Episode 312: Creatine, Exercise, Chronic Cardio, Fasting and Menstruation, NSAIDS, Low Dose Aspirin, ApoB, Statins, And More!

Intermittent Fasting

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Apr 09

Welcome to Episode 312 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:

LMNT: For Fasting Or Low-Carb Diets Electrolytes Are Key For Relieving Hunger, Cramps, Headaches, Tiredness, And Dizziness. With No Sugar, Artificial Ingredients, Coloring, And Only 2 Grams Of Carbs Per Packet, Try LMNT For Complete And Total Hydration. For A Limited Time Go To drinklmnt.com/ifpodcast To Get A FREE Sample Pack With Any Purchase!

AVALONX magnesium 8: Get Melanie’s Broad Spectrum Complex Featuring 8 Forms Of Magnesium, To Support Stress, Muscle Recovery, Cardiovascular Health, GI Motility, Blood Sugar Control, Mood, Sleep, And More! Tested For Purity & Potency. No Toxic Fillers. Glass Bottle.  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!

Athletic Greens: 75 high-quality vitamins, minerals, whole-food sourced ingredients, probiotics, and adaptogens in one delicious scoop! Get A FREE 1 year supply of immune-supporting Vitamin D AND 5 FREE travel packs with your first purchase at athleticgreens.com/ifpodcast

To submit your own questions, email questions@IFpodcast.com, or submit your questions here!! 

SHOW NOTES

1:10 - 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!

4:00 - 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!

13:45 - AVALON X MAGNESIUM: 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!

16:30 - Listener Q&A: michelle - Does Creatine Break a Fast?

16:30 - Listener Q&A: Gwen - Does Creatine break your fast?

Episode 292: Creatine, Brain Health, Sex Hormones, Muscle Building, Insulin Sensitivity, Sarcopenia, Andropause, Mood, Motivation, BDNF, And More!

Introducing... Creatine By Cynthia Thurlow

23:00 - Listener Q&A: Laura - Question

40:00 - Listener Q&A: Kristen- If and Periods; Does taking ibuprofen or Tylenol break a fast? 

50:55 - 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

52:05 - Listener Q&A: Lauri - If Your current self and knowledge could go back in time to your younger self what would you do differently knowing what you know now as far as career and life hacks.

Our content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and answers to personal health questions.

TRANSCRIPT

Melanie Avalon: Welcome to Episode 312 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: A 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.

Hi friends. I'm about to tell you how to get my favorite electrolytes, some of which are clean fast friendly for free. Yes, for free. It's not just me who is obsessed with these electrolytes. You guys are so obsessed as well. Honestly, every time I post about LMNT electrolytes, so many people overwhelmingly comment about how much they love them. I'm just going to read some random comments for example, here's one. "LMNT is the greatest thing ever. My friends and I drink one a day. It's our treat. We are ER nurses and know how important electrolytes are." Here's another. "My pack is on the way. I've been drinking it for a while. It is my new favorite thing during my eating window. I will be starting training for the Honolulu Marathon next week. So, this is perfect for my electrolyte balance." Here's another. "I think chocolate LMNT in hot water is my favorite now, it's like hot chocolate and then we always just have a sprinkling of I love LMNTs."

The more I research, and the more I study, the more I realize just how important electrolytes are. They are key for cellular function. Electrolytes facilitate hundreds of functions in the body, including the conduction of nerve impulses, hormonal regulation, nutrient absorption, and fluid balance. That's why LMNT can help prevent and eliminate headaches, muscle cramps, fatigue, sleeplessness, and so many other things related to electrolyte deficiency. Athletes, for example, can lose up to 7 grams of sodium per day. If that sodium is not replaced, it is very common to experience muscle cramps and fatigue. But friends, it is not just athletes. Electrolytes can help everyone, whether it's after a few glasses of wine, "Oh, hey," keeping an active lifestyle, or especially if you are fasting or doing a keto diet, electrolytes may be key.

That's because both fasting and the keto diet specifically deplete electrolytes. But here's the thing, so many electrolytes on the market are full of so many things that you don't want. We're talking fillers, junk, sugar, coloring, artificial ingredients, things you don't want to be putting in your body. That's why I love LMNT. It has none of that. It contains a science-backed electrolyte ratio of 1000 milligrams of sodium, 200 milligrams of potassium, and 60 milligrams of magnesium. Right now, LMNT is offering our listeners a free sample pack with any purchase. That's right, you can get eight single-serving packets for free with any LMNT order. This is a great way to try all eight flavors or share LMNT with a salty friend. The raw unflavored version, by the way, is clean fast friendly. Get yours at drinklmnt.com/ifpodcast. That's D-R-I-N-K-L-M-N-T dotcom slash ifpodcast. And LMNT offers, no questions asked refunds, so you can try it totally risk free. If you don't like it, share it with a salty friend and they will give your money back, no questions asked. You have nothing to lose, drinklmnt.com/ifpodcast and we'll put all this information in the show notes.

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 may be 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 counter time for anti-aging, counter match for normal skin, counter control for acne and oily prone, and counter start for sensitive. I use their Overnight Resurfacing Peel and vitamin C serum every single night of my life. And their makeup is amazing. Check out 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 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.

Melanie Avalon: Hi, everybody and welcome. This is episode number 312 of the Intermittent Fasting podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.

Cynthia Thurlow: Hi, Melanie. How are you today?

Melanie Avalon: I'm good. I did something sort of fun. I'm curious. Do you like jazz music?

Cynthia Thurlow: I do. I definitely do. I got into that in my 20s when I was trying to drown out the noise of the street and study. [laughs]

Melanie Avalon: Oh, wait, now another tangent. [laughs] I'm reading a book right now called Golden: The Power of Silence in a World of Noise. And it's really funny because right before that, the book I read-- this was just complete happenstance, and this is all to interview people. So, the book before that was called Sentient, which blew my mind. Oh, my goodness. It was all about the different senses in animals and how it compares to humans and what we can learn from that. I didn't realize we have so many senses. And we do not just have five senses. We have like a ton, it's debated, but it's like up in the teens or maybe 20s. Can you think of some other ones? Besides the five?

