In the mid-nineteen-nineties, a young French geneticist and physician named Gerard Karsenty became curious about a mysterious protein, called osteocalcin, that is found at high concentrations in the skeleton. He worked with mice that had been engineered to lack the substance, expecting to find problems with their bones. But their skeletons appeared essentially normal, he says, a result that left him “deeply depressed.”

The mice did have issues, though. Their abdomens were fatty, they had trouble breeding, and they were “stupid,” meaning “they never rebelled or tried to bite or escape,” said Karsenty, now fifty-nine years old and the chair of the department of genetics and development at Columbia University Medical Center. He has studied osteocalcin for almost two decades. While its role within the skeleton remains unknown, he has shown that the substance has wide-ranging effects on mice’s fat stores, livers, muscles, pancreases, testes, and even, as new evidence suggests, their brains. It turns out that osteocalcin is a messenger, sent by bone to regulate crucial processes all over the body.

The finding represents new ground in how researchers view the skeleton: not only do bones provide structural support and serve as a repository for calcium and phosphate, they issue commands to far-flung cells. In mice at least, they talk directly to the brain. “This is a biggie,” said Eric Kandel, the neuroscientist and Nobel Laureate. “Who thinks of the bone as being an endocrine organ? You think of the adrenal gland, you think of the pituitary, you don’t think of bone.”

But Karsenty has long believed that our skeletons do a lot more than just give our bodies their shape. In 2007, he suggested that bones play a crucial role in regulating blood sugar: mice engineered to lack osteocalcin were essentially diabetic; they were less sensitive to insulin, and produced less of it. When he provided osteocalcin, however, their insulin sensitivity and blood sugar normalized. When Karsenty first presented these findings at a conference, endocrine experts were “overwhelmed by the potential implications,” as one of them told me at the time.

Similarly, Karsenty has raised provocative questions about the skeleton’s role in fertility. In 2011, he showed that bones play a crucial role in male reproduction: mice that did not produce osteocalcin had abnormally low levels of testosterone and were sterile. Mice that produced high levels, on the other hand, had more testosterone and bred more frequently. (The mechanism did not appear to be relevant to females.)

The most recent finding concerns the skeleton and the brain. In a paper published in late September in the journal Cell, Karsenty showed that bone plays a direct role in memory and mood. Mice whose skeletons did not produce osteocalcin as a result of genetic manipulation were anxious, depressed, and almost completely unable to master a test of spatial memory. When Karsenty infused them with the missing hormone, however, their moods improved and their performance on the memory test became nearly normal. He also found that, in pregnant mice, osteocalcin from the mother’s bones crossed the placenta and helped shape the development of the fetus’s brain. In other words, bones talk to neurons even before birth.

What might this chatter mean for human health? As we age, our bone mass decreases. Memory loss, anxiety, and depression also become more common. These may be separate, unfortunate facts about getting old, but they could also be related. “If you ask physicians the best things to do to prevent age-related memory loss, they’ll say exercise,” Kandel points out. Does exercise help partly because it works to maintain bones, which make osteocalcin, which in turn helps preserve memory and mood? (Karsenty speculates that a higher bone mass means a greater capacity for osteocalcin production, though this has yet to be established.) Even more fantastically: Would it ever be possible to protect memory or treat age-related cognitive decline with a skeletal hormone? These are the kinds of questions that can spur either false hopes or imaginative leaps.

Karsenty’s vision of the skeleton as central to energy usage, reproduction, and memory has persuasive evidence in mice. If one of these studies “had come in isolation, I think I would have more skepticism toward it,” Sundeep Khosla, of the Mayo Clinic, said. But they’re “part of a whole series showing that bone helps regulate other tissues, and the findings in mice are well done and compelling.” (Much of the earlier work has also been corroborated by other labs, also using mouse models.)

The question has always been the extent to which these results translate to people. “I don’t know of any hormone that functions in mice but not to some extent in humans,” Thomas Clemens, of Johns Hopkins, told me in 2011. Still, osteocalcin is clearly not the only substance that regulates blood sugar or male fertility or cognition, and its relative importance may be different in people. In mice, no other substance can compensate for a lack of osteocalcin when it comes to these functions, as Karsenty’s work shows. Is the same true in humans?

One tantalizing hint comes from men who are unable to respond to the hormone as a result of a genetic mutation. Karsenty has identified two such men, and they are both infertile and unable to regulate sugar normally—what the mouse models would predict. The real test, however, would be a clinical trial in which researchers identified patients with a genetic defect related to osteocalcin—or patients with low levels of osteocalcin, perhaps as a result of declining bone mass—and treated them with the hormone to see whether it reversed low fertility, poor memory, anxiety, or depression.

