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Melanie Avalon: Welcome to Episode 284 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, biohacker and author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my cohost, Cynthia Thurlow, nurse practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us, check out ifpodcast.com, melanieavalon.com, and cynthiathurlow.com. Please remember, the thoughts and opinions on this show do not constitute medical advice or treatment, and no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup of tea, or even a glass of wine, if it's that time and get ready for The Intermittent Fasting Podcast.

Hi friends. I'm about to tell you how to get two grass-fed, grass-finished 10-ounce New York strips and one-half pound of sustainable wild caught lobster meat all for free. Yes, for free. So, we are huge fans around here of a company called ButcherBox. They deliver 100% grass-fed, grass-finished beef, free range organic chicken, heritage breed pork, that's really hard to find by the way, and wild caught sustainable and responsible seafood shipped directly to your door. When you become a member, you're joining a community focused on doing what's better for everyone. That includes caring about the lives of animals, the livelihoods of farmers, treating our planet with respect and enjoying deliciously better meals together. There is a lot of confusion out there when it comes to transparency regarding grazing practices, what is actually in our food, how animals are being treated. I did so much research on ButcherBox. You can actually check out my blog post all about it at melanieavalon.com/butcherbox. But I am so grateful for all of the information that I learned about their company. 

All of their beef is 100% grass-fed and grass-finished, that's really hard to find. They work personally with all the farmers to truly support the regenerative agriculture system. I also did an interview with Robb Wolf on my show, the Melanie Avalon Biohacking Podcast, all about the massive importance of supporting regenerative agriculture for the sustainability of not only ourselves, but the planet. This is so important to me. I'll put a link to that in the show notes. The value is incredible. The average cost is actually less than $6 per meal, and it's so easy. Everything ships directly to your door. I am a huge steak lover. Every time I go to a restaurant, I usually order the steak. Oh, my goodness, the ButcherBox steaks are amazing. 

We are so excited because ButcherBox, has an incredible offer just for our audience. You can get some of those steaks for free and lobster to go with it. You can go to butcherbox.com/ifpodcast and get two 10-ounce grass-fed, grass-finished New York strips and one-half pounds of wild caught sustainably raised lobster meat, all for free in your first box. Yes, completely free. That's butcherbox.com/ifpodcast and we'll put all this information in the show notes. 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 and 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 1000 compounds found in conventional skincare and makeup in the US due to their toxicity. These include endocrine disrupters, 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 body's studies have shown they do things, like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that. Beyond weight gain and weight loss, these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so 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. 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. Use the coupon code CLEAN for all 20, 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. Definitely check it out, and 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. 

Lastly, if you're thinking of making Clean Beauty and Safe Skincare a part of your future, like we have, we definitely recommend becoming a band of beauty member. It’s sort of like the Amazon Prime for Clean Beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally completely worth it. So again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code CLEAN for all 20 to get 20% off your first order. 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 284 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.

Cynthia Thurlow: Hi, Melanie, how are you? 

Melanie Avalon: I'm good. How about you? 

Cynthia Thurlow: Doing well, doing all the things. All the mom things, we're heading into week three of the school year and I feel maybe everything's-- the kids are getting settled back into a routine, I have a new driver in the household with exceedingly exorbitantly expensive car insurance, just to be able to allow him to drive, it's insane. He doesn't even have a car. 

Melanie Avalon:  But just because of the demographics that he falls into.

Cynthia Thurlow: Correct. We had to have a whole discussion about that. I was like it's the outliers of the population that generally are the ones that are more likely to have accidents, and especially young males, which is what you are. 

Melanie Avalon:  It's interesting that there's not more political backlash about stereotyping with insurance companies, even though it's based on data. But that could be a thing, that could be like a cancel the insurance companies. 

Cynthia Thurlow: We're fortunate. We have USAA because my father was many years ago served in the navy during Vietnam. I told my husband, "It'd be way worse if we didn't have USAA." So, I don't even want to complain however, I said, I'm not stressing about this, because our wonderful 17-year-old is going to pay for his own insurance he has a certain amount he has to pay us every month and I feel like I'm teaching him some degree of responsibility. You should have seen the expression on his face when we said, "This is what you will owe us every month." He was like, "What?" I was like, "Yes, and you have a job and you have money in savings and I know how much you have in your savings; you can totally afford this."

Melanie Avalon: Wow. Nice, sets him up for life. 

Cynthia Thurlow: Exactly. 

Melanie Avalon: I've been having an interesting experience related to something that our audience loves. I forgot how often do you wear CGMs? Do you wear the one all the time still?

Cynthia Thurlow: No, probably the first 18 months I wore them near continuously. During the book launch, I just found that I would get like excited when I had press to do or podcasts or media work to do, but I would just watch my cortisol go up and my blood sugar would go up and it was like up down, up down all day long, so I didn't wear them for about two to three months. This summer I've had maybe once a month I've been wearing it, but I think I definitely have a better sense now of where I need to be in terms of my macros and managing my stress. So, to answer your question, there's a lot of utility but I don't wear it as much as I did two years ago. 

Melanie Avalon: Yeah, I was similar. When I first started using them a year ago or a year and a half ago, I went months [laughs] having one on all the time. Now it had been a while, but I actually reconnected with a friend from high school who comes here to Atlanta and she's into all of this stuff. So, we decided to put one on together and make a Reel and all of that stuff. So, this is the first time I'm wearing one. And for listeners who are not familiar, a CGM is a Continuous Glucose Monitor, it goes on your skin, super painless to put on and it measures your interstitial fluid to continuously measure your blood glucose levels, which can be incredible to see how you react to food and fasting and exercise. And as Cynthia, was talking about, adrenaline are stressful situations. But in any case, so I haven't worn one in about a year, and my blood sugar control seems to be substantially better from a year ago. I don't know if this is what it is, but I think it might be all the Emsculpt that I did, that I've been doing, building muscle.

Cynthia Thurlow: Yeah. I mean it makes sense, you know insulin sensitivity.

Melanie Avalon:  I just think we know that insulin resistance likely starts at the muscle and our muscles are a bank basically for glucose. Really, the only big thing I've changed in the past year is probably doing. I've been doing so much Emsculpt, which is muscle stimulation that literally builds muscle. I think I've built a lot of muscle; I'm just looking at my levels. My peaks are much lower than they were before and this is eating massive amounts of carbs, and then during the day just the average is probably like five or six or seven points lower. So, yeah, it could be other things as well, but it's cool to see. It's motivating. 

Cynthia Thurlow: I think it's also important just to, from the perspective of checking in with yourself to see how you're doing. I'll give you an example, so last night we had dinner at a neighbor's house. They know that I don't drink alcohol, so they came up with a mocktail. I literally when she started telling me what was in the mocktail, I was like, "Oh, Lord, I can't like politely not."

Melanie Avalon:  It was like all sugar? 

Cynthia Thurlow: Yes, it was pineapple juice. She was like, "Agave syrup." I literally like my husband, like kicked me under the table. So I just had to sip it and the whole time I was like, "Lord," I'm just going to have to make sure that I go to the gym tomorrow and lift heavy things. But, yeah, it was humorous to just imagine in my mind understanding like I'm just going to just eat protein tonight. I'm going to politely sip this drink. I'm going to dump it when no one's looking. But it was so thoughtful, I want to be very clear, but I don't normally consume sugary drinks ever. That's just not really my thing, but in terms of insulin sensitivity, it's one of those things. In my head, I was like, "Okay, what could I do after we leave here?" I'm like, "Okay, I can walk the dogs like." We would do that anyway, all the things. "Okay, tomorrow, I'm going to go to the gym. I'm going to fast a little longer, I'm going to lift heavy things." Like in my mind, I was already knowing the things I needed to do to help dispose of the said sugary beverage that I consumed. 

Melanie Avalon: That's so funny. Yeah, so out of curiosity, when you're in situations like that, at dinners where somebody has made something for you, what are your lines or rules? How often do you have the sip, or versus just saying, "No, thank you." 

Cynthia Thurlow: Well, I felt obligated to consume some of this because she specifically made sure to have a mocktail. So, I had actually brought a bottle of low sugar kombucha with me and I was like, "I'll just have this over ice, this will be fine." I would say that, something like that, knowing that I'm very physically active, very insulin sensitive, and like one half cup serving of that is not going to derail all the good things that I do. But it definitely makes me very cognizant of just how-- I don't want to use any negative work note or terminology, just how happy I am with my current lifestyle and how I eat food and consume beverages and I just don't realize how unusual sometimes my habits may be to other people. They were incredibly accommodating. They know I'm gluten free and I'm dairy free and so they had this lovely charcuterie platter that was out that I was trying to eat as much meat as I could, while I was sipping on said very sugary beverage, but I would say that there are some deal breakers like for me, I just don't do well with dairy. 

So, if I went to someone's house, and they had a very dairy heavy dessert, or were trying to incur, I would politely say, "I actually just don't do well with dairy." I think most people don't have a problem with that. I do find that the most triggering thing of all is when you just explain either, "No, I'm not drinking," or, "I don't drink alcohol." Then people don't know what to do with, and I was like, "I'm totally fine with that. You do what you need to do, and I'd be happy with a glass of water." I genuinely do pretty well with what works best for my body. 

The interesting thing was the guys were having some type of local pubs beer brew, and the mom was saying, "Oh, I don't normally have mocktails. But I didn't want you to feel left out." I was like, "No, no, I'm really good. I'm not triggered by what if everyone else is drinking, that's not a problem for me, but I think it comes down to--" first of all I have to genuinely be hungry to eat. I don't ever eat at someone's house just out of a sense of obligation, but I also am very grateful and try to be very appreciative. I don't want anyone to feel like the efforts they've made are not appreciated and valued. To me seed oils are probably at the top of my list of things, I really try to avoid as much as possible. So, I'm the person that will sometimes come to someone's house and I'll make a wonderful salad dressing, because then I have some control over what's in it. But I would say the other thing is, if I'm at all concerned about something not meeting my needs, like desserts are easy to pass up, alcohol is easy to pass up, it's usually when you sit down, and I'm sure any listeners probably have experienced this, you go to someone's house, and they have a bunch of salad dressings out and most conventional salad dressings are not going to meet my needs, so sometimes I'll just ask for olive oil, and vinegar, and people generally don't have an issue with that either. 

I don't want to sound like I'm one of those unappreciative guests. I'm generally very easy, but I think all of us have to figure out, how to navigate those social situations and not feel like you're a weirdo. 

Melanie Avalon: Yeah, I think it's such an important topic, because I just think it's something so many people struggle with. Honestly, I think it can be one of the hardest things about any dietary change or protocol that you're adhering to. And I hadn't really thought about it before, but the similarity between not drinking is really similar to like, if a person is fasting, not eating, I get so many DMs about this, whenever I post pictures of me at events or parties, where there's obviously food, I just normally don't eat anything. This is for the fasting, not for the alcohol related thing, unless it's like a dinner I'm going to where I can like order specifically what I want to order. But it took me a long time to get to the place where I am now. I don't know if I'm still like a little bit insecure about it, but I mostly just don't care. I feel pretty comfortable in just saying like, "No, I'm not eating right now."

Cynthia Thurlow: I think that's important, irrespective of where we are, who we are, what we're doing, just feeling comfortable with your decisions and not feeling a sense of obligation. One of the things I've really been working on the last few years is, I grew up in a family with a lot of trauma. So, the way that I that I mentally work through all that in my childhood and young adulthood was to be the people pleaser, and to always be the good kid and the kid that never got into trouble and got good grades. So, my people pleasing tendencies I've been actively really working on the last several years. Sometimes I'm just okay saying, "No, I appreciate that. But I'm not interested in having that." And feeling very comfortable and not feeling like I have to explain myself and I think that's a beautiful thing to get to that point. So, I love that you stand your ground and advocate for what you and your lifestyle need.

Melanie Avalon: I'm glad you said that, because that's what I have found to be the most minimal drama response because I think I used to feel the need to explain. It's funny, I'm just thinking about now how you've helped me with other things in life where you're like, "You don't have to explain, you can just say no," but I think I did used to feel the need to explain and now I normally say, "Thank you. I'm good." Normally that just does it. Sometimes there'll be follow up questions, "Oh, are you not hungry?" or "Are you not eating," or, "Why?" And then you have-- 

Cynthia Thurlow: I think it's a sense of you just want to make people feel inclusive. I know if I had someone at my house and they were abstaining from eating-- I just want to make sure like, do you have options and you feel good about the options that are available and as long as they're good, I'm like, "Okay, we're all adults." We're all adulting we have to figure out what works for us. 

Melanie Avalon: Exactly. So, I will give a link for listeners if they would like to get a CGM, though. Oh, which by the way, CGM, if you were that to a party, you will get a lot of questions.

Cynthia Thurlow: Yes, you will. 

Melanie Avalon: Our link for it, you can get $30 off. Just go to nutrisense.io/ifpodcast, and that is good for any of the subscription programs that they have. The subscription programs are more cost effective, so we definitely recommend going that route especially, you'll probably find it's hard to do it just once because it lasts for two weeks. So, you can do it just once, but a lot of people want to keep it on for a little bit.

Cynthia Thurlow: Very insightful. 

Melanie Avalon:  Hi friends. I'm about to tell you how to get 15% off my favorite blue light blocking glasses ever. I am often asked what are my favorite “biohacking products,” and something I truly honestly cannot imagine my life without are blue light blocking glasses. In today's modern environment, we are massively overexposed to blue light. It's a stimulating type of light, which can lead to stress, anxiety, headaches, and in particular sleep issues. Blue light actually stops our bodies from producing melatonin, which is our sleep hormone. Our exposure to blue light can completely disrupt our circadian rhythm, make it hard to fall asleep, make it hard to stay asleep and so much more. Friends, I identify as an insomniac. I would not be able to sleep without my blue light blocking glasses. I also stay up late working and wearing blue light blocking glasses at night has made it so I can do that and still fall asleep. 

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Melanie Avalon: Okie-dokie. Shall we jump into questions for today? 

Cynthia Thurlow: Absolutely.

Melanie Avalon: To start things off, we have a question from Bo. The subject is, "Adrenal Fatigue and IF." Bo says, "Hello, first off, thank you both for guiding me through my first few months of IF. I started in September 19th of 2018. I don't think I could have gotten through my first couple of months without binge listening to your podcast, joining both of your groups on Facebook and listening to both of your books as well." By the way, this question was written when Gin was still hosting the podcast." She says, "Thank you for all the resources, also giving up stevia in September was probably one of the best things I've done. Thank you, Gin, I will most likely never ingest stevia again. I would choose honey or maple any day. I have been paleo-ish, mainly gluten free, dairy free, wholefoods approach for several years now, and even with my clean diet a couple of years ago, I was diagnosed and treating hypothyroidism. More recently after starting IF, I was diagnosed with the dreaded adrenal fatigue.

Even though I am treating both adrenal fatigue and hypothyroidism and doing IF 19:5 to 17:7, I'm still not losing weight. I originally lost five pounds the first couple of weeks and since then nothing. I'm about 15 to 20 pounds away from my ideal weight and feeling my best body. Since starting my IF lifestyle, I've gone down the rabbit hole of health-related podcasts, all the usual suspects in the keto/paleo sphere. I've heard them mention not to do IF with adrenal fatigue, what are your thoughts? My doctor, who is treating my adrenal fatigue says to listen to my body and see how I feel with IF and my energy levels. My energy levels are always pretty wonky, sometimes stable, other days awful, but never that amazing energy and mental clarity that you both talk about all the time. 

I'm wondering if I should focus on healing my adrenals, then come back to IF when they heal in a few months. Do you know if IF is too stressful for adrenal fatigue? Maybe this is why I'm not losing weight. Thank you for your help. Big hugs, Bo." 

Cynthia Thurlow: Well, Bo, I think you've answered your question here. First and foremost, for listeners, when we hear the term adrenal fatigue, it's really not adrenal fatigue. It's Hypothalamus-Pituitary-Adrenal Axis Dysregulation, which is a big fancy way of saying, your brain which oversees communication with glands and different organs in the body. As we are transitioning, I don't know Bo's age, so Bo might be in perimenopause, might be in menopause, we don't know but that's when women tend to be much more susceptible to this dysregulation. What drives a lot of HPA dysregulation is stress and inflammation and insulin resistance. There's many, many factors that play into this. I find that our modern-day lifestyles are a huge contributing issue, so I'm grateful that you're working with a knowledgeable physician, number one. 

Number two, even in my book, I talk a lot about adrenal and thyroid health and how important it is? I would be the first person to say that you really have to view intermittent fasting as a form of hormesis, so that's a beneficial stress in the right amount at this right time and based on what you have shared here, and again, I'm not giving medical advice, I would defer to your primary care provider internist functional medicine person that you're that you're seeing, but I would not be adding in more stress when your body is already overstressed. Whether it's an underactive thyroid, you have insulin resistance, you just went through a divorce, a hospitalization, you had a big move. Goodness, the pandemic hasn't helped anybody, any of these things can really overtax the body. And from my perspective, depending on what life stage you're in whether or not you're still menstruating, I really think you need to focus in on healing your body before you start adding in additional stressors. Another good resource for you, I interviewed Dr. Doni Wilson earlier this year, she has a great book called Master Your Stress, that you can find on Amazon and we'll put a link to that. 

I did a great podcast that we'll link in the show notes as well. She talks a lot about, you know, she has a very specific methodology on how she supports her patients when they are going through this specific type of stressors, how to manage it. She's not a fan of utilizing intermittent fasting when people are still healing. I would probably say that I would be in 100% alignment on that. That's not to suggest that doing 12 hours of digestive rest is a bad thing, but when you think about intermittent fasting as a form of beneficial stress, when your body's already too stressed, it's probably the time to give it a rest and then later reintroduced when you're feeling consistent energy, sleeping well, just the fact that your weight loss resistant tells me that your body has some degree of inflammation and figuring out why your body is so inflamed is going to be an important piece of that puzzle. I hope that helps. 

Melanie Avalon: Awesome. Yes, I'll just add to that. I was curious how you're going to start off or how are you going to approach the adrenal fatigue concept because it's interesting how debated it is, even in our world, just as far as does it exist? Does it not exist? Is it a real thing? I recently interviewed Ari Whitten. He's kind of known for his book on red light therapy, but his newest book is called Eat for Energy. He actually opens the book by talking about his experience with being diagnosed with adrenal fatigue, and then researching it and realizing that in the actual scientific studies and literature, it's hard to find support that it's an actual thing. That your adrenals are actually fatigued, or that's actually a concept of what's going on. 

I was just looking at a quote, he says in his book, "The vast majority of studies that tested adrenal function and cortisol levels and those with chronic fatigue conditions versus normal healthy people found no differences whatsoever in adrenal function or cortisol levels." But the larger picture that it goes to from that is that people get into the states of fatigue and over stress, and he breaks it down to basically the mitochondria, not being able to adequately deal with all the stressors that were exposed to. Cynthia was saying, intermittent fasting is a hormetic stress, but of course, based on your entire stress bucket, it may or may not be too much for you. I think it's interesting, we talked about this recently, when we were talking about some of Dr. Sarah Ballantyne's work, we can put a link in the show notes to that episode. But we were looking at some studies on intermittent fasting and how it affected stress biomarkers.

And in those studies, they actually found that it was contrary to what they thought they were going to find, but they actually found that intermittent fasting, at least in the setup of those studies, it overall encouraged parasympathetic tone, which is actually the opposite of the overly stress state. All of that to say is, I think I've said a lot of stuff, I think is very individual. So basically, for some people, and how you're doing intermittent fasting, it may be too stressful with your life situations and your "adrenal fatigue," depending on what that actually is or for some people it may be that it fits in well with their life, and it actually alleviates some of their stress and helps their "adrenal fatigue." I think it's just really, really individual so I think you have to do a more comprehensive picture of how you are reacting to it, which is what her doctor told her exactly.

Cynthia Thurlow: Bio-individuality rules, as it always goes.

Melanie Avalon: Yeah. I was thinking about this actually, yesterday. Why was I thinking about this? Oh, I'm prepping to interview Dr. Nayan Patel, he wrote a book about called, The Glutathione Revolution, all about glutathione. I was reading my notes on antioxidants and oxidative stress. He has a chapter about, what type of stress does glutathione help? I was just contemplating, does mental stress create free radicals? I'm on a tangent right now, but does it create free radicals and physical things like that, or is it that it's a taxing stressful situation that leads to the same stressed-out end angle, that physical stress leads to.

Cynthia Thurlow: It's a good question. I think it could be either. The other thing that I would just tack in there before I forget. I, at one point trained with one of the big functional medicine doc's Andrew Hyman, and he was talking to me about adrenal fatigue. In the context of people are really getting this wrong, it's really related to the hippocampus, which is this part of the brain and how sometimes the hippocampus doesn't heal from the insult or the stress that people are experiencing, which can leave them in this kind of downward spiral. This is, I promise, relevant to what you're saying about Ari's book. But you start thinking about if most people over the age of 40 have got mitochondrial dysfunction, is it any surprise that I see prolific amounts of women, north of 35, north of 40, that are just so exhausted. 

I think it's a combination in modern day lifestyles and depletion of role of antioxidants, depletion of glutathione. I literally was looking at a research article this weekend, talking about how the past two years, like our longevity here in the United States is actually getting worse and not better, but that probably isn't a surprise. But they were looking at all these like retrospectives, like what's the longevity of someone in Japan or in Korea versus the United States, it's quite significant. I start thinking about these kinds of chronic insults, it's like a bucket, the bucket continues to fill year after year. And then we just get to a point where our bodies are not as stress resilient. 

We talk about adrenal fatigue, but really, we're talking about the accumulation of many, many years of insults to the body, whether we're cognizant of it or not, and the resultant fatigue that comes out of that. And for many people, they don't get the answers they want or deserve to get, and so I love that you're introducing so many of the listeners to different perspectives on how people navigate these changes. I will have Ari on, but not until I'm going to say February, because we had to reschedule because he got scheduled on my birthday, which is a whole separate tangential conversation. I don't work on my birthday. That's a standing rule. 

Melanie Avalon: Neither. I'm so glad you elaborated on that, because I should probably share his central thesis, which is that the mitochondria basically have two roles. They have a dual role. They have the energy production role, and then they have a defensive stress sensing role. They can't really do both at the same time. So, if they're in the stress mode, the stress mode reacting to threats, it shuts down energy production. So, yeah, I'm excited for you too, to interview him. It's a really good book. 

Cynthia Thurlow: Yeah. I mean it's definitely I feel very grateful, as I know you do that. We get opportunities sometimes to read people's books before they are ever officially published. As I'm looking at the voluminous amount of books, I have in my study I feel very grateful, because there's always opportunities to learn something that not only can you share with listeners, but you can take a bit of that and apply it to your own lifestyle. I'm looking at James Nestor book Breath, because it's such a bright cover, it stands out amongst all these other muted books. Makes you realize, every book I read, I try to take something away to be able to share with listeners, share with my community, improve my quality of life, improve someone else's quality life and that's really what it's all about. 

Melanie Avalon: I cannot agree more. That example of that cortisol sentence from Ari's book was something that really, really stuck with me, because I had never read that. That he had reviewed the literature and that the majority of it didn't find substantial differences in cortisol levels, which I actually find that really-- I think it's very reassuring, because I think a lot of people get a little bit stressed about being stressed. I do think cortisol levels can be an issue, like you were talking about how they are an issue for people, but I think it's nice to know that maybe it's not quite as intense as we think it might be, because I think it can be very easy to get into a just like an overwhelmed, stressed state about our state of stress and like worried that our cortisol levels are super high, and we should address it, but we can do that without fear. I think just hearing that one sentence, I mean, it made me feel a lot better. 

Cynthia Thurlow: Absolutely.

Melanie Avalon: Random thing about James. I didn't realize he wrote a book that I had years ago and now I want to-- I don't know if I actually read it though if I just bought it. But now I want to see if he wants to come on to talk about this book, even though it's like one of his really old works. He wrote a book called Get High Now (without drugs). Have you heard of this book? 

Cynthia Thurlow: I have not.

Melanie Avalon: It's like all of the different non drug related things that create a different state of consciousness. From the description, he says, "Lucid dreaming, optical and auditory illusions, controlled breathing, meditation, time compression, physical and mental exercises." I want to invite him on for this. I wonder how often authors get invited to do an interview on one of their old-- this is a 2009 book.

Cynthia Thurlow: I bet you, he'd be very flattered. I found him to be delightfully down to earth. Given his-- would I perceive to be definitely one of the more well-respected science writers that’s out there.

Melanie Avalon: I'm going to reach out. So okie-dokie. Shall we go on to our next question? 

Cynthia Thurlow: Absolutely. This is from Gretchen, and the subject is "Smells." "Thank you so much for your podcast. I've been listening to it nonstop and started my IF journey on mundane. My question about smells. We're spending most of our time at home nowadays. And my husband loves to cook big breakfast and lunches. He's downstairs making something delicious for lunch, and my mouth is watering from the glorious aromas. Can this cause insulin levels to spike just as artificially sweetened beverages can? I've been able to breezed the days without hunger unless he is cooking. "

Melanie Avalon: All right, Gretchen, thank you so much for your question. I believe my thoughts on this answer are, yes. We've talked about this before on the show but it's to the same extent as the artificial sweeteners. What I think is important to understand is, I think people think with insulin release, that it's just one process so it's released or it's not released. And once it's released, it's releasing. But there's actually two phases to insulin release. There's the cephalic phase insulin response, which basically your pancreas always has a little bit of insulin ready and waiting and it taps out. There's only so much there and that's for when you smell something or when you're anticipating about to eat, so it releases a little bit of insulin, but then for the actual, like insulin bolus that keeps going in a sustained, that's created then in the pancreas, and that's more when you're actually eating. I've looked at a study before and I think we've talked about on a prior show. 

Basically, yes, the smells can likely release some insulin, but it's probably not going to start that second train of insulin production. Meaning, you can basically wait it out, if that makes sense. Do you have thoughts, Cynthia?

Cynthia Thurlow: I would agree with you too. I think that we don't want to navigate our lives feeling fearful that if we smell something delicious, that somehow we've broken our fast or derailed our fast. We have to think big context, like when we're talking about breaking your fast, I really think it needs to come down to ingesting something as opposed to smelling something. I think we would otherwise go through our lives, not just enjoying, being present, being around family, being around friends, being in a work environment, and being fearful, we're going to smell something delicious. I think we have to think about the big picture. Generally, I look at it, have you ingested the food? That is more important to me than if you just smelled the food because the cephalic phase insulin response, yes, that's there. But I have to believe that our bodies, it's more sophisticated than that. I mean, you will get this small release in response to smelling something delicious but that's really irrelevant. It's more about what habits are going to break your fast and ingesting the food we'll do that.

Melanie Avalon:  Exactly. I'm trying to remember because there was definitely [sighs] there was a study I had read and it was about people smelling chocolate, or it was literally asking this exact question, and what were the effects? The answer was that, yes, it likely releases insulin, but it's just that small amount. And it's something that you weighed out, I'm really glad that you drew attention to the practicality of it all. If you couldn't smell things, that's no, not practical.

Cynthia Thurlow: It's interesting because there's-- and I don’t mean to speak over you. One of the most powerful connections to memories that we have, is there an olfactory system. If I smell carrots, I instantly and brought back to my grandparent's garden in Colorado. Our memories are so intertwined with smells, and our olfactory system, I think it's really important that we not try to diminish those experiences. I think that's just important to state that it's really tied in with memories. There are certain smells like wonderful, delicious smells related to food that bring me back to happy times in my childhood or young adult adulthood. And you don't want to diminish those. I think that's important. 

Melanie Avalon: I could not agree more. I'm trying to remember Mark Schatzker, who I keep talking about with The End of Craving and The Dorito Effect. I learned in that book that we have more DNA devoted to our nose and the mouth than any other part of the human body which is fascinating. It's definitely something that we should be engaging in. 

Cynthia Thurlow: Yeah. Exactly. It's the same thing and I'm sure you get these questions, where people are paranoid to brush their teeth or they're paranoid to take a medication that's prescribed with for fear that it's breaking a fast. And I always say let's think big picture. Like not brushing your teeth, the ramifications of that are greater than brushing your teeth, provided you're not swallowing your toothpaste, which I don't think anyone--that's an adult does that. I know toddlers are notorious for that. I just think we always have to be focused on the big picture. I think that's what's most important.

Melanie Avalon: I cannot agree more. All right, so we can go on to our next question. I don't know how to say her name, It's U-T-E, Ute maybe.

Cynthia Thurlow: Ute, that sounds good. 

Melanie Avalon: She's from Germany. The subject is "Menopause." Ute says, "Hello, ladies. I discovered your podcast last weekend while researching a healthy lifestyle that I can maintain effortlessly. Calorie counting is so depressing and it drives me bonkers. Thank you for all the great information and tips. Since I'm going through menopause, fun times, I wonder if there is some advice you can give." That's a very wide-open question. This is a Cynthia question.

Cynthia Thurlow: Yeah. Truly. Well, I think it's always the reframe. We shouldn't perceive that menopause or perimenopause is a negative thing. I mean, you're going through reverse puberty, but there's so many benefits to not having to worry about getting pregnant anymore, you're not having a cycle every month, your fertility is waxing and waning, and then it's gone. But to me, being at a different stage in my life, I think it's really empowering. I have the bandwidth to do things I wasn't capable of doing 15 or 20 years ago. So, in terms of resources, I would say I've done a lot of podcast around perimenopause and menopause, most recently with Dr. Louann Brizendine, who is a neuropsychiatrist, trained at Harvard. I mean, she's absolutely brilliant. She wrote a book called The Upgrade. The upgrade is menopause, but she said, if we really reflect on the fact that a lot of the terminology around women and aging was created by men, generally, male physicians and the pharmaceutical industry.

She does a really beautiful job of helping us reframe what's happening in our bodies, so we are no longer menstruating or we're getting close to no longer menstruating. We're not in a position where we can become pregnant without technology, that there are changes to our brain, there's changes to the way we perceive the world. There's changes to the way our body responds to certain macronutrients and exercise and sleep. There's lots of really wonderful books. I would say, The Upgrade is definitely a favorite. 

I would say Dr. Lara Briden, has a really excellent book called Hormone Repair Manual. That's Dr. Lara Briden, and I've had her on the podcast. Dr. Sara Gottfried has some fantastic resources, probably my favorite book of hers is The Hormone Cure. Then I think about researchers like Dr. Lisa Mosconi, who is an Alzheimer's brain health researcher at Cornell, she wrote a book called, The XX Brain that I recommend almost daily. I would say those are really great resources and I've done podcasts with each one of them except Dr. Mosconi because she's doing so much research, I literally harass her publicist, probably once a month. I'm going to eventually get her on the podcast. I think a lot of menopause is reframing things. Hot flashes, weight, gain, inflammation, etc., are largely a byproduct of how well we take care of ourselves. So, there's always room for improvement and I find most women, usually within a year or two going through menopause, their symptoms will settle down. 