Cynthia Thurlow: I mean, I could talk about something that's not tangible, intuition. I do think about that on an energetic level. But that's another aspect of sensing information, energy, etc.

Melanie Avalon: Yeah, they didn't talk about any intuition senses, I don't think, but there're so many. There's like with touch, it's not just touch there's temperature sensing, there's pain sensing. So that's like two more right there. When it comes to sight, there's different types of sensing. There's like with sleep, for example, part of our eyes that have light informing our circadian rhythm, that's like a different sense. And it's not related to seeing. It's literally just the light-activating melanopsin cells that inform our circadian rhythm. So, that's technically a sense. There's a sense of balance. There's a sense of "Oh, I love this one, what's it called pracio--"

Cynthia Thurlow: Proprioception.

Melanie Avalon: Yes, proprio-- yeah whatever you just said, which is basically knowing where one of your body parts is?

Cynthia Thurlow: In time and space.

Melanie Avalon: Yes. And he talks about these fascinate-- Okay, some people-- There have been these times that have happened where people have not had that sense. There was this guy, and just one day, I don't know what happened, but he just lost that sense. And so, all of a sudden, he didn't know where his different body parts are. He could inform it if he could see his limb. That's how he taught himself to live without this sense. He couldn't walk when it first happened because he didn't know where his feet were. But eventually, he learned if he could watch, he could walk and stuff like that. But if he didn't, so if he had his hand-- like if he was watching his arm, he could direct his arm and make it do things. But if he wasn't watching his arm, it would just, like, do stuff. [laughs] Like it would just, like, move around [laughs] which I just find so funny. The animal they were talking about in relation to that, and sorry, this is so random. I just find it so fascinating. So, like, the octopus, for example, they think it has local, whatever that word is, proprioception.

Cynthia Thurlow: Proprioception.

Melanie Avalon: Yeah. [laughs] I need to learn it before I interview. Their tentacles probably have that sense locally. So, when an octopus is doing stuff, all of its arms can do different things, and it's not really even aware unless it's looking at the arm and doing it on purpose. If you cut off an octopus' arm, it will actually keep doing stuff for a little bit. Like, it'll keep picking up stuff and try to feed it to the octopus, and they know it's intuitive. Like, they know it's not just muscle memory because they've done a study where they'll cut off an octopus' arm or tentacle, they'll give it normal food, and then like poison food, and the tentacle will only interact with the normal food and try to feed it back to the head that's no longer there.

So, that was such a tangent, it's a really fascinating book, Sentient. Oh, but the point of that was I read that, and then the next book I'm reading now is called Golden and it's about silence, which is the opposite, but not really because they kind of relate because they're both talking about our senses, which all goes back to what you were saying, which was trying to drown out the noise. The reason I brought that up was I went to really spontaneously, a friend from college came in town and we found this really nice jazz club where they do like dinner and drinks, and it was like super classy. I love just doing completely random stuff like that. It was not planned. There were two tickets left. We're just going to do this. It was a Fleetwood Mac jazz band. It was a great time, so yeah. Do you like doing super spontaneous random stuff?

Cynthia Thurlow: It's harder because we have kids and dogs. There's not a ton of spontaneity, although I think this summer, we're going to have both the boys in-- one's going to be an engineering camp at Duke and the other one will be kind of in an entrepreneurial Duke program. We'll have overlap where both the kids are going to be away at the same time. I said to my husband, this is wild. [laughs] Never are home by ourselves for extended periods of time. So, this will be interesting, maybe then we'll be able to do something totally spontaneous. But no, not a lot of spontaneity over the last 18 years because of kids and dogs and all sorts of stuff.

Melanie Avalon: Oh, man, I can imagine. Well, you have to let me know if you do some fun stuff then.

Cynthia Thurlow: Definitely.

Melanie Avalon: Anything new in your life?

Cynthia Thurlow: Not a whole lot. We're getting ready to-- by the time these airs, we will have just gotten back from our spring break vacation. So, I'm really looking forward to going to Portugal. And we've got a really fun itinerary. It's like one of my favorite things to do as a family is to vacation with them. By the time this is airing, we will have just gotten back from Portugal, which should be a lot of fun.

Melanie Avalon: Very exciting. I cannot wait to hear about all the things.

Cynthia Thurlow: Absolutely.

Melanie Avalon: Hi, friends. I'm about to tell you how to get 10% off my new magnesium supplement. Magnesium is such a crucial mineral in the body. It's involved in over 600 enzymatic processes. Basically, everything that you do requires magnesium including creating energy from your food, turning it into ATP in the mitochondria, boosting your antioxidant system. Magnesium has been shown to help with the creation of glutathione, regulating your blood sugar levels, affecting nerve health, muscle recovery, muscle contractions, supporting cardiovascular health and blood pressure, aiding sleep, and relaxation, and so much more. It's estimated that up to two-thirds of Americans do not get the daily recommended levels of magnesium and on top of that, magnesium deficiencies can often be silent because only 1% of magnesium is actually in our bloodstream. So, that might not be reflective of a true magnesium deficiency. Our modern soils are depleted of magnesium. We're not getting it in our diet. That's why it can be so crucial to supplement with magnesium daily.

