Episode 262: Linguistics, ADHD Stimulants, Medication, CGM, Prediabetes, Berberine, Metabolism, Stress Related Weight Gain, Birth Control, And More!

Intermittent Fasting


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Apr 24

Welcome to Episode 262 of The Intermittent Fasting Podcast, hosted by Melanie Avalon, author of What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine and Gin Stephens, author of Delay, Don't Deny: Living An Intermittent Fasting Lifestyle

Today's episode of The Intermittent Fasting Podcast is brought to you by:

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BEAUTYCOUNTER: Keep Your Fast Clean Inside And Out With Safe Skincare! Shop With Us At MelanieAvalon.com/beautycounter, And Something Magical Might Happen After Your First Order! Find Your Perfect Beautycounter Products With Melanie's Quiz: melanieavalon.com/beautycounterquiz
Join Melanie's Facebook Group Clean Beauty And Safe Skincare With Melanie Avalon To Discuss And Learn About All The Things Clean Beauty, Beautycounter And Safe Skincare!

Listener Q&A: Sarah - The way you say words

How Y’all, Youse and You Guys Talk

BLUBlox: Go To blublox.com And Use The Code ifpodcast For 15% Off!

Listener Q&A: Rebecca - ADHD meds and elevated blood glucose levels

Methylphenidate has mild hyperglycemic and hypokalemia effects and increases leukocyte and neutrophil counts

The Melanie Avalon Biohacking Podcast Episode #128 - Dr. Michael Platt

Adrenaline Dominance: A Revolutionary Approach To Wellness

The Melanie Avalon Biohacking Podcast Episode #48 - Dr. Daniel Amen

FEAL: Go To feals.com/ifpodcast To Become A Member And Get 50% Off Your First Order, With Free Shipping!

Listener Q&A: Kristi - Weight Gain


Listener Q&A: Rosie - Those little pills

White Birch Professional Teeth Whitening Serum - Activated White Charcoal


Melanie Avalon: Welcome to Episode 262 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my cohost, Gin Stephens, author of Fast. Feast. Repeat.: The Comprehensive Guide to Delay, Don't Deny Intermittent Fasting. For more on us, check out ifpodcast.com, melanieavalon.com, and ginstephens.com. Please remember, the thoughts and opinions on this podcast do not constitute medical advice or treatment. So, pour yourself a cup of black coffee, a mug of tea, or even a glass of wine if it's that time, and get ready for The Intermittent Fasting Podcast.

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And one more thing before you jump in. Are you fasting clean inside and out? Did you know that one of our largest exposures to toxic compounds, including endocrine disrupters, which mess with our hormones, obesogens, which literally cause our body to store and gain weight, as well as carcinogens linked to cancer is actually through our skincare? Europe has banned thousands of these compounds for being toxic and the US has only banned around 10. It's honestly shocking. When you're putting on your conventional skincare makeup, you're likely putting toxic compounds directly into your body. These compounds can make you feel bad, can make it really hard to lose weight, can affect your hormones, your mood, your health. And ladies, if you're thinking of having kids, when you have a child, these compounds actually go directly through the placenta into the newborn. That means your skincare makeup that you're putting on today actually affects the health of future generations. 

Did you know that conventional lipstick, for example often tests high for lead and the half-life of lead can be up to 30 years in your bones? That means when you put on your lipstick, 30 years later, half of that lead might still be in your body. Thankfully, there's an easy, easy solution to this. There's a company called Beautycounter and they were founded on a mission to change this. Every single ingredient and their products is extensively tested to be safe for your skin. You can actually feel good about what you put on. And on top of that, their products actually work. That's because they're not “all natural.” They actually combine the best of both worlds, both synthetic and natural ingredients to create products that actually support the health of your skin and make your skin look amazing. They have skincare lines for all your skin types, deodorant, shampoo and conditioner that I love, anti-aging and brightening peels, and vitamin C serums, and incredible makeup. If you see my makeup on Instagram, that's all Beautycounter. You can shop with us at melanieavalon.com/beautycounter. 

And if you're thinking of making safe skincare a part of your future like we have, we definitely suggest becoming a Band of Beauty member. It's sort of like the Amazon Prime for clean beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership, totally, completely worth it. Also, definitely join my clean beauty email list at melanieavalon.com/cleanbeauty, I give away a lot of free things on that list and join me on my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. I do a weekly giveaway every single week for Beautycounter, people share their experience and product reviews, and so much more. And again, the link to shop with us is melanieavalon.com/beautycounter. All right, now, enjoy the show.

Melanie Avalon: Hi, everybody and welcome. This is Episode number 262 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Gin Stephens.

Gin Stephens: Hi, everybody.

Melanie Avalon: How are you today, Gin?

Gin Stephens: I'm doing great. It is a beautiful day and I'm loving it.

Melanie Avalon: I haven't been outside yet.

Gin Stephens: Oh, [laughs] It's sunny, and warm, and just the perfect spring day. So, it made me so happy to be out there. If you can walk barefoot outside on the driveway, that's my happiness.

Melanie Avalon: Oh, yeah. I'm getting flashbacks to childhood. Yes. Do you put a wreath on your door?

Gin Stephens: Only at Christmas. 

Melanie Avalon: Okay. I have discovered the wonderful world of wreaths on Etsy. 

Gin Stephens: Oh, that's fine. 

Melanie Avalon: Do you ever shop on Etsy? 

Gin Stephens: Sometimes, when I need a special pillow, for example. I found this fabric that I loved and I had the name of it. I went to Etsy and sure enough, there was someone selling pillows made out of that fabric for a lot less than I could hire someone to make them. I could make pillows myself, but I no longer have a sewing machine. When we moved the last time, mine didn't make the cut. I'm at the point I'd rather just pay someone to do it for me, but I got pillows on Etsy. I love Etsy.

