Ep. 249 AMA Episode: Dr. Mindy Pelz: Troubleshooting Fasting, Electrolytes, Hormones & More

Your trusted source for nutrition, wellness, and mindset for thriving health.

I have the honor of reconnecting with Dr. Mindy Pelz today. She was with me before on podcasts 113 and 184.

Dr. Mindy Pelz, D.C is a bestselling author, keynote speaker, and nutrition and functional health expert who has spent over two decades helping thousands of people successfully reclaim their health. She is a recognized leader in the alternative health field and a pioneer in the fasting movement, teaching the principles of a fasting lifestyle, diet variation, detox, hormones, and more. Her popular YouTube channel (which just celebrated 23 million lifetime views) regularly updates followers on the latest science-backed tools and techniques to help them reset their health. She is the host of one of the leading science podcasts, The Resetter Podcast, and the author of three best-selling books; The Menopause Reset, The Reset Factor, and The Reset Kitchen, and her current book published with Hay House, Fast Like a Girl, is available for pre-order. Dr. Mindy has appeared on national shows like Extra TV and The Doctors and has been featured in Muscle & Fitness, Well + Good, SHEknows, Healthline, and more. 

For this episode, I have a new format of ask me anything questions and answers. Dr. Mindy and I answer many of the questions women have sent in about nutrition, navigating fasting, electrolytes, and estrogen and progesterone-promoting foods. We discuss perimenopause, PMDD and hormonal fluctuations, carbohydrates, hormesis, the parasympathetic nervous system, and magnesium. We get into the impact of fasting on the liver, changes in our cycle, and the need for liver and gallbladder support. We also answer several questions about troubleshooting and talk about Dr. Mindy’s new book, Fast Like a Girl. 

I hope you enjoy our new format and listening to today’s discussion with Dr. Mindy Pelz.

“As women, we need to embrace that we are rhythmic. We have cycles. We have a natural ebb and flow.”

-Dr. Mindy Pelz.


  • Should fermented foods (sauerkraut) be eaten first or at the end of a meal?
  • When indulging in something sweet from time to time, is it better to use organic sugar or honey than agave? Or is pure stevia preferable?
  • Which foods are beneficial for progesterone production?
  • Is there a way to prevent cravings for salty or sweet snacks after dinner?
  • Some tips to make losing five to ten pounds a bit easier.
  • Are products with zero carbs and zero sugars suitable for fasting if they have a sweet taste?
  • Some simple ways to relieve the symptoms of PMDD (Premenstrual Dysmorphic Disorder).
  • When is the best time for a perimenopausal woman who suffers from anxiety and irritability before getting her period to use progesterone cream?
  • Should a woman in perimenopause keep a twelve-hour fasting window until her period starts, even when her cycle is unpredictable? What happens if she skips a cycle?
  • Dr. Mindy and I share our opinions on Ozempic (Semaglutide).
  • What nutritional information should people look at if they have high cholesterol that cannot be explained?
  • How can lifestyle changes allow people to avoid having to take statins?
  • What should you do if you become fatigued when fasting?
  • What does it mean if you start losing your hair when you fast

Connect with Cynthia Thurlow

Follow on Twitter, Instagram & LinkedIn

Check out Cynthia’s website 

Podcast 113– How to Survive the Ups and Downs of Menopause

Podcast 184 – Hormonal Symptoms Don’t Have To Be a Result of Aging

Connect with Dr. Mindy Pelz

On her website

On Instagram

On YouTube

On Facebook

Get your copy of Dr. Mindy Pelz’s new book, Fast Like a Girl.


Cynthia Thurlow: Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the honor of reconnecting with my good friend, Dr. Mindy Pelz. We have previously connected on podcasts 113 and 184 and today we went into a new format on Everyday Wellness. I hope that the listeners will enjoy this. It’s a questions and answers or Ask Us Anything and we spoke about a lot of the questions that came in from women specific to nutrition, how to navigate fasting in a fasted state, the role of electrolytes, estrogen and progesterone-promoting foods. We spoke about perimenopause, PMDD and hormonal fluctuations, the role of carbs, hormesis, the parasympathetic nervous system and magnesium as well as fasting and the impact on the liver as well as changes in our cycle, the need for liver support, gallbladder support, and then several questions on troubleshooting.

We also spoke about her new book Fast Like a Girl. I hope you will enjoy our discussion and I hope this is the first of many of these Ask Me Anything formats which are becoming increasingly popular and is really a fun way to pick our brains.


I’m super excited to bring you back, first of all to congratulate you on your new book, which is due out any day. By the time this podcast releases, it’ll have been out for about a week. But I thought it might be fun because we’ve recorded together several times and do kind of a Q&A.

Mindy Pelz: Oh, let’s do it.

Cynthia Thurlow: Some of these questions are really quite honestly are funny. I thought to myself, I was like, this is fantastic because I can’t think of anyone else I would prefer discussing them with other than you.

Mindy Pelz: I love it.

Cynthia Thurlow: So, so good to have you back, my friend.

Mindy Pelz: Thank you.

Cynthia Thurlow: How is the pre-book launch phase going for you?

Mindy Pelz: Oh, God. Well, okay, so this is my fourth book. So, we have an idea of the game that needs to be played. We’ve been going strong for six months and I would say that we’re a week out. This weekend I hit like a moment where I haven’t had a day off. Starting in September, I think I maybe had four days off total where I just didn’t do anything. So, as you know, it’s a lot to launch a book of this magnitude out into the world. And it’s not just you, right, it’s your publisher, it’s your agent, it’s your team. It’s a loaded question how I’m doing, other than we’ve done a lot and I’m excited to get it out into the world.

Cynthia Thurlow: Yeah, absolutely. I remind people. People think of it like it’s just a sprint to the publication date. I remind them it’s a marathon because it’s not just the time leading up. You don’t want to abandon your book. So, it’s understanding. It’s like this long process of publishing, and so my heart goes out to you. [Mindy laughs] I know that you’ve been through this process before. This was my first time and I can honestly tell you that it was very humbling. I would encourage you to find an opportunity, like set up a vacation or something in the distance so you can look forward to because that was one of the best decisions I made, was three and a half months after publication, I had a vacation with my family, and it was like, the first time I had exhaled in probably nine months and it felt really glorious.

Mindy Pelz: Okay, good. Yeah. We’re going to go. We have Hawaii on the calendar for March.

Cynthia Thurlow: Perfect. Well deserved.

Mindy Pelz: It’s hot but, like, to your point, after launch week, I look at January and February, it’s all booked, but it’s all good. I love writing. I love the process of writing. As you know women need all the resources they can get right now, so I’m excited to launch it.

Cynthia Thurlow: Absolutely. I’m so excited to have you on the podcast. We’ll start with the nutrition questions because there were so many of them. In fact, my team was laughing last night when they shared things with me. They were saying it’s heavily nutrition focused. And I said, that’s not a problem.

Mindy Pelz: No, it’s great.

