Whether you have kids going back to school or not—tell me you don't feel it. That unmistakable shift at the end of August when the calendar suddenly gets serious. The easy, unstructured pace of summer starts to compress. Something in your body already knows: routine is coming back.
August is Immunization, Back to School, and Wellness Check Month. And while most of my patients are adults who left the school calendar behind years ago, every single one of us feels this seasonal pulse. It is one of the most reliable motivators I see in the clinic—people come in at the end of summer wanting to reset, check in on their health, and get ahead of whatever fall is about to bring.
So, let's do exactly that. Here is the wellness check I'd give every adult walking through my door in August.
The Vaccine Nobody Thinks to Ask About—and Why That's About to Change
We do not talk about immunizations much in the longevity space, because most adult vaccines are a one-and-done conversation. But Shingrix is different. The data coming out on this vaccine has shifted from "interesting" to genuinely compelling—and I want every patient over 50 to know about it.
Shingles and the Brain Connection
Shingles is caused by the reactivation of the varicella-zoster virus (VZV)—the same virus that causes chickenpox. If you had chickenpox as a child, the virus never left your body. It went dormant in nerve tissue and can reactivate decades later, particularly as immune function declines with age. Most people know shingles as a painful rash. What most people do not know is what that virus does to the nervous system—and what it appears to do to dementia risk.
The varicella-zoster virus, when reactivated, triggers neuroinflammation. It has been found in the brain tissue of Alzheimer's patients at elevated rates. Multiple research groups have now proposed that recurrent low-level viral reactivation—even subclinical reactivation that never produces a visible rash—may contribute to the inflammatory cascade that drives cognitive decline.
What the Research Shows
A landmark 2025 study published in Nature[1], covering over 280,000 adults in Wales, found that individuals vaccinated against shingles had a 20% lower risk of developing dementia over seven years compared to unvaccinated individuals. The protective effect was even stronger in women.
A 2024 study published in Nature Medicine[2] used data from the US electronic health record database TriNetX—roughly 100,000 patients in each matched group—and found that Shingrix specifically was associated with a significantly lower risk of dementia than the older live vaccine, and a substantially lower risk than no vaccination at all.
GSK—the manufacturer of Shingrix—presented its Epi-Z-103 study[3] at the Alzheimer's Association International Conference in 2025. It followed over 65,000 adults vaccinated with two doses and found a 51% reduction in dementia risk compared to unvaccinated individuals, and a 27% lower risk compared to those who had received a Tdap vaccine instead—suggesting the effect is specific to the shingles vaccine, not a general healthy-user bias. Worth knowing that this one comes from the manufacturer, and was presented at a conference rather than published.
A June 2026 study from Brown University[4], analyzing Medicare data from over 500,000 adults who had been in skilled nursing facilities, found a 24% lower risk of dementia diagnosis over four years in those who received Shingrix.
The proposed mechanisms include: prevention of neuroinflammatory cascades triggered by VZV reactivation, reduction in vascular inflammation (shingles vaccination has also been linked to lower rates of stroke and heart attack), and possibly direct protection of neural tissue from viral injury.
The Bottom Line for Our Patients
Vaccination has become a deeply personal topic, and I respect that entirely. What I ask is that you evaluate Shingrix on its own merits—separate from the conversations that have eroded trust in recent years. This is not a new vaccine. It has been in widespread use since 2017, the mechanism is well understood, and much of the dementia research behind it is independent, peer-reviewed science. The CDC recommendation is two doses starting at age 50—but more than a recommendation, it is the data that I find compelling.
This is one of the better-supported options we have for reducing dementia risk, and it is two doses. I think that is worth a conversation.
I do not administer Shingrix in my practice and this is not a vaccine clinic, but I do offer consultations to review your overall dementia-prevention strategy and to help you understand how this emerging data might fit into your broader risk-reduction plan. Shingrix is widely available through pharmacies and primary care offices without a separate prescription, so any decision to receive the vaccine should be made between you and the clinician administering it.
If you are 50 or older and have not had Shingrix, it may be worth discussing the potential benefits and risks with your pharmacist or primary care provider, and we are happy to help you prepare for that conversation as part of a comprehensive brain-health visit.
Your Internal Clock Took a Summer Vacation—Here's How to Bring It Back
Most of us know what it feels like when our rhythm is off. Difficulty falling asleep. Waking at 3 am. Craving food at strange hours. Feeling flat and unrested even after a full night. That is not weakness—that is circadian disruption, and summer is one of the most reliable causes of it.
Later sunsets push bedtimes back. Travel crosses time zones. Irregular schedules dissolve meal timing. Vacation mode is wonderful—but the body's internal clock does not take vacation with you. And when it gets thrown off, the downstream effects are more significant than most people realize.
What Circadian Science Actually Tells Us
Circadian rhythms are 24-hour biological cycles that govern virtually every physiological process in the body: sleep, wakefulness, metabolism, immune function, hormone secretion, blood pressure, even DNA repair. Every cell in your body contains a molecular clock. When these clocks fall out of alignment with each other—or with the light-dark cycle—the consequences show up across multiple systems simultaneously.