Melanie Avalon: If you want something very specific, you can find it. I found this amazing. Actually, it might have been a few different companies, but I found one girl that makes handmade wreaths. So, I made Disney-inspired ones for all the seasons. 

Gin Stephens: Well, that's really fun. I think I've seen them on Instagram. I know I have seen them on Instagram. [giggles] I have seen your wreaths on Instagram. [laughs] 

Melanie Avalon: I think I've posted all of them except the summer one. Oh, it's exciting.

Gin Stephens: You love the summer one? 

Melanie Avalon: It's really pretty. Yeah. 

Gin Stephens: What makes it super exciting in Melanie's world? 

Melanie Avalon: Have you been to Disneyland? 

Gin Stephens: Never Disneyland. Only Disney World.

Melanie Avalon: Okay. Have you heard of World of Color? 

Gin Stephens: No. 

Melanie Avalon: Are you familiar with the setup of Disneyland?

Gin Stephens: No. I know it's a lot smaller than Disney World. You've been to Disney World, I imagine. 

Melanie Avalon: Mm-hmm. Yeah, I love Disney World.

Gin Stephens: I just know it's smaller. That's all I know about it. It's smaller and it's the original. 

Melanie Avalon: Yeah, so, it's two parks. It's Disneyland and California Adventure. The weird thing about Disneyland, though, is if you've grown up going to Disney World and going to Magic Kingdom, Disneyland is like the same thing. Some of the stuff is the exact same, but then, some of the stuff is slightly different. So, it's like when you're in your dream and something's just off.

Gin Stephens: It's just how here and when I was a teacher, Columbia County where I taught had one elementary school plan that they built for several years, like, every elementary school had that same plan, but they were all slightly different. Where a hallway was they decided, "Oh, that was not a good place for a hallway." They closed it or whatever. You felt it was the same as model as like my elementary school. So, I'd always felt slightly lost. Yeah, I get it. 

Melanie Avalon: That's it. It's weird, because you're like, "This is right, but not."

Gin Stephens: Yeah. Well, the house I'm moving into, the whole little neighborhood has exactly the same house plan built over and over, but with different colors. So, I bet when I start meeting people and getting to know them, it's going to feel wacky.

Melanie Avalon: Oh, wow. Oh, that's interesting. 

Gin Stephens: Yeah.

Melanie Avalon: Yeah. The other park is called California Adventure. This comparison is not going to make any sense to you, because you haven't seen it. But there's this show called a World of Color and it is the most magical thing. It's water, and color and they project Disney clips and play music, but the color is the most. It's like the experience of color incarnate in magical fountains of overwhelming epicness. That is what I tried to embrace in my summer wreath.

Gin Stephens: Well, that sounds really pretty. I can't wait to see it. When do you put it out, like, June? 

Melanie Avalon: I decided I'd put everything out on the day the season started. 

Gin Stephens: Yeah, that makes sense. 

Melanie Avalon: So, I think I learned this year when the season started.

Gin Stephens: It's not always the same number day. Did you know that? 

Melanie Avalon: What? [laughs] Wait, explain.

Gin Stephens: It's astronomical. It has to do with the position of the Sun and length of the day. I think it can be very one way or another. 

Melanie Avalon: Oh, man. Okay. I was also reflecting on this morning time. Because I was thinking about how we both show up at the time to start this podcast. In theory, when did they decide time? Could it have been different?

Gin Stephens: I guess. They could have divided it differently. Yeah. 

Melanie Avalon: When did they decide noon? 

Gin Stephens: Well, technically, when the Sun is directly overhead, they call that noon. I mean, it does. But it's based on a certain time of the year, I don't know. I just looked up spring, the first day of spring in the northern hemisphere can either be March 19th, March 20th, or March 21st. It has to do with when it's the equinox, which is when at whatever point they used to just-- See, I'm telling you what, teaching elementary school just absolutely lets you know a lot of these things. [laughs]

Melanie Avalon: It never came up when they decided noon?

Gin Stephens: When they decided? I know it's based on when the Sun is directly overhead at whatever time of the year that is. I don't know. I can't remember.

Melanie Avalon: It must have been some day, though, because every day would be slightly different, I assume.

Gin Stephens: It's when they came up with clocks. Once they came up with clocks and they were able to keep the time, of course, they were not accurate. But it was all rough estimate. Until we got to the modern era, there was no conformity, if that makes sense. It varied. 

Melanie Avalon: Oh, the clocks all around? 

Gin Stephens: There was no like-- Here's the time it is everywhere in the world at this exact moment. Before we got to the point where we could communicate from place to place, it's possible every place had a different noon.

Melanie Avalon: Before the advent of railways in the 1800s.

Gin Stephens: See, I just know so many random things.

Melanie Avalon: All time was local. Noon was simply when the Sun was directly overhead wherever you were in what is called solar time.

Gin Stephens: Right. In that one, I just said I didn't know it was the railroad, but that makes sense. I knew there was a reason everyone suddenly synchronized, it makes total sense that it was the railroad. Yeah, time was pretty much like local. And then, they decided this is where it's this-- Whatever that was, that's when they decided, here's what we're going to call noon based on this and then, everybody just went along.

Melanie Avalon: Before that, when you traveled to another town, you would simply change your watch. I learned something else that was determined by railroads that relates to diet.

Gin Stephens: What's that? 

Melanie Avalon: It's one of the main reasons we eat muscle meat and not the organs and different parts of the animal. Had to do with shipping and how they kept it cold.

Gin Stephens: Yeah, convenience. That makes sense. A lot of things are convenience related, aren't they? 

Melanie Avalon: Yep. 

Gin Stephens: But it's easiest to do. Very interesting. See, I just refined my knowledge a little bit more and you learned some new things. 

Melanie Avalon: I know. So much to learn.

Gin Stephens: There really is. You realize the things that you don't know, when you start learning them, you're like, "How did I never knew that?"