Cynthia Thurlow: The typical perimenopause, menopause, miscellaneous, lots of miscellaneous, I was like, I don’t even know where to put this. But let’s start from the very beginning. Many listeners know that you are very keto, probiotics in general, fermented foods, how important they are. Someone asked when adding sauerkraut and I apologize to those that submitted questions, but my wonderful team did not add the person’s name, so I can’t say Lindsey asked. We’ll just do this is question number three. [laughs] “Sauerkraut to a meal, is it best for gut health to eat at first or at the end of the meal and why?”

Mindy Pelz: Oh, that’s a great question.

Cynthia Thurlow: Yeah.

Mindy Pelz: I’ve never gotten that question. You know what? I would say that you either eat it with the meal or before the meal because it’s your microbes that help regulate blood sugar and break that food down and pull the nutrients out of it. I think that’s the biggest thing that people don’t realize, that we put so much focus. If we just even take the mitochondria, how many thousands of hours of conversation about the mitochondria have you had and how many hacks out there to hack the mitochondria. But really, it’s your microbes that are going to determine what happens to your food, which is why sauerkraut is amazing. So, we typically do like we’ll do a grass-fed steak with a sweet potato and then a cup of sauerkraut. That’s a pretty common meal. And I just eat it all together. I don’t know about you, but it’s not my favorite, so I either eat it before or with the meal just to get it down.

Cynthia Thurlow: Yeah, it’s interesting. There’s a manufacturer of a locally grown crowd and they have all these more exotic crowds, things that have got curries in them and coriander. I usually will stand at the refrigerator with a fork and I’ll take a couple of bites of my kraut as I’m like reheating, because usually I’m in reheating mode as I’m reheating something for lunch or I’m cooking dinner and I’ll use it preemptively. But I agree with you, I think taking it with a meal or prior to a meal is the way to do it.

The other thing that’s the kind of second part of this question was someone on social media underneath actually added, “Well, if your gut is healthy, why do you need probiotic rich foods?” Which I thought was– this is a common perception. I think for a lot of people, they’re like it’s just not important if your gut is healthy, but I would probably argue that most if not all of us have gut health issues we need to work on, even if we’re not aware of it presently.

Mindy Pelz: Oh, my God. Again, such a good conversation. I think what we have to realize is that we always talk about the trillions of bacteria in our gut, but if you look at species wise, how many species of bacteria are in there, the statistics I’ve seen have been anywhere from a couple thousand up to 7000 different types of bacteria. Each one of these bacteria are going to do something different, and they each have a food that they’re going to resonate with that the other set of bacteria may not. My experience and I’d be curious your opinion on this as well, has been that people eat the same foods over and over and over again. Sauerkraut can be the same thing. You eat the same sauerkraut over and over and over again, and so you create a monoculture.

I think what we’ve got to get back to is understanding that the name of the game is to keep diversifying your foods so that you can keep neurotransmitter production up, you can keep your immune system up, so you can feed the bacteria that break estrogen down. Those become massively important whether you’re trying to repair your gut or not. I don’t have any gut problems, but feeding these microbes is on my mind every single day.

Cynthia Thurlow: I always jokingly say that monogamy is a good thing in relationships, but food monogamy is not.

Mindy Pelz: No.

Cynthia Thurlow: We want to try different things and I’m as guilty of it as the next person. Like, I love steak, I love bison, I love eggs. I incorporate them throughout the week, but I’m always trying different fermented foods because I’m dairy free. For me, it’s really like leaning into those fermented vegetables. But I have fermented okra. I mean, I have kraut, I have multiple kinds of kraut. In fact, my husband told me the other day, he thinks we have science experiments going on in the top shelf. And I’m like, “No, no, they’re all healthy.”

Mindy Pelz: Right.

Cynthia Thurlow: He’s like, “Anyone wants to eat fermented okra,” he’s like, “Only my wife.” I said, “No, but it’s good to try different things every day” because I fervently believe and as someone who three and a half years ago, I was on six weeks of antifungals, antibiotics and then got another round of antibiotics when I had my appendix out. I remind people that just one dose of antibiotics can impact your gut microbiome, I think anywhere from 18 months to two years. So, for me, I’m still actively working diligently on my gut. You just think about the average person probably needs more fermented foods, beverages, etc., than they’re probably consuming right now.

Mindy Pelz: On that point also, if you eat out, you’re getting glyphosate. If you eat wheat, the wheat right now in America has Bt toxin in it, which is going to affect those microbes. We live in this world where there’re so many things trying to deplete our microbial health, let’s make a stand for always helping to grow it.

Cynthia Thurlow: Yeah, absolutely. I think and especially as we are getting older, understanding that as we have less hydrochloric acid production, as we could potentially be no longer making as vibrant digestive enzymes as we are exposed to more estrogen-mimicking chemicals in our food, environment, and personal care products just understanding that we diligently every day want to be doing even if it’s small things that are going to benefit the gut microbiome. I would say I humbly bow at the temple that is the gut microbiome because the more I learn, the more I just kind of am fascinated that we humans bumble through life and don’t even think about it.

Mindy Pelz: Yes, Amen to that.

Cynthia Thurlow: Next question is about, “If I indulge in something sweet from time to time, would organic sugar or maybe honey better than say, agave or should I use pure stevia?”

Mindy Pelz: Oh my gosh, these are good questions. I love it. Okay, well, I think A, you got to look at what personal preference. I personally do not like stevia, so I don’t gravitate to stevia-type foods, so, there’s that. You could look at the glycemic index and say, well, okay, stevia has got 0 supposedly, agave is I think under 10 on the glycemic index, it’s a little bit lower. Honey is around a 30 or 40 and organic sugar even though it’s organic, is up around a 70. The higher the glycemic number, the more of an insulin response you’re going to have. So, you choose, you’re going to have to think about that if you’re concerned about your sugar addiction or craving.

Now, the nuance on that is, stevia sometimes can trigger that same desire for more sugar. It’s a really tricky one, but I would say I choose mine off a personal preference and I choose it off glycemic index. I too I don’t know about you, Cynthia, but I’ve spent a lot of years as a sugar addict and for me I know if I eat sugar like three days in a row, there becomes like a point of no return where now I have to really hunker down to make sure I don’t have sugar again. So, I’m very careful to not have it too much for fear that will trigger that old pattern back.

Cynthia Thurlow: Yeah, and it’s interesting because I would imagine most, if not all of us are actually at least mildly addicted to sugar because it just proliferates, it’s in our condiments, it’s in our ketchup, it’s in our salad dressings. I would agree with you that for each one of us, we have to decide, can we tolerate one square of high-quality dark chocolate? Can we tolerate some of these items, like, I really don’t use honey. I mean, maybe in the past I might have used honey, but I really try to avoid using a lot of sugars personally because, as you mentioned, you start getting this dopamine hit, it feels good, you want more. Obviously, we’re heading into Christmas at my house and New Year’s, we’ll have family here in a couple of days. I was actually saying to my kids, for me, I have to plan, like, if I’m going to indulge in something, I know what the net impact will be the following day.

