15: Intermittent Fasting and Holistic Health with Cynthia Thurlow
24 Feb 2025 · 55 min
Podcast episode (recorded Feb 24, 2025) in which Aaron Hartman, MD interviews Cynthia Thurlow about her shift from traditional allopathic practice to lifestyle and nutrition medicine after personal family and health crises. Cynthia recounts childhood adverse experiences (ACE score 9), severe gastrointestinal illness and ruptured appendix leading to prolonged hospitalization (multiple complications, prolonged recovery), and how those events catalyzed a career pivot to help women. The conversation covers intermittent fasting as a hormetic stressor that must be individualized by life stage and cycle phase; the centrality of adequate protein for women (recommendations: hit ~30 g leucine threshold per meal; baseline ~100 g/day starting point); creatine as a multifunctional supplement (muscle, brain, bone, jet lag); and the gut microbiome/estrobolome’s role in estrogen detoxification. Cynthia’s projects (podcast Everyday Wellness, upcoming book on gut microbiome and women’s hormones) and contact routes are mentioned.
Questions this episode answers
February 24, 2025.
9.
She reports an initial 13-day hospitalization and later a prolonged/30-day hospitalization period during the complications and recovery.
Two times.
Chapters
I think after me, my husband starting a family and having a child like there and food allergies, that really caused me to have this incredible pause and think about why did my child develop food allergy? And so it started to force me to think differently about traditional allopathic medicine. It started to force me to think more about nutrition and lifestyle medicine. And so fast forward me a few years. I had a second child who did not have any food allergies, thank goodness. And I just became increasingly disillusioned with traditional allopathic medicine.
I'm so excited to be with you all today once again and be with my friend, colleague, Dr. Cynthia Thurlow. I'm going to dive into a lot of brief stuff with her after we go through her bio. She is an awesome resource and we'll get started with our conversations. A few things really quick about Cynthia. She's a seasoned nerve practitioner and an expert in intermittent fasting. She's got her book in the background. She's working on second and we'll probably talk about here in a bit. She's been on TedX Talk two times. She's a multiple best selling book. Intermittent Fasting and Transformation Cynthia offers a wealth of knowledge in health and wellness. Her specialty of intermittent fasting programs have empowered countless women to take the reins in their wellness journey and propel them toward optimal health. Cynthia's core mission mission is to help women understand and achieve optimal wellness through everyday Wellness podcast, which right now Cynthia is. Where is that at? That's like the whole fourth time I was like, what's happening?
Or worst, it's like leading Health and wellness Nutrition podcast.
Yeah, just pretty, just pretty awesome.
It's exciting.
Yeah. Where she went on this podcast, she provides trustable, engageable content on the benefits of intermittent fasting and holistic health and a bunch of other topics. She interviews a lot of really cool experts on there as well. Her approach combines practical strategies with insightful education, making her podcast a valuable resource for those seeking a healthier and more fulfilling life. Great to have you here today, Cynthia.
I've been looking forward to this.
So one of the things we actually were talking about briefly before we started, a lot of people look at, look at individuals look at you and they say, hey, you're doing great. Look how amazing things are. But people don't realize, a lot of people get in this space because they have a story and they don't realize that the story may go back 5, 10, 15, 20, it may go back decades. And so if you could just share with us a Little bit. That's what you know. One of the things I want to talk about is your story. Not just your educational background and being a cardiac nurse practitioner, John Hopkins and all that fancy stuff, but also you for your, your health journey. How you're here, when, at what the point in time in which your health started getting affected and how that led up to you using that like as your superpower which now is enabled you to help tons of people through your own personal trials, struggles, your journey.
Yeah, I mean I think it's easy for people to look at any successful individual irrespective of what area you work in and assume that it was all easy. I like to share with people that I grew up the byproduct of divorce, like many kids in the 70s and 80s and my parents did the very best that they could and I was one of those kids that knew I was the leave New Jersey. I was going to go off to college and never go back again. But initially I started as someone that was going to go to law school and when as it got closer to graduating from undergrad it was clear to me that I didn't want to be an attorney. Now it offends any attorneys that are out there, but I felt a tremendous desire to be of service to others. And so I graduated from college. I ended up taking two years of pre med classes. I ultimately developed an interest in HRV and AIDS research which really led me to John Hopkins, went there as another undergraduate degree, a graduate degree, ultimately became an adrenaline junkie, fueled ER nurse leader, a nurse practitioner and I think after me, my husband starting a family and having a child, life threatening food allergies, it really caused me to have this incredible pause and think about why did my child develop food allergy. The allergist, well meaning allergist said something along the lines of carrying that be pet and prey which never sat well with me. No parent wants to hear that. And 19 years ago there just weren't a lot of kids with food allergies. And so it was, I was fearful of eating out, I was fearful of taking him to well meaning family and friends homes who didn't understand. I was like if you've seen anaphylactic shock, you don't want your child to go through that process. And so it started to force me to think differently about traditional allopathic medicine. It started to force me to think more about nutrition and lifestyle of medicine. And so fast forward me a few years, I had a second child who did not have any food allergies. Thank Goodness. And I just became increasingly disillusioned with traditional allopathic medicine. There's certainly a place, let me be very clear. But I did not like the de emphasis emphasization on lifestyle as medicine. I started to look at most of my patients and say, if you didn't have diabetes, if you didn't have the ornovascular path, which means they had head to toe vascular to das, if they could manage their stress. I lived in Washington, D.C. one of the most stressful places to live in the United States, and not just in an election year. And helping people understand that the choices we make about managing our, our sleep and our stress and exercising and the types of food we eat are important, probably more so than anything else. And so eight years ago, I took a tremendous leap of faith, kind of left traditional allopathic medicine, started my own business, and I said to my husband, I don't have a business plan. I've decided to take this leap of faith. I know I can make an impact. And I decided like two years later, as I was building my business and I had a lot of women in Perry, menopause and menopause coming to me, it was evident that what I was doing was needed. People felt seen, heard and validated. And I did a talk that obviously changed the trajectory of everything. And so I always say that all of the decisions I've made up until this point have led me to where I am today. And all of the nurse practitioner and all of the nursing training and all of the things I was interested in prepared me for doing my second career, really working at health and Wellness, based as an entrepreneur and being able to make a larger impact. And that's really what it come down to. And for me, feeling life, the work that we're doing is like peeling an onion. Everything we're doing is preparing us for the next level. And I know this is something that we both share in common, is really understanding your patients, your client, so that you can serve them at a different level. So that is kind of briefly how I came to where I am today. But if you would ask me when I was in high school or college, would I be working in healthcare, I would say absolutely not, because so many people in my family were physicians, nurses, and that to me was what everyone else did, not what I did.
