Episode 285: The Mandela Effect, Dry Fasting, Nutritional Supplementation, Pregnancy, Prenatal Health, Maintenance Fasting, Intuitive Eating, And More!

Welcome to Episode 285 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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SHOW NOTES

LMNT: For A Limited Time Go To drinklmnt.com/ifpodcast To Get A FREE Sample Pack With Any Purchase! Learn All About Electrolytes In Episode 237 - Our Interview With Robb Wolf!

BEAUTYCOUNTER: Keep Your Fast Clean Inside And Out With Safe Skincare! Shop With Us At melanieavalon.com/beautycounter or beautycounter.com/cynthiathurlow And Use The Code CLEANFORALL20 For 20% Off PLUS 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!

GREEN CHEF: Go To greenchef.com/ifpodcast135 And Use Code IFPODCAST135 To Get $135 Off 5 Boxes And Free Shipping!

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!

Listener Q&A: Leah - Ship food and I don't mean cruise liner

Enjoy 20% Off at At Energybits.com With The Coupon Code MelanieAvalon or CYNTHIAthurlow!

Ep. 226 The Ultimate Superfoods: Spirulina and Algae with Dr. Catharine Arnston

The Melanie Avalon Biohacking Podcast Episode #129 - Catharine Arnston

Get an exclusive discount at melanieavalon.com/perfectamino with the code melanieavalon!

Listener Q&A: Jacek - Fasting without water

Dry Fasting Physiology: Responses to Hypovolemia and Hypertonicity

Effects of Daytime Dry Fasting on Hydration, Glucose Metabolism and Circadian Phase: A Prospective Exploratory Cohort Study in Bahá'í Volunteers

Listener Q&A: Sara - Fasting and pregnancy

Athletic Greens: Get A FREE 1 year supply of immune-supporting Vitamin D AND 5 FREE travel packs with your first purchase at athleticgreens.com/IFPODCAST.

Listener Q&A: Rebekah - 16 Hour Daily Fasts Enough for Weight Maintenance?

Listener Q&A: Heidi - Learning your body

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.

TRANSCRIPT

Melanie Avalon: Welcome to Episode 285 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 podcast 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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Robb Wolf, who as you guys know is my hero in the holistic health world, worked with the guys at Keto Gains to get the exact formulation for electrolyte supplements to formulate LMNT Recharge, so you can maintain ketosis and feel your best. LMNT Recharge has no sugar, no coloring, no artificial ingredients, no junk. They're used by three Navy SEAL teams, they are the official hydration partner to Team USA weightlifting, they're used by multiple NFL teams, and so much more.

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And one more thing before we jump in, are you fasting clean inside and out? When it comes to weight loss, we focus a lot on what and when we eat. It makes sense, because these foods affect our hormones and how our bodies store and burn fat. But do you know what is possibly one of the most influential factors in weight gain? It's not your food and it's not fasting. It's actually our skincare and makeup.

As it turns out, Europe has banned over a thousand compounds found in conventional skincare and makeup in the US due to their toxicity. These include endocrine disruptors, which mess with your hormones, carcinogens linked to cancer, and obesogens, which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream. And then in our bodies, studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat, and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that.

Beyond weight gain and weight loss, these compounds have very detrimental effects on our health, and they affect the health of our future generations. That's because, ladies, when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so, so shocking and the effects last for years. Conventional lipstick, for example, often tests high in lead and the half-life of lead is up to 30 years. That means when you put on some conventional lipstick, 30 years later, maybe half of that lead has left your bones. On top of that, there is essentially no regulation of these products on the shelves.

That's why it's up to us to choose brands that are changing this. The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin so you can truly feel good about what you put on. And friends, these products really, really work. They are incredible. They have Countertime for anti-aging, Countermatch for normal skin, Countercontrol for acne and oily prone, and Counterstart for sensitive. I use their overnight resurfacing peel and vitamin C serum every single night of my life. And their makeup is amazing. Check on my Instagram to see what it looks like. Tina Fey even wore all Beautycounter makeup when she hosted The Golden Globes. So, yes, it is high-definition camera ready. They have so many other products, deodorant, shampoo and conditioner that I love, products for babies, and so much more.

You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20, to get 20% off your first order. Also, make sure to get on my clean beauty email list. That's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. So, definitely check it out. You can join me in my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well.

And lastly, if you're thinking of making clean beauty and safe skincare a part of your future like we have, we definitely recommend 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. It is totally, completely worth it. So, again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20, to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.

Hi everybody and welcome. This is episode number 285 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.

Cynthia Thurlow: Hey, Melanie.

Melanie Avalon: Cynthia, I have an important question for you.

Cynthia Thurlow: Okay.

Melanie Avalon: When you had your boys growing up, did they watch VHS Disney movies? Or is that more of a girl thing?

Cynthia Thurlow: Did they watch Disney movies? Yes.

Melanie Avalon: There's a reason I'm asking.

Cynthia Thurlow: Yeah. So, DVDs, yes. And that was before like streaming was a thing.

Melanie Avalon: So, were they growing up at all during the VHS phase?

Cynthia Thurlow: No. Unh-uh.

Melanie Avalon: Okay, so this might not be applicable. My sister and I [chuckles] had like a two-hour conversation about-- have you heard about the Tinkerbell Mandela Effect?

Cynthia Thurlow: No.

Melanie Avalon: Okay, this is not even relevant. Well, I will [chuckles] put it out to the audience, because I posted about this on Instagram. And I don't think I've ever received so many DMs in my life about something. So, are you familiar with the Mandela Effect?

Cynthia Thurlow: Not offhand.

Melanie Avalon: Oh, it's so fascinating. It's basically the concept of memories that society will have that are not real. It started from this idea where apparently-- you would know this. Do you have a memory of Nelson Mandela dying in prison in the 1980s?

Cynthia Thurlow: I thought Mandela died in the 2000s because I was actually in South Africa when he was still-- let me see, what year did he die?