It's important to understand the things we need to prioritize in this time in our life. I think about sleep quality, stress management, anti-inflammatory nutrition, that could look different for most everyone. But I find the most inflammatory foods for most women are dairy and gluten and alcohol and sugar. Let me put an apostrophe time seven next to sugar. And understanding that your relationship with certain types of foods are going to shift really focusing on, they call it neat, but the exercise we do outside of formal exercise is important. Walking, just being active, not sitting on your rear end all day long and then lifting weights. 

I see so many women that I'm inspired by on social media, there's the good and the bad with social media, but there are definitely average everyday women that I see on social media that are just killing it in their 40s, 50s, 60s, and beyond, like doing amazing things. It's a time of tremendous creativity, it's a time to really reflect on your life and your contributions. And so I would say, I hope that those resources are helpful, we'll make sure that we link those podcasts, and those books in the show notes, so that will be available to you as well. 

Melanie, is there anything that you'd like to add? I know that you're not in this stage of life, but I'm sure you probably interviewing so many people, you probably have some suggestions as well.

Melanie Avalon: Resources wise, that was very comprehensive and amazing. I'm actually just personally, I'm very curious what my experience will be when I go through menopause because I feel like when I had my period of heavy metal toxicity, like to the extreme mercury toxicity that I exhibited, it was like all the symptoms that I see listed as menopausal symptoms. Just because of the, I guess, the hormonal dysregulation from that. I've been very curious when I go through menopause, if it will be. I remember when I was in that I was like, "When I go through menopause, it's going to be a breeze once--" I guess if I can get through this. But I would get all of that like hot flashes and fluctuations and insomnia, and create, like just so many, all of the things. So, that's not very helpful. It's just my experience.

Cynthia Thurlow: I think the better you take care of yourself in perimenopause. From 35 up, the better you take care of your nutrition and your sleep and your stress management and doing the right kinds of exercise, the easier that transition will be. I would say for most people, it's bumpy, because they still want to act and behave like they did at 20 and you can't. And that's not a bad thing. I don't want to eat the way I did when I was 20, I don't want to live the way I did when I was 20, and so once I kind of understood, I had to eliminate some foods, focus on other areas really prioritize sleep, which I affectionately call an art form, because truly it is. Melanie, at some point, I'll have to tell you about my new sleep device that I'm using that you'll probably laugh about. But we'll talk more about it. 

Melanie Avalon: Do I know what it is? 

Cynthia Thurlow: Probably not, because I haven't talked a lot about it on social media. But I have something called Somnox, S-O-M-N-O-X. It looks like a stuffed bean. Like it's the shape of a bean or like a mitochondria. That's probably a better more apt description. You hug it while you're starting to fall asleep, and so I set mine for 30 minutes, and it actually will adjust to your breathing pattern. And what it's doing is stimulating the autonomic nervous system parasympathetic. I've doubled my deep sleep. 

Melanie Avalon: Is it a similar concept to the Apollo Neuro where it's using the vibrations? 

Cynthia Thurlow: Yeah. It's different. It's different than the Apollo Neuro which obviously I love, and love, love, love that. That's certainly very helpful for stress reduction. But for me, I've just been using it before I go to sleep. And my husband is like, "Oh, my God, what's next for you? You sleep with the sleep mask, you've got your blue blockers--[laughs] You've got all these things that you do and you sleep with your Oura ring." But it's honest to goodness, it's doubled my sleep. Let me be clear, they gifted this to me, I was not even aware of it. They gifted to me, and this is my objective opinion. I don't have an affiliate account with them. I mean, I don't get anything for talking about it. Just really have been impressed with the technology and then it turns off. It's not exposing me to anything that's negative. But, yeah, I now sleep with what looks like a little mitochondria tucked up against my chest. 

Melanie Avalon: Can you connect me to them? I want to try this. I'm surprised they haven't reached out to me. That's right up my alley. 

Cynthia Thurlow: I know. It's completely random that they reached out because sometimes I'm sure this happens to you too. People reach out to you randomly and sometimes I'm just very polite and say, "I don't really think I would use that. I don't want to waste your time or your resources sending me something that I don't think I would use or support." I looked at and I was like, "Oh, it can't hurt." My husband was like, "What next?" I was like, "I don't know." I just know that’s helping my deep sleep and that for me as a middle-aged woman is pretty incredible. 

Melanie Avalon: What was it called again? Somnox.

Cynthia Thurlow: It's Somnox, S-O-M-N-O-X. I think it's a German based company. 

Melanie Avalon:  That is so cool.

Cynthia Thurlow: That's very cool. Except my husband is now embarrassed. He's like, "What is that thing?" I'm like, "It's my little Somnox."

Melanie Avalon: Oh, my goodness. What color is it? 

Cynthia Thurlow: It's blue. It's a delightful pleasing blue. It's blue like dark blue and light blue. 

Melanie Avalon:  You hug it, basically. 

Cynthia Thurlow: Yeah. It's curved, so it's designed to just fit in to your chest as you sleep, so I turn on my side. I do like 30 minutes and it acclimates to my breathing and I just fall blissfully asleep. It's amazing. There's no nothing else that's changed. 

Melanie Avalon: I need this. Okay, this is great. Wow. To-do list. One other question, I don't even know if I should ask it because it's a big question but with the menopause stuff, do you find people benefit from HRT? 

Cynthia Thurlow: I do. I think the Women's Health Initiative came out in 2002. So right as I was finishing up my NP program, and the research that was done, and the points that were drawn from the research, there's a lot to unpack here. I did a great podcast with Dr. Avrum Bluming and Carol Tavris, talking about why estrogen matters. That's their book, but it basically explains what was flawed about this study. And it's really important that I just state an entire generation of clinicians, and an entire generation of women have been harmed by the way that this research was shared. We're just now getting to a point where I think most, if not all, clinicians are talking openly about the fact that there is benefit from replacing hormones that our bodies have naturally stopped producing. 

As an overall, like general statement, I do think women benefit from Bioidentical Hormone Replacement. I do. I myself take compounded, good Lord, compounded progesterone and compounded T4/T3. I have testosterone, I also have estrogen, I've got it all. I really do think for me personally that they help asleep, they help with inter kind of synergistically, each one of them is helping me with different aspects of navigating these years. But the thing that I get most concerned about, and anyone that's listening, that's 35 and up, I worry the most about cognitive function because Alzheimer's and dementia, they don't start in your 70s or 60s, the groundwork is laid many years before. This is important 30s, 40s, 50s, how well we take care of ourselves sets us up for developing disorders of cognition. 

For me, I'm most concerned about brain health, and then secondarily to that bone and heart health, of course. Then beyond that, just wanting to be able to navigate every stage of life that I'm in, I want to be able to enjoy my life and not feel like I can't be 100%. So, getting back to your original question, I do. I think it's all about finding practitioners that are not only capable, but current and openminded to help you find the combination of medications that are best for you. Like I've now gotten to a point that anything that's made conventionally just has not worked well for me. Now we just finally stopped Synthroid and Cytomel, now I'm on compounded T4 and T3 and my functional medicine doc told me I have the most "curious thyroid panel" he's ever seen. With that being said, everyone that's listening, I have women who are petrified of hormones, I have women who are openminded to hormones. I think it's just important to have those conversations, like whether it's with your GYN or your internist or your girlfriend, just understand there are options, you don't have to suffer. 

Melanie Avalon:  I'm really, really happy to hear you say that. That was my understanding of that, of the Women's Health Initiative because basically, the takeaway was they said it encouraged, was it breast cancer? It was not done correctly and interpreted correctly and created a potentially-- Yeah, well, everything that you said, misled.

Cynthia Thurlow: It's unfortunate because the samples, the study participants were older, they weren't 49, 50, 52, they were in their 60s. Many of them had been smokers, they had high blood pressure, they were diabetic, they were obese. They weren't a healthy population to start with and they used Premarin and they use Progestin, which is synthetic form of progesterone. It's interesting, everyone knows that you and I both love Huberman and Dr. Peter Attia, they had a really interesting discussion. Peter Attia was a guest on Huberman lab. Fairly recently, in about an hour in to the podcast interview, Peter Attia effectively stated that this was one of the greatest disasters he's ever witnessed as a clinician, that it has such profound implication and impact. 

I look at my mother's generation, my mom is 76 and has terrible osteoporosis and we're starting to see some degree of cognitive changes. It's unfortunate, because she thought, "Oh, if I'm using vaginal estrogen that's going to protect me." And I said, "It doesn't protect your bones, maybe your vagina," which I mean, let's be honest, that's an important part of being a woman, but there was just not good information given to these women. They were not fully informed and so I think we just have a whole generation of women and clinicians that are fearful about prescribing hormones. I almost get a question about this every single day on social media, which tells me that we need to continue talking about it. It's important for people to know that working with a talented, competent clinician, if you're in a situation where you need hormonal therapies that there are people out there that can help you through that. 

Melanie Avalon: Yeah. I'm just thinking, I don't know if I'll be able to articulate this, but it was an effect that was very pervasive because I feel like even me, even before I was super steeped in the health and wellness sphere, and even when I was younger when I wasn't even thinking about this type of stuff, there was a vibe surrounding HRT that it was, like not a good thing to do. I just think it really, really got into culture, which is kind of a shame that it went that way. 

Cynthia Thurlow: Absolutely, because we have a generation of women that are struggling. It's not like the conversation I had with Dr. Louann Brizendine, and she's based out of California. She's almost 70, she doesn't look at first of all, and she's like, "I have amazing bone strength." She's been on HRT for almost 20 years and she's a tiny petite person and she said, "I have amazing bone strength. I've got very healthy bone, but I credit that to HRT."

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All right. Shall we answer one more question? 

Cynthia Thurlow: Absolutely. This is from Sybil Ann, subject is, "Need help from South Africa." "Hi, first of all, thanks so much for all the effort you put into the podcast. Love, love, love the podcast. I'm not sure how to 100% phrase my question, but what strategies do you or did you use to stick to the plan. I started out really strong. The first two weeks, I almost effortlessly fasted 18 to 20 hours daily and then all of a sudden it became difficult. It's like I have a mental block, I can't move past. Nothing significant has happened in my life, so it's not related to stress or anything. I follow all recommendations and fast, totally clean. Did this ever happen to you? You wake up one day and fasting seems hard. I don't understand how I could do so well and feel so good, and then a few weeks in, feel different. Did this ever happen to you? Any advice or tips would be greatly appreciated. Thanks so much for taking the time to read my question. Best regards, Sybil." 

Melanie Avalon:  All right, Sybil from South Africa. Thank you so much for the question. So, I do think this is a common thing that happens with people. It's not exactly the same thing but it's sort of how with even calorie restriction or normal diets or crash diets, people can sometimes do it really well in the beginning and then it becomes really, really hard. The reason that happens is because it's not sustainable, whatever dietary restriction that the person is doing. I think with fasting a lot that this can also happen where somebody starts intermittent fasting. In the beginning, it's great, they're losing weight, their adrenaline's probably up, they have energy. But then if the actual eating window is not a sustainable amount, then you're going to reach a point where your body's going to give signals to you that it's not a sustainable amount. 

This is the case I would really, like, where you just randomly one day it's hard, I believe it might be because you're actually not fueling adequately in your eating window. So, I would suggest one of two things, either having a longer eating window, so changing the fasting hours, or really addressing what you're eating in that eating window, making sure that you're getting adequate fuel, adequate protein, especially, depending on what macros you're doing. If you're doing a mixed diet, then this wouldn't really apply, but if you're doing a low carb diet, making sure you're getting ample fats to support your fast, if you're doing high carb, making sure you're getting enough calories in the form of the carbs. So yes, I think what happens, I've already said it, but it's people like going on adrenaline and doing well in the beginning, but their eating choices aren't actually sustainable. So that's what I would look at. Do you have thoughts? 

Cynthia Thurlow: Yeah. I mean, of course, I always come from the perspective, are you having a harder time with fasting depending on where you are in your menstrual cycle? Because it's much easier to do that when estrogen predominates in the follicular phase, which is in the beginning versus the week before your menstrual cycle. I do think when we are creating lifestyle change opportunities, we have to be really mindful of what is sustainable. Are you too restrictive? Are you not getting enough macros during your feeding window? Are you not sleeping well? Are you over exercising? Is there just too much stress going on in your personal life? I think sometimes we set really not necessarily unachievable, but not sustainable goals. And so I would really encourage you to think about what is something you can do for the rest of your life versus something for just a couple of weeks, because that's a really important distinction. 

For me, personally, if someone said to me I could never have dark chocolate for the rest of my life, that would not be sustainable, versus if I say to myself, I'm allowed to have a small piece of dark chocolate every other day, and I can sustain that, then that is a sustainable goal. I'm giving a terrible example. Dark chocolate is my one vice. If people don't know that already, that's like my one vice in life. It'd be very hard to give that up. So, I think when you're looking at a plan and you're creating changes, sometimes I see people doing too many things all at once. Meaning, they're trying to improve their sleep, they're trying to exercise or trying to fast, they're trying to do all the things all at once. What they really need to do is pick one thing at a time, master that and then add more things and that is much more achievable and sustainable. 

Melanie Avalon: Yeah. I cannot agree more. So hopefully that's helpful. All right. One more question we can sneak in. This comes from Cheyenne, and the subject is "Easing into a fast." Cheyenne says, "Hello, I've been listening to your podcast for just a few days and love it. I've been practicing IF for about 9-years. For most of those years, I had great success and practicing a 16:8 fast and have been able to maintain a healthy weight. That said, I've been slowly putting on weight for the last year or so, I'm starting to think it has to do with my age. I'm currently 41. After listening to your podcast, I thought I might try to increase my fasting to a 24 or one meal a day. It was tough. About two hours before I was to break my fast, I got really cold in my extremities and became pretty weak. When I finally broke my fast, I didn't binge but I was extremely tired and had to go to sleep. My question is how do I ease into a longer fast comfortably? P.S. I did have my thyroid checked, and though it's on the low side, it's still a normal range and my doctor is a big proponent of IF. Thanks so much. 

Cynthia Thurlow: This is a great question. This goes back to something a theme that I am starting to talk about more openly on social media. The presumption that what you have to do is fast longer and restrict more and what it may mean because you're in that perimenopausal age range, it can be a lot of factors, that could be why you're becoming weight loss resistant. Have you lost muscle mass. Melanie and I were talking earlier about the loss of insulin sensitivity with less muscle that we have and we start to lose muscle after the age of 40. And depending on who you're talking to, it could be 3%. It's pretty significant and it starts to just accelerate like a freight train. What's your stress management like? What's your sleep quality like? Are you exercising? Are you lifting weights? Are you having an anti-inflammatory diet? I don't like short feeding windows, because you're never going to be able to hit your protein macros. I would encourage you to explore those other lifestyle pieces first. If you decide for yourself that you got all those things ratcheted in, I would not be doing a short OMAD type eating methodology. I would not be doing that every day. It's going to be very hard to hit your protein macros, and you don't want to be losing insulin sensitivity and muscle mass, especially as you're heading into perimenopause and menopause. Melanie, what are your thoughts? 

Melanie Avalon: I think it's interesting, because people, like you basically just said this, but people when they have an issue with not losing weight, or not feeling like their diet is working, they think the answer is automatically fast more, like that's the answer. I personally think there's so much benefit that can go into looking at the food choices specifically. Especially, when people writing questions, I don't think she mentions at all what she's eating. When people don't mention actually what they're eating, then I feel there's possibly the potential for a lot of the benefits that you want to experience by addressing what you're eating rather than fasting more. If you're not eating a whole foods based diet, moving to a whole foods based diet. Like Cynthia said, really focusing on the protein, things like that can be huge. But then if you do want to fast for no reason-- so basically, she went from going nine years 16:8, jumping into a short eating window. I would suggest just slowly tightening it up and slowly approaching if you want to make a shorter eating window, so doing a 17:7, and then 18:6 and seeing how you feel going a little bit longer. 

There's nothing wrong with just fasting a little bit longer, you don't have to jump into a short eating window you could just add an extra hour here or there. Also, little hacks that you could do maybe fasting just a little bit longer, like adding an extra hour and really putting in some physical activity near the end of that fast, that can have a really beneficial effect for people, both for fat burning, as well as setting you up for your eating window, insulin sensitivity and things like that. So, yes, I would just take a different approach than the jumping all in to the short eating window approach. 

Cynthia Thurlow: I agree. I think and I hope that we will continue kind of investigating this triad that I'm seeing in a lot of women where the presumption is more fasting, more exercise, more food restriction is going to allow them to lose the weight they're frustrated with.

Melanie Avalon: Exactly. Awesome. All right, so this has been absolutely wonderful. So, a few things for listeners before we go. If you would like to submit your own questions for the show, you can directly email questions@ifpodcast.com or you can go to ifpodcast.com and you can submit questions there. You can find the show notes, I feel like we talked about so much stuff in today's episode. I always feel bad for Brianna, our show notes creator, all the links we'll be sending her way to put into the show notes. They will be at ifpodcast.com/episode284. You can follow us on Instagram as well. That is @ifpodcast. I am @melanieavalon, Cynthia is @cynthia_thurlow_. Well, this has been absolutely wonderful. Anything from you, Cynthia, before we go.

Cynthia Thurlow: No, just we got through a lot of questions today. I think I always feel very productive when we can make that happen. 

Melanie Avalon: Same thing. All right. Well, I will talk to you next week. 

Cynthia Thurlow: Sounds good. 

Melanie Avalon: Bye. 

Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.

[Transcript provided by SpeechDocs Podcast Transcription] 

STUFF WE LIKE

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

TRANSCRIPT

Melanie Avalon: Welcome to Episode 274 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, biohacker and author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my cohost, Cynthia Thurlow, Nurse Practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us, check out ifpodcast.com, melanieavalon.com, and cynthiathurlow.com. Please remember, the thoughts and opinions on this podcast do not constitute medical advice or treatment and no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup of tea, or even a glass of wine, if it's that time and get ready for The Intermittent Fasting Podcast.

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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 disrupters, which mess with your hormones, carcinogens linked to cancer, and obesogens, which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream. And then in our bodies, studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat, and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that. Beyond weight gain and weight loss, these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies, when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so, so shocking and the effects last for years. 

Conventional lipstick, for example, often tests high in lead and the half-life of lead is up to 30 years. That means, when you put on some conventional lipstick, 30 years later, maybe half of that lead has left your bones. On top of that, there is essentially no regulation of these products on the shelves. That's why it's up to us to choose brands that are changing this. The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin, so you can truly feel good about what you put on. And friends, these products really, really work. They are incredible. They have 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 on my Instagram to see what it looks like. Tina Fey, even wore all Beautycounter makeup when she hosted The Golden Globes. So, yes, it is high-definition camera ready. They have so many other products, deodorant, shampoo and conditioner that I love, products for babies, and so much more. You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. Also, make sure to get on my clean beauty email list. That's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. So, definitely check it out. You can join me in my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well. 

And lastly, if you're thinking of making Clean Beauty and Safe Skincare, a part of your future like we have, we definitely recommend becoming a Band of Beauty member. It's like the Amazon Prime for clean beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally, completely worth it. So, again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.

Melanie Avalon: Hi, everybody and welcome. This is Episode number 274 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with, Cynthia Thurlow.

Cynthia Thurlow: Hey, there.

Melanie Avalon: How was your trip?

Cynthia Thurlow: Amazing. I think that's the best, the best way I can describe it. I think on a lot of levels that far too many of us don't take breaks from work. For me, I was really, the entire time during the book launch, I kept saying to myself, “If I can get till June 15th, if I can just get to June 15th, then as soon as I got on that plane, I was so ready to disconnect and spend time with my family” and it was absolutely perfect. We had great weather, we ate amazing food, we saw amazing things, we had a lot of togetherness. I'm sure the teenagers would say that they loved it, too, even though, there was a lot of togetherness and a lot of disconnection from their electronics because we didn't allow them to have an international plan on their phones, which I thought was the best decision ever.

Melanie Avalon: My family is actually in Europe right now and they did get a plan. It's so funny how things have changed because I remember when they would go to Europe years ago, now, it just feels the exact same as them being here in the US with the international plan.

Cynthia Thurlow: I didn't even have an international plan. That was my decision that I really did not want to be that accessible. My husband has an international plan. So, I kept saying, “You know what, anyone that was, the dog sitters, the house sitters, anyone that needed to reach us, they could reach my husband, but I only had Wi-Fi in my hotel.” And so, it was wonderful.

Melanie Avalon: That's so nice. What was the highlight of the touring and everything that you saw? 

Cynthia Thurlow: Oh, I think Prague. We started our journey in the Czech Republic. We as a family have all said the same thing that Prague absolutely blew our minds like everything about it. The fact that we just really explored every square inch of the city, and we're able to do a laundry list of things, the kids had prioritized, and my youngest has been learning German, and so, he's been really interested in going to Eastern Europe, and he identified very specifically as is his personality. things he wanted to do, and so, we hit all the things that everyone wanted to do, and just really enjoyed the culture, and the people, and whether or not listeners know this about me or not. My first undergraduate degree was in international studies. I had a foreign affairs degree and I was all pre-law and undergrad, and gotten into law school and didn't go. But here's the big thing. I was in college when the Berlin Wall came down. I was in college when Eastern Bloc countries really started to dismantle. And to actually be there, and to be able to ask people what it was like to live under communist rule, and what it was like when the Soviets occupied a lot of these countries, for me being a gigantic international studies nerd, it just-- My kids were so embarrassed like, “Please don't tell another person that you were in college, when the Berlin Wall came down.” They were so embarrassed. But for me, I just savored every bit of it and love the people. 

When you think about just the influence on architecture and the hardships that people have really grown up with, I found everyone in Prague to just be so gracious, and humble, and interested. Another thing that really impressed me was the support for those in the Ukraine throughout Eastern Europe. Everyone was happy to take in the refugees and there were a lot of demonstrations, very peaceful ones. But for me, I would say probably, Prague. I was really surprised. It's a very, very special place for all of us and I think it's really cool that my kids got to see so much history during this trip, not just in the Czech Republic, but throughout Eastern Europe. 

Melanie Avalon: Here's a question for you related to the show, because Gin and I used to discuss this a lot. So, how do you change or how do you adapt to your fasting and eating windows when you travel?

Cynthia Thurlow: Yeah, it's a question I got so often that I just didn't ask me anything on Instagram, because I was like, “Thank you for the 500 questions I've gotten in my DMs.” I adopt a more relaxed pattern. And so, it may be that I have a wider feeding window, I may do a longer fast, I definitely had days where I really wanted to travel and savor the foods of where we were traveling to. I might have had something around breakfast time, I might have eaten something midday, I might have had a dinner. I would say, I allotted a lot of flexibility. We did a lot of walking. We were very physically active. So, I wasn't worried if I was consuming more food because I know for myself personally. It isn't dessert unless it's chocolate and there's just not a lot of chocolate there. For me, there wasn't the temptation of having dessert. It was more-- one place or we traveled to, they would make me gluten free bread, which I then felt obligated to eat, which I then slathered a lot of butter on. And so, I just savored the fact that I was on vacation.

The honest answer is everything was a little different each day, I definitely had some days where I would have-- there might have been a day where I eat more than I normally did. The next day I might have just fasted longer. The thing that I found most humorous was obviously, I've teenage boys. So, they ate voluminous amounts of food 24/7. I would sit down and try to explain to a waiter or waitstaff that I wasn't eating, they were like, “Are you sick, are you on a diet?” And so, finally, it just said, “No, I intermittent fast” and they're like, “What is that?” That was a very easy way to make conversation with people, but I just leaned into my body, I made sure I hit those protein macros more often than I asked for extra protein. Anytime there was a steak served, I always asked for a bigger piece of steak, which they were humored to say they're like, “You really want more steak?” I was like, “More steak.” 

I think the message I would send to our community is to just be open, to not being so strict on vacation. To me, I just enjoyed eating foods I don't normally eat and then not stressing about it, because I was doing so much walking and I knew I could just augment what I was doing very easily. The next day, it's like, “Okay, yesterday, I had gluten free bread twice. Am I going to beat myself up? Absolutely not. Am I going to make sure I fast maybe a little bit longer today and then I really lean into those non-starchy veggies and lots of protein? Absolutely.” I came back from vacation. I have not weighed myself, but my clothes fit the way they did before I left for vacation. And so, from my perspective, it was a win-win without feeling any sense of guilt. Having a conversation with my kids all along the way. They think I'm weird anyway that need as much food as they do. But just encouraging them, “Try something new, I tried lots of new food,” and I definitely felt it was the perfect balance of having fun, hitting most of my macros most days because I can conventionally, visually evaluate like, “Did I hit my protein macros,” and then just enjoying the rest, and not being super strict.

But I might be one of those people that's just unusual or odd that I've never been someone like I go on vacation. I blow the Mother Lode on my nutrition because I just don't feel good and it's more important to me that I sleep well and I feel good then it is that I eat something that I know isn't going to agree with me. So, it's easy to avoid those kinds of things. For me, those kinds of foods are generally alcohol and a lot of sweets. In Eastern Europe, there just aren't a lot of sweets, at least, not where we were. If they did, it was more like bread sweets, which just isn't really my thing anyway. But if they had showed me a lot of chocolate and I did indulge in some chocolate in Vienna, there was this amazing chocolatier that was there and we got some tiny truffles, but they were delicious and I was like, “That was worth it.” But beyond that, unless it's chocolate, it's not dessert in my mind.

Melanie Avalon: Well, first of all, for me for traveling, I haven't traveled that much recently. But the one thing I used to dread before adopting a Whole Foods type lifestyle and intermittent fasting, I would be the type that would just go crazy with all the food and everything. Now, I remember feeling so happy once I found a dietary approach that I genuinely-- I love the foods that I eat, and I can still eat the way I eat at restaurants and such and still enjoy it to the same extent that I would have before with the way I used eat. I'm super grateful that-- It gets rid of the one stress I had surrounding traveling, which was just going off the rails with diet, because now, I just keep doing what I'm doing with the jet lag and such. Have you ever used fasting to align your circadian rhythm with the new time zone?

Cynthia Thurlow: Yeah, I definitely do that. In fact, I'm the person on the plane that never eats. [laughs] 

Melanie Avalon: You and me both.

Cynthia Thurlow: Yeah, I don't eat on the plane and I have to always just explain to-- Yes, I know. They ordered me a gluten free and dairy free meat. Yes, I know that they did. I won't eat it. Thank you very much. And then they just look at me like I have two heads, but I just find that I do a whole lot better especially if I'm not sleeping well on the plane. I didn't on the way to Prague and we had a two hour-- It's not worth boring the listeners with the two-hour ground delay we had. We were on the plane, and there was some maintenance form that hadn't been properly signed, and so, we had to go back to the gate, so, it ended up being a 10-hour flight. By the time that we touched down in Prague, I hadn't slept much at all. I always credit hydration electrolytes and fasting for helping me get pretty quickly on schedule. And so, for me, it's just one less thing to worry about. 

Then I'm not dealing with eating food that is not going to agree with me, although I always travel with Paleovalley beef jerky and salted macadamia nuts, and a little bit of dark chocolate. Those are things I typically travel with. If I were exhausted and starving, I could have something. But I do think that utilization of fasting as an adjunct to improving jet lag, I think I really credit it with being able to travel as much as we do and feeling-- When I hit the ground, I don't have the degree of jetlag I used to have when I was younger, which you would think would be completely the opposite seeing as I'm now older, but I think a lot of it has to do with the fact that the circadian biology, it's get light exposure, get hydrated, get yourself moving. We did a lot of walking on the first day in Prague, a lot. I really credit that with everyone being able to get on that schedule, 26 hours ahead of me, it's manageable, but not feeling quite as jetlagged as we could have been. 

Melanie Avalon: I think it's such a valuable hack that a lot of people don't realize and there's actually been studies on it. They've studied using fasting. I'm trying to remember-- It's been a while since I read it, but there was one on jetlag and using fasting patterns to basically alleviate those symptoms, because like you said, they are such a-- What's the word? Zeitgeist? Oh, no, no, zeitgeber, so basically something that informs your body of the time. [chuckles] You can travel, and essentially adopt the pattern you would have had in your normal time zone, and it can sink your body to the new time zone. If I'm just traveling, because when I was in California, I would often travel back and forth between Eastern time zone and Pacific, and that's not a huge difference, but there was zero issue with switching back and forth. Continental travel for me is no issue, because I just always stick to my window which is an evening dinner and I just basically reset my body wherever I go.

Cynthia Thurlow: Yeah, the fasting longer piece is usually how I do that. I'll be in Austin in a couple days and I already know-- I’ve an early morning flight, I'll land there at 12, and my plan is to get off my flight. I know exactly where I want to go for lunch. I'm going to have a big lunch, and I'll you know break my fast which will probably be fairly long, almost probably I would guess closer to 24 hours at that point, but I'll break my fast, so that I'll get as quickly as I can, because if you look at conventional research on changing time zones, you need one day per hour of difference, where is time for that. I don't have time for that. I know you don't have time for that. And so, I do all the things to make sure I try my hardest to buffer those time differences as quickly as possible. But I love that you even at your stage, you're able to go back and forth to the West Coast and then just keep that consistency with your meal timing.

Melanie Avalon: Yeah, it was literally no issue doing that for me. You mentioned that when you were in Prague and such, people would look at you strange with the fasting, so, did you find that--? Because now in the US, I feel fasting is a known thing, intermittent fasting is. Did you find it wasn't as much of a thing there?

Cynthia Thurlow: No. I think it has a lot to do with Europeans overall. They eat smaller portions. They don't understand-- You ate last night, but now, you're not hungry at all. You're hungry, but you're not going to eat. And so, just trying to explain to them that this is not a diet. This is a lifestyle. I do this, so that I can enjoy all the other things I eat in my feeding window and so, I definitely felt I had a lot of conversations, although, ironically, for part of our trip we were on a ship, there was a very large table of Americans sitting next to us, and I heard a woman say, “Oh, yeah, I've been using this new strategy. It's intermittent fasting.” And so, I heard that, my whole table, my kids and my husband, their ears perked up. I was humored to listen to her talk about this. She was probably a woman in a different life stage than I am, but she was talking about it very openly and saying, this is how she has been able to fuel her lifestyle and feels good. She was explaining it to the waitstaff as well. And so, I feel I was probably not the only one that talked to them about that. But they were fascinated. They're like, “You choose not to eat, even though you could.” I was like, “Yes.” They're fascinating.

Melanie Avalon: This is something I haven't looked up. I wonder if there are any other countries that-- I feel it's well known in the UK because we have a lot of UK listeners and Canada. I wonder if there are any other countries that practice this as a lifestyle more and more. 

Cynthia Thurlow: What's interesting is, a lot of the Eastern European countries we were in are predominantly Roman Catholic, at least based on the guides that we had, discussions that we had. And so, a lot of the major religions, it's an aspect of practicing their religion. I would imagine that there's probably some degree of fasting, although it's probably more related to high holy days as opposed to something people are doing ritualistically every day. But I can tell you that when I talked about fasting with people who are curious, they were like, “Wow.” But what's interesting to me consistently and I was in five different countries, people were much more active and it could have also been that we were closer to cities and where people are just more active to begin with. But I didn't see the amount of obesity we have here in the States. People were very active, portions were small, certain countries, there's a lot more smoking, but people were just more focused on enjoying lives. They're enjoying their lives. They don't work the same hours that Americans do. I think that there's a lot more savoring experiences in their lifestyle. And of course, this is a gross generality. I was not in every square inch of each one of those five countries, but just my general observations, being a tourist, I was really pleasantly surprised to see that.