Yeah. And that's just a really interesting story. It's really interesting how, how much like someone's superpower, like what they're really good at actually comes from a trial, a struggle, sometimes, like the dark, the Valley, where you go through some significant. And you had some significant health issues that were particularly life threatening. Could you kind of walk us through how some of those things kind of challenged you, caused stressors, trauma, kind of, and they kind of helped you realize that you had other things going on that under the hood that no one had previously talked about?
Yeah, I would say, number one, obviously I grew up with parents who did the best they could, but adverse childhood event. I was led to believe during my medical training that adverse childhood events were things that happened to people that witnessed a murder, they were raped, suicide. So I was like, I didn't have any of those. So I didn't experience adverse childhood events before many years later. And I realized when I reflect back on my childhood and I actually took the exam, I have a very high adverse childhood events score, a nine, which is pretty high. I grew up with alcoholism, physical and verbal abuse, a narcissistic parent, another parent who's on the spectrum. And so there was a lot of poor emotional regulation, a lot of physical, emotional violence. And so my autonomic nervous system has just been red dot permanently for my entire life. And I didn't actually realize that it's probably what drove me to be a caretaker, probably what drove me to be a people pleaser. And so as I kind of Traverse 20s, 30s, 40s, my husband and I like to do a long travel. In 2018, we went to Morocco and southern Spain. I got the worst food poisoning of my life. So bad that I thought I was going to tear my esophagus. For anyone who worked in healthcare, we talked about this Mallory Weiss tear. I've seen plenty of them in the er. I came back from that trip and didn't really think about that, that event again until fast forward five months later. I think that I again, food poisoning, coming back from a trip with my husband. And what I actually have is a ruptured appendix with a flu complication. Spent 13 days in the hospital. Every complication you can imagine, don't want to have, I got. And they actually wanted to take me to surgery the first night. And I begged them not to take my colon. And for anyone out there who loves their colon like I do, I was like, I do not want a colostomy bad. I want to advocate for myself. And So I spent 30 days in the hospital, lost 15 pounds, most of my muscle, went on to do a talk that changed the trajectory of my career. And then after my talk, I actually knocked my appendix out. So I waited six weeks after that and I did not realize. I did not realize that picking up that giardia bug in Morocco kind of set the stage and primed the pump, if you will, for developing this significant, substantial Chrysler. Because not only did I know that I was sick enough that I could have died, I had never. I had always thought of myself as being invincible. Certainly I've been through a lot, physically, emotionally, psychologically throughout my lifetime. And that brought me to my me. I, I tell everyone that 2019 into 2020 is the hardest year of my life on every level, like in every aspect of my life. Brought me to my knees and made me question everything. And what came out of that is I became a stronger person, I developed better boundaries, I got very clear about what I wanted in my life and what I didn't. And so now I can proudly say, like, that was the best thing that ever happened to me because it forced me to uplevel everything in my life and to take my health ob. I, I took this seriously before, but now it's an art form. Like, now I really am super conscientious about making sure I'm doing all the right thing to support my body because the trauma does not per se go away. We just learn how to adapt. And even now, being hospitalized when I had my appendix out, I got triggered again because I was fearful, like I was gonna have a complication. I ended up bending. They took me from the, the outpatient or to the inpatient or. And I. That got me triggered again. That fight or flight response that we get when we're scared or nervous or anxious, starting all over again. And so it has really been my biggest teacher. Like, all these experiences, I don't look at them as like, poor me. I look at it and these things have all allowed me to show up in ways that I would not have been capable of showing up otherwise. Like all of the major traumas, micro traumas, all of them have, have helped guide me into being the person that I am today, that I would not be if I had not experienced those things otherwise.
It's really interesting.
We're.
We're in a group of high performing executive entrepreneur types. And it's amazing how many people in that group that are really successful, when you dig into it, have a history of trauma, have a history of abuse, and it's almost like part of their therapy, their drive becomes part of their therapy. And how many, for how many of them, what they do as a work becomes almost like their way of escape. Escape the trauma, the escape or what they've gone through, which makes Them really good at certain things. But also it means they suppress, they put down, they suppress until they have some kind of health event. And the health commit could be a concussion, it could be a tick bite, it could be mold, it could be a near death event. All of a sudden all the brain starts connecting things. Actually a patient this past week who been seen here for a couple of years, it was really interesting. She just expressed to me this past week that one of the reasons why she has a hard time coming to the office getting blood draws is because it triggers an abusive event she had in the past. It's kind of like how's the blood draw? But for her it is. And so understanding that just it's amazing how our brains do trick us and sometimes with the whole trauma thing it can actually slow our healing down. So on that note, you take a little diversion with trauma because we were kind of talking about this before we started recording. How do you see like not just the, the, the, the ACE events, adverse child events, but also your interaction with the healthcare system. I personally feel like our healthcare system trauma causes people sometimes the way where we do mammograms, the way we do women's breast health, for example. Like how have you seen these micro traumas play into some of your health health things that you're struggling with right now?