Melanie Avalon: 2013.

Cynthia Thurlow: Yeah.

Melanie Avalon: Okay, so you are not part of that. So apparently, a lot of people remember him dying in the 1980s.

Cynthia Thurlow: No, because I was going to say when I was actually in Cape Town. I was in South Africa when he was still alive.

Melanie Avalon: Okay. Wow. Yeah. So, that's where the name came from. But there's all of these examples. So, if you google Mandela Effect and there's a Wikipedia page about it. There's all these things where people have memories that are just not accurate. And it's a lot of like weird things where it's like why would everybody remember this very specific thing? That's not true. It's a lot of like logos like people think the Fruit of the Loom has a cornucopia logo, but there's not people think with a Chick-fil-A that it's spelled, how do you think Chick-fil-A spelled?

Cynthia Thurlow: Isn't it? It's like CHIK?

Melanie Avalon:  Right? That's what people think it's not. It's CHICK.

Cynthia Thurlow: See, you know what's interesting though like to me in my brain there's a difference between knowing when Mandela died. Versus like fast-food names. But I agree with you, I can see that.

Melanie Avalon: I remember in the VHS's, of Disney movies with the opening icon where it's the castle, I remember some sort of thing where Tinkerbell comes and flies and like dots the 'I' or like touches the castle with her wand. And if you go online and my sister remembers if you go online, there are like Reddit threads and boards like hundreds of comments and YouTube videos with people being like, "This happened. I remember it," but it didn't. Nobody can find any footage of it. And when I posted it on my Instagram, I probably got 40 DMs of people being like, "Yeah, that happened. I have it in my VHS's." And I had to respond to everyone and be like, "Well, if you find it, you're going to go viral, because nobody can find it." Isn't that crazy?

Cynthia Thurlow: That's just crazy.

Melanie Avalon: So, I don't know. It is a rabbit hole. So, listeners, if you remember this, and if you have footage, please let me know. Because you'll change the internet. Sorry, that's my random opening.

Cynthia Thurlow: No, no, I was going to say, were we spending time last evening thinking about this contemplating?

Melanie Avalon: No, I just had it on my to do list to bring it up on the show, because I literally went down the rabbit hole sort of recently. And then with the Instagram I was like I have to talk about on the podcast. I want to hear our listeners' thoughts, because we have an audience of 40,000 people, and I want to be vindicated in this memory.

Cynthia Thurlow: [laughs] But it's so funny that when you said Mandela died in the 90s, I was like "No, he didn't." I was there. Like I wasn't there when he died but I was in Cape Town the year that he passed away. So, that left an indelible impression on me. And if any listeners have ever been to South Africa or Cape Town, it's one of the most beautiful cities I've ever been to.

Melanie Avalon: It's just so fascinating. Some of the other ones are people apparently remember some Sinbad Genie movie that does not exist and--

Cynthia Thurlow: Are you talking about the really bad, like 1960s version that has very obvious faux creatures.

Melanie Avalon: Is it with Sinbad?

Cynthia Thurlow: Yeah. But no, not the Sinbad. Like the comedian in the Sinbad story.

Melanie Avalon: Oh, oh, no, this is the comedian.

Cynthia Thurlow: Oh, yeah, no, mm-hmm.

Melanie Avalon: And then like, where's Waldo?, people remember him incorrectly. There's so many things. I find it so fascinating. Oh, Froot Loops is the way it's spelled. It's F-R-O-O-T, Froot Loops.

Cynthia Thurlow: Is it really?

Melanie Avalon: Mm-hmm

Cynthia Thurlow: My parents never let me have those cereals.

Melanie Avalon: I need to ask my mother this, because we could eat the conventional cereals. Like all of them but we couldn't eat Fruity Pebbles because it "had too much sugar." And I have no idea. Like, didn't they all have too much sugar? Why was Fruity Pebbles different? Yes.

Cynthia Thurlow: No, my mom is first generation, and she was very strict about what we ate. Not per se in a bad way but it was a very nutrient-dense whole food. Like we were eating fresh, made bread and liver before it was in vogue.

Melanie Avalon: Wow, I'm jealous of you.

Cynthia Thurlow: No, I don't like liver. To this day, I don't like-- I think it's too metallic. I'm never going to be that person that can eat organ meats and do it with a smile on my face. I'm just being honest.

Melanie Avalon: I've thought about this a lot. I've talked about it with things. I would think that I would like organ meats because of the way I eat and they're so nutritious, but I just don't. They don't taste good to me.

Cynthia Thurlow: Yeah, it's very metallic. I remember and I know you've interviewed Paul Saladino on your podcast as well. And one of the listener questions was what is he eating, and he had just had like spleen and pancreas. And I think I vomited in my mouth. I was like, "Wow."

Melanie Avalon: Testicle?

Cynthia Thurlow:  Yeah, I was like, "That's so impressive." And I'm so impressed. But I could not do that. Not willingly.

Melanie Avalon: It reminds me of the guy who runs Ancestral Supplements who's on Instagram, he's always eating all the organ meats. And Joe Rogan recently made a comment about him being on steroids or something. And he responded and he's like, "No, it's all the organ meats."

Cynthia Thurlow: Oh, jeez. [chuckles]. More power to you, my friend.

Melanie Avalon: Yeah, well, in any case, anything new in your life?

Cynthia Thurlow: No, just three programs are like underway. September's always like a super busy month. And I'm just grateful. And hopefully my creatine will have a date for it to be officially launched. I'm just kind of holding my breath. Lots of little things along the way that we've had to dial in on to make sure it's perfect to be able to share with the world.

Melanie Avalon: I'm so excited for you for that and I'm so excited to start taking because I've never taken creatine.

Cynthia Thurlow: The one thing that's interesting is if you read the research on creatine, that's number one. I mean, there's real research, but I've been taking it consistently, since I-- so, when I had my hip surgery in May, and then I wasn't clear to go back to the gym until June, and I didn't get back to the gym until like late June, early July. I track all of my progress through an app on how much weight I can lift and I'm consistently going up by 10 or 15 pounds every single week. And that's with consistent utilization of creatine, which I'm excited about.