Melanie Avalon: And speaking to the religious piece, I'm actually currently reading-- It's funny. I thought I had read the book, but I actually haven't. It's Jason Fung and Megan Ramos’ Life in the Fasting Lane. So, I'm enjoying that book. But I think it's in that book, they were saying, they made the case that every single major religion has fasting in it. I was like, “hmm.”

Cynthia Thurlow: It really does. It's interesting that when people try to, “Oh, it’s new and novel.” No, it's not. [laughs] It dates back to Biblical times, people and beyond.

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When you wear a continuous glucose monitor, which is painless to put on, I promise, I have a lot of videos on my Instagram of how to put them on. So, definitely check those out. It gives you a picture of your blood glucose levels 24/7 for 14 days. What I love about the NutriSense CGM program is, it has a super awesome app that helps you interpret the data and really understand what's going on. In the app, not only does it track your data, but you can log meals, see macronutrient breakdowns, and so much more. It even gives you an overall score for each of your meals based on your body's response, so you can really find what meals are working for you. Each subscription plan includes one month of free support from a registered dietitian. NutriSense dieticians will actually help you identify what you should be paying attention to, what that data actually means. They can really hold your hand if you're new to the space or if you're already knowledgeable, then they can provide you even more advanced tips and recommendations. They'll make sure that you adjust your diet and lifestyle to find what you enjoy doing, so that you can have long-term sustainable changes. NutriSense also has a private Facebook group for members, where you can find support from other members and learn about their experience. I love wearing a CGM. I just think it is so profound. Even if you just do it once for 14 days, I think you will learn so, so much. But then, of course, lasting sustainable change can take time. Getting a longer-term subscription can be an amazing option to consider. 

NutriSense has six and 12-month subscriptions and those are cheaper per month allowing you to not only achieve your health goals, but also ensure that you stick to your new healthy lifestyle for the long term. It's helped me realize for example, how low carb versus low fat affect my blood sugar levels, how berberine has an amazing effect at lowering my blood sugar, and so much more. You can get $30 off any subscription to a NutriSense CGM program. Just go to nutrisense.io/ifpodcast and use the coupon code, IFPODCAST for $30 off. That's N-U-T-R-I-S-E-N-S-E dot I-O slash IFPODCAST with the coupon code, IFPODCAST for $30 off any subscription to a CGM program. There's a reason Cynthia and I talk about CGMs all the time. We love them. NutriSense is giving you guys’ access to them. So, definitely check this out. And we'll put all this information in the show notes. All right, now back to the show. 

Melanie Avalon: Last question. So, you're a chocolate person?

Cynthia Thurlow: I'm absolutely a dark chocolate aficionado snob/patron. Love it. It's my one like vice. It's the one thing my husband will say to my kids, “Don't touch anything of your mother's as it pertains to chocolate without asking her first.” I'm always like, “It's the only thing in the house that's mine.”

Melanie Avalon: That's my mom, too. I'm fascinated why there's a dichotomy between chocolate and vanilla. Why? Because that must just be cultural. It's not they're opposites in their compounds inside of them, but I am very much a vanilla person.

Cynthia Thurlow: I like vanilla, but I love chocolate.

Melanie Avalon: I like chocolate, but I don't crave chocolate ever. I think I have once and I was like, “What does this mean?”

Cynthia Thurlow: [laughs] Well, that's why we say to people, when our waiters would always offer dessert options, I was like, “No, I'm good.” They were always like, “We don't understand.” I said, “Unless, it's chocolate, it's not dessert.” That's my mentality. I've been that way my whole life. It's not even a chocolate cookie, chocolate cake, it's like, “Give me a piece of chocolate and my life is good.” That is my mentality. Whereas my kids and my husband, if you give them ice cream, they don't need anything fancy. They would just love some ice cream. And so, I think each one of us in our minds designate. For me, it's not a craving. It's a polyphenol rich substance that if used appropriately is something that can be beneficial to your lifestyle. But for me, I'm not eating a Hershey's chocolate bar. I don't even like that kind of chocolate. I am a purveyor of higher end dark chocolate, and I just have a little bit, and I'm so happy. In a pinch, I might have some stevia sweetened dark chocolate in a pinch. However, that chocolatier in Vienna, oh, my gosh. I even took photos, I took videos, it's all in my fasting stories, little thing for Austria. Yeah, for me, those are moments that make me so happy. Something really simple like that. I don't have to make it complicated, it doesn't need to be Black Forest Cake or some type of intricate latticework on a pie. Nope, just give me a piece of dark chocolate and I'm happy and very simple.

Melanie Avalon: I know listeners know exactly what my equivalent is to that. Do you know what mine is?

Cynthia Thurlow: No, I don't. You have to tell me. 

Melanie Avalon: Funfetti cake.

Cynthia Thurlow: Really? 

Melanie Avalon: Yes.

Cynthia Thurlow: That's--. Is it the moistness, is it the little sprinkles?

Melanie Avalon: There's some chemical they have that just speaks to my brain. But yeah, the Funfetti cake, so any birthday cake with the Funfetti flair to it, it used to be a running thing on the show because I hadn't had it since changing my diet. Gin was insistent that if I were to have it now, I wouldn't like it anymore and I was like, “No, you don't understand.” [laughs] It will taste amazing. And then finally I tried. They have a gluten free version. So, it wasn't even the original and it was the most fantastic thing. Oh, here's a question. Did you do ZOE, the muffins?

Cynthia Thurlow: It's still in my freezer and my husband is so mad at me because we just had a colleague of mine, they have a cow share, and they had too much meat. They gave us part of their cow share, which means our freezer is completely packed with grass-fed meat and my husband's like, “Please get rid of these.” I was like, “I promise I'm going to do them” and he's like, “You've been telling me that for three months.” “No, I need to do it. It's embarrassing.” I'm saying this to the entire IF Podcast community. I will be doing that the month of July. I will be doing it. It's some two-day, one-day interval. It's coming up.

Melanie Avalon: I'm very excited to hear your experience and lot to talk about it on the show. I have a theory about it, though, and I polled my audience, and my polling confirmed my theory, which is that the muffins, people will talk about how they're the worst tasting thing. I was looking at the ingredient list before doing it. Again, it's something Gin and I would talk about and I was like, “I'm going to love these muffins.” I can just tell. These muffins are going to taste like heaven and they did because this was the first time eating a sugar fat process combination and probably, I don't even know how many years. It was literally, I saw my brain light up. It felt like a drug to me. And then I pulled in my Facebook group and I asked, “Did you like the muffins?” There were four options. It was like, I liked the muffins and I don't normally eat processed foods, I like them and I do eat processed foods, I don't like them and I—So, every combination of that. Basically, the people who don't normally eat processed foods liked the muffins and people who do, do not.

Cynthia Thurlow: I'll be interested. I'm not a vanilla cake person. Here again, you can see, there has not been this desire to eat said muffins, but I'm like, “I have it, I'm going to do it. I'm probably going to have a love-hate experience with this,” because three muffins is a lot. I was like, “How am I going to eat all that, especially because they're not chocolate?”

Melanie Avalon: I was like, “This is going to be a breeze.” I was licking the foil, I was like, [chuckles] “I need more.” Because then there's this miserable period where you can't eat for so many-- For listeners, I'm just assuming listeners know what ZOE is because we talk about it all the time on the show, but it's a program created by Tim Spector, who I've had on Melanie Avalon Biohacking Podcast, if you want to listen to that episode. Have you interviewed him?

Cynthia Thurlow: I have not. The reason why I have not is because I think I literally went through-- I got them and then I had that whole histamine response, head to toe hives after being treated for Candida and parasites. And so, then that put the kibosh on doing anything. I explained to them, I was like, “I had three days of systemic hives, something's amok.” And so, that got stabilized and then I had surgery, and I was not-- Because you can't exercise when you eat those things. I was like, “There's no way I'm eating this and then being completely sedentary.” I've just had a million excuses, which I didn't mean to make excuses. It's just been a couple of things have happened that I've not been able to do it sooner, but it is on my to do list, it will happen in the month of July. So, I haven't had them on yet, because I haven't done the testing. I had to explain to his assistant very nicely, I was like, “I am so sorry. It will happen this summer and then we'll get him on in the fall.”

Melanie Avalon: I really, really think his work is very nuanced. He's very plant based and everything, but he just does a really nice-- really, at least from my perspective approaching as unbiased as you can be analysis of the literature. His chapter on wine and alcohol was-- It's the first time I've read somebody basically-- He talks about the role of wine, and alcohol, and health, and he literally says in the book that and this is very controversial. So, I don't even want to say it. But even with pregnancy, it's probably not as much of an issue as people think. But in any case, so, for listeners, what the program is, it's these muffins that you have, and you wear a CGM, they provide you with the CGM, and it evaluates how your body processes sugars and fats, you also do a gut microbiome test, then it gives you a personalized interpretation of how you basically handle food, and what foods you should be eating. I think I have a code for that. Had they given you a code yet?

Cynthia Thurlow: I'm the slacker that they're waiting on me to get my act together. So, I will eventually have a code.

Melanie Avalon: My code is MELANIEAVALON10, yours will probably be CYNTHIATHURLOW10, because I think that's the format they use. One last thing about it, though, that's funny is, so, when I looked at how you have to do it, because basically the first day you eat these muffins, and then I think you have to wait four or five hours. For me, they were a miserable four or five hours because you basically eat something that just spikes your blood sugar, and then you have to fast. It's so hard. I was like, “This is what it's like to not be adapted to fast, to live in the blood sugar swinging state.

Cynthia Thurlow: Eating a Standard American Diet. 

Melanie Avalon: Yeah. Mm-hmm. I was like, “This is what this feels like.” It gave me empathy for people who haven't experienced the ease of fasting yet because I'm like, “This is probably what they're thinking fasting would be,” which is just really unpleasant. If you do a dinner only eating window like me, you can still hack it. I started it at, I don't even know what I did. I timed it so that I still could eat my dinner pretty late, and still have the muffin, and all be within the evening window. I think I was eating at 2 AM.

Cynthia Thurlow: Yeah, for me, because I am so protein centric, the thought of having something that I know is going to dysregulate my blood sugar so substantially, which has not been-- The N of 1 experiment has not been the one I've been looking forward to doing. I'm like, “Okay, this is not going to make me feel good.” Years ago, before I started putting two and two together as a perimenopausal woman, I would say to my husband-- Sometimes, we would have these dinner parties, and we would all eat good food, and then you'd have, I don't know-- Back in the day, when I could get away with eating a little more dessert and having a little more alcohol or having any alcohol, and then I would want to take a nap, and I didn't realize because my blood sugar had crashed, I was like, “That's just not a good feeling.” And so, I'm going to think optimistically that I'm going to be able to weather whatever happens. But for me personally, as much like you do, I think because we eat such a nutrient dense Whole Foods diet and keep our blood sugar really within a very healthy range, those extremes don't make you feel good. And so, I need to just rip off the band-aid and do it.

Melanie Avalon: I was so apprehensive about doing it. What I do recommend is planning it out, so that in that time following it, you have an activity, something very distracting. Actually, a fun fact they might have changed this. I feel I probably drove them crazy. I was asking them, because they have really amazing customer service and the app when you're doing it, and you can message and ask a lot of questions, and I asked so many questions. You technically, at least when I did it don't have to do day two of the muffins. Just a little fun fact.

Cynthia Thurlow: Oh, I'll have to check that out because I have a package of three and a package of two, and I just kept saying, “God.”

Melanie Avalon: Yeah. At least when I did it day two, it did not inform your personal results. It only informed their data collection. So, I was like, “Well, if it's not affecting me, I don't know if I'm going to--" But then actually, I did end up doing it because they were so delicious and I was like, “I want to repeat this experience.”

Cynthia Thurlow: Your fun Funfetti ZOE, that's hilarious. 

Melanie Avalon: Yeah, So, for listeners, we'll put a link to everything that we talked about in the show notes. Okay, shall we answer some listener questions?

Cynthia Thurlow: Absolutely. 

Melanie Avalon: All right. To start things off, we have a question from Deanna and the subject is: “IF and the aging menstrual cycle.” And Deanna says, “Hi, I have tried to search for answers on this. I googled, but I'm not finding any info from actual IF-ers. Only what Western medicine has to say. I've been doing IF for about three months. I started in February. I was really surprised at how simple it was right from the start. I thought, “Wow, I have finally found something that works” is totally doable and actually sustainable. Yay! I have been clean fasting since day three, which is when I learned what it was. Even the black coffee was a fairly easy transition. I originally thought it would be totally impossible and wasn't even going to try it, but I did and now, I crave my black coffee. I'm still amazed. That was one month-- One month ago, I experienced some cramping and a very short spell of bleeding. It stopped after a couple of days and it wasn't heavy at all, it was somewhere between spotting and light. But now, a few days ago, cramping again. Nothing sharp, but dull and constant, and the bleeding started again, but heavier this time around, also a longer duration for days so far. 

I thought maybe I'd worked too hard. I raked and burned leaves all day, Saturday and Sunday for 15 hours. I'm 52 years old. I had an IUD placed in January of 2018. I stopped getting a period entirely early mid-2020, which was awesome. I was told at the time of the IUD that I was in perimenopause and that by the time it would need to be removed, it's a five-year thing. I would likely be in menopause and would probably not have a period anymore. What are your thoughts about my resurrected period? I’ve a doctor appointment this week, it's about something else entirely, but I will bring this up. I'm just afraid the doctor will poo-poo my IF lifestyle. I feel IF has to be a part of what's happening, but I was hoping it was just making me age and reverse. Ha, ha, could that be true? I think it sounds reasonable. I would love to hear what you think about all of this. I know I can't possibly be the only one that has had this issue, but I asked in my IF Facebook group, and everyone thought it was really odd, they had never heard of such a thing, and they all told me to contact my doctor. I'll be watching for podcasts about this, but if you don't, no worries, I'll keep reading and searching for answers. Thank you for your time, Deanna.” So, this is a fun, interesting question.

Cynthia Thurlow: Yeah. Well, I have multiple thoughts. Deanna, thank you for your question. Being 52 years of age, here in the United States, the average age of menopause is 51. When your doctor placed, I presume a progesterone-related IUD, intrauterine device. You mentioned that you went two years without any bleeding, whether or not that is a byproduct of the IUD, I'm not sure. Could that have been menopause already? Not sure. And then you started having more bleeding. There's a lot of anecdotal evidence about women. When they start fasting, sometimes, they may get changes in their menstrual cycle either lighter, heavier, more frequently, less frequently, and I always give women the advice that to weather whatever is happening, meaning it could be your body, just finding a way to recalibrate hormones in a healthy way. Really the only way to know where you are and at 52, you're very close to menopause. What we typically end up seeing is, as women are at the tail end of perimenopause, for anyone's listening, 10 to 15 years preceding menopause starts in your mid-30s, mid to late 30s, you're there, and this is when we start to get this drop off on progesterone. We get some relative estrogen dominance. 

Women can have very different experiences in perimenopause. Some people breeze through it very easily, others really struggle through a variety of reasons. When you see your doctor, I would absolutely identify that you hadn't had any type of bleeding or cycles in about two years and whether or not that's a byproduct of the IUD. I'm not 100% certain. I have plenty of patients that don't get menstrual cycles while they're on the IUD. I have others that do sometimes have some ovulatory discomfort, although the closer you get to menopause, you're not ovulating every month. Could this have just been a quirky ovulatory period? Absolutely. But your doctor needs to run some labs. I actually have done quite a few podcasts on these kinds of topics. If you're not a listener of Everyday Wellness, most recently, I did two podcasts with Dr. Tabatha Barber. She's called The Gutsy Gynecologist. She's absolutely lovely. We talked about topics just like this. How do we find out where we are in perimenopause, are we in menopause, what's going on? The IUD is just a band -aid, so it can really mask knowing when that transitional period has occurred. They can draw an FSH, a follicular stimulating hormone, typically that needs to be drawn at least on two separate occasions. This is communication between the brain ovaries. And typically, when it's greater than 40 on two separate occasions, that can be a sign. It's not definitive that you are very close to menopause.

You can look at a DUTCH, a dried urine and saliva test and I've done a lot of podcasts with different experts talking about the DUTCH and the validity of that. But I think this is just one of those times where as your body is getting better balance, you're probably getting more insulin sensitivity, probably getting a little bit better balanced with your sex hormones, and better appetite regulation. You may see some changes in your menstrual cycle, but this is one of those vague questions. Meaning not that you haven't given enough information, it's just we need more information to be able to provide additional insights. But I would say Dr. Tabatha was a recent favorite. I actually did a podcast with Dr. Sara Gottfried recently. But if you do a Google search on my website, it'll bring up all the perimenopause and menopause-related podcasts that I've done. I can tell you from personal experience that a lot of women go from having super regular cycles to then having none, I've had women, as they get closer and closer to menopause, I've had a lot of other women that just start having more and more regular cycles, heavier, lighter, shorter, more frequent. For each one of us, it's really very unique. Sometimes, we can talk to our mothers to see what their experiences were like. But average age of menopause in the United States is 51. So, it's very likely you're very close to that period. Good luck. Do you have anything you want to add, Melanie?

Melanie Avalon: Well, first of all, I just knew that you'd be a wealth of knowledge about all of that. I'll just add two really quick things. I did find one really interesting review, especially because Deanna says, she likes reading and researching. It's called menstrual cycle variability and the perimenopause. It just talks about this whole transition, and process, and why those fluctuations might be happening. I always think it's funny when there's, what's the word, colloquial language, very casual language. The abstract is very scientific. It says, “another hypothesis is that the increased variability and that variability being the changes in your cycle” reflects “slippage of the hypothalamus, which loses the ability to regulate menstrual cycles at older reproductive ages.” Basically, the hypothalamus because it talks about how the dwindling pool of follicles is changing and creating changes. But I just love this concept of the hypothalamus. I don't know if I love the concept, but it's a funny concept to me that the hypothalamus is just--

Cynthia Thurlow: It’s a slipped gear. 

Melanie Avalon: Yeah. It's not quite handling the signals that are coming in and not quite sure what's going on, which would make sense with something like hormonal birth control or an IUD affecting those hormones and further exacerbating how the hypothalamus is interpreting what's going on. So, that would make sense.

Cynthia Thurlow: Do you want to know something interesting? In my book, I actually talk about the five phases of perimenopause, because there's just not enough research done in this area, but I'm getting ready to interview Dr. [unintelligible [00:46:49] Brighton, and there is some research to show that if you're on oral contraceptives for years and years and years, like many of us were including myself that it may actually hasten going into menopause. So, it's something that I'm going to talk to her about in greater detail, but the use of synthetic hormones may actually shorten that duration of reproductive years. I thought that was really interesting. For listeners, once I interview her, I will then feel more comfortable talking about that. But I do talk about in my book about perimenopause pretty extensively that there are these five identified phases of perimenopause. Do all of us go through each one of those neatly and nicely? Probably, not. But I love that you brought up the interrelationship between the HPA axis or HPO, hypothalamus pituitary ovarian axis. There were always constant communication and it's a slipped gear that it was working efficiently and now, it's like slipping a gear on a bike.

Melanie Avalon: That actually reminds me of, I would be curious if you have any thoughts on this. I interviewed Simon Hill this week. Do you know him? 

Cynthia Thurlow: I don't.

Melanie Avalon: The Proof Is in the Plants guy. He's really big in the vegan sphere. He was so nice. It was a really good episode. One of the things we're talking about, I don't remember why this came up, but we were talking about the role of reproduction evolutionarily, and how basically our bodies, the goal in our body from an evolutionary perspective is to have a child. And so, what I was wondering, I don't know if they've done studies on this and I haven't looked into this, but I wonder if you've had a child and you control for-- Let's assume that you have a child and you return, afterwards you regain your metabolic health to the same extent that you had it before. So, a healthy person who's equal levels of “health on both sides of a pregnancy” is her lifespan going to be shorter, because she's accomplished the goal compared to a woman who never has a child. If you haven't had a child as the body's still like, “We can do this.”

Cynthia Thurlow: These deep questions that Melanie comes up with I'm like, “I don't even know which angle to hit that from.” It's interesting because you'll see certain types of cancers are more prevalent in nulliparous, which means women who have not had a child.

Melanie Avalon: Oh, what's that word? I need this word in my vocabulary.

Cynthia Thurlow: Nulliparous. Yes, it's one of those weird, awkward medical words.

Melanie Avalon: Nulliparous. It a noun like I am nulliparous or it's an adjective?

Cynthia Thurlow: No, no, I am nulliparous or we would talk about a patient, this is a nulliparous female. 

Melanie Avalon: Oh, so adjective.

Cynthia Thurlow: Yeah. From my perspective, looking at it from the perspective of whether it's by choice or someone tried and couldn't does that put them at greater risk for certain types of disorders, cancers, etc. I come at it from a different angle. This is the thing I love about Melanie as my friend is that she comes up with such creative, interesting, refreshing takes on topics maybe that I've never even thought of-

Melanie Avalon: Thank you.

Cynthia Thurlow: -things I love about you, I'm like, “Oh, I hadn't thought about that before.”

Melanie Avalon: I love that you love engaging with the content or [laughs] just like, “Okay.”

Cynthia Thurlow: No, that's more to critically thinking. It's putting those thoughts out there.

Melanie Avalon: When I asked Simon about it, it wasn't the first time I thought about it. I think I thought about it a lot because I don't know, but I don't think I'm going to have children. And so, I'm so obsessed with longevity. I've thought about this concept a lot. Is this hurting or helping my longevity?

Cynthia Thurlow: I think I would probably guess it might help your longevity and I love my children. Let me be very clear. I was meant to be a mom, I'm happy being a mom, but there are moments in my children's lives that I know have hastened my longevity when I say this with love and reverence, I have a child who fell out of a second story window when he was two and had no injuries. Said same child when he was 10 years old-- 10, yeah, it was four years ago. 10 years old, coming back from all stars practice for swimming, fell off his bike and broke his arms, and needed emergency surgery, and walked in the house and his arms were concave, and I was like, “If any child has hastened my life, it's this kid.” I have no doubt there have been moments as a parent that have been terrifying and have likely killed off a lot of telomere length, and given me gray hair that I now pay copious amounts to cover up and that's a whole separate topic. But yeah, I would imagine it would probably help your longevity, Melanie. That's my guess.

Melanie Avalon: Oh, my goodness. Two quick things. One, he fell out of a two-story window?

Cynthia Thurlow: Yes. To give context to this conversation, this was the same week after his brother had fallen and broken his arm, and we had to take ambulance to a tertiary care center, because the hospital near my house would not reduce his fracture. My anxiety levels as a clinician were through the roof. Yes, and this child who we call him like MacGyver, he managed to open up a window out of curiosity, he was looking at something outside, pushed the screen and fell out two stories.

Melanie Avalon: Did you see him fall out?

Cynthia Thurlow: I did. I was sitting in the den and I saw a flash of red, and it was my two-year old, and it was the worst thing that's ever happened to us. 

Melanie Avalon: I can't even imagine.

Cynthia Thurlow: Yeah. And so, for listeners, he was fine. There was an ER physician walking her dog who was at his side and called EMS. I can get very emotional thinking about it. He was okay. We spent two days in the PICU and everyone was amazed, this kid did okay. From that point forward, I was like, “This kid is going to do big things,” because this could have ended very differently. I was an ER nurse, a trauma nurse. So, I've seen lots of horrible things happen with kids falling out of windows and the house that we lived in at the time any other window if he had fallen out if he would have fallen on something hard. 

Melanie Avalon: What did he fall on to?

Cynthia Thurlow: Grass. We had a bay window and so, he must have pitched himself in such a way that he bounced off of this other window, and then fell into the grass, and it had rained the night before. So, the ground was soft.

Melanie Avalon: Was he all scraped up?

Cynthia Thurlow: He had a scratch on his toe. When I say my kid is meant to do big things, [laughs] I have no doubt. But for the longest time, anytime, I heard an ambulance or a fire truck because the ER doc, who was at my son's side said, “If it were really bad, I would have called the chopper” and she's like, “You know that.” I was just like, “Whoa,” as a parent. Then the kid, when he was 10, fell and broke both his arms and had to go in for major-- He has plates and rods in his arms because he did such a bang-up job. I've told him, I was like, “Liam, I can't handle another big thing [laughs]. you have done it all.” Yeah. So, I think that being a parent is a wild ride and one that I'm grateful for. [laughs] I can speak from two experiences being a parent that have definitely aged my husband and we joke about it. We're like, “Yeah, he keeps us on our toes.” Actually, that's why we don't have any more children. We're like, “That was God's way of telling us we were done.” We have our hands full and he reminds us of that every day why he would never have been a middle child.

Melanie Avalon: Wow. Well, the second thing that reminded me up was, last night, I listened to Rhonda Patrick's newest episode. It's with a guy named Stuart Phillips. 

Cynthia Thurlow: Yes, I need to listen to that. 

Melanie Avalon: I really recommend it for listeners. It's a deep dive into protein intake and muscle. Really, really fascinating. A lot of stuff we talk about on this show. They talk about, do you really need the amount of protein that they say, and he argues that, yes, that dietary recommendations should not be called recommendations, they should be called minimal intakes. But he was talking about why when you're very young, you break a bone or something happens and kids, they don't need rehab or anything. The body fixes itself. And then when you're older, not so much. So, he just talks about that concept. So, I can put a link to it in the show notes. 

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Melanie Avalon: All right, shall we do one more question?

Cynthia Thurlow: Absolutely. This comes from Monica. Subject is: “Magnesium question.” “Can you share your favorite magnesium brand for sleep? I was using magnesium complex by Nature's Way. I ran out and I couldn't find it, and used another brand, and don't really care for it. Before I go looking for the Nature's Way, I wanted to see what you recommended. Thank you.”

Melanie Avalon: All right, Monica, thank you for your question. [chuckles] I always want to laugh when I get questions like this that are so perfect for what's happening in my life product wise. I feel like Cynthia I have to fill you in on all the inside jokes on this show. Gin and I used to laugh because one time we got an email from somebody who basically accused us of creating questions, making up questions to plug products or whatever and we were like, “If people knew how many questions we get, they would realize we would never need to [laughs] create a question.” We have hundreds of questions. But in any case, I did want to time this for this episode because I am currently this week. When this comes out, it will have already happened. But right now, the moment I'm in right now, we are launching my magnesium supplement this week, which is so so exciting. It's been such a long journey. That's with MD Logic. My first one, the AvalonX serrapeptase. This is AvalonX Magnesium 8 and then (broad spectrum complex). I know Monica's asking about sleep and I'm going to speak to that specifically because there is a certain type of magnesium that is better for sleep. 

But just in general, magnesium and my head has been literally yesterday was just magnesium all day. Researching, and writing, and getting together promo material, but basically, if you go into the literature on magnesium, it is shocking the extent to which this mineral is crucial for so many processes in our body. They used to say over 300 in somatic processes, but I found a really recent article, I think 2022 saying, actually, now it's over 600. It's involved in basically, every single cell, so a third of the magnesium is in our cells, two thirds-is in our bones, less than 1% is actually in our bloodstream, and the significance, on top of that it's actually highly controlled in our bloodstream. It's calcium. It’s how people will say that a certain diet might not affect your calcium levels and you can get a blood test and look at your calcium. But pretty much your blood calcium is probably always going to be in normal range. Things have to be really off for it not to be. 

The same is with magnesium, because so little of it is actually in the bloodstream. It might not be reflective of underlying deficiencies. It's so important. It's involved in energy production, creating ATP in the mitochondria, it helps create glutathione, so it can serve as an antioxidant, and then cardiovascular health, bone health, blood sugar control, muscle recovery, so many things, and of course, sleep, and mood. The AvalonX-- which was so exciting, you can buy this now. It is available. AvalonX Magnesium 8 will be great for all of that, it will also support sleep. So, Monica, definitely, definitely try that. On top of that there's a certain type of magnesium called Magnesium Threonate. It is actually a type of magnesium that specifically crosses the blood-brain barrier. It has an even more potent effect on sleep and relaxation. That would be something to consider. I'm going to be releasing a magnesium threonate probably next. So, stay tuned for that. I think we're going to call it Magnesium Nightcap or something. The reason Threonate is not in my blend is because you actually need a pretty high dose to get that therapeutic effect and so, we wanted it to be a separate add on type thing. But yeah, so basically, Monica, my recommendation is getting my Magnesium Spectrum 8, and then the Nightcap when it's available, and you can use the coupon code, MELANIEAVALON, and that will get you 10% off. So, that was a lot about magnesium. Cynthia, do you take magnesium?

Cynthia Thurlow: I do, I do. With my background in cardiology, I'm very mag savvy and I'm super excited about your new product. But if Monica is looking for something right now specific to mag L Threonate, while you're waiting for your next product to come out. I like designs for health. You're right. You do need quite a bit in order for it to be properly therapeutic, but that's actually the product I take before bed. I do take other types of magnesium during the day and I also fervently believe that people need both oral and transdermal magnesium to be able to absorb it properly. The product that I recommended to my cardiology, my electrophysiology patients, so people that were dealing with palpitations, and had defibrillator errors, and pacemakers, and all sorts of electrical issues with their heart, when I could get their magnesium levels more therapeutic, and then this started to work into all of my work with everyone. Everyone needs magnesium. There's no one listening who does not need repletion, we lose it when we're stressed, we lose it if we're having diarrhea, if we're having an acute illness. Certainly, when you travel, you're losing electrolytes. And so, I'm a big fan of transdermal applications. There's a company called Ancient Minerals. I have no affiliation with them. I just think they have high quality.

Melanie Avalon: I've used them before. 

Cynthia Thurlow: Yeah, they have sprays, they have lotions. I’ll typically recommend people spray. The oil is my first choice. Couple pumps into two hands, rub it on your trunk, your arms and legs, leave it on for 20 minutes. Use it before you get in the shower. You need about 20 minutes for absorption. When people do both of those things, they supplement with oral magnesium and they also use transdermal magnesium, they find that that is the perfect combination. For a lot of people, they need the additional, literally layer of magnesium to help them with sleep quality. Now, I'll be completely honest and say that when we get questions about sleep, there's so much that goes into sleep. Maybe we'll have to do a whole separate-- We’ll have to do a whole episode just talking about sleep modalities, because there are so many things that can impact our sleep quality. I know Mel and I are very, very proactive about our sleep and I feel I have maybe finally for myself found the right combinations and the right things that I do prior to bedtime and right before I go to bed that have really netted an impressive amount of improved sleep quality measured by Oura Ring data, etc. But I do think that using that two-pronged approach with magnesium is generally what I recommend. Transdermal and oral therapies, it sounds like Melanie has an amazing option right now. Magnesium L Threonate is the thing I think is so helpful for sleep and then using transdermal magnesium as well.

Melanie Avalon: Is it true? They say that this is why you experienced this and I experienced this that, if you put on a transdermal and it stings, they say it's because your skin is sucking it in so fast. That's why it stings. Do you know if that's true?