Yeah, I mean I, I would say one thing that really stands out. So when I was hospitalized I had, I was fortunate, superlative physician care. Like just fight sure happens down. The docs that were on call were fantastic and were a hundred percent on my team. I can speak from experience. I have some great nurses and I had some terrible nursing care to the point where I will give an example. So not surprisingly, when I ruptured my appendix, I ultimately developed inflammation in the entire trajectory of my colon and I developed a small bowel obstruction. And anyone who worked from healthcare me a small bowel obstruction. More often than not you're going to get a tube place down your nose. Needs a gastric chair into your stomach to help decompress all the therapy. Because I looked six months pregnant. I applied since and the, the nurse team care that I had was less than stellar because they never properly secure the NG tube. So it wasn't like I had it placed once. I had it placed three times and it was so traumatizing. Like the first time was bad enough, but then it two more times within a 24 hour span of time until my surgeon I think just about strangled care because she was like this should not happen. And then Also a healthcare provider too. I, I, I can tell you that after I was discharged, I was walking through Target a few months later and I ran into that nerve. She didn't recognize me, I recognized her. And it set off this incredible fireflight response. My heart was pounding, I started to sweat, I got the tunnel vision. I recognize it for what it was, but it was such a, an unsafe feeling. Like suddenly I felt like I was free falling all over again. But I think when you are both a healthcare provider and a patient, it can go one of two way. You can either be a controlling pain in the ass and be totally non compliant or in my case, I was so sick I surrendered and I was so grateful. Like I remember when the night nurses used to come on, they were fantastic. And I would say, thank God, I'm so grateful because I know at least from 11 o' clock at night until 7 o' clock in the morning I'm safe. And so it was really interesting to have that experience, but also to be around and more often than not, just incredibly compassionate, kind people who really were looking out for me. But one prevailing theme of that hospitalization that I'll just share is that everything hurts. It was interesting for me to be on the other side where it didn't matter what they were doing. Like I ended up having retroperitoneal abscesses and they had to go put drains in. So they calling your ventral radiology in the middle of the night. And I just recall like as I was lying in the CT scanner and they were figuring out where I put this drain, I was like everything hurts. Like nothing doesn't not hurt. And at that point you're like, I'm just going to surrender because the, the other option is worse than this. So I, I think that as a healthcare provider at some point you have to shut your brain off, otherwise you're just going to drive yourself crazy. But it was very, very clear to me. I knew that I was sick enough that I could die. And that was terrifying with like you start having this bargaining with God of well, if I get out of here, I promise I'm bad here, I will do three things for the rest of my life without question, because the alternative is unacceptable. And I think that is interesting to go through as a healthcare professional. But, but what I'd say is it was always my experience as a clinician that people were either controlling ass hacks or they were just too sick. And they were like, please just take care of me or help me get out of this. And I definitely Was more the latter than the former.
Gotcha. So that's, you know, I think just for people to understand. Retroperitone abscesses. If you don't treat those, you die. All the. I was very perforated appendixes. If you don't treat those. I mean, these are multiple things. Being in the hospital for as long as where you lose a lot of muscle mass, which can affect inflammation. Your gut microbiome is totally. Your gut bacteria. Totally nerfed up. Yeah. How do you. You know, it's a little bit of a transition. Either these kind of events, we have them. They either. They either they put you in one of two directions. Either you kind of become sour and not trusting and fearful, like, oh, my gosh, am I going to die again? Or they kind of like, supercharge you to, like, okay, I'm going to conquer this. I'm going to move forward. And people inadvertently will actually use that as a superpower to help improve whatever they're doing. Two paths. And obviously you've used that to. To up level your dang, so to speak, as far as how you're helping people, how you're getting the message out that how would you. If you could walk us through how that informs you to become better at what you do, how your trial, how your difficulty, that many people, the result would be chronic fear. Fear. Oh, my gosh. When's the next thing gonna drop? My kid. Oh, my gosh. And my kid. They can almost make people disabled and just frozen. How did that help you to, like, take you to the next level?
I mean, I think because I'm a survivor. I think that for me, the first couple months, I really felt very dissociated from my body. Like, I. Very clearly, when I think about March 2nd through the summer, I don't. I mean, I know I did a TED Talk. I know I told my kids I was going to take the week, the whole summer off. I remember all those things, saying all those things, but I was not present in my body. So I think that whole, like, fawning response where people kind of dissociate, I think that was protective. And then I actually decided in August of that year to go to Mindshare. And when I got to Mindshare, I was like, okay, I've got a viral TED Talk. I'm clearly like, the universe is telling me to keep going. And so I think it was investing in myself and my business and saying, okay, the universe has kind of told me I'm headed in the right direction, even if I don't necessarily know what I'm doing. And so I literally went to Mindshare. I joined that mastermind, and then I just did everything I was told to do. Like, I'm very coachable. And so I think that was my lifeline. That was what professionally allowed me to continue to move forward. And then I'm such a competitive person with myself that I was like, I'm going to use. I know this wasn't deprived in you. I'm going to use what has happened to me to be more empathetic, to understand some of the trials and tribulations people go through, because there are certain people who've gone through way worse. I have friends who were diagnosed with cancer that year. And I would say to them, like, I'm not comparing my circumstance or I was saying, for me, this was the most traumatizing thing I've ever been through. And so for the next year, it was consistently working toward improving, defining, throwing my energies into move my business forward. And then the pandemic happened. And so when pandemic did for everybody, it forced all of us to contract a bit. And I look at that as a blessing because it. It forced me to get really clear about what is most important in my life, my family. And then secondary to doubt is, how do I continue to serve women? What are the things I need to do to continue to serve women? And so that was, I think, that kind of survivalistic mechanism in my body. It can't hold me down for very long. And I think that stems from how I grew up. Like, I recognize at a very early age, I mean, I've been happily married for 21 years, but I would be the first person to say my choice in partner has helped me get to where I am, because with him, I feel safe, I feel validated, I feel heard. And I didn't feel any of those things in my childhood. So I think that I've had to learn to depend on people, and I've had to learn to communicate, and I've had to learn to just continue putting my one step in front of the other. And that is, I think my childhood kind of pricked me for how I was going to pull myself out of the abyss, if you will. I don't want to sound overly dramatic, but I definitely was dissociated from my body for months and months and months. I think largely as a byproduct of my brain just had not caught up with my body. I think I literally was incapable of connecting that mind. Body connection was totally offset for months probably to be protective, to be honest. Like, I can't even watch that second TED Talk because it's too painful. Because when I look at that, I'm like that woman who had only been out of the hospital for like two weeks and was prepping for this talk had no idea what was coming. She had no idea. And so when I look at that, I'm like, wow. Like, there, there was the. Before the hospitalization meet and the post.
