Welcome to Episode 284 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 Cynthia Thurlow, author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging.
Today's episode of The Intermittent Fasting Podcast is brought to you by:
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1:10 - BUTCHERBOX: For A Limited Time Go To butcherbox.com/ifpodcast And Get Two, 10 Oz New York Strip Steaks And 8 Oz Of Lobster Claw And Knuckle Meat Free In Your First Order.
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19:15 - BON CHARGE: Go To boncharge.com And Use Coupon Code IFPODCAST To Save 15%.
21:40 - Listener Q&A: Bo - Adrenal Fatigue & IF
35:30 - Listener Q&A: Gretchen - Smells
40:35 - Listener Q&A: Ute - Menopause
55:50 - AVALONX Magnesium 8: Get On The Email List To Stay Up To Date With All The Special Offers And News About Melanie's New Supplements At avalonx.us/emaillist, And Use The Code Melanieavalon For 10% On Any Order At Avalonx.Us And MDlogichealth.Com!
58:30 - Listener Q&A: Sybil-Anne - Need help from South Africa
1:03:10 - Listener Q&A: Cheyenne - Easing into a fast
Our content does not constitute an attempt to practice medicine, and does not establish a doctor-patient relationship. Please consult a qualified health care provider for medical advice and answers to personal health questions.
Melanie Avalon: Welcome to Episode 284 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, biohacker and 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, Cynthia Thurlow, nurse practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us, check out ifpodcast.com, melanieavalon.com, and cynthiathurlow.com. Please remember, the thoughts and opinions on this show do not constitute medical advice or treatment, and no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup 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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Melanie Avalon: Hi, everybody, and welcome. This is Episode number 284 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.
Cynthia Thurlow: Hi, Melanie, how are you?
Melanie Avalon: I'm good. How about you?
Cynthia Thurlow: Doing well, doing all the things. All the mom things, we're heading into week three of the school year and I feel maybe everything's-- the kids are getting settled back into a routine, I have a new driver in the household with exceedingly exorbitantly expensive car insurance, just to be able to allow him to drive, it's insane. He doesn't even have a car.
Melanie Avalon: But just because of the demographics that he falls into.
Cynthia Thurlow: Correct. We had to have a whole discussion about that. I was like it's the outliers of the population that generally are the ones that are more likely to have accidents, and especially young males, which is what you are.
Melanie Avalon: It's interesting that there's not more political backlash about stereotyping with insurance companies, even though it's based on data. But that could be a thing, that could be like a cancel the insurance companies.
Cynthia Thurlow: We're fortunate. We have USAA because my father was many years ago served in the navy during Vietnam. I told my husband, "It'd be way worse if we didn't have USAA." So, I don't even want to complain however, I said, I'm not stressing about this, because our wonderful 17-year-old is going to pay for his own insurance he has a certain amount he has to pay us every month and I feel like I'm teaching him some degree of responsibility. You should have seen the expression on his face when we said, "This is what you will owe us every month." He was like, "What?" I was like, "Yes, and you have a job and you have money in savings and I know how much you have in your savings; you can totally afford this."
Melanie Avalon: Wow. Nice, sets him up for life.
Cynthia Thurlow: Exactly.
Melanie Avalon: I've been having an interesting experience related to something that our audience loves. I forgot how often do you wear CGMs? Do you wear the one all the time still?
Cynthia Thurlow: No, probably the first 18 months I wore them near continuously. During the book launch, I just found that I would get like excited when I had press to do or podcasts or media work to do, but I would just watch my cortisol go up and my blood sugar would go up and it was like up down, up down all day long, so I didn't wear them for about two to three months. This summer I've had maybe once a month I've been wearing it, but I think I definitely have a better sense now of where I need to be in terms of my macros and managing my stress. So, to answer your question, there's a lot of utility but I don't wear it as much as I did two years ago.
Melanie Avalon: Yeah, I was similar. When I first started using them a year ago or a year and a half ago, I went months [laughs] having one on all the time. Now it had been a while, but I actually reconnected with a friend from high school who comes here to Atlanta and she's into all of this stuff. So, we decided to put one on together and make a Reel and all of that stuff. So, this is the first time I'm wearing one. And for listeners who are not familiar, a CGM is a Continuous Glucose Monitor, it goes on your skin, super painless to put on and it measures your interstitial fluid to continuously measure your blood glucose levels, which can be incredible to see how you react to food and fasting and exercise. And as Cynthia, was talking about, adrenaline are stressful situations. But in any case, so I haven't worn one in about a year, and my blood sugar control seems to be substantially better from a year ago. I don't know if this is what it is, but I think it might be all the Emsculpt that I did, that I've been doing, building muscle.
Cynthia Thurlow: Yeah. I mean it makes sense, you know insulin sensitivity.
Melanie Avalon: I just think we know that insulin resistance likely starts at the muscle and our muscles are a bank basically for glucose. Really, the only big thing I've changed in the past year is probably doing. I've been doing so much Emsculpt, which is muscle stimulation that literally builds muscle. I think I've built a lot of muscle; I'm just looking at my levels. My peaks are much lower than they were before and this is eating massive amounts of carbs, and then during the day just the average is probably like five or six or seven points lower. So, yeah, it could be other things as well, but it's cool to see. It's motivating.
Cynthia Thurlow: I think it's also important just to, from the perspective of checking in with yourself to see how you're doing. I'll give you an example, so last night we had dinner at a neighbor's house. They know that I don't drink alcohol, so they came up with a mocktail. I literally when she started telling me what was in the mocktail, I was like, "Oh, Lord, I can't like politely not."
Melanie Avalon: It was like all sugar?
