Episode 288: Fiber, Psyllium Husk, Glyphosate, Constipation, Nutrient Timing, Hunger During The Fast, Protein, Bioidentical HRT, And More!

Welcome to Episode 288 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:

BUTCHERBOX: Grass-Fed Beef, Organic Chicken, Heritage Pork, Wild-Caught Seafood: Nutrient-Rich, Raised Sustainably The Way Nature Intended, And Shipped Straight To Your Door! For A Limited Time Go To butcherbox.com/ifpodcast And get one 10-
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To submit your own questions, email questions@IFpodcast.com, or submit your questions here!! 

SHOW NOTES

BUTCHERBOX: For A Limited Time Go To butcherbox.com/ifpodcast And Get One 10-14 Lb Turkey FREE In Your First Box!

How She Grew Pre-Sale! 

The Melanie Avalon Biohacking Podcast Episode #165 - Dr. Karen Becker

Go To yummerspets.com And Get 10% Off Sitewide With Code MELANIEAVALON!

Listener Q&A: Becca - Benefiber and psyllium husk pills

Simply Fiber: Digestion Resistant Starch/Fiber Blend

FOOD SENSE GUIDE: Get Melanie's App To Tackle Your Food Sensitivities! Food Sense Includes A Searchable Catalogue Of 300+ Foods, Revealing Their Gluten, FODMAP, Lectin, Histamine, Amine, Glutamate, Oxalate, Salicylate, Sulfite, And Thiol Status. Food Sense Also Includes Compound Overviews, Reactions To Look For, Lists Of Foods High And Low In Them, The Ability To Create Your Own Personal Lists, And More!

Listener Q&A: Samantha - Nutrient Timing?

#224 ‒ Dietary protein: amount needed, ideal timing, quality, and more | Don Layman, Ph.D.

Use Code CYNTHIA30 for $30 off or MEL for $50 off at lumen.me!

Listener Q&A: Moose - Struggling with IF

Ep. 206 Pt 1: A Deep Dive into Perimenopause- Hormonal Imbalances and Birth Control with Dr. Tabatha Barber

Ep. 212 Pt. 2: A Deep Dive into Hormonal Imbalances and Menopause with Dr. Tabatha Barber

AVALONX MAGNESIUM 8: Use The Code Melanieavalon For 10% On Any Order At Avalonx.Us And MDlogichealth.Com!

Listener Q&A: Robin - Two Questions

The Melanie Avalon Biohacking Podcast Episode #123 - Dr. David Minkoff

Get a discount at melanieavalon.com/perfectamino with the code melanieavalon

Ep. 198 – Dispelling Myths About Hormone Replacement Therapy

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 288 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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Hi everybody and welcome, this is episode number 288 of The Intermittent Fasting Podcast. I'm Melanie Avalon, I'm here with Cynthia Thurlow.

Cynthia Thurlow: Hey, Melanie, how are you today?

Melanie Avalon: I'm good, how about you?

Cynthia Thurlow: Doing well, just in the throes of homecoming and trying to narrow down options for my grumpy 14-year-old child who is intermittently grumpy but today it's mostly grumpy.

Melanie Avalon: Homecoming like homecoming dance?

Cynthia Thurlow: Yeah, so they have a homecoming event. My kids go to two different high schools and my older son’s already had homecoming, and so this is my younger son's first opportunity to go and today I finally got him to tell me what he wants to wear. And it's an interesting compilation, it's interesting to see between different high schools what kids are wearing and I have my work cut out for me.

Melanie Avalon: Just having flashbacks now. I'm just thinking about how funny growing up there is the key moments where you get to dress up and wear dresses. And now in my life, any chance I can get, I like to dress up for things with dresses.

Cynthia Thurlow: I love it. I'm actually in the midst of finalizing my outfit for this black-tie event for an event I'm going to in Scottsdale. And my poor husband was watching just like box, after box, after box, coming to our home because we live in a--

Melanie Avalon: Did you order from Macy's?

Cynthia Thurlow: I did not, I did not. It was from a variety of places. There is a wonderful woman I work with who's a stylist and I love her to pieces and she knows me really well. And so, we were trying to find a heel that wasn't six-inch stilettos because I was trying to explain it. I was like, I cannot stand in five-inch heels all night long, my feet will hate me. And I finally found the right dress, and I found the right bag, and I found the right shoe, and I found the right earring. And so now I feel I'm finally I can exhale and I have my outfit for next week. Because I don't get an opportunity to get that dressed up all that often but I will be on stage a couple of times, so, I'm excited.

Melanie Avalon: Yes, that's the crème de la crème, the black-tie events. I have one coming up in November and, "Oh, it's so exciting." I'm like all about it.

Cynthia Thurlow: I know you are you wearing black?

Melanie Avalon: Oh, yes. Always.

Cynthia Thurlow: I love it. I'm wearing like a-- it's an off shoulder, it's maroon, it's fitted, which is generally what I look better in any way. And then these really beautiful shoes and beautiful handbag. And because you have to have something to throw your lipstick and your phone into, now we're getting very nuanced, but I love getting dressed up. And it's a full day, I have a documentary I'm participating in, and then I have that in the evening. And I have to give an award out. I will be on stage and have to be 100% and I was laughing and saying I think I'm going to need a nap because I'll be on Pacific Coast time. And my body's going to think it's a lot later than it is?

Melanie Avalon: How tall are you again?

Cynthia Thurlow: 5'3.5”.

Melanie Avalon: Oh, we've talked about this. You look a lot taller.

Cynthia Thurlow: Everyone tells me that. It's one of the most common things people are like you're short, and I was like, with heels on I look very tall. But I usually, I've started now wearing heels on stage. And then my feet have absolutely decided they're done with heels, I almost always bring some fashion sneakers that I have that are awesome, they're very neutral, and then people are like, "Oh my God, you're so petite." I'm like, “Yes, I am.”

Melanie Avalon: That's how we're similar to. People say the same thing about me. They think I am a lot taller.

Cynthia Thurlow: How tall are you?

Melanie Avalon: 5'4.5”.

Cynthia Thurlow: Oh, yeah, so you're not much taller than me?

Melanie Avalon: Yeah, I actually love my height. I would to be like really tall. I don't know I think it could be fun. I like when your average female height, which I think literally 5'4.5 is average female height. I can still wear you're mentioning-- I love wearing really tall heels. I can still wear the really tall ones and then be a really good height.