So you've been watching this.
Let me.
So even watching the TED Talk, even though it's you, you're doing great and you got people for. Even though. So that the. The unconscious observer, they would have no idea. Like, just because your brain. That was a triggering for you.
It's very triggering. And it's. And it's also because I was so disconnected from my body. That's the only way I could. I could pull that talk off. Having literally, I did that talk at the end of March, and I was discharged on March 2. And then 10 days after that talk, I had my appendix out. How many people do a TED Talk with a ruptured appendix? The craziest story. So I think for a lot is individual. I can now acknowledge that there was this degree of dissociation which allowed me to perform at a level that obviously changed the trajectory of my life and my business and it. For which I am grateful. Like I say all the time, I'm so glad that happened in my panics because I wouldn't be where I am today. But so much emotional growth that came out of that, that I was still and processing, like, it's again by killing that onion. Like, just when I think I've gotten over that next hill I have to climb, I'm like, oh, no. It's like scratching the surface. You're like, no, you got more work to do. So it's just kind of further validation that the work that we do emotionally, spiritually is lifelong work. It's not like you do it once and then you're better. And so, yeah, I can. People are amazed when I say I can't watch that talk at all if I see clips of it. And that's as much as I can watch.
Well, I think it's really interesting because I hear it with patients. I'll hear stories about how they. Things that don't appear, like giving or giving blood draw, for example, like things that you think are not triggering, but because of the way your brain disassociates and reconnects. And unfortunately, many people don't have the Awareness to say, ah, it's, this is a trigger event. They will think it's smell or color or they don't realize why every year at this time of year they have an issue or panic attack. It's because the way the sun is falling on the leaves that trigger a response. And so, I mean it's curious for you that you figured that out on the front end, but many, many people deliver years and years and have no idea that their, their symptoms are happening. Certain times of the year, certain events are actually triggered traumas.
Yeah, no, I, and I, I, I think that because I had never associated the word trauma at life because I've been conditioned to believe that it's the macro traumas that are traumas. When I started to think back, I, I, I could probably connect the dot for 20 things that had happen that incrementally magnified the trauma I experienced as a child. And my way of dealing with it was to not acknowledge it, to move forward and to achieve. So like achievement for me throughout my lifetime was the way that my parents left me alone. And so even now I have to kind of check in with myself. Even my team knows this really well. Like, are we making this decision for the right reason? Is this really something you want to do or are you like leaning back on those people pleasing tendencies because you don't want to see people be upset with you? And it's just been, it's been very interesting to acknowledge that that is, that has been the way I survived my childhood and young adulthood was achievement, achievement, achievement. And so being really conscientious when I'm making decisions now, am I doing it for the right reason? Have you ever lost trust in your own body or in the doctors who were supposed to help you heal? It happens to millions of people who are stuck in the cycle of prescriptions, tests, and more questions than answers. That's why Dr. Aaron Hartman wrote his new book Uncurable. As a physician and a parent, he's lived through the pain of being told there's nothing more we can do. But instead of accepting that, he built a new path, one that combines traditional and functional medicine to uncover what's really driving illness. Uncurable is more than a book. It's a roadmap to help you find the root causes your doctor might have missed, reactivate your body's natural healing systems, and finally believe in what's possible again. If you've lost hope or trust in the system, this book will help you take back control. Go to UncurableBook.com and grab your copy along with Dr. Hartman's free resources to help you start your healing journey today.
And just to kind of, kind of transition to the next thing I want to talk about with you. You mentioned how like you have a passion for women's health now. I feel like we're kind of, it's kind of getting to public consciousness that we're realizing hey, women are different than men and our healthcare system treats them differently. And you know, we actually do things in some situations like with mammograms and breast health took traumatized women. So purpose of that transition is how do you see hormones? When it's hormones that's kind of for your passion with women, how do you see fasting? You got your book in the background there because that's one of your, that was one of your, your tech talk topics was actually fasting, how that affects women. Could you kind of take a little, take a little deep dive into how is fasting and the, and how it relates with hormones and sugar levels. How does that actually affect women's hormones either positively or not fast and eat too much negative negatively impact the hormones?