Cynthia Thurlow: Yes, it was pineapple juice. She was like, "Agave syrup." I literally like my husband, like kicked me under the table. So I just had to sip it and the whole time I was like, "Lord," I'm just going to have to make sure that I go to the gym tomorrow and lift heavy things. But, yeah, it was humorous to just imagine in my mind understanding like I'm just going to just eat protein tonight. I'm going to politely sip this drink. I'm going to dump it when no one's looking. But it was so thoughtful, I want to be very clear, but I don't normally consume sugary drinks ever. That's just not really my thing, but in terms of insulin sensitivity, it's one of those things. In my head, I was like, "Okay, what could I do after we leave here?" I'm like, "Okay, I can walk the dogs like." We would do that anyway, all the things. "Okay, tomorrow, I'm going to go to the gym. I'm going to fast a little longer, I'm going to lift heavy things." Like in my mind, I was already knowing the things I needed to do to help dispose of the said sugary beverage that I consumed.
Melanie Avalon: That's so funny. Yeah, so out of curiosity, when you're in situations like that, at dinners where somebody has made something for you, what are your lines or rules? How often do you have the sip, or versus just saying, "No, thank you."
Cynthia Thurlow: Well, I felt obligated to consume some of this because she specifically made sure to have a mocktail. So, I had actually brought a bottle of low sugar kombucha with me and I was like, "I'll just have this over ice, this will be fine." I would say that, something like that, knowing that I'm very physically active, very insulin sensitive, and like one half cup serving of that is not going to derail all the good things that I do. But it definitely makes me very cognizant of just how-- I don't want to use any negative work note or terminology, just how happy I am with my current lifestyle and how I eat food and consume beverages and I just don't realize how unusual sometimes my habits may be to other people. They were incredibly accommodating. They know I'm gluten free and I'm dairy free and so they had this lovely charcuterie platter that was out that I was trying to eat as much meat as I could, while I was sipping on said very sugary beverage, but I would say that there are some deal breakers like for me, I just don't do well with dairy.
So, if I went to someone's house, and they had a very dairy heavy dessert, or were trying to incur, I would politely say, "I actually just don't do well with dairy." I think most people don't have a problem with that. I do find that the most triggering thing of all is when you just explain either, "No, I'm not drinking," or, "I don't drink alcohol." Then people don't know what to do with, and I was like, "I'm totally fine with that. You do what you need to do, and I'd be happy with a glass of water." I genuinely do pretty well with what works best for my body.
The interesting thing was the guys were having some type of local pubs beer brew, and the mom was saying, "Oh, I don't normally have mocktails. But I didn't want you to feel left out." I was like, "No, no, I'm really good. I'm not triggered by what if everyone else is drinking, that's not a problem for me, but I think it comes down to--" first of all I have to genuinely be hungry to eat. I don't ever eat at someone's house just out of a sense of obligation, but I also am very grateful and try to be very appreciative. I don't want anyone to feel like the efforts they've made are not appreciated and valued. To me seed oils are probably at the top of my list of things, I really try to avoid as much as possible. So, I'm the person that will sometimes come to someone's house and I'll make a wonderful salad dressing, because then I have some control over what's in it. But I would say the other thing is, if I'm at all concerned about something not meeting my needs, like desserts are easy to pass up, alcohol is easy to pass up, it's usually when you sit down, and I'm sure any listeners probably have experienced this, you go to someone's house, and they have a bunch of salad dressings out and most conventional salad dressings are not going to meet my needs, so sometimes I'll just ask for olive oil, and vinegar, and people generally don't have an issue with that either.
I don't want to sound like I'm one of those unappreciative guests. I'm generally very easy, but I think all of us have to figure out, how to navigate those social situations and not feel like you're a weirdo.
Melanie Avalon: Yeah, I think it's such an important topic, because I just think it's something so many people struggle with. Honestly, I think it can be one of the hardest things about any dietary change or protocol that you're adhering to. And I hadn't really thought about it before, but the similarity between not drinking is really similar to like, if a person is fasting, not eating, I get so many DMs about this, whenever I post pictures of me at events or parties, where there's obviously food, I just normally don't eat anything. This is for the fasting, not for the alcohol related thing, unless it's like a dinner I'm going to where I can like order specifically what I want to order. But it took me a long time to get to the place where I am now. I don't know if I'm still like a little bit insecure about it, but I mostly just don't care. I feel pretty comfortable in just saying like, "No, I'm not eating right now."
Cynthia Thurlow: I think that's important, irrespective of where we are, who we are, what we're doing, just feeling comfortable with your decisions and not feeling a sense of obligation. One of the things I've really been working on the last few years is, I grew up in a family with a lot of trauma. So, the way that I that I mentally work through all that in my childhood and young adulthood was to be the people pleaser, and to always be the good kid and the kid that never got into trouble and got good grades. So, my people pleasing tendencies I've been actively really working on the last several years. Sometimes I'm just okay saying, "No, I appreciate that. But I'm not interested in having that." And feeling very comfortable and not feeling like I have to explain myself and I think that's a beautiful thing to get to that point. So, I love that you stand your ground and advocate for what you and your lifestyle need.
Melanie Avalon: I'm glad you said that, because that's what I have found to be the most minimal drama response because I think I used to feel the need to explain. It's funny, I'm just thinking about now how you've helped me with other things in life where you're like, "You don't have to explain, you can just say no," but I think I did used to feel the need to explain and now I normally say, "Thank you. I'm good." Normally that just does it. Sometimes there'll be follow up questions, "Oh, are you not hungry?" or "Are you not eating," or, "Why?" And then you have--
Cynthia Thurlow: I think it's a sense of you just want to make people feel inclusive. I know if I had someone at my house and they were abstaining from eating-- I just want to make sure like, do you have options and you feel good about the options that are available and as long as they're good, I'm like, "Okay, we're all adults." We're all adulting we have to figure out what works for us.
Melanie Avalon: Exactly. So, I will give a link for listeners if they would like to get a CGM, though. Oh, which by the way, CGM, if you were that to a party, you will get a lot of questions.
Cynthia Thurlow: Yes, you will.
Melanie Avalon: Our link for it, you can get $30 off. Just go to nutrisense.io/ifpodcast, and that is good for any of the subscription programs that they have. The subscription programs are more cost effective, so we definitely recommend going that route especially, you'll probably find it's hard to do it just once because it lasts for two weeks. So, you can do it just once, but a lot of people want to keep it on for a little bit.