Melanie Avalon: It's a little bit stressful to think about, because you could pick any one topic and you could probably, literally just study that topic for your entire life.

Gin Stephens: Well, that's what people do. Experts in fields.

Melanie Avalon: You could study leaves and just study leaves. 

Gin Stephens: Yeah, Chad studies organic and heterocyclic chemistry. Most people are probably like, "I've never even heard of heterocyclic chemistry."

Melanie Avalon: Yeah. So, never be bored, always something to learn. Anything else new or shall we jump into everything for today? 

Gin Stephens: Yeah, let's get started. 

Melanie Avalon: Well, actually, our first question relates to all of this a little bit and it's not a fasting related question, but we got a really fun email from a listener, because Gin and I will often go on tangents about how we say words the same or differently. Sara emailed us and said, the subject was: "the way you say words. She said, "Hi. Okay, you guys keep talking about the different way you say words. So, have you ever taken the New York Times dialect quiz? It's so fun. You should take it together before or after podcasting, or with friends, because it's fun to see the differences." We both took this. What I thought was so interesting is, Gin, when you were taking it and it shows you all of those words, I immediately picked out my answer and a lot of other words I had never even heard of.

Gin Stephens: I had heard of a lot of them. There weren't very many that were unfamiliar to me, but it was very easy to know which one to choose, which is interesting, because I did grow up in the mountains of Virginia. I wondered how that would impact my results, but it was really funny what it said. It pinpointed me as being from Augusta Richmond County, which is where I was born and where I live right now. But I didn't live here all the time. I was always here, my dad was always here, but my parents got divorced when I was little, and I moved to Virginia, and so, I went to all of elementary school through high school there, went to college in North Carolina, and then, came back here after college, and have been in this area. But I knew, Augusta Richmond County. I was like, "This is bizarre." 

Melanie Avalon: Yeah, we actually both got Augusta, which is--

Gin Stephens: Yeah, that's funny.

Melanie Avalon: You got Augusta, Montgomery, and Huntsville. Oh, no, no, no, no, that's me. That's me. I got I Augusta, Huntsville, and Montgomery, you got Augusta, Columbus, and Jackson.

Gin Stephens: Yeah. But the fact that it pulled out Augusta, I did this in my community in the Delay, Don't Deny Community. If anybody's looking for that community, by the way, ginstephens.com/community. That gets you there. But we did it there and it was so interesting to hear people what they got. They come up with their little place. It was fun to do it as a community. 

Melanie Avalon: You did it after receiving this email? 

Gin Stephens: Yeah, I just popped it up, because we like fun things in the Delay, Don’t Deny Community. I popped it in and said, "What do you all get?" People liked sharing what they got. I shared the link there. The people from Canada, they were like, "Well--" It gave them, like, they're closest to US. One person from Canada got, I don't know, somewhere in Washington State, because that's the closest. Anyway, it was a lot of fun. I'm glad that-- Sara, thank you for sharing it. It was fun to do, and fun to share with the community, and apparently, we say things pretty similarly, Melanie.

Melanie Avalon: I know. It was weird for me, because I grew up in Atlanta, and then Memphis, and then LA. I didn't get anything by there. Yeah, Augusta is the closest. So, for listeners, we'll put a link in the show notes.

Gin Stephens: I feel Atlanta is right in the middle of all of that.

Melanie Avalon: Yeah. 

Gin Stephens: But it's funny that both of us got Augusta and you didn't get Atlanta or neither of us got Atlanta. I think Atlanta says, things all weird. Sorry, Atlanta. [laughs] That's what all I can come up with. Or, Atlanta is also maybe more of a mixture of people from all over. It's very metropolitan. I wonder what the Atlanta dialect would be. Now, I'm curious, because I know there's people in Atlanta from really everywhere.

Melanie Avalon: Yeah, that's true. Actually, my Huntsville is it's close-ish to Memphis.

Gin Stephens: I'm surprised I didn't get any Virginia in there. 

Melanie Avalon: I'm surprised I didn't get Memphis. 

Gin Stephens: Yeah. It's funny. Because some of those words-- There was a couple times, I was like, "Between a couple--" I'm like, "Well, I know what I probably should say based on where I live," but I actually say these other words, I'm going to pick it and I did. I always picked what I really said.

Melanie Avalon: It was fun to see words that had never occurred to me that it was a thing. The question like, "Do you say icing or frosting?" All the options for that, what did you put for that? 

Gin Stephens: I think I put either as right.

Melanie Avalon: Me, too. It never occurred to me that they were different. [laughs] 

Gin Stephens: I wish they'd had dressing and stuffing. 

Melanie Avalon: Oh, that would have been a good one.

Gin Stephens: That wasn't there, which do you say?

Melanie Avalon: I would say both. If I could do a sliding scale, it would lean more towards stuffing, but I don't mind either.

Gin Stephens: See, we totally say dressing, because we don't stuff it. In our family, we don't stuff the bird. We don't stuff it in the bird. We've had big debates around the Thanksgiving table about y'all better not call this stuffing, [laughs] because stuffing is stuffed in, dressing is on the side. If I bake a turkey, I stuff it with chopped up onions, and garlic, and aromatics to flavor the bird, but we don't take-- I actually then take that out and make gravy out of it whatever was in there while I cooked goes into the gravy to flavor the gravy. I make some really good gravy, but the dressing is cooked on the side and a casserole dish.

Melanie Avalon: Yeah, that's the way it's always been for us. What did you say for fireflies and lightning bugs?

Gin Stephens: We say lightning bugs. 

Melanie Avalon: Okay. I said fireflies and lightning bugs. It's just interesting, because for listeners, when you take it for these answers, there'll be 10 options. Some of them I had never--

Gin Stephens: Which is why it's so odd that we both got Augusta. 

Melanie Avalon: Mm-hmm.