Yeah, I mean I think it comes back to bio individuality. Where is a woman in her life cycle? Is she peak fertile years under the age of 35 and she's really lean and exercises a lot? Well, I not recommend eating less often to someone like that. Versus you've got a woman in perimenopause 10 to 15 years preceding menopause and she's got PCOS and she's insulin resistance. Well, this is a great strategy to use to help balance insulin and glucose and sometimes cortisol if it's used strategically at the right time in a woman's cycle, like in the follicular phase when estrogen predominates versus luteal phase where it might be a little bit too much stress. And let me back up and just talk about fasting as a hormetic stressor. Just like exercise, just like carbohydrate restriction, just like cryotherapy, cold plunges, infrared, sauna, sauna, all are stressors that are designed to make us stronger, more resilient in the right time, at the right time, in the right circumstance. And so I think for a lot of women, as the best example, women who want to lose weight irrespective of what life stage they're in. Menopause, perimenopause, Pete, fertilizers. It's all about intentionality and being very clear about why you're using this strategy. Because you can evoke some of the same benefits of fasting from other things like intense exercise or gamma cold therapy, heat therapy. So I think for a lot of individuals, they come to fasting out of a desire to lose weight and then we have to peel that the layers again. If you are insulin resistant, you got borderline blood pressure problems, your pcos, you're starting to kind of have that slippery slide into metabolic disease. Great way to kind of get things in, in a position where you're optimized. Now I, I think when we talk about women and we're talking about what makes us unique, we're really talking about our ability to reproduce, we're talking about our ability to carry childs. And so even if we choose not to have children, our bodies are primed and designed to procreate and to, to sustain life. And so if we look at it through that lens, it made sense that women that are in their peak years, they're, you're not going to want to do a lot of fasting versus a menopausal woman who's got 15 or 20 pounds to lose. Compressing their feeding window can have huge net benefits. And so it goes without saying that bio individuality rule, knowing when in your cycle, if you're still getting a cycle, when too fast, if at all, and then also just being conscientious. We know the average American, and this is based on Thach and Hamburg data, the average American's eating eight to ten times a day. No wonder why we're dealing with metabolic health issues. So helping people understand that it is beneficial to eat less often, even if that's a 12 hour feeding window, two to three meals a day can have huge net effects. And unfortunately, I think what happened with fasting, like most hormetic stressors, is that people go to an extreme. If a little bit of fasting is good, more is better. If a little bit of exercise is good, more is better. And now we've got a whole legion of women that are chronically undernourishing their bodies, chronically under eating, over exercising, if they're doing that. And the point of fasting is not to nourish your body, the point of fasting, it's to determine that there's specific times and during the day that you're going to eat and there are specific times that you don't eat. But that, that is kind of the, the gestalt about fasting as it pertains to women. And it also comes back to if you're in perimentopathy, menopause Are you sleeping through the night? If you're not sleeping through the night, please do not start fasting. Are you managing your stress? You and I could argue that people think they manage their stress and they don't. Are you eating an anti inflammatory diet? And that looks different at 25 as opposed to 45. There are things I could eat at 25 that I cannot eat now and I'm older than 45, but I cannot eat that thing. And I don't look at it as a, as a bad thing. It's just building awareness of how does food make me feel, how does fasting make me feel? Is it something I want to engage in? And there can be a season and a reason. So I have a lot of female clients that they May fast for 612 months and then they're not fasting, they're just eating in a 12 hour feeding window. And so fasting doesn't have to be. You're rigid and dogmatic and that puts you to every single day and you whittle yourself down to one meal a day. That it never going to be what I suggest. But it is one of many strategies that women can use to help support metabolic health, sex hormone health, all of these hormones that are chemical messengers that a lot of people don't fully appreciate or understand.
I think one of the keys of what you said early on with that was that this has to be individualized and personalized to the person which is obviously what you know, we want to do with people. The second thing is that think a lot of people realize is that as a woman your needs change from 20 to 40 even between like 35ish was today unfortunately as early as 32 and 33, women are starting to have their testosterone go down, their progesterone's go down early. I mean you say about going through menopause even, even now, maybe our mid-30s is kind of crazy based on where you're at. Then maybe you go to menopause of 52. So all of a sudden that's gonna change a little bit and you're in your book. Fasting Transformation was actually one of the first books I read that actually separated out those concepts of throughout the month your, your carbohydrate and fasting abilities change, but also found your life based on these, these things. But one thing that's really unique is that women tend to need more protein per kg body weight than men do. At the same time when we do these limiting diets, these fab diets, one of the first Things they do is minimize women's protein. That's something I know you're really passionate about. You know a lot about. You talk about like how important protein is particularly in women for detoxification, for muscle mass maintenance, even just good old fashioned cognitive function, like how important that is and how we don't want to necessarily cut that out when we're doing these diets.
