Medicine Perspective on Vitality, Stress, and Balance

As we approach the Lunar New Year and enter the Year of the Horse on February 17, 2026, I notice a familiar theme emerging in my practice and conversations: a strong desire to move forward, regain momentum, and do more. At the same time, many people feel conflicted—mentally motivated, yet physically tired or strained.

In Traditional Chinese Medicine (TCM), the Lunar New Year isn’t simply a calendar change. It marks a shift in energetic rhythm, much like a seasonal transition. Each year carries a particular tone, and the Horse is associated with movement, circulation, and Fire energy. At its best, this energy supports vitality, clarity, and engagement with life. At its worst, it can amplify stress, inflammation, anxiety, and burnout. In my clinical work, I often see both sides show up simultaneously.

The Horse in Traditional Chinese Medicine (TCM)

From a TCM perspective, the Horse corresponds primarily to the Fire element, which governs the Heart, the nervous system, and the Shen (mind/spirit). Fire energy is responsible for circulation—of blood, Qi, and emotion—as well as connection, presence, and joy.

When Fire is balanced, people often feel motivated yet grounded, emotionally connected without feeling overwhelmed, and resilient under stress. When Fire is out of balance, symptoms tend to emerge. These can include anxiety, restlessness, insomnia, racing thoughts, chronic inflammation, pain flares, or the familiar feeling of being “wired but exhausted.” I often find that people today are not lacking Fire; instead, they lack the containment, recovery, and rhythm needed to keep that energy regulated.

Why the Year of the Horse Can Feel Both Energizing and Exhausting

The Horse amplifies motion. When the body has adequate reserves, this forward energy can feel invigorating. When reserves are depleted, that same motion can strain the nervous system. Clinically, I see this show up as neck and shoulder tension, headaches, jaw tension, digestive symptoms tied to stress, pain flares during emotional or work pressure, and sleep that feels unrefreshing despite exhaustion.

From a Eastern medicine lens, the Year of the Horse isn’t asking us to stop moving. It’s asking us to move more wisely, with greater attention to pacing, recovery, and support.

How Acupuncture and Eastern Herbal Medicine Support Horse Energy

In East Asian medicine, the goal during Fire-dominant periods isn’t to suppress energy but to regulate and anchor it. This is where acupuncture and Eastern herbal medicine can be especially supportive.

Acupuncture for Nervous System Regulation and Pain

In my practice, I use acupuncture to help calm excess nervous system activation, improve circulation without overstimulation, reduce pain signaling, ease muscle guarding, and support sleep and emotional regulation. Unlike forceful or one-size-fits-all interventions, acupuncture is responsive. Treatments are adjusted session by session based on how the body responds, which makes this approach particularly appropriate for people who feel sensitive, inflamed, or easily aggravated.

Eastern Herbal Medicine for Balance and Recovery

Eastern herbal medicine isn’t about indiscriminately boosting energy. Carefully selected formulas are used to calm excess Fire, reduce inflammation, support recovery reserves, and help the nervous system adapt to stress more effectively. In clinical practice, herbs are used thoughtfully and conservatively, especially for people already dealing with chronic pain, fatigue, or anxiety.

Living Well in the Year of the Horse

Working with Horse energy doesn’t require dramatic lifestyle changes. In fact, I often find that small, consistent shifts are far more effective than extremes. From both a Chinese medicine and naturopathic perspective, a few themes become especially important during Fire-dominant periods.

Consistency matters more than intensity. Regular, moderate movement supports circulation without exhausting reserves. Sleep becomes foundational medicine, helping contain Fire energy rather than letting it run unchecked. Paying attention to where momentum turns into strain is essential, as pain and fatigue are often signals rather than obstacles to push through. Finally, choosing joy that restores rather than overstimulates helps support the Heart and nervous system in a sustainable way.

These principles closely overlap with what I consider foundations of health in my naturopathic work: adequate sleep, nervous system regulation, steady nourishment, appropriate movement, and time for recovery. When these foundations are weak, Fire energy often flares as pain, anxiety, inflammation, or exhaustion. When they’re supported, the body tends to be far more resilient.

Celebrating Lunar New Year in the DC Area

Lunar New Year is traditionally a time to clear stagnation, set intentions, and gather in community. Even if this tradition is new to you, participating in local events can be a meaningful way to mark the seasonal shift and embody a rhythm of reflection and renewal.

DC Chinese Lunar New Year Parade (2026)

The DC Chinese Lunar New Year Parade is a vibrant annual celebration in downtown Washington, DC, featuring music, dance, and cultural processionals. It’s a joyful way to experience the collective energy of the new year and mark the beginning of a new cycle.

Lunar New Year Tea Tasting at Seven Tea House

Tea rituals are deeply aligned with Chinese medicine principles. A tea tasting at Seven Tea House offers an opportunity to slow down, support digestion, and ground Fire energy through warmth and presence. This type of ritual can be a beautiful complement to the reflective nature of the Lunar New Year.

A Closing Reflection for the Year Ahead

The Year of the Horse invites movement, but not at the expense of health. From a Chinese medicine perspective, true vitality isn’t about speed. It’s about circulation with containment, momentum with recovery, and action that’s sustainable. If pain, stress, fatigue, or nervous system overwhelm have been louder than your capacity to cope, this season can be an opportunity to reassess patterns and support the body more intentionally. Often, the most meaningful shift isn’t doing more—it’s learning how to move differently.

About the Author

Dr. Sarah Giardenelli is a naturopathic doctor and licensed acupuncturist in Northern Virginia. Her work integrates Traditional Chinese Medicine, acupuncture, Eastern herbal medicine, and naturopathic principles, with a clinical focus on nervous system regulation, chronic pain, stress-related conditions, and long-term resilience. She is particularly interested in helping patients understand how seasonal and energetic patterns interact with the foundations of health, and how small, consistent changes can create meaningful shifts over time. Through individualized, thoughtful care, Dr. Giardenelli supports patients in moving forward with greater balance, sustainability, and intention rather than pushing through symptoms.

Photo by Andrey Soldatov on Unsplash

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