Cynthia Thurlow: Very insightful.
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Melanie Avalon: Okie-dokie. Shall we jump into questions for today?
Cynthia Thurlow: Absolutely.
Melanie Avalon: To start things off, we have a question from Bo. The subject is, "Adrenal Fatigue and IF." Bo says, "Hello, first off, thank you both for guiding me through my first few months of IF. I started in September 19th of 2018. I don't think I could have gotten through my first couple of months without binge listening to your podcast, joining both of your groups on Facebook and listening to both of your books as well." By the way, this question was written when Gin was still hosting the podcast." She says, "Thank you for all the resources, also giving up stevia in September was probably one of the best things I've done. Thank you, Gin, I will most likely never ingest stevia again. I would choose honey or maple any day. I have been paleo-ish, mainly gluten free, dairy free, wholefoods approach for several years now, and even with my clean diet a couple of years ago, I was diagnosed and treating hypothyroidism. More recently after starting IF, I was diagnosed with the dreaded adrenal fatigue.
Even though I am treating both adrenal fatigue and hypothyroidism and doing IF 19:5 to 17:7, I'm still not losing weight. I originally lost five pounds the first couple of weeks and since then nothing. I'm about 15 to 20 pounds away from my ideal weight and feeling my best body. Since starting my IF lifestyle, I've gone down the rabbit hole of health-related podcasts, all the usual suspects in the keto/paleo sphere. I've heard them mention not to do IF with adrenal fatigue, what are your thoughts? My doctor, who is treating my adrenal fatigue says to listen to my body and see how I feel with IF and my energy levels. My energy levels are always pretty wonky, sometimes stable, other days awful, but never that amazing energy and mental clarity that you both talk about all the time.
I'm wondering if I should focus on healing my adrenals, then come back to IF when they heal in a few months. Do you know if IF is too stressful for adrenal fatigue? Maybe this is why I'm not losing weight. Thank you for your help. Big hugs, Bo."
Cynthia Thurlow: Well, Bo, I think you've answered your question here. First and foremost, for listeners, when we hear the term adrenal fatigue, it's really not adrenal fatigue. It's Hypothalamus-Pituitary-Adrenal Axis Dysregulation, which is a big fancy way of saying, your brain which oversees communication with glands and different organs in the body. As we are transitioning, I don't know Bo's age, so Bo might be in perimenopause, might be in menopause, we don't know but that's when women tend to be much more susceptible to this dysregulation. What drives a lot of HPA dysregulation is stress and inflammation and insulin resistance. There's many, many factors that play into this. I find that our modern-day lifestyles are a huge contributing issue, so I'm grateful that you're working with a knowledgeable physician, number one.
Number two, even in my book, I talk a lot about adrenal and thyroid health and how important it is? I would be the first person to say that you really have to view intermittent fasting as a form of hormesis, so that's a beneficial stress in the right amount at this right time and based on what you have shared here, and again, I'm not giving medical advice, I would defer to your primary care provider internist functional medicine person that you're that you're seeing, but I would not be adding in more stress when your body is already overstressed. Whether it's an underactive thyroid, you have insulin resistance, you just went through a divorce, a hospitalization, you had a big move. Goodness, the pandemic hasn't helped anybody, any of these things can really overtax the body. And from my perspective, depending on what life stage you're in whether or not you're still menstruating, I really think you need to focus in on healing your body before you start adding in additional stressors. Another good resource for you, I interviewed Dr. Doni Wilson earlier this year, she has a great book called Master Your Stress, that you can find on Amazon and we'll put a link to that.
I did a great podcast that we'll link in the show notes as well. She talks a lot about, you know, she has a very specific methodology on how she supports her patients when they are going through this specific type of stressors, how to manage it. She's not a fan of utilizing intermittent fasting when people are still healing. I would probably say that I would be in 100% alignment on that. That's not to suggest that doing 12 hours of digestive rest is a bad thing, but when you think about intermittent fasting as a form of beneficial stress, when your body's already too stressed, it's probably the time to give it a rest and then later reintroduced when you're feeling consistent energy, sleeping well, just the fact that your weight loss resistant tells me that your body has some degree of inflammation and figuring out why your body is so inflamed is going to be an important piece of that puzzle. I hope that helps.
Melanie Avalon: Awesome. Yes, I'll just add to that. I was curious how you're going to start off or how are you going to approach the adrenal fatigue concept because it's interesting how debated it is, even in our world, just as far as does it exist? Does it not exist? Is it a real thing? I recently interviewed Ari Whitten. He's kind of known for his book on red light therapy, but his newest book is called Eat for Energy. He actually opens the book by talking about his experience with being diagnosed with adrenal fatigue, and then researching it and realizing that in the actual scientific studies and literature, it's hard to find support that it's an actual thing. That your adrenals are actually fatigued, or that's actually a concept of what's going on.
I was just looking at a quote, he says in his book, "The vast majority of studies that tested adrenal function and cortisol levels and those with chronic fatigue conditions versus normal healthy people found no differences whatsoever in adrenal function or cortisol levels." But the larger picture that it goes to from that is that people get into the states of fatigue and over stress, and he breaks it down to basically the mitochondria, not being able to adequately deal with all the stressors that were exposed to. Cynthia was saying, intermittent fasting is a hormetic stress, but of course, based on your entire stress bucket, it may or may not be too much for you. I think it's interesting, we talked about this recently, when we were talking about some of Dr. Sarah Ballantyne's work, we can put a link in the show notes to that episode. But we were looking at some studies on intermittent fasting and how it affected stress biomarkers.
And in those studies, they actually found that it was contrary to what they thought they were going to find, but they actually found that intermittent fasting, at least in the setup of those studies, it overall encouraged parasympathetic tone, which is actually the opposite of the overly stress state. All of that to say is, I think I've said a lot of stuff, I think is very individual. So basically, for some people, and how you're doing intermittent fasting, it may be too stressful with your life situations and your "adrenal fatigue," depending on what that actually is or for some people it may be that it fits in well with their life, and it actually alleviates some of their stress and helps their "adrenal fatigue." I think it's just really, really individual so I think you have to do a more comprehensive picture of how you are reacting to it, which is what her doctor told her exactly.