Melanie Avalon: Do you know if a person-- because I eat such a high protein diet, do you think I would still benefit from creatine supplementation?

Cynthia Thurlow: I think you could, and I've had conversations with Dr. Gabrielle Lyon about this because obviously I've had her input on some recommendations. We know if you look at research that menstruating women, so if you're actually actively menstruating, menopausal women, vegetarians, and vegans actually need more creatine than those that are not actively menstruating, those that are not postmenopausal. In terms of the research, I think most would do well with at least 3 grams a day of creatine. And then if you're one of those people, like vegetarian, vegan, because you just don't get enough exogenous creatine in your diet, they would likely need 5 grams a day. So, definitely there's differentiators for individuals. And you're still at an age where you've got peak bone and muscle mass. Very different than if you're looking at a 40-year-old woman versus a 50 or a woman versus a 60-year-old woman. So, I think that you're at a position to be able to really maximize muscle mass at your age, knowing what you know, versus people that are a little bit older. They have to work a bit more diligently to build that muscle.

Although it's interesting, one of the things that I've learned is, as we get older, our protein needs actually increased because we don't pull as much-- I mean we just don't break down the amino acids quite as effectively. And so, a 30-year-old like yourself, I know you eat copious amounts of protein, your body probably does a better, more efficient job breaking the protein into amino acids and assimilating them than someone at my stage where I might have to eat a little more protein to make up for the fact that my body doesn't utilize it as efficiently. And that's something I'm constantly thinking about. That's why it's so important you're hitting those protein macros, as opposed to things we just take for granted. Our bodies just don't work as efficiently as we get older. It's almost like we become a very fine-tuned car. And so, there's less bandwidth with which to work with and you have to really be consistent to be able to see efforts. I look at my teenagers who put on muscle effortlessly, because their bodies are in this massive anabolic phase, versus where I am where I'm in more of a catabolic phase, unless I'm working against that diligently. I'm not sure, did that help?

Melanie Avalon: It sounds like, especially as you're older, it's much more of a needs-based situation compared to maybe from just more of an optimization situation.

Cynthia Thurlow: Absolutely. And that's the beauty of being younger/.Things just work at a more optimal level. And of course, we don't realize this until we get older than we're like, "Oh, I never appreciated that because I just didn't know." That's kind of how I reflect on the differences of what I knew 15 years ago, versus now like, "Dang, had I known I would have lifted really, really heavy in my 20s and 30s." And whereas now it's like it requires twice as much effort to get enough of that muscle protein synthesis, and a little bit of HRT definitely helps.

Melanie Avalon: Or it's kind of similar to-- the next supplement I'm making with the NMN, very similar. And that I feel like when you're older, we know NAD levels are so depleted with age. And so, you would definitely from a needs space be wanting to take it and in higher quantities compared to when you're younger, it just helps. It just optimizes everything. Obviously. We're curious, in general, with that, with creatine, with anything, I wonder what the effects are. If you do start younger, and doing it consistently, are you kind of warding off some of those deficit issues later?

Cynthia Thurlow: I would hope so. I've had whole conversations with my kids about the fact that-- one's almost 18 years, he's fully grown, He's 6 feet tall. And whether or not we're going to consider adding creatine, that remains to be seen. I think when you're a fully grown adult, it's different than people who are still kind of growing in this massive anabolic phase, especially young men.

Melanie Avalon: Yeah, completely makes sense. Wow, super excited for that to be available. So, listeners, stay tuned. When it is available? You think it will be on your website?

Cynthia Thurlow: I think that's the general plan. We're going to actually create a lead page so that people can get on the list for when it goes on sale, because we do anticipate it will sell out and so they'll get the first rights of purchase over other individuals.

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All right. Shall we jump into everything for today?

Cynthia Thurlow: Absolutely.

Melanie Avalon: All right. So. to start things off, we have a question from Leah. And the subject is "Ship food, and I don't mean cruise liner." Leah says, "Good morning, Cynthia and Melanie. I'm a Navy sailor and so is my fiancé, Chris, who is actually on deployment right now. He is totally on board with IF. Ha, ha." I think your pun is funny, Leah. "And he tried to start it while he was out on the ship but it's difficult because meals have set times when the galleys are open, and the food is definitely not choice food. Knowing that IF is here to stay for me even if when I should wind up back on the ship, and that he very much wants to get into shape and stay that way, so IF we'll probably stick around for him too, I have questions about supplementation in the absence of being able to make better food choices.

For those of us who don't have the ability to get food that is good for our bodies, is there something we could use to give our bodies the nutrients needed? Examples would be anything fresh in the way of fruits and veggies. For my last deployment. I remember it being difficult to find spinach and the salad bar was often quite sad and fruit was really, really rare. Everything was ultra-processed, and the breads were all the cheapest white breads. Rice too was low quality. Now that Cynthia is on the show as a resource from the healthcare field, and knowing that Melanie is all about the food choices, I wonder if either of you all would have ideas on how to be as healthy as possible without access to wholefoods or farmers' markets, or such things as I've started to utilize after learning about food industry things. God bless your tangents, Melanie. That led to your other show.

I fully intend to utilize some of the supplements I've already experimented with while looking for foods that had the things, like iron in the form of beef organ supplements and Melanie's magnesium that I also got my mom onto." Yay. "And try others as I go along. But my knowledge of supplements is limited to what I've learned from y'all. There's also powders for greens and things, but I don't know how to sift through them. Ha, ha, you can tell I love dad jokes and puns and learn which ones are good and which ones are not worth it. Basically, assume I'll get some form of meat, pork and chicken and occasionally ground beef, limited to one or two servings per meal. And that's about it. Everything else will need to be something I provide myself. This is daunting. Sorry, y'all, Leah."

