How Trauma Can Fuel Health: Cynthia Thurlow’s Transformation from NP to Wellness Warrior

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 great stuff with her after we go through her Bobby. She is an awesome and we'll get started with our conversations. Few things really quick about Cynthia. She's a seasoned dirt 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 a text talk two times. He's a multiple bestselling 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 is to help women understand and achieve optimal wellness through her everyday wellness podcast, which right now Cynthia is. Where is that at? That's like the whole point. I was like the top, third, worst.

It's like leading Health and Wellness Nutrition podcast.

Pretty awesome.

It's exciting.

On this podcast she provides accessible, engageable content on the benefits of intermittent fasting and holistic health and a bunch of other topics. And 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 I wanted 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 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 we 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 health journey. How you know you're here 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 has enabled you to help tons of people through your own personal trials, struggles, your journey.

Yeah, I mean, I, 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. Um, I like to share with people that I grew up the byproduct of divorce. Like many kids in the 70s and 80s, um, and my parents did the very best that they could. And I was one of those kids that knew I was gonna leave New Jersey, I was gonna go off to college and never move 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. No offense to 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, later a nurse practitioner. And I think after, you know, me and my husband starting a family and having the child life threatening food allergies, that really caused me to have this incredible pause and think about why did my child develop food allergies? You know, the allergist, well meaning allergist said something along the lines of carrying EpiPen and prey, which never sat well with me. No parent wants to hear that. And you know, 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 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 you on a vascular path, it means they had, you know, head to toe vascular disease 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 perimenopause 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. You know, really working in the health and wellness space as an entrepreneur and, you know, being able to make a larger impact. And that's really what it comes down to. And for me, feeling like the work that we're doing is like peeling an onion, you know, 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, you know, 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 struggle. You know, sometimes like the dark nar of the valley where you go through some significant. And you've got 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, how kind of. And that kind of helped you realize that you've 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 event 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 and 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 traversed, you know, 20s, 30s, 40s, my husband and I like to do a lot of 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 works 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 event again until fast forward, you know, 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 of complication and 13 days in the hospital. Every complication you can imagine that you 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 13 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 have 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 the significance of Dancholic 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 means 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. Obviously 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 things to support my body because, you know, 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 spending, you know, they took me from the outpatient or to the inpatient or. And I. That got me triggered again. You know, 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, 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 way 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, you know, 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, you know, a near death event. All of a sudden the brain starts connecting things. I actually saw a patient this past week who been seeing it for a couple of years and 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 and then blood draws is because it triggers an abusive incident past 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 ace of events, adverse child events, um, but also your interaction with the healthcare system? You know, I personally feel like our healthcare system traumatizes people sometimes. The way, you know, where we do mammograms, the way we do, you know, women's breast health, for example. Like how have you seen these micro traumas play into some of your other 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, pure happenstance. The docs that were on call were fantastic and were 100% 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 in healthcare may have a small bowel obstruction. More often than not. You're going to get a tube placed down your nose needs a gastric tube into your stomach to help decompress all the therapy because I looked six months pregnant. I applied since and the, the nursing care that I have 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 health care provider too. I can tell you that after I was discharged, I was walking through Target a few months later and I ran into that nurse. She didn't recognize me, but I recognized her. And it set off this incredible fight or flight response. My heart was pounding, I started to sweat. You know, 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 ways. 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, you know, 11 o' clock at night until 7 o' clock in the morning, I'm staged. 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 drainage in. So they had to call in interventional 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 to 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, you know. So 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. You know, it was like, you start having this bargaining with God of if I get out of here, I promise I'm out of 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 say is it was always my experience as a clinician that people were either controlling ass hats or they were just too sick and they were like, please just take care of me and 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, you know, retroperitone abscesses, if you don't treat those, you die. You know, I was nervous. Yeah. Perforated appendixes, if you don't treat those, I mean, these are multiple things. You know, being in the hospital for as Long as where you lose a lot of muscle mass, which can affect inflammation. You know, your gut microbiome is totally. Your gut bacteria. Totally messed up. Yeah. How do you. You know, so a little bit of a transition. You know, either these kind of events, when you have them, they either. They either they put you in one or 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 as a superpower to help improve whatever they're doing. You know, two paths. And obviously you've used that to. To uplevel your game, 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. You know, fear. Oh, my gosh, when's the next thing going to drop My kid. Oh, my gosh. And my titter. You know, they come with. Make people disabled and. And just frozen. How did that help you to, like, take you to the next level moment?