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Melanie Avalon: So, to start things off, we have two questions, which are the same question. One comes from Michelle and the subject is, "Does creatine break a fast?" Michelle says, "Hi, Melanie and Cynthia, I love your podcast. This may be a question you've already answered, and if so, could you direct me to the episode?" I will say really quickly for people, if you go to ifpodcast.com there's a search bar and we have transcripts of all the episodes so you can search, and if we talked about it is probably on the website. That search bar is actually very effective, because some websites searches are not very good, but ours works pretty well. Okay, so she says, "I am wondering about how to utilize creatine on days of extended fasting. For example, if I plan to do a 36 to 42-hour fast once or twice a week, how does creatine factor into that? Will creatine stop autophagy in its tracks? If I take it on my down day, extended fast day, and/or is it okay to not take creatine once or twice a week, and how will that affect the storage levels of creatine in my body overall?" If the purpose of autophagy is to use junk proteins in my body to create new proteins, wouldn't I want to encourage autophagy, even if that meant not taking creatine for a day or two? I'm a 58-year-old postmenopausal woman who began intermittent fasting eight months ago. I'm active and fit for my age and regularly engage in strength training as well as cardio activities, running, and biking. I also hike and walk a lot with my two dogs. I implemented some extended fast into my protocol due to a fasting insulin level of 44.4," wow, "which decreased to 3.3 within three months." Wow. That's wow. Okay. [laughs] She says, "I have a history of both type 1 and 2 diabetes in my family, so the fasting insulin was not a surprise." Thank you so much for your podcast. I learned so much from you both. I would just comment really quickly that's incredible that in three months, your insulin went from 44.4 to 3.3. Crazy. And then Gwen says, "Does creatine break your fast?" So, this is definitely a Cynthia question.

Cynthia Thurlow: Well, Michelle, thank you for your question and Gwen, I would point you in the direction in terms of creatine information to Episode 292 that I did with Scott Emmens, the COO of MD Logic, and there's a lot of really helpful information in there. I think my general recommendations about creatine for women are that we want to aim to take it daily because we make 70% to 80% less creatine than men. We know, based on research, that women that are having a menstrual cycle as well as perimenopausal, menopausal women, we have fluctuations in our needs throughout the month.

Obviously, menopausal women, you're not having as much hormonal flux, but we still benefit from a brain health and metabolic health perspective. I generally recommend that you take it in a feeding window because it will stop autophagy. If you are doing extended fast, I would recommend that you just skip taking creatine on that day. I do think it's important to be consistent. If it's a day where you're not lifting weights, you still want to take creatine as well as on days that you are lifting weights. I think it's amazing that you've had such improvement in your fasting insulin levels. To go from 44 to 3 is pretty significant in such a short span of time. So, congratulations and kudos for taking such good care of your health and certainly we're so glad to know that you enjoy the podcast.

Big takeaways are take creatine in your feeding window. If you are doing an extended fast, you can hold the creatine because it will technically break a clean fast. But with that being said, consistency is really where you see the most benefits. I have a 70-year-old, very petite client/friend of mine who weighs 90 pounds, who can actually do a leg press of over 300 pounds after taking consistent creatine. And so, it's really amazing. It's not just something that benefits younger women, it benefits all women. But a great question, so thanks for asking.

Melanie Avalon: Do you know about her question about storage levels of creatine? Does the body store creatine?

Cynthia Thurlow: We have 70% to 80% less endogenous creatine, which is why it is very important that we supplement. You don't get enough from your diet. I don't care how much steak you eat, you cannot replete to the same degree that men can, so yes you will-- Creatine monohydrate is something that's up-taken by our muscles, but the benefits come from taking it on a daily basis. That's why I haven't missed taking a dose in, gosh, like 16 months. I think it's really made a big difference in not just sleep, but also in how I'm able to lift heavy at the gym, which is important to me because I want to maximize muscle protein synthesis. So, like, the nutrition, the creatine, the lifting heavy, all are really integral and important to be able to do that. But yeah, you have a lot less storage capacity as a female, which is why you can't eat enough creatine-laden foods, and that's why exogenous creatine is so important.

Melanie Avalon: Gotcha. And how can people get your creatine?

Cynthia Thurlow: Yeah, really easy. If you go to my website, it's www.cynthiathurlow.com/creatine and you will have direct access. Right now, we just started a subscription service and that's been really well received. People are excited to be able to get discounts on purchasing and knowing that they will never run out. Because I know that I sometimes forget I'm running out of supplements and then I have to wait a week or two until I get new ones. This just makes it very easy and seamless.

Melanie Avalon: I love the subscription options. By the time these airs, we will have like, mm, a few weeks ago launched. We're testing out a larger bottle subscription option for Serrapeptase and then hopefully extend it to the other supplements as well. But always just trying to make things even more sustainable because right now with the bottle supplements, the subscription, you basically get three bottles at once for a few months. So, then you're saving on shipping and it's better for the environment and all that. But now we're taking it one step further and doing a large bottle. So, yes, definitely subscriptions are the way to go for all the products if it's something that's in your daily life, and they usually have a built-in discount. I'm assuming that Creatine has a built-in discount with the subscription.

Cynthia Thurlow: Mm-hmm.

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

Cynthia Thurlow: Absolutely. This is from Laura. Subject is question. I stumbled across your books, podcasts, and community about a month ago after rereading the Obesity Code. I absolutely, but not literally ate your books up and then read them again. I've always been an intermittent faster 19/5, however, never realized that's what I was doing. I was also exercising three to five times per week. I stayed a small size eight, Australian size, for about eight years until the pandemic, when I went from approximately 62 to 63 kg to 73 kg. I was eating excessively to cope with my work and overall stress. It was my heaviest weight ever, I felt horrible.

I dragged myself back to the gym when restrictions eased and went low carb, which I still do the majority of the time, with the exception of chocolate on Shark Week, you know when that is and special events. When I read your books and connected the dots that this was what I have always done but never knew, I was beyond thrilled. I immediately started. I had structure and abundance in information, and I knew my body loved this way of eating. I don't weigh myself, but I can see that I am down at least two pant sizes with a combination of intermittent fasting, low-carb-ish diet, and continue to work out about three times a week in addition to walking my dogs. My body has been used to four to five days of exercise, weights, walking, and cardio class. But as I work as a nurse around the clock, and I'm getting older at 37, I would prefer to keep my exercise less vigorous and control my weight through my diet as much as possible, with exercise adding to my health and not dictating it.

A very long intro for a short question, I apologize, but during the weight-loss period, how much exercise do you recommend and also in maintenance? My thigh area is really the hardest to budge, and I don't want to run 35 km a week or train five days to slim them down again. Love all the way from Australia, Laura.