Cynthia Thurlow: Well, Leah, thank you to you and Chris for all that you do to help protect us as a nation and for Chris' current deployment. When I read through your question, I thought immediately of Athletic Greens, which is a product that I myself have used over the last two years. And for full transparency, I think I've tried everything on the market, and I'm not exaggerating. And I find most greens powders are incredibly herbaceous, to the point where they're not palatable. Athletic Greens has been something that myself, my husband, and my kids have been able to utilize. And I think it's a really nice balanced way to get quite a bit of vitamins, minerals, and greens powders into your diet, especially if you're feeling or perceiving that when you are deployed, you're really limited in your fresh fruit and vegetable options alongside with protein. So, I probably would make one investment as opposed to multiple investments and at least try it out. I think that's a good first step in order to kind of flesh out the options that you have available. And plus, it's convenient, because they have little packets that you can just throw into water. So, you don't have to a blender, you can literally throw out one of their shaker bottles and use some filtered water and you've got a really clean option that you can utilize. It's high in ORACs, so high in antioxidants. And it tastes good, which is most important because if it tastes good, then you'll consume it.

Melanie Avalon: Awesome. Yeah, speaking to the Athletic Greens, personally, I have actually haven't tried them or used them, but I knew Cynthia was a huge fan. And they approached us about wanting to support the podcast, which is awesome. And I was like, "Oh, I know Cynthia loves them." So, we will have a code for them. Because I know they're on your other show as well. In general, Cynthia, do they normally have a discount code? Because we don't know right now, as of this recording, what our offer is going to be. Is it normally a discount?

Cynthia Thurlow: Typically, what they do is they give you a free vitamin D and then travel packs. That's part of using the discount code. So, it's really convenient, because for me, I don't like to have to put things in plastic baggies to take them with me. I can just throw the travel packs in my luggage or my bag and it's totally portable. And who doesn't need more vitamin D? Let's be honest.

Melanie Avalon: Awesome. So, by the time this episode does air, there will be a spot for it, an ad for it in this episode. So, either look in the show notes and/or listen to that when it plays in probably a few minutes, and it will have the offer. So, check out that link for the offer for that. I would supplement that, no pun intended, I'm a little bit unclear if she can just bring supplements, or if she can also bring packaged food type situations. Because basically the way I would approach this is maximizing-- I know you said you're limited on how many servings of meat that you can have, but maximizing all of the servings of meat that you can get. The nice thing about meat, and this is something that Robb Wolf talks about a lot, which is that even the worst quality meat-- and I know there's lots of issues with conventional agriculture. And I could go on a whole tangent about that and problems with it and how it's not humane and the environment. And I'm not just saying that that's not a problem. That said, conventional meat is still very nutritious, which is great for protein, vitamins.

So, I would maximize all of the meat that you actually can eat. If you can bring actual packaged food with you, some things you could bring would be-- I don't know what stores are called in different places. But like at Kroger and Ralph's and places like that, you can get salmon pouches that are in these-- I don't remember what the brand is. They're like packets and they're salmon and the good thing is, they don't say wild caught on the-- or they might. I have read that canned salmon and packaged salmon tend to be wild caught actually. So, I would get like those packets, those would be really easily transportable. Other protein sources like jerky sticks and things like that. I know. Isn't there a brand that you'd like for jerky, Cynthia?

Cynthia Thurlow: I love Paleovalley, I'm devoted to Paleovalley. I love Paleovalley. We'll include a link in the show notes. That's my favorite by far.

Melanie Avalon: Okay, awesome. So that would be an option as well. Then also, if you feel like you're just not going to get enough protein, this might be a situation where you want to bring a protein powder. I've had on my shows, both John Jaquish as well as Dr. David Minkoff. They both have a protein powder supplement that's a complete protein powder without additives. Dr. Minkoff's is called Perfect Amino. I'll put a code in the show notes for that. So, for that, you can go to melanieavalon.com/perfectamino and use the coupon code, MELANIEAVALON. So, that might be something to try.

And then, moving beyond the actual protein, the second aspect of it would be what Cynthia was talking about with Athletic Greens. Getting those greens-related nutrition, and then some. I do think the Athletic Greens would be an amazing way to go. Something else might be spirulina tablets. We're actually currently in development to create a Spirulina that I will have produced, in part, which will be very exciting. So, stay tuned for that. In the meantime, I love, and listeners have really loved Catharine Arnston's ENERGYbits.

Cynthia Thurlow: She's awesome.

Melanie Avalon: Yeah. I really like those listeners really love those. And those are really, really rich nutrition. Do you have a code for them as well, Cynthia?

Cynthia Thurlow: I do. I literally just had a podcast drop about a week and a half ago from her. So, we can include that.

Melanie Avalon: Yeah, I know, mine for that is energybits.com with the coupon code, MELANIEAVALON, for 20% off.

Cynthia Thurlow: And mine's CYNTHIATHURLOW.

Melanie Avalon: Perfect. So, either of those will get you 20% off. And then like I said, we are hopefully developing my own. But I think that algae situation is a really great way to get really concentrated nutrition in a very travel global form. Another thing to consider might be nutritional yeast, if that's something that you like. Well, first of all, I find it so delicious, but it is just like super high and all of the vitamins including B12. So, it can be great for vegetarians and vegans, which I know does not apply to you but that's another great option. Although I personally really advocate getting a version without folic acid because a lot of them are fortified with folic acid. There's one brand I really like called Sari, S-A-R-I, so I'll put a link to that in the show notes. But that's all the things I would look into.

Cynthia Thurlow: I think that's very comprehensive.

Melanie Avalon: Awesome. Well, hopefully that was helpful for Leah. Shall we go on to our next question?

Cynthia Thurlow: Absolutely. This is a question from Jasick. The subject is "Fasting without water." "Could there be some health benefits to prolonged not drinking anything? I mean, not even water? Do you know of anyone who's seriously considered that or is it just assumed that there are none? Seems to me, all the evolutionary arguments usually given in favor of fasting apply just as well also in that case."