Cynthia Thurlow: Bio-individuality rules, as it always goes.
Melanie Avalon: Yeah. I was thinking about this actually, yesterday. Why was I thinking about this? Oh, I'm prepping to interview Dr. Nayan Patel, he wrote a book about called, The Glutathione Revolution, all about glutathione. I was reading my notes on antioxidants and oxidative stress. He has a chapter about, what type of stress does glutathione help? I was just contemplating, does mental stress create free radicals? I'm on a tangent right now, but does it create free radicals and physical things like that, or is it that it's a taxing stressful situation that leads to the same stressed-out end angle, that physical stress leads to.
Cynthia Thurlow: It's a good question. I think it could be either. The other thing that I would just tack in there before I forget. I, at one point trained with one of the big functional medicine doc's Andrew Hyman, and he was talking to me about adrenal fatigue. In the context of people are really getting this wrong, it's really related to the hippocampus, which is this part of the brain and how sometimes the hippocampus doesn't heal from the insult or the stress that people are experiencing, which can leave them in this kind of downward spiral. This is, I promise, relevant to what you're saying about Ari's book. But you start thinking about if most people over the age of 40 have got mitochondrial dysfunction, is it any surprise that I see prolific amounts of women, north of 35, north of 40, that are just so exhausted.
I think it's a combination in modern day lifestyles and depletion of role of antioxidants, depletion of glutathione. I literally was looking at a research article this weekend, talking about how the past two years, like our longevity here in the United States is actually getting worse and not better, but that probably isn't a surprise. But they were looking at all these like retrospectives, like what's the longevity of someone in Japan or in Korea versus the United States, it's quite significant. I start thinking about these kinds of chronic insults, it's like a bucket, the bucket continues to fill year after year. And then we just get to a point where our bodies are not as stress resilient.
We talk about adrenal fatigue, but really, we're talking about the accumulation of many, many years of insults to the body, whether we're cognizant of it or not, and the resultant fatigue that comes out of that. And for many people, they don't get the answers they want or deserve to get, and so I love that you're introducing so many of the listeners to different perspectives on how people navigate these changes. I will have Ari on, but not until I'm going to say February, because we had to reschedule because he got scheduled on my birthday, which is a whole separate tangential conversation. I don't work on my birthday. That's a standing rule.
Melanie Avalon: Neither. I'm so glad you elaborated on that, because I should probably share his central thesis, which is that the mitochondria basically have two roles. They have a dual role. They have the energy production role, and then they have a defensive stress sensing role. They can't really do both at the same time. So, if they're in the stress mode, the stress mode reacting to threats, it shuts down energy production. So, yeah, I'm excited for you too, to interview him. It's a really good book.
Cynthia Thurlow: Yeah. I mean it's definitely I feel very grateful, as I know you do that. We get opportunities sometimes to read people's books before they are ever officially published. As I'm looking at the voluminous amount of books, I have in my study I feel very grateful, because there's always opportunities to learn something that not only can you share with listeners, but you can take a bit of that and apply it to your own lifestyle. I'm looking at James Nestor book Breath, because it's such a bright cover, it stands out amongst all these other muted books. Makes you realize, every book I read, I try to take something away to be able to share with listeners, share with my community, improve my quality of life, improve someone else's quality life and that's really what it's all about.
Melanie Avalon: I cannot agree more. That example of that cortisol sentence from Ari's book was something that really, really stuck with me, because I had never read that. That he had reviewed the literature and that the majority of it didn't find substantial differences in cortisol levels, which I actually find that really-- I think it's very reassuring, because I think a lot of people get a little bit stressed about being stressed. I do think cortisol levels can be an issue, like you were talking about how they are an issue for people, but I think it's nice to know that maybe it's not quite as intense as we think it might be, because I think it can be very easy to get into a just like an overwhelmed, stressed state about our state of stress and like worried that our cortisol levels are super high, and we should address it, but we can do that without fear. I think just hearing that one sentence, I mean, it made me feel a lot better.
Cynthia Thurlow: Absolutely.
Melanie Avalon: Random thing about James. I didn't realize he wrote a book that I had years ago and now I want to-- I don't know if I actually read it though if I just bought it. But now I want to see if he wants to come on to talk about this book, even though it's like one of his really old works. He wrote a book called Get High Now (without drugs). Have you heard of this book?
Cynthia Thurlow: I have not.
Melanie Avalon: It's like all of the different non drug related things that create a different state of consciousness. From the description, he says, "Lucid dreaming, optical and auditory illusions, controlled breathing, meditation, time compression, physical and mental exercises." I want to invite him on for this. I wonder how often authors get invited to do an interview on one of their old-- this is a 2009 book.
Cynthia Thurlow: I bet you, he'd be very flattered. I found him to be delightfully down to earth. Given his-- would I perceive to be definitely one of the more well-respected science writers that’s out there.
Melanie Avalon: I'm going to reach out. So okie-dokie. Shall we go on to our next question?
Cynthia Thurlow: Absolutely. This is from Gretchen, and the subject is "Smells." "Thank you so much for your podcast. I've been listening to it nonstop and started my IF journey on mundane. My question about smells. We're spending most of our time at home nowadays. And my husband loves to cook big breakfast and lunches. He's downstairs making something delicious for lunch, and my mouth is watering from the glorious aromas. Can this cause insulin levels to spike just as artificially sweetened beverages can? I've been able to breezed the days without hunger unless he is cooking. "
Melanie Avalon: All right, Gretchen, thank you so much for your question. I believe my thoughts on this answer are, yes. We've talked about this before on the show but it's to the same extent as the artificial sweeteners. What I think is important to understand is, I think people think with insulin release, that it's just one process so it's released or it's not released. And once it's released, it's releasing. But there's actually two phases to insulin release. There's the cephalic phase insulin response, which basically your pancreas always has a little bit of insulin ready and waiting and it taps out. There's only so much there and that's for when you smell something or when you're anticipating about to eat, so it releases a little bit of insulin, but then for the actual, like insulin bolus that keeps going in a sustained, that's created then in the pancreas, and that's more when you're actually eating. I've looked at a study before and I think we've talked about on a prior show.