Yeah, I think one of the ways that I help women understand how important protein intake goes is that when we are younger, like I eat two very athletic teenage boys, they could probably get sufficient muscle protein synthesis so their body gets the, the, the message that okay, we're here to build, maintain muscle with 10 grams of protein, 15 grams of protein. We know with age we actually need more. Minimum of 30. There's actually this leucine threshold, which is an amino acid. You have to hit a certain threshold to actually trigger that muscle protein synthesis. So number one is without a doubt, every single woman, when I ask them to give me a diet recall, they're under eating protein. What does that look like? If you are eating one meal a day as a woman and you're eating a teeny tiny piece of protein and it's 20 milligrams. Well, you, you've actually lost your ability to build this muscle protein memory, the myokine, to trigger the myokine, their muscle chemical messengers, to tell them, okay, we're here to build muscle. If you're not hitting that 30 gram threshold, does that mean that what you've eaten is not helpful? Yes and no. Obviously I think most, if not all women are chronically under eaten protein. They're wondering why they're losing muscle mass, cause they're getting older and, and the role of sarcopenia is not a question of if, but when. So it really accelerates after 40. I forget I'll say about the percentage in, but it's anywhere from like 1 to 5% per decade. I mean it's quite significant. And so the, the key about why muscle is so important and why I talk so much about protein is that muscle is this organ of longevity. When we look at like a filet versus a ribeye, yes, they're both delicious. But that marbling is actual inflammation. And marbling is, is this infiltration of adipose tissue, which is not just fat, is not just fat. Fat is actually the gland in the body. It actually can, it's very inflammatory with cytokines, a lot of inflammatory property. And that is what old muscle looks like. Young muscle, like my teenagers, looks like the filet we want to look like the filet and not the rib eye. And what's interesting to me is that when we talk about what are the mechanisms of why we want to maintain muscle mass, number one, it helps with insulin sensitivity. Muscle is a glucose. It is. That is actually the first site of where we become insulin resistant. So that is very important to understand. How do we combat this? Number one is the X strength train. Number two, we've got to make sure we're eating enough protein. So protein is satiating, so it keeps you feeling full. It is going to be very, very beneficial for nearly every single thing that you can think of in your body. Hormones, cartilage, tendon, all of which are really dependent on protein. It keeps you satiated, keeps your blood sugar stabilization. How many people eat like a plate of pasta and then an hour later they're starving? And it's because not only did they just have these processed carbohydrates, but no protein or probably healthy fats to help buffer the blood sugar response to that particular meal. So protein is incredibly important. I typically will say no less than a hundred grams a day. And you can track on apps like Chronometer, which is free. But building awareness around how much protein you're eating in a meal are issue number one. And then issue number two is how do you create a imbalance of two to three meals a day so that you can get in sufficient amounts of protein? Now, if you hear from experts like Dr. Gabrielle Lyons, she took about one gram per pound of ideal body weight. I use a hundred grams as a starting point, and then we ratchet back from there. So as an example, if you are metabolically healthy and you're not insulin resistant, you're not treated for high blood pressure, you don't have high triglycerides, et cetera, then you can probably have more flexibility with carbohydrate than someone who is pcos, inflow resistant, hypertensive, high triglycerides, low hdl, some of those lipid abnormalities that we'll see with poor metabolic health. That's someone where I'm going to say, I don't want you having more than 20, possibly 30 grams of carbs in a meal. That is the most your body can buffer safely. And if you're really dealing with a lot of poor metabolic health, it may be that we go petogenic or traditionally low carb. And for a lot of people, that can be a bit of a challenge because we're. Our diets are kind of so fixated on processed carbs. Bread, pasta, all these processed carbohydrates, which really are very different than having like a sweet potato or squash or low glycemic berries or things like that. But protein is one of the most impactful macronutrients. It is the one that I usually will call people. If you can dial in on the amount of protein you should be consuming with a meal, you will find we'll be eating a lot less snacking. You're not going to be looking for junk in your closet at 10 o' clock at night. The other thing that I want to just mention is there's something called a protein leverage hypothesis. Very important for women to understand. In particular is that as we are getting older, protein leverage hypothesis is an important concept to understand, because if you understand as we are getting older, as are we are having fluctuations in sex hormone, they become much more common to see the catabolism of muscle. So especially as we are losing estrogen, it accelerates this catabolism or breakdown of muscle. And if we are not actively working against and consuming enough protein with heavy weight, this actually gets worse. But what's interesting is if you're not hitting your protein threshold, your body is going to look for additional calories generally from fat and carbohydrates. And it's not like you're going to create an avocado. You'll be craving light chips and junk and sweet things and ice cream. And so that protein leverage hypothesis for me is a very important concept to help people understand why it was so important be hitting those protein macros. Because if you don't, you're going to pray food. You're going to wonder like, why am I going into my pantry or my freezer or why am I baking brownies at 7 o' clock at night? Because your body is looking for a way to chew on nights that chloric intake that you should have consumed during your day. So I would say if you feel like you want to snack at night, think back to what you ate during the day.
That's really interesting. I've not heard that protein leverage hypothesis before. Is that going to be you going to be mentioning that in your new book or is that.
I might be. I might be. And it's interesting, like there's solid science rooms that it talks about this acceleration as FSH is going up, as estrogen is going down in latter stages of perimenopause and menopause, it really accelerates that sarcopenia and, you know, feeding into the fact that if you're not kind of Buffering, slash, leveraging that protein intake your body like I'm still hungry and you haven't fed in enough food and so it will like unravel. I'll have to send it a paper.
Yeah, but I guess the way the other thing to think about is does eating adequate protein and the effect it has on gut microbiome, phase two detoxification and what you're referring to with some of sugar metabolism, does it actually make the transition through menopause easier or better?
Yeah, I think it does. Because what's interesting is if you look at the research on like David motor hot flashes, the unpleasant, like the really unpleasant things that women go through, brain fog, almost all those are exacerbated by blood sugar dysregulation. So when you start to think about it through that lens, the women that I can get on board and say, okay, we're gonna have a bolus 30 to 40 brands of protein 2 to well at least three times a day. If not, you're going to do 50 grams twice a day. Suddenly they have, they sleep better, they have more energy. And so I really think that protein is the key for so many of these middle aged women, myself included. Like I tell people, like when I think about how I eat 10 years ago or now, it's very, very different. And so with that understanding it makes sense to me that I didn't get sleepy after meal. I'm, I have great to stay energy all day long. I'm not struggling to make it from breakfast to lunch or lunch to dinner. And oh by the way, I'm taking a break from fasting. But how would people understand that that protein really is a very important component of metabolic health? As we're navigating perimenopause and menopause, I think it's critically important.
So what? And I know you're a big proponent of creatine and how it impacts particularly with women, muscle energy, brain function. Could you just sprinkle that into here how it plays into the metabolism of women as well?