So, it’s finding I tolerate a little bit. Personally, I find that a lot of the artificial or the contrived sugars, monk fruit erythritol tend to be perhaps a little bit better tolerated. People can tolerate some of the sugar alcohols like erythritol. My 15-year-old has been experimenting with Swerve, which has been interesting to watch. With that being said, I generally say agave is a no go because agave is straight fructose and it’s metabolized very differently.

I know a lot of people still think of it as being very benign. I watched a friend pouring it all over her pancakes and I kind of just cringed [laughs] watching it thinking that this is not going to have a good end result. I’ve talked quite a bit and I’m sure you probably have seen that paper about nonnutritive sweeteners that came out probably two months ago that was talking about the net impact of sucralose, NutraSweet, saccharin, which I don’t know where anyone is using any saccharin at this point in time. And then looking at stevia in just for a 28-day period using those sweeteners again, some are artificial, depending on what type of stevia it wasn’t identified, change the gut microbiome as well as impact oral glucose tolerance. I think it really speaks to the fact that all of us need to examine our relationship with sugar.

Mindy Pelz: Yeah. Again, if we can get to sugar that has more fiber in it, like an apple, it’s going to have a different blood sugar spike. One of my favorite things, I know this is going to come out in January, but one of my favorite holiday things is I make a wicked pumpkin pie and I use coconut sugar and I use so much full fat in it. If you pair and it’s so good, it fills me up and it’s not like I’m craving sugar the next day. I think pairing a fat with your favorite sugar is also a trick that seems to not for me as an extra addict, it doesn’t seem to cause me to crave it the next day.

Cynthia Thurlow: That’s a really good point. It’s interesting. I really like dark chocolate.

Mindy Pelz: Me too.

Cynthia Thurlow: That’s like my one vice left. What I’ve been trying is doing some dark chocolate with maybe a teaspoon of MCT oil because then I’m satiated because I think that’s part of the problem is that when we eat some of these foods, if there’s not enough fat associated with it that it can trigger these desires to continue eating it. If I’m eating a piece of dark chocolate, sometimes I’ll have a scoop of high-quality nut butter and that’s usually what I will pair together that I find is really impactful. I agree with you about the fruit. Fruit in its whole form, whether it’s an orange or some berries or if you have an apple, preferably not one of the ones that’s engineered to be super sweet.

I was trying to explain to my kids when I was talking about how modern-day farming has really continued to evolve and to “mature,” this sugar desire because Honeycrisp apples, Gala, Fuji apples are apples that tend to be a bit sweeter. It’s not like the McIntosh that I’m sure you and I had when we were kids, [laughs] [crosstalk] but there weren’t a lot of options. Maybe there was like a Golden Delicious. There were very few options back then in the 70s and 80s, but now there’s this proliferation of very sweet apples and understanding that further is that desire to eat more sugar. We just don’t recognize it as such.

Mindy Pelz: Yeah, well said. Isn’t that fascinating. I was sitting there thinking as you were talking, like if we look at the trends in nutrition, we jumped all into the low-fat movement back when you and I were growing up in the 70s and the 80s, and then we had to course correct by adding sugar because nothing’s really good without fat. So, we changed everybody’s tastebuds to the point that we’re now even highlighting the more sweet fruits out there because everybody’s tastebud is so conditioned for that.

Over time, I would say the majority of my diet is meat and vegetables. I love sweet potatoes, probably because of what it does to my hormones. I love me some good dark chocolate for the same reason. But I think as you change your food habits and you’re using foods that are more nutrient dense and they are feeding your hormones, they’re feeding the cells in such an efficient way, you start to see that sweetness is not really something you crave. And I know that’s impossible for people to think about if that’s all they can think of want is sugar. But I promise you over time it just all of a sudden goes away. I say that as an ex-sugar addict.

Cynthia Thurlow: Yeah. I think that transparency is super helpful. It was interesting. I was stuck in a very long delay at Chicago O’Hare Airport on Saturday, coming back from LA. Ironically, my gate was across from McDonald’s. I was watching this group of people. They were going over McDonald’s and getting a meal, and they would come back and then getting ice cream. It was so bad that [unintelligible [00:17:15] have rolled out a cart essentially to apologize for all these lengthy delays, a seven-hour delay. I just watched this crowd of people, no judgment, but everyone like, woofed down all the Cheez-Its and the Goldfish crackers and the Fig Newtons and all the other things that were there. I walked over, grabbed a bottle of water, and sat back down and someone said to me, “Well, it’s been so many hours since you last ate, you must be starving.” And I was like, “Nope.”

Mindy Pelz: Nope. Oh, my gosh. Every time I’m in an airport, I am so grateful that I’ve trained myself to fast because I watch the people or even like I recently got off coffee watching the people in the lines. It’s like, “Wow, it’s hard.” I say this with love and compassion, but I also say it as you can do it yourself as well, but there’s nothing worse than waiting in line for food or coffee in the airport, especially if you have to catch a plane. So that was yeah, totally get it.

Cynthia Thurlow: Yeah. Yet another benefit of fasting is that if you need to fast, you can effortlessly do that. Now, because you were just speaking about balancing hormones, we got questions specific to progesterone as well as estrogen, and you do a really nice job in your book talking about this. Let’s unpack which foods, because there are a lot of questions around this. What foods are beneficial for progesterone production and the body, and for many people that are in perimenopause, understanding physiologically what’s going on in the body and why this can be very helpful.

Mindy Pelz: Yeah. So, here’s in the book, I have a line. It’s probably my favorite line in the book, where I say that, “We have to look at estrogen and progesterone as like twin sisters with vastly different personalities.” We need to feed them something different. I would say, just the basics, when you look at estrogen, in general when estrogen is coming in, the lower glycemic, the lower glucose foods are going to be great. This is where your meats and your vegetables, oh, my God, estrogen, if she could talk to you, she would say, “Feed me more leafy greens than you could possibly handle.” I think also some of your beneficial oils, like flaxseed oil, she really thrives with those healthy oils. A little more of a ketogenic diet is really what estrogen needs.

Progesterone is completely the other way. She’s like, “Don’t give me low glycemic foods. I need glucose to be higher to be able to show up and be produced.” Again, the sweet potato, I feel like is the hero of the progesterone day. I have sweet potatoes all the time. By the way, I do back to the microbe thing. We do variety of sweet potatoes. Have you ever wondered when you’re at the market, we call them all sweet potatoes and yams, but what are they really, because some of them are purple on the inside, some of them are white, some of them are yellow, some of them are orange. The skin color is different, but they’re all in the same section.

We did some research a couple of years back and found out that the purple ones actually have a specific, well, purpose, not that anybody really knows this, but to feed the bacteria in your large intestine down deep into the large intestine. Whereas the other vegetable, other sweet potatoes tend to go in not the small intestine, but more entry point in the large intestine. I never looked at different foods feeding different microbes along the transit process, which is really interesting. Sweet potatoes are great. Chocolate, dark chocolate, I don’t think we should fear chocolate, but I’m not saying go out and Hershey’s chocolate. You got to be really smart about your super, super dark chocolate is incredible. The other thing progesterone that in the keto world everybody’s scared of, and I’ve actually brought this back in is bananas, tropical fruits, mangoes, bananas, great for progesterone. Citrus fruits, great for progesterone. Grass-fed meats are still really good. Quinoa, rice, it’s very much when we want to bring progesterone up, we got to bring glucose up. Do it with nature’s carbs, don’t do it with other carbs.