Gin Stephens: The people in the community got so many different things. It's clearly not everyone gets Augusta. We're like, I got the exact town in California where I live. So, fascinating. Yeah. 

Melanie Avalon: And when you get your results, it's also really a little bit interactive. You can see all these different versions of your results.

Gin Stephens: Oh, and it shows you what you're not like. I'm super not like what was in Michigan or something.

Melanie Avalon: I was not like Milwaukee, Grand Rapids, and Detroit.

Gin Stephens: Yes. Oh, I am not like Minneapolis, St. Paul, Detroit, oh, and Seattle. That's where I was the most different. I was the most different Seattle, Minneapolis, St. Paul, and Detroit. 

Melanie Avalon: I was laughing out loud with some of them. I don't know what will I do, know why, because there'll be the question and there'll be all the answers, and then, one of them would just say, "I have no word for this." That was me for some of them. Oh, good times. So, listeners, we'll put a link to this in the show notes.

Gin Stephens: And have fun with it, make your whole family take it and see if y'all get the same thing, that would be fun.

Melanie Avalon: Yeah, I'm going to email this to-- or text this to my family after this.

Gin Stephens: That will be interesting. 

Melanie Avalon: Okay.

Gin Stephens: So fun. 

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Melanie Avalon: Shall we jump into some fasting related questions?

Gin Stephens: Absolutely. We have a question from Rebecca and the subject is: "ADHD meds and elevated blood glucose levels." She says, "Hi, Gin and Melanie, I was formally diagnosed with ADHD last year and I was prescribed a well-known stimulant medication after some discussions with my doctor. I've been taking the medication only on weekdays for about five to six months and have seen huge improvements in my quality of life and mental health. I am 29 years old, have a late-night eating window of four to five hours usually starting to eat anywhere between 6 PM to 8 PM. Eat mainly Whole Foods cooked at home, beets, fruits, veggies, grains, etc., but do enjoy an occasional restaurant meal some weekends or a dessert here and there. I have been clean fasting since November of 2019, lost 69 pounds, and have kept it off. Yay. I'm also relatively active. I stand all day at my standing desk, move around frequently, and then, go for about a three to four mile walk with my dog every day after work before I eat my first meal. 

Last year before the ADHD meds, I used my NutriSense CGM, thank you for the rec, Melanie, for three months and learned so, so much about my body. I got the itch to do it again and so, I ordered more, popped one of those bad boys on, and was shocked to see how different my levels were from last year. I'm now on my third CGM this time around and I've seen consistent numbers or patterns in all three CGMs, so, I know it isn't just a fluke. Before my fasting blood glucose levels in the morning were averaging in the low 100s to 90s, and then, throughout the day, as I got deeper into my fast, they would steadily drop into the 80s, and then, sometimes into the 70s. Then, when I ate, my glucose levels would usually go to 110 to 130 and would almost always stay under 140. If I did have a larger glucose spike, I would recover relatively quickly. Now, it is completely different. Even though, I clean fast all day, my glucose levels almost never get below 100. I wake up and my glucose levels are usually around 120 to 130, then, I take the medication, and my glucose levels go up to 130 to 140 or even higher, and stay up there for about five hours, and then, will finally start to decrease. But even in the descent, it never gets below a 100, usually not even below 115 until I go for my daily walk. 

After my walk, my levels will drop to around 100 or in the high 90s if I'm lucky. Then, when I eat, my glucose levels spike like crazy, almost always at least to 150 or 160, or sometimes higher if I eat anything even remotely higher carb, and then, will stay mostly high throughout the night while I sleep. Sleep average is around 135, but will oscillate above and below this number throughout the night. I've tried to eat right before my daily walk, so that the exercise helps to blunt the glucose spike of my first meal. But if I do this, one, I am forcing myself to eat when I'm not hungry and two, my blood glucose levels never get below 110, because I'm not exercising fasted. Any thoughts on this? What is better? Blunting the spike with a walk, but never getting below 110 or taking a walk getting my glucose levels down and then, eating and having a larger spike? 

On the weekends, when I don't take the medication, I thought that my levels would go back to the way they were before but they don't. They are still about the same as during the week, but maybe slightly better. I assume this means that the stimulants are still affecting my glucose levels, even after two days of not taking them. Naturally, I was stunned and slightly scared about what I was seeing. So, I googled it. And apparently, stimulant medications are known to raise blood glucose levels. I'm so surprised that I've never heard this or that it isn't more widely discussed, especially because the effects, at least in my case are quite significant. Why did these stimulant medications cause the higher blood glucose levels throughout the day during my fast and then, the more exaggerated spikes when I eat my meals? What is the mechanism behind this? Is it the same mechanism behind what raises our blood glucose when we eat or is it different? What does this mean for insulin? Are my insulin levels raised this entire time, too? What are the possible implications? Is this something that could result in diabetes? Do these numbers mean I'm potentially pre-diabetic? 

The medicine truly has made a massively positive impact on my life, but I also don't know how these higher glucose levels will affect my health long term. Any helpful info or advice you can provide would be greatly appreciated. I'm hoping that this discussion will make other people with ADHD aware of this critically underdiscussed issue. By the way, I do plan to talk to my doctor about this, but don't necessarily have high hopes, since neither my primary care physician or my psychiatrist said anything about the topic when I started the meds. Thank you both so much for everything you do. You have no idea how much you have impacted my life. red heart, Rebecca." 

Melanie, this was so interesting and I think it shows just how much goes on in our bodies, but before people had CGMs, people had no idea. 

Melanie Avalon: I know. 

Gin Stephens: This is what this is showing me. It's showing me that this has probably been going on for so many people, but people just don't know, because they don't see the data, but Rebecca has the data. 