Melanie Avalon: Awesome. Laura. Well, thank you for your question. Cynthia, do you ever watch Shark Week?

Cynthia Thurlow: I used to when my kids were younger.

Melanie Avalon: I don't think I-- it was never really my thing, but I actually-- [laughs] a guy that I dated for quite a while, he did a segment once on it. I think he went in a cage. I don't know why he was doing that, but he went in a cage and like, oh, that's what he did. He built a suit to swim with the sharks not in a cage. He was a magician. So, fun times.

Cynthia Thurlow: Did I ever tell you that when I was in South Africa with my husband for our 10th wedding anniversary, we did shark diving?

Melanie Avalon: No. With great whites?

Cynthia Thurlow: They chum the water. Do you know what chum is? It's like--

Melanie Avalon: No, what does that mean?

Cynthia Thurlow: Bits of fish and innards they throw in the water to attract blood. They attract sharks. No need to ever do that again.

Melanie Avalon: Was it scary?

Cynthia Thurlow: I was more freaked out that I had a head-toe wetsuit on. Like, I just felt like sensory wise, I was so fixated on the fact-- and they put a weight belt on me, I'm not a big person, and they were concerned I wasn't going to be able to get to the bottom of the cage. And I just remember as soon as there was an opportunity to get out of said cage, I was happy to never do that again. I mean, the sharks come right up to you. It's not like they're far away. It was a very interesting experience; one I don't ever need to do again. I have great respect for sharks. I don't need to connect with them in that capacity ever again. But my husband was delighted. He thought it was the coolest thing ever.

Melanie Avalon: Okay, wait, so to get into the cage, do you get into the cage where it's like-- [crosstalk]

Cynthia Thurlow: From the boat on the top.

Melanie Avalon: Where the sharks are going to be before they chum them, call them over.

Cynthia Thurlow: The cage is attached to the boat, and the people that take you out, I mean, they're conservationists, so they're very conscientious about-- you know they're the people that are out studying the sharks. The unfortunate thing is, I've now heard I mean, we will have been married for 20 years this year, so 10 years ago, there were still quite a bit of sharks outside of the Cape Town area, and now there aren't as many. And so, people may desire to go out and do that kind of activity, but there's no guarantee they'll actually see sharks. So, yeah, you're in a cage attached to the side of the boat in a head-toe wetsuit with a weight belt, and then you get to watch. It's kind of surreal. I mean the whole time I kept thinking, I don't want to leave my children, orphans. I want to make sure we get back from South Africa. Definitely not, like my husband thought it was awesome. I think I was completely exhausted from the stress. Definitely not the most enjoyable thing I've ever done.

Melanie Avalon: Oh, yeah, that would not be my thing. [laughs] How long were you down in the cage?

Cynthia Thurlow: Like 15 or 20 minutes.

Melanie Avalon: Wow, okay, that's cool. [laughs] That's up there for cool things.

Cynthia Thurlow: Totally bizarre. So, yeah, when you talk about Shark Week, I'm like Ah-Ha [laughs]

Melanie Avalon: Wow. I think the things out of all the nature things that you can do, I think the thing that would freak me out the most that I just could not do would be the cave where you crawl through really small cave spaces.

Cynthia Thurlow: I'm claustrophobic, that would be a .

Melanie Avalon: I would literally have a panic attack. I could not do that, because I remember my parents in Hawaii, they did one where-- I think it was, you went and looked at some really nice caves, but you had to crawl to get to them through these tunnels. And I was like, nope. So, I could do like hot air-- have you done a hot air balloon?

Cynthia Thurlow: I have not. You know it's funny, we've done a lot of pretty adventurous stuff, but there are definitely things that we have not officially done. And that would be another one. I think we had talked about doing that in Turkey, but given the humanitarian crisis there and in Syria, I'm not sure that's going to happen either. But that's okay.

Melanie Avalon: Yeah. Would you do Skydiving?

Cynthia Thurlow: We've done Skydiving. I mean, I've done it.

Melanie Avalon: Oh, you've done it?

Cynthia Thurlow: Yeah, I mean, we've done quite a bit-- when I tell you, especially having boys, there's just a lot of stuff that you have to get comfortable with, like cave diving and I mean, we've done it all. That was definitely like my kids think going to-- there's Costa Rica trip we took December of 2021. They'll always talk about how that's one of their favorite vacations ever. It was the vacation where I said, I will never do this again. [laughs] They thought it was awesome. I'm like, no thanks. I don't need to be wet for like two days straight, nope.

Melanie Avalon: Wow. And was skydiving scary?

Cynthia Thurlow: Yeah, but not as much as the shark stuff.

Melanie Avalon: Wow. Okay.

Cynthia Thurlow: It was just a lot. So, I think it's all relative. You know for me. We do our research, we make sure that we're going with qualified people. For me, it was like trusting in the process. There's so much of just letting go.

Melanie Avalon: Yeah. If I had to, I could do skydiving. Going back to you talking about putting on that suit, it's more the things you have to wear in these different adventures that I don't like. That's usually like the thing. I don't know, putting in all the gear and getting up there and the effort required to make it happen is what I don't like so much. But if I just popped up in the top of a plane and they were like, okay, jump out now, I probably could, but I don't seek it out. So, okay, Laura, so thank you for mentioning Shark Week, because that is what happens with that.

So, to answer your question, first of all, congrats on your lifestyle approach and everything. I love what you said about how with exercise specifically, you want to control your weight through your diet as much as possible with exercise adding to your health and not dictating it. And I think that is such a beautiful approach to exercise.

So many people do turn to chronic cardio and exercise as the modality to lose weight. I just feel like it's pretty consistently shown that that approach, like, solely exercise. So, trying to burn off calories at the gym is not the most effective way to lose weight. The body is, especially when it's like long at longer durations of exercise. And actually, Dave Asprey, who I am interviewing week after next, I think. Thank you, Cynthia, for that reconnection. His new book called Smarter Not Harder I think. He talks all about this. So, when you're putting your body into longer term approaches of stress like exercise, in order to lose weight, that just doesn't give the body the signals it needs to get the results that you want compared to short, punctuated, intense, basically gives you much more bang for your buck.