Cynthia Thurlow: Yeah, well and it's funny. Lewis Howes last week was humored because I came in, in my fashion sneakers, and he complimented me on those. And then I was like, "Oh, hang on a second," I had the shoe in the bag and he was laughing. He's like, every woman does this. And I was like, “Oh, why are you going to kill your feet?” And I put them on for the interview and photos and stuff. And then before I left, I quickly changed my shoes again and he just thought that was hilarious. And I said men don't understand a lot of these really beautiful shoes. And I love a beautiful shoe, are not shoes you can walk in the city and be comfortable. And I'm all about-- I'm just at a stage in my life where comfort is important, fashion is important, but there is a point to which I'm like, I'm not going to go down an elevator, walk across a bunch of concrete, try to flag down a car, and have to do that in four-and-a-half-inch heels. I'm gotten very practical.

Melanie Avalon: Also, the thing that related to that, that men don't understand, the getting ready process. It's so funny. I went-- Oh, it was fabulous. I went to this event at the Georgia Aquarium. It was called Aqua Vino so it was wine tastings and dueling pianos and an auction. So, I was supposed to go with my dad. But this happened right after all of the hurricane stuff that I talked about last week. And he was just really stressed and wasn't feeling up to it. And thanks, dad, you let me know like right before. I was like, who can I find to go with me? And I was like, well, it has to be a guy because no girl would be able to get ready at this last minute. So I went with my cousin, it was really fun. Although I got so many DMs about my date, I was like, "It's not a date."

Cynthia Thurlow: Nope, Melanie. This is my cousin. That's on Wednesday night.

Melanie Avalon: A decade younger than me.

Cynthia Thurlow: Yeah, my cousin and I went out with him and I was laughing because he's super tall. And, he has a wonderful girlfriend who wasn't able to make the dinner. And we ended up going to this French bistro place and it was fantastic. We both had an amazing steak and I was saying to him I was I forget how tall you are, you are a foot taller than me. I look like a midget standing next to you.

Melanie Avalon: Good times. Some women do not like dressing up, which I will never understand.

Cynthia Thurlow: No, I'm a total girly girl. I mean, I'm all about the details.

Melanie Avalon: I live for it.

Cynthia Thurlow: I'm all about the details and it totally makes a difference.

Melanie Avalon: Especially traveling, it's so stressful for me and I don't like doing it. But if there is any chance of getting me there be like well, there is a formal or black-tie thing. I'll be like, okay, maybe. So, yes. Well, okay, two quick announcements before we jump in. I mentioned both of these last weeks. There is an amazing online conference summit thing called How She Grew. It's by a few influencers, including Noelle Tarr, who is the co-host of the Well-Fed Women Podcast and one of my really, really, good friends. And I am a speaker in it. Cynthia might be, we're not sure. But it is all about-- really, it's all interviews with successful women and how they grew. So how they're doing what they're doing with their businesses, very practical, helpful information to just like learn how these women did and do what they're doing. You can go to melanieavalon.com/howshegrew, if Cynthia is doing it, you can go to cynthiathurlow.com/howshegrew. This episode airs October 24th, up until November 1st, they will have a pre-sale discount. So, use that link now to snag that discount.

And then, the second thing I want to talk about, I talked about this last week as well but as of this recording right now, the episode that is airing on Melanie Avalon Biohacking Podcast is with Dr. Karen Becker for her book called The Forever Dog. Definitely, friends, even if you don't have pets, listen to it. But if you do have pets, listen to this episode. This is actually fun fact. My editor who edits the show, he never comments, I just send him the episode he sends it back edited. He never ever makes a comment about the content for this episode. He literally wrote out like, wow, this was one of the most amazing things I've ever listened to. And so many people have told me that. It's mind-blowing if you care? If you are concerned with the health of your pets, listen to it. All of that to say I think what we feed our pets is really, really important. And I'm thrilled because there is a new company called Yummers. And I think I'm really good friends with the co-founder Rebecca. She actually co-founded it with Antoni Porowski from Queer Eye for the Straight Guy and his boyfriend, Kevin. But they actually make really incredible healthy toppers for dogs and cats. Literally no problematic additives, just the good stuff, they have like, liver supplement toppers, chicken toppers.

One of the problems with conventional pet food is that they include all of these natural flavors and enhancers to make the pets really want to eat it. And that pet food really ends up commercial pet food. I mean, it's shocking. It's basically the equivalent. This is what Dr. Karen Becker was talking about. It's the equivalent of eating breakfast cereal for like every single meal of your life. So, like an entirely processed diet, fake, low moisture, not the correct macronutrients to support health it's really, really, a problem. And they use these natural flavors to make the pets basically addicted to it. Yummers uses real food ingredients that have that same palatability effect for the dogs and cats so they love it and it's super healthy. My mom's puppy, Mia, loves it, my sister's cat Jackie loves it. So, definitely check it out. I'm excited to see the future of the company because they might have more products in the future but they have a lot right now as well. So, you can go to yummerspets.com. That's Y-U-M-M-E-R-S-P-E-T-S dot com. And you can use the coupon code, MELANIEAVALON, to get a discount site wide.

Cynthia Thurlow: There are many things I love about the fall. The crisp cool weather, the warm, cozy fall flavors, all of the festive holidays coming up. One thing I don't love though is the constantly growing to-do list that seems to come with the fall season. Shuttling my kids to various activities combined with all of the prep work for holidays can feel like another full-time job on top of my actual job. I know I'm not alone in this. That's why the Prep Dish is the best way for busy people to get healthy meals on the table without stress. Subscribers receive an email every week with an organized grocery list and instructions for prepping meals ahead of time. This means dinnertime is super quick and easy every day. And if you think you don't have time to meal prep, I used to think the same thing. But with the Prep Dish super-fast meal plans I can prep five healthy dinners in just one hour. Trust me that one hour of meal prep pretty much saves my sanity for the rest of the week. It is 100% worth it. If you want to serve meals like these without the stress, the founder Allison is offering listeners a free two-week trial to try it out. You can't beat that. Check out prepdish.com/ifpodcast for this amazing deal. Again, that's prepdish.com/ifpodcast. So, your first two weeks free, this is a total no-brainer. Recent favorites were the slow cooker Moroccan spice chicken with roasted sweet potatoes and kale as well as the bison burgers with caramelized shallots and sauteed asparagus. Again, you can check out prepdish.com/ifpodcast for an amazing deal, giving you a two-week trial to try this out.

Melanie Avalon: Let's jump into questions. Would you like to read the first question?

Cynthia Thurlow: Sure, this is from Becca. Subject is: "Benefiber and psyllium husk pills." “Before I started intermittent fasting, I was taking Benefiber and psyllium husk pills in the morning and before bed, I have continued to do that since I started fasting. I was wondering if I'm breaking the fast with these two things. I have not really been successful at losing any weight. I've been doing intermittent fasting since January. I feel good and my clothes fit better. But it is occurred to me that I may be breaking my fast without realizing it by taking these two things. Any suggestions? Maybe I don't even need the fiber or I should be taking something else instead. Thank you for your help. Becca.”