A 2026 review in Nature Reviews Genetics[5] traces how deeply circadian genetics run through human health and disease. The picture that has emerged is not one master clock but a network of them—nearly every tissue keeps its own time, which is why disruption does not stay in one lane. Chronic misalignment has been linked to increased cardiovascular risk, metabolic dysfunction, impaired immune response, accelerated cellular aging, mood disorders, and worsening inflammatory markers.
The good news is that circadian rhythms are responsive. The clock can be reset—and August, with its natural push back toward structure, is an ideal time to do it intentionally.
A Practical Reset Protocol
- Anchor your wake time. Consistency in when you wake—even on weekends—is the single most powerful signal you can give your circadian system. Bedtime variability matters less than wake-time consistency.
- Get morning light within 30 minutes of waking. Natural bright light in the first hour of the day is the strongest external signal available to reset the clock. Even five to ten minutes outside without sunglasses—not staring at the sun, just in natural light—makes a meaningful difference.
- Time your meals. Chrononutrition research shows that eating within a consistent window, and finishing your last meal at least three hours before sleep, substantially improves metabolic and circadian alignment. Late-night eating is one of the most disruptive patterns for the internal clock.
- Dim blue-spectrum light after 9 pm. Blue light from screens suppresses melatonin secretion and delays the onset of the circadian sleep phase. Blue-light glasses, screen filters, or simply putting devices down are all effective.
- Move at a consistent time. Exercise is a potent secondary zeitgeber—a time-cue that helps synchronize peripheral clocks throughout the body. Morning or early afternoon exercise tends to support circadian alignment most effectively.
If you are on hormone therapy, the circadian connection is even more direct: cortisol, melatonin, thyroid hormone, estrogen, and testosterone all follow circadian release patterns. When the clock is disrupted, hormone optimization becomes harder to achieve and harder to sustain. This is one reason we look at sleep quality and lifestyle rhythms as part of every hormone conversation.
The Wellness Check Most Adults Have Never Actually Had
August is Wellness Check Month, and I want to be direct about what that means in a functional medicine context—because it is very different from what most people have experienced.
A conventional annual physical typically checks blood pressure, basic metabolic panel, maybe a lipid panel, and a CBC. That is a useful baseline. But it does not tell you much about how you are aging, where your metabolism actually stands, what your inflammation burden looks like, whether your hormones are in an optimal range—or even an adequate one—or whether your nutrient levels are supporting your cellular repair processes.
A comprehensive adult wellness evaluation at TREVI includes:
- Full hormone panel: testosterone (total and free), estradiol, progesterone, DHEA-S, SHBG, thyroid (TSH, free T3, free T4, reverse T3), cortisol
- Metabolic assessment: fasting glucose, insulin, HbA1c, lipid particle size and count (not just total cholesterol), homocysteine
- Inflammatory markers: high-sensitivity CRP, ferritin
- Micronutrient levels: vitamin D, B12, magnesium, zinc, omega-3 index
- Body composition analysis: muscle mass, fat mass, visceral fat, and metabolic rate—not just weight on a scale
What we find when we actually look is almost always informative. Vitamin D deficiency even in summer. Testosterone in the "normal" range that is nonetheless optimal for no one. Insulin resistance brewing years before diabetes appears. Inflammation running silently in the background. These are the patterns that accelerate aging, increase disease risk, and make people feel off—and they are almost all addressable.
The back-to-school feeling is your body giving you a nudge. Use it. If it has been more than a year since comprehensive labs, this is the right time.
The Check-In That Actually Matters
Back to school does not mean what it used to for most of us. But the seasonal rhythm is real, and it is worth using. Your body responds to the same cues the calendar does—and August is one of the best natural windows to reset, check in, and prepare.
The Shingrix vaccine takes 20 minutes. A circadian reset takes about two weeks of consistency. A comprehensive wellness evaluation gives you a clear picture of where you actually stand. None of these are difficult. They are just deliberate.
That is what we do here.
Dr. Josie
References
- Eyting M, Xie M, Michalik F, Heß S, Chung S, Geldsetzer P. A natural experiment on the effect of herpes zoster vaccination on dementia. Nature, 2025;641:438–446. nature.com
- Taquet M, Dercon Q, Todd JA, Harrison PJ. The recombinant shingles vaccine is associated with lower risk of dementia. Nature Medicine, 2024. nature.com
- GSK. Epi-Z-103 data presented at AAIC 2025 — 51% reduction in dementia risk with 2-dose RZV (manufacturer-sponsored, presented at conference). gsk.com
- Dementia Risk After Recombinant Herpes Zoster Vaccination in Older Adults With a Recent Skilled-Nursing Facility Stay: A Target Trial Emulation. Annals of Internal Medicine, 2026. brown.edu summary
- Time matters: circadian genetics and the molecular logic of human health and disease. Nature Reviews Genetics, 2026. doi.org