Cynthia Thurlow: That’s such a good point, and it’s interesting. I have always been a just green banana person. It’s whenever we buy bananas and they come home, I will enjoy on a day that I’ve lifted, I’m like, I’ll have half of a small, like, just green banana, but it’s literally just turned from green to yellow. It has a very different flavor profile, a lot less sugar than the brown bananas that my husband loves to eat, which I think is a byproduct of the fact that no one else will touch them. I’m glad to hear you say that, you know leaning into some of those tropical fruits.

Obviously, portions are important, so it doesn’t mean that you eat five mangoes and a pineapple and a bunch of bananas. But leaning into and kind of intuitively eating, I think this is important. I know not everyone is necessarily at a point where they’re able to intuitively eat or intuitively fast, but if you are at that point, you’re metabolically healthy. I do encourage people, if it’s a higher carb day, lean into those starches that you talked about, just being mindful of portions, depending on where you are in the metabolic flexibility spectrum.

Mindy Pelz: Yeah, I was on a podcast interview a week ago, it was a sugar addict podcast, and the woman told me that she had been for 90 days eating for her cycle and fasting for her cycle and that she came in heavier with the carbs. I just talked about the week before her period, which would be appropriate for progesterone. What she noticed was the rest of her cycle, she actually craved carbs less. I actually have, outside of the microbe idea, my actual gut sense, no pun intended, is that when we actually feed our hormones appropriately, oftentimes the craving goes away.

So, we definitely have to look at the microbial issue. If you have a candida or something like that, it’s going to make you crave it more. This is our message that we’re trying to get out, is eat and fast according to your cycle. You’d be amazed how some of the things that we have said are genetic or they’re normal or I never can get over this hurdle are just because you’re living out of accordance with your hormones.

Cynthia Thurlow: I think that’s such a good point. I remind people all the time when you’re craving certain types of food, it’s your body’s way of telling you you’re missing something in your diet. As the example, there’re a lot of us in this low-carb ketogenic space and I have women that will say, “Well, I’m not supposed to have more than X number of carbs a day” and I’m like, listen, “If you allow yourself to have more discretionary carbohydrate in that luteal phase, especially the week before your menstrual cycle, and you adjust your fasting schedule, you are going to have much greater success rather than white knuckling it,” which is what I see a lot of women doing.

I always say we don’t want to be rigidly dogmatic about anything. I think that is one of the things that I find personally can be confusing. You and I are both clinicians, but for the lay public, when people are looking us for information, we are not rigidly dogmatic. We encourage our patients and clients not to be rigidly dogmatic because you may go through a period of time where you’re doing carnivore-ish then you may go back to low carb or ketogenic, you may do paleo. I mean, just understanding that our kind of preferences for nutrition can evolve throughout our lifetime, you stay in one lane and you never deviate.

Mindy Pelz: Yeah. I have come to this conclusion that one of the things we need to embrace as women is that we are rhythmic. We have cycles. As I am starting to enter more into my menopausal time, I’m actually looking at the moon cycle and timing a lot to the moon cycle. When I go back and I research that there’s a lot of history showing that women, if we didn’t have all this blue light, that we would actually all sync up menstrually, our cycles would all sync up with each other, and it would be synced to the moon.

We have a natural ebb and flow. If you look at our personalities in a month period when you’re menstruating, you’re going to have times where you’re supercharged. Your brain feels incredible, and you feel very social. There are other parts of the cycle where you’re like, I’m going to sit on the couch here with my sweet potato and my box of few chocolates and I’m going to watch a Netflix series because that you might shame yourself or say that you shouldn’t be doing that, but certain hormones demand that you do that. I love this idea of letting go of the rigidity. We as women are meant to be in flow and we’re meant to be in rhythm. It’s just that it’s a little harder to find that. Once you start to practice the principles that you and I are teaching, you find your natural flow and it gets much easier.

Cynthia Thurlow: And I think that’s really important. This is one of the things that I value so much, is that we’re both committed to the same population of individuals and women and helping empower them. I jokingly always say I know more about the menstrual cycle now-

Mindy Pelz: Right. [laughs]

Cynthia Thurlow: -than I ever did when I was still getting a menstrual cycle, which is really sad and really speaks to the fact that we aren’t taught enough about our cycles. I’m not even sure I have friends who are GYNs. I’m not even sure they feel like they understand. They understand the textbook, conceptualization of menstruation, follicular phase, luteal phase, ovulation, etc., but on a level that is in essence that they’re trying to control, like, oh, if you have short cycles, then we lean in this direction. You have heavy cycles we lean in this direction without even really understanding that there’s likely an imbalance that is driving some of the symptoms that their patients are experiencing. So, I’m grateful that we’re talking more about it so that younger generations will be more empowered. They won’t feel like there’s such a mystery about their evolution through peak fertility, perimenopause, and menopause.

In kind of getting back to the cravings piece, I had an interesting question. This young woman said, “I’m not sure if it’s a bad habit or a craving, but I’m great eating wise for lunch and dinner. Before my window closes, I want treats like chips or sweets. I’m trying to get enough protein at lunch with eggs and chicken with a salad and then dinner is usually fish or meat with vegetables. I’m not insulin resistant because I just had labs drawn and I only need to lose 5 to 10 pounds. How can I drop those night snacks? Or do you have any options for something healthy?” So, again, leading into these cravings that were just talking about.

Mindy Pelz: So, let me make sure I understand this. Her big hurdle is, she is the night habit.

Cynthia Thurlow: The night habit because she’s craving salty, sweet stuff after her last meal.

Mindy Pelz: Well, based off of what I heard from her dinner, the first thing I would say is make sure you’re getting some good fat in there, because even just meat and vegetables can often still leave you craving something. Make sure you drizzle some oil on the veggies and try to get some good fat. The other trick that I’ve done immediately following dinner is I’ll just have a little square of dark, dark chocolate just to kind of pacify the brain, and then I’ll move to a cup of tea. If my brain wants something to snack on, I’ll move to that. So, I think she’s got to dial in that dinner with a little more fat to make sure that the next day is going to be a little bit smoother for her and then she’ll lose that 5 to 10 pounds.

The second thing and I know you’ll love this one and agree with this one and I’m doing this for myself now that I don’t have my kids at home, is eat a little earlier in the evening if you want to lose that 5 to 10 pounds. You want to make sure that you’re eating a little bit earlier and eating within the, like, sun goes down here at 6 o’clock. I’ve been trying to eat my biggest meal, get it over with by 05:00. Now that’s going to take a little more strength when you go into that nighttime snacking. Get yourself some good tea, something that’s not going to spike your blood sugar. But if you eat earlier, once melatonin is on the scene, you’re more insulin resistant, you could drop 5 to 10 pounds just from that.