Melanie Avalon: That is such a good point. Yeah, for listeners, we talk about CGMs a lot, but they are continuous glucose monitors, and you put them on your arm, and they measure the interstitial fluid of your cells, and give you essentially 24/7 view of your blood sugar levels. Like Gin just said, they can be really eye opening, because you can realize things that you had no idea, or affecting you, or that your blood sugar levels are reacting to diet, or lifestyle, or exercise and you don't even know. What's so interesting is, the difference between hyperglycemia and hypoglycemia, I feel people can more often become aware of hypoglycemia, because you can get really symptomatic from that.

Gin Stephens: You feel it. 

Melanie Avalon: Yeah. But hyperglycemia not necessarily. Rebecca, thank you so much for your question. I thought I knew what was going on here, and then, I googled it, and it was what I thought. With stimulant medications, well, it's interesting, because some studies actually find that stimulant medications reduce blood sugar, but a lot show that they can increase blood sugar, which is what you're experiencing. I'll put a link into the show notes to one interesting study. That's a really long title. It's methylphenidate has mild hyperglycaemic and hypokalemia effects, and increases leukocyte and neutrophil counts. Rebecca actually told us the medication she's takin. I'm not going to comment on what she's taking specifically, but there are a few different types of stimulant medications, and they likely have a similar effect in this regard. 

As stimulants they activate our body's stress response, our sympathetic nervous system. They can encourage the release of cortisol, and epinephrine, and norepinephrine. And that signaling to the body can encourage the body to release glucose from the liver, because it interprets the situation is needing fuel, so, like the fight or flight response. Some people, who are on these medications, it basically just creates a situation, where your liver is consistently keeping your blood sugar levels higher. The study I just mentioned, and then, it also summarized a few other studies, and it found that in general, there's around 22% increase in blood glucose levels for people on specifically methylphenidate, which is Ritalin, I think. So, yes, that is probably what is happening. To answer your questions, what is the mechanism? It's the liver releasing glucose. Is it the same mechanism behind what raises our blood glucose when we eat or is it different? It's different in that when we eat, we can immediately get a blood glucose spike from what we just ate rather than what was already stored in the liver and/or gluconeogenesis. The liver creating new glucose, because it needs it. When you're eating, it can be coming from what you ate, actually, in addition to the liver. So, it's a little bit different. 

What does this mean for insulin, are my insulin levels raised this entire time, too? Quite possibly. You might want to actually get a fasted insulin test, because our pancreas can respond to high blood sugar levels and pump out insulin to try to reduce them. It is possible that you are releasing insulin to try to bring down those levels, but your liver just keeps pumping out glucose. That actually is not good and that's why there's a transition from being nondiabetic to prediabetic to diabetic as you are transitioning, as your body is constantly experiencing these higher blood sugar levels, your pancreas is working to keep them down with insulin, but if you just keep on that train, it can just get worse and worse, and so, you can end up diabetic. Is this something that could result in diabetes, do these numbers mean I'm potentially prediabetic? Technically, by the levels, yes, you are prediabetic because a fasting blood sugar level of 99 or less is considered normal. Prediabetic is 100 to 125. You definitely fall within that range. Over 126 or higher indicates you have diabetes and she said that, what is it during the day? Is it above--? Now, when she wakes up, the glucose levels are usually around 120 to 130 and then, they go up to 130 or 140. Actually, your levels right now are diabetic levels. I would not take this lightly. I'm not trying to scare you. This is empowering reframe. This is very empowering that you've done the CGMs and you've realized this. I would probably find an endocrinologist to look into this more. Also, maybe, okay, I'm not a doctor. I'm not saying change your medication. I would speak with your doctor though and maybe see if he can reduce your medication. I don't know what dosage you're on. Maybe that's a possibility. 

Something I will say and I feel I might get negative feedback for this, but I had Dr. Michael Platt on the Melanie Avalon Biohacking Podcast and he has a book called Adrenaline Dominance. He talks a lot about this, and he's a big fan of progesterone, and his go to method, he has helped a lot of people with ADHD actually through progesterone supplementation. I'm not saying to quit your meds and do progesterone, but I'm just saying, because if this continues the way you are right now, this is not a good thing. Maybe looking into alternatives, I know that the medication is really helping you and so that's amazing. But maybe if you can work with your doctor to get on the lower dose, or maybe try a different one, and/or find some other options that might work. In the meantime, other things that you could do to help with this-- Her situation is that, when she exercises fasted, it brings it down. But then, she eats, and it spikes, and so, she's saying, "Could she eat and then exercise after to reduce that spike?" I would not eat to lower your blood sugar. I would not make that the goal of eating. Actually, Marty Kendall, his whole thing, is it data driven fasting? Oh, which speaking of tangent, if I may. He randomly DMed me this week and was like, "You've got to have Mark--" Is it Schatzker, The Dorito Effect?

Gin Stephens: Oh, yeah, he's great. I love that book. Have you read the book?

Melanie Avalon: No, but you had mentioned it, and then people keep mentioning it, and then I actually saw a friend, and he mentioned it, and then I came home, and Marty Kendall was like, "You need to interview this guy."

Gin Stephens: There's the universe telling you. Yeah.

Melanie Avalon: I actually had an email from him this morning. I haven't read it yet, because I emailed him last night, but I think he is coming on. So, that'll be exciting. Marty Kendall's thing and actually, Cynthia Thurlow in her new book, Intermittent Fasting Transformation also talks about this. They are a huge, huge proponent of measuring your blood sugar levels before eating and not eating until your blood sugar levels are low. It's actually the opposite of what you are proposing, because you're proposing eating to lower them or eating to lower them and exercising after. Maybe you aren't proposing to actually eat to lower them, but you're going to move your exercise to afterwards. But they are a huge proponent of not eating when your levels are high. I would say, again, this is all just my thoughts and opinions, but I would exercise before and after. I would not switch. I would do as much as you can to help mitigate this. Definitely keep wearing a CGM and this might be something where I would really, really-- I know you're eating Whole Foods and it sounds like a really "healthy diet" and all of that stuff. But I would play around with that because you do notice you said that when you have a higher carb meal, it spikes even higher. This might be a situation, where low carb might be something that you might want to consider and see how you react with low carb. 