Basically, yes, the smells can likely release some insulin, but it's probably not going to start that second train of insulin production. Meaning, you can basically wait it out, if that makes sense. Do you have thoughts, Cynthia?
Cynthia Thurlow: I would agree with you too. I think that we don't want to navigate our lives feeling fearful that if we smell something delicious, that somehow we've broken our fast or derailed our fast. We have to think big context, like when we're talking about breaking your fast, I really think it needs to come down to ingesting something as opposed to smelling something. I think we would otherwise go through our lives, not just enjoying, being present, being around family, being around friends, being in a work environment, and being fearful, we're going to smell something delicious. I think we have to think about the big picture. Generally, I look at it, have you ingested the food? That is more important to me than if you just smelled the food because the cephalic phase insulin response, yes, that's there. But I have to believe that our bodies, it's more sophisticated than that. I mean, you will get this small release in response to smelling something delicious but that's really irrelevant. It's more about what habits are going to break your fast and ingesting the food we'll do that.
Melanie Avalon: Exactly. I'm trying to remember because there was definitely [sighs] there was a study I had read and it was about people smelling chocolate, or it was literally asking this exact question, and what were the effects? The answer was that, yes, it likely releases insulin, but it's just that small amount. And it's something that you weighed out, I'm really glad that you drew attention to the practicality of it all. If you couldn't smell things, that's no, not practical.
Cynthia Thurlow: It's interesting because there's-- and I don’t mean to speak over you. One of the most powerful connections to memories that we have, is there an olfactory system. If I smell carrots, I instantly and brought back to my grandparent's garden in Colorado. Our memories are so intertwined with smells, and our olfactory system, I think it's really important that we not try to diminish those experiences. I think that's just important to state that it's really tied in with memories. There are certain smells like wonderful, delicious smells related to food that bring me back to happy times in my childhood or young adult adulthood. And you don't want to diminish those. I think that's important.
Melanie Avalon: I could not agree more. I'm trying to remember Mark Schatzker, who I keep talking about with The End of Craving and The Dorito Effect. I learned in that book that we have more DNA devoted to our nose and the mouth than any other part of the human body which is fascinating. It's definitely something that we should be engaging in.
Cynthia Thurlow: Yeah. Exactly. It's the same thing and I'm sure you get these questions, where people are paranoid to brush their teeth or they're paranoid to take a medication that's prescribed with for fear that it's breaking a fast. And I always say let's think big picture. Like not brushing your teeth, the ramifications of that are greater than brushing your teeth, provided you're not swallowing your toothpaste, which I don't think anyone--that's an adult does that. I know toddlers are notorious for that. I just think we always have to be focused on the big picture. I think that's what's most important.
Melanie Avalon: I cannot agree more. All right, so we can go on to our next question. I don't know how to say her name, It's U-T-E, Ute maybe.
Cynthia Thurlow: Ute, that sounds good.
Melanie Avalon: She's from Germany. The subject is "Menopause." Ute says, "Hello, ladies. I discovered your podcast last weekend while researching a healthy lifestyle that I can maintain effortlessly. Calorie counting is so depressing and it drives me bonkers. Thank you for all the great information and tips. Since I'm going through menopause, fun times, I wonder if there is some advice you can give." That's a very wide-open question. This is a Cynthia question.
Cynthia Thurlow: Yeah. Truly. Well, I think it's always the reframe. We shouldn't perceive that menopause or perimenopause is a negative thing. I mean, you're going through reverse puberty, but there's so many benefits to not having to worry about getting pregnant anymore, you're not having a cycle every month, your fertility is waxing and waning, and then it's gone. But to me, being at a different stage in my life, I think it's really empowering. I have the bandwidth to do things I wasn't capable of doing 15 or 20 years ago. So, in terms of resources, I would say I've done a lot of podcast around perimenopause and menopause, most recently with Dr. Louann Brizendine, who is a neuropsychiatrist, trained at Harvard. I mean, she's absolutely brilliant. She wrote a book called The Upgrade. The upgrade is menopause, but she said, if we really reflect on the fact that a lot of the terminology around women and aging was created by men, generally, male physicians and the pharmaceutical industry.
She does a really beautiful job of helping us reframe what's happening in our bodies, so we are no longer menstruating or we're getting close to no longer menstruating. We're not in a position where we can become pregnant without technology, that there are changes to our brain, there's changes to the way we perceive the world. There's changes to the way our body responds to certain macronutrients and exercise and sleep. There's lots of really wonderful books. I would say, The Upgrade is definitely a favorite.
I would say Dr. Lara Briden, has a really excellent book called Hormone Repair Manual. That's Dr. Lara Briden, and I've had her on the podcast. Dr. Sara Gottfried has some fantastic resources, probably my favorite book of hers is The Hormone Cure. Then I think about researchers like Dr. Lisa Mosconi, who is an Alzheimer's brain health researcher at Cornell, she wrote a book called, The XX Brain that I recommend almost daily. I would say those are really great resources and I've done podcasts with each one of them except Dr. Mosconi because she's doing so much research, I literally harass her publicist, probably once a month. I'm going to eventually get her on the podcast. I think a lot of menopause is reframing things. Hot flashes, weight, gain, inflammation, etc., are largely a byproduct of how well we take care of ourselves. So, there's always room for improvement and I find most women, usually within a year or two going through menopause, their symptoms will settle down.