Um, I mean, I think because I'm a survivor, I think that, you know, 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 knew 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 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 is deprived of Neil. 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's 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. 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, you know, moving my business forward. And then the pandemic happened. And so when pandemic do 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. That's my family. And then, you know, secondary to doubt it. 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. You 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, you know, one step in front of the other. And, and that is, I think my childhood kind of correct 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 outta 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 that hospitalization meet and the post. They're so different.

So even watching this. Let me see. Even watching the TED Talk, even though it's you and you're doing great and you got a lot of people for. Even though to the unconscious observer, they would have no idea. Like, just because your brain, that was just 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, you know, 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 rectured appendix? The craziest story. So I think for a lot of 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 for which I am grateful. Like I say all the time, I'm so glad that happened in my appendix, because I wouldn't be where I am today. But so much emotional growth that came out of that, that I was still in processing, like, it's again, like killing that onion. Like, just when I think I've gotten over that next, you know, hill I have to climb, I'm like, oh, no. It's like, no 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. Like, I see clips of it. And that's as much as I can watch.

Well, I think it's really interesting because I hear 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, you know, 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, you know, kudos to 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 having 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 dots with 20 things that had happened to me over the years 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 road raise up 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, you know, hormones, women's hormones? That's kind of part of 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 tech talk topics was actually fast and how that affects women. Could you kind of take a little, take a little deep dive into how is fasting and then how it relates with hormones or sugar levels? How does that actually affect women's hormones either positively or not fast and eat too much negatively impact the hormones?

Yeah, I mean, I think it comes back to bio individuality. You know, 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 would 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 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, you know, 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, perimenopod, pete fertile years. 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, you know, other things like intense exercise or again, the 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 out the layers. You know, again, if you are insulin resistant, you got borderline blood pressure problems, your pcos, um, you know, you're starting to kind of have that slippery slide into metabolic disease. Great way to kind of get things, you know, 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 crimes and designs to procreate and to, to sustain life. And so if we look at it through that lens, it makes sense that women that are in their peak early 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, you know, 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. You know, we know the average American, and this is based on fashion hamburger data. You know, 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 you know, the point of fasting is not to nourish your body. The point of fasting is to, you know, determine that there are specific times and during the day that you're going to eat and there are specific times that you don't eat. But that is kind of the, the gestalt about fasting as it pertains to women. And it also comes back to, you know, if you're in perimenopause and menopause, are you sleeping through the night? If you're not sleeping through the night, please do not start fasting. You know, 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 their 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 know, you're rigid and dogmatic and that's what you do 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 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 and 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 going down early. I mean you say about, you know, going through menopause even, Even now, maybe mid-30s is kind of crazy, but based on where you're at, you know, 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. Fast and Transformation was actually one of the first books I read that actually kind of separated out those concepts of throughout the month your, your carbohydrate and fasting abilities change, but also throughout 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 and 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. You know, 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 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, that 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, 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 as they're getting older. And the role of sarcopenia is not a question of if, but when. So it really accelerates after 40. I forget offhand what the percentage in, but it's, you know, 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 this gland in the body. It actually can, it's very inflammatory with cytokines, a lot of inflammatory properties. 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 ribeye. 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 thing. It is, that is actually the first site of where we become insulin resistance. And that is very important to understand. How do we combat this? Number one is we have strength training. 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, you know, 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. Um, I typically will say no less than a hundred grams a day. And you can track on app like Chronometer, which is free. But building awareness around how much protein you're eating in a meal is 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, you took about one gram per pound at 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, etc. Then you can probably have more flexibility with carbohydrate than someone who is pcos, insulin resistant, hypertensive, high triglycerides, low hdl. You know, 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 ketogenic 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, you know, 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 tell 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, you know, 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 hormones, it becomes much more common to see the catabolism of muscle. So especially as we are losing estrogen it accelerates this catabolism of breakdown of muscle. And if we are not actively working against and consuming enough protein, lifting 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 crave an avocado. You're going to 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 to be hitting those protein macros. Because if you don't, you're going to crave 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 augment that chloric intake that you should have consumed during your day. So I always 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 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 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 the sugar metabolism, does it actually make the transition through menopause easier or better?