And then, also, I would really suggest something like berberine, an herb that rivals metformin in the clinical literature. You could also do metformin, I suppose. Metformin, the pharmaceutical and berberine, the herb have very impressive effects on lowering blood sugar levels. Berberine is debated on how it does it, there's a lot of potential mechanisms. It's possible that it actually discourages the liver from engaging in that process I mentioned from releasing the liver or from gluconeogenesis creating new glucose and/or, probably and it seems to encourage or stimulate AMPK, which is normally or stimulated in the fasted state, and helps the body take up blood sugar, and burn body fat. It creates a state of the body thinking there's like a fuel deficiency, which is a little bit ironic, because the stress hormones that I was talking about also are similar, because the body thinks it needs energy and it's releasing blood sugar. But something like berberine or metformin is going to have a different effect. It's actually going to help lower blood sugar. So, that was a lot-- 

Oh, also the half-life of the stimulants can be around nine to 14 hours and potentially, 72 hours to be cleared. Like you picked up on, that's likely why you're still having issues over the weekend, because it's still in your system. I would not take this lightly. I would talk to your doctor, find an endocrinologist, wear CGM, and play with your dietary choices, try low carb, try berberine, and move around, exercise more. Cryotherapy might also help that can help lower blood sugar levels. Yeah, Gin, thoughts? 

Gin Stephens: But I don't know how to add very much to that. [giggles] But what I would like to say is, this just really illustrates how things that we put in our body, this medication changes how our bodies function and what happens. Thank goodness for CGMs pointing out what's happening in her body. She now has the knowledge, and can address it, and talk to her doctors about what would be right for her if there might be another medication option that could give her the same mental health benefits that she's looking for, and not the negative effects that she's seeing. Knowledge is power. Again, it's just fascinating to think about how many people are taking so many medications and they're additive they add up. You take one, and then it gives you another issue related to that medication, and then you have to take something else to counteract that, and then you take something else, and it just grows and grows, which is why I think most people in America are taking multiple medications. I can remember, even before I was an intermittent faster, I had fibroids, and I had to have them surgically removed, and this is in maybe 2013, and I was obese. But I went to the pre-op treatment, or the pre-op appointment and they're like, "All right, what medications are you on?" I'm like, "None." [laughs] And they were like, "What?" 

Somebody's coming in and especially someone obese like me having surgery, but was on zero medications. Every person kept asking me, "Are you sure?" I'm like, "Yeah, I promise you. I'm not on any." But the way that they reacted to me being on no medications in my 40s was eye opening. We're not meant to just need a lot of medications and I'm not saying anything about her not needing it for ADHD, clearly. I'm not saying she shouldn't take it, but it's just interesting. Like you mentioned, there might be a natural approach that could help our brain. With Will, I talked about in Clean(ish), cleaning up his diet. We kept him off medications. I'm sure he would have been diagnosed with all sorts of things had we not changed his diet. We took out artificial flavors, artificial colors, preservatives. Again, that's nothing to do with Rebecca's situation. The brain is complicated. You had Dr. Amen on your show before? I love Dr. Amen and the work that he does. I actually first saw him speak in person. It was a Brain-Based Learning Conference in 2006 in San Diego and I was fortunate enough to get to go there. My elementary school sent four of us to this conference and he had a session on the brain and ADHD, and all the different ways the brain can look different types of ADHD presentations. It was just fascinating, and I bought his book, and then I got his book about the brain and weight loss. Fascinating.

Melanie Avalon: Yeah, I really, really love his book. He does the brain SPECT scans. I actually got one at his clinic here in Atlanta, which was really cool. But yeah, and I was just googling the stats. This one study from 2018 said that-- This is a government study. It said that 6.6% of US adults use prescription stimulants in 2017. Yeah, just to bring it full circle. I bet so many people are experiencing this and they just wouldn't know.

Gin Stephens: Yeah, if that many people are taking stimulants? Wow. What was the percent you said?

Melanie Avalon: The one I was just looking at said 6.6% of Americans in 2017 had used stimulant medication. I don't know if that's-- The first thing that comes up says that prescription stimulants 2.9 million people that's for 2020. Regardless, it's not a small number. This is something, though, that I think, Rebecca, we're happy that you found this out, I would definitely look into all of those things that I was talking about. And let us know, let us know. 

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Melanie Avalon: All righty. Shall we go on to our next question? 

Gin Stephens: Yes. 

Melanie Avalon: We have a question from Christie and the subject is: "weight gain" and Christie says, "Hi, there. I have been doing IF for short while, probably about seven months. I was doing the Dr. Bernstein diet as well from January until March and lost about 14 pounds." Do you know what is the Dr. Bernstein diet? Do you know, Gin? 

Gin Stephens: I don't really know. 

Melanie Avalon: I just looked it up and it is a low-carb diet. Appropriately enough, it says an engineer by training Bernstein pioneered blood glucose self-monitoring and the tight control of blood sugar that is now accepted as the standard treatment of diabetes. She says, "I was doing the Dr. Bernstein diet as well from January until March and lost about 14 pounds. I normally work out five mornings a week at Orangetheory fitness. Since COVID hit, I have gained so much weight. All the weight I have lost and probably another five pounds despite being more strict with my eating window. I used to be 16:8, but now, my fasting hours are 17 and a half to 18 hours. I usually open my window around 12:30 and close it at 6:30. I still work out five days a week with at-home workouts, but they are not as good. I know for a fact, I'm not eating as clean as I should, but I do still eat relatively healthy with lots of vegetables and fruits. With that said, I do have a sweet tooth. I'm wondering if my body is reacting to having gone from such a restricted diet to now, basically, eating what I want. Have I messed up my metabolism? If so, how can I restart it? I am a 42-year-old mother of two, who is a teacher consultant and under a lot of stress right now trying to get materials out to our amazing educators in our district. I'm feeling so gross, I need to get this figured out, help. Thanks so much," Christie.