It's important to understand the things we need to prioritize in this time in our life. I think about sleep quality, stress management, anti-inflammatory nutrition, that could look different for most everyone. But I find the most inflammatory foods for most women are dairy and gluten and alcohol and sugar. Let me put an apostrophe time seven next to sugar. And understanding that your relationship with certain types of foods are going to shift really focusing on, they call it neat, but the exercise we do outside of formal exercise is important. Walking, just being active, not sitting on your rear end all day long and then lifting weights.
I see so many women that I'm inspired by on social media, there's the good and the bad with social media, but there are definitely average everyday women that I see on social media that are just killing it in their 40s, 50s, 60s, and beyond, like doing amazing things. It's a time of tremendous creativity, it's a time to really reflect on your life and your contributions. And so I would say, I hope that those resources are helpful, we'll make sure that we link those podcasts, and those books in the show notes, so that will be available to you as well.
Melanie, is there anything that you'd like to add? I know that you're not in this stage of life, but I'm sure you probably interviewing so many people, you probably have some suggestions as well.
Melanie Avalon: Resources wise, that was very comprehensive and amazing. I'm actually just personally, I'm very curious what my experience will be when I go through menopause because I feel like when I had my period of heavy metal toxicity, like to the extreme mercury toxicity that I exhibited, it was like all the symptoms that I see listed as menopausal symptoms. Just because of the, I guess, the hormonal dysregulation from that. I've been very curious when I go through menopause, if it will be. I remember when I was in that I was like, "When I go through menopause, it's going to be a breeze once--" I guess if I can get through this. But I would get all of that like hot flashes and fluctuations and insomnia, and create, like just so many, all of the things. So, that's not very helpful. It's just my experience.
Cynthia Thurlow: I think the better you take care of yourself in perimenopause. From 35 up, the better you take care of your nutrition and your sleep and your stress management and doing the right kinds of exercise, the easier that transition will be. I would say for most people, it's bumpy, because they still want to act and behave like they did at 20 and you can't. And that's not a bad thing. I don't want to eat the way I did when I was 20, I don't want to live the way I did when I was 20, and so once I kind of understood, I had to eliminate some foods, focus on other areas really prioritize sleep, which I affectionately call an art form, because truly it is. Melanie, at some point, I'll have to tell you about my new sleep device that I'm using that you'll probably laugh about. But we'll talk more about it.
Melanie Avalon: Do I know what it is?
Cynthia Thurlow: Probably not, because I haven't talked a lot about it on social media. But I have something called Somnox, S-O-M-N-O-X. It looks like a stuffed bean. Like it's the shape of a bean or like a mitochondria. That's probably a better more apt description. You hug it while you're starting to fall asleep, and so I set mine for 30 minutes, and it actually will adjust to your breathing pattern. And what it's doing is stimulating the autonomic nervous system parasympathetic. I've doubled my deep sleep.
Melanie Avalon: Is it a similar concept to the Apollo Neuro where it's using the vibrations?
Cynthia Thurlow: Yeah. It's different. It's different than the Apollo Neuro which obviously I love, and love, love, love that. That's certainly very helpful for stress reduction. But for me, I've just been using it before I go to sleep. And my husband is like, "Oh, my God, what's next for you? You sleep with the sleep mask, you've got your blue blockers--[laughs] You've got all these things that you do and you sleep with your Oura ring." But it's honest to goodness, it's doubled my sleep. Let me be clear, they gifted this to me, I was not even aware of it. They gifted to me, and this is my objective opinion. I don't have an affiliate account with them. I mean, I don't get anything for talking about it. Just really have been impressed with the technology and then it turns off. It's not exposing me to anything that's negative. But, yeah, I now sleep with what looks like a little mitochondria tucked up against my chest.
Melanie Avalon: Can you connect me to them? I want to try this. I'm surprised they haven't reached out to me. That's right up my alley.
Cynthia Thurlow: I know. It's completely random that they reached out because sometimes I'm sure this happens to you too. People reach out to you randomly and sometimes I'm just very polite and say, "I don't really think I would use that. I don't want to waste your time or your resources sending me something that I don't think I would use or support." I looked at and I was like, "Oh, it can't hurt." My husband was like, "What next?" I was like, "I don't know." I just know that’s helping my deep sleep and that for me as a middle-aged woman is pretty incredible.
Melanie Avalon: What was it called again? Somnox.
Cynthia Thurlow: It's Somnox, S-O-M-N-O-X. I think it's a German based company.
Melanie Avalon: That is so cool.
Cynthia Thurlow: That's very cool. Except my husband is now embarrassed. He's like, "What is that thing?" I'm like, "It's my little Somnox."
Melanie Avalon: Oh, my goodness. What color is it?
Cynthia Thurlow: It's blue. It's a delightful pleasing blue. It's blue like dark blue and light blue.
Melanie Avalon: You hug it, basically.
Cynthia Thurlow: Yeah. It's curved, so it's designed to just fit in to your chest as you sleep, so I turn on my side. I do like 30 minutes and it acclimates to my breathing and I just fall blissfully asleep. It's amazing. There's no nothing else that's changed.
Melanie Avalon: I need this. Okay, this is great. Wow. To-do list. One other question, I don't even know if I should ask it because it's a big question but with the menopause stuff, do you find people benefit from HRT?
Cynthia Thurlow: I do. I think the Women's Health Initiative came out in 2002. So right as I was finishing up my NP program, and the research that was done, and the points that were drawn from the research, there's a lot to unpack here. I did a great podcast with Dr. Avrum Bluming and Carol Tavris, talking about why estrogen matters. That's their book, but it basically explains what was flawed about this study. And it's really important that I just state an entire generation of clinicians, and an entire generation of women have been harmed by the way that this research was shared. We're just now getting to a point where I think most, if not all, clinicians are talking openly about the fact that there is benefit from replacing hormones that our bodies have naturally stopped producing.