Karsenty also believes that we know enough now to recognize that the body is far more networked and interconnected than most people think. “No organ is an island,” he likes to say. And if X talks to Y, then Y should talk back to X. This insistence on reciprocity has animated much of his career, with the skeleton often playing a surprise role: insulin acts on bone, and bone should help regulate insulin. Testosterone has an influence on bone mass, and the skeleton should act on the testes. And just as the brain talks to the skeleton, he says, “I always knew that bone should help regulate the brain. I just didn’t know how.”

Photograph: Marcel van den Bergh/Hollandse Hoogte/Redux

Post by Amanda Schaffer is a frequent contributor to

Interview with Julia about her studies in India

LF: You seem really different since being in India over the last 12 years? What have you learned there?
JL: The Vedic teachings have taught me how to be at peace with myself in a steady, continuous way. I’ve sat with Swamiji Dayananda studying the sacred texts in a traditional setting. Within this teaching, I’ve come to know myself to be more than my body and my thoughts, that I am complete and wholly acceptable as I am.

LF: What is this Vedic teaching?
JL: This teaching is meant to help the student abide in composure. There is an effective way of thinking objectively and perceiving oneself. This is not a mere state or a passing experience. It is a vibrant awareness and a way of life. It is a matter of owning up to the fact that our intrinsic nature is free of everything unwanted. This understanding provides a firm basis from which to address any sense of stress, fear or inadequacy that may arise.

LF: What a profound teaching!
JL: The yoga practices I teach can facilitate physical, mental, emotional and spiritual integration. After a long and deep study I have been given status of a qualified teacher of this ancient, unbroken lineage. I am honored to share with you these teachings. This complete yoga is the blossoming of the whole person.

Can Meditation Help Pain After Surgery?

Patients who have back surgery, a procedure that can cause severe pain for weeks, may have a new relief option beyond narcotics: meditation.

In a study at Mount Sinai Hospital in New York City, a neurosurgeon has teamed up with a geriatrician who leads meditation classes to test whether the technique can lessen pain in spine-surgery patients and reduce the need for opioid painkillers, which can be highly addictive. The randomized trial trains patients in a simple form of meditation and asks them to practice it starting two weeks before their surgery and for six weeks after, using audiotapes to guide them.

Results of the study might not be available for at least a couple more years, as the researchers have so far signed up about half of the 50 participants they aim to recruit. Some of the patients who have tried meditation say it seems to make their pain more tolerable than they expected.
“We are not hoping to replace the need for pain medication,” says Patricia Bloom, a clinical associate professor of geriatrics at the Icahn School of Medicine at Mount Sinai. “We are trying to understand, can you help people’s pain to resolve faster and can you make their need for narcotics less,” says Dr. Bloom, a co-investigator on the project with colleague Arthur Jenkins, an associate professor of neurosurgery and orthopedic surgery.

Dr. Arthur Jenkins, of Mount Sinai Hospital in New York City, is conducting a clinical trial to see if meditation can help control the intense pain many patients suffer after spine surgery and reduce reliance on addictive narcotic pain medication. ENLARGE
Dr. Arthur Jenkins, of Mount Sinai Hospital in New York City, is conducting a clinical trial to see if meditation can help control the intense pain many patients suffer after spine surgery and reduce reliance on addictive narcotic pain medication. PHOTO: MATT KOZAR
David Langer, chairman of neurosurgery at Lenox Hill Hospital, in New York City, says meditation can help reduce anxiety and stress, which can make pain worse. Still, “I would be surprised if it had a large impact on post-operative pain,” in part because many patients will find it difficult to commit themselves to meditate regularly after major surgery, he says.

Meditation has previously been found to benefit patients with a host of medical and psychological issues. Studies have looked at whether it can help control hypertension, assist people suffering from heart disease or help relieve chronic pain, Dr. Bloom says. What makes the Mount Sinai study unusual is its focus on acute post-operative pain—the kind that typically requires opioid drugs to control, she says.

Dr. Jenkins says there has been growing pressure on doctors to reduce reliance on narcotic painkillers because of the dangers of addiction. He says he tried ways to reduce the use of drugs, including performing less-invasive surgeries with smaller incisions and shorter recovery times, but that isn’t always possible. Five years ago, Dr. Jenkins says he had an “epiphany” after reading a scientific study showing meditation could reduce physical pain.