Melanie Avalon: All right, Becca, I'm really excited about this question because it's something I've been wanting to talk about. Because it's becoming a thing. I know Dave Asprey talks about it in his fasting book. I know Dr. Gundry talks about it, I think in his most recent book, a lot of people have been-- I know she's asking about it breaking the fast but a lot of people I guess, Dave Asprey and Gundry, and maybe some others have talked about the benefits of taking fiber while fasting to not feed you but feed your gut microbiome, which then can create short chain fatty acids from that. That idea does not resonate with me so much. And the reason being is even if fiber is non-nutritive to us, like I said, just now the gut microbiome can break it down and create energy from it. And just on top of that, it's a substance that stimulates the digestive process. even if it doesn't have "calories" to us, it still has to go through that digestive process and stimulate that. I think personally, taking in something that is doing that while fasting, I find it counterintuitive to the concept of fasting. I'm not a fan of fiber during the fast. On top of that, I don't know why you're taking the fiber. You don't say why? I'm wondering if it's just because there is this conventional idea that we need to be taking fiber. I am all about getting fiber from whole foods, I would look at your food choices. And how can you eat fiber-rich fruits and vegetables that really work for you and your digestive system? So those are my thoughts "Oh, she said she's not been successful and losing any weight." I mean, that could be a lot of factors. I don't know that it's the fiber completely, I would look at your food choices in general and the fasting window that you're doing. But those are my thoughts on that. What are your thoughts, Cynthia?

Cynthia Thurlow: Well, I think on a lot of levels, typically Benefiber and psyllium are recommended by traditional allopathic trained providers. For a lot of people, it's to help with constipation, just to include the amount of fiber in their diet, I do agree with you and echo your sentiments about getting fiber from whole food sources. My concerns about Benefiber and psyllium husk is the exposure to glyphosate. For listeners that's a pesticide, herbicide that is most of our crops are exposed to. We know that there is a direct link with developing small intestinal hyperpermeability, which is when we develop leaky gut, foods that you're eating or then you're leaking food particles into the bloodstream, which can set up an inflammatory response and you can become sensitive to the foods that you're eating. From a health provider's perspective that's the first thing I think about, there are definitely other options. I prefer that fiber be taken if you do have to consume it during your feeding window. I do the idea of resistance starch, I actually have a product called Simply Fiber, which has green banana flour in it and potato starch, which are in their clean sources. But I always recommend that people consume those in their feeding window as opposed to in their fasted state.

And I agree with Melanie, that there can be many, many contributing factors to why you're not seeing weight loss. It could be as simple as your macros, meaning insufficient protein, too many of the wrong types of carbs, and inflammatory fats like seed oil, really closely examining what you're eating in your feeding window, and making sure you're getting a sufficient amount of protein in, I say no less than 100 grams a day. I do talk a lot about these types of subjects in my book. I also think about what else are you doing? How's your sleep? What's your stress management style like? Are you lifting weights? What's your gut health like.” There can be many things that can contribute to weight loss resistance or an inability to see weight loss in and of itself. I think there is a lot that could be going on, I would experiment with the types of products you're using. I would try to bump up your non-starchy vegetables to see if that's able to help you in the absence of using Benefiber and psyllium husk and then really getting acquainted with other options that are available to you if you feel you do need those to have a bowel movement, and there are people that benefit from taking supplementation with fiber, but you want to look at the quality of what you're consuming, to make sure it's the least inflammatory choice of all options.

Melanie Avalon: I am so glad you brought up the glyphosate issue. I do think that is such a huge problem. I really think that's a problem, too. I was mentioning earlier how dog food and pet food is eating cereal all day. That's something I think it's probably a lot of huge issue for glyphosate exposure.

Cynthia Thurlow: And it's interesting not to step on your toes while you're speaking. But there was a podcast I did with Jeffrey Smith last fall that to me really opened up my eyes. He's doing a lot of research and a lot of advocacy to help educate people about exposure to glyphosate and genetically modified foods. And we'll include that in the show notes so that that's available for you to learn from. He's a researcher and also an advocate and pretty powerful message. And someone that does it in a way that makes the information accessible and not scary. But certainly, it's a resource that I recommend for people to learn more about so that they're limiting their exposure overall to glyphosate as much as possible.

Melanie Avalon: I'm glad you said that, I really need to bump him up. He's the one that fell through the cracks with us trying to schedule him for the show.

Cynthia Thurlow: And that happens. I mean I think we all realize that happens, especially when you've got a show your Biohacking Podcast where you just get inundated. We do too. I would say, more often than not, we end up turning potential people away because there just isn't- there aren’t enough slots in here to get all the podcasts people in. But yeah, he would be fantastic on your podcast.

Melanie Avalon: Yeah, I really, really want to interview him. I think what happened was he reached out at the height of a lot of the politicalness of COVID. And I wasn't quite sure the extent of his content, and I wasn't sure if it was going to be too controversial for the show. But now after hearing you interview him, really looking at his work now I really want to bring him on. And it's not because I personally, I like to think I'm very open minded. it's not about me, it's more about concerns with podcast, censorship that can happen.

Cynthia Thurlow: Yeah, and we stayed way away from the fray of discussions about the pandemic, and the virus and all those things to stay. He didn't even bring any of that up. I completely understand.

Melanie Avalon: Yes, I'm happy you brought that up. And then I'm so happy you brought up the constipation piece. Because yes, that is a reason that a lot of people take this often. And I wish that I was the type of person that responded well to fiber helping constipation because there are a lot of people who fiber does help constipation. There are also a lot of people who, and I existed for a very long time-- this is a reason that I want to talk about this. I existed in a very long-time experiencing constipation and thinking fiber was the answer and like trying to shove the fiber down my throat. And it just made it much worse. And it took me a long time to really realize that. I just want to encourage people that if they're taking fiber for constipation, and it's not working, they might benefit A, from just not taking extra fiber, B looking at the type of fiber they're taking, so like for me, I do really well with a low-FODMAP diet. So, I eat fiber-rich vegetables that are low in FODMAPs, which are easily fermentable different substrates that can exacerbate gut issues due to fermentation.