The reason I say all of that is when it comes to weight loss and exercise, I would err on the side of-- you know if you're going to do it being super way more effective with it. Things like HIIT, interval training, high-intensity interval training, and going hard and fast, really short and then recovering rather than like this chronic exercise, which is probably not going to give you the results that you want.

Of course, that's different from people who approach it just because they really love it. Like some people love running and they do want to run a 35 km stint or they do want to train multiple days a week. If that's what you do because it makes you happy, go for it. If your main goal is weight loss, that's not the approach I would take. It sounds like with you, Laura, that you don't want to be doing this really intense exercise. So, I would definitely say don't worry about it. 

Especially you're a nurse, you're working around the clock, so you're getting a lot of physical activity and physical movement, which is great. So, when it comes to the exercise side of things, I would recommend actually focusing on muscle and strength training if you're going to do things like that. Because maintaining our muscles is so key for longevity, health, and for weight, because by creating muscle, that actually does help you burn fat, raises your metabolism, makes you more toned, just has so many benefits.

So, I would focus more on the strength training side of things. And then when it comes to exercise, for-- she asked about the weight loss period versus the maintenance period. Again, I actually go back to what I was just saying and that I wouldn't use exercise as like the weight loss key. So, I wouldn't even really think in those terms. I would focus like you're doing on your diet and your fasting and your lifestyle and your sleep, which being a nurse, I don't know how your sleep is, but I would focus on all of that as the pillar or the foundation, and then add in exercise in a way that makes you happy. Whatever helps with your stress and then for the actual weight loss, focusing on more interval-type approaches and the strength training side of things. So, Cynthia, what are your thoughts?

Cynthia Thurlow: Well, I mean, this is a 37-year-old female and I think it's really important to understand what's starting to happen physiologically in our bodies towards the beginning of perimenopause. So, late 30s, early 40s is when most women are hitting that time period in their lives. I think it's really important to not be over fasting, to not be over restricting, to not be over exercising, which is a problem that I see in a lot of women. Understanding when to fast during your menstrual cycle and when you should not be fasting and I do a great deal of discussion about this in my book Intermittent Fasting Transformation.

I think that it's much more important that you are doing things like Zone 2 training and also weight training. I think that's far more important than doing chronic cardio. And you have to do stuff that you enjoy. If you're saying that you're running 35 km a week and then you're also training on top of that, that sounds like that's a lot of stress that you're putting your body under. And there are times in your menstrual cycle when you can get away with a lot of training and times when you need to back off. Again, I talk about this a lot in the book. I just think you have to be attuned to understanding the role of estrogen and progesterone and how you can eat and train for both those hormones and the menstrual cycle.

So, more focusing on targeted weight training and Zone 2 training. Some nurses are active and some are not, so it really depends clinically where you're working. I know that people that are in certain areas of the hospital, they may just be standing all day long, versus an ER nurse is going to be doing a lot of movement, versus an ICU nurse may just be one-on-one with one patient. I think a lot of it comes down to where are you in your menstrual cycle. Understanding that the over fasting, too much low carb, too much over exercising can really put your body under quite a bit of stress.

And it sounds like you're very nicely attuned to the influences of what works well for you and what does not. And especially during the pandemic, noticing that once you're able to get back to the gym, you could kind of get back into a rhythm and a routine. I think that's probably the best recommendations I have is to make sure that you acknowledge our own physiology as a component of successful fasting and exercise management. But I don't think any of us should think that exercise is the way to attain the body that you want.

I think we have to really understand that lifestyle, the sleep, the stress management, the right types of nutrition are going to be the most important component. And then exercise should be one way that we support our bodies but it shouldn't be the one lever that we push in an effort to stay a certain size. Over time, you'll just find that that's not as effective or as efficacious.

Melanie Avalon: Awesome. I definitely made a big assumption there about the nurse that she was the type that's moving around a lot, but that could manifest a lot of different ways. You do go to the gym and do like weights, right?

Cynthia Thurlow: I do, three days a week. That's like usually the goal. And I've also been doing more Pilates as well.

Melanie Avalon: Do you work with a trainer for the weights?

Cynthia Thurlow: I have a trainer, but I work with her app, so I'm pretty self-motivated. I acknowledge that probably makes me weird, but she monitors what I'm doing in the app and so that's worked really well for me because very much when I go to the gym, it's not a social experience. I like to get in and get out. I'm very deliberate and it's just not a social experience for me. I'm certainly friendly, but I'm not there to hang out with girlfriends. I'm there to get in and get like a 30 to a 45 minutes workout done and then get back out so that I can get my work day started.

Melanie Avalon: Well, I'm not, I am not a gym person, and it was never a social thing. I have a mirror gym thing, and I don't use it. I really should try it. Wait, you said Pilates. I should try it for Pilates just to see if I like it or tai chi or something. I feel like if I got into a habit of it, I might like it.

Cynthia Thurlow: I definitely like it. I actually preferred solid core, which I found more challenging, but there's not a studio that's really close to where we live, it's a little bit of a drive, so Pilates has kind of taken the place of that. But I've kind of gravitated towards the instructors that are just a little more tough because I like that challenge. There's definitely a mental challenge to be engaging your core as much as you do. And I definitely enjoy the social aspect of seeing certain people in those classes, but I tend to be a lone wolf. I like to do my own thing, and I think as an introvert, it's kind of like why I don't really bring social media into the gym with me. I may take a photo, but I'm never going to be that person who's going to feel comfortable with someone filming me in the gym, because that's my time. That's my decompression time.

Melanie Avalon: My version of the gym. I do the EMSCULPT a lot and where I go, which I love. So, Slim Studio in Atlanta, plugging them, they often say that they want me to do promotional videos or things like that. I'm like, I just want to come here this is like, my me-time. I don't want a camera. I don't want to like get dressed up.