As an overall, like general statement, I do think women benefit from Bioidentical Hormone Replacement. I do. I myself take compounded, good Lord, compounded progesterone and compounded T4/T3. I have testosterone, I also have estrogen, I've got it all. I really do think for me personally that they help asleep, they help with inter kind of synergistically, each one of them is helping me with different aspects of navigating these years. But the thing that I get most concerned about, and anyone that's listening, that's 35 and up, I worry the most about cognitive function because Alzheimer's and dementia, they don't start in your 70s or 60s, the groundwork is laid many years before. This is important 30s, 40s, 50s, how well we take care of ourselves sets us up for developing disorders of cognition.
For me, I'm most concerned about brain health, and then secondarily to that bone and heart health, of course. Then beyond that, just wanting to be able to navigate every stage of life that I'm in, I want to be able to enjoy my life and not feel like I can't be 100%. So, getting back to your original question, I do. I think it's all about finding practitioners that are not only capable, but current and openminded to help you find the combination of medications that are best for you. Like I've now gotten to a point that anything that's made conventionally just has not worked well for me. Now we just finally stopped Synthroid and Cytomel, now I'm on compounded T4 and T3 and my functional medicine doc told me I have the most "curious thyroid panel" he's ever seen. With that being said, everyone that's listening, I have women who are petrified of hormones, I have women who are openminded to hormones. I think it's just important to have those conversations, like whether it's with your GYN or your internist or your girlfriend, just understand there are options, you don't have to suffer.
Melanie Avalon: I'm really, really happy to hear you say that. That was my understanding of that, of the Women's Health Initiative because basically, the takeaway was they said it encouraged, was it breast cancer? It was not done correctly and interpreted correctly and created a potentially-- Yeah, well, everything that you said, misled.
Cynthia Thurlow: It's unfortunate because the samples, the study participants were older, they weren't 49, 50, 52, they were in their 60s. Many of them had been smokers, they had high blood pressure, they were diabetic, they were obese. They weren't a healthy population to start with and they used Premarin and they use Progestin, which is synthetic form of progesterone. It's interesting, everyone knows that you and I both love Huberman and Dr. Peter Attia, they had a really interesting discussion. Peter Attia was a guest on Huberman lab. Fairly recently, in about an hour in to the podcast interview, Peter Attia effectively stated that this was one of the greatest disasters he's ever witnessed as a clinician, that it has such profound implication and impact.
I look at my mother's generation, my mom is 76 and has terrible osteoporosis and we're starting to see some degree of cognitive changes. It's unfortunate, because she thought, "Oh, if I'm using vaginal estrogen that's going to protect me." And I said, "It doesn't protect your bones, maybe your vagina," which I mean, let's be honest, that's an important part of being a woman, but there was just not good information given to these women. They were not fully informed and so I think we just have a whole generation of women and clinicians that are fearful about prescribing hormones. I almost get a question about this every single day on social media, which tells me that we need to continue talking about it. It's important for people to know that working with a talented, competent clinician, if you're in a situation where you need hormonal therapies that there are people out there that can help you through that.
Melanie Avalon: Yeah. I'm just thinking, I don't know if I'll be able to articulate this, but it was an effect that was very pervasive because I feel like even me, even before I was super steeped in the health and wellness sphere, and even when I was younger when I wasn't even thinking about this type of stuff, there was a vibe surrounding HRT that it was, like not a good thing to do. I just think it really, really got into culture, which is kind of a shame that it went that way.
Cynthia Thurlow: Absolutely, because we have a generation of women that are struggling. It's not like the conversation I had with Dr. Louann Brizendine, and she's based out of California. She's almost 70, she doesn't look at first of all, and she's like, "I have amazing bone strength." She's been on HRT for almost 20 years and she's a tiny petite person and she said, "I have amazing bone strength. I've got very healthy bone, but I credit that to HRT."
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All right. Shall we answer one more question?
Cynthia Thurlow: Absolutely. This is from Sybil Ann, subject is, "Need help from South Africa." "Hi, first of all, thanks so much for all the effort you put into the podcast. Love, love, love the podcast. I'm not sure how to 100% phrase my question, but what strategies do you or did you use to stick to the plan. I started out really strong. The first two weeks, I almost effortlessly fasted 18 to 20 hours daily and then all of a sudden it became difficult. It's like I have a mental block, I can't move past. Nothing significant has happened in my life, so it's not related to stress or anything. I follow all recommendations and fast, totally clean. Did this ever happen to you? You wake up one day and fasting seems hard. I don't understand how I could do so well and feel so good, and then a few weeks in, feel different. Did this ever happen to you? Any advice or tips would be greatly appreciated. Thanks so much for taking the time to read my question. Best regards, Sybil."
Melanie Avalon: All right, Sybil from South Africa. Thank you so much for the question. So, I do think this is a common thing that happens with people. It's not exactly the same thing but it's sort of how with even calorie restriction or normal diets or crash diets, people can sometimes do it really well in the beginning and then it becomes really, really hard. The reason that happens is because it's not sustainable, whatever dietary restriction that the person is doing. I think with fasting a lot that this can also happen where somebody starts intermittent fasting. In the beginning, it's great, they're losing weight, their adrenaline's probably up, they have energy. But then if the actual eating window is not a sustainable amount, then you're going to reach a point where your body's going to give signals to you that it's not a sustainable amount.
This is the case I would really, like, where you just randomly one day it's hard, I believe it might be because you're actually not fueling adequately in your eating window. So, I would suggest one of two things, either having a longer eating window, so changing the fasting hours, or really addressing what you're eating in that eating window, making sure that you're getting adequate fuel, adequate protein, especially, depending on what macros you're doing. If you're doing a mixed diet, then this wouldn't really apply, but if you're doing a low carb diet, making sure you're getting ample fats to support your fast, if you're doing high carb, making sure you're getting enough calories in the form of the carbs. So yes, I think what happens, I've already said it, but it's people like going on adrenaline and doing well in the beginning, but their eating choices aren't actually sustainable. So that's what I would look at. Do you have thoughts?