Gin Stephens: All right, well, we look this one up and it turns out this one came in April of 2020. This was the height of when we were all in that pandemic stress. There was so much stress related weight gain going on during that particular window of time and I was still on Facebook, I was in the Facebook groups. What Christie wrote in right here, we were getting posts in the groups every single day that were exactly like this. It was, "Help, I've been doing fasting, it's been working, all of a sudden, I'm gaining weight, encouraged me at the time." I was like, "I got to write a blog post about this and talk about it." If you go to ginstephens.com, The Blog Directory, I actually released a blog post at that time that talked about the effect that stress can have on weight. Basically, you can gain weight based on being super stressed, your body's like, "Okay, we're going to have to pack on some pounds, because something really terrible is going on." I talk about more of it in the blog post. You can take a look there. But all this to say, it is completely normal to find that if you're going through something exceptionally stressful, weight gain is likely to come along with that. 

Now, with Christie, I would say, part of it is that physiological part that I talked about where your body starts storing more based on the stress response, but the other part is and I'm reading between the lines of Christie's post that she has changed up what she's eating and says, she's not eating as clean as she should, and having a sweet tooth, and she's basically eating whatever she wants. I found that to be true for me during the early days of the pandemic as well. I was having cocktail hour every day and baking more, and I have a little window creep, and my honesty pants started to get a little tight. I pulled out a fasting app and went back to that. I'm like, "I need a little bit more structure. I need to stop this one to creep in. I need to just nip that in the bud. And also, I do not need to be baking cinnamon rolls, and Irish soda bread, and cookies all the time." I knew that that was not helping my body, so, I stopped doing all that. Now, am I still going to eat cinnamon rolls here and there? Yeah. But I didn't need to have something new coming on every day. Basically, I went back to how I had been eating, my honesty pants fit again, that's how it worked out, and I didn't need to keep using the app. 

Even though, the pandemic stress of April 2020 is behind us, there's still a lot of stress in the world going on. There's always something new, especially, if you're watching the news, something new to be stressed out about. It's almost we're in this constant state of fight or flight. If you are like Christie, finding that you're more stressed and suddenly, you're having a different weight gain than you had before, number one, examine your window, examine if you've really changed what you're eating. And if so, be really honest with yourself and you may need to make some tweaks there. But also understand, you may need to do some mindful things to get your stress levels down. You need to take some time for yourself easier said than done. If you've got family, small kids, job with lots of responsibilities, but you need to carve out some time for self-care, whatever that looks like for you. Even if it's getting up a little earlier and having meditation, or yoga, or prayer, or taking a walk around the block, or whatever feels like self-care to you, so that you can let your body know, "Ah, I'm going to be okay." Because that makes a huge difference.

Melanie Avalon: Yeah, I think that's great. Actually, it loops in a little bit to Rebecca's question just as far as their physiological responses to our bodies being in a perceived stress state. Rebecca's question, it was taking a stimulant medication that was telling her body to be in fight or flight mode with the COVID situation and stress from life, it can have that same effect. Actually, that was something I forgot to mention answering Rebecca's question was, one of the studies was looking at why there is this increase in hyperglycemia. So, blood sugar from the stimulant medications. It theorized that it might be unique to the individual and their own stress response.

Gin Stephens: There's that bio individuality, again. Some people drop weight when they're really stressed. It's very, very, very, very different from person to person, but I was choosing soothing foods. Like I said, the cinnamon rolls and stuff, because your body drives you to that. It's like, "Are you gaining weight, because you're eating for or are you eating more because of the stress?" But whatever it is, it's a very natural biological response driving you to eat those foods.

Melanie Avalon: Yeah, exactly. Oh, this might help explain, because it can seem confusing, because the fasted state is in theory, it's releasing adrenaline, and it can release cortisol, and it can also be that state of needing fuel. How is that different from these other manifestations where we don't get health benefits? The context is just so important. Cortisol, for example, when we release cortisol fasted, it can actually help our body free up fat stores and release glucose to burn. But it can have a beneficial effect in burning through our bodies stored energy, but if we have high cortisol and then, we eat, it actually encourages fat storage. So, people often say, high cortisol levels create, or lead to fat gain, or weight gain, but it's always context dependent.

Gin Stephens: Right. That's great, because we hear that all the time from people like, "Yeah, but fasting's going to raise my cortisol. I'm going to gain a lot of weight."

Melanie Avalon: The key is, actually, I'm interviewing this week, Thomas DeLauer and he talks about this a lot in his book. But basically, cortisol while fasted can be a great thing, because it will help you burn body fat. Cortisol, while eating is not a good thing. He talks about the importance of when you're breaking your fast, making sure that your cortisol levels are reduced. You can do that by mindfulness practices like Gin was talking about, meditation, breathing, but he also talks about supplements like magnesium or even salt can help reduce cortisol. So, yes, it's all very important to take all the context into account. And also, Gin touched on this and it was something I was going to touch on, too, and I thought you did a nice job of this, Gin, but Christie definitely is giving-- Again, this was a while ago. Maybe it's resolved. I'd love to hear how it has gone for you Christie. I feel it's possible that there are things that you might be aware that you're turning to food more for stress relief rather than nourishment. I don't know. I was looking at how she says, I'm feeling so gross and that feeling of grossness from food that can often come from turning to foods that would make you feel gross, if that makes sense. I think language can be very revealing. I just really. I think it'd be hard to feel gross from food if it's eating purely just for nourishment, if that makes sense. Do you have any thoughts?