Cynthia Thurlow: But I think it's also important to just honor who you are as an individual. Like, I'm an introvert, so for me I acknowledge that on social media there are things I do share, but there are a lot of things I don't. Another example is people always want to know, give us a house tour, show us what your house looks like. And my kids don't want that. They want some degree of privacy. So, I think there's probably a happy medium. And I know businesses love to have their place of business featured on social media, but I just remind people that everyone's got a different comfort level, and I'm sure the extroverts of the world, they're totally fine with that. I think you have to be true to who you are and do what makes you feel most comfortable.

Melanie Avalon: I agree. Well, our next question actually relates to something that you were just talking about a little bit. So, this is good timing. So, Kristen has two questions and the first one is, "Is it wise to fast while on your period given the fluctuations in hormones?" So, this is something that we just talked about, but do you have any other thoughts if you wanted to add to that piece Cynthia? 

Cynthia Thurlow: Yeah, I talk about this extensively in the book. You don't want to fast five to seven days preceding your menstrual cycle for a variety of reasons. This is really a time to back off on fasting, no more than 12 to 13 hours. And depending on the individual, some people feel well enough to start fasting again once they start menstruating. Really dependent on the woman, I've met several women who've just said that they just feel weak until they get to the end of their menstrual period. But 12 to 13 hours is certainly reasonable.

Melanie Avalon: Awesome. Okay. And then her second question. She wants to know, "Does taking ibuprofen or Tylenol break a fast?"

Cynthia Thurlow: I think the real question should be, everything I've ever read and certainly directions that I've given to patients is that anti-inflammatory agents like Motrin, like Aleve, like ibuprofen, should be taken with food to help buffer the impact on the gut microbiome. And Tylenol is another product. Years and years ago, we used to use quite a bit of it in the ER, and I think the safety and efficacy of Tylenol just really gives me pause. In fact, we don't even carry it in my house anymore, so I would definitely take that with food. I would avoid taking it in a fasted state. It really depletes glutathione, which is a master antioxidant in the body. Years ago, when we used to use 3 to 4 grams with patients, we now know that everyone has a different therapeutic index for Tylenol or acetaminophen. And so, I generally recommend avoiding it or using it in very limited quantities and not certainly at larger doses.

Melanie Avalon: How do you feel about low-dose aspirin?

Cynthia Thurlow: I think of aspirin differently. I mean, it works differently than NSAIDs and acetaminophen. It's interesting because I'm in the midst of a big cardiac workup, which is kind of a surprise. I'm having a coronary artery calcium score done on Thursday, and I'm doing a CIMT, which is this carotid intima-media thickening to kind of look at my carotids. I think aspirin is pretty benign, but like, a baby aspirin, I think, is fairly benign. When I fly, if I'm doing long distances, I'll take a baby aspirin. It just helps with the antiplatelet function. To me, I think of that as much more benign than some of these other drugs.

Melanie Avalon: Yeah, I'm so fascinated by aspirin. It's one of those things. So, I take an aspirin daily, but I know it's debated. I know recently they released some study saying that these benefits of aspirin were not accurate or whatever. I need to do a deeper dive into the literature. But, yeah, it's something I'm always curious about with the cardio workup. Do you have thoughts on ideal ApoB levels?

Cynthia Thurlow: Yeah, ideally, I think under 70 or under 80 is what we're ideally looking for. I think when it's elevated above that, it isn't, per se, a knee-jerk reaction that someone needs to be on a statin agent or needs to be on aspirin. But it does beg the question of what else could be driving inflammation in the body, number one. Number two is, do they have latent cardiovascular disease that they're just not aware of? And interestingly enough, my ApoB has always been under that threshold. But the last bit of labs we did, it was 130. And so, my functional medicine doc is kind of at a loss. He said I feel obligated to do some testing just by virtue of the fact that there's some degree of inflammation. We don't know what's driving it.

So, my lipids otherwise look pretty good. We did Lp(a), we did ApoB, we did my fasting insulin is 3, you know my A1c is low, my high-sensitivity CRP is low. So, we're not sure if it's just this, errant lab value or there's something else going on. So, I've got a little bit of a work up coming up in the near future, this week and next week that I had to kind of begged to get squeezed in because I was like, I'm not waiting until next month. I need you to do these tests now so that we don't need to be concerned about this.

Melanie Avalon: I'm so fascinated by it. So, this has haunted me. I don't know if you listened to this Peter Attia's recent episode all on ApoB, I'd be really curious your thoughts on this. He was talking about the ideal levels that you would need for ApoB to be a centenarian. He basically said that it probably needs to be something that is only achievable with statins, so like 30s or 20s. I was like, "Oh, do I need to get on a statin?

Cynthia Thurlow: No, the side effects of statins are pretty significant. My functional medicine, integrative Medicine doc is not a fan of using them at all. We talked about would it be cholestyramine, would it be Zetia? I think the cognitive net impact of a statin agent is something that has to really be carefully evaluated before people just think of it as this benign entity. Unfortunately, there's just too much research to demonstrate that there can be potential harmful impact of being on long-term statin therapy. I've certainly watched family members that have been on statins that have had some significant cognitive decline, which has been concerning as a clinician and as a family member as well.

Melanie Avalon: Wow. Yeah, I was thinking all about it not about getting a statin, but so Inside racker, they're actually a sponsor on today's episode and I was trying to find-- I don't think we have the link for them yet, but I think it's probably-- so listen to the ad in today's episode to confirm or check the show notes. I think it's probably going to be insidetracker.com/ifpodcast probably with the coupon code IFPODCAST. They just recently released an ApoB test, which was really exciting because I had been dying to test mine and I feel like it's just not very common something that doctors test.

So, they added it to their ultimate plan, which is their entire order of biomarkers related to longevity and you can add on this inner age thing where you get a sense of your "True biological inner age." But it was nice to see that. So, my ApoB level, I'd have to double-check. It was in the 70s, so that was really interesting to see. But the coupon code hopefully IFPODCAST will get you a discount there. Well, keep us updated on what you find with all of your stuff. It's nice that you have your background, that you have a lot of knowledge with all of this because I feel like so many people will probably just be really lost in testing all that information and learning from it.