Melanie Avalon: All right, Jasick. Thank you so much for your question. I'm actually very surprised by the lack of scientific literature looking at this, I thought there would be a lot more studies and there are all I could find like as far as large studies go, I found a 2020 study called "Dry fasting physiology responses to hypovolemia and hypertonicity." And then, I found one called Effects of daytime dry fasting on hydration, glucose metabolism and circadian phase. A prospective exploratory cohort study." And do you know if it's Baha'i, is that how you say it, Cynthia? B-A-A-H-A-I with a lot of interesting punctuation, symbols. Something in India, I believe Baha'i fasting. So, in those volunteers, and that was a 2021 study- It was nice reading the studies. They also noted in the study that there's not a lot of literature, which not that I like reading that, but it makes me feel better about not completely missing something when they're saying that, "Yes, indeed, this is not very much explored."

So, the 2020 study was a very small study, but they basically looked at five consecutive days of dry fasting, that's a long fast, preceded by two days before where they ate normally, and then three days after where they ate normally. And they were just basically looking at their biomarkers and were trying to see if it had any negative effects on everything that they were experiencing. And they concluded that it was essentially safe to follow and there wasn't anything too concerning.

And then, the follow-up study was the one that talked about in those Baha'i fasting people. And what it was noting was that a lot of the studies on fasting are typically on people fasting for Ramadan, and that this Baha'i fasting situation was actually a more appropriate way to look at dry fasting specifically. And they as well found that it's safe and has no negative effects on hydration, it can improve fat metabolism and it can cause transient phase shifts of circadian rhythms. The improved fat metabolism is something that I think people talk about, because you will hear about people dry fasting, and it's come up in a few different books that I've read.

And it is advocated, and I say this hesitantly because this is what "they say, but like I said, I couldn't find many studies on it. They say that you will burn more fat if you're dry fasting. And the concept, or at least one of the theories is that when you're not taking in water, your body needs hydration. And so, we can actually create metabolic water by breaking down fat. And it's actually something that's not in the context of dry fasting and weight loss but Dr. Rick Johnson, who Cynthia and I both love, he actually talks about this whole process of metabolic water created from fat.

And so that study that I referenced in the Baha'i people who are fasting, they did find when they compare the data to Ramadan fasters, that it seemed like-- they said basically, in Ramadan, with weight loss, it can be all over the place. Like sometimes people lose, sometimes they don't. In this Baha'i study, everybody seemed to lose. And they posited that potentially dry fasting could lead to more weight loss than not dry fasting. So, yes, my takeaway, it sounds like when it's studied scientifically, that it's probably okay and safe from a health perspective. That said, I can totally see that people might have issues with electrolytes. So, please don't go by just that. If you're going to dry fast, go by your body and how you feel. It's possible that you might lose more weight dry fasting than not. We definitely need a lot more research on all of it. Do you have thoughts, Cynthia?

Cynthia Thurlow: I do. And it's interesting, because the conversation that I had with Rick Johnson when we talked about the camel, everyone assumes the camel has water in its hump and it's actually fat. And so that metabolic water that's created as the camel needs food was fascinating, and I think in many ways, really shifted my thought process about dry fasting. Now with that being said, I think dry fasting is absolutely positively a more advanced technique. This is not for newbies; this is for people who are very attuned to their bodies. I think that dry fasting is something that's employed by a lot of influencers that are out there. And I think you have to be very mindful of your own baseline health before you start utilizing it. If you're someone that's prone to orthostatic dizziness, you're dizzy, you get lightheaded, probably not the strategy for you because part of dry fasting is not ingesting any water. And there's hard dry fasting and there's soft dry fasting, let me explain a distinction.

Melanie Avalon: Did not know about that.

Cynthia Thurlow: Oh, yeah, it's fascinating. So, I've been down a rabbit hole about dry fasting. So, soft dry fasting means you still take a shower. Because you're still absorbing water, when you are showering, right? If you are a hard dry faster, it means you are not bathing. Or maybe you're quickly washing your armpits and other areas that need washing. But you're really not getting in a shower, you're not getting in a bath, you're not absorbing water through your skin. You're very, very devoted to the process of a hard dry fast, which is designed to be exactly that, hard. It's my understanding that a lot of people were so conditioned to being hydrated during the day, I know I'm very water focused all day long, which is why, more often than not, if I do a long podcast, I have to run the bathroom when I'm done just to empty my bladder.

But with that being said, I think this is absolutely a strategy that we probably need more research on. It's not one to be entertained by people that are new to fasting. That's my personal opinion, I think it's a strategy that should only be utilized by people who are ready for that kind of fasting, because it is going to be a bit more vigorous than a traditional water fast for 24 hours or a water fast or 48 hours. And you really have to understand that you may lose weight during the dry fast. But as soon as you hydrate, that's probably going to just kind of equal out. I think it's being very clear about what are you trying to do. A lot of people are like, "Oh, I want to do dry fasting, because I want to lose more fat." And that's all fine and good. But I think for me personally, although I have tried dry fasting, I'm the kind of person who really enjoys drinking water. So, it's actually harder for me not to drink water than it is for me not to eat food because it's such a part of my lifestyle.

I think there's a lot that remains to be seen. I would imagine a lot of the big intermittent fasting community probably would be aligned with what we're saying that we need more research. This is a more advanced technique. In fact, I'm in the midst of creating like an advanced intermittent fasting, either webinar or series or class or something, and dry fasting will absolutely positively be part of that.

Melanie Avalon: I wish they would do some randomized controlled trials, and really trying to figure out if this theory about dry fasting, creating the need for water, and so breaking down fat to create metabolic water that we otherwise wouldn't have broken down, I would just love to know if that's actually what's happening. Because if so, it's potentially a very nice tool in the toolbox to do smartly. But it would be nice to know if that's actually the case [chuckles]. Or if it's just people are not drinking water and so all the weight loss is more related to dehydrated cells. I'll be excited to see what you continue to learn with all that, especially if you do integrate it into some of your programs.