That's why people see my stories all the time buying pounds of cucumbers from Costco, like, I do really well with a lot of fiber from cucumbers and blueberries and things like that, so just Becca, if it is constipation related, the fiber may or may not even be helping, I will put out a resource. If you're curious about FODMAPs, you can get my app called Food Sense Guide. It has over 300 foods for 11 potentially problematic compounds that are found in foods so things you may be reacting to based on your personal constitution. It does include FODMAPs. It also includes lectins and gluten and histamine and oxalates and sulfites and all these things. you can get that at melanieavalon.com/foodsenseguide and Cynthia do you have thoughts about Dave Asprey, Gundry, and people who say that you actually should take fiber while fasting to create these short-chain fatty acids?

Cynthia Thurlow: I think there are many different ways to impact short-chain fatty acids and I'm embarrassed to say I know far more about this subject than I'd like to. Just because of my own gut health journey post-- goodness, so many different things including LPS, lipopolysaccharides. I probably had some E. coli, I got a parasite when in Morocco, I've been treated for said parasite and there has been a lot of gut rebuilding, and I think it's going to be a long process. I actually do better when I take-there is actually a product called [unintelligible 00:25:06] and I do better taking that in a fed state. My stomach's just--

Melanie Avalon: What is it?

Cynthia Thurlow: [unintelligible 00:25:11]. I'll have to give you some separate information. It's essentially a fertilizer for the short-chain fatty acids. And my functional medicine practice really likes it. And so, from their perspective, that's a superior option. I think for a lot of people, some of these resistant starches can be very bloating, and you had mentioned, some people are more sensitive to some of these FODMAP-esque properties, some of these carbohydrates. I think on a lot of levels, obviously, Dr. Gundry is an incredible resource. Dave Asprey obviously does his research as well, he's very comprehensive, but I really think it comes down to the beauty of the N of 1, what really works best for you. And the products I take, I take in my feeding window because I then don't get bloating, I then don't have some of those side effects. There is a degree of experimentation that I think can be helpful. I think for some people they're told to take these products on an empty stomach to lessen the likelihood that they are going to have slowed absorption or less likely to interact with other foods or other supplements or medications and I get that, but I think it's all about the individual. And I know we talk a lot about that. But I think each one of us have to do a little bit of experimentation to find out what works best.

Melanie Avalon: Awesome. I love that, same page, alright. Shall we go on to our next question?

Cynthia Thurlow: Absolutely.

Melanie Avalon: This question comes from Samantha. The subject is: Nutrient Timing? And Samantha says, "Hey, ladies, thank you as always for all you do, seriously changing the world for the better." You cover so many great topics, but I'd like to ask more about exercise. I really embrace exercising while fasted which feels great. I usually do light lifestyle exercise, a brisk walk with the dog, house and yard work, sports with my kids. I know I should start doing more lifting and weight-bearing exercise as I'm approaching 40, it's on the list. In past episodes, you’ve spoken about refueling not being an urgent postexercise need. What you do in the 24-hour period is what matters. Also, I love the discussion surrounding the need for protein. I have made protein a focus for me and my family. Recently, I've noticed the phrase nutrient timing. I've heard Cynthia refer to it and today, Dave Asprey. Can you elaborate and discuss, are there certain levels of exercise where the timing does matter more for certain macros pre and post workout? Also, on a side note, my son plays hockey and hates to eat prior. He's only 10 and a strong lean kid. I encourage at least a protein smoothie. Sometimes he accepts and sometimes he refuses, but he has a ferocious appetite for the rest of the day, so I'm not overly concerned. He eats super healthy too and definitely does not lack for energy. But might he benefit from some better nutrient timing? Thanks, sincerely, Samantha in Canada, she also says she is excited for her Lumen delivery this week.

Cynthia Thurlow: Great question, Samantha, thank you for your questions. And I'm glad that you are leaning into the possibility of starting some weight-bearing exercise, strength training is so so important for us. And for anyone that's listening, the more muscle mass we have, the more insulin-sensitive we are. And this becomes even more important as we are getting closer to middle age, in terms of protein and refueling and nutrient timing, obviously with a teenager and I'm assuming your son is, oh he is 10, so he's a preteen, so he's a tween, kids are still growing. And I think it's certainly very important to make sure that they are getting the right types of fuel in around workouts, they're still growing. Hopefully, we are not still growing at this stage of life we're in, protein and carbohydrates around workouts for them. I think for each one of us, and I'll go back to the bio-individuality piece, I think it's very, very important to identify what makes our bodies feel good. Obviously, if you're lifting heavy things, and you're doing intense physical activity, it's going to be more important to how you are timing those food intakes. And if you're intermittent fasting, I get less concerned about people feeling the need to refuel around a workout. Because as we've talked about before, it's more important over a 24-hour period of time, what I get concerned about though is that a lot of women undereat protein, and if you're trying to build muscle, you're trying to lean into metabolic flexibility.

And remember peak bone and muscle mass is our 20s and 30s. if you're 40 you're already at that stage where you're losing some degree of muscle mass and I know on days I lift heavy yesterday was a leg day and it was a punishing leg day, because I had not been lifting heavy the entire week because I was traveling, I did break my fast earlier and I ate more food than I normally do not because I overate, but intrinsically, my body was telling me I needed to have a larger serving of protein, I needed a bit more carbohydrate. And when I talk about nutrient timing, I also like to think about intuitive eating. And not everyone that's listening is at a point where they're able to intuitively eat. I don't want to spend a lot of time focusing on that. But I do want to encourage people to understand that if you are eating to build muscle and you are intermittent fasting, you have to be very careful about when you're eating. And this goes along with not doing these long fasts, not just eating one meal a day, it's very important that you're getting two good-sized portions of protein in in your feeding window, along with the right types of carbohydrates, and healthy fats if they're not already incorporated into your protein source. It sounds like you're doing a lot of the right things. But kids are very different, even my teenagers are still growing. I'm more concerned about them getting their fuel in around their workouts because they are still growing up, so they're still in this massive anabolic phase. I'm on the other end of the spectrum trying to make sure I'm not breaking down my muscle by not giving it enough stimulus and then not giving it the right nutrients over a 24-hour period of time. Melanie, what are your thoughts?

Melanie Avalon: I thought that was great. This was perfect timing because I'd already scheduled this question in the lineup. And then I had been listening to Peter Attia’s, I think his most recent episode, have you listened to it with Don Layman?

Cynthia Thurlow: So good.