Cynthia Thurlow: I know too much and that's both a blessing and a curse. But I also know my personality and my feeling is I just want to know. I have to go back for more blood work this week. I have my CAC on Thursday. I have the CIMT. Those are both noninvasive for anyone that's listening. They're generally not covered by insurance, but thankfully they're not particularly expensive. But if my CAC score is 0 then that's great. If my carotid intimal, the inside aspect of my carotid arteries is not narrowed by plaque then that's a lot less concerning. But we have to get the information and then review it. And I feel very comfortable and confident with my provider, although he thinks there's probably something that's going on with my gut.

I came back from London and did a bunch of testing, just routine testing, and one of the first calls I got was from the office saying, "Are you having any symptoms? Because your stool study showed salmonella." And I was like, well, I did eat steak tartar when I was in London, but it was a good restaurant, like a very, very high-end restaurant. Here's a fun fact, that's a diagnosis that the lab is required to share with the public health department. So, I had an epidemiologist call me yesterday to ensure that I was not symptomatic. I just said, listen, I'm a clinician, I get it, I know you're doing your due diligence, I have no symptoms, I've discussed with my physician, I don't think you need-- and they're like, "Is anyone else sick in your family?" I was like, "I was in London and I ate rare steak or rare meat." It could very well then where I got it from, but I'm not symptomatic at all. But it became very humorous, my husband was like, "Good Lord, [laughs] you're so high maintenance." I'm like, "No, it's just digging for different things." So never a dull moment. So, for listeners, know that you are not alone in trying to figure out what's going on with your health. I'm a constant work in progress.

Melanie Avalon: I've eaten so much raw meat in my life, [laughs] I actually recently did a round. Have I talked on the show or are you familiar with Mimosa pudica?

Cynthia Thurlow: I think you've talked about it.

Melanie Avalon: Yeah, I did another round of it recently. I kind of want to add it, like, eventually make it one of my AvalonX supplements because it's just so cool. It's basically this gelatinous material supplement. I don't know what it comes from. It just grabs and paralyzes things. Yeah, the pictures people post online of stuff that comes out. But I've done it in the past. Yeah, I definitely have talked about this on the show. They'll say that because if you open one of the capsules and put it in water, you'll see what it becomes, which is like this long stringy thing. So, you can see how if it just went through you and came out, it would look like a parasite anyways. So, you have to keep that in mind. But when it pulls out things that are very evidently not the supplement, it's crazy and people swear by it. But yeah, I feel like I should maybe do like a round of that, like once a year just because of all the rare meat that I eat and have eaten. I'm really bad about that. So, it's interesting to me that you're concern about having it one time and being worried. I'm like, "Oh, I've eaten, like, pounds and pounds of rare meat all the time."

Cynthia Thurlow: Well, I was just trying to think of something that might have been a precipitant. The good thing is, my doctor and I were messaging back and forth through the portal, he was talking about standard of care is this, I'm reluctant to put you on antibiotics unless we have to. You could also be a carrier. I'm like that's even more disgusting. There are people out there who just carry some of these microorganisms and they're not symptomatic. It's kind of like having a friend that just kind of hangs out in your colon. It'll be interesting to see what the rest is because I did a three-day stool test, which in and of itself is a disgusting hot mess. But it'll be interesting to get all those results and have a better sense of what's going on throughout my body.

Melanie Avalon: Well, definitely keep us updated.

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Next question is from Lori. "If your current self and knowledge could go back in time to your younger self, what would you do differently knowing what you know now as far as career and life hacks," interesting.

Melanie Avalon: Yeah. This is such a hard question and there're so many things, and I think it's mostly just that-- well, life hack-wise this is probably the biggest. I really wish growing up I had eaten healthy. I wish I had eaten whole foods, like natural good foods, not all that processed junk. I'm glad that I haven't been eating that for a while, but yeah, it's just-- I was listening to a podcast interview last night. I don't remember which one it was, but they were talking about how basically if we had no processed foods and everybody just ate real food, like the effect that that would have on chronic disease. Not that it would be nonexistent, but I mean, it would be shocking, the difference. Yeah, life wise, that's probably the main life thing. And then all of the amazing biohacking-type things that I experience now that I love. I of course, I'm like, "Oh, I could have been doing this earlier."

I try not to think that way. I try to just think about everything that I love now and have gratitude for it now and not think in the mindset of, like, would have, should have, could have, not having regrets. But career hacks the thing that comes to mind, actually. And it's something where I'm very happy with the trajectory of my life and my career. I think it's been taking me a while to become really autonomous and actually move forward on a lot of projects that I wanted to do and not being scared, because it's really scary to, like you know especially being like a self-employed entrepreneur, took me a long time to just jump all in with that. Actually, that's what-- I lost my-- I was doing a surveying job for quite a while and I lost it with the pandemic and that's what really made me bite the bullet. So, honestly, if the pandemic hadn't happened, I might still be waiting tables, which is not a bad thing. I don't mean to say that as a bad thing, just that it took that push to actually not be scared, to try to just be self-employed, which is a very scary concept, but you can do it. And actually, interestingly, the woman I interviewed yesterday, she runs a company called Encircled, and she makes sustainable clothing. Friends listen to this interview when I air it was mind blowing. We talk about toxins a lot, like toxins and skincare and makeup and food in our environment, but we don't talk about our clothes. It's crazy. So, there's like, chemicals in clothes, like A lot of clothes when they're shipped internationally, they actually spray them with preservatives. About the majority of what we focused on actually wasn't so much the toxins. She's certified by this. There's this company that certifies clothing manufacturers. It was more, though, about sustainability and greenwashing and the clothing industry. And it was so fascinating. Why am I saying that?