Dr. Patricia Bloom, a geriatrician at Mount Sinai Hospital in New York City, also teaches meditation at the hospital. She is a co-investigator on the study looking at meditation and postsurgical pain in spine patients. ENLARGE
Dr. Patricia Bloom, a geriatrician at Mount Sinai Hospital in New York City, also teaches meditation at the hospital. She is a co-investigator on the study looking at meditation and postsurgical pain in spine patients. PHOTO: HARRISON BLOOM
The study, published in 2011 in the Journal of Neuroscience, involved 15 people who were subjected to pain using heated probes. The researchers used an MRI to scan the brains of the volunteers and found that pain intensity was 40% less when they practiced meditation than when they didn’t, says Fadel Zeidan, the study’s lead author and an assistant professor of neurobiology and anatomy at Wake Forest School of Medicine, in North Carolina.

“Wow, that is exactly what I am looking for,” Dr. Jenkins recalls thinking. He says that during his 15 years practicing spine and neurosurgery, he has become increasingly open to other healing options, such as working with chiropractors as a complement or alternative to surgery. “I have evolved to a more holistic approach,” he says.
Dr. Jenkins and Dr. Bloom set about designing a randomized trial to explore whether meditation could help with spine-surgery pain, which can last for six weeks or longer. When patients agree to participate, the researchers use a deck of cards—drawing either red or black—to decide who will practice meditation along with getting painkillers, and who will only get painkillers.

One patient, Clifford Glenn Gualano, 55 years old, had spine surgery several years ago that left him in “excruciating” pain. Ahead of another operation on Sept. 7, he says he was dutiful about listening to the audiotapes and trying to meditate, but was still very skeptical. “I am not a tree-hugger, and this is kind of how this strikes me,” says Mr. Gualano, a police officer in Spring Valley, N.Y. Still, Mr. Gualano was wary of narcotics and decided “to take a shot” at meditation. “If it works and you can sell me, you can sell anybody,” he says.

Since his operation, Mr. Gualano says the meditation exercises don’t reduce the “very severe pain” he has, but they help him relax. He had difficulty waiting the prescribed four hours between doses of hydromorphone, a narcotic. But if he meditated it helped him to hold out until the next dose.

Mr. Gualano recently moved to a rehabilitation facility, where he was given a second painkiller. He has been meditating some but hopes to do it regularly once he gets home. “If it starts hurting, and I need to take a pill, I will try the meditation first,” he says.

Dr. Fadel Zeidan, an assistant professor of neurobiology and anatomy at Wake Forest School of Medicine in North Carolina, has been studying meditation’s effects on pain. A 2011 paper he and his team published helped inspire the current study at Mount Sinai on postsurgical pain in spine patients. ENLARGE
Dr. Fadel Zeidan, an assistant professor of neurobiology and anatomy at Wake Forest School of Medicine in North Carolina, has been studying meditation’s effects on pain. A 2011 paper he and his team published helped inspire the current study at Mount Sinai on postsurgical pain in spine patients. PHOTO: COURTNEY ZEIDAN
Wake Forest’s Dr. Zeidan says it is possible certain forms of meditation can help with the pain from back or neck surgery. His team has published more research, including a 2015 study that found benefits from so-called mindfulness meditation. It “works by teaching you to regulate your response to pain,” Dr. Zeidan says. “People learn to accept the pain as opposed to trying to fight it.”

Mount Sinai’s exercises are a hybrid of mindfulness meditation and a type of mind training called Open Focus to help with relaxation and pain reduction, says Dr. Bloom. In one segment on stress reduction, Dr. Bloom, whose voice is heard on the tape, tells listeners to gently close their eyes and allow “your mind to relax and restore.” She instructs them to focus on different parts of their body and to concentrate on each breath they take.

In another segment devoted to pain, Dr. Bloom tells listeners to “turn your attention to the pain that you feel, seeing if it is possible to visualize the length, width and shape of your pain.” The message: Let “your pain be there, not holding on to it but not pushing it” away, either.

Dr. Bloom acknowledges the meditation techniques aren’t for everyone: “Some people would think it is too woo-woo.”

Barry Wollner agreed to give meditation a try ahead of his spine surgery last year. He found that he suffered minimal pain after the operation, which he attributes to the meditation. ENLARGE
Barry Wollner agreed to give meditation a try ahead of his spine surgery last year. He found that he suffered minimal pain after the operation, which he attributes to the meditation. PHOTO: RONNIE HOCHBERG
When Barry Wollner, 63, was scheduled for spine surgery last year, Dr. Jenkins’s team asked him if he believed in meditation. “I said that I don’t not believe in it, but I had never done it,” says Mr. Wollner, a retired housing official for the state of New York.

He diligently set about doing the exercises ahead of his surgery, as often as three times a day, he says. After the operation, he continued meditating and says he found the pain tolerable. He was prescribed oxycodone, a narcotic painkiller, but used very little. Staff at the hospital were surprised. “They would look at me and say, ‘You really didn’t take any?’ and I would say no,” he recalls. “It was the meditation.”