I would, yeah, I think it does. Because what's interesting is if you look at the research on, like vasomotor 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 grams of protein, shoot it well at least three times a day. If not, you're gonna 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 you know, I don't get completely after meal. I'm, you know, I have great state 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 many 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 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 have a look at creatine and like a, it's a multi faceted supplement, you know, if you want to, you know, 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, you know, when women are feeling like they have more energy, when they have more higher estrogen levels, they have less energy. When progesterone predominate. The number one is strength, number two is there was, 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. Um, there are some emerging papers about bone health and we know for many people, myself included, I was on oral contraceptives for 20 years and my, my volume actually kept it on very low hormone state. And so I, I missed out on the opportunities to build peak bone and muscle mass. You know, 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. It is emerging research. The other thing that I Find really interesting about creatine is it helps with jet lag. So it got some components. I mean think about it in terms of ATP production and how it can, you know, hydrating 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 as to cross that blood brain barrier for 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 you know, one hour, one day per hour of time change. So by the time you get used to being on the west coast, you're flying back and 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 braided health. I do think that there's enough research to suggest it's helpful for sleep architecture and jet lag 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 in your gut microbiome. You know, you said, mentioned 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 it's kind of leading into your some of your new stuff you're looking at.

Yeah, so I would say, you know, the big kind of takeaway is that when I got food poisoning in Morocco that my husband and 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 to made me much more susceptible to not just picking up diarrhea, which is a pretty ugly bug, but also the significant endotoxemia 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 tight junctions open up and then everything you're eating is driving this inflammatory and immune response. So your immune response gets over activated, gets its overacted exaggeration that goes on. And understanding, it's kind of like the perfect storm. So when I reflect back on 2018, when I got, when I got sick that time with the. It was just the perfect example. Like, I ingested the bug, my knee system was depressed because I had these changes in estrogen. I got such a whopping. They call it lipopolysaphoritis is toxins that get released. It's why I was so, so incredibly sick at that time. And so this book is 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 about 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 GLP1 agonists are very popular right now, rightfully so. Um, but we actually make GLP1 and GIP 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, you know, 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 going to 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. If they're 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, you probably have it in your oral microbiome, your vaginal microbiome. They're all interrelated. 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 you know, to, to talk. When I did my training, my functional medicine training started back in 2010 12, to listen to people talk about how in the 80s this idea of leaky 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 Alessio Fasano, Dr. Morland 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 aren't 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 mucus pill or a vomit color. And so it's just not, if there's not a direct pharmaceutical or thin or intervention, it's like, well, we're not going to 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 it's not your pcos that you women with fibrocytic breasts that you women with heavy periods, endomyosis, which they don't realize, endometriosis, they don't, a lot of them won't realize they're 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 think 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 body there's phase one and phase two detoxification. This is an actual thing, you know, phase one is when our bodies taking toxins and making them into water soluble compounds to get them out of the body in phase two and then phase three is 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 that bites hello. With mthfr, 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 eating 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, you know, ovarian senescence. You know, what is driving the aging profit from women is that our ovaries are as old as we are. You know, 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 at very heavy crime scene period 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 even 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 I hope 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 you know, we have too much circulating androgens relative to pcos, 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, you know, 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 a luteal phase defects that 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. Estrogen, I think about fiber, I think about cruciferous vegetable. Obviously there are specific supplements that could be helpful. Thrombos for people dim or calcium d glucarate, depending on where they need phase one, phase two support. And so 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 that. 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 their, their 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 gay cycles, it's probably dysfunctional urine, which I found really, really interesting as 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 weaker forms of estrogen like estrone, which is a weaker form of estrogen that our body will make in fat tissue by women in menopause generally are not very happy about suddenly dealing with more fluff than they had before. Like subcutaneous 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 you know things like the Dutch test I think are beneficial. I specifically like a Dutch test for that to really look are, are you able to break down and detoxify your estrogen looking at, you know, some stool testing or adding a beta glucuronidase, which is an enzyme that kind of gives a clue of whether or not you're able to break down and process the active 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. So I knew you've got a lot of things going on a lot of other projects if people want to know more about you, follow you. Um, how can people learn about you? Where can people follow you?

Yeah, probably easiest to go to my website, so www.cynthiafniverlo. 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 the Midlife Pause dot 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 am. 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.

Cool. Well, thank you so much, Cynthia, for your time and your generosity. Really appreciate that, everybody. You 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.

All right, take care.