Gin Stephens: I would love to hear about how Christie's doing now. Again, that period of time, the panicked Facebook posts were coming in left and right. That's why I wrote that blog post just because people who had been maintaining for a long time, suddenly were gaining. They're like, "Is intermittent fasting stopped working?" I'm like, "That's not what happens." Intermittent fasting doesn't stop working. It's always "working behind the scenes," but it's not like a magic bullet when other things are starting to go out of whack.

Melanie Avalon: Mm-hmm. Exactly.

Gin Stephens: All right. We have a question from Rosie and the subject is: "those little pills." "Hi, Gin, hi, Melanie. My name is Rosie and I live in London. I have recently begun my IF lifestyle and so found your fabulous podcast, I have binged up to Episode 45 in the last week and I am loving it. I started with a 16:8 window, but over the last three weeks, it has naturally shrunk to a 19:5. I'm interested to see how this changes when I am no longer furloughed from work. Anyway, to my question, how does IF work with contraceptive pills? I have recently changed back to pills from the contraceptive implant due to the lockdown. I can't get it replaced. So, needs must." That's a very British way of saying it. [laughs] "Should I be taking the pills during my window, are they okay to pop in the morning as I do my makeup, my old routine. I know some can spike hunger in a big way and I'm worried that I'm going to disrupt myself massively. Thank you so much for taking the time to do the research required to check this out and forgiving me a new lease on my eating life," Rosie.

Melanie Avalon: And then, she followed up to say, "I can confirm that my pill is making me hungrier and more sleepy, which is annoying as it is making IF so much harder. I know I am in adjustments. So, hopefully a month down the line, it will be much easier." But yes. To answer the question, you can take your birth control pills fasted or not. I would just suggest, which is sounds like what Rosie is doing. If I mean, obviously go by the, what's the word? What it says to do on the bottle? The prescribed method of taking it, I would just experiment to find when taking it works the most seamlessly with your fasting. Because this ties into the whole theme of today's episode that these things are going to have profound effects on our body's physiology. So, we have to work with that and adjust accordingly. Any thoughts about that, Gin? 

Gin Stephens: Yeah, just honestly, take it when it works for you. If you take it and you feel fine, that's fine. But if you take it, and then you're starving, and you feel shaky and nauseous, then change it. Take it at a different time based on how you feel. Now, she has more to her question. She said, "I was just wondering, I am mainlining black coffee, and I'm getting worried about coffee breath, and staining on my teeth. Any hints and tips? My peppermint oil is in the post. I mentioned the charcoal tooth powders to my other half and he was appalled and basically forbid me from putting black powder in his shiny white bathroom. I am incredibly clumsy and messy, so I can see his point. Thanks, again, and thank you so much for all your super advice. I am now on Episode 54, and I am both excited to catch up and sad that I'll only get one episode a week. Ha, ha."

Melanie Avalon: Okay. Thank you for your question, Rosie. Yes, that black charcoal powder, there's like-- I don't know. I think there's two things that I've experimented with it just get everywhere and that would be activated charcoal powder. Spirulina and chlorella just is not easy. There are alternatives. I actually really, really I've been using-- I'll put a link to in the show notes. It's White Birch Professional Teeth Whitening Serum. It's something that you brush your teeth with. I really like that. Also, on Amazon, there are a lot of the professional at home teeth whitening kits and it's where you put this gel. Normally, it's a peroxide type gel in a tray, and you put in this light thing in your mouth, and those actually work really, really well. Because I know the dentists, they can charge a ton of money to basically give you the same thing. I found a lot on Amazon that work really well. But there is the potential for sensitivity, so you might want to take that into account. I like to do oil pulling every morning. I really, really like that. That's where you swish around in oil like coconut oil. Some people use other things. I actually use MCT oil for about 20 minutes. I found that really, really helpful. Some of the toothpastes have whitening things for them. But yes, this is definitely something that happens. Gin, do you have advice?

Gin Stephens: Well, no. As far as the coffee breaths, she's got peppermint oil. Well, I think we're good to go. But yeah, I was the same way about the charcoal. I was making a giant mess. I'm like, "Okay, no." 

Melanie Avalon: It gets everywhere. 

Gin Stephens: That's just so funny. It gave me a little flashback of remembering it like, "Yep."

Melanie Avalon: But there are some toothpastes that have-- The serum that I mentioned has white charcoal in it and then, there are some toothpastes that are made with charcoal and so that--

Gin Stephens: Yeah, I've seen that. Well, you have your teeth all black, it's crazy.

Melanie Avalon: Oh, I know. I know. My problem used to be I use to get major stains from fruit, from the blueberries. Very, very bad. So, okay. That'd be something that you would think, this will be something if somebody could invent something that fix this problem with coffee stains. Think about how well that would. So, you think there would be something.

Gin Stephens: There are a lot of products out there that are targeted to coffee stains.

Melanie Avalon: Something preventative that somehow allows you to minimize coffee stain, like, when you're using straws, but you can't use straws with coffee. I just wonder if there's something out there that could-- I don't know. I'm going to think about it. All right. So, this has been absolutely wonderful. A few things for listeners before we go. If you'd like to submit your own questions for the show, you can directly email questions@ifpodcast.com or you can go to ifpodcast.com and you can submit questions there. You can get all the stuff that we like at ifpodcast.com/stuffwelike. The show notes will be at ifpodcast.com/episode262 and you can follow us on Instagram. I am @melanieavalon, Gin is @ginstephens. I think that is all the things. Anything from you, Gin, before we go? 

Gin Stephens: No, I think that's it.

Melanie Avalon: All right. Well, this was wonderful and I will talk to you next week. 

Gin Stephens: All right, bye.

Melanie Avalon: Bye.

Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice. We're not doctors. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, theme music by Leland Cox. See you next week.


Check out the Stuff We Like page for links to any of the books/supplements/products etc. mentioned on the podcast that we like!

More on Gin: GinStephens.com

Theme Music Composed By Leland Cox: LelandCox.com

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