Cynthia Thurlow: Well, what I used to tell patients was that it was just validating that they needed more magnesium. Now, there are definitely people who are sensitive to magnesium. They'll feel tingly and it's uncomfortable. A little bit of tingle is expected. Really tingly, uncomfortable. 

Melanie Avalon: Mine was painful. 

Cynthia Thurlow: Yeah. Those people sometimes need the sensitive skin varieties of which Ancient Minerals has plenty of options. But I usually tell people, “It's just validation that you need to do this more often.” If you can tolerate, obviously, don't shave your skin and put it on. That would be torturing yourself. 20 minutes in your bathroom with your privacy, then jump in the shower. Some people don't like how it feels a little oily and I would say, just do it before-- I used to do before I would take a bath. I would literally just load up, do whatever I needed to do for bedtime, then get in the tub, then I would soak in more magnesium. I'm a little magnesium crazy. I'll admit after all the impressive things I saw it improve in patients, I was like, “This is something I need to commit to doing regularly.” But yeah, the tingle is generally a sign that needed the repletion.

Melanie Avalon: Gotcha. I'm glad you brought u, because I didn't even touch on how our modern lifestyles deplete our magnesium and-- [crosstalk] 

Cynthia Thurlow: Magnesium depleted soil. Just think about it. You could be eating all organic and you're just not getting the same nutrient profile that our grandparents did. It's just impossible.

Melanie Avalon: If you're eating conventional, specifically glyphosate, chelates, minerals. I know it can be controversial to talk about glyphosate. I literally read this in the PubMed scientific article I was reading.

Cynthia Thurlow: Have you interviewed Jeffrey Smith, yet?

Melanie Avalon: No. Ever since. [laughs] I feel so bad. I actually had it on my list to follow up with him. For listeners, he's a wealth of knowledge about GMOs, and glyphosate, and such.

Cynthia Thurlow: We'll plug my podcasts with him. But I interviewed him and the first thing I said to Melanie after I finished was, you need to interview him. He was just-- everything you wanted to know about GMOs, glyphosate in a way that is designed to educate and empower, and not scare the bejeebers out of you.

Melanie Avalon: What happened with that was he reached out to me independent of all of this and wanted to come on the show, and I got really excited, because I saw he had books on GMOs, and I was like, “Yes, I would love to do an episode on GMOs.” Then his people said, “Well, we really want to focus on his current work,” which was a little bit political and based on current events. I was like, “I just don't know if it's the best fit right now,” because this was a while ago and this was in the heat of a lot of political stuff. I don't think I really realized who he was. If so, I think I would have handled that differently and I reached back out to him ever since you told me about it, but I haven't heard back. So, I need to reach out again, because I really want to interview him now.

Cynthia Thurlow: I think you'd really like him. I know your listeners would really enjoy that conversation, too.

Melanie Avalon: Yes, to-do list. And then I will say just one last thing before we go. All the supplements that I make, I really wanted to make the best form of the supplements on the market and only what I would want to put in my body. It's free of all potentially problematic fillers, it's tested for allergens, super, high-quality, it has activated cofactors to help absorption, so, it has methylated B6, and then it has chelated manganese, because magnesium can actually reduce your manganese levels, so, it's to help with that. Definitely the way to go and that is again, avalonx.us, not to sound like a commercial. But this was absolutely amazing. I've missed talking to you, Cynthia, because it's been so long.

Cynthia Thurlow: I know. But the cool thing is, we're recording a second episode right after this.

Melanie Avalon: I know. [laughs] So, here we go. Well, this has been absolutely wonderful. 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. You can get all the stuff that we like at ifpodcast.com/stuffwelike. You can follow us on Instagram. I am @melanieavalon, Cynthia is @cynthia_thurlow_ and we are @ifpodcast on Instagram, and I think I'll open up next week with something that we're talking about sleep. I started using something that I think has had a massive influence on my Oura Ring. So, maybe I'll start with that. All right, well, for listeners, this has been absolutely wonderful and I'll talk to you next week. But I'll actually talk to you right now. [laughs]

Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.

STUFF WE LIKE

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

TRANSCRIPT

Melanie Avalon: Welcome to Episode 272 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, biohacker and author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my cohost, Cynthia Thurlow, Nurse Practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us, check out ifpodcast.com, melanieavalon.com, and cynthiathurlow.com. Please remember, the thoughts and opinions on this podcast do not constitute medical advice or treatment and no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup of tea, or even a glass of wine, if it's that time, and get ready for The Intermittent Fasting Podcast.

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Of course, it is important to remember that CBD works differently for everybody based on your own unique cannabinoid system, so, you might need to work to find your perfect dose. Experiment over the course of a week or so, and you may find that you need more or less depending on the effects that you're looking for. I'm also super grateful because they have an incredible offer for our audience. You can start feeling better with Feals. Become a member today by going to feals.com/ifpodcast and you'll get 50% off your first order with free shipping. That's FEALS dotcom slash IFPODCAST to become a member and get 50% automatically taken off your first order with free shipping. feals.com/ifpodcast. When you get that offer, you'll be joining the Feals community and you'll get Feals delivered directly to your doorstep every month. You'll save money on every order and of course, you can pause or cancel anytime. So, definitely try it out for the first month with our code for 50% off and see how it works for you. 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 disrupters, which mess with your hormones, carcinogens linked to cancer, and obesogens, which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream. And then in our bodies, studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat, and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that. Beyond weight gain and weight loss, these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies, when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so, so shocking and the effects last for years. 

Conventional lipstick, for example, often tests high in lead and the half-life of lead is up to 30 years. That means when you put on some conventional lipstick, 30 years later, maybe half of that lead has left your bones. On top of that, there is essentially no regulation of these products on the shelves. That's why it's up to us to choose brands that are changing this. The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin, so, you can truly feel good about what you put on. And friends, these products really, really work. They are incredible. They have 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 on my Instagram to see what it looks like. Tina Fey, even wore all Beautycounter makeup when she hosted The Golden Globes. So, yes, it is high-definition camera ready. They have so many other products, deodorant, shampoo and conditioner that I love, products for babies, and so much more. You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. Also, make sure to get on my clean beauty email list, that's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. So, definitely check it out. You can join me in my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well. 

And lastly, if you're thinking of making Clean Beauty and Safe Skincare, a part of your future like we have, we definitely recommend becoming a Band of Beauty member. It's sort of like the Amazon Prime for clean beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally, completely worth it. So, again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.

Melanie Avalon: Hi, everybody and welcome. This is Episode number 272 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with, Cynthia Thurlow.

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

Melanie Avalon: I'm good. How about you?

Cynthia Thurlow: I'm great. In three days, I will be on vacation with my family. 

Melanie Avalon: This is very exciting. 

Cynthia Thurlow: It is really exciting. The most exciting part that I've realized is that now, my children are old enough that they have to get all their clothing and all of their things together without my help. 

Melanie Avalon: Oh, that's nice.

Cynthia Thurlow: It’s a huge milestone. For 17 years, I've been packing four people for trips and now, technically, I'm guiding two, and I'm only packing one, and that's very exciting.

Melanie Avalon: I should after this call my mother and thank her for all the time she did that. [chuckles] I think my favorite part of traveling when we were little was everything, she would pack us for the plane ride.

Cynthia Thurlow: I used to do all that. Now, I've got two surly, yet wonderful teenage boys. Other than making sure, I've got one EpiPen packed and a couple sundry things. They're very fairly independent. Let me make-- I provide that qualifier. But I'm Marvel now when we get on planes that I don't have to-- Let me just backtrack. When you have younger children, it's like, “I don't want them to have a poopy diaper, I don't want them to make a lot of noise, I don't want them to scream.” Now, they are quiet, and they either eat or they're attached to their iPads, and it's very pleasant. Very, very pleasant.

Melanie Avalon: Does one of them have a life-threatening allergy?

Cynthia Thurlow: Yes. My 16-year-old has peanut and tree nut allergies. If I had to pick a child to have a food allergy and I would not, of course want either of my children to have a food allergy, but he is by far the most conscientious of the two. And so, he navigates pretty well. Very responsible. Now, he's at the age where he can carry his own EpiPen, but I always have a backup. He navigates his carnivorish world really nicely. And so, when we travel, it's always the-- Let's hope it's the airline that doesn't serve peanuts as a snack.

Melanie Avalon: Are there airlines that still serve peanuts?

Cynthia Thurlow: Occasionally, I see that and I generally, when I get on the plane, I just politely ask. [chuckles] There is a person on the airplane that an aerosolized peanut could be a problem if you're on a long flight. I have never had a problem. People have always been super respectful of that, thankfully.

Melanie Avalon: What will set it off?

Cynthia Thurlow: Well, it's interesting. Every couple of years, they do RAS Testing, which is really looking at provoking the inflammatory response in the blood. And so, what's been interesting is that his results have never gotten better over the years. It's like in the hierarchy of nuts, it's like walnut, and hazelnut, and then peanut, and then almonds don't even register, but I just don't ever want to take the chance. And so, from our perspective, he's only had one confirmed contact with a tree nut, which was probably, I don't know, eight years ago, and he vomited violently, and had some wheezing, and it was all incredibly scary, and then, actually had a second exposure, even though we were really diligent when we went to a restaurant explaining what his allergies were. He had the whole like his lips started to tingle, and his tongue started to tingle, and then of course, we go down the rabbit hole of, “How far away from a hospital? Making sure we have the Epi Pen and trying to get things on board to help quiet the inflammatory response, the histamine response,” and it's scary. 

It's interesting because teenage boys are the most likely to trigger an anaphylactic episode because they think they're completely impervious to anything. Their frontal lobe isn't fully developed and I worry more about him when he starts navigating life outside of our house, and dating, and the exposures he can get there, and his allergies have never gotten better. When we looked into peanut desensitization, he would have to do it for the rest of his life like you do a series of these immunological therapies and then it resolves itself, it's like forever, and he said, “I don't want to do that.” He's like, “I'd rather just avoid.”

Melanie Avalon: One of the last serving jobs that I had and this was in LA. It was at a really nice steak house and one of the managers had a peppermint allergy. They said, “You can't have peppermint.” My thing, as listeners know and I might have told this story on the show before. I'm obsessed with my peppermint breath spray. I make it out of peppermint essential oil and water and it's like a thing on this podcast, by the way, people make it. We have links to the way I make it in ifpodcast.com/stuffwelike. I have this spray with me all day, every day. I use it all day, every day. I have an oral breath, fresh breath fixation. They said, “You can’t have peppermint” and I was like, “Okay, but I can have peppermints?” I was like, “It can't be that big of a deal.” All he did was use the peppermint spray while working and he had to go to the hospital. I was like, “Oh.” Then it was a running joke and they're like, “It's fine. It's not a big deal. This happens with new servers.” [laughs] I felt so bad. I felt terrible. I brought him the next day, massive gift of like, “Wine?” He's like, “I can't accept this.” I was like, “You have to. [chuckles] I'm so sorry.” So, yeah, that stuff can be serious. 

Cynthia Thurlow: It really can be. Had I not seen the impact as a nurse in the ER many years ago, I would never have understood how significant it can be. I just saw too many anaphylactic episodes. For anyone that's listening, this isn't familiar with that term. It's the most life-threatening response to an allergen and unfortunately, we're seeing more and more of this. Only 30% of kids outgrow their food allergies. It's a really small percentage. There're so many people navigating, young adulthood, and adulthood with food allergies. And so, yeah, it's surprising how the body can manifest exposure to specific allergens. It's really humbling quite honestly. Like, “Had I not had a child with a life-threatening food allergy?” I think my life would have been very different because it changed everything for me. I just didn't view the world as a safe place anymore. When I kept thinking like, “We could go anywhere, and he could get an exposure, and what's going to happen?” I don't want to be jabbing my two-year-old with an EpiPen. Obviously, I would have done it if I needed to. It definitely can be frightening as a parent and I think it's one of those things unless you've experienced it like you did with your boss, you probably can't even appreciate how significant it can be.

Melanie Avalon: Yeah. In a way, I'm glad that I had that experience, because I will really, really respect that going forward. Now, I'm just thinking, I bet in the future of healthcare way down the road. I feel they'll probably come up with something where they literally-- I understand that the allergy desensitization is this technique, but I wonder if in the future, there'll be a process where it literally just tells the immune system, “Hey, this isn't a big deal” like an instant shift. 

Cynthia Thurlow: I hope so. I just think there are a lot of families that are navigating. I know I felt fear and overwhelm even as a healthcare professional because my son’s allergist resounding words were, “Carrying EpiPen and pray.” I was like, “Who wants to hear that when they find out their two-year-old has life-threatening food allergies?” It's the last thing you want to hear. There're plenty of people that are hearing the same information from their allergist. Hopefully, there's something coming, there's some amazing, amazing immunologist, allergist out there that's going to revolutionize the way that we look at food allergies.

Melanie Avalon: I bet there is. Did you read Dr. Jason Fung’s, The Cancer Code?

Cynthia Thurlow:  I did.

Melanie Avalon: This was not allergies. But I feel the last part of his book had a really interesting information about immunotherapy for cancer, and just modulation of the immune system, and such.

Cynthia Thurlow: Yeah. It's interesting because it's such a departure from the conventional allopathic model that has been the norm over the last 50 years. I think Jason's brilliant and I'm so glad that he got people interested in having different types of conversations around cancer therapies because-- Did you interview? Why am I drawing a total blank, Sam Apple? 

Melanie Avalon: No.

Cynthia Thurlow: He brought back Warburg's research on the cancer model that is more aligned with Jason Fung’s book and was moving away from DNA-based or genetic-mediated types of cancers. He was a Jewish scientist in the midst of World War II and for some reason, Hitler took a liking to him and allowed him to continue his research. The book is really interesting. I'd love to share it with you.

Melanie Avalon: Wait, how old is he now? Because you asked me if I interviewed him?

Cynthia Thurlow: He's dead. Yeah, and then at Warburg-- Sam Apple is the author.

Melanie Avalon: I'm so confused about this timeline. [laughs] 

Cynthia Thurlow: Sorry. No, Sam Apple is the author and he's a research scientist. Yes, Warburg is the-- [crosstalk] 

Melanie Avalon: Oh, what is his book called? Does it the word Warburg in the title?

Cynthia Thurlow: I'm terrible with names. Melanie knows this about me. It's a struggle. I've been this way my whole life. Sometimes, I have these moments where I'm like, “I can't remember.” I can see the cover I’ll have to share it with you separately.

Melanie Avalon: Ravenous: Otto Warburg, the Nazis, and the Search for the Cancer-Diet Connection.

Cynthia Thurlow: It was very interesting.

Melanie Avalon: That sounds like a health page turner.

Cynthia Thurlow: Sometimes, a lot of times, Melanie and I, our podcasts overlap with guests and sometimes it doesn't. But I kept thinking, I was like, “I don't know if you've interviewed him.”

Melanie Avalon: I have not. There were some moments in Jason's book, where I was like, “Dah, dah, dah.” I was so invested. He does really nice reveals. The nuance that I didn't realize until reading his book was that the big paradigm shift that happened with Warburg was re-understanding because basically, the Warburg effect is the idea that cancer cells use-- They use glycolysis. They're running on glucose rather than fat. Jason talks about how they're actually-- it's not because they can't burn fat, it's because they're choosing to burn sugar, which is very interesting to me.

Cynthia Thurlow: Well, and you think about in the 1950s as Crick and Watson discovered the DNA Helix. That really shifted research in a totally different direction. And so, yeah, we're coming back to a principle that has been around for 80 years that largely had been left unrevealed, undiscovered, rediscovered, I had to think about.

Melanie Avalon: Hiding, I don't know.

Cynthia Thurlow: Hiding. Hiding probably because of the context in which that research was ongoing. 

Melanie Avalon: Oh, yeah, literally hiding. 

Cynthia Thurlow: Yeah. [laughs] 

Melanie Avalon: Well, for listeners, we'll put links to all of this in the show notes. And again, the show notes will be at ifpodcast.com/episode272. 

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Melanie Avalon: Shall we jump into everything for today? 

Cynthia Thurlow: Absolutely. 

Melanie Avalon: All right. To start things off, we actually have some listener feedback and this comes from Sarah. Sarah says, “I want to thank you. Several months ago, I got a CGM from NutriSense and I realized my fasting blood sugar was higher than it should be. The NutriSense dietician was encouraging me to eat breakfast earlier to help with high blood sugar in the morning. I just knew that couldn't be the answer. For months, I reached out to you, Benjamin Bikman, Cynthia Thurlow, and another doctor. I just couldn't figure it out. I heard your interview with Dr. Rick Johnson and that was so amazing. Then you guys talked about an interview with Peter Attia and David Perlmutter, and that was also amazing. I bought Nature Wants Us to Be Fat.” And for listeners, that is Rick Johnson's book. “Guess what changed. I started drinking more water and stopped eating dark chocolate with sugar at night. Well, I cut out all sugar, I also started taking vitamin C. That's it. I have lowered my blood sugars to the mid-90s. I couldn't be happier. This could have potentially been so bad down the road and so much harder to deal with.” So, that's some pretty cool feedback from Sarah. For listeners, I had Rick Johnson on the Melanie Avalon Biohacking Podcast. Cynthia had Rick Johnson on Everyday Wellness. 

I said last week that it was going to be this week, but I was incorrect in the lineup. Next week, Rick Johnson is actually going to be on this podcast. This is a really great teaser question for next week's episode. You definitely want to check it out, but Rick has some very, very interesting information surrounding the role of sugar, and fructose, and metabolic health, and in particular, Sarah was talking about some things that he talks about to help with all of that, particularly, the role of vitamin C. But super happy for you, Sarah that you're able to solve the issue. And also, I like the feedback about how-- because if you haven't a CGM from NutriSense, you do get to work with a dietician who can help you with your results, and what they mean and make suggestions. It's nice that Sarah was able to work with them, but also knew that for her personally, those suggestions weren't probably going to-- they weren't what resonated with her. So, I'm glad that she was able to find something that did work. Do you have thoughts, Cynthia?

Cynthia Thurlow: No, I think it really goes back to bio individuality the N of 1. The recognition that it may take multiple changes to your lifestyle to see some significant improvements. I'm sure the hydration and the reduction in processed sugars really made a big difference. One thing I want to point out that Sarah mentioned was that she stopped eating chocolate at night. And so, it's probably a good reminder, just to remind people that we have more insulin sensitivity during the day. If you're already leaning in the direction of insulin resistance or you're noticing your blood sugars are higher, you really want to be examining, like, how close to bedtime you're eating, what you're eating for your last meal, and sometimes, if you're deciding to have more discretionary carbohydrates, maybe easier and better to do that earlier in the day.

Melanie Avalon: Awesome, awesome, awesome. I think the vitamin C piece was because it lowers uric acid, I believe, I think that's the connection with that. So, again, listeners, tune in next week to learn more.

Cynthia Thurlow: I love Rick Johnson. I think resounding. I say to everyone, he's one of the most delightful interviews I've had easily in my podcasting career. He's just infectious everyone. That's my number two downloaded episode of the year. I'm not exaggerating.

Melanie Avalon: I should go and look at my stats.

Cynthia Thurlow: I'm very OCD about that. That's why some people come back multiple times. I'm like, “Your content really resonated and I need to bring you back.”

Melanie Avalon: I should probably do that. Yeah. I rarely look at the numbers. I probably should.

Cynthia Thurlow: I don't know. I'm very competitive with myself. It's like, I want to know each month that there are more people curious and interested and it allows me to see what content really resonates. Obviously, I think you're the same way. You wouldn't bring someone on The Biohacking Podcast unless you were super interested in them as an individual in their work, in their research. But it's always amazing to me, there are sometimes surprises, sometimes, I'm surprised by something will really resonate or other times, I'm like, “Oh, my gosh, this is the best interview” and then it doesn't get as much downloads. And so, I just find it all fascinating.

Melanie Avalon: I was just thinking about that because I was thinking about how people I bring back, it's honestly, it's based on who I really like. I know I've brought back some people that-- Again, I'd have to go look at the numbers, but my gut tells me they probably weren't necessarily the highest in the numbers, but I just really wanted to talk to them again. Yeah, it's an interesting balance. It's really fun. I think it's really fun like how we get to choose the lineup, really creating shows.

Cynthia Thurlow: Absolutely, absolutely. Speaking of amazing people that I know you've had on twice, I've had on twice. Robb Wolf, I could talk to. He's another person I could just talk to you for hours.

Melanie Avalon: Between the two shows, I think it's been, is it four? It's definitely three. He can come on anytime. I'll just have The Melanie Avalon Biohacking Robb Wolf Podcast.

Cynthia Thurlow: That's awesome. He's such a cool guy. He’s just so humble, down to earth, and just a great human.

Melanie Avalon: I know. Oh, and that was super fun. Cynthia and I both got to interview Mark Sisson last week and it was back-to-back.

Cynthia Thurlow: Yeah, we had an embarrassing kerfuffle on my end, which I'm grateful that I have a friend who intervened immediately, but there was a miscommunication between my podcast team member and what time Mark said he was available. And so, I was on the fly. [laughs] I think it turned out fine, but it was one of those things where you can't apologize enough when you're leaving someone at that level in their business wondering what you're doing. So, anyway, I think it'll all be fine. But still, it was a little embarrassing.

Melanie Avalon: Yeah, you and I talked about it right after it happened. I just would have been so flustered in my head, but I'm sure he probably didn't think about it nearly as much as you did.

Cynthia Thurlow: No, he's probably like amateur. I think it was fine. I agree with him.

Melanie Avalon: What's really interesting about him is, I was thinking beforehand, because I've been a follower of him for so long. I know Elle really well, I know his coauthor Brad really well, but I've never met him. I had an idea of what I thought he was going to be like and he was exactly what I thought he was going to be like, which was I thought he was going to be just really nice and just really, really energetic. Because I feel with people and interviews, everybody who I've had on has been so gracious and lovely. But sometimes, you get the sense that I thought with Mark, I didn't feel I was going to get any sense that this was out of his way or anything like that. This is what he does. I just thought he'd be all energy, and all in, and that's that was really the vibe I got, which was very inspiring, because I think he's 76? Oh, 67, 67. 

Cynthia Thurlow: 69.

Melanie Avalon: 69. Well, not 76. Sorry.

Cynthia Thurlow: Yeah, no. I was going to say, if he's 76, it looks pretty dang good. He was delightful and humble. I loved that. He is very committed to his family and the tail end of our discussion was about, how did you find balance with your family? Then he gave some really great insights and certainly, things I got off and I was just like, “Wow, the greatest gift you can give your loved ones is time.”

Melanie Avalon: Yeah, I love that. All right, shall we go on to our next question?

Cynthia Thurlow: Absolutely. This is from Sia. Subject is: “Help me please.” My name is Sia. I'm 41 and pretty sure I'm pre-menopausal. My thyroid is a tad off and I'm trying to correct that. I started fasting November 15th, and I started at 167 pounds, and here it is April 23th, and I weigh 162 pounds. I've always been a healthy eater, I switch it up with OMAD and ADF, and feel tired all the time. It's been hard to workout, I'm sure because of thyroid. I listen to your podcasts, and I've read your books and others from Dr. Fung. I know we're not supposed to compare ourselves to others, but I feel I'm seeing super slow results. Can you give me some tips or what your thoughts are? Sincerely, Sia.

Melanie Avalon: All right, Sia, thank you so much for your question. First of all, with the thyroid stuff, I'm super curious. This is a good thing to talk about just for listeners in general. The hypothyroidism issue can be a really tricky one to tackle and I think it's really, really important to work with a practitioner who's really knowledgeable in making sure they are addressing it correctly. By that, testing all the levels they need to be testing. The free T3, the total and free T4, the TSH, the reverse T3, Elle Russ has a really great book called The Paleo Thyroid Solution. For anybody who wants to get, I believe the most comprehensive overview of hypothyroidism, and what you need to be testing, and how diet affects it. I've been texting her this week about my own panel, because the doctor and I was telling Cynthia about this as well. I've been working with a conventional doctor on my-- because I have hypothyroidism and I'm on thyroid medication. This has been a whole experience just hitting home again, how important it is to take agency in your own health and your relationship with your doctor, and the labs that are being drawn, and stuff like that, because I've been working with conventional doctor for a while on my thyroid and I was working with her, because I found her within my insurance plan, and she actually was open to testing everything, and what she was prescribing me was what I also thought I should be on, and I was feeling good. 

But actually, the most recent time around, she changed my dosage. I was telling Cynthia about it. But basically, it was incorrect. The way she changed, it didn't make sense math wise for what she was trying to do. All of that to say, I'm all over the place right here. But I think it's really, really important to work with a practitioner who really can help you. I'd be curious, Sia, when you say, it's off. I'm wondering in what regards it's off. Is it what are you low in, how are you addressing it, is it with the medication and how is that being adjusted? And then all of that to say, but I'm super curious to hear Cynthia's thoughts on this. But if you're struggling with hypothyroidism and this issue, it sounds you're doing a lot of fasting and I probably would not be doing all of that fasting, especially like the ADF. What are your thoughts?

Cynthia Thurlow: Oh, I have so much. For full disclosure, Sia, I also have hypothyroidism, probably have Hashimoto’s, but I've never had positive antibodies, probably, because we're gluten free. There's a lot that I think about. When someone's in perimenopause and we're talking about hormesis, which is this hormetic stress in the right amount at the right time, there are a couple things that I think about. You mentioned that your values are off and I don't have a sense of what your labs were, but we have to think comprehensively. We have to think about what's your sleep quality, are you exercising, are you eating an anti-inflammatory diet? We know with an autoimmune issue you really have to work on gut health. I don't know, if you're just on synthetic medications like Synthroid. And if you are, that's totally okay, that's synthetic T4. But if your body can't actively convert T4 to the active form of thyroid hormone, which is T3, that could explain why the way the scale isn't really budging and why you're so tired. 

But the fact that you're so symptomatic, you're very tired. That should be a clue that you need to back up the bus, I would stop doing this really long fasts because in and of itself that is a stress to the body. I would absolutely positively work with a thyroid specialist, whether that's an endocrinologist, an integrative medicine, or an open-minded primary care provider, and make sure that they're looking at cofactors. I would ensure they're looking at iodine, and magnesium, and zinc, and your B vitamins, and looking at inflammatory markers. I see a lot of women that in early perimenopause are becoming insulin resistant and it could very well be. It's a combination of multiple factors that are contributing to why you feel so poorly. Weight loss resistance is more often than not, because of multiple factors. It's not just one factor. I think this really speaks to doing more digging. I would imagine it is not just your thyroid. It could also be adrenals, it could be low progesterone in relationship to estrogen, it could be your sleep quality. Don't give up hope, you just need more information, and I would absolutely positively back off on those long fasting windows. There's just no way you're going to be able to get in enough protein in one meal a day to be able to properly feel your body at this point. It sounds the fatigue is what you really need to use as your gauge. You can do fasting when you're not quite so tired. Then, it might just be that you start with a 12-hour window of not eating and slowly opening that up. But I really do fervently believe that you need more information. 

I love Elle’s book. Elle is a fantastic resource. I also think about and I'm turning my head to look, because I have a bunch of thyroid books. I actually did a reels on this talking about my favorite thyroid resources. We'll put the list of books that I generally recommend. I've got four or five. But I think Elle Russ' book is an excellent first choice to help educate you. She's all about empowerment and she really comes at it from the perspective of she suffered for years because she was navigating a world in which they weren't looking at the full picture. I think it's important to really understand, like, a full thyroid panel is a TSH, it's a free and total T3 and T4, it's a reverse T3, its antibodies. You can split hairs beyond that, but it really is important to have all those factors. If you're on medication that is not supporting your body adequately and you're not getting the right labs, not the errors on your part, but the practitioners are not ordering the right labs, it may not illuminate what is going on and giving you the full picture. So, good luck and definitely keep us posted.

Melanie Avalon: I actually emailed my doctor and I sent her, I was like, I don't know how she's going to take this, but I sent her a really long thing. I tried to approach it to her as not me saying like, “This is the way it is,” but saying like, “Oh, I'm curious about this. What do you think about this?” It was resources surrounding-- A discussion we had been having, because her concern, for example, and Elle was telling me about how this is such an issue is. Oftentimes, when people are on thyroid medications, if they're on T3 medication, it can or it should in a way suppress their TSH. And so, doctors treat to not lower the TSH, and so, then they can possibly keep patients in a hypothyroid state when arguably the TSH should be lowered when you're on T3 supplementation. So, that's a little bit of a nuance and I don't know if it's relative at all to Sia’s situation, but it could be something to consider for people. 

Cynthia Thurlow: I think it's really hard. I have to be honest I have functional training and I can tell you that if I had not been seeing an integrative medicine provider at the time of my diagnosis, I probably would have been left floundering for a few years. There are still individuals that are open-minded. I know Melanie works with someone who takes insurance that's open-minded. These unicorns do exist. Another resource that I generally direct people to is www.ifm.org, where you can look for practitioners in your area that have functional medicine training and tend to be a little bit more open-minded. I certainly have done a lot of podcasts with thyroid experts, some of whom are clinicians. Recently, it was Dr. Amie Hornaman is one. I know she works throughout the United States, I think about Dr. Eric Balcavage, who's wonderful and has a new book coming out. I think about Elle and there's someone else that we have scheduled for the podcast that's coming out this fall. But there's definitely a lot of resources. Dr. Amy Myers has a lot of resources online. Like I mentioned, I will make sure that we put it in the show notes. Some of the books that I give like a stepwise progression, because I probably have every book that's out there on thyroid. The ones that I think that I reference the most for patients, the Elle’s book is a great, first step for sure.

Melanie Avalon: Awesome. Again, we'll put links to all of that in the show notes and the show notes have a full transcript as well. All right, so, the next question, actually, the good question to piggyback on that. This comes from Gab and the subject is: “Podcast question.” And Gab says, “Hi, I have PCOS, hypothyroidism, and Hashimoto’s. My Hashimoto’s antibodies have gone down. So, it feels I'm mainly dealing with hypothyroidism and PCOS now. I love eating keto because it finally makes my chronic inflammation go down, my bloating has resolved, and I don't feel as swollen. However, I feel very restricted and limited with the way I'm eating and I'm still not losing fat. I have a huge laundry list of food sensitivities and allergies due to my Hashimoto’s, and I've been feeling so much better after staying away from all the foods that came back reactive from the test. I do take HCl and digestive enzymes along with one berberine a day at my meal, which is always in the evening. Melanie and I are very alike. My eating window is later at night. 

I'm in a bittersweet spot. The information of knowing my trigger foods for sensitivities is helpful, but now, I feel I have to eat this careful and clean forever just to feel okay. I'm trying to lose six to 10 pounds and the fat won't come off. I'm only 5’1”. Even two pounds is very noticeable for me and physically uncomfortable. I've heard you talk about this before on, “what exactly is the body running on if carbs are low?” I stay away from all processed foods and PUFAs, and I've been doing protein-sparing modified fast days here and there. My fat is also not high because I know eating high fat can stall fat loss. Nothing is working. The stubborn fat I'm trying to lose is on my arms and thighs. What is going on if my body is not using fat stores as fuel and energy, what am I running off of then? I'm in no way eating at a calorie surplus and I'm definitely not eating enough to maintain either, yet, here I am maintaining or gaining. Am I just doomed because of my hyperthyroidism? I'm finally on a medication that is starting to make me feel a little better each month. I take LDN, a B complex and I am constantly searching supplements and protocols. I take magnesium and CBD at night etc., etc. I do Pilates, lightweight training, walking, and yoga. When I used to do heavier weights training, I bulked up. This is probably due to my PCOS and the fact that I am testosterone and DHEA dominant. I know this probably means cortisol is my root issue. 