Melanie Avalon: Yes. it's episode number 224. The title is Dietary protein: amount needed, ideal timing, quality, and more by Don Layman, PhD. I was excited last night because he started talking answering this question. I was like, yes, it’s perfect. So, interestingly and apparently, he works with Dr. Gabrielle Lyon a lot, which is awesome. He talks about the nutrient timing of protein. And I realize--, okay, she specifically makes it about protein, which in general, nutrient timing, I do believe is speaking to this protein question. Something I did not know until listening to that episode last night. Yes, so protein is key to maintaining muscle, building muscle post workout. He talks about how if you don't achieve a certain amount of protein after the stimulus of working out, you're not going to build muscle, you've got to have at least was it 30 or 50 grams, I'd have to double check. People who just graze on protein in small amounts all day, they made the case that even if you ate the same amount of total protein, if you ate it in small amounts constantly, you wouldn't get those benefits, especially if you're older because there is a slight caveat for children.

Cynthia Thurlow: Your protein needs change as you get older, you actually need more protein, because you may not be capable of breaking it down as efficiently, so I totally agree with you.

Melanie Avalon: Yeah, exactly. That's why I mean, even in the longevity sphere of people who are really steeped in the vegan world, who are proponents of low-protein diets, even they say, after a certain age, I think it's 60, how you do need a higher protein intake. And what it likely comes down to is just the ability of the body to actually utilize that protein. And you can overcome that by adding more protein to the mix. The fascinating thing that I did not know until listening last night was he said, for people who are new to training, resistance training for muscle building for them-- yes, you can always, within 24 hours, the signals that are created from that muscle training lasts for up to 24 hours, you can refeed later with protein. If you're new to training, you will get a better effect within two hours post workout. If you are accustomed to training and you've been doing it for a while, those benefits aren't really there anymore. So basically, the more trained you get, the less important it becomes to eat right after working out.

But if you're new to it, it might be more important to eat right after working out. And I was glad to hear that because I had not heard that before. I had been just saying basically the 24-hour thing, which is still true. But I think that's a really important nuance to understand. Something else he talked about and this relates to the question about the kids is apparently kids having little amounts of protein all throughout the day, they actually can utilize that pretty well and that will benefit them, like protein snacks and just that's going to help them. He said for older populations basically said there is no point, really once you're a certain age you've got to get a concentrated amount of protein. And having a little bit of protein here isn't really going to add anything, like it's not going to create the benefits that you want. If anything, it might just be taxing on the system. He came to the same conclusion that Cynthia said, which was, you definitely want to get at least two big protein-rich meals. And the most important ones are the first and last meal. He did say also that you can counter some of the effects. When you get older and you're struggling with the body really utilizing that protein, that's when it becomes even more important to do things which stimulate the hormones to stimulate muscle protein synthesis. Again, that's resistance training. Even fasting is counterintuitive as it may seem, but maybe not to our audience because we talk about that a lot. Fasting actually does, prime the body to have a growth stimulus once you actually do start eating again, which is super awesome.

Yeah, and then also they talk about, I know, there are a lot of people who follow for various reasons vegetarian and vegan diets. I completely respect everybody's opinion on that and why they do that. If you're doing it purely for health reasons, and not for personal ethical reasons, I would reevaluate that the more and more I learn about animal protein and its role in the human body, and especially listen to this episode with Don Layman, he really makes the case just how much more suited that is to the human body. And it provides the amino acids that we really need. He also talks about the specific amino acids that are key for muscle building, specifically leucine as well as methenamine and those are going to be higher in animal products. And then something else, I did know this, I don't think it's talked about enough in the vegetarian and vegan world. We often will look at herbivore animals and say, well, they're eating all like a plant-based diet. And they have like, they're super muscular, gorillas and cows and things that. What's really important to understand is that they could have a certain type of gut bacteria that actually ferments plant-based protein and fibers. I don't even know if it's necessarily protein. It can ferment is plant substrates into protein compounds that the animal then can use and we don't necessarily do that. I think that's really, really important to keep in mind, that was a tangent, any other protein thoughts.

Cynthia Thurlow: No, I think that the biggest takeaway for everyone irrespective of what nutritional philosophy they embrace is the importance of protein. Protein, protein, protein is so important. And I find after working with thousands and thousands of women, when women tell me what they're eating, more often than not, they're really undereating protein and they're wondering why they can't build muscle. They're wondering why they're losing insulin sensitivity irrespective of the life stage that they're in. And I just remind them, this is really something that we can lean into. And it doesn't mean that you go from eating 40 grams total a day to 100. But it's something you can be diligently work towards every single day to get to a point where you're going to garner the best benefits.

Melanie Avalon: Exactly. Alrighty.

Cynthia Thurlow: Next question.

Melanie Avalon: I will just comment one last thing. She said she was excited for her Lumen delivery, if listeners are curious what that is. Do you have a Lumen?

Cynthia Thurlow: I do?

Melanie Avalon: Yeah, it measures the levels of carbon dioxide in your breath to ascertain if you are burning carbs or fat and then it helps make macronutrient recommendations to help you take charge of your metabolic health. Do you have a code for them, Cynthia?

Cynthia Thurlow: I do. It might be CYNTHIA, will have to double-check them.

Melanie Avalon: Okay, we can put both in the show notes. I know mine is melanieavalon.com/lumen and while it changes around right now the code is MEL M-E-L that gets you $100 off, which is amazing, but sometimes it changes. If you want to check the most recent code, you can actually have a Facebook group for Lumen as well as for CGMs and Biosense, which is a ketone device. So, just go to Facebook and type in Lumen Melanie Avalon, and that should come up. So, Okie Dokie. Shall we go on to our next question?

Cynthia Thurlow: Yes. Our next question is from Moose and the subject is: Struggling with intermittent fasting. “I first learned of intermittent fasting about six months ago when my yoga teacher suggested I check out the Delay Don't Deny Facebook group. I ordered the book since I've also ordered Fast. Feast. Repeat and I'm reading that as well. I have been listening to the podcast also. I've been attempting intermittent fasting since then and did have a hiccup. For a phase I was drinking Laqua because I thought that was allowed but I learned otherwise and quit that several weeks ago. I have been drinking black coffee and water and doing the clean fast, I know no gum, mints, etc., or anything with flavor. But I really struggle with being so hungry and my tummy growling, I have been tracking my fasting and on occasion I make it to 16 hours, but often I get hangry before then. I'm just wondering if this is common since most of the stories I hear on the podcast people share they have no problem. And it was easy for them to go 18-plus hours early on. I feel like a failure and I'm frustrated. I believe in fasting and the health benefits and want to embrace it completely and lose weight. And I'm not in a hurry but I know that what I am doing, only making it 12 to 16 hours is more for maintenance and not weight loss. For reference, I am 5’6” and currently about 170 pounds and 45 years old, I would like to lose at least 25 pounds. Thank you much for any support or advice.”