Cynthia Thurlow: Yeah, definitely, it's on the to do list. And every week, my team and I have a meeting and every week, we say. "Cynthia is going to table this till next week." I was like, "That's right."

Melanie Avalon: It's one of those things.

Cynthia Thurlow: Yeah, It's like I have a long list of things I want to do when I can't get all the things done in my life. So, it'll happen eventually.

Melanie Avalon: So, my assistant for the biohacking shows emails me every Wednesday with an updated list of guests we are reaching out to and where I'm at with certain guests. And there's some people that I just table every week. I'm like, "Ask me next week [chuckles] Ask me next week." But it's always on the list.

Cynthia Thurlow: Yeah, I mean, there's the things that have to get done. And then, there's a long list of things that should get done.

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

Cynthia Thurlow: Absolutely.

Melanie Avalon: So, the next question comes from Sarah. Subject is "Fasting and pregnancy." And Sara says, "Hey, gals, you've covered bits and pieces of this question on other podcasts, but I'd love to hear what you imagine would be a good beginning to protocol to follow once one discovers she is pregnant. I'm not currently with child, but if I was, for instance, do you IMMEDIATELY stop fasting when you get pregnant, when is it okay to start fasting? Again? I know fasting while nursing is a no, no, but when is it okay to resume? How do you resume a more typical all-day eating schedule? Do you talk to your doctor at all about fasting? Inquiring minds want to know. Very best, Sara."

Cynthia Thurlow: Well, Sara and this is definitely an area that I talk about in my book and certainly across social media. I feel very strongly that when you are creating a human or feeding human, it is not the time to restrict your macro intake. If you found out at six weeks that you were pregnant, I would stop that, and this would be my best recommendation. Of course, I would discuss this with your physician, OBGYN, etc. My general recommendation would be when you find out that you're pregnant, you stopped fasting. You're in a position where you're growing a human and especially at the key areas of neurodevelopment, you don't want to be restricting healthy fats, protein, etc.

And from my perspective, when you're done breastfeeding, I think it's absolutely fine to resume intermittent fasting. I know that I have never had a larger appetite than I did when I was breastfeeding. I have two boys. I breastfed both of them for a year. And I jokingly say I could eat like a linebacker. I have never been able to eat that much food since then. But I cannot fathom-- and this is not judgmental. I'm just saying I cannot fathom how you could get by with fasting and breastfeeding because I ate copio-- I mean, I probably had three or four meals a day, large meals, and I was still hungry. And that was not even with exercising. I just walked when I was breastfeeding, I didn't even go to the gym and lift.

I think from that perspective, stopping when you find out you're pregnant with fasting, resuming fasting only after you're done breastfeeding, and having a conversation with your healthcare professional. I've spoken to many, many, many physicians and researchers about this. And we're 100% in agreement about how important it is not to be fasting while pregnant, and not to be fasting while breastfeeding.

Melanie Avalon: So, at that moment, when they find out they're pregnant, and they immediately stopped fasting, do you have a recommendation for how they resume that all-day eating schedule?

Cynthia Thurlow: I think just having like a 12-- like having three meals and maybe having a 12-hour eating window, I think is absolutely fine. I don't encourage anyone to stuff themselves. But when you're actively growing a fetus, the idea of being restrictive about behavior is one that's woefully unaligned with fetal development and neurobiology and all the things that I know. And certainly, I'm not a researcher. But in conversations with so many experts, I feel very, very comfortable saying I would not recommend fasting. I think a 12-hour digestive rest kind of formulation. Same thing I tell women, five to seven days preceding their menstrual cycle, if they back off on the fasting and just have a 12-hour eating window, I find a lot of women actually do really well with that. And 12-hours should really be the minimum for all of us whether we're fasting or not. There should just be 12 hours of digestive rest. It's a great way to optimize digestion.

For a lot of women in pregnancy, they start struggling with constipation, they have a lot of reflux. Especially as the fetus is growing and it's putting more pressure on their digestive organs, it can make eating more challenging because they just can't eat large boluses of food. So, they may find that they have to eat a little more frequently, not in a negative way, but they may find that they tolerate maybe a slightly smaller meal and maybe they're eating every four to six hours in that window.

I had two boys that are 26 months apart. I had an 18-month-old when I got pregnant with my second son. And I remember I was one of those people that when I breastfed, I was working part time as an NP and my options in the hospital were either to have time to pump or eat. So, for the first year of my older son's life, I pumped in the hospital while I was running on patients, and I really didn't have time to sit down and eat a proper meal. So, I ate whatever I could grab on the go. And I'm not suggesting women do this, but it was either I ate a protein bar or I ate nothing. And so, I ate a lot of protein bars on the days I worked. And by the time I got pregnant with my second son, I had no adipose tissue, I was very skinny. I don't recommend anyone do this. But I didn't even realize it was so subtle, I had really lost all my fat stores because they were being utilized to create breast milk. So, I recall my first-- and I was underweight for where I normally was. In the first trimester with my second, I want to say I gained 10 pounds. And my OB wasn't worried because he knew. He just said, "I think your body had to get back to a certain level of body fat to be able to sustain a pregnancy." And I just kind of mindfully ate. I remember there were certain things I craved but I didn't crave junk. It was mostly like protein and carbohydrates, and that's really what my body craved.

I think each pregnancy is unique and different. I was surprised at how good and active I was throughout my pregnancies. I know not everyone may be in the same position, but I was pleasantly surprised.

Melanie Avalon: Do you know if there's a concern about if a woman is breastfeeding and losing weight of the toxins from the fat stores going into the breast milk?

Cynthia Thurlow: I mean, that could be. I mean, that certainly could be a possibility. I think that this is why we want our health really optimized before we become pregnant. I think a great deal about the fact that I have one child who has life-threatening food allergies, so it weighs heavily on me. Was there something I did that made him more susceptible to developing food allergies? I think every mother blames themselves. There's something I must have done that created this, even if empirically there's no evidence to suggest otherwise.