Does this mean my body refuses to lose fat because I'm running off cortisol? My body feels best when I'm doing low impact workouts and walking. It still is infuriating because I'm not eating enough and I know starvation mode is half myth, half reality. But you said it best on one of your pods, “you just can't gain fat if you're not eating enough to gain.” I've heard high insulin could also cause fat retention, but my insulin isn't a problem. I got a NutriSense CGM sent to me. I'll be setting up that soon to see what's happening. Please help. I feel hopeless, and helpless, and that my metabolism is permanently shut down. I love you both and I've been binging both of your podcasts. No pun intended. I'm losing my mind. I just want to lose the last pounds of fat, but nothing I do works.”

Cynthia Thurlow: Oh, Gab, I have to tell you. When I read this before we got on today and then listened to Melanie share your podcast question, you need to give yourself some grace. I sense that you're really, really hard on yourself and I don't know how long you've been on this journey. I think that sometimes when I sense that patients are really frustrated, we have to really simplify things. There is the power of our minds and I think that we have to look at things from different angles. When we're talking about weight loss and it's something we want really badly, I always remind people that we have to get our bodies better balanced in order to lose weight. I know that that's very often. The point of frustration that people as an example will come to me and say, I want to lose weight, but really, it's all the other things going on. I don't know how long you've been fasting, I don't know if you're doing OMAD, you've mentioned several times in this question that you are concerned you're not eating enough. The concept of your body perceiving that there's not enough food coming on board can absolutely positively-- negatively impact your metabolism. 

I think that we have to be very, very clear that if you're eating at a caloric deficit all the time, and you've got thyroid issues, and you've got some PCOS, and you've got food sensitivities, and you're being really strict with your nutrition, and you're doing this exercising, it tells me that there's a degree of intensity that needs to first be backed off of, but I don't know your age. So, I don't know if you're still in your peak fertile years or you're in perimenopause or menopause, but there's a lot to unpack. I think it really needs to really reflect on simplifying your program, because this degree of intensity is telling me that you're putting your body under an incredible amount of stress, whether you recognize it or not. If you're in the hierarchy of hormones, as I know, Melanie's talked about and I've talked about a lot on podcasts. If cortisol is up, glucose is going to be up and your body is really going to struggle on a lot of different levels. When I work with PCOS patients, yes, sometimes they do very well with a 12-hour, 13, 14-hour period during the day where they're not eating and maybe they do well on low carbs. So, it doesn't mean everyone does well. 

I had Dr. Sara Gottfried on recently and I know Melanie also recently interviewed her. She talks a lot about that there are women, who due to their own genetic makeup do need some degree of discretionary high-quality carbs in order to get that proper T4 to T3 conversion, so, inactive to active thyroid hormone. I think there's a lot here to work with, but I think you also need to start giving yourself some grace. I don't say that to be flippant or unreceptive, because I've been that person, the scale was stuck, and I was frustrated, and I'm not a very tall person. I'm only 5’3”. So, I completely understand that. But at one point and certainly with myself personally, we had to level the playing field and start over and it may be that you need to back off on the intensity of what you're doing. The last thing that I just want to add is depending on how old you are, Melanie is a very young, metabolically flexible woman. Melanie can eat late into the evening and it works for her. But I find for women as they're getting closer to middle age, and certainly, I'm 50. I'm at a different life stage. That doesn't work as well. We know we're less insulin sensitive during the evening and that might be another reason to reflect on when you're eating, what you're eating, and being a little bit kinder to your body. Lean into the lifestyle, give yourself some grace, maybe there's value in working with a practitioner who's going to be able to look at a whole system as opposed to just one issue related to having an underactive thyroid and PCOS. But all these pieces of the puzzle will fall into place eventually. 

Melanie Avalon: Yeah, I thought that was an incredible answer. I could not have said it better. I have quite a few thoughts and they all are very similar and echo what Cynthia said. It's a really good question. You keep asking, if you're literally not eating enough to maintain or gain, how are you maintaining or gaining? That's a reality where if you are maintaining or gaining, you are eating enough to maintain or gain, but it might not be because you are eating a lot. It's more likely the hormonal system that your body is in, and it's learning how to adapt, and how to deal with what you are taking in. It can feel like, no matter how much you restrict, your body's going to just maintain at that or you're saying gaining. It's really, really interesting, especially the more I learn about, the book I'm reading right now, I'm really excited. I'm going to be interviewing-- Do you know Ari-- Is it Ari Whitten?

Cynthia Thurlow: Yes, he's on my schedule.

Melanie Avalon: Okay. Are we both for his Eat for Energy? Have you read the book, yet? 

Cynthia Thurlow: Mm-mm.

Melanie Avalon: I’ve just started it. A lot of it is talking about the mitochondria and it's just making me realize more and more how-- Because the thesis thus far, I just started the book. But the primary thesis is that chronic fatigue and all of these health issues really the root of them is in the mitochondria. If the mitochondria are not producing energy or shutting down their energy production, we're going to have all of these experiences. That's a very hormonal thing. The mitochondria not producing as much energy as they should be, that's what they're doing because of the environmental stressors that they are exposed to. That's a language of your body and that's why the answer, I believe is and Cynthia said this is, in a rebalancing. The answer is likely in a more broad lifestyle shift change and all this rather than-- because you say that you're looking for supplements, and trying all these different things, and the answer probably is not there. I am really curious to see what you learn with the NutriSense CGM. That might be helpful seeing how your blood sugars are reacting to things. I did want to comment on that you say you know that you don't have issues with insulin. I'm wondering how you know that, especially if you still have active PCOS that is often linked to insulin. I would find it interesting if your insulin is great and you're experiencing all these issues and have PCOS. That would seem a little bit like an anomaly to me. I do wonder if maybe insulin is still high for you. 

But going back to the dietary approach, because it sounds what you're doing is, you really want to be doing keto, and you're doing a very restrictive, it sounds like a low-fat version of keto, and it doesn't seem to be working. There are two big paradigm shifts that I would suggest trying. One would be going higher fat on the keto, but adding those fats from C8 MCT oils. Basically, eating what you're eating now, but adding in a- This is just something to try. I'm not saying this is necessarily the answer, but if you add in a lot of fat from C8 MCT oil, you can stay in this keto state that you want to be in, and that's a very metabolic fat, and that it stimulates energy production. It can really stroke your metabolism and it itself is not easily stored as fat. It might be something that can give your body a signal of abundance while supporting a fat burning state. It's just something to try. 

Option number two and Cynthia touched on this going on a higher carb approach. We've had a lot of people throughout the years reach out to this show, who have been doing low carb. They're just wedded to low carb and they just you know are convinced that keto is the only way that things are going to work. We've suggested or I've suggested trying actually-- I know Cynthia was talking about Sara Gottfried’s approach, which is still a ketogenic approach, but with more carbs. But I would also like to suggest that and/or an actually high-carb approach. A lot of people switch to a high carb, low fat approach still Whole Foods based, still high protein. That is like the thing, I can't tell you how many people I've suggested this to and then they reach back out and say, “Wow, I got my energy back, I started losing weight again.” That's something to try. I know it can be really scary, especially, if you are scared of carbs, but it's something to try. To clarify, I like with the high carb doing a lower fat approach, because then you're not hitting your body with fat and carbs at the same time in a high amount, which I think for a lot of people does not work that well for metabolic health. Yeah, those are just some of my thoughts. Any follow up thoughts?

Cynthia Thurlow: Yeah, I think it's really the N of 1. It's definitely on this journey and there's no one size fits all. But I think if you're too fervently trying to move too many levers all at the same time, it's going to be hard to know what's effective and what has been helpful. But I think getting things back to a really simplistic methodology is the best starting point and just giving yourself grace because I know how frustrating it can be to be weight loss resistant. I've now been there twice in my 40s and so, I think it's important to just understand that there's some imbalanced part of your system. If you look at your body as a system, there's something that's imbalanced that's creating this resistance. Once you figure out what it is, it will fall into place.

Melanie Avalon: And also, something to consider because we don't know what your weight is. It's also possible to evaluate the weight that you're looking to lose and I'm all for people wanting to lose whatever weight they want to lose, like, no judgement. People can do whatever they want. But the six to 10 pounds, are they the last six to 10 vanity pounds or are you coming from a higher weight? It might be that where your body is right now is a very healthy weight and losing those six to 10 pounds are going to be something that will be hard just because depending on what your weight is right now, they're not something that your body has any intention of losing because it doesn't perceive that as something that it needs to be if you're a completely normal weight or on the lower side of normal. So, something else to consider.

Cynthia Thurlow: Absolutely. But first and foremost, give yourself grace.

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Melanie Avalon: All right, shall we go on to our next question?

Cynthia Thurlow: Yes. This is from Christina: “Confused on eating in window.” “Hello, I'm so excited to start this journey with intermittent fasting. I am four days in and doing a 16:8. So far, it's been good. However, I feel I'm only cutting out breakfast and a snack. I'm a CrossFitter. So, I'm used to eating nonstop through the day. Sidenote, On break from CrossFit as I've been on and off since October, hello sinus season and weight gain. I've been having my normal lunch grilled chicken, broccoli, cauliflower, sweet potatoes, and red potatoes followed up with mixed nuts, snack, and then dinner which varies, but I try to stick to protein and veggies. I'm wondering if this is too much. I'm typically hungry by lunch. As for the snack I worry it's just out of habit. Any recommendations? I'm breaking the constant eating once I open my window. Also, I have now been craving pineapple listening to your podcast all day at work. So, I switched from nuts to a bowl of fresh fruit. Pineapples, strawberries, red grapes, cantaloupe, watermelon as of today. Thanks for the advice and looking forward to this journey.”

Melanie Avalon: All right, Christina, thank you for your question. I think you’ve answered your question when you asked us about-- Well, you said you're wondering if it's too much for the snack you worry, it's just out of habit. It sounds you have a pretty intuitive idea that the snack you're eating you're not actually hungry for. I don't want to put words in your mouth, Cynthia, but haven’t you talked before about how you are not a fan of snacks?

Cynthia Thurlow: I'm generally, generally not. I think sometimes, maybe we didn't have-- As an example, she's giving a good example of protein and some healthy carbs, and maybe she needed to add some fat to that meal to maybe keep her satiated, because she was going towards nuts. Whether or not, that's by habit or it's by her body just needing to feel they're fully satiated I, sometimes feel like, “If you're using those carbohydrates, it's fine to use a little bit of olive oil, or butter, or something that's going to keep that satiety.” I don't know, if she's just not getting enough nutrient density in that meal, obviously, that's a clean meal, but maybe there's not enough nutrient density there and that could be what's driving that. I know for myself personally, today, it was my first day back in the gym doing a heavy lifting day and I definitely am finding my first meal that I had was definitely there was more substance to it than on the day that I'm not exercising as fervently. CrossFit is intense. 

The other thing that I think about is, I don't know how young this woman is, but are you exercising for your menstrual cycle? Your follicular phase from the day you start bleeding up until ovulation, if you have a typical 28-day cycle, you can get away with more intense types of exercise. But if you're after ovulation closer to when you're going to start bleeding, your body's going to struggle a bit more. You're going to have more cravings for some carbohydrate rich foods, you may not be able to work out as intensely, and so really examining if you're still menstruating, where you are in your cycle to lean towards what will work best for you. 

The other thing is, if you look at people like Dr. Stacy Sims, who is anti-fasting, but does a lot of research in women's physiology and athletes. We're talking about a very small subsect of the population. Again, the menstrual cycle is important. Where you're training, at the level you're training is important to really be cognizant of how that's going to impact your recovery. Do you really want to be restricting food if you're training for something? Those are the things that come up in my head and definitely as listeners are leaving questions in the future, I would encourage them to at least give us some context like, “Are you 35 or are you 50? Are you 25 or are you 40?” Because that can help guide some of the suggestions that we make.

Melanie Avalon: Yeah. It sounds like if I'm reading it correctly, so, she's not doing any CrossFit right now. I think the issue is that she's used to eating a lot from doing CrossFit, but now, she's not doing CrossFit and so, she's wondering if this is all just habit from her CrossFit days.

Cynthia Thurlow: But she seems pretty intuitive. When people say, “I wonder if it's X,” they generally, probably already have a sense of what may need to be adjusted.

Melanie Avalon: Yeah, exactly. [chuckles] As far as it sounds you're eating the exact same amount of food that you're eating when you were heavily doing CrossFit, and now, you're wondering if it's too much. I know it sounds really simple, but you're asking how do you stop the habit of eating constantly the whole time. There's a magic to just creating some rules, some yes/no rules that you stick to and trying it. Rather than saying, “I'm going to eat my meal, and then I'm going to try not to have a snack, or maybe I'll have like a little bit of a snack,” and you could just say, “I'm not having snacks.” I know that sounds very simple, but it's approach that you can stick to. You can have your meal, and have it in a set place like in the kitchen, and then when you're done with the meal putting everything away, and then kitchen closed and no snacks, and even not having the snacks in the house, so that they're not accessible, and then holding yourself accountable, then having your dinner later. I think we can empower ourselves a lot more than we think we can if we just set up a rule that we say we're going to follow and then we follow it rather than trying to follow it, which is a nuance, a small nuance with language, but I think it makes a big difference. Shall we do one more question? 

Cynthia Thurlow: Sure. 

Melanie Avalon: All right. We have one more question from Michelle. The subject is: “Blood work” and I feel this is a really good question for Cynthia. Michelle says, “Good afternoon. I've been doing IF since March 28th, 2021 and I love it. I'm 39 years old and I'm having issues with bloodwork. My bloodwork is always good, but I've always had low iron. This past time, it was 8.6. My doctor encouraged me to really take my iron for three months and take ibuprofen a few days before my super heavy periods to decrease the flow. Taking the ibuprofen actually works. My last test, my iron was up to 12, but my sodium chloride and potassium were all off. Any ideas of what's going on? Could this be due to fasting? I use the sauna several times a week and I do hot yoga. I'm going to have it rechecked next week, but I wanted to see if anyone else had these issues. Thanks in advance,” Michelle. And now, Cynthia, now that I read this, I see what you're saying. So, thoughts on that?

Cynthia Thurlow: Yeah. Well, there's a lot here. I think Michelle is actually referring to her hemoglobin going from 8.6 to 12. It's definitely heading in the right direction. First of all, she's 39. This is perimenopause. When our bodies are heading towards 10 to 15 years out for menopause and our ovaries are producing less progesterone, so, we have this relative estrogen dominance, which can contribute to heavy menstrual cycles amongst other symptoms. That's number one. 

Number two, if she's doing a lot of exercise and she's doing the infrared sauna, you can absolutely lose discretionary electrolytes. I actually just did a podcast with the amazing Robb Wolf on this particular topic, because we get so many questions. And so, yes, you can effectively lose sodium chloride, magnesium, potassium with sweating. You can have renal losses in your urine. If you are not replacing the electrolytes after sauna and yoga, you absolutely need to be. In fact, I generally recommend that people are using electrolytes throughout the day, especially if they're fasting, but then you add in the exercise and all the extra sweating, and you need to replace not only the water that you've lost, but also the electrolytes. 

Couple of different things. This is perimenopause. Your heavy menstrual cycles will probably persist and continue. There's a lot of different ways to address that, but it sounds like relative estrogen dominance, but most importantly and the thing that I think will be most beneficial is to replace the electrolytes. I have a product called Simply Hydration that you can take in a fed or a fasted state and then, I love LMNT, Robb Wolf's product. My favorite is Orange Salt. I would say in our family, the next big flavor is Grapefruit, which unfortunately, they only have out in a limited amount. But those are definitely some options. You want to salt your food and you want to be making sure that you're staying ahead of those electrolyte losses. I don't know what your numbers were, so, they may just be suboptimal or if they were significant, I would imagine this healthcare practitioner probably would have sent you home with some recommendations. So, those are my thoughts. What do you think, Melanie?

Melanie Avalon: Yeah, I thought that was great. For listeners, LMNT is actually a sponsor on today's episode. I think it's in the pre-roll. You can listen to that to get a free offer and I think a discount on electrolytes. So, check that out. They just changed it. it’s some offer, but I think it's a discount. Yeah, regarding the iron, the hemoglobin, so, I have struggled historically with anemia and mine got very bad. Very, very bad. Mine got to four. I thought I was dying. The reason I bring that up is you're asking if it could be due to fasting. My historical struggle-- So, now, I very intensely monitor my iron panel. Its changes and its fluctuations have been pretty independent of my fasting experience. There are a lot of potential causes and your doctor, hopefully, talked to you about this. But there are a lot of causes for anemia and the inability to keep up your hemoglobin or keep up your ferritin, which is a storage form of iron. It can be internal bleeding, which is what they thought it was with me because mine was so severe. It can be absorption issues, just not being able to absorb. People with celiac often have this issue. You could have normal iron levels, but not have ferritin, because your body is not converting it to ferritin or hemoglobin is just not building up. I'm actually about to read a book. I'm really excited. Do you know Dr. Morley Robbins? 

Cynthia Thurlow: I’ve heard of him.

Melanie Avalon: He wrote a book called, I think, Cu-RE. I haven't read it yet, but he's going to be coming on my show and apparently, he talks all about the copper-iron relationship and that whole role. I think at least, a reason that the body struggles so much with iron is because it's actually a very inflammatory compound. It's ironic because we need it. It's vital to our life. We would be dead without it. Like I said, I literally felt I was dying when I was that anemic. It does create oxidative stress, it's inflammatory, it can potentially feed pathogens. The body is very, very intense in regulating it sort of like a blood sugar, how blood sugar can be toxic, so the body's really intense about regulating that. There are so many places that things can go wrong. [chuckles] Like, where you're getting it from, where you're absorbing it? All of that to say, I don't believe the fasting is the cause of that. It's probably something else and it's probably something where you really need to work with a knowledgeable practitioner to find the root of it. 

I will say what's worked for me for keeping up my iron, actually, I know you're really good friends with her, Dr. Cochrane? Are you friends with Teri.

Cynthia Thurlow: Yes, very good friends.

Melanie Avalon: She made the suggestion to supplement with chlorophyll to boost iron and I found that really helpful. I also supplement with grass-fed spleen that has the highest amount of heme iron of basically, any animal product that you can get. I currently use ancestral supplements. If I make my own organ supplements down the line, I definitely want to make a spleen one. But that might be something to try. I can put a link in the show notes. I have a discount code for them, I think. But yeah, the iron one is tricky. So, really quickly do you have thoughts on her taking the ibuprofen for the periods?

Cynthia Thurlow: I know that it helps with prostaglandins and I think that's part of it. When I read that, I was like, “Oh, she's estrogen dominant.” And so, until you address that, that persists and then it goes into the synthetic hormones, and IUD, and ablation, and hysterectomy. That's what's coming for her, unfortunately. That's the allopathic model. I managed to get through perimenopause without any of the above. I'm happy to say, “Thank God.”

Melanie Avalon: Congrats. All right, well, hopefully, that was helpful, Michelle and definitely feel free to update us with anything. This has been absolutely wonderful. A few things for listeners before we go. If you would like to submit your own questions for the show, you can directly emailquestions@ifpodcast.com, where you can go to ifpodcast.com and you can submit questions there. This was definitely an episode where you want to check out the show notes. We had talked about so many things. Everything as well as a transcript will be at ifpodcast.com/episode272. And then you can follow us on Instagram. I am @melanieavalon, Cynthia is @cynthia_thurlow_ and we are @ifpodcast and definitely tune in next week. Again, I mentioned it before, but Rick Johnson will be our special guest next week. And Cynthia have fun on your travels.

Cynthia Thurlow: I will. I'm so excited. It's hard to believe the past two years, we have not been back to Europe. And so, we are headed to the Czech Republic, and we start in Prague, and end up in Budapest. So, I haven't been to Eastern Europe with my kids. I'm super excited to unplug with them.

Melanie Avalon: I'm really excited for you. You deserve it after all of the book launch. You're coming out of like the storm. 

Cynthia Thurlow: Oh, yeah, that's a whole conversation in and of itself. I'm like, “I'm burned out, I need a break.” So, I'm super excited. But in my absence, I know everyone will love hearing from Rick, who I put on a pedestal.

Melanie Avalon: I know. It'll be great. All right, I'll talk to you in a few weeks then. 

Cynthia Thurlow: Sounds good. 

Melanie Avalon: Bye. 

Cynthia Thurlow: Bye. 

Melanie Avalon: Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.

STUFF WE LIKE

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

TRANSCRIPT

Melanie Avalon: Welcome to Episode 269 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, biohacker and author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my cohost, Cynthia Thurlow, Nurse Practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us, check out ifpodcast.com, melanieavalon.com, and cynthiathurlow.com. Please remember, the thoughts and opinions on this podcast do not constitute medical advice or treatment. And no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup of tea, or even a glass of wine if it's that time and get ready for The Intermittent Fasting Podcast.

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If you recently saw a documentary on Netflix called Seaspiracy, you might be a little bit nervous about eating seafood. Now, I understand why ButcherBox makes it so, so clear and important about how they work with the seafood industry. Everything is checked for transparency, for quality, and for sustainable raising practices. You want their seafood, the value is incredible, the average cost is actually less than $6 per meal, and it's so easy. Everything ships directly to your door. I am a huge steak lover. Every time I go to a restaurant, I usually order the steak. Oh, my goodness, the ButcherBox steaks are amazing. I remember the first time I had one and I just thought, “This is honestly one of the best steaks I've ever had in my entire life.” On top of that, did you know that the fatty acid profile of grass-fed, grass-finished steaks is much healthier for you than conventional steaks. And their bacon, for example is from pastured pork, and sugar and nitrate free. How hard is that to find? I'm super excited, because ButcherBox’ bacon for life is back and it's even better, because you get $10 off as well. Yep, right now, new members will get one pack of free bacon in every box for the life of your membership, plus $10 off when you sign up at butcherbox.com/ifpodcast. That's one pack of free bacon in every box for the rest of your life, plus $10 off. Just go to butcherbox.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 disrupters, which mess with your hormones, carcinogens linked to cancer, and obesogens, which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream. And then in our bodies, studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat, and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that. Beyond weight gain and weight loss, these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies, when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so, so shocking and the effects last for years 

Conventional lipstick, for example, often tests high in lead and the half-life of lead is up to 30 years. That means when you put on some conventional lipstick, 30 years later, maybe half of that lead has left your bones. On top of that, there is essentially no regulation of these products on the shelves. That's why it's up to us to choose brands that are changing this. The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin, so, you can truly feel good about what you put on. And friends, these products really, really work. They are incredible. They have 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 on my Instagram to see what it looks like. Tina Fey, even wore all Beautycounter makeup when she hosted The Golden Globes. So, yes, it is high-definition camera ready. They have so many other products. Deodorant, shampoo and conditioner that I love, products for babies, and so much more. You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. Also, make sure to get on my clean beauty email list, that's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. So, definitely check it out. And you can join me in my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well. 

And lastly, if you're thinking of making Clean Beauty and Safe Skincare, a part of your future like we have, we definitely recommend becoming a Band of Beauty member. It's sort of like the Amazon Prime for clean beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally, completely worth it. So, again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.

Melanie Avalon: Hi, everybody and welcome. This is Episode number 269 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow. How are you today, Cynthia?

Cynthia Thurlow: I'm doing well other than two surly teenage boys.

Melanie Avalon: When did they get out for school?

Cynthia Thurlow: Officially on June 2nd. We've already had the award ceremonies, and I'm happy to report they had high academic honors, which was awesome. But they are teen boys and they did not permit any photos to be taken of them. And so, all the friends of mine that have daughters, there were pictures of the family, and their awards, and my kids, no, not so much. I took pictures from far away and I just decided I was like, “There are battles worth fighting and this is not one I choose to fight.” But yeah, they will officially be out on June 2nd and I'm pretty excited. This is really their first full year of school in two years, to be physically in school, the entire school year. 

Melanie Avalon: Oh, wow. That's crazy. 

Cynthia Thurlow: No, the pandemic has definitely-- It's not just my kids, it's every child, every family has been impacted by the pandemic. For me, I'm just so grateful that they were in school for an entire year. Things that you take for granted that we never imagined we would have two years of or a solid year of being at home and being in school, and then partial back to school last year. So, I'm just grateful they got to be in school with their peers, part of the year unmasked, then they've been doing really well, despite all the stress and the drama of the last two years. 

Melanie Avalon: I'm getting flashbacks now. There's something so glorious and wonderful when you are growing up and summer vacation. It is just so exciting. [chuckles] 

Cynthia Thurlow: Well, it's done and to be honest with you as a parent, I always really, really looked forward to mid-May, because all of a sudden, the sports were over, [unintelligible [00:09:40] education was over, it was like the carpool nonsense that all parents go through just stops. And so, they would just go to school, and they would come home, and it was just a lot more togetherness, and they're probably getting more sleep, and my husband and I are obviously spending less time driving back and forth between multiple sports. It gives you a prelude to what the summer is going to be like. For me, I'm very much the kind of mom where I let my kids sleep in. They have chores, but I like them to actually decompress. I'm not super strict as long as they get their work done. I know that may be a departure from some families that are listening, but I've just come to understand like, “My kids do really well in school and they're good kids.” I let them do a lot of decompression activities during the summer. 

When they were younger and they had to be in a structured activity, because they had so much energy, and they needed an outlet. Now, it's more thinking about what college does my oldest one to apply to. He's leading into STEM curriculum. Looking at AP classes and it's so different. You really develop a very different relationship with your kids as they're getting older and so, it's also to me picking my battles, So, it's less about keeping them under my thumb, and forcing them to do so many hours of reading every day, and now, it's a different playing field.

Melanie Avalon: That's very much the way I was raised as well. My parents were like that. Of course, I was very on top of things. I remember for summer reading, I would read the books a minimum of two times, sometimes more, which looking back, I'm like, “Why did I do that? Why did I read The Hobbit twice after already having read it” in the past as well?

Cynthia Thurlow: That doesn't surprise me that you would be a willing overachiever. Not someone who's doing it for any other reason than to thoroughly be invested, and really understand, and comprehend what you're reading. I love that we both share that although, we would not have been in school at the same time together. I do love that we are both very cerebral and enjoy-- Just enjoyed learning. What a blessing that is, right?

Melanie Avalon: Speaking of, Gin and I used to always talk about, “Would we be friends in high school and will we be at the same lunch table?” We decided that we might be, but probably not, probably slightly different lunch tables. Which lunch table were you at in high school?

Cynthia Thurlow: It's ironic that in high school and in college, I was part of a very popular crew. However, in my popular career, there was the subcategories of popular girls and I was part of the smart girls that got good grades, and weren't promiscuous, and had boyfriends, but we were nice to people. To me, at that stage, it was actually cool to be smart, whereas the people who were the creme de la creme popular people didn't care about school. I just stayed focused on like, “I want to go to college, and I want to do this, and I want to do that, and I know I'm not going to stay in this school.” But I was always nice to everyone. I was also vice president of my class and captain of back in the day I played field hockey. To me, it was important to just be kind and nice to people. Yeah, my kids cannot believe that I was popular. They're like, “You're so dorky and nerdy,” and I'm like, “Oh, but it's all in the down low. No one knows that unless they know me well." How about you? I would imagine you were like top in your class and super, super, super smart.

Melanie Avalon: There's the honors English class and it was basically the really intellectual “smart kids.” But it was similar. It had some popular people from the popular crowd in it. It was just like the nice, smart people. That was my main group. Yeah, I really excelled academically. You probably would have been at my school in the honors English group class. But you would have been in the popular like the popular people who are in the honors class.

Cynthia Thurlow: Yeah. It's funny because I had this not so nice high school boyfriend. When I look back and he used to call it the nerd herd. He would make fun of the fact that I was in AP classes and honors classes, and I was like, “Who ended up doing better?” Looking at where he is and where I am, and let me be clear, I'm friends with his wife, and his mom, and his sister. I have a very nice relationship with all them. But I look back that he would like tease me and I was like, “There's nothing to be ashamed of for being smart. Smart people run the world.” That's my feeling. It's good to be smart.

Melanie Avalon: I love it. By the way you interviewed Robb Wolf again, right?

Cynthia Thurlow: I did. He's so wonder-- It’s such an easy interview because he's just so gracious and humble. With my cardiology background, we’ve talked a lot about electrolytes and we did talk about overtraining, because I know and I'm very aligned with his perspectives on the overtraining goes along with the over restriction of food, goes along with over fasting, goes along with plateaus. We did touch on that which was really important to me, because I wanted him to also know, there are clearly people that go overboard with all of the above, but it was a really nice conversation. It was nice for someone else to talk about the value of electrolytes and not just me saying, “Oh, by the way, I worked for 16 years in cardiology and I got really, really good at replacing electrolytes.” I got really good at replacing electrolytes and no one really wants to hear about that because it seemingly seems so insignificant, but yet, it's so important. I was actually saying, “Robb, I had surgery almost a month ago” and I knew that my body was going to take a hit, because of this orthopedic surgery, and I was telling him, I said “My HRV, my heart rate variability has really been in the toilet.” [laughs] Clearly, as well as I'm sleeping, my body still perceives, there's all this ongoing stress and my cortisol levels must still be dysregulated. I said, “I just kept adding more sodium and they kept coming down.” I said, “It's just so amazing, something so simple.” It can be so helpful. So, yes, Robb was amazing. Then the other guests that I had most recently that really just-- I'm still in such awe of my conversation with Sara Gottfried, which I know you interviewed her recently as well and she's just so-- [crosstalk] 

Melanie Avalon: We pushed it. So, it's in a few weeks. 

Cynthia Thurlow: Oh, sorry. Well, mine just dropped. When I was listening to it, I feel so very grateful as I know you do that we have platforms in which we can connect with such profoundly influential individuals in the space and be able to share all of their wisdom with the world.

Melanie Avalon: Yeah, I am so, so excited to interview her. It's really exciting. 

Cynthia Thurlow: She's so smart. 

Melanie Avalon: Yeah, this upcoming week for me is actually unique. I'm only going on a podcast. I don't actually have an interview, but I'm scrambling. Every now and then, I have a little panic moment where like, “How am I going to prep everything?” But [chuckles] then I take a moment and I breathe. I'm really excited about the lineup. Oh, that's the next person I'm interviewing, Mark Sisson.

Cynthia Thurlow: No way. 

Melanie Avalon: I'm so excited. [chuckles] 

Cynthia Thurlow: Did you sacrifice your firstborn child? 

Melanie Avalon: Basically. [chuckles] 

Cynthia Thurlow: I say that very lovingly. The facetious future born child, I'm like, “That's awesome.”