Melanie Avalon: Thank you for your question and whenever we get a question like this, I always think it's a little bit telling or noteworthy when people tell us about their fasting experience and issues with either hunger or not working, and then there is no mention of what they're eating, so it's just about fasting. And to me that says I think a lot of people look to fasting and they think fasting, all of the magic is in the fasting, but there is much magic in what you're eating as well. And this actually piggybacks pretty nicely off of the question right before this. Because if you're experiencing hunger, addressing what you're eating could possibly help that a lot. So, are you eating a high protein or moderate to high protein diet in your eating window, making sure that you actually are getting in the fuel and the substrates that you need? So, we'll make it much more likely that you won't be as hungry while eating. Also, the actual macros of what you're eating can be really helpful, so some people do really well with low carb, for example, and they find that when they go low carb with their eating choices, it actually really, really helps their hunger in the fasting period. Some people, it's the complete opposite. they try to stick out this low-carb situation, and they just never feel full. And then they add in carbs. And that's magic for them. I personally follow a-- and I always wonder how many people think I'm low carb, I eat a really high-carb, low-fat diet. That's all whole foods, it's really high protein. But I basically eat a ton of like, and I'm not saying everybody should do this, because I think everybody should find what works for them but like, for me what really works is really high protein from fish and shellfish and chicken and steak, lean cuts of all of that. And then, I eat a lot of fruit and it works really well for me, and I do the fasting. But some people do really well with low carb. Their handle is Moose Elk, so Moose Elk, I would look at your eating and what you're doing there. Yeah, I would really look at the eating honestly. Do you have thoughts, Cynthia?

Cynthia Thurlow: I do and I'm not 100% sure if this is a male or a female, I'm going to assume a female and just speak from the perspective of if you've been doing this for six months, and you're still struggling to get to more than 16 hours, then something needs to shift. It may be that you're not eating enough in your feeding window. It could be as simple as you need larger portions of protein which is going to help with satiety like Melanie mentioned there needs to be a degree of experimentation. You're also if you're a female, you're in this perimenopausal range and it is going to get a little more challenging, it does not mean impossible to fuel weight loss because you're having these fluctuations and progesterone and estrogen. This is a perfect example of, really leaning into what's your stress management like, how is your sleep? Are you consuming an anti-inflammatory diet that could be, removing inflammatory foods like gluten, grains, dairy, and yes, dairy can be inflammatory in certain people alcohol, sugar, I would definitely try an elimination diet to see if maybe there is a food that's inflaming you I do find for a lot of perimenopausal women that gluten and dairy, in particular, can be problematic as well as alcohol, making sure you're lifting weights. I don't know if you're doing any weight training that is certainly very important that will help with insulin sensitivity. But I do find that perimenopause is a particularly challenging time. Sometimes people are over fasting and that's driving problems. People are eating too many nuts and too much cheese which is easy to overeat. I think you really just need to look comprehensively at what you're doing and make some adjustments and know that no one should have to white-knuckle fasting. If you're really struggling then I would break your fast and eat.

But I would also really make sure you're eating the food and the meals that you're consuming. Melanie and I are very transparent about the way that we eat. I eat a lot of protein. I generally carb cycle which means I don't eat the same amount of carbohydrates every day. I really like berries a couple of times a week depending on how much I'm lifting, I may have squash or sweet potato. I really try to stay away from grains because they generally don't agree with me. But I think for each one of us, it's leaning into what makes our bodies feel good. I do better with leaner meat and leaner fish than I do with fatty fish and fatty meats. And I've been consistently that way my entire life, but I would encourage you to really, maybe keep a food diary, maybe do a whole 30 to figure out what's going on. And the other thing that I would say is because you're 45, I would make sure you have baseline metabolic health markers done. What's your fasting insulin? Do you have a glucometer? Or do you have a CGM, continuous glucose monitor I am really looking at the nuances and we will link up some of the more popular podcasts I've done talking about perimenopause, one of the top five podcasts this year was with Dr. Tabatha Barber. And we'll include that with the show notes so that you can listen to that at your leisure. But perimenopause is a time when a lot of things have to change. I'm obviously a living example, I tell everyone that you can navigate your 40s and 50s and still be metabolically healthy and flexible. But you have to make changes and that's the most honest answer I can give you.

Melanie Avalon: That was very helpful and very comprehensive. Thank you.

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Melanie Avalon: Shall we go on to our next two questions?

Cynthia Thurlow: Absolutely.

Melanie Avalon: We have two questions from Robin. She says, “I am a 67-year-old female doing IF since August 2021. I'm 5’7”, my starting weight was 188, my current weight is 155, and my goal weight is 145. Number one, what protein powder do you recommend? Can I mix it in Greek yogurt? I find it hard to consume enough protein in my four to eight-hour eating window.” Do you have a recommended protein powder?

Cynthia Thurlow: I do if you tolerate whey, I like MariGold, It's New Zealand small batch whey. They have chocolate malt, they have vanilla, they have unflavored and that's my preferred whey protein. If you're going to mix it, I would do full-fat Greek yogurt. But I would also make sure that that's not the only protein source you're getting in your window. You really should have an eight-hour window to make sure you're getting no less than 35 to 50 grams of protein in boluses. I think that's super important.

Melanie Avalon: Yes, so basically refer to the earlier questions about all of the proteins. I had Dr. David Minkoff on the show. I really like his perfect amino protein powder. If you go to melanieavalon.com/perfectamino, the coupon code MELANIEAVALON will get you a discount. Beyond that, I eat much just real protein, I don't ever eat really protein powders. But if I do eat protein powders, I encourage listeners to look at the ingredients on the protein powders, because there are many on the market and they're full of just gross stuff, like additives and flavors and just things you don't want in your body. So, finding protein powders that are really just the source of the protein is, in my opinion, really ideal. So, that PerfectAmino is literally just aminos essentially. There are some nice grass-fed whey proteins on Amazon that I've ordered before. I also like single ingredient like egg white-type protein powders. And yes, Cynthia said, of course, yes, you can mix it in your yogurt.

Cynthia Thurlow: And that will definitely bump up your protein and MariGold is great. It's a small company and if you use code, CYNTHIA, you'll get free shipping on it. But that's probably my best recommendation. If someone's listening that's plant based. There is a lot of junky plant-based options that are out there, but Food Babe’s Truvani is probably the cleanest that I've seen for people that are looking for a plant-based option. I personally don't love it because it doesn't mix very well. But I've tried everything, everything I've recommended, I've tried including the whey protein, although I have to be careful with that because I'm dairy-free and dairy doesn't always agree with me. But I think if you're tolerating dairy that is a nice option and if you're looking for a lower likelihood of immunity, evoking immune response, you can look at Tera’s whey T-E-R-A, Tera’s whey. They have a sheep milk protein that is super high-quality small batch and you can purchase that pretty readily and easily as well.