But I think if a woman is already obese, and she gets pregnant and she's potentially releasing some of these toxins, whether it's heavy metals or estrogen-mimicking chemicals, etc., absolutely, I think about-- and I don't have current research on this. So, I can't speak to it beyond just thinking in my knowledge about what happens through lipolysis. I do think that would be of concern if someone was unhealthy and became pregnant. And it also speaks to the fact that people who are metabolically unhealthy are more at risk for certain pregnancy complications, gestational diabetes. Certainly, women that already have PCOS, as an example, are at greater risk for complications related to a multiplicity of factors.

I think the big takeaway from me is, get as healthy as possible before you become pregnant. I know sometimes that occurs randomly, and sometimes people don't have-- the planning per se is maybe not in place but it's certainly something- and that's why I think prenatal nutrition is important. Prenatal care is important. I think it's important to be thoughtful about if you're choosing to have a child that your health is really optimized. Before becoming pregnant, I'm in some ways, I'm grateful, I didn't know as much as I know, now, back then. Because there's a lot that I think about. But from a de facto clinical perspective, absolutely. Everything is intertwined. And we used to think about adipose tissue as just being its own organ, but we didn't think about how sophisticated it was, we didn't know. And now, we understand it's highly inflammatory, full of cytokines, all sorts of inflammatory matter that you don't want to have released into breast milk ideally. But having said that, certainly people have survived through the millennia without knowing as much as they do now.

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Melanie Avalon: All right, shall we answer another question?

Cynthia Thurlow: This is a question from Rebecca. Subject is "16-hour daily fast enough for weight maintenance." "Over the course of the past two years, I lost 100 pounds through Weight Watchers. I found that I enjoyed eating bigger meals. So, a lot of times I ran out of points by 2 PM and unintentionally fasted intermittently in order to make Weight Watchers work for me. A coworker asked if I ever looked into intermittent fasting since I was already doing it many days per week without realizing it. Now that I've already reached my goal weight, I started tracking my fast with a goal of 16:8. Most of the time when you two recommend smaller windows to listeners, it seems to be for weight loss. Since I already have my portions under control and have been maintaining my weight for seven months so far, I wanted to ask how important is it that I try to increase my length of daily fast.

I think what I'm asking is it okay if I just enjoy my life on 16:8 since I feel great and I'm at a healthy BMI. I feel the pressure to only eat one meal per day since you both follow this plan, but I'm resisting the idea. Asking your permission to stay where I am. Thank you for your podcasts and your books. I bought both of them." And I just want to note that this question actually came in while Gin was still hosting.

Melanie Avalon: Yes, the comment about only eating one meal a day was the protocol that Gin and I follow, although we debate the terminology of what constitutes one meal a day. So, I actually could answer all of this just in one word, which is yes. It's okay. You have permission, Rebecca. But the longer answer is-- I find it really interesting. I feel probably Rebecca and I think a lot of people might experience this, especially in the dieting world. It's safe and comfortable to exist within a specific plan. So, Weight Watchers was a really regimented system and it worked for you which is great and congratulations on losing 100 pounds, that's incredible. So, that probably felt very safe. And while existing in that, you were doing what the system told you to do, and it worked. And so now, you're at a weight that you love and at BMI and you feel great, but you're not quite doing the system that has been attributed-- although historically, I hope we haven't given this impression that you can only lose weight on one meal a day, because that's not at all the impression I would want to give. So hopefully, we can clear up that confusion. But there's probably this idea that sticking to that protocol, instead, will-- again, it brings that safety as the thing that you should be doing to have the weight loss.

But there's all of this theory and conjecture and what people can say will work. And then, there's what's actually working. And what you're doing right now is working. So, 100%, you are totally fine to be living your life on 16:8 and having that for maintenance. You don't need permission, you can grant yourself permission for anything you want to grant yourself permission for. I'm all about listening to your own body. So please don't feel the stress. Of reason that you might want to do a longer fast, I wouldn't even say for the maintenance of the weight loss. It might just be a therapeutic longer fast. So, maybe you want to get some of the health benefits of increased autophagy, and just a longer fasting from that perspective. So that's the reason I would do a longer fast if you wanted, but I wouldn't for the maintenance. Thoughts, Cynthia?

Cynthia Thurlow: No, I think that was a beautiful explanation. Congratulations, Becca, on your sustained weight loss, that's incredible. I come at this from a similar/different perspective. I think that a lot of what is important for sustainability in terms of weight loss is getting sufficient amounts of protein in and that's much easier to do in two meals a day. So, if that's working for you, I think you should experiment if you want to do an 18-hour fast, a 16-hour fast, a 14-hour fast, you want to do a 20-hour fast, I think one thing that I think is very important is that we not get into a widget where we only do the same thing every day. We don't eat the same foods every day. We don't do the same exercise every day. I think it's important that we honor and nourish our bodies with some degree of flexibility. And one of the ways that you can do that is just to play around with your fasting window. And if you don't feel like doing a longer fast, there's no pressure to do so. I think that being very clear about what your goals are, what's important to you, you're not looking to lose weight. And there's a lot of research to demonstrate this kind of law of diminishing returns. If you're already at a healthy weight, doing a prolonged fast, finding where exactly that middle ground is, in terms of how much benefit are you getting from 24 hours of fasting or 48 hours of fasting, if you're not looking to lose weight, you can end up losing muscle. Muscle is pretty important for women. I don't know of your age, that's another piece of the puzzle. But I think you're doing a beautiful job. And I would just encourage you to experiment to find what works best for you and your lifestyle.

Melanie Avalon: Yeah, I thought that was great. And we actually have another question that sort of relates to all of this from Heidi. Would you like to read that, Cynthia?