Melanie Avalon: That's going to be a really, really surreal moment, because it's surreal anyways with all the people that I get to interview, but really there's a handful of people that are the people I've been following from day one. It's basically Robb, Mark Sisson, Dave Asprey, probably those three. Yeah, and I haven't interviewed Mark. 

Cynthia Thurlow: That's so cool. Did I tell you that a couple years ago, I literally ran into him because I wasn't looking where I was walking.

Melanie Avalon: No way. 

Cynthia Thurlow: And he could not have been more polite. I remember, I was so like, “Oh, my God, I just ran into Mark Sisson” and he was so polite.

Melanie Avalon: I got connected to him through Brad Kearns, who I'm pretty good friends with who's coauthor. And so, I've been talking with Brad about what direction to take the interview, because there're so many ways you could go, but I think I might focus more on him. His personal life, because he's done so many businesses, and I would just love to hear all about that rather than focusing on the primal stuff as much.

Cynthia Thurlow: I think that's so exciting. I'm so excited for you. It's interesting because a lot of these people when you've been following them for a long period of time, that's how I felt about Sara Gottfried in addition to the other people you mentioned. When I was talking to her, I was trying not to fan girl. I was really nervous. I told my husband, I was sweating, I tried to be as cool as I could be, [laughs] but to actually meet some of these people that we've been following for years, and valuing the message and methodology of their brands and their vision and to me its-- I tell everyone all the time like one of my greatest blessings in my business is being able to podcast because as you've said it's the best way to network. You just don't even realize how important it is until you get in a position where you either meet someone in real life and you're like, “Oh, my gosh.” I mean, you really do become friends and acquaintances with so many of these people. We're all trying to positively impact lives in a way that leaves people better off and to me, it's so amazing. So, I love that you-- That was probably a year or two ago, you're like, “Podcasting is the best way to network” and I was like, “Oh, my God, that's exactly what it is.”

Melanie Avalon: Because it's basically conversations that aren't superficial, because they're deep conversations where you're talking about their work, and you're really connecting, and then you're just doing that regularly, and it's all the amazing people. So, I'm just so grateful. I'm really in awe.

Cynthia Thurlow: Well, and for anyone who doesn't know this about you, I do know this about you. I probably spend five to 10 hours per each podcast, just organizing, listening to other podcasts, trying to get a sense for what the person's like. Melanie is next level, because she is graciously on a few times shared her notes and they are so detailed. For anyone that's listening, you have no idea. When Melanie says she's preparing, she's preparing to go do a doctoral dissertation. She's so well prepared. If you don't know that about her, you should know that about her. So, as I say, you always encourage me to level up how I prepare and how I get ready for my own podcasts.

Melanie Avalon: Well, thank you so much. I echo that back to you as well, because I feel there are a lot of podcasts out there. and there are a lot of people who don't prepare, and do just show up, and I get the exact same sense from you with the preparation. So, yeah, it's a good place to be. 

Cynthia Thurlow: Absolutely. I can tell you now that I've been on the other side having had a book launch, the people that were prepared, I really appreciated that because you get to a point where you're just doing so much press that you're exhausted. I remember, there were weeks where I was doing 12 to 15 podcasts a week on top of other media and you were like, “Where do I need to show up and what am I talking about?” You were just showing up, and being yourself, and being enthusiastic, and I would have people, they're like, “Yeah, I haven't really read your book and just tell me what you want to talk about?” I was like, “What?” [laughs] I was like, “Not even a skim, not even read the appendix or read the table of contents anything.” When there's no judgement, sometimes, I was like, “Oh, man, this is going to be harder than I thought.”

Melanie Avalon: When people ask me basically to provide all the questions for the interview. I still do it and I'm so grateful, but I appreciate it much more, like you said, when it's really evident that they've read the book, and they come with the questions, and everything.

Cynthia Thurlow: Well, and it's interesting, because I interviewed Dr. Avrum Bluming and Carol Tavris about their book, Estrogen Matters. It was funny. After we recorded, they both said to me, “Cynthia, your assistant reached out to us and asked us to tell you what we wanted to talk about.” They were taken aback and they said, “But now that we've met you, we understand that you really just wanted to make sure that you are aware of what we thought was most important.” But by the same token, you did so much prep work like that podcast, I probably spent more time on than anyone I've done this entire year, because I felt the Women's Health Initiative as an example, had led so many clinicians and patients to be fearful of hormone replacement therapy and I was like, “I know, I've got this platform.” So, I think in most instances, I really endeavor to think about how do I ensure that person knows I value their time, but also let them know like, “I'm in the game, and I'm super prepped, and I've read all your stuff, and I've outlined, and I've listened to podcasts to just to get a sense.”

I just interviewed the head researcher for HVMN and he was so delightful. He was like a Rick Johnson-esque person. So enthusiastic, so excited. He was able to translate the science into layman's terminology and that was such a joy, and I was like, “Wow.” I was so surprised. I instantly liked him and I thought to myself, “This is what's so awesome to be in this space.” We can actually have these opportunities to take real research and make it relatable for the average person, because that's really the platform that I think we're both on, although obviously you're on a biohacking platform and I'm on a 35 and up trying to translate how to navigate our lives without too much stress and distress.

Melanie Avalon: Two thoughts to that. One, so, the way I tackle getting the vibe of what they want to talk about while also having them know that I value their time, I just in the intake form, all of the questions are optional and there's just one question that says, “Are there any topics in particular you'd like to talk about?” Rather than asking like, “What questions you want me to answer?” It's just very open, I feel that accomplishes that goal, at least for me.

Cynthia Thurlow: I may have to borrow that. Of course, with credit given to you.

Melanie Avalon: No, I don’t need. No credit needed. I probably took it from somebody else. The second thought was, I was listening as per usual last night to a Peter Attia episode and they were talking about, it was one of the Q&As and the cohost was saying, how he always will reach out. When he read studies, if he has questions, he'll literally just email the researchers on the studies. The majority of the time they always answer and usually are really excited to talk about the studies. So, I was like, “I should start doing that.”

Cynthia Thurlow: Yeah. Well, you know what's interesting is, so, Dr. Bluming, who I just bow at his feet, his book is so amazing, and he sends me updates. He just did an editorial for a journal and sent me the update and I was like, “Thank you so much. I can't wait to read it.” I meant it genuinely, because he's helping to change the narrative, and the discussions around, and the fears around prescribing and taking hormones. I was like, “He's doing amazing, amazing things.” Yeah, they love to talk about that stuff.

Melanie Avalon: And for listeners, this is Cynthia's Everyday Wellness Podcast.

Cynthia Thurlow: That podcast dropped in February and as you know, I'm a big nerd. I like to look at my metrics. Number one for the year thus far is Megan Ramos and then, Rick Johnson. 

Melanie Avalon: I'm interviewing her in a few months. 

Cynthia Thurlow: Yeah, there's no comparison. Her downloads are way more than anyone else's. And also who else is in there? Dr. Bluming is in there. So, clearly, these are concepts and methodologies that are really relating to people, which I think is great. Yeah, but Rick Johnson's amazing,

Melanie Avalon: I should look at my stats and see which ones were the biggest.

Cynthia Thurlow: Yeah, I trend it. I don't know if it makes me, like, it just allows me to see who do I want to bring back, what really resonates, what was a do-do? I think sometimes, you do a great interview, and it just doesn't resonate with your listeners, and you're like, “Gosh, that was surprising.” And then sometimes something that you-- [crosstalk] 

Melanie Avalon: Or, the reverse. Yeah.

Cynthia Thurlow: Correct? [laughs] That happens, the unicorns are like, “Where did that come from?”

Melanie Avalon: For me, I have genuinely, because people will ask me, I think actually, you've asked me before like, “Has there ever been an episode that I didn't want to air or didn't really like?” I can genuinely say, I have really loved every single interview that I've done. But sometimes, I do an interview and I love it, but I just don't know if the topic or the content will really resonate. Yeah, sometimes, I'm really surprised that they freak out and [chuckles] love it.

Cynthia Thurlow: Yeah, I've only had three and almost four years of podcasting that I had to toss in the toilet, which is always disappointing. But I was like, “Sometimes, you just don't get a good interview.” You could have someone that's super smart and they're just not easy to interview or they go off on a tangent that is so not aligned with your own methodology that you're like, “I can't release this, because it would be a problem.” But yeah, I think that's how you just navigate knowing what your audience really wants to hear and resonate with.

Melanie Avalon: Definitely. Well, before we jump in, I have one really quick baby teaser and this is going to be such a vague teaser. But for listeners, I am so excited because in creating supplements now, there are a few supplements that I really want to create, but I don't know if I can, or it might be tricky, or things with like FDA regulations and such. So, this is just a baby teaser that I found out yesterday or the day before that one of the main supplements I want to make that I thought we couldn't, we probably are going to be able to, because we might have an FDA approved version. So, I get really excited. 

Cynthia Thurlow: Now, I can’t wait to hear more. 

Melanie Avalon: For listeners, if you'd like to know what that is, definitely get on my supplement email list because that's where I will be announcing the news. Also, I keep getting questions literally every day about when am I going to be releasing my magnesium supplement. The email list for all the information is avalonx.us/emaillist.

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Melanie Avalon: Shall we jump into everything for today?

Cynthia Thurlow: Let's jump in.

Melanie Avalon: To start things off, we have a question from Alexa and the subject is: “IF foods.” Alexa says, “Hello, ladies. I'm on my second week of IF clean and I'm loving it. I tried IF last year, but was not doing it correctly as I was still putting creamer in my coffee. I recently found your podcast and I'm hooked. My question is regarding the type of foods I'm consuming after I break my fast, which I've decided to begin with a 16:8. I find that sometimes, I get hungry early between 9:30 to 10 AM, then it goes away. I noticed once I get past noon, sometimes, I can push through to about 1:00 to 1:30 PM usually, because I'm busy working. But I seem to gravitate towards a heavy lunch. For example, a tuna melt, bag of chips and water, or sometimes, I'll have Mexican tacos that are super delicious. Typically, carne asada or other type of meat. I am just wondering if I should be careful about breaking my fast was such heavy food. Also, sometimes, I don't get too hungry for dinner, so I'll have a light dinner. Do you have suggestions on how to eat correctly when IFing. I forgot to mention that I also work out three to four times a week. Thank you and sorry for all the rambling.”

Cynthia Thurlow: Well, Alexa, I think first and foremost, just the fact that you're asking if you need to break your fast with a lighter meal demonstrates to me that you're already thinking that might be a problem. I typically recommend that you break your fast like maybe start with some bone broth as a light alternative or a light salad, and then perhaps, have a less complicated meal like maybe you're having some chicken, or some steak, or you're going to have a bison burger, or you're having a piece of fish with some vegetables like non-starchy vegetables, because it could very well be that between the mayonnaise, and the cheese, and I don't know if you're making the Mexican tacos or buying them out, you can be exposed to seed oils. It might just be overwhelming your digestive processes. So, that's my first thought is break your fast with something lighter and less fat dense that might be part of it. 

The other thing is, depending on where you are in your cycle, so, I don't know if you're still menstruating. I am an advocate of women. You can get away with intermittent fasting for usually the first three weeks of your cycle. But if you're within a week of getting your menstrual cycle or bleed week, then I typically recommend you back off. The fact that you are feeling like you're having such a heavy meal and then you're not really hungry for your second meal makes me concerned that you may not be hitting your protein macros. For anyone who is new to listening to me on the podcast, I'm all about protein, protein, protein. We really need it for so many reasons. One of them is satiety and other one is to have adequate muscle protein synthesis. Hitting those protein macros is going to be really important. So, I would probably recommend you start with a lighter meal when you break your fast, so that it'll allow you to get in enough protein between your two regular meals during your fasting window.

Melanie Avalon: That reminded me of the interview that I did have in the interim since we talked which was Dr. Gabrielle Lyon, who is as well all about the protein, and really, really knows the science of it, and why it's so important. I really can't wait to air that. I agree with everything that you said. I like what you said about the fact that she's asking means that she might be intuitively on to something. I do think that this is something pretty intuitive because we are really, really unique everybody, individually. Some people can handle having a big bolus of food and be fine, and some people are delicate butterflies, and need to really take a more measured approach like Cynthia said with maybe breaking with bone broth, or something more gentle. I found for me, I break my fast, I post about this all the time on Instagram so people know, with cucumbers and wine, but then I move into a really heavy meal, actually. But I do slowly ease into it. I will say, if you are eating heavier--

I don't know if we need to define what heavy mean, because on the one hand, you could have a meal like I eat, where it's a huge amount of protein, which would seem like a “heavy meal.” But it's not necessarily heavy in the sense that it's a lot of mixed macros, and fat, and processed foods and that type of heavy. I think heavy can mean different things. Mine's just heavy in a mechanical sense and that protein requires a lot of energy to break down. There's a reason it has the highest thermogenic effect of any food. You “burn” about 30% of the calories and protein just by breaking it down because it does require a lot of digestion and energy to do that. All that to say if you do want to eat “heavier meals” and find that you're not digesting it well, you might want to consider HCI supplementation and/or digestive enzymes. That might be something that can really help. I've always been really fascinated in the ordering of it, because the natural digestion process would happen in a certain order. So, basically, we release stomach acid first, HCl and then later as the food moves into the intestines that's where enzymes process that. I've always been a little bit haunted about just there needs to be a certain order to it. I've asked a lot of guests this and I get different answers. But the way I do things is I use HCI first in my meal and then I add digestive enzymes afterwards. So, that might be something to consider. I don't necessarily think there's a correct way, but we are really individual and it's good to be intuitive.

Cynthia Thurlow: Well, this is just my little clinician caveat that in the past two years, I have not done one GI-MAP, maybe one or two out of hundreds of women that hasn't had H. pylori. I tend to be a little more conservative with recommending betaine or HCl, because if someone has an active or unknown H. pylori infection, that can actually exacerbate symptoms. I would say that under normal circumstances, I think digestive supports are great. But I think of in the hierarchy, digestive enzymes are pretty benign, but I tend to be a little bit more conservative about HCI just in case someone has H. pylori, which, if you're not familiar what that is, it's opportunistic organism that sometimes in the setting of low hydrochloric acid can flourish. And so, I'm just seeing so much of it now on GI-MAPS, which is a DNA based stool test that I'm tending to be really conservative with HCl until I have testing. So, I agree with everything that you're saying. 

However, that how we define a heavy meal might be different to each one of us, but I define a heavy meal is something that's going to be harder on our body to digest. If you're not making the tuna melt, you don't know what the ingredients are, if you're not making those Mexican tacos, you don't know what seed oils are being used and so, that could be contributing to why it's feeling like you're having a little bit of a digestive backup or just feeling very full. The other thing is if you're sleepy after a meal that could be a sign that not only is it too large of a meal, but you might have eaten enough carbohydrate that you're getting some degree of blood sugar dysregulation. If that persists, you may want to check your blood sugar. I think that's certainly really reasonable. Glucometers are very inexpensive, but your blood sugar should come back to baseline within two hours of eating ideally, just a thought.

Melanie Avalon: Question about the H. pylori. So, it flourishes in low HCI environment or high HCI environment?

Cynthia Thurlow: No, low. Because it's like anything. We start producing less hydrochloric acid as we get older. It's much more common to see HCI flourishing, because it's the first line of defense. Hydrochloric acid is designed to kill things. If you have inadequate levels and certainly it gets depleted, you can get HCI depletion just from not having enough precursors like certain types of zinc. I remind people that until proven otherwise, until I know someone definitely doesn't have H. pylori, and this is just my own clinical environment. My sometimes will hold off on doing HCl, but there's certainly other things you can do to help support digestion. As you mentioned, digestive enzymes are great. I'm just seeing so much H. pylori now, I think it has a lot to do with the impact of stress on the gut microbiome. That's been my working hypothesis that the doctors at the GI-MAP lab agree with, because I've never seen so much H. pylori, never.

Melanie Avalon: Wouldn't taking HCI benefit that then?

Cynthia Thurlow: You have to kill the infection. You remove what doesn't belong and think about it this way. If you are getting H. pylori and you're taking a stool sample, it's gotten from the stomach through the entire digestive system, small intestine, large intestine, into the rectum and expelled. Whatever amount you're seeing quantified on DNA based technology is actually higher. We eradicate first and then we go to supplementation with HCl. But it's usually created in a low hydrochloric acid environment and that's oftentimes related to age-related changes or people don't have the cofactors to be able to create enough hydrochloric acid. That's where I go from, and that's what I was taught, and it's definitely been my clinical experience to see that that you want to make sure that you're not addressing HCI issues if someone has H. pylori.

Melanie Avalon: Okay, I'm still not following. If the problem with H. pylori is low HCl because of the ulcers.

Cynthia Thurlow: Well, there's many different types of H. pylori, and so some are prone to precancerous lesions, they can lead to certain types of duodenal ulcers, etc. When you do the testing, especially the type of testing I mentioned, it'll help you differentiate if they have any of the pathologic cofactors that go along with it. But here's the thing. If HCl is at a proper level, you should not have an issue with H. pylori. It's in the setting of a low hypochlorhydria. In that setting that is when you can make this opportunistic opportunity for things not to get killed off, that could be a parasite that you ingest. And yes, it is as horrifying as it is to think. We ingest a lot of things and we are dependent on this first line of defense in our stomach to have enough hydrochloric acid to kill things off. But what I see in most women that I work with is that they do not have optimal levels of hydrochloric acid and therefore, it bypasses this first line of defense. We should not have H. pylori in our stomach. Certainly, not at detectable levels. With DNA based stool testing, you are seeing signs of a mechanism that could be also a reflection of the impact of stress on the gut microbiome, because we know that impacts immune function as well.

Melanie Avalon: So, the reason not to take the HCl is, so that you can test and see if you have H. pylori. 

Cynthia Thurlow: Well, that's one of the reasons. But that’s also, sometimes, people will start H. pylori and they all of a sudden get reflux, or they're burping a lot, or they're nauseous, or they're bloated and so.

Melanie Avalon: They start HCl or they start--?

Cynthia Thurlow: It can exacerbate their symptoms from H. pylori. Sometimes, it can be very subtle. They might just have bloating and they just assume bloating is normal like, “Oh, I had dairy and I'm bloated” or “Oh, I had some gluten and that's why I'm bloated.” But it could in fact be related to imbalance in the gut microbiome. There's a lot to unpack here, but certainly H. pylori is an opportunistic infection and more often than not it is attributable to a low HCI environment in the stomach.

Melanie Avalon: Okay. [chuckles] I'm just not understanding if it's attributable to low HCl, what is the reason for not taking HCI?

Cynthia Thurlow: Because you have to kill the infection, you remove what does not belong before you start adding digestive support like that. This is a clinical thing like this is a best practice thing. This is something that I learned in school and has been the case I don't start hydrochloric acid, unless I'm sure someone has cleared H. pylori. You think about digestion from a north to south process, what's in the stomach, you have to address what's there before you address Candida, or a parasite, or dysbiosis, or any other worms, which occasionally come up on diagnostic testing. You start north to south and so, you have to eradicate what does not belong in the stomach before you start addressing things that are going on lower in the digestive system.

Melanie Avalon: Oh, okay. So, I just really want to understand what you're saying. To resay what you just said, you need to address these infections before you work on digestive support as a solution.

Cynthia Thurlow: Well, you want to. Before you prescribe or recommend HCl, you want to make sure they don't have H. pylori. That's where it stems from. If they don't have H. pylori, you could absolutely start hydrochloric acid. More often than not, people will see improvement in protein and amino acid breakdown. For many people that can be a simple fix to why they struggle with a protein bolus. But I always like to be thinking as a clinician and that's one of those things I always say, more often than not hydrochloric acid is pretty benign. However, here's my caveat in my clinical experience. “You want to be careful about dosing it if you haven't already ruled out H. pylori.” There's just so much of it. I have seen more in the past two years than I've seen the last 10 years. That's how much I've seen.

Melanie Avalon: Is that an easy test? Can people ask their practitioner for that test or would it be a GI doc that normally does that? I know you're not a GI.

Cynthia Thurlow: I would say it's someone that's functionally or integrative medicine trained. For me, before I started working with the DUTCH, I think the GI-MAP is one of the best tests I've worked with, because it's a starting point. It's been my experience that most primary care providers, internists, and most traditionally trained gastroenterologists are not using it. Because it's not part of that allopathic medical model. It doesn't mean that it's not valuable, but for a lot of people they do pay out of pocket. That can be something that's limiting. I've had people come to me who've been to their traditional, they've done the GI workup, they've had breath testing for H. pylori, and I tell everyone, the gold standard is stool. The best way to rule out H. pylori as disgusting as it is because think about it. H. pylori is in the stomach. If you get a positive test with stool that means it made it all the way.

Melanie Avalon: So, it won't find the dead DNA?

Cynthia Thurlow: Well, you're shutting it. It's really going in with testing. I can send you some of the information, so you can learn more about the testing. But it's been one of those things that that amount of shutting, if you get it all the way into your stool is pretty significant. I always say to people like, “Yeah, the numbers not all that high, however.” [laughs] We weren't going into your stomach and taking the sample there. Breath testing is not as reliable. If anyone's listening and they've had that testing, I oftentimes will say, “Gold standard is stool.” It's not impossible to get it done. You just have to advocate. For a lot of people that are experiencing reflux, and heartburn, and burping, and belching, they're put on proton pump inhibitors, which in and of themselves have a lot of long-term health complications. I say this with respect, because we put everyone in the hospital on Protonix, which is a PPI. But the more I learned about how important stomach acid is, we're actually making it worse by putting people on these drugs long term.

Melanie Avalon: I cannot agree more. I've had that stool test and I've had-- Do they test for H. pylori when they do endoscopies? 

Cynthia Thurlow: Yeah, they can do little samples and send them off. And obviously, that's up close and personal. Think about it in the hierarchy of costs, it's much more cost effective to do a stool test versus an invasive procedure. But sometimes, you need the invasive procedure. If they're in there, they can do a biopsy or testing.

Melanie Avalon: Yeah. Awesome. All right, shall we go on to our next question? 

Cynthia Thurlow: Sure. This is from Leah. Subject is: “Coffee differences.” “Hello, I wrote before with a question, but now, I have another one. I'm listening to an episode, where a listener asked about teeth whitening strips and it made me think of the time, Gin said, she had black coffee from McDonald's and it made her shaky. Now, I stopped getting flavored roast and only finished off my current stock of flavored roast during my window once I started fasting. My question is that besides the flavored roast, by flavored, things like hazelnut, toffee, winter mint, etc., how would we who are still relatively new to IF know if black coffee effects are fast in a bad way like McDonald's did for Gin? I buy whole bean coffee from Gobena, a not-for-profit that sends its proceeds to help orphans around the world and partners with adoptive families to help them fundraise and have been getting the Yirgacheffe light roast instead of the flavor roasted beans. I grind them at home and send about half of a five-pound bag overseas to my fiancé, who has also started fasting with me. He already liked his coffee black, so, no trouble there. What could have made that McDonald's coffee different? How could we find out? I want to fast clean, but the sheer relief. I could keep coffee even if I just stopped putting cacao in it during the fast was so nice. You gals will never run out of things to talk about on the podcast. We'll always have questions. Leah.”

Melanie Avalon: All right, Leah. Well, thank you so much for your question. I do remember when we were talking about this, and so, I looked up the McDonald's coffee and it is just coffee. There're no additives. I thought this was interesting. They say there's the potential of a dairy allergy. I'm guessing that's cross contamination from they're assuming with the coffee machine that it's possible that dairy could get into it. That's what I'm guessing rather than from the source. I don't know. It could be a few things. One, there's the whole movement of mold free coffee like the Bulletproof coffee with Dave Asprey. Do you drink coffee, Cynthia?

Cynthia Thurlow: I do not drink coffee. However, in our house, we have Purity and we have a company called Square Feet, and the latter of which is a very small like home-based business, but the man who runs it is very OCD about mycotoxins and tests multiple different ways. So, that's typically what we have in our house and what I generally recommend.

Melanie Avalon: Oh, nice. We will put links in the show notes to these coffees. The show notes by the way will be at ifpodcast.com/episode269. My coffee intake, I literally have a sip every morning. It's very, very small, but I drink Dave Asprey’s Bulletproof coffee because of the mycotoxins and mold issue. I've also used Ben Greenfield’s Kion coffee in the past. But people who react to these mycotoxins and mold, I think it can really be a thing. I think it could create that shaky affected people. So, it could be that. I don't know what else it would be. Do you have thoughts about it, Cynthia?

Cynthia Thurlow: Yeah, I think the concern about mycotoxins is a real issue, but I just can't imagine that McDonald's quality would be-- Who knows what else it's cross contaminated with. Could it have been blood sugar dysregulation, could have been a spike in cortisol? Because we know in some people coffee or whether it's the polyphenols, we know that you can get some appreciable cortisol dysregulation, which is going to raise your blood sugar, which is going to raise insulin. The shakiness could have been from a few different things. But certainly, quality is important. And so, it sounds Leah’s makes a very conscientious effort to select a product that sounds it's probably high quality. But I always think mycotoxins until proven otherwise, because coffee beans are readily known to be a mold sensitive or mold prone product, just like peanuts and legumes and things like that. So, that's probably where I would lean first. Yeah, I agree with you.

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Melanie Avalon: Okay. We have a question from Trina and the subject is: “Keto and OMAD,” one-meal-a-day question. Trina says, “I've been using OMAD for just under a week and have been doing okay. No weight loss yet, but I do have hunger pains periodically and some lasts for over an hour. I'm also doing keto while I'm having my one meal a day. Is this too much to do OMAD and keto at once and could this be causing me to feel hungry while I'm fasting? Or, should I stay the course or if I'm not going to lose weight, because I'm being too restrictive by using keto, should I add bread, pasta, etc., here and there? I do think I'd feel fuller at the moment, but I don't want the grains/carbs to spike my insulin. I've been keto since April 1st pretty strict and only up and down a few pounds weight loss, but overall, still the same weight. I did IF for 18:6 for a couple of weeks, no weight loss. Now, trying OMAD has been about a week. I maybe adrenal fatigued. Could this be my body healing instead of losing weight? If so, when oh when, can I hope to see any weight loss? I really do like the OMAD, but I'm getting frustrated. By the way, I eat in the middle of the day currently, but maybe shifting to an evening OMAD might help. I work full time, very busy, and was worried. I'd be dragging if I didn't eat in the middle of the day. But eating with my family would be more enjoyable for all of us.” And then she has a second question, but I thought we could answer this first.

Cynthia Thurlow: Yeah, there's a lot to unpack here. Unfortunately, the toxic diet culture has convinced women in particular that weight loss is the only metric to demonstrate if a new strategy is effective. If you look at the research typically, because women have different body fat to muscle mass composition, as well as hormonal fluctuations. I don't know how old Trina is. I don't know if she's insulin resistant. But depending on where you are life stage wise, it may take six to eight weeks to start seeing significant and when I mean significant, really one to two pounds a week over six, eight weeks, yes, I would expect to see some weight reduction. I think it's important to focus on non-scale victories. Meaning, are you getting changes in body composition, are your clothes fitting a little more loosely, are you having more energy, more mental clarity, etc.? I think there's a couple things to focus on. One meal a day for many people may not allow you to get enough macros in. I know this is something that Melanie and I have talked a lot about outside of the podcast. There's a lot of layers to this question. Obviously, the first one being be patient. I know it's easier said than done, of course. But I think that it's important to understand that you may not see a scale shift immediately and to just trust the course. 

The other thing is, can you get enough protein in one meal a day? That's always my concern with women. If you really just have one meal, are you getting enough food in? You also mentioned being adrenal fatigued and so, there's a lot to look at. When women are fasting, I think it's really, critically important that you focus on what's your sleep quality like. That's foundational. If you can't sleep through the night, your sleep quality is eroded, you need to back off on fasting. Number two, what's your stress management like? That's not three minutes of meditation once a week. Anti-inflammatory nutrition, I think keto can be helpful. However, maybe you need to really be thinking thoughtfully about what's working for your body. Protein, non-starchy vegetables, right types of fats. Then the last thing that I think about is, I don't know if you're exercising. It sounds like you've got a very busy schedule. But we know that insulin resistance starts in our muscles as an example. Some type of physical activity is going to be very important to help with insulin sensitivity. But it's hard for me to completely provide some perspective about the adrenal fatigue. If you're in perimenopause or menopause, more than likely your adrenals need some love and support and that's why the stress management and sleep are so important and the right types of exercise and food. Melanie, what would you add to that?

Melanie Avalon: That was very comprehensive. That was wonderful. The only thing I would add would be, so going back to the keto, I think there's this binary dichotomy that people have viewing keto, where they're either keto or they're eating bread and pasta, where I think it's much more nuanced than that. Adding carbs to keto doesn't have to be bread and pasta. It doesn't have to be this huge whack of high GI, potentially inflammatory carb source. You can add in some carbs while still existing more within a “keto paradigm.” A lot of people on keto do include berries, for example like small amounts of berries. Even upping the vegetable intake could potentially up the carb count. I would not go to bread and pasta to make yourself less stressed or less restrictive. I don't think for most people that that would be the solution. Some other thoughts about existing within the keto paradigm and frame, Cynthia mentioned this, but the role of protein is so important. I don't know if you're doing a super high fat version of keto or not, but adding that more protein and maybe if you are doing super high fat, titrating down the fat, that might be a way to A, feel more full because the protein is going to do that. B, more nourished via the protein and potentially encourage weight loss by titrating down the fat. 

Also, switching out the types of fats might be helpful. Depending on what type of fat you're having in your keto diet, MCT oil, for example, is a very thermogenic fat. If you are adding oils or butter, or things like that switching some of that out for MCT oil might have a beneficial effect on your weight loss. There is the option because you're worried about keto plus fasting being too stressful. There is the option of trying fasting with not keto. That is an option. Trying a higher carb, lower fat approach, for me personally that works really well. Again, we're all individual. When did she start this? Only a couple of weeks. Okay. I wouldn't jump to this right now, because like Cynthia said, it's only been a couple of weeks and I would stick it out a little bit longer. That said, if you make it months, and you're still not happy, and you're not seeing weight loss, some people do find that they do better on a higher carb, lower fat approach with the fasting. So, that is definitely something to try. 

Cynthia Thurlow: Well, It's interesting. When I talked to Sara Gottfried a few weeks ago, one of the things she was talking about is, women have to use keto differently than men. It's been my experience that men seem to be able to eat copious amounts of both plant-based and animal-based fats. We really have to reflect on the fact that carbs and protein are four calories per gram, even though I don't encourage people to count calories. Let me just put that in there. Whereas fats are nine calories per gram. You don't need as much fat as you think you do. As an example, if you're having a piece of salmon steak or a ribeye, guess what the fats are already in there. You don't need to add more fats. This is where I see a lot of women get into trouble, because dairy, cheese, cheese is delicious and nuts are delicious. And so, people are like, “Yay, I'm doing keto. This is awesome.” Before they know that they've eaten four portions of cheese, and three have nuts, and they've blown, any caloric deficit that might have even been created by intermittent fasting. So, just something to think about that plant-based fats for a lot of people including myself. I tend to do better with those, so less heavy fats, but really leaning into where you life stage wise, are you insulin resistant, and maybe being really mindful about your portion sizes of fats.