Melanie Avalon: And here's a huge question for you, Cynthia. I'm super excited for when you release your creatine powder. So, creatine is an amino acid. Is it something that people use for their protein intake? Or is it a more specific use not really related to protein intake numbers?

Cynthia Thurlow: Yeah, it's an important question. It's to be used in addition too, we know that women's creatine needs to change with their menstrual cycle, they actually increase if you're vegetarian or vegan. And there is a lot of really good research to demonstrate that creatine is absolutely critical with menopausal, perimenopausal women, so there is really no one that doesn't need it to help with ATP production, to help with healthy muscle maintenance, to help with cognition, and brain health. And I was telling Melanie before we started recording that we're getting very close, hopefully next month the creatine will be available and I'm really excited because the more I learn about creatine, the more I realize that we should all be adding this as a supplement. So, you can throw it into things like a smoothie, you can throw it into water, it's going to be very multifunctional and no junk.

Melanie Avalon: I'm so excited especially because I keep hearing people talk about it. And I do think it's really important. I've never personally used it and I can't wait till you have yours because I'm going to integrate it into my personal arsenal.

Cynthia Thurlow: Thank you.

Melanie Avalon: All right, second question from Robin. She says, “I've been on bioidentical hormone replacement therapy since I went through menopause at age 57. I still have a uterus, so I take estrogen and progesterone sublingually as well as topical testosterone. In the past when I took too much estrogen, I bled some, so now I take a lower dose. My gynecologist told me I have a hypersensitive uterus. I've even considered a hysterectomy. I won't have to worry about this. My question, “Can I do bioidentical hormone replacement therapy for life?” And all your podcasts I've listened to on hormones I haven't heard this question addressed. Also, what do you think about a hysterectomy for my situation? Thanks, Melania and Cynthia. I love you ladies. And I'm thankful for you both.” And she is from Florida. I hope all is well with her with that hurricane situation.

Cynthia Thurlow: Exactly. Well, Robin, thank you for your thoughtful question. First and foremost, a lot of the research and this is not medical advice let me just say that upfront, just based on what you've shared. I really oral progesterone that actually is much more protective of the uterus, so that might be something worth discussing with your GYN. I don't think it's so much that you have a hypersensitive uterus. I just think there is a right dose for you. And perhaps you and your GYN have not finetuned that enough yet. Yes, when estrogen and progesterone are not properly balanced, it can cause you to have some bleeding which, of course, is not fun in menopause, of course. In terms of whether or not you can take bioidenticals for life, the research is now suggesting that it is safe to do so. There are just many benefits. I think for a lot of women, they go a period of time greater than three to five years after going through menopause before starting the medications, starting hormone replacement therapy. And there is some research to suggest that the most benefit is garnered when it started within three to-- there is a beautiful three- to five-year window after going into menopause when you've utmost benefit from starting it. But that does not mean if we have a listener who hasn't started it in that window that there are not benefits. We know there are a lot of benefits, especially because we think about brain health, heart health, bone health, cognition, vaginal health, etc. I'm glad that your GYN is comprehensive because you're also on testosterone, which is also very important. And for people that are listening, the more you learn about testosterone and the benefits of that it's very, very important for maintaining healthy body composition.

Although it can be tricky because some healthcare providers do not offer that as an option. Your second question is what do you think about a hysterectomy for your situation? I would have to really be at a point where I was having a lot of bleeding to consider going through a surgical procedure although hysterectomies can now be done through the vagina, so they can be pretty benign. That's probably a better question for your GYN. Some women think it's no big deal to have their uterus removed. Others are very sensitive to having their uterus removed emotionally and otherwise. And so, I think that's a highly personal question. But with dosage adjustments, hopefully, you will not have any more bleeding and that will not be problematic, and you will avoid having to have a surgery. But I'm grateful that it sounds like you've got a very comprehensive GYN that they're so on top of not only your symptoms but helping to take care of your brain, body, bones, and heart in menopause. Melanie, what are your thoughts?

Melanie Avalon: Yeah, just a few quick things. We've talked about this on the show before. But every time the question of bioidentical hormone replacement therapy comes up, I do think it's important to share the information about how a lot of the potential fear surrounding bioidentical hormones was based on studies that have since been reevaluated and that they're potentially misleading in the cancer risks for women related to this, just something to consider. it could be really beneficial for a lot of people and I think a lot of the concerns and fears surrounding it might be based in some misleading data that happened with, was it the Women's Health Initiative?

Cynthia Thurlow: Yeah, that came out in 2002 and we have a whole generation of providers and women who are fearful to take hormone replacement therapy. I did an excellent podcast with doctors Avrum Bluming and Dr. Carol Tavris earlier this year, which we'll link in the show notes. There is a fantastic resource called Why Estrogen Matters. And I have to honestly tell you that that book is life-changing. I can't tell you how frequently I recommend it, not just for other healthcare professionals that I work with and interact with, but also patients. And I think it's very important that women understand that you don't have to white knuckle perimenopause, and menopause, you don't have to suffer. Your quality of life is hugely impacted by replacement of the hormones that you've lost. It does not mean there is anything wrong with you. I think it's all about honoring each woman and what they want to have done. I worry the most about brain health. I should be completely honest with you. We look at women's rates of Alzheimer's, they go up exponentially when they're in menopause, as we're becoming less insulin sensitive. I just did a fantastic podcast with Max Lugavere talking a lot about this and about his trajectory in his career and the impact of his mother's illness on his decision to really lean into cognition and brain health. And really that's become his life's work. And so, I always say to women that each one of us have to make the decision that makes the most sense for us.

But education and empowerment are absolutely critically important. And I would strongly recommend if you're on the fence or you're feeling unsure, or you're working with someone that's not comfortable prescribing hormones that you work with someone that is and a lot of the clinicians that I've done podcasts with and there are many of them. Dr. Tabatha Barber, Dr. Shawn Tassone. Dr. Bluming is, I believe, no longer practicing. But there are many practitioners Dr. Felice Gersh, who's going to come back on the podcast this fall and we're going to talk all about perimenopause and menopause. There are many heart-centered practitioners, who want women to thrive in perimenopause and menopause. You don't have to do it white-knuckling it kind of like this is this reoccurring theme in this podcast? You don't have to white-knuckle fasting and you don't have to white-knuckle going through reverse puberty. Hopefully that's helpful, Robin but I think you're It sounds like you're in very good hands. And I'm very happy to see that.