Cynthia Thurlow: Yeah. I mean, of course, I always come from the perspective, are you having a harder time with fasting depending on where you are in your menstrual cycle? Because it's much easier to do that when estrogen predominates in the follicular phase, which is in the beginning versus the week before your menstrual cycle. I do think when we are creating lifestyle change opportunities, we have to be really mindful of what is sustainable. Are you too restrictive? Are you not getting enough macros during your feeding window? Are you not sleeping well? Are you over exercising? Is there just too much stress going on in your personal life? I think sometimes we set really not necessarily unachievable, but not sustainable goals. And so I would really encourage you to think about what is something you can do for the rest of your life versus something for just a couple of weeks, because that's a really important distinction.
For me, personally, if someone said to me I could never have dark chocolate for the rest of my life, that would not be sustainable, versus if I say to myself, I'm allowed to have a small piece of dark chocolate every other day, and I can sustain that, then that is a sustainable goal. I'm giving a terrible example. Dark chocolate is my one vice. If people don't know that already, that's like my one vice in life. It'd be very hard to give that up. So, I think when you're looking at a plan and you're creating changes, sometimes I see people doing too many things all at once. Meaning, they're trying to improve their sleep, they're trying to exercise or trying to fast, they're trying to do all the things all at once. What they really need to do is pick one thing at a time, master that and then add more things and that is much more achievable and sustainable.
Melanie Avalon: Yeah. I cannot agree more. So hopefully that's helpful. All right. One more question we can sneak in. This comes from Cheyenne, and the subject is "Easing into a fast." Cheyenne says, "Hello, I've been listening to your podcast for just a few days and love it. I've been practicing IF for about 9-years. For most of those years, I had great success and practicing a 16:8 fast and have been able to maintain a healthy weight. That said, I've been slowly putting on weight for the last year or so, I'm starting to think it has to do with my age. I'm currently 41. After listening to your podcast, I thought I might try to increase my fasting to a 24 or one meal a day. It was tough. About two hours before I was to break my fast, I got really cold in my extremities and became pretty weak. When I finally broke my fast, I didn't binge but I was extremely tired and had to go to sleep. My question is how do I ease into a longer fast comfortably? P.S. I did have my thyroid checked, and though it's on the low side, it's still a normal range and my doctor is a big proponent of IF. Thanks so much.
Cynthia Thurlow: This is a great question. This goes back to something a theme that I am starting to talk about more openly on social media. The presumption that what you have to do is fast longer and restrict more and what it may mean because you're in that perimenopausal age range, it can be a lot of factors, that could be why you're becoming weight loss resistant. Have you lost muscle mass. Melanie and I were talking earlier about the loss of insulin sensitivity with less muscle that we have and we start to lose muscle after the age of 40. And depending on who you're talking to, it could be 3%. It's pretty significant and it starts to just accelerate like a freight train. What's your stress management like? What's your sleep quality like? Are you exercising? Are you lifting weights? Are you having an anti-inflammatory diet? I don't like short feeding windows, because you're never going to be able to hit your protein macros. I would encourage you to explore those other lifestyle pieces first. If you decide for yourself that you got all those things ratcheted in, I would not be doing a short OMAD type eating methodology. I would not be doing that every day. It's going to be very hard to hit your protein macros, and you don't want to be losing insulin sensitivity and muscle mass, especially as you're heading into perimenopause and menopause. Melanie, what are your thoughts?
Melanie Avalon: I think it's interesting, because people, like you basically just said this, but people when they have an issue with not losing weight, or not feeling like their diet is working, they think the answer is automatically fast more, like that's the answer. I personally think there's so much benefit that can go into looking at the food choices specifically. Especially, when people writing questions, I don't think she mentions at all what she's eating. When people don't mention actually what they're eating, then I feel there's possibly the potential for a lot of the benefits that you want to experience by addressing what you're eating rather than fasting more. If you're not eating a whole foods based diet, moving to a whole foods based diet. Like Cynthia said, really focusing on the protein, things like that can be huge. But then if you do want to fast for no reason-- so basically, she went from going nine years 16:8, jumping into a short eating window. I would suggest just slowly tightening it up and slowly approaching if you want to make a shorter eating window, so doing a 17:7, and then 18:6 and seeing how you feel going a little bit longer.
There's nothing wrong with just fasting a little bit longer, you don't have to jump into a short eating window you could just add an extra hour here or there. Also, little hacks that you could do maybe fasting just a little bit longer, like adding an extra hour and really putting in some physical activity near the end of that fast, that can have a really beneficial effect for people, both for fat burning, as well as setting you up for your eating window, insulin sensitivity and things like that. So, yes, I would just take a different approach than the jumping all in to the short eating window approach.
Cynthia Thurlow: I agree. I think and I hope that we will continue kind of investigating this triad that I'm seeing in a lot of women where the presumption is more fasting, more exercise, more food restriction is going to allow them to lose the weight they're frustrated with.
Melanie Avalon: Exactly. Awesome. All right, so this has been absolutely wonderful. So, a few things for listeners before we go. If you would like to submit your own questions for the show, you can directly email firstname.lastname@example.org or you can go to ifpodcast.com and you can submit questions there. You can find the show notes, I feel like we talked about so much stuff in today's episode. I always feel bad for Brianna, our show notes creator, all the links we'll be sending her way to put into the show notes. They will be at ifpodcast.com/episode284. You can follow us on Instagram as well. That is @ifpodcast. I am @melanieavalon, Cynthia is @cynthia_thurlow_. Well, this has been absolutely wonderful. Anything from you, Cynthia, before we go.
Cynthia Thurlow: No, just we got through a lot of questions today. I think I always feel very productive when we can make that happen.
Melanie Avalon: Same thing. All right. Well, I will talk to you next week.
Cynthia Thurlow: Sounds good.
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 and no patient-doctor relationship is formed. 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, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.
[Transcript provided by SpeechDocs Podcast Transcription]
STUFF WE LIKE
Check out the Stuff We Like page for links to any of the books/supplements/products etc. mentioned on the podcast that we like!
Melanie's What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine
Cynthia's Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging
More on Melanie: MelanieAvalon.com
More on Cynthia: cynthiathurlow.com
Theme Music Composed By Leland Cox: LelandCox.com
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