Melanie Avalon: Three thoughts to that. I'm glad you mentioned Sara Gottfried because I was going to bring her up in my answer because I was going to say that her, and you, and Dr. Anna Cabeca, all of you guys are really wonderful in talking about the nuances of keto for women specifically and how that might need to be adapted for women. I think that's really valuable. Cynthia's book, Intermittent Fasting Transformation, Dr. Gottfried’s-- What is Dr. Gottfried’s most recent book?

Cynthia Thurlow: Women, Food, and Hormones. 

Melanie Avalon: Wait. Straight to the point. 

Cynthia Thurlow: Yeah, Women, Food, and Hormones.

Melanie Avalon: So, if that title doesn't just say it. Dr. Anna-- What's Dr. Anna Cabeca’s most recent book?

Cynthia Thurlow: MenuPause. So, it's like M-E-N-U-pause.

Melanie Avalon: I actually haven't read-- I think that's her only book I haven't read. 

Cynthia Thurlow: It's beautiful. The photos, and the recipes, and she really did a nice very thoughtful, very, very thoughtful job. Yeah, it's a beautiful book. The photography is so pretty. We think about we eat with our eyes. And so, I told her, I was like, “Oh my gosh, the book is so beautiful.” If you do nothing else, it's artwork just to look at.

Melanie Avalon: I'm going to have to check it out. That's amazing. Well, we'll put links to all of those books in the show notes. The other thought I had was, again, listening to Peter Attia last night, one of the episodes I was listening to was, he was talking about people not losing weight on keto. He said, the first thing, if that's the case is he suggests titrating down the fat, which is just to echo what we both just said, Oh, yeah. The third thing is, I'm so glad you brought this up, because I think about this a lot. I think because we do live in such-- especially with the keto movement and this idea that has to be super high fat, we just have this feeling that with all of our food, we need to cook it in fat, and add all these oils, and you don't have to. Especially, if you're talking about salmon, salmon has a lot of fat in it. A not lean chicken breast, chicken thighs or chicken breasts with skin, that has fat in it. Steak has fat in it. So, you don't necessarily have to add a ton of fat. I know there are people like, is it Dr. Gundry, who says he pours olive oil by [laughs] a liter?

Cynthia Thurlow: I think about it. He's a dude. I always say like, “That's the one thing we--" Bio-individuality rules, but I don't see a lot of women that can eat copious amounts of fat. The worst thing is when someone says, “Oh, my God, I did keto and it was great until I gained 10 pounds.” It's almost always because they didn't realize how calorically dense fats are. I always say like, “If a little bit is good, too much is not good.” I will fully disclose that my favorite healthy fat, I love macadamia nuts. I have to portion out a quarter cup because they're so easy to overeat. I literally take the bag out, take my measuring cup out-- I don't measure my food otherwise. Take my measuring cup out, put in a bowl, put the bag away, and I'm like, “I'm done.” Because it's like kryptonite, it’s very easy to overeat fats.

Melanie Avalon: Nuts are a gateway food for me. I've said this on the show a lot. I don't know if I've said this to you. But one of the biggest epiphanies I had with all of this was, people will say that on keto, for example, that you can have unlimited fats, because they don't raise insulin. But the reason they don't really raise insulin is because they don't really need insulin to get stored. The ironic thing is, the same concept of fats not releasing insulin and the conclusion you could draw could be one of two things that are complete opposites. The conclusion that most people draw is, “Well, no insulin. So, it's not going to get stored. I can have all the fat I want.” But really no insulin, because it's so easily stored. So, just something to ponder.

Cynthia Thurlow: It's interesting. Ben Azadi always says, “You want to burn endogenous fat before you consume exogenous fat,” which means all of us have plenty of fat just to burn off. We want to burn the fat in our bodies as opposed to ingesting lots of fat. When we're thinking about evolved keto, meaning, as Melanie just said, people say, “Oh, I've no blood sugar spikes on my CGM.” It's understanding because you make it very easy for that extra energy just to get stored as fat. And so, we want to burn the fat inside before eating copious amounts of exogenous or external sources of fats as delicious as they are.

Melanie Avalon: I'll put a link in the show notes to that Peter Attia episode because it was his AMA #22.

Cynthia Thurlow: I love his AMAs. 

Melanie Avalon: Me, too. The title is Losing fat and gaining fat and it was all about the concept of fat flex, and how does fat actually go in and out of cells, and how does keto affect that. So, be very helpful for people. Trina had one last quick question. She said, “Also, do we count our fasting from beginning of eating window to the next beginning of the eating window or do we count it from where we end our eating? I'm getting confused on the whole 22:2 or 23:1, and where the hours are counted from. Thanks for all you do and I appreciate your time.”

Cynthia Thurlow: I always count it from when you stopped eating. 

Melanie Avalon: Yes. 

Cynthia Thurlow: It's interesting because I'm running a fasting group right now and there were two or three women that were struggling because they were thinking about it too much. I just said, “Whenever you stop eating is when your fasting window starts and that's the easiest way to think about it. Don't overthink it.”

Melanie Avalon: People get really caught up because when you end your meal, you're fasting but you're not in the fasted state. It can be confusing. If Cynthia said, if you're overthinking it, but don't overthink it. You are fasting and that's what you're counting. So, fasting is when you're not eating. 

Cynthia Thurlow: Yeah. I tell people it really takes about 12 hours for your body to get to a point where it's burned off or working through that last meal. It's important to not stress yourself out, because I tell everyone, I'm like, “We're so hard on ourselves, we endeavor to integrate these new strategies to make ourselves healthier.” Then next thing I know people are down a rabbit hole stressing and I'm like, “Listen, no stress. There's no stress.” When you stop eating is the beginning of your fasting window until you eat again.

Melanie Avalon: Here's a question for you that we've often discussed on this show and I'm always curious what people’s thoughts are. If you're doing a time approach where it's a 16:8 or something like that, would you rather count the fasting hours or the eating hours? I can clarify more if you need me to clarify. So, Gin, for example, likes to have a four- or five-hour eating window, whereas I like to have minimum fasting hours. I like to count the fasting hours.

Cynthia Thurlow: I count the fasting hours. I really lean into how I feel in terms of-- Because I have a wider eating window. That's one way I can get in the amount of protein that I need every day. For me, I really reflect on what my minimum fasting hours should be and that's usually what I work from.

Melanie Avalon: Same. It's exactly what I do.

Cynthia Thurlow: Yeah. I'm checking myself like, “When I stop eating last night?” Last night, I went out to dinner with my 16-year-old, so, I ate a little later than I normally do which is okay. Yeah, I usually focus on, “Okay, how do I need to adjust my fasting windows to make sure I'm at least hitting that minimum for me?”

Melanie Avalon: Same. What I don't like is, I don't like the thought of having to close my eating window at a certain time. Once I start eating now, I have this amount of time to eat that I find that very stressful.

Cynthia Thurlow: When do you open up your feeding window, because I know you stay up a little later than I do? 

Melanie Avalon: Like nine. 

Cynthia Thurlow: That's hilarious. For listeners, I know, you know that Melanie stays up a little later and I go to bed a whole lot earlier. But I was thinking one day, I was like, “I wonder what time she starts eating,” because I know what time I start eating and they might be like 12 hours apart. [laughs] 

Melanie Avalon: It's very possible. The only time I eat earlier is if I'm getting dinner out. I've been doing it for so long, too.

Cynthia Thurlow: That's what we're-- This is really leaning into what works for you and your body. If I eat at 9 o'clock at night, my sleep would be a disaster. [laughs] But I also go to bed a lot earlier. So, I think last night I was up late. My Oura was like, “You stayed up till 10:15.”

Melanie Avalon: Oh, I would be so proud of myself if I went to bed at 10:15. I would be so proud of myself if I got up when you get up, too.

Cynthia Thurlow: Yeah, well, it's funny. My Oura was squawking at me last night that it wants me in bed between 8:30 and 9:30 and I'm like, “Oh.” Sometimes, I just don't want to go to bed that early. And then it squawks at me, because my sleep latency is two to three minutes because I take progesterone which is sedating and helps me fall asleep. So, I just say I'm not going to worry about the sleep latency. I know why I fall asleep quickly.

Melanie Avalon: Yeah, I think I've said this before, but I I've hit up ceiling on my Oura Ring. I don't think I can get better than a certain score that I received. I don't think I can get higher than 90, because of how late I go to bed. Even if everything else is great, it considers that a problem, even though it tells me to go to bed late. It's ironic. Well, this has been absolutely wonderful. I want to just keep answering questions, but I guess, we'll have to wait till next week. So, a few things for listeners before we go. If you would like to submit your own questions for the show, directly emailquestions@ifpodcast.com or you can go to ifpodcast.com and submit questions there. I will say, Cynthia, we've been getting because you weren't here before you were here. There's definitely been an influx in questions and Cynthia has come onboard and it's really exciting. I think people are really excited to get your perspective on things. So, keep the questions coming. The show notes again will be at ifpodcast.com/episode269 and you can follow us on Instagram. I am @melanieavalon. Okay, wait. Let me try. Cynthia is @cynthia_thurlow_.

Cynthia Thurlow: Yes. Just to make it complicated. 

Melanie Avalon: Yes. I think that's all the things. Anything from you, Cynthia, before we go?

Cynthia Thurlow: No, I'm loving all the questions. In fact, as Melanie stated, we have an influx of questions and we're just trying to diligently hit a couple every episode. So, keep them coming and I've been encouraging people that have been asking questions in my DMs across social media to email them to us, so we can answer them on air.

Melanie Avalon: Yeah, definitely. Because people will DM me as well. But if you want it on the show, the email is where it needs to be. That's how it goes through the system to potentially get into the lineup. So, all right, well, this has been absolutely wonderful. Happy Memorial Day weekend.

Cynthia Thurlow: Thanks. To you, as well. 

Melanie Avalon: I will see you next week. 

Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.

[Transcript provided by SpeechDocs Podcast Transcription]

STUFF WE LIKE

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

TRANSCRIPT

Melanie Avalon: Welcome to Episode 267 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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And one more thing before we jump in. Are you fasting clean inside and out? So, 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 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 disrupters, which mess with your hormones, carcinogens linked to cancer, and obesogens, which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream and then in our bodies. Studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat, and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that. Beyond weight gain and weight loss, these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so, so shocking. And the effects last for years. 

Conventional lipstick, for example, often tests high in lead and the half-life of lead is up to 30 years. That means when you put on some conventional lipstick, 30 years later, maybe half of that lead has left your bones. On top of that, there is essentially no regulation of these products on the shelves. That's why it's up to us to choose brands that are changing this. The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin, so, you can truly feel good about what you put on. And friends, these products really, really work. They are incredible. They have counter time for anti-ageing, 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 on my Instagram to see what it looks like. Tina Fey, even wore all Beautycounter makeup when she hosted The Golden Globes. So, yes, it is high-definition camera ready. They have so many other products, deodorant, shampoo and conditioner that I love, products for babies, and so much more. You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. Also, make sure to get on my clean beauty email list, that's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. So, definitely check it out. And you can join me in my Facebook group, Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well. 

And lastly, if you're thinking of making Clean Beauty and Safe Skincare, a part of your future like we have, we definitely recommend becoming a band of Beauty member. It's sort of like the Amazon Prime for clean beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally completely worth it. So, again, to shop with us, go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code, CLEANFORALL20 to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.

Melanie Avalon: Hi, everybody, and welcome. This is Episode number 267 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I am here with, Cynthia Thurlow. How are you today, Cynthia?

Cynthia Thurlow: I'm doing well, my friend. How are you?

Melanie Avalon: What's crazy and new in your life? I know you're all over the place with shows, and book madness, and everything.

Cynthia Thurlow: Yeah. No, I think our mindset were four weeks away from a vacation. It's getting two teenage boys, and my husband, and myself mentally prepared. If anyone's listening has teenagers, that they grow so fast at this point that they have to try on a bunch of clothes, because where we're going to we're going to need some nicer things for dinner. And so, nothing that they had from last summer fits them. Absolutely nothing. There's been a lot of growing pains in this past weekend. Lots of boy hormones and nonsense, but I think we finally got it organized and under control. We live in a part of the country where we have four seasons. I was transitioning closets, and sheets, and all of these things, lots of motherly things, and then gearing up for a busy week of Everyday Wellness podcasting myself.

Melanie Avalon: I don't think I know, how old are they? 

Cynthia Thurlow: My oldest is 16 and my youngest is 14. One is six feet tall and the other one is 5'5". They're wonderful, but we have moments. Hormonal moments with boys, even though, they keep to themselves. I would say, it's almost living with a college student, because they stay up really late, they sleep in and I let them sleep in, because we're coming off of spring sports, we haven't yet started summer sports. And from my perspective, as long as they get good grades and they've got a nice group of friends. I'm pretty tolerant. But yeah, it's like they come out of their rooms to eat, and shower, and then they go back. They are like moles. I just think it's very different than when I grew up. My mother would not have been tolerant of that, but I just think it's coming off the past two years of a pandemic. The fact that they had an entire school year, where they were physically in school, and got to participate in sports, and got to spend time with friends that I'm like, "Them sleeping in on the weekend is really not a big deal," although, they do stay up later than my husband and I. It's a known fact. They're probably up till two on the weekend and then they sleep until noon. 

Melanie Avalon: I'm researching sleep a lot, and adolescence, and even like in your teens and stuff you really do need more sleep. Whenever I read that, I get jealous of my former self because I still sleep in and so back then it was scientifically normal. And my mom as well always let me sleep in which I'm very grateful for.

Cynthia Thurlow: They really do need to sleep. If you understand physiologically what's happening with their bodies that to me, there's no value in waking them up at 7 AM and having them be really grumpy and disagreeable. I'm like, "I'd rather they sleep." Much to the same point, one of the blessings of the past few years is that I was much less regimented about getting up really early to go to the gym. And now, most days, I wake up without an alarm clock and my body naturally on its own will wake up somewhere between six and seven, and I'll go to bed between 9:30 and 10. But I think it's important for all of us to lean into our biologic needs as it pertains to honoring our own unique chronobiology. I know that I tend to get up early, and you tend to stay up late, and even as adults, I think each one of us has our own innate, I don't want to say peculiarities, but things that make us unique. I think I would never have survived working in medicine, if I was not someone that could get up early, because we had to be rounding really early in the morning like obscenely early.

Melanie Avalon: That's something that we'll carry on. Gin, as well was or is [chuckles] a lion, an early bird as well. We balance that dynamic. It's funny. I sleep in, I stay up really late, I work late, I sleep in, I still feel guilty about it every single morning. I should probably work on that. Because I don't think I need to be feeling guilty, but I do. 

Cynthia Thurlow: Yeah. No, you shouldn't. Well, because I think as a culture, we praise people.

Melanie Avalon: it's out of line with society. 

Cynthia Thurlow: Yeah. It's like we praise people. But now, if the past two years have taught us nothing, we have way more flexibility than we ever thought were possible. If you have the ability to work from home, find the schedule that works for you. I can tell you quite honestly, I would much rather work really hard while my kids are generally in school, and then late afternoon when carpool starts, I can jump into that, and then I can relax into my evening as opposed to-- Years ago, I would fight myself to stay up really late and work, and there's this law of diminishing returns that I fervently believe in. And for me, especially, when I was writing my book, I was like, "I'm much better in the morning. Much better in the early afternoon." And then as the day goes on, I get a little less patient and a little-- It's not that I can't do podcasts recordings, because I'm sure both of us have had to be flexible with people that live overseas or have varying types of different work schedules. But as a rule, I've just come to find out like I'm at my best earlier in the day.

Melanie Avalon: Yep. And I'm at my best at night.

Cynthia Thurlow: [laughs] And so, we record in the afternoon when we're bridging both.

Melanie Avalon: Yeah. [chuckles] Works well. My mom, though, she's been very supportive of my sleep schedule like you, she let me sleep in. Every time I come to her, and lament my staying up late, and sleeping in late, she's like, "Melanie, that's just the way you are. Don't try to change it," because she's a night owl, too, and her mom and her dad are. 

Cynthia Thurlow: That's really interesting. My mom was one of those people, who worked. She's always had a very demanding job. Before she retired as a CIO of a huge medical system, I think she was probably getting by on three or four hours of sleep a night. And now, that she's retired, it is so nice to see her actually sleeping in. There was a Sunday morning, I think I called her at nine and she was like, "Oh, we hadn't gotten up yet." I was like, "I'm glad to know you're becoming a normal human and listening to what your body needs." She even acknowledges now that all those years where she didn't get enough sleep and it impacted so many things including her metabolic health that she wishes she had listened more to what her body was trying to tell her.

Melanie Avalon: Have you interviewed Matthew Walker? 

Cynthia Thurlow: I have not.

Melanie Avalon: I really want to interview him. He's the sleep guy. What's his book called?

Cynthia Thurlow: I'm not familiar with his work. But yeah, I think all the chronobiology and all the research that's emerging about circadian biology to me is really fascinating. The more I understand and the more I can share with people. It just explains so much about melatonin clocks, and digestion, and why we shouldn't eat two to three hours before bedtime, and how that impacts insulin sensitivity. All of a sudden, all these things make sense. I don't know about you, but if I eat too late into the evening, my Oura Ring's just squawking at me the next day. Your heart rate was up, it was elevated overnight. I'm like, "How does it know I didn't even eat that much?"

Melanie Avalon: It's funny. I eat very late, and right up until bed, [chuckles] and my Oura Ring, so, It's interesting. I've hit a glass ceiling I think in that-- It'll say that I slept really great and it will give me a good readiness score. Actually, when I interviewed Harpreet, who was the CEO at the time of Oura, he's not anymore. I don't know-- [crosstalk] 

Cynthia Thurlow: I know. I know, because I was trying to get him on the podcast and then they politely told me he was gone.

Melanie Avalon: Yeah. I saw that on Instagram. It says former CEO. I was like, "Oh." Basically, I could have a perfect sleep, but because I go to bed so late, even though, the Oura Ring knows I go to bed late, and it recommends that I go to bed at 2 AM, it's not going to give me over a certain score. Because one of the factors is, if you went to bed early, so, I think that hinders my score. But it's interesting. It will say, "Did you eat too close to bed?" But I still get a really good score.

Cynthia Thurlow: But I also think there's an age-related variable. I think Peter Attia was talking about as an example like HRV, if you plot it someone at 30 is going to get a different HRV than someone say, my age. I'm 50. If listeners don't know that, I'm 50. He was talking about like an HRV predicted average for a 30-year-old might be very different than someone at 50. I have patients that are always fixated on their HRV information or a variability, and I have to point them to his article and I'm like, "Maybe you need to take a look at this," because there is some age-related variance. Just like my bone mass and my muscle mass isn't going to be the same as it was in my 30s and that's okay. I think HRV is another one of those metrics that can be impacted by age. Just based on chronologic age, not that I'm not a good example of a healthy 50-year-old, there're some variances that you got that are unique to the aging process.

Melanie Avalon: Actually, I finally bit the bullet and subscribed to his subscriber feed. I'm working my way backwards through all of his Q&A episodes.

Cynthia Thurlow: Oh.

Melanie Avalon: They are so good. I just listened to the HRV one. It took me a while to bite the bullet, but totally worth it.

Cynthia Thurlow: It was totally worth it. I was actually telling my husband is obsessed with Peter Attia and now, listens to his podcasts and Huberman. He's an engineer. To him, the level of detail he really appreciates, even though he's not someone that's an academic and he's works for a German-based company. I was trying to convince him to get the insider with Peter Attia and he was like, "Well, you can just tell me what I need to know." I was like, "Buddy, I take notes." When I listen to Peter, I have a notepad out, same thing with Huberman. I just take notes, because I'm learning so much. I think that's one of the really amazing attributes of podcasting is you have the ability to impact so many people unknowingly. It's a wonderful resource and it's a wonderful way to learn.

Melanie Avalon: If I get to interview him, I told you how I finally connected with his people, right? So, if I get to, I will be so nervous. I don't even know. Oh, my goodness.

Cynthia Thurlow: I think that'd be a really cool thing. 

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Melanie Avalon: For listeners, we have gathered some feedback, which I was posting in my Facebook group, IF Biohackers about Cynthia being on board, which is just so exciting. I'm already just so enjoying this. But it was interesting because people were putting comments of what they were looking forward to-- Oh, which if you haven't heard the announcement. If you would like to get the missing secret Episode Number One of this show, which was lost for a long time, and I did get a question about this. Somebody emailed and said, "I thought you said this was lost. How do you now have it?" It was lost. When Gin was working on making the transition, she was cleaning up her emails and everything, and she found it in our old emails to each other. That's how it randomly popped out of the universe. If you would like to hear the missing Episode number 1, we will send it to you. Just write a new or update your old iTunes review for this show and include in the review what you are excited to experience or learn about with Cynthia specifically, and email that to questions@ifpodcast.com, and we will send you that first episode. 

All of that to say, one of the feedbacks that we have been getting is that people are really excited, especially, so, Cynthia is a Nurse Practitioner, and has a clinical background, and so, people I think are really excited for us to dive a little bit more into more clinical stuff, and studies, and things like that. We thought for today's episode, which is still listener Q&A, but we would start things off by, it was actually perfect timing. A study came out which a lot of you might be familiar with because it hit all of the headlines. The study itself is called "calorie restriction with or without time-restricted eating and weight loss." It was published on April 21st, 2022 in the New England Journal of Medicine. We'll put a link to it in the show notes. And again, the show notes will be at ifpodcast.com/episode267. But in any case, what is so special about this study is that it took over the news. The headlines were things like, "time-restricted eating, no better than counting calories study finds," that was on CNN. New York Times said, "Scientists find no benefits to time-restricted eating." It definitely created a lot of controversy. We thought we would actually take a moment, and look at this study, what is it showing, what is it finding, are these headlines correct, and what they are portraying? You want to start Cynthia, anything to say about the study?

Cynthia Thurlow: Yeah, it's interesting. The media likes to just be sensational and sensationalize information. As soon as it came out, I went and pulled the study, and looked at it, read through it, and most of my clinical peers felt very similarly that when you're looking at research, and I'm not sure. If you've talked about this on the podcast before when you're looking at research, you want to look at how many people were enrolled, were they healthy, was there a breakdown? One of the things that stood out almost automatically was that I think the BMI range like as an example. Body mass index, which isn't per se necessarily, particularly accurate, especially if you're muscular. But the body mass index was between 28 and 40. And for context purposes, a BMI of 30 and above is obese and then 40 and above is considered to be morbidly obese for most metrics that are used. It stood out to me initially, they're saying that no one is diabetic. But yet, clearly, this is not the healthiest population of people to start with. That was the first thing that stood out. 

Another thing that stood out for me was that in terms of looking at the population, there was no accountability for physical activity. They weren't observing people eating and they had some degree. I forget how the terminology they use, but there was some type of processed food products that they were expected to consume. We don't really know, per se, and this is why nutritional science is so confounding is that it's actually very hard to track with every single thing people put into their mouths, unless they're in a controlled environment. So, those were the first two things that stood out to me. How about you, Melanie? When you were looking at the research what stood out for you?

Melanie Avalon: Yeah. I actually have it pulled up right here, so they can comment on what they were eating. They were following, for men, it was a 1,500 to 1,800 calorie per day diet and women, it was a 1,200 to 1,500 calorie per day. And then that processed food you were talking about was they were provided one protein shake per day for the first six months to help improve adherence, which speaks to what you just said that it's difficult when it's an outpatient study, where it's not controlled, [chuckles] where they're not in a metabolic ward receiving all of their food, it's difficult to actually have people to know exactly what they're eating and if they're adhering. 

That was one of the big things that stood out. Because the study is talking about the benefits of intermittent fasting versus calorie restriction. It's actually shocking to me that they did not pull the participants on their ease of use. They didn't ask them at all about their psychological experience of it, because oftentimes, they'll ask that in studies. I forget the terminology they use, but it'll be like, "Was it difficult or not?" And they didn’t ask them that at all. We have no idea if the people who were doing the calorie restriction versus the fasting and calorie restriction, if one of those was an easier protocol to follow or not, which would have major implications for how this actually would apply to real life.

Cynthia Thurlow: It's interesting not to interrupt you, but one of the other things that something you said reminded me of this one issue. When you were looking at the macro breakdown to the breakdown of protein, fat, and carbs. I was like, you already have a potentially, metabolically unhealthy group and it was very heavy on carbohydrates. I'm not anti-carb. Let me be really clear. I don't think that everyone has to be low carb or ketogenic. But if you already have a population of people that are being enrolled in a study that we know are probably insulin resistant or at least are diabetic, even though they screen for diabetes, but there's no way someone with a BMI of 40 is not insulin resistant. It's really interesting to me that instead of pushing the protein lever, it was still a very carbohydrate focused diet. With a macro breakdown to me was not the macro breakdown I suggest for people when they're trying to lose weight.

Melanie Avalon: Yeah. No, that's an excellent point. I wonder the screening, because they did screen for diabetes. I wonder if they were screening for type 1 and type-- They're probably screening for both, but they didn't screen at all for prediabetes. 

Cynthia Thurlow: Yeah. The conventional Western medicine or allopathic model is still really looking at fasting glucose and A1c, which is a 90-day snapshot of blood sugar control. The thing that I like to always introduce, well, your fasting blood sugar can be okay and your A1c can still be okay. But if your fasting insulin is dysregulated, that's oftentimes the very first biomarker that will dysregulate, they're very likely not even looking at that. I can't tell you how many people, like, I talked to them and they'll share their labs and I'm like, "Where's the fasting insulin?" Then they get a fasting insulin back. And instead of being between two and five, which is where ideally it should be, it's 20. I'm like, "Okay, well, this explains why your weight loss resistant." 

I don't think that they provided information about how they were screening. I agree with you that that could have also very likely been a way that they may have missed people, who would not have been metabolically flexible enough to be able to participate in a meaningful way. Not to mention the fact that oftentimes, insulin resistance can also be connected with leptin resistance. I'm sure our listeners are really savvy about leptin being this other hormone. I just start to think about all of the little nuances like as a clinician that I didn't see were even addressed or mentioned in that study. I think the other piece is like, New England Journal of Medicine is a preeminent Journal. Even really good journals can have research in them that cause us all to scratch our heads and say, "Okay, well, it was helpful. We have to do more research to look at these variables, and we have to be even more conscientious about who we're enrolling in these studies, and what's really going on for them outside of this laboratory environment."

Melanie Avalon: So, something you said sparked a very tiny little baby rabbit hole for me tangent. Actually, the episode I was listening to last night that Peter Attia, Q&A episode, I was listening to the one on continuous glucose monitors and he was talking about, "Would we ever have a continuous insulin monitor?" The potential with that or the issues with that he answered the question of what did he think was the first biomarker that would be off that would indicate prediabetes or headed that route? Do you want to guess what it was?

Cynthia Thurlow: Probably, not going to be like uric acid or something like that.

Melanie Avalon: It's in the realm of what you were talking about. 

Cynthia Thurlow: So, did he think it was insulin? 

Melanie Avalon: Yes, but what type. when? 

Cynthia Thurlow: Probably, postprandial?

Melanie Avalon: Yeah. Basically, after eating, the insulin that would be the first thing. But that's something that we're not really ever testing. So, that's why he was saying, one of the benefits of having a continuous insulin monitor would pick up on that. In any case, back to the study. I guess, we can talk about what it actually found. This is probably the first thing that stood out to me the biggest thing, which was, if you had come to me and said, "We're going to do a study, where we will compare people on calorie restriction and then people on calorie restriction with fasting," what do you think we'll find? Honestly, I think I would say, "What this study found is pretty much exactly what I would have anticipated finding," which is I would anticipate that they both lose weight or I would guess that the fasting people would lose a little bit more weight. But I wouldn't think that it would be a massive amount more, because both are calorie restricted. I would expect that all other biomarkers would probably improve a little bit more in the fasting group, which is exactly what this study found, despite the lack of "statistical significance," which is something I can comment on in a little bit of detail. We'll put a link in the show notes. 

Jason Fung did a nice write up on this in his Substack. We can put a link to that. He talks about this in that right up. But basically, for people who aren't familiar, when you have a study, significance means statistical significance. It doesn't mean because if people hear significance, they might think it means like, "Oh, that was like a really good effect." But it just means that it's showing statistically that this is happening. But I think a lot of people don't realize is, it's not you do the study, and then you look at the data, and then you determine if what you found was statistically significant. It's set up from the beginning to only be statistically significant if a certain outcome happens. That's a subtle nuance, but it's really important and it has to do with something called powering a study. 

This study was powered to find a weight loss difference of 2.5 kilograms, which is five and a half pounds. What that means is that if the fasted group did not lose five and a half pounds more than the other group, then the conclusion is it's not statistically significant. What ended up happening was, the fasting group lost about four pounds more, not 5.5. Because of that, they can conclude, "Nope, there's no statistical significance," which I think is doing a bit of disservice to the whole concept. What Jason talks about in his write up is he says that if you look at the numbers, so, basically, the calorie restriction group, they lost 6.3 kilograms after 12 months, which means that the fasting group in order to be statistically significant would have had to have a 40% increase in weight loss, numbers wise. 

As Jason points out in his overview, that's a really high bar, [chuckles] especially when they're already losing a significant amount of weight. But when I say significant, I don't mean statistically significant. In any case, the study was underpowered. Not that it was set up to fail, sort of was. We can put a link in the show notes. Peter Attia also has a really nice write up, where he it's a five- or six-part series, where he talks about how to interpret and read studies. He talks about this about powering studies and he talks in that about how just because something is not statistically significant, it doesn't mean that it's not showing something. And just because something shows something, they don't necessarily correlate. So, I have other thoughts, but I'll stop because that was a lot.

Cynthia Thurlow: No, I think you did an excellent job. I think on a lot of levels, right after that study came out, I jumped on and did a really short IG live saying, "This is not going to change my perspective on fasting." I think this really speaks to the fact that the media likes to jump on one little snippet and say to propagate this misinformation that, "Oh, fasting isn't valuable." I always explained that if you looked at the groups, the fasting group always did better. It just didn't reach, as you mentioned, the statistical significance that had been set up prior to the study starting. I think this is a really important reason for why even at a very basic level, each one of us need to understand how to properly interpret a study or even to be able to look at some of the big highlights that you and I have talked about, so that you can examine it and say, "Is this really valid?" Can we extrapolate from one study, that fasting is invaluable or is not valuable, rather? I think it really goes back to not throwing the baby out with the bathwater. I mean, I hate that expression, but it just seems really appropriate in the circumstance. And certainly, you and I both have seen thousands and thousands of people that have benefited from eating less often. 

The other piece is, and someone asked me this, and I never dove down the rabbit hole to figure out who had sponsored the study. I know it was done in China, but I don't know who sponsored the study. Because sometimes, when you see who's sponsoring particular research, it makes you understand why they're getting results that might be contrary to what is commonly believed to be true. 