Melanie Avalon: Thank you for drawing attention to that. Something I haven't even remotely thought about, not having had that experience of perimenopause and menopause. The only other thing I was going to comment on was, the testosterone piece is just something I want to share. It's with the Women's Health Initiative study thing. I mentioned last episode, how I recently had Doc-Koz back on my show for his new book called Get the Func Out which is a really comprehensive look at seven key hormone systems in the body and how to address that. But he actually opens up the book, and we talked about his story on the show. He went on testosterone therapy, so this is for men. We talked about this, like, I don't know why this isn't more well-known apparently if you're a man and you go on testosterone therapy it can actually lead to infertility, at least while you're on it. So, like, while he was on it, it dropped his sperm to like 0, which he didn't even know is a thing and apparently, it's very, very common. And he was able to reverse it by going off of the testosterone and doing a lot of specific nutritional protocols. And he did say he reversed the fertility issue while he is in this period of maybe wanting to have children, but then he did say, once he after-- when he is on the flipside of children, he'll definitely go back on it because it's the best he's ever felt. I asked him about testosterone supplementation in women and he said that he doesn't really see it.

Cynthia Thurlow: Is he a clinician?

Melanie Avalon: Yeah, he's a doctor. Yeah. And then I was talking with one of my other doctor friends about females and this is why I'm just really curious your thoughts on it about testosterone supplementation in women and he was not a fan either. Have you done it in your practice?

Cynthia Thurlow: Well, here's the thing, and this is going to come. This might be the most strongly worded response this entire podcast listener base has ever heard from me. When men are trying to tell women, this is very much part of the patriarchy. Rarely will you hear me sound this firm about this. When men are trying to tell women that testosterone is not important, we actually have more testosterone in our bodies until we go into menopause than we do relative to estrogen. It is in smaller amounts. But it is very important for brain health, for bone health, for muscle health, to somehow suggest that women don't need supplemental testosterone. And obviously, this is prescription. This is not supplementation. Typically, it's in a cream form. I think on a lot of levels when you have women going into menopause, and they're starting to struggle with body composition changes, they're losing muscle mass, it is a direct reflection of this loss of testosterone and testosterone starts to slowly peter off, unlike estrogen that gets almost you get shoved off a cliff. It can be a precipitous drop, as you're in the latter stages of perimenopause. I always with caution when I hear male physicians suggesting that it's not important. That has never been my clinical experience. Most if not all of the male and female physicians that I refer to and work with and interact with that are GYNs. They're very pro-testosterone for the right person. Obviously, most people in the United States, both male and female, that have low testosterone levels, it's a direct reflection of stress because our body has a hormone hierarchy. They can also be a direct reflection of insulin resistance. And you get this aromatization of testosterone to estrogen. That's why you sometimes will see feminization of men, not because they choose to become more feminized, but it's because their testosterone is being aromatized into estrogen. And I think it's highly personal. I do find most in the functional integrative medicine space talk very openly about using testosterone. It's very much a bio-individual thing.

But the more I learn about the way that hormone therapy has been put on hold effectively since the Women's Health Initiative came out, the more I feel it's important for providers to speak out and just say that most of the women that I see fully optimized in perimenopause and menopause are very likely on some degree of testosterone and I'm not talking about pellets? Pellets are wildly unpredictable. I have colleagues that call it 1920s medicine. Now, if you're someone that gets pellets and you feel good on pellets, great, but I find most women feel good for about a week or two, and then their testosterone levels plummet and they don't feel great. But testosterone is needed for a lot of different things in the body. And although I respect the physicians that you've interacted with, I have to politely disagree and say that testosterone therapy is absolutely part of bioidenticals for the proper individual at the right time. I see a lot of people do really well starting with progesterone and then adding in testosterone if it's needed, and then adding in the estrogen piece, but it's really dependent on your labs, how you feel, the symptoms you're experiencing, and finding the right provider to be able to support your body and your needs and your goals in a way that is aligned with what you're looking for?

Melanie Avalon: Thank you for sharing that. Yeah, like, I'm so new to the whole testosterone supplementation. And it was-- it was interesting that within a very small timeframe, I discussed it with two different doctors. And yes, very interesting that it was the male perspective and so that's really valuable information.

Cynthia Thurlow: Yeah, and I never, like anyone that knows me the phrase, the patriarchy never comes out of my mouth. However, it has been my experience, the more I learn about this time period in women's lives, the more that that really becomes apparent. And I think for everyone listening, finding a provider that can meet your needs is absolutely important. There are some really good books and maybe that'll be part of another podcast where we can unpack that a little bit more and just talk about some of the books that I think are very, very helpful for women. But Why Estrogen Matters is a great starting point to have that conversation with your healthcare professional. And quite frankly, I say this a lot, www.ifm.org I have no affiliation with them but those are functionally integrative medicine-trained people. And you can look in your area, there might be people that are practicing gynecologists or there’re internal medicine physicians, and NPs, and PAs that have an interest in women's hormones and women's health and can meet your needs and you don't have to suffer, so that's the big take home as you do not have to suffer in perimenopause and menopause.

Melanie Avalon: I'm really glad I said that because I'm really glad to hear that answer, so that was very valuable. Thank you.

Cynthia Thurlow: You're welcome.

Melanie Avalon: Quick comment on the patriarchy thing. I wish it would be possible to-- because if you use that word, it feels it comes with all of these assumptions about-- I wish we could just acknowledge it when it actually is existing objectively without feelings of a bias or emotions, but there might just be systems that are from a patriarchy type system manifesting especially in things healthcare.

Cynthia Thurlow: I rarely say that so for listeners to understand that it takes a lot to get me fired up about something. And this is definitely a subject that I feel it is going to be part of my life's work and helping to dispel bad information, bad research, bad results that were reported from Women's Health Initiative and how we effectively have an entire generation of clinicians and women who were fearful to prescribe and then fearful to take hormone replacement therapy.

Melanie Avalon: Awesome. While this was very valuable information for listeners, okay, [01:07:40] a few things for listeners before we go. If you would 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 notes will be at ifpodcast.com/episode288. Those show notes will have a full transcript, so definitely check that out. It will also have links to everything that we talked about and we talked about a lot of things. And you can follow us on Instagram. We are @ifpodcast and I am @melanieavalon and Cynthia is @cynthia_thurlow_. I think that is all the things. Anything from you, Cynthia, before we go?

Cynthia Thurlow: No, just know that keep the questions coming. We're loving all the variety and we appreciate you and all the listeners’ support. It really means a lot.

Melanie Avalon: I echo all of that completely. While this has been absolutely wonderful and I will talk to you next week.

Cynthia Thurlow: Sounds good.

Melanie Avalon: Bye.

Thank you 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 re-composed by Steve Saunders. See you next week.

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