The last thing I’ll say is you might throw a longer fast at it and Fast Like a Girl I mapped out six different lengths and one of them is the 36-hour fast. I have found that once you’ve trained yourself to fast, if you can throw one of those 36 hours at it, it can be enough to drop that extra 5 to 10 pounds.

Cynthia Thurlow: Those are some really good suggestions. What I would add is making sure you’ve got enough protein in that last meal because I know if I eat 50 to 60 g of protein in a meal, I am way too full to be thinking about more eating. I would additionally add, I know that even for myself, if I’m by myself in my house and I’m like, maybe I’ve got a busy, busy week, I’m thinking of 1000 things. Sometimes I’m in my pantry and I’m like, what am I doing? The interruption of that habit so that’s sometimes, it’s like 20 degrees this morning when I got up, but last night, I took my dogs for a walk. Took them for a walk when I was thinking about something in the pantry that I didn’t need to be eating, took them for a walk. And I interrupt that activity. I actually went upstairs and took a bath and went to bed early because I was dealing with some jet lag.

So, understanding there’s definitely different ways that we can address this, but thinking about more fat with your meal, thinking about more protein, understanding that we’re more insulin sensitive during the day, and as it gets, here it’s like 04:30, 04:45 it’s starting to get dark on the East Coast. Understanding that sometimes closing that feeding window a little earlier than normal and then also considering an extended fast, I think is a really great strategy.

Mindy Pelz: Yeah, agreed.

Cynthia Thurlow: Okay, I got a question about electrolytes, which is completely timely. “I’m taking a brand with zero carbs, zero sugars, and it says it’s suitable for fasting. However, it does have a sweet taste.” She was saying, “In the book I’m reading about how any sweet taste spikes insulin, regardless of whether or not it’s actually sugar. I’m glad she’s making that association.” “Can you possibly shed some light as I’ve been drinking these during my fasting hours, and now I’m not sure if it’s breaking my fast.”

Mindy Pelz: Yeah, in that dilemma, I would get a continuous glucose monitor and know for sure. If you don’t have the financial resources to get the kind that plugs onto your arm, just get a little small one that you can get at your drugstore or a Keto-Mojo. I would just make sure that you test the sweetener and find out. We did this in my Resetter Collaborative, our free fasting group on Facebook, we did a test, and it was with tens of thousands of people, and we tested stevia. I was like, “Okay, everybody, I just want to see,” and this was both men and women. “I want to see what happens to stevia with your blood sugar.” I gave them the blood sugar test. Test your blood sugar and then just put some stevia right on your tongue without anything and then test it a half an hour later. There was no consistent certainty. Everybody had a different response. So again, we’re back to the microbes. They determine your blood sugar. I think you got to make it personal and do N of 1.

Cynthia Thurlow: Yeah, absolutely. That bio individuality rules and it’s important for people to understand this whole cephalic phase insulin response. It is very unique and I do think having a glucometer or continuous glucose monitor can allow you to see how you’re best served. A lot of those products when it says zero calories, zero sugar, they typically have some type of an artificial sugar. Going back to that nonnutritive sweetener study, we’ll make sure we put it in the show notes., important to understand that specific ones like sucralose, aspartame, even stevia in the context of this particular study impacted the gut microbiome, impacted oral glucose tolerance, which is a totally different test. Just to kind of keep that in mind that if you’re concerned about it breaking your fast, breaking a clean fast, eat it during your feeding window if you’re at all concerned about it. That’s an easy way to not even have to go to those extremes if you don’t want to. But I’m a data nerd and I love to test things all the time.

Mindy Pelz: Agreed.

Cynthia Thurlow: Okay, let’s move on to some hormone questions. What are some good ways? This is in the context of someone who’s still getting a menstrual cycle and has pretty severe PMS. She has PMDD, which is this premenstrual dysphoric disorder. What are some good ways to relieve those symptoms? Have you had experience with your patients in PMDD?

Mindy Pelz: Well, the first thing I would say is make sure you’re eating enough carbs so that progesterone can actually make her appearance. The second thing I would say is make sure you’re not pushing through like stressing that week. These are really simple kind of basic things. Sometimes I find questions like somebody wants to fancy supplement or the fancy trick, but it really let’s go to the foundational more. Make sure you’re getting that glucose up and then make sure stress isn’t high. So that would be the second thing. Magnesium, if you want the magic supplement for that time of your cycle, it really is magnesium.

Actually, going back to the stress, I would even take in like if you’re working out really hard, yoga is an amazing thing. You want to be in recovery that week and I think this is the biggest thing that I would love to get out to the world because how many times have we bitched and moaned about like, “Ugh, I feel horrible, I’m tired, I crave carbs, I want to sit on the couch, it’s like I don’t want to talk to anybody.” And progesterone is like, “Yep, that’s what we do.” And yet we push through that. As women have become more in the workplace and having to do work and families, there’s this push on through that is not serving us during that week. So, make sure you’re giving yourself plenty of nurturing. Maybe get a massage during that time and up your magnesium. Lather yourself in magnesium.

Cynthia Thurlow: Yeah. Such an invaluable response. I think that it’s really important for us as women that white knuckling it, whether it’s in a certain time in our menstrual cycle, during fasting, etc. That is not what we advocate for. Being kind to yourself is so important. It’s taken me a long time to learn this. It’s like I had to keep learning it over and over and over again.

Mindy Pelz: Oh, my gosh.

Cynthia Thurlow: I sometimes think about the fact that the times when I had the worst PMS were the times when I was taking the least good care of myself. I’d push through those really hardcore workouts, I would be going really low-carb, I just didn’t know any better. Obviously, now I do. I wasn’t getting my sleep that I needed. I wasn’t saying no enough. So, when you’re dealing with significant PMS, really understanding that is the time your body is really encouraging you to slow down, lean into some more carbohydrates, be more gentle. That’s not the time to be doing these crazy fasts. Maybe 12 hours of digestive rest. I love that answer. And magnesium, I always say everyone needs more magnesium in their life.

Mindy Pelz: Yeah. The other thing that I’ve been thinking about lately that we don’t talk enough about as women is that what is the actual, the action of your period? Like, when you shed blood, it’s actually a bit of a detox, and it can detox toxins, it can detox emotions. If there’s any point in our cycle where we have got to take better care of ourselves, it’s during that time. When we look at PMDD and we look at other hormonal situations, even PCOS, infertility, we really have to get to know where our behaviors have to change at different points of our cycle. And then honoring that menstruation, I loved what you said about I almost wish I had a cycle again. Now that I understand it at 53, I’m like shish, I wish I understood it at 33, like I understand it now. But it’s really that in the book I call this the nurture phase, that week before we need to nurture ourselves.

Cynthia Thurlow: No, it’s such a good point and I think every woman listening needs to lean into nurturing themselves more. There are very few people I meet that nurture themselves enough, really and truly. I say that from the most loving perspective, myself included. I’m a work in progress. Okay.

Mindy Pelz: Well said.