Write to Lucette Lagnado at

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Meta-Yoga– A way of life

Meta-yoga is a way of life in which one becomes alive to all realities. Swami Dayananda’s essential message was to expand awareness such that one’s essential experience of life is transformed forever.

Meta-yoga involves a method of expanding your awareness that shifts your relationship both to yourself and your world. Realities of life are defined in three categories: the absolute, objective and subjective. They are discussed in great detail in the Vedanta scriptures, i.e., the Bhagavad Gita and the Upanishads. Distinguishing and applying these realities forms a context for realizing what it means to live a fully satisfying life.

There is a time tested method to elevate yourself to a higher awareness, when you sharpen your observations, your life experiences are heightened. Meta-Yoga is a way of life that gives you clarity about how to obtain joy when it is otherwise hoped for but seems unobtainable.

This deepens your relationship with yourself whereby this ancient method of contemplation and meditation points to your own presence as a source of stability. As the observer you are the one present to everything– the world, your body, your breath, even your thoughts and emotions. As an observer, you are basically your own stable presence, not even your mind engaged in relationships, etc. How does this alter your awareness? You are the heart of heart behind your relationships with your world. Everything passes through your stable awareness, like clouds in the sky. As awareness you are the stable witness of your life. In meditation, your stable awareful presence is a profound and fulfilling topic to meditate upon. The mind can finally rest in the ground of your own present awareness.

The phrase “be present to what is” has deeper implications– the more self-aware, the more inner joy. The more you connect with your own awareness you find more tolerance for everything else. This gives a new level of trust in yourself and your perceptions. And when you see others perspective, it is with compassion for their humanity, not by losing yourself or resisting views of others. Simple transparency and acceptance about the human condition is so freeing.

With increased clarity it feels more normal to be with things as they are without reactions of anxiety, fear, anger, etc.A first step is truly noticing that you are centered in yourself without needing the world and your life to be different in any way. You are not your desires! You are the one who is present to them; you are the one who is aware of them. These are not mere empty words; this is a living experience that you can choose to own up to. You can become truly self-empowered person with the help of a knowing guide.

I invite you to be more at peace and centered in your self, your life and your relationships through Julia’s life coaching sessions and guided meditations. This ancient method of gaining clarity is practical at all levels of experience.


Let’s consider Three Principles of Living Free of Back Pain from a holistic mind-body perspective:

1) Center of balance

It may not be as easy to find your center of gravity as you may think.  When properly balanced, your pelvis is in alignment with your head and feet.  From a side view, the ankles, hips, and ears should all form one straight line.  Generally, it is possible to discover areas, poses, and series to retrain the body in order to find the center axis of alignment. When you’re aligned, there’s more balance and ease in your body, mind, and breathing.

2) Breathing  

Deep breathing is a learned skill and is one of the best strategies for calming and strengthening the mind and body.  Learning the habit of deep breathing is first done through awareness of breathing. The mind affects breathing more than we think.  When the mind is disturbed or restless, our breathing becomes shallow, irregular, and we lose our rhythm.  The exhalation breath is key to healing low back issues, because in a complete exhale breath, the core muscles are engaged. This not only increases strength and tone in the thoracic diaphragm, it also tones a lesser-known diaphragm – the pelvic diaphragm.

3) Strengthening deep core muscles

Strength in deep core muscles improves posture, balance, and breathing. As a result, one finds oneself more easily balanced in one’s center of gravity.  Deep core muscles, which include a tent of muscles around the torso, support the spine. Also, the pelvic floor muscles are considered to be key trunk stabilizers, and they are often left out.  Strengthening these muscles not only maintains center of balance, but also engages diaphragmatic breathing.One can bring visible and dynamic change to the targeted area. Core strength determines performance in one’s life activities and sports, and can have additional health benefits. Many daily activities (such as vacuuming the floor, for example) require us to maintain, as best we can, the function of bending and lifting.  For this, strong core muscles are required to protect and maintain stability in the spine and to prevent injury to the lower back.

There is a synergy between these 3 principles and they are considered to be keys to treating and preventing low back pain. One enhances the other and together they are key to adapting to the stresses and strains of life. In workshops presented by Julia Lorimer and Mitchell Kauk, PT OCS, RYT, each principle is addressed in terms of the mind and the body’s approach with the ultimate goal of having an integrated understanding.

This article on principles for living without back pain is co-written by Julia Lorimer and Mitchell Kauk, PT, OCS, RYT .

Julia Lorimer, e-RYT-500, Pain Relief Specialist teaches yoga workshops for addressing chronic pain. She co-teaches with Mitchell Kauk, PT, OCS, RYT yoga workshops– Living without Back Pain. She also offers Special Asana Series Workshops for exploring these and other principles further.