Cynthia Thurlow: Absolutely. Subject is "Learning your body." "Hi there. I've been off and on for intermittent fasting for a year or so. For some reason, I keep giving myself reasons to stop. Anyway, I've been listening to your podcasts and reinforcing what I know about the process. My question is, I keep hearing you mention to listen to your body, and it will tell you what to do. Keep fasting, eat what you want to eat, etc. How do you learn to know what you're listening for? How do you become more in tune with what your body needs? I can get through about a 62-hour fast and feel pretty good, but not sure how to determine what my body needs after that. Any suggestions are welcome. Thank you in advance, Heidi."

Melanie Avalon: All right, Heidi. This is a great question, and it ties really well into what we were just talking about, especially because I think it provides a little bit more nuance and complexity to what we were just saying about potentially switching things up or listening to your body and making those decisions. Because I think on the flip side, so while we want to support everything that we just said, I think people can also get into a space where maybe having some sort of paradigm to exist in that does have more delineated-- I don't want to use the word 'rules', but does have some sort of parameters, I think can be very, very helpful. Because on the flip side of listening to your body and living intuitively, some people can do really well with that, and they really will just fast as long as they need to fast and eat when they need to eat. Some people won't. Some people need some sort of guidance. And it sounds like for you, you've been doing IF on and off, but then you don't stick to it you give yourself reasons to stop but then you also do like a 62-hour fast which is very long. So, clearly you are able to fast. There just seems to be some sort of-- I don't know if it's like cognitive dissonance or just inability to find a protocol that is something to stick to while still being intuitive.

What I would suggest, and I hope that doesn't undo everything that we were just saying, is if you want IF to be a part of your life, I would subscribe to a daily fasting window that maybe has flexibility in the parameters, but it would still be a daily fasting window. So, rather than fasting, and then not fasting, and then doing a 62-hour fast and being confused about what to do, and then worried about what to eat, maybe deciding to, "I'm going to fast daily," maybe around like 16:8, and then having some sort of flexibility surrounding that. So, maybe fast, a little bit more one day, a little bit less one day, but I would find something that you can stick to that actually can provide some consistency. And then, within that consistency, being more flexible if your goal is that you want to have IF as a daily part of your life. I wanted to talk about this with everything that you were saying, Cynthia, is I think it can be hard for people because we can say, "Be intuitive and listen to your body," but it's kind of like what Heidi says, what does that actually mean? And I think some people actually do benefit from picking some sort of system and then being more flexible within that system.

Cynthia Thurlow: I couldn't agree with you more. And one thing that I think is important for listeners to understand, we can talk about bodily intuition and intuitive eating, intuitive fasting, but if you're not metabolically healthy, which is most people, most people are, I think it's 92% to 93% of people are not metabolically healthy, you have to get those hormones balanced first. And I agree with you 100% that you need some type of a system to work within before you're going to be ready to intuitively fast, eat, etc. I think we do a lot of disservice when we expect people who are not metabolically healthy to be able to intuitively lean into what their body's telling them because there's this lack of insulin sensitivity, there's profound food cravings that go on, they're not sleeping well, they've got stress management issues, there's so much to unpack there.

And I say this with love. This comes from the most loving place in the world. But if you're feeling you're struggling with the concept of intuitively doing anything, it's because your body's not in a place yet where it's ready to do that work. So, until that point, I would have systems in place. And it doesn't have to be complicated. It could be as simple as, "I'm going to check my blood sugar after I eat a meal. If I'm still feeling hungry, and my blood sugar is high, then it might be that I had too many carbohydrates. It could be that I need to ratchet down on a portion of something that's going to mitigate and improve some of those symptoms."

We could have a whole episode just talking about these things. But I think it's important for people to understand that those processes and those symptoms take time to lay down. I think even for those of us that are metabolically healthy, I'm always changing things up. I'm usually transparent after the fact is I kind of work through carbohydrate tolerances, exercise, etc. So, I think we always have to invite ourselves to change things, to not feel like we have to be rigid and dogmatic. And I think dogmatism is a huge problem. Whether it pertains to a particular nutritional dogma or fasting in general, sometimes people don't realize that they're so rigid that they're no longer serving their primary needs of why they're embracing a particular philosophy or strategy.

Melanie Avalon: That was so perfect. That was exactly what I was trying to say [laughs]. It's very rare that I hear something-- well, probably shouldn't say it's rare. It is rare that I hear something within the type of content that I tend to consume, where I think it's a concept that could be doing a lot of damage. And I think there's a lot of potential damage that happens with messaging surrounding intuitive eating. Like I was listening to one podcast, and they were basically saying that you should be able to eat these processed junk type foods intuitively. And if you can't, then that means you're not an intuitive eater. Basically, you should be able to have the cake and just have a little bit of cake. But some people would be better off just not having the cake, because having the cake will create factors in their body that create a completely different metabolic state that then you have to fight against. I'm all about the intuition coming in with knowing how you exist in your relationship to food and fasting and knowing what you need. Do you need systems or not, do you need rules or not? And then living within that. And so, it sounds like for Heidi, coming up with a more like picking an actual system to stick to might be something that would work well for her.

Cynthia Thurlow: Absolutely.

Melanie Avalon: All right. Well, 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 questions@ifpodcast.com or you can go to ifpodcast.com and you can submit questions there. The show will have all the links, that will be at ifpodcast.com/episode285. And again, by the time this comes out, we mentioned Athletic Greens, which is a new supporter on the podcast and the amazing offer from them will be in the ads, so listen to that. You can follow us on Instagram. We are @ifpodcast, I'm @melanieavalon. Cynthia is @cynthia_thurlow_. Yes, I think that is all the things. Anything from you, Cynthia, before we go?

Cynthia Thurlow: No, keep the great questions coming. We've been really enjoying all of the feedback and great questions we've been receiving. So, keep them coming.

Melanie Avalon: I cannot agree more. All right. Well, enjoy the rest of your evening, and I will talk to you next week.

Cynthia Thurlow: Sounds good. Bye.

Melanie Avalon: 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]

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