Melanie Avalon: Yeah. It says that it was supported by some Grants National Key Research and Development Project, Outstanding Youth Development Scheme of Nanfang Hospital, a lot of other research programs. It's just so interesting. In a way, it's arbitrary. If the researchers had decided beforehand, let's set it up to look for a four-pound difference, then it would have been a completely different interpretation. Isn't that crazy? You would have a completely different headline, same findings, probably, to that point about the benefits extending beyond just the fasting. Basically, in the fasting group, because they looked at the participants results six months out and 12 months out, and basically, everything got better in the fasting group compared to the calorie restriction groups. The HOMA-IR, which is huge comparing insulin and glucose, the insulin, glucose, HDL, triglycerides, blood pressure were all better in the fasting group. LDL was very similar in the two groups, which is interesting. I don't know why that might be. I was actually wondering if you had any theories on why the LDL is really interesting. At six months, it was down negative 5.9 in the fasting group and down negative 11.3 in the calorie restriction group. So, almost double. But then it evened out at 12 months. Negative 8.4 compared to negative 8.9.

Cynthia Thurlow: I wonder if it's really a marker in that instance of inflammation and a reduction in oxidative stress, because it's not uncommon. For listeners benefit, when we're looking at LDL, it's only one piece of a puzzle. I always like to look at advanced lipid analysis. Looking at particle size and as an example, you can have light and fluffy or you can have dense and small. The latter, it tends to be more atherogenic. If you're already looking at a population that to me sounds, they're not metabolically healthy. I think that weight loss is probably what's driving the lowered LDL numbers. Why the HDL--? Well, they didn't account for physical activity. I think that was one of the things that stood out to me, because we know that HDL is-- There are many things that impact HDL, obviously. But one of the things that's impacted by HDL is exercise. If these people were couch potatoes, I don't know what the equivalent would be. I don't know how physically active this group was. I'm assuming they weren't. That could account for why there wasn't a significant change in their HDL, my first thought.

Melanie Avalon: I think the biggest difference just looking through the charts, the area of abdominal subcutaneous fat was really different. At 12 months, the calorie-restricted group lost 37 centimeters squared and the time-restricted eating group lost 53.2. 

Cynthia Thurlow: That's significant. 

Melanie Avalon: This was subcutaneous. The visceral was still it was 21 for the calorie restriction and 26 for the fasted group.

Cynthia Thurlow: No, so that differentiators, the subcutaneous fat is an annoying fat. That's the one that most of us, when we think about fat on our bodies that we don't like, that's not as pathogenic as visceral fat. I think that with weight loss, you'll see changes in both, but one is certainly more significant than the other. And obviously, where we carry fat is significant. On our butt, in our thighs, as women is much less significant than our abdomen area like our truncal. They call it truncal obesity, but that area is much more significant, because that's closer to our major organs and generally correlates with metabolic inflexibility and insulin resistance.

Melanie Avalon: Yep. That's all in my head right now because I'm prepping to interview Sara Gottfried on Monday, who Cynthia just interviewed as well. She talks a lot about the role of different types of fat in the body and how it changes for women in menopause and good times. But yeah, so, basically, it's frustrating, honestly, because the study showed in my opinion, really great things about fasting and just the takeaways in the headlines are just so not representative of what it actually found. And then on top of that, I can see the benefit of comparing fasted calorie restriction to calorie restriction. But at the same time, I think, in general, the reason people love fasting is they get the benefits without the calorie restriction. I was reading one comment on the study and I actually laughed, because it's not funny, but it's the type of thing I would laugh at and it was like-- Somebody said, "Well, basically, all the studies showed is that calorie restriction works," which yes, [laughs] if it's actually controlled.

Cynthia Thurlow: Well, and I think it goes back to there's always this debate about calories versus the carb, insulin hypothesis, and weight loss. It's two different dogmas really fighting fervently to better understand what drives inflammation, and weight loss resistance, or weight gain, and so. The debate is still out there. There's no question that fasting is a valuable resource. For a lot of people, who don't want to calorie count and I'm definitely one of them, I just enjoy knowing that I can eat within a particular window and I can modulate a lot of different factors that helped me maintain a healthy weight.

Melanie Avalon: Exactly. I think what's interesting and this is a question that has stuck with me in my show, The Melanie Avalon Biohacking Podcast. I've interviewed so many people, but every now and then I ask a guest a question, and it just sticks with me asking them, and it sticks with me their answer. And one of those questions was, when I had James Clement on the show. He wrote a book called The Switch and we've become really good friends. But I asked him all of these different things like fasting, calorie restriction, protein restriction, are they additive, or are they all activating similar pathways? So, they're not additive. He said, "They're not." They basically cancel each other out. If you're doing calorie restriction and calorie restriction in fasting, you're not necessarily going to see a huge additive benefit, because they both work by similar mechanisms even though fasting doesn't necessarily require calorie restriction. They activate similar pathways. So, yeah.

Cynthia Thurlow: I haven't interviewed him, yet. 

Melanie Avalon: He's lovely. Although, I was just talking to him, because [chuckles] I was giving him my monologue of what I thought about the study and to see what his thoughts were and he said he basically agreed. So, I felt good. [laughs] 

Cynthia Thurlow: Good to have that validation.

Melanie Avalon: I know. I was like, "Okay, from the scientist." He runs a lab that studies the blood work of super centenarians. He did this huge super centenarian study, and then he wrote The Switch, and right now he's actually working with Steve Horvath, who I would die to interview. [laughs] George Church wrote the foreword to his book, it's all the big wigs in the genetics world. He did say, last night, he's not really doing podcast interviews anymore. I don't think they're his thing. 

Cynthia Thurlow: A lot of those researchers-- I always think like Rick Johnson, for anyone that's listening, he's this amazing fructose researcher. But he is probably one of the most gregarious, happy, extroverted researchers I've ever met in my entire life. I thought when I recorded with him that it was so dense in terms of content that I was like, "Well, I'm going to be curious to see how this resonates with my listeners" and they loved it. They're like, "Oh, my gosh, he makes it so clear." I agree with you that sometimes these research folk tend to be a little more cerebral, they're a little more introverted, they might be less comfortable doing podcast interviews, which is a shame because I think podcasting is such an amazing way to really get a sense for what people are doing and to share ideas in a way that can inspire others to take better care. My feeling is, I listen to podcasts, because I'm always looking for another angle to look at to help patients take better care of themselves. But not all of us are extroverts and introverts. Some people are just true introverts. The thought of being on a podcast probably gives them hives.

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AvalonX supplements are free of all common allergens like wheat, gluten, eggs, soy, dairy, shellfish, nuts, even rice, which is very, very common in a lot of supplements. Check for that. They also come in glass bottles and are vegan. For my first supplement serrapeptase, we created a special process that requires small batches to make that uses only a small amount of MCTs as a lubricant and filler. None of the other serrapeptases on the market are doing this. That was actually one of the biggest things to tackle, because most of the serrapeptase on the market has problematic fillers and suspicious enteric coatings, which likely contain plastics and other potentially toxic compounds you don't want in your body. We use a special delay release capsule that ensures the serrapeptase reaches your small intestine, so that it can be absorbed into your body. 

What is serrapeptase? It's a proteolytic enzyme created by the Japanese silkworm. When you take it in the fasted state, it actually breaks down problematic proteins in your body. So, it can really help anything where your body is reacting to problematic proteins. That's why it can radically help with allergies, it clears my sinuses like none other, and it can clear brain fog, studies have shown it may help reduce inflammation, enhance wound healing, help with pain, even reduce cholesterol, and break down amyloid plaque. Basically, it's the coolest supplement ever and it is an awesome way to really amplify your fast. I take it every single day. We also recently launched subscriptions so that you can get a big discount on my supplements, as well as help, support, sustainability by reducing emissions from shipping. And my next supplement is coming soon. That is magnesium. Get excited. If you want to get the latest information, specials, news about new supplements, and stay up to date on everything, AvalonX, definitely get on my email list. That's at avalonx.us/emaillist. When you join that list, check for the welcome email to make sure it doesn't go to spam. And you can shop, of course, at avalonx.us. Again, that is avalonx.us. A-V-A-L-O-N-X dot US, avalonx.us. And I'll put all this information in the show notes. All right, now, back to the show.

Melanie Avalon: I'm glad you brought Rick up. When Gin and I were discussing, transitioning her out of the show, and I wasn't sure yet about Cynthia, I was like, "Oh no, I need to bank up some interviews." I actually reached out to Rick to see if you'd like to come on this show, because I just think his content is so valuable and listeners of this show would really love his work, because I had him on the other show. So, I'm actually interviewing him for this show. I don't know when we'll air it, but just to have it. I'm interviewing him this week.

Cynthia Thurlow: I think he's amazing. He's probably easily one of my favorite interviews I've done this year.

Melanie Avalon: He's just fabulous. [laughs] So, listeners get excited. I'm not sure when we'll air that, but we will have an episode on this show with him upcoming. Okay, I think we tore that study apart. Again-- [chuckles] For listeners, again, the show notes will be at ifpodcast.com/episode267. We'll put a link to that study there. If you want to read the whole study, it is in the New England Journal of Medicine. Right now, only the abstract is available, but you can sign up for a New England of Journal Medicine account and you get I think at the beginning three free studies. Use them wisely. [laughs] So, you can grab this one if you like. Okay, shall we jump into some listener questions? 

Cynthia Thurlow: Sure. 

Melanie Avalon: To start things off, this is very exciting, because Cynthia and I were brainstorming about topics to talk about and Cynthia, specifically, wanted to talk about creatine and I was like, "Well, I got you covered," because if listeners are curious, we have this massive document of all questions that have ever been submitted to the show ever and it is hundreds and hundreds of questions. If there's ever a topic we actually want to talk about, we don't have to make up a question. I just have to go in there and find it, because I'm sure somebody has submitted one before. We have two questions about creatine that I'm going to read and then I'm super curious to get Cynthia's thoughts on this. The first question is from Zach and the subject is: "Creatine." And Zach says, "Hi, thank you for all the work you do on this podcast. I'm a former American football player, who has had great success using intermittent fasting one meal a day, paleo eating, and HIIT workouts to lose weight and develop an awesome fulfilling lifestyle. When I finished playing football, I was 300 pounds with zero diet discipline. Luckily, my brother." Hi, John, "told me about your podcast and your books and in the 10 months since my football career ended, I've lost about 80 pounds. I'm still losing weight, but I am also at the point, where I would like to work on muscle mass and tone again. In pursuit of this, I've hidden my scale, opting instead to focus on being happy with my body and not relying on what the scale tells me for my happiness. I use a one-meal-a-day approach. While I have tons of energy for my workouts, I am looking for something to maximize my muscle recovery given my intense workouts. In the past, I've had success taking creatine for this purpose, but that was during my football, eat everything, and get as huge as possible regardless of impact on your body stage. That's my comment." That sounds really intense. He says, "I don't think that creatine has been discussed on the show yet and if so, I apologize for the repeated question. What are your thoughts about supplementing creatine, whether it is beneficial or harmful? If beneficial, when to take it, how much to take, etc.? Thank you so much in advance and keep up the amazing work." And then, Cynthia actually got a DM question from Laura Dana or Laura Dana. And she says, "That she would like advise/education on using creatine as a woman. When, how much, expected reaction, brand? Thanks." She says she loves Cynthia's book, which, by the way is Intermittent Fasting Transformation. So, creatine questions from a man and a woman.

Cynthia Thurlow: I love it. It's interesting. I started working with a new trainer in 2021 like out of her mouth, the first thing she said to me and she's very research based, she's a former attorney, she's just incredible. She was like, "You need to use creatine." I was like, "Wait a minute." I was like, "I've heard so many conflicting things." For benefits of the listeners, there are sex differences between the utilization of creatine. But in terms of benefits, they include things like increased muscular endurance, they increase muscular power, strength, they can improve bone health, and we know that it improves brain health, and it can improve cognitive function, and it helps recycle ATP, which I'm sure Melanie and Gin have talked about, it decreases the effects of sleep deprivation, improves mood and memory. There's lots of benefits, obviously. 

And obviously, the first question comes from someone who played what sounds to be professional football. The second question comes from a young woman, who's asking and so, what I always say is that there are sex-related differences with creatine. We know that women make 70% to 80% less amounts of endogenous creatine in their muscle tissue. But what's interesting is we have increased higher resting concentrations of creatine. It's like, what we do have is significant in terms of, it's almost like testosterone. Women make less testosterone, but what we have in our bodies is the most bioavailable hormone. So, much the point of what we're saying with creatine, there are sex-related differences. What's interesting though is when I looked at the research, we know that there are changes during our menstrual cycles with creatine. We actually get, when we have a more higher estrogen state, so in the follicular phase, we have increased creatine kinase and this can impact glucose oxidation. We know that creatine supplementation in women can be really beneficial in perimenopause and menopause, can actually improve muscle, bone strength and help ward off sarcopenia, which is a term that is essentially muscle loss with aging.

It's not a question of if but when, it starts to accelerate after 40. For those that aren't aware, we have peak bone and muscle mass in our 20s and 30s. I, of course, didn't appreciate this until I got to middle age. It's really important. I think even if you're looking at a review of randomized controlled studies, it definitely looks like supplementation with creatine has a lot of benefits. If people want us to go into a deeper dive into these things, there's a lot. It's so interesting. If you look at the research, sometimes, people will talk about needing a loading phase. I'm not sure, per se, that we all need a loading phase. But I do think it is interesting and what I generally recommend people aim for is a gram a day and the product that I use and take which was recommended to me by my trainer. I want to give her full credit is a product called Con-Cret. It's CON-CRET. And the manufacturer is Promera Sports. You can go to their website. 

What I like that is important is that a lot of times people are worried about taking creatine, because they think it's going to make them bloated, it's going to make them look bulky. As it pertains to women, we just don't have enough circulating testosterone for that to be an issue. Obviously, I use one scoop a day in a protein shake and that works really well for me. Do I feel like it has to be timed around workouts? No. That's oftentimes the question I get. But I do take it during my feeding window. I don't take it in a fasted state. I would imagine men could definitely start with a higher starting dose. This Con-Cret product, it's 750 milligrams in a scoop. Obviously, if we're aiming for a gram a day, you probably want a little more than a scoop and a half or a woman. For a man, you might want a product that has more concentration of the product per scoop. Because for men, it was looking like maintenance phase is somewhere between two to five grams a day. Now, with that being said, I think low and slow is the way to go. Try it out, see how you feel, be careful sourcing supplements on Amazon. I don't know if you've talked about this before.

Melanie Avalon: We talk about this so much. 

Cynthia Thurlow: Yeah. You may actually get something legitimate on Amazon, but the statistical likelihood is pretty low. As it pertains to creatine, you can go directly to the Con-Cret website. I have no affiliation with them whatsoever. But that's generally the recommendation, because there's a lot of junk that's out there. I'm not going to name stores that I think of when I say this, but you really want to look like-- My trainer at one point was an IFBB like bodybuilder. She now looks like a very petite normal person. But this is the product she uses and recommends for her clients, and she's very research based, and very smart. And so, I always like to give her props. But creatine, yes. Creatine supplementation, especially for women really important. We don't have as much circulating in our tissues. In our menstrual cycles, we definitely want to be supplementing it. If we are perimenopausal, menopausal, we want to be more apt to be utilizing creatine because it can help with muscle and bone strength. Like I mentioned, it's not an if but when. Sarcopenia will happen if we don't work against it. That's why Melanie and I always talk about this. You have to eat enough protein, make sure you're doing some weightbearing exercise, getting high-quality sleep, all of which can help you ward off sarcopenia.

Melanie Avalon: I love this. Did you listen to--? How many times can we say Peter Attia on today's episode? Do listen-- [laughs] We're such fan girls. Did you listen to his interview with Layne Norton, recently?

Cynthia Thurlow: I have not, because I went down a rabbit hole listening to-- So, do you know the Low Carb MD Docs?

Melanie Avalon: I do. Who are they? I think so. 

Cynthia Thurlow: It's Dr. Tro and then Brian Lenzkes. They're very good friends. But Tro and biolane as he calls himself have had some knockdown drag outs. But they did actually have a very respectful conversation. I've listened to him on a few other people's podcasts and I have to set aside the time, because as anyone who knows Peter Attia, or Huberman Lab, or any of those, it can sometimes be a two-and-a-half-hour conversation. I have to mentally be on my game to set aside that amount of time and take notes. I haven't listened yet. That was my long explanation for having listened yet, but I do intend to.

Melanie Avalon: Do you what's funny? Speaking of sleep earlier, I listen to very specific podcasts at night during my routine. The shows I listen to at night are always either Ritual, Well-Fed Women, or Peter Attia. I just wonder if I were to listen to Peter Attia during the day, if I would get sleepy, because I'm so conditioned to-- It's like my wind down. I find it very comforting to hear him talk about. [laughs] In any case, though, that recent episode, we can put a link to in the show notes, because they did a deep dive into creatine. Layne was talking about the importance of what you just talked about of finding a good version. They were talking a lot about all the claims that are often put on them are just marketing. 

Cynthia Thurlow: Yeah. Melanie will share the research study I shared with her via text message before we jumped on. My hope is that we are going to be able to offer up some research-based opinions on a lot of topics that people are interested in learning more about. And obviously, if people are interested in learning more, I actually have a lot of notes. I took a lot of notes when I was reading a lot of research articles, because there's a lot to creatine, it's really interesting. Maybe what we'll do is create a mini-creatine PDF or something in the future.

Melanie Avalon: Yeah, that'd be amazing. Questions for you. "Should everybody be taking creatine?"

Cynthia Thurlow: Well, from what it sounds like, I didn't see any major contraindications. Meaning, things that people shouldn't be doing. But I think when women are in their follicular phase, that's when actually creatine is at its lowest. It's reduced in pregnancy, it's obviously lower in postmenopausal women. Obviously, if you're pregnant, I'm not advocating you take this. Let me just put that caveat in there. You have to have a conversation with your OB or your nurse midwife. But menstruating women, yes. Postmenopausal and Perimenopausal women, yes. Because what people don't understand is that muscle loss with aging also impacts our insulin sensitivity, and impacts our metabolic health, and we want to do everything we can to maintain as much lean muscle mass as we can throughout our lifetime. What's interesting is we become insulin resistant in our muscles first. This is really important for people to understand. 

To me, I want to do everything I can to preserve my muscle mass and to continue to build it. I know you're going to interview Dr. Gabrielle Lyon. She's a good friend and I've interviewed her on my podcast. We can even include that link. But she is a muscle protein synthesis expert and she talks a lot about these kinds of topics. I always say she's rubbed off on me entirely, forced me to really understand muscle physiology to different level. For everyone that's listening, unless you're pregnant, I'm not making any blanket statements about pregnant women. But menstruating women, men, and women in middle age like perimenopause and menopause, you can benefit from this. I think it's fairly inexpensive. I want to say, when I bought Con-Crete, I think it was under $25 and it's got 64 servings. You might buy a couple of these a year trying to see how you feel it does for you. But for me, because I'm at a stage where I need to continue to preserve, and maintain, and build what I have, and I'm working at a hormonal disadvantage at this stage. If you're under the age of 40, you're at a hormonal advantage to someone who's middle age. So, it's easier to build and maintain muscle. But at my stage, I have to work harder at it and I'm okay with that. I'm not complaining.

Melanie Avalon: "Since it's an amino acid would you consider breaking the fast?" 

Cynthia Thurlow: Yeah, I would take it. I take it in a shake. To me, I can consume it in a feeding window. I think one of the things that I've seen pretty consistently in your communities and our new shared communities, but also in your own community, people are trying to figure out like, "When they can take something?" When they can't take it, take this with food, or take this with a meal, or take it in a shake. There's no taste to it. I've even put it on water. That's not my preferred way, but you don't have to take it immediately after exercise. Just like you don't have to consume 30 grams of protein immediately after exercise. Your body keeps track over a 24-hour period of time. Don't get caught up in the before and after nonsense. There's so much misinformation about that in particular that I just see across social media. People are paralyzed about when to take stuff. This is definitely something worth taking in your feeding window. 

Melanie Avalon: Yeah, that was actually something from the Layne Norton episode. He's all about eat protein constantly all day.

Cynthia Thurlow: Have you seen him? He's pretty big. He's a big guy.

Melanie Avalon: Yeah. What's interesting about the creatine, so, it recently, semi-recently came on my radar, independent of all of this conversation. I'm going to interview a guy named Simon Hill, he wrote a book called The Proof Is in the Plants. Do you know him? 

Cynthia Thurlow: Mm-mm.

Melanie Avalon: He's big in the vegan world. He was on Rich Roll and they were talking about creatine because there is this study that is, I guess, hotly debated. It's called The Influence of Creatine Supplementation on the Cognitive Functioning of Vegetarians and Omnivores. And basically, what it did was it looked at omnivores and vegetarians before with no creatine supplementation, and then gave them these different cognitive tests, and then had an arm who took creatine to see how they performed with the creatine. When they did that the vegetarian arm performed way better, way better. Whereas before, they had been pretty similar in their performance on the cognition test. It's complicated and the reason it's debated is people debate about how to interpret those findings. But the main way it's been interpreted is, since the vegetarians did way better with creatine supplementation than the omnivores indicates that maybe they were deficient in creatine. That might be something to consider, which is that if you are everything. Cynthia was just saying, if you're not getting all of your protein, or if you're on a vegetarian, or a vegan diet, this definitely might be something that you would like to supplement with.

Cynthia Thurlow: No, I'm so glad you brought that up because that was a part of my little segue. The other thing that I just want to interject that I thought was interesting is, we know that creatine has benefits on sleep, because it interacts specifically with glycine and GABA. These are these inhibitory neurotransmitters in the brain. A lot of people take GABA before bed. But I will say that since I've been taking creatine, I feel there's a whole mountain of things I take to support sleep. I'll be totally transparent. But when I've been consistently taking certain supplements, I've definitely noted an improvement in my sleep quality for sure. But there's also research to show that it can be helpful for sleep support as well.

Melanie Avalon: Out of curiosity, what have been some of the main things that you've implemented that you've noticed? Again, it's hard like you just said because there are so many factors. But what are some of the things that you've noticed the biggest effects on your sleep?

Cynthia Thurlow: In terms of supplementation or just lifestyle? 

Melanie Avalon: Yeah. I guess, anything.

Cynthia Thurlow: I would say GABA and L-theanine for me have been huge, huge. Those two in particular and then high-dose melatonin, and obviously, north of 40, we make less melatonin. Just like every other hormone, we start producing less and less of things. I started working with a new integrative medicine doc towards the tail end of 2021. When he looked in his labs, the first thing he said was, "Oh, my God, you need some melatonin." I said, "Well, my sleep isn't that bad." And then we started talking about the role of melatonin and how it's this master antioxidant. And so that's something I've been using with my own patient's, high-dose melatonin that has really been life changing. This is not medical advice. Obviously, have a conversation with your healthcare provider. But if you're north of 40, you're making less of it and melatonin is more than just helping you sleep. I think those three things for me, the GABA, the L-theanine, the high-dose melatonin has really made a tremendous net impact. I think you're going to interview Dr. John Lieurance, right on your Biohacking.

Melanie Avalon: I did interview him. 

Cynthia Thurlow: Yeah. He reschedules, I reschedule. He reschedules, but he has a product called Sandman. Have you tried it? 

Melanie Avalon: No, it's in my refrigerator.

Cynthia Thurlow: I think it freaks everyone out, because it's per rectum, which my entire family thinks it's hilarious. I only maybe use it once a week. But wow, that stuff-- it's pretty powerful. Don't be afraid of it. But I think when you're younger, there's probably less need of being on super physiologic dosing. I look forward to connecting with him because the more I learn about chronobiology, and circadian biology, and melatonin, the more I feel I'm just I'm like, "Wow, my eyes are open to a whole new world."

Melanie Avalon: I think you and I talked about this when I interviewed you on my show. But I interviewed John, I read his book, which is I think called like Melatonin Miracle or something like that. I was like, "Well, this is very convincing." I still even despite reading his whole book, which talks a ton about there not being a feedback loop system that would hinder your natural melatonin production, I was still not quite sold. He sent me that you use different words that I normally hear. What word did you use for it?

Cynthia Thurlow: Yeah, per rectum, it's how you take it. I was trying to explain to people like you put it up your bum, that's how you take it. It's a very vascular area. So, it's a good way to administer medications or supplements.

Melanie Avalon: Yeah, what's funny-- It's fit in my refrigerator. I feel like John will text me every month or so. I'll be like, "Have you tried it yet?" I'm like, "It's still there."

Cynthia Thurlow: No, don't freak out about it. But I do agree with you, Melanie. Even when I was talking to Michael Breus, I asked him what he thought about high-dose melatonin. He wasn't a fan. I think it always needs to be taken in the context of, for me, I'm 50 years old. My body makes less of it. I sleep better with some supplementation. I'm okay with it. But would I have taken that at 30? Probably, not. Your body's still making vibrant amounts of that hormone and so I think maybe cut it in half and use half the dose.

Melanie Avalon: Well, two things shifted my thinking on that. One was I-- Three things. One was, when I got COVID, the doctor I was working with who is more-- He's a conventional MD, but more open minded. Part of his protocol was getting on melatonin for COVID. I was taking pretty high-dose melatonin during that and not experiencing any perceived negative benefits of that. And then two other things happened. One, the melatonin I currently use is by Pure Encapsulations. It's the exact same bottle as my digestive enzymes. Same size, same color, same everything. I take an exuberant amount of digestive enzymes, like a ton, especially I eat pounds and pounds of protein. I took half a bottle, not realizing it. [chuckles] What was interesting was, I woke up the next day, because I didn't realize that I'd taken that much-- I didn't realize until the next night that I'd taken in half a bottle of melatonin. I was like, "Oh, okay, I think may be my perception--" I didn't experience any feelings of grogginess or anything. I just felt really good the next day. I was like, "I wonder how much my perception of melatonin making me feel too drowsy or an issue. How much of that is psychological?" Because when I took half a bottle not realizing it, it was fine. 

The third thing that sold me on it was interviewing Dr. Steven Gundry for his newest book. His book, Unlocking the Keto Code, he talks a lot about the mitochondria in the cell and everything that's happening with energy production. And even though, John Lieurance talked about in his book, I don't think I really grasp the fact until I read Stephen Gundry's Unlocking the Keto Code that in our cells, the two things that are really keeping those mitochondria going and serving as antioxidants are glutathione and melatonin. Then I was like, "Oh, so, melatonin, it has a lot of benefits on a cellular level beyond just sleep." Now, I do supplement with it more. I'm trying to find my right dose, but I take at least one of my pills each night. I think it's three milligram. 

Cynthia Thurlow: Well, it sounds appropriate. It's funny. MD Logic makes a product and I was transitioning from designs for health. They have a sustained release formulation. In my mind, I was like, "Okay designs for healthy dose and I'll make the equivalent with this other product." It's the first time I've taken too much melatonin. Three of the same, it was the same dose, but MD Logic's product was stronger. I woke up the next day and I could barely get my eyes open. I was like, "The thing you do if you've taken too much melatonin as you get sunlight exposure on your retinas that will help suppress melatonin, increase cortisol." I'm oversimplifying, but yeah, I got out and took a two mile walk outside in the Sun without sunglasses, and then felt better. But I was like, "Whoa, that is not the same. It's much stronger."

Melanie Avalon: Which brings us back to the importance of vetting your brands. There actually is a study, when I was researching, I think for this show, I was researching, when they test supplements, the actual-- what's included in the supplement and there's a study on testing melatonin supplements. Oh, my goodness, the range of what was in them compared to what they said is just so scary. [chuckles] You definitely want to make sure that you are taking brands that you trust, and it sounds like MD Logic's melatonin probably, actually has what it says it has. 

Cynthia Thurlow: Yeah, no, no, it was unbelievable. I was stunned. I think after many years of prescribing medications, and supplements, and things like that, I'm pretty savvy. But that was a little humbling. I was like, "Oh, thank God, I'm glad I didn't have to be talking on a stage that morning. I would have been feeling I was struggling a bit." I'm like, "I got a little too much melatonin," but you can work around that.

Melanie Avalon: If you would like to get their melatonin, we'll put a link to their website in the show notes, but the code, MELANIEAVALON will get you a discount code on their website. So, okay, well, this was so fun. I'm excited, because this was our first-- Last week, I just interviewed you. But this was our first normal episode [chuckles] and I really enjoyed it.

Cynthia Thurlow: Absolutely. No, it's nice to have a forum to be able to discuss some of these things, because it's hard on social media. I endeavor to try to respond like when that New England Journal medicine article came out, I did a very brief IG live, just so that it was available to be able to send out and share with people. But as I'm sure you're in the same boat, it's impossible to get to every question and answer every question. I look forward to seeing what the listeners want to learn more about. And obviously, we didn't get to all the questions that we've been asked. So, we'll get to those in future episodes.

Melanie Avalon: Exactly. Yeah, it's really nice to have, especially the creatine as well, to have had a foundational conversation. Then in the future, when people are like, "What about creatine?" We can be like, "We talked about it on the IF podcast. For listeners, if you go to ifpodcast.com, there is a search feature there. Because we have transcripts for all the episodes, you'll usually find the episode, where we talked about it, which is really nice. Definitely take advantage of those transcripts and the search function, which some resources for you guys. If you would like to submit your own questions for this show, you can directly email questions@ifpodcast.com or you can go to ifpodcast.com and you can submit questions there. You can get all of the stuff that we like at ifpodcast.com/stuffwelike and you can follow us on Instagram. I will say, Cynthia, you're one of my Instagram role models. [chuckles] You do it so well. You do all those IG lives and I'm like, "Ah." They drain me so much, the IG lives.

Cynthia Thurlow: You and I've learned shorter is better. Not only does it get more views, because I used to get so many questions when I would do Ask Me Anything. I was like, "Oh, I'm going to do an IG live and I'll answer all them all at once." No, no, it turns into an hour-long discussion. I told my team, "Now, I'm going to just be targeted." When I come on, I've got something to say. My team did reels yesterday that has gotten some interesting feedback. I may have to address that in an IG live this Week at some point.

Melanie Avalon: Oh, exciting. For listeners, if you'd like to see all of that content, okay, tell me your handle, again. There are underscores in it, right?

Cynthia Thurlow: Yeah. It's @cynthia_thurlow_. If anyone who's wondering, I used to have a business name. And so, after the viral TED talk, I got the bright idea that I was going to change all of my social media handles to the same thing. The unfortunate thing for me was that a lot of the handles that I wanted were already taken by other Cynthia Thurlow. So, I was left with-- It's bizarre constellation of different usernames on different platforms. But yeah, @cynthia_thurlow_, you'll see me there.

Melanie Avalon: And I am just @melanieavalon. I've actually been pretty surprised with social media that knock on wood. Melanie Avalon was pretty much always available everywhere. Even on Venmo, [chuckles] it's like a unique name that I guess nobody has.

Cynthia Thurlow: This is my married last name. And so, there are a lot of Cynthia Thurlows and that's their maiden name. So, inevitably, at least once a month, I get a message asking, if I'm someone that's from Maine, and I'm like, "No, this is my married name. I'm nor that person. Nope, nope, nope."

Melanie Avalon: So, yes. Well, I think that is all the things. This has been absolutely wonderful and I will talk to you next week. 

Cynthia Thurlow: Sounds great.

Melanie Avalon: Bye. 

Melanie Avalon: Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs, and original theme composed by Leland Cox, and recomposed by Steve Saunders. See you next week.

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