Cynthia Thurlow: Another progesterone question as it relates to perimenopause. This young woman says, “I’m 50. I still have a regular period. But that week before my period, when I pause my intermittent fasting, I feel very anxious and annoyed with everyone. I just bought progesterone cream and used it the week before my last period, but I’m wondering if I should be using it throughout the month. Thank you for everything you do for women’s health. You and Cynthia are my gurus.”

Mindy Pelz: Ah, I love it. Well, yeah, anxiety at that time of your period is definitely low progesterone. As far as the progesterone cream, that’s really a question for your doctor. I think the big thing on any kind of creams or bioidenticals is there’s an art to mastering it for you. I think one of the misconceptions is I’ll just rub some cream on myself.

And actually I’ll give you a story about progesterone cream that I did as a 53-year-old woman. As I test all this stuff out on my own and I put progesterone cream on this summer, I still was having a bit of a cycle this summer and I literally went crazy. I was like everybody was agitating me. My kids had come over. I was not kind to them, which I apologized a bit later, and I couldn’t understand what was going on with me. What I figured out was that at 53, I have low estrogen, too. So, when I rubbed the progesterone cream on me, it took estrogen even lower, which my ability to handle stress became even more difficult.

So, I think for this woman at 50, you find a good practitioner who can help you with dosing that. Again, I would go back into everything we’ve said about progesterone soften that week and make sure you’re eating more carbs and the magnesium. Like, it’s really about slowing down, which is probably the hardest thing to do.

Cynthia Thurlow: Absolutely. And such a good response. I would add to that that bio-individuality rules, definitely have a conversation with your medical provider, get your hormones tested.

Mindy Pelz: Yes.

Cynthia Thurlow: This is one thing that I really encourage women to do. Nothing makes me more angry. This is tangentially, I’m just going to say this one thing because I know you appreciate this, Mindy. A woman said to me recently, “My doctor told me I don’t need to check my hormones because I’m in menopause.”

Mindy Pelz: Ugh.

Cynthia Thurlow: I said, “You need a new provider.”

Mindy Pelz: Yes, well said.

Cynthia Thurlow: [chuckles] Like, that was my standard refrain. So, knowledge is power. Work with someone that’s going to work concurrently with you. Work as a team so that you get the information that you need. I do find for younger women sometimes that progesterone cream, if needed, can be helpful that week before.

Mindy Pelz: Agreed, agreed.

Cynthia Thurlow: I do think for other women, they may need oral progesterone if that’s what they’re interested in doing. You would obviously want to make sure that you’re working with your provider. I would get tested because the fact that you had this exacerbation of just being irritated much to, Mindy’s point, if you’re at the tail end of perimenopause, your estrogen levels are probably pretty low to begin with and it would really be a value to know exactly where you are. Get your labs tested. Work with someone that will consider all the options that are available to you.

Mindy Pelz: Yeah, well said.

Cynthia Thurlow: Okay, “I need some clarification. I’m still foggy with perimenopause and fasting for my cycle. If I don’t fast the week of my expected cycle and then my period does not start, do I keep a 12-hour fasting window until my period starts? What if I skip and cycle completely? I want to work with my cycle but in a season of unpredictability I am not able to get into a good rhythm. I typically have a 30 to 35-day cycle and I would like to do a 16:8 at least two to three days per week. Any thoughts?”

Mindy Pelz: Oh my gosh. So, the perimenopausal woman, we’ve been there, we get it and it’s hard and it’s probably the hardest age range to explain how to eat and fast because there’s no predictability. Here’s what I say is couple of things, you want to get to know the personalities of your hormones. This is how I look at it is that when I would all of a sudden, like, I’m actually 90 days into no cycle. I don’t have anything to map it to, so I usually go, okay, if I’m anxious, I didn’t sleep well, and low back pain is the one that shows up for me with progesterone, I go, okay, and I’m hungry in the morning. Those are signs that I need to feed progesterone. I won’t fast that day or I won’t fast as long and I’ll lean into more foods like we’ve talked about.

When my skin is really dry, mucosal membranes are really dry, my brain can’t hold on to information. That’s when I’m like, “Ooh, I need more estrogen.” Okay. Estrogen likes me to fast and likes me to go into more of a keto diet. I use their symptoms that they give me to help myself understand that. The other thing is, again, I’m back at the moon cycle. This woman could just chart her cycle according to start you know the new moon’s on day one you could go around that and then the last one is that I’m actually having some perimenopausal women do ovulation kits, which is so silly. This woman, what she could do is honor that week before her cycle. So, I think she said, she had a 34 day.

Cynthia Thurlow: Yeah, 30 to 35 days.

Mindy Pelz: Yeah. So, make sure you’re eating more carbs and you’re not fasting. And then it’s the 35th day, go back into more of your fasting, more of your keto and then maybe 10 days after that do an ovulation test. You can get them really cheaply off of Amazon and see if you’re ovulating at that point. You almost kind of have to make your own cycle up. Which is why I like the moon or I like the ovulation kit. Otherwise, you got to get to know the personalities.

Cynthia Thurlow: Yeah, that’s such a great way of thinking about it, Mindy, it’s funny. I had pretty regular cycles till maybe the last two years before I was hospitalized in 2019. I remember being so frustrated when you think you’re going to get your cycle and then it doesn’t start. I completely understand how frustrating that is, but you really gave us some good tips.

Okay, we’re going to shift gears because there were so many questions about perimenopause and menopause, but let’s shift gears. Can you please share your opinion on the latest Ozempic craze? So, this is semaglutide, this is this GLP agonist, this is the drug that a lot of people, a lot of celebrities, not just people who are obese or diabetic, are using to help lose weight. Do you have any experience with it?

Mindy Pelz: I don’t have any experience with it. I recently heard about it a couple of weeks ago. But I would actually flip this one and ask you on this because the way I look at every single drug is there’s always a consequence. A drug where people are dropping weight finally, there’s a consequence to it. Make sure you know, read what the adverse reactions are to it. The other thing that I would say about drugs like that is that you are really pulling yourself out of your natural rhythm and the whole goal of what you and I are trying to teach is how to eat and fast according to your natural rhythm. Now you’ve forced the body to do something and it’s just like birth control we’re manipulating the body, so you may see your friend use it and you’re like, “Oh my God, they lost so much weight.” But just sit tight with this drug, I promise you, a couple of years from now we’re going to start to see the dark side of it because there’s no perfect drug out there.

Cynthia Thurlow: No, it’s very true. I do have clinical experience with this drug and certainly have read a lot about it. There’re different ways it can be utilized, kind of the standard ways. It takes a couple of weeks to get to a point where you’re at a full dose. But the two main side effects that I see with my patients and I don’t prescribe it, let me be very transparent. Sometimes I work with people who are already on it.

Number one is nausea, significant nausea, like pregnancy nausea. If any woman that’s been out there that’s been pregnant, that’s not fun. Number two is constipation because it’s slowing gut motility. And so, imagine you are trading. Maybe you don’t have the healthiest lifestyle. Maybe you’re weight loss resistant, you’re feeling desperate, and this seems to be this panacea. This is not to suggest there aren’t drugs that you may need a drug and there’s no shame in that.