Yeah, so we know. So I, I haven't looked at creatine as like a, it's a multifaceted supplement, you know, if you want to kind of constrain what you're taking. Creatine helps with muscle strength. We know that women during different stages of their menstrual cycle need more creatine than others. So it's interesting when you're looking at the follicular phase where the, versus the luteal phase, when women are feeling like they have more energy when they have more higher estrogen levels, they have less energy when progesterone predominates. The number one is strength, number two is there. There's research to actually support it helps with brain and cognition, but you actually need a higher dose because that's across the blood brain barrier. There are some emerging papers about bone health that we know for many people, myself included, I was on oral contraceptives for 20 years and my, my volume actually kept at a very low hormone state. And so I, I missed out on the opportunities to build peak bone and muscle mass in my 20s and 30s. So isn't any wonder I'm a little osteopenic right now. Having said that, helping women understand that there may be a role for creatine monohydrates in buffering bone response in menopausal women in emerging research. The other thing that I find really interesting about creatine is it helps with jet lag. So it's thought some components, I mean think about it in terms of ATP production and how it can hydrate in the muscles. But thinking about it from the perspective of jet lag support like this has now become what I do when I travel. I'll be taking it with me to Arizona when I travel taking higher doses of creatine again, it has to cross that blurbing barrier. But helping with sleep architecture and jet lag has been a really interesting because I traveled to Europe multiple times in the past year and then I'm going west tomorrow. I found that when I increased my intake of creatine it almost completely offset that circadian upset that we get when we travel. So usually one hour, one day per hour of tire change. So by the time you get used to being on the White coast, you're flying back, then you're really upside down. But helping people understand that from my perspective, this is a multi functional supplement for women because it has so many things. It helps with the strength, teeth, it helps with bone and brain health. I do think that there's enough research to suggest it's helpful for sleep architecture and jetlag as well.
Oh, that's all a very, very intriguing information. I want to like almost hearken back to something you said maybe 20 minutes ago and just link it to what you're actually working on right now. And that's hormones or your gut microbiome you said mentioned when we were talking before. You're actually working on book and it's going to address like the gut microbiome, which is the bacteria in your gut and specifically for women, how that affects your hormones. So could you share a little bit me personally, about how that has impacted you and, and how that's kind of leading into your. Some of your new stuff you're looking at?
Yeah. So I would say the big kind of takeaway is that when I got street poisoning in Morocco that my son, I ate same food and he did not get sick. I suspect at the stage of perimenopause I was in that the changes in estrogen, so estrogen and immune function are intricately related, made me much more susceptible to not just picking up diarrhea, which is a pretty ugly bug, but also the significant end of which means that my body got a hefty dose of toxin and it developed a leaky gut. So our small intestinal line was only one cell layer thick and it doesn't take a lot to disrupt that cell layer. So that's number one. So if, if the high junctions open up and then everything you're eating is driving this inflammatory and immune response. So your immune response gets over. Activated. That this overacted exaggeration that goes on and, and understanding it's kind of like the perfect storm. So when I reflect back on 2018, when I got that, when I got sick that time with the. It was just the perfect example. Like I ingested the bone. My knee system was depressed because I had these changes in estrogen. I've had such a whopping. They call it lipopolysaphoritis. This toxins that get rubies. It's why I was so, so incredibly sick at that time. And so this book had really. That's, that's like my backstory to the book. It explained like, oh, this is why I was so susceptible. Now this makes so much sense. And then fast forward five months and then I in the hospital and I almost die. But the book is really dedicated to helping us understand the gut hyperbiome. This is something that you and I did not learn out in our training initially because it wasn't even a thing. And so helping people understand like what is changing as we're getting older and how that impacts immune function, bone health, how that impacts leaky gut, how that impacts sex hormone production. Because it goes without saying, when you start to understand and dismantle that a gut microbiome is responsible for so much, including endogenous GLP1 production. So we CLP1 agonists are very popular right now, rightfully so, but we actually make GLP1 and GIC, these two different peptides. We make them in our body and so when things are not properly aligned in the body, it makes it harder for us to be satiated, makes it harder for us to turn off the satiety mechanisms. So there's a lot to the gut microbiome and I promise it's really very interesting. And no one is really talking specifically about these things, but I think it makes it really relevant given the timeframe that we're in, where there's greater acceptance for talking about what women are going through in perimenopause and menopause, because it is such a profound change in everything that goes on. Just like when we went through puberty when we were teenagers, it's like ramping everything back down. But I think there's building greater awareness of why lifestyle is so important, why hormone replacement therapy is so beneficial, why these peptides can be beneficial. And so we're gonna wrap it up in that, in that book. And I'm really, really excited because as I said, when you and I both trained in the 90s, we were not talking about the gut microbiome. And yet it impacts everything. And it's not just the gut microbiome, it's our oral microbiome, it's our vaginal microbiome. They're all connected more often than once, more often than not. If you have an imbalance of non beneficial to beneficial bacteria in your gut microbiome, they probably have it in your oral microbiome, your vaginal microbiome. They're all intra related. Again, no one was talking about these things when we trained. And it's kind of interesting to see the signs of all.
What's really, what's really interesting about that as well is to talk. To talk. I did my training, my functional medicine training started back in 201012 to listen to people talk about how in the 80s this idea of leashy gun was a bunch of hooey, holistic nonsense. It was kind of like, oh my gosh, that's not a thing. What are you talking about? And then you have people like Rusto Fasano, Dr. Morgan Hopkins, like bring their stuff to light. And then I feel like it's almost like all stars have aligned in the last year. It's almost like even like doctors have heard about leaky gut. It's just people don't know what to do with it because we're just not trained. And again, we're trained in what it, what it is and we're still not really that much. And then it's like, what do you do with it? Well, it's Not a prescription drug. It's not a microbiome pill or a, a mucus pill or a zombie water. And so it's just not, if it's not a direct pharmaceutical or intervention, it's like, well, we're not gonna really discuss all the other stuff because there are tons of other things we can do do for that. Could you briefly, briefly talk about estrogen? Because one thing you mentioned with metabolic syndrome and a lot of people with metabolic syndrome have estrogen dominance. Oh God. I think a lot of people don't realize that's your pcos, that's your fibrocytic breast, that's your women with heavy periods. Endomyosis, which they don't realize. Endometriosis, they don't, a lot of them don't realize the horrible pelvic pain actually play into this estrogen dominance. Can you talk about that a little bit with how the liver and the gut interact to actually increase that?