Oh, so she talked about how she had a corporate job 9:00 to 5:00 and had this clothing company on the side, and making that decision to just jump all in with it was, she said, like, terrifying. And I hear that story so often. So, I really encourage people with their careers and whatever passions they have to just jump in. Obviously, you have to be responsible, and you do have to pay the bills. I understand that's very multifaceted and layered, but I do want to encourage people to just follow their dreams, and you can do it. And then just like a very more specific thing is, I do think press and PR as much as I loathe it is really important. And it's something I feel like I wish I focused on it earlier, but also, it's very expensive. So, it's like, I don't know that I could have done it more earlier.

Yes. Oh, and then last thing, sorry for all the things. I feel like this is something that I'm going to wish I had started earlier. Somebody did reach out to me after I talked about this last time on the podcast. So, I am looking to get an intern. So, if the position is still open, I'm going to post it online. I'm waiting, I think, for it to be approved. But I'm going to send out a thing on my email list. So, get on my email list at melanieavalon.com/emaillist. Or if you're interested, just email me at podcast@melanieavalon.com. I think that's something I'm going to wish I had started sooner.

So, also, just in general, I'm sort of a control freak. And so, with my career, I always feel like I have to do all the things and be in control, and learning how to outsource and let go of things I think has been really helpful. And then just life hack in general, I wish I'd focused more on gratitude historically and not been so stressed. So, all the things to help with stress. Okay, that was a lot. Cynthia, how about you?

Cynthia Thurlow: I think I ended up exactly where I was supposed to be. I started off as a pre-law major and got into law school and then decided I didn't want to go to law school. And so, I worked for two years and had really a job that reaffirmed for me that I didn't want to be in corporate America, no offense to anyone who loves doing that. Went back to school for premed classes and got two more degrees. I think medicine for me was absolutely the place I needed to be. I was so intellectually stimulated. I loved that I saw different things every day I went to work. I spent all of my 20s really just being surrounded by some of the smartest people I've ever met in my entire life. I wouldn't per se change anything in that regard. But I think that I would have probably pivoted earlier.

I don't believe in the would've, should've, could've, but I think if I had not been so appropriately focused on raising little people and for anyone that's listening that has small children, you know that raising them at that stage is all, like, consuming, because you can't leave them. They can't trust themselves. They can't feed themselves. They can't bathe themselves. I might have actually left medicine earlier to become an entrepreneur, but I think things kind of worked out the way they were supposed to. I don't think per se, I would have changed my career path because I'm exactly where I need to be. But I think that I probably would have thought differently about nutrition. I think back when I was younger, I just assumed things that were in the grocery store were all innocuous and benign and assumed that when you went to restaurants everything was innocuous and benign.

And now of course I know differently. But there's not a lot that I would honestly change because I've been so blessed and so fortunate to have a great life partner, healthy happy kids, a really great career, I've got a great team, there's not a ton I would change. I think the intermittent fasting piece came about at the right time for me. I don't think that I would have really been interested in doing that when I was younger because when you're breastfeeding kids, you're hungry all the time I don't care how much food you eat. That would not have been a good time for me to do that.

Up until I was probably 40, the way I was eating really worked well for me and it wasn't until I hit the wall of perimenopause. Not a lot of things that I would change, but I think I probably would have pivoted a bit earlier in my nurse practitioner career. But I also think on a lot of levels at the time that I left, within a year or two, were able to be fully autonomous in our state without a practice agreement. I think things have just kind of naturally evolved for me and not a whole lot that I would change, to be honest with you. I feel fortunate for being able to say that. But as I've stated in other podcasts, I think I've always been doing the work and working diligently. I think I probably would have been less of a people pleaser if there's one thing I would have probably done differently. I'm a really good nurse practitioner.

But one of the reasons why I got along with my peers so well was I was very accommodating versus now I would not be so accommodating. I would definitely stand up for myself more than I did. And I wasn't doing it in a way that it compromised patient care, but just from a thoughtful perspective. We worked with a lot of very domineering, strong personality male physicians and sometimes I would just go with the flow because I didn't want to argue, whereas now I might not be so willing to be so accommodating. But that's a great question.

Melanie Avalon: We're so similar because I feel the same way as you. I really am grateful for everything and how it's manifested. Like, me saying these things is not like the would've, should've, could've. Like everything I feel like did happen the way it was supposed to happen. I think a lot of it is like evolutions of mindsets that have shifted that I find so helpful. I think especially doing more inner work and becoming aware of-- I'm triggered by something like what does that mean? And being aware of how you're reacting to the world and something I just learned, actually in Gabor Maté's book, which is something I think is really going to stick with me.

He talks about a new definition of forgiveness, which I thought was really beautiful. I just pulled it up. He said it's to grieve for what did happen, what didn't happen, and to give up the need for a different past, to accept life as it was and as it is. So not taking it as acceptable, but just that it happened and that it will not define my life negatively now. And I'm really excited to just learn that because I think that I feel like I've been searching for a definition of forgiveness that really resonates with me, because it's like-- I don't want to say the one thing, but it's like, a thing, which is like a concept I really love and want to have more in my life. But it's something that's like so hard to practically do.

Like, I'll see my therapist and I'm like, "I don't know-- it's like, how do you forgive if you want to and you say you do when you try to, but you don't actually feel it?" And so, I loved reading his definition about it and I feel like that's something I'm going to integrate and something I wish I had thought about earlier. So, awesome, awesome.

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 notes will be at ifpodcast.com/episode312. Those show notes will have a full transcript, so definitely check that out. And you can follow us on Instagram. We are @ifpodcast I am @melanieavalon. Cynthia is @cynthia_thurlow_. And I think that is all the things. Anything from you, Cynthia, before we go? 

Cynthia Thurlow: No, I am all good.

Melanie Avalon: Awesome. Well, this has been amazing and I will talk to you next week.

Cynthia Thurlow: Sounds good.

Melanie Avalon: Bye.

Thank you so much for listening to the Intermittent Fasting podcast. Please remember everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing a 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.

[Transcript provided by SpeechDocs Podcast Transcription]

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