Let me be very clear. I take thyroid medicine every day because there’s no other way my thyroid is going to be optimized because I’ve done all the other things. I think it’s important to understand that when we introduce these kinds of drugs into our body, there are side effects and right now the two main ones that I’m seeing are constipation. I had a woman who said, “I just don’t even get hungry at all” which is concerning because you’re missing out on opportunities to hit your protein macros. Very likely you’re dysregulating normal hormonal communication within the body because your brain thinks you’re full, but your stomach could still be very hungry. I just think about when we’re looking at predominantly women north of 40, we’re already at risk for sarcopenia. The more muscle mass we lose, the more insulin resistant we become. That really sets us up for a lot of health issues.

So, if you use semaglutide, if that’s what you choose to do, just be very aware of the side effects. Be aware of the net impact of not getting enough protein and the muscle loss piece. And lastly, I just interviewed, Dr. Amy Killen, and she was mentioning that now people are kind of micro dosing semaglutide so that they get the benefits, but they’re not eating and they’re not losing as much weight. She and I were talking about how there’s this very fine line of just being careful understanding. The point is not to never eat again. We’re not looking to developing eating disorder by virtue of medication, my dogs are agreeing. I think by virtue of that question, it just speaks to the fact that we’re seeing a lot of information in the media. It’s very confusing. People are trying to make sense. And because a lot of celebrities are using the drug, people then assume that if it works for that celebrity, then it’ll work for them as well.

Mindy Pelz: Right. The sarcopenia thing is big because A, you and I have talked about this, that you need more muscle as you age. But what most people don’t realize is you need muscle to be more insulin sensitive. If you’re losing muscle and you’re losing weight and you’re like, “Oh, I feel great,” I’m like, yeah, a couple of years from now there’s going to be a boomerang effect. If it’s the hot new thing, typically I back away from the hot new things and say, okay, let me just see how this is going to play out.

Cynthia Thurlow: Yeah. I really think one thing that I know we both really speak a great deal on is the lifestyle piece. Like really leading with lifestyle before we start adding supplements, before we start adding medications, if that’s the direction you need to go in. And I say this with love, but it’s really important to be that methodical. I think for a lot of people, we’ve kind of conditioned our patients to ask for the drug first and then maybe consider the lifestyle piece after the fact. I always say start with lifestyle, then move forward. If you end up needing a medication, then so be it. Okay.

Mindy Pelz: I feel like too, on that point, you could apply that to everything, bioidenticals, HRT, cholesterol medication. Ask yourself have I done everything with my lifestyle first before you go on to that. So, really well said.

Cynthia Thurlow: Well, what’s interesting is, Dr. Mindy, does not know the next set of questions that I have, but ironically, she just touched on them.

Mindy Pelz: Oh, nice.

Cynthia Thurlow: Exactly. So, it’s all this synergy between us. Okay, so cholesterol, fasting, okay. So, I’m going to paraphrase, when people have high cholesterol that cannot be explained, what information should we be looking at in terms of nutrition?

Mindy Pelz: Okay, so if you have high cholesterol, the first thing I want you to think is your liver needs some love. Like, let’s support, the liver is making cholesterol. It breaks it down, gets it out into the body. And I’ve seen this so much in my community that when we look at the liver, we got to look at the gallbladder, we got to look at the common bile duct, and we have to look at the small intestine. The easy first thing to do is make sure you’re eating enough bitter foods. That would be like, let’s start there.

Second thing is, I’m a fan of fasting for anything that’s going on in the small intestine because SIBO, not that this person has SIBO, but if you had any dysbiosis in the small intestine, to date there hasn’t been a lot of great supplement remedies for that. But fasting will fast, will bat that stuff down. Make sure that you’re cycling your fast and maybe even go in. I like for gut health at a 24-hour fast. Outside of that, then you’ve got your castor oil packs and your coffee enemas, which I think are good. In general, we need to think liver, when we think high cholesterol, especially before we get on a statin because we know that the brain needs cholesterol.

The other thing I want to point out, and you and I have never talked about this, is I’ve seen some research showing that at different times of our cycle, we actually have different cholesterol surges. If you’re a cycling woman, make sure that you’re looking at where you are in your cycle, like in the follicular phase. That like day one through like day 15, it’s natural for total cholesterol to go up. Now it goes up in HDLs, which is great, but you need cholesterol to make estrogen. If you’re a perimenopause or menopausal woman, your body might be trying to make more cholesterol in order to make estrogen. If you go on a statin and you shut that down, now we’ve got a hormonal problem.

Cynthia Thurlow: Oh, it’s such a good point. And you’re right we have never talked about this, but yet it makes complete sense that where we are in our menstrual cycle vis-à-vis having lab testing can be incredibly impactful. Obviously, I used to prescribe a lot of statins, and because that was traditional evidence-based medicine, let me be very clear I was following the party lines. Talking about statins. I had this wonderful researcher from the NIH, and when she explained to me physiologically what’s happening when we take statins and the net impact on cholesterol synthesis and how that impacts cellular membrane health. It took me back like 100-fold. And I immediately that day called my parents, both of whom were taking statins, and I said, “I want you to talk to your doctor about what other options are available.” I had one parent who went off in conjunction with their healthcare provider.

We’re not telling anyone to stop their statins. Talk to your healthcare provider. My dad has remained on his statin and has been on that for probably 30 years, and in no way are we recommending you stop medication. The point of why I’m sharing this is that if we understood the net down toward effect of statin therapy, I think most people would do everything they could to avoid being placed on a statin. Has that been your experience when you’re working with people, helping them understand what statins do?

Mindy Pelz: I think our there are age group and the younger than us, I feel like they’re waking up to statins and they’re asking, I think in general, I feel hopeful that a lot of people are saying, “What can I do before medication?” It’s the generation ahead of us that I’m concerned about. This is where we’re looking at Alzheimer’s. One out of three women I just want to say it’s the women are getting Alzheimer’s right now in their 70s, and this is the 70 and 80-year-olds.

Well, let’s go and look at what they did, because if we don’t want Alzheimer’s, let’s try to not do what they did. They were low-fat, the low-fat movement, and almost all those women are on statins. That was the thing you did, is you went on to statins. I feel like it needs to be, the prescriptions are written like, yeah, this is what you do. You’re aging, you have high cholesterol, you go on statins. I think we really have to put a stop to that because there is more damage than good. If you’re on one go back and do the lifestyle changes necessary, and then go work with your doctor to get off of them. I think we need to look at them like antibiotics. They should be done only if you’ve tried everything else.

Cynthia Thurlow: No. Unfortunately, we live through that low-fat, non-fat craze.

Mindy Pelz: Yeah.

Cynthia Thurlow: And so much of the information I was telling my patients not to eat fatty meat, not to eat saturated fat, to avoid and fear fat to use these fake Brummel & Brown. There’re like a myriad of seed oil spreads we used to suggest in the interim. And we’re wondering why we have a whole generation of people that were never satiated, they were never full. They became addicted to sugar very easily. They’re eating too many carbohydrates. It’s really understanding that that has had a really profound negative net impact.