Yeah, so it's so interesting because I, I think with, and I just interviewed someone talking about River Health yesterday on the podcast. So it's all kind of fresh in my mind. So our liver is designed to be our big filter. In our eye there's phase one and phase two detoxification. This is an actual thing. Phase one is when our body's taking toxins and making them into water soluble compounds to take them out of the body in phase two and then phase freeze in the gut. And there's actually something called the estrobolome, which is kind of an odd name, but it, it's a way that our body can package up and help get rid of excess estrogen. But for a lot of people, whether it's related to genetic susceptibility like those of bites.
Hello.
With nchfr, we don't do such a great job with that latter part of the detoxification process. And so our body can then recirculate estrogens that we're exposed to. So not just endogenous estrogen that our body makes, but also estrogen mimicking chemicals that we are exposed to our environment, personal care products and food. And sadly we are exposed to it in lots. So I find a lot of women in kind of perimenopause and menopause. Maybe this hasn't been magnified as it was when they were younger. But as an example, the hallmark of ovarian aging is ovarian senescence. What is driving the aging profit for women is that our ovaries are as old as we are. Unlike men that replenish sperm. I think every 72 hours, women have ovaries that are as old as we are. And by the time we're like 40, we have a lot less ovarian follicle. And so our ovaries are making less progesterone. And oversimplify things, we get this relative estrogen dominance where we have a bit more estrogen relative to progesterone, which can manifest in different things. They can show up as very heavy quarantine periods that I used to call out. You may get fibroid, you may have fibrocystic breasts. We may deal with weight loss resistance. Helping women understand you've made a constellation of symptoms that can go on. PCOS can be related to a lot of things. There's even some research to show now that it might, there might be an autoimmune component. Not just genetic susceptibility, but autoimmunity. Oh, hello. Add this to the milieu of things that we deal with. But not only people understand that one of the things that I think is so helpful and beneficial is that when we don't have estrogen properly regulated in the body, whether it be severe, the aging process, when there's relative estrogen dominance or we have too much circulating androgens relative to pcof, et cetera, it can show up in different ways. And so this is a, this is a growthful hormone. Estrogen is a hormone that promotes growth in the body. So that's why you may deal with fibroids, you may have cysts, you may have these heavier cycles, et cetera. And so you can address this in, in different ways. Obviously, the traditional allopathic medicine ways with oral contraceptives shut the hormones down. That will fix the problem. Sometimes it needs a little bit of progesterone depending on where you are in your cycle. Most people with PCOS do all gluteal phase defects, so they don't have enough progesterone to help counterbalance the other sex hormones. But other ways that you can think about is what are the things that are going to help that estrobolone help happen. Excess estrogen. I think about fiber, I think about cruciferous vegetable. Obviously there are specific supplements that could be helpful from just for people dim or calcium to glute, depending on where they need phase one, phase two support. And so I, I think that estrogen is a growthful hormone, literally and not just figuratively. And so understanding that many of the kind of constellation of experiences that women have as younger adults and that middle aged adult are exacerbated by this imbalance. And adding synthetic hormone like oral contraceptives might blunt the symptoms for a period of time, but does not for stay fix the underlying problem. And that's where a medical detective like yourself is really helpful to help kind of dig a bit deeper and look at what might be exacerbating the I, I think for a lot of women they don't realize that they can also be in menopause still not be having cycles for 12 months or longer. And you can also be estrogen dominant too. So adipose tissue tends to be very estrogen rich. That's why oftentimes I will see thinner women go into menopause earlier than more obese women who may be having cycles in their early to mid-50s but they aren't actually ovulating anymore because they just have so much estrogen rich tissue that kind of buffers they're, they're kind of menopausal experience. It's interesting. I interviewed Dr. Felice Gersh and that was one of the things she said was if you're over the age of 51, 52 and you're still getting cycles, it's probably dysfunctional urine which I found really, really interesting as the first time I heard someone say that. And I was like that makes a great deal of sense. So understanding that our body can create whig or form for estrogen like estrone, which is a weaker form of estrogen that our body will make in fat tissue by women in menopause, I'm like are not very happy about suddenly dealing with more fluff than they had before. Except cutaneous bats different than estradiol which is the predominant form of estrogen our bodies make prior to going into menopause. But you can be in menopause and still be estrogen dominant. So important to know how you detoxify. That's where things like the Dutch test I think are beneficial. I specifically like the Dutch test for that to really look are are you able to break down and we talk the bi your estrogen looking at some stool testing or adding a beta glucuronidase which is enzyme that kind of gives a clue of whether or not you're able to break down and process the XF estrogen And again you don't have to be obese to be dealing with those things. It can happen in thin people too. And I think that we need to build awareness around this and so this is exciting.
Looking forward to when your book comes out. It'll be interesting to see what kind of tidbits you give us there and that sort of. I knew you got a lot of things going on a lot of other projects. If people want to know more about you, follow you. How can people wonder about you? Where can people.
Yeah, probably easiest to go to my website, so. Www.cynthialo.com you can check out my podcast, Everyday Wellness. Dr. Herman's been a guest. He'll be back again, hopefully this fall when my podcast studio finally gets finished. You can find me across social media. I'm most active on Instagram. I do have a free Facebook group called thenitlikepaws.slash my name. There are men and women in that group. If you follow me on Twitter, you may find him a little snarky at times. I. That's where I can kind of get away with that. But those are probably the best. Oh, and I'm also slowly building my YouTube channel so you can also see full video and audio of all the podcasts are up on YouTube as well.
Well, thank you so much, Cynthia, for your time and your generosity. Really appreciate that. And everybody you've heard where to find her. So great spending time with you today, Cynthia, and I'm sure we'll see each other soon.
Yes, thank you.
I take care of.
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