Okay, a couple last questions because I want to be respectful of your time. These are like a grab bag. These are like the troubleshooting questions.

Mindy Pelz: I love it.

Cynthia Thurlow: Where is your starting point when someone starts fasting and they tell you they are fatigued or tired?

Mindy Pelz: When they start fasting?

Cynthia Thurlow: Yeah.

Mindy Pelz: Well, okay. The first thing is think of it like if you went to the gym for the first time and you’re like, I’m going to get on the treadmill for 30 minutes and you haven’t been on the treadmill and you haven’t been walking at that length, and you get on it 15 minutes and you’re like, “Oh, my gosh, I’m exhausted.” Then it’s time to get off the treadmill and not do it. You just want to push it to that hormetic stress so that your body can start to adapt. Whatever hour you’re at, if you’re getting tired, just then bring food back in. Let’s eat. Next day, try it again. Let’s say it’s 13 hours, you’re at 13 hours, you’re tired. Next day, try 13 hours and 5 minutes and just push your body so that you’re gently causing it to adapt. We don’t need to grit it, but it’s the small little pushes of stress that in fasting that’s going to improve that mitochondrial health.

The other thing I would say is, again, I thought where you were going to go with this question. This is one I get all the time is where do I start with fasting? My recommendation is you start with food, and you change your food out, and the number one change you need to make is get the bad oils out and the good ones in. So, it could be that maybe you need to clean some things up with your food in order to make fasting a little bit easier.

Cynthia Thurlow: No, that’s such a great point and the only thing I would really add is the hydration piece. I think a lot of people think it’s not important to hydrate, that electrolytes aren’t important. I remind them that if you’re making these nutritional changes and you’re eating within a compressed window and you’re losing electrolytes, we lose them every day. We breathe, we sweat, we poop, we pee, all those things we lose electrolytes. But if you’re also going low carb, you’re going to have renal loss of sodium. That means you’re going to lose salt in your urine. That can mimic a lot of the fatigue, muscle aches, just feeling not particularly clear cognitively, so electrolytes are your friend. Don’t be afraid of them. We’ll link a couple in the show notes as well, so you’ll have them available to you.

I think that fatigue is one of those kind of vague. It can mean so many different things. If it’s persistent, obviously you need to get things checked out. If it’s transient, I think, just as you stated, adjusting macros, kind of leaning into that, get the junk out of your diet. Understanding seed oils, which I know we both talk about a lot, they impact the health of our mitochondria and our cellular membranes for a long time. Read every food label because they’re in everything, unfortunately.

Mindy Pelz: Yeah, unfortunately, for sure.

Cynthia Thurlow: Okay, last question. I had many, many questions about hair loss. “If I start fasting and I start losing my hair, what does that mean?”

Mindy Pelz: It ties so well into what you just said. The first thing I would say is my shock in watching millions of people fast is how mineral depleted of a world we’re in, and especially here in America, our soils are so depleted of minerals that I would say anybody, as they embark upon a fasting lifestyle, needs to assume that they need more minerals. So, to your point, mineral packets and water, I think is incredible.

Second thing I would say is you also have to look at, well, what might be blocking a mineral receptor site, the mineral’s ability to get into a cell. A lot of times we’ve noticed heavy metals, especially thallium, and thallium is in more fish than ever because of the nuclear fallout in Japan years ago. I’m on the West Coast, and I will never eat a fish coming from the West Coast because of the amount of thallium that’s in there. We’ve done a lot of heavy metal testing in our community. I will tell you that about 70% of the time, if somebody has hair loss, they’ve got high thallium levels as well.

And then the third thing would be to check your thyroid and make sure that you’ve got proper thyroid function. I know you and I, we haven’t talked about this, but I’m pretty sure you and I agree on this, is that if you have a thyroid problem, you just have to make sure when you open up your eating window that you’re eating. Eat. The studies have shown calorie restriction is hard on the thyroid, not time restriction. So you’ve got to open up. When you open that eating window up, you might need to eat more.

Cynthia Thurlow: Yeah, it’s such a good point. In terms of proximity, you are closer to Fukushima. That’s where that nuclear meltdown was. I can completely understand the hesitancy about eating a lot of fish. What’s interesting is we used a thallium tracer on some of our stress testing and cardiology. When I tell you it was handled in such a careful way, even though people were giving minute amount of thallium as a tracer. So, to back up nurse practitioner in Cardiology, we used specific type of chemical stress testing and we used this isotope to be able to trace the heart, to see where the perfusion issues were if they were at all there. Very interesting about thallium in terms of seeing high levels of thallium correlated with hair loss, I would also add mineral depletion absolutely looking at thyroid, but also sometimes I will see it’s a normal byproduct of weight loss. People will actually get this hair shed. We’re seeing significant amounts of it post COVID for people that have had the virus that they’re having very significant hair loss post COVID. Just understanding that there’s something, whether it’s iron, thyroid, testosterone, post COVID, whatever is going on, get things checked out if it’s really significant. The other thing is, for people who are breastfeeding or have been pregnant, sometimes you’ll get a hair shed as well. Just understanding where you are in time and place.

Well, Dr. Mindy, I hate to turn off the conversation because I know that we could go for hours and hours, but I do feel like we covered quite a bit of territory.

Mindy Pelz: Yeah, we did.

Cynthia Thurlow: And I hope we’ll be able to have a round 2, because this has actually been really fun to do.

Mindy Pelz: I agree. Yeah. No, I agree. Thank you for asking me food questions because you know in getting a book out there into the world, like, after a while you’re like, can we talk about something else? This was really mind candy for me and, yeah, let’s do more. I think that one of the things that I’ve been really emphasizing with Fast Like a Girl is that as women, we need to come together and collaborate. We need to support each other and have discussions like this. What I hope the listeners will do is take what they learned here. Now go have that discussion with your girlfriends because hormones have been almost like this dirty topic that we’re not allowed to talk about and we need to bring it back into the light and have and talk about it from whatever angle we can. So, I love this. Thank you for having me.

Cynthia Thurlow: Of course, of course. Let listeners know how to get your book. By the time this comes out, the book will be out. How to connect with your amazing podcast, which I’ve been blessed to have been a guest on twice, how to connect with you on social media, etc.

Mindy Pelz: Yeah, for the book, you can go to fastlikeagirl.com. I will tell you, one of my pleas has been because, yeah, the book will already be out, booktopia.org is like a great place to tap into your independent bookstore or go to your local bookstore. Let’s bring those local indie bookstores back. If you have the time and the resources to do that, go do that. Otherwise go to fastlikeagirl.com. Everything’s there on how you order it. Yeah, YouTube is my biggest social, so I put out two videos a week. Lots of great fasting and food information there. And then of course, Instagram, Facebook. If you forget all that, you can just go to drmindypelz.com.

Cynthia Thurlow: Well, thank you again, my friend. Good luck with the launch although I know you’re doing really well.

Mindy Pelz: Yeah, thank you. Appreciate you.

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