Ep. 306 Q&A: Best Supplements for Women and Creatine Benefits with Cynthia Thurlow, NP & Intermittent Fasting Expert

Connect with Cynthia Thurlow

Follow on

• Twitter
• Instagram
• LinkedIn

Check out Cynthia’s website

Submit your questions to 

support@cynthiathurlow.com

Dr. Roseann’s website

My YouTube video:

Stop Wasting Your Money on These Supplements

Transcript

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.

Well, hello there, my Everyday Wellness listeners. This is AMA #5, and as promised, you all have given me so many questions to be able to create content around. Today, we’re really going to focus deep on supplements. I got a plethora of questions. I tried my very best to paraphrase as much as I can and get through as many questions as I can. The goal of the AMAs is to really keep them under 35-40 minutes, to make them quick and digestible. I think moving into 2024, we might make them longer, just depending on what direction your questions are going in.

[00:01:04]
So today, we’re going to start with Diana. Her question is about branch chain amino acids or BCAAs. And she says, “I am a lean, postmenopausal woman of 56, living with Hashimoto’s thyroiditis for 20 years, for which I take T4 and T3.” For those listening, if you’re not familiar, T4 is the inactive form of thyroid hormone and T3 is the active form. “And I follow mainly a paleo diet with low carbs added in and have an exercise regimen which comprises strength training, three days per week, zone two, gentle cycling, three days per week, and Plyo ten minutes twice a week, in addition to daily yoga nidra, meditations, and slow daily walks with my dog. Would taking BCAAs daily benefit me? And if so, how and when would I take the supplement each day?”

[00:01:49]
This is a really great question, Diana. I actually just did a YouTube video, and my team will link this up. There’s a YouTube video that I talked about three supplements that I think are probably not worth your time and money. And I do go into some detail about why I’m now recommending essential amino acids instead of branch chain amino acids. And for consistency’s sake, let’s talk about what these represent. So, essential amino acids are building– well, all amino acids are essential building blocks of protein. Protein is broken down into amino acids. There are 20 total, 9 of which are essential. So, when we talk about the essential amino acids, these are the ones that your bodies cannot make on their own and you need to ingest protein in order to extract these amino acids.

[00:02:40]
And I think it’s important to kind of touch on a broad subject. Podcast with Dr. Lyon will be out in a couple of days. It’ll actually be out prior to this podcast coming out, so you can reference that. Dr Gabrielle Lyon is a dear friend, has heavily influenced my perspective on protein intake. And we know as we get older, we need more protein with age. We need so much more because as we are losing estrogen, as our follicular stimulating hormone is going up, our body goes into a catabolic state. That means that our muscles will get broken down as a byproduct of these hormonal fluctuations and changes. And so, this is where it becomes even more critically important to get adequate protein in. If you are listening and you intermittent fast and you don’t eat enough protein,

[00:03:20] I really want you to really pay heed to what I’m saying now. Our protein needs increase with age. That means that if you got by with 20 grams of protein in a meal at 20 years of age that probably was sufficient. We know that younger people need less protein to stimulate muscle protein synthesis. As we get older, we need more protein to stimulate muscle protein synthesis. Why is this important? Because this is what drives the anabolic process of building muscle. We’ll touch on what leucine thresholds are, etc., but you can also reference that podcast that I did with Dr. Lyon. So, we need to be getting at least 100 grams of protein into our diet daily. If you’re not there yet, do not panic. There’s something called the protein leverage hypothesis that also talks about the fact that if we don’t get enough protein into our diet, this is why a lot of late perimenopausal women, menopausal women, will complain of cravings. They’ll say, “I ate a good dinner and I’m still craving more food,” has a lot to do with this protein leverage hypothesis. If you’re not hitting those protein macros, your body is looking for more caloric intake and generally you are going to get it from carbs and fat. Carbs and fat are not bad, but protein really needs to be the mainstay of maintaining lean muscle mass, maintaining metabolic flexibility, etc.

[00:04:30]
So, Diana’s question is specific to branch chain amino acids. I think that if you’re getting at least 100 grams of protein plus 1 gram per pound of ideal body weight is what we’re aiming for, but at least 100 grams of protein a day considering essential amino acids is not unreasonable. I am now recommending essential amino acids over branch chain amino acids. Branch chain amino acids are just three. They’re leucine, isoleucine, and valine versus the nine essential amino acids that are a compilation of those and six others. I touched on a very important amino acid very briefly called leucine. Leucine is a specific amino acid that is critically important to trigger muscle protein synthesis, and something called mTOR. Dr Donald Layman is the individual that actually discovered this and you need 2.5 grams of leucine in a meal to trigger this. This is why we talk about 30 grams minimum of protein in a meal. And I would probably argue most of you need more than that, especially as you’re getting older. And especially if you’re intermittent fasting.

[00:05:28]
I don’t want to kick a hornet’s nest because it’s not the impetus for this conversation to talk about not eating enough protein. But a lot of people that are intermittent fasting are not eating enough protein and you’re really putting yourself with risk for losing muscle mass, losing metabolic flexibility and being skinny fat, which we don’t want. So, I have no proprietary relationship with Kion, K-I-O-N, but I’ve been using their essential amino acids. I use them in my feeding window, I put them into my water. Yes, I put a lot of things in my water” but I’m very kind of conscientious about, “Okay, now it’s time to add the essential amino acids.” They have a lot of different flavors. I don’t get any kickback from recommending them. That’s just the product I’ve been using. And I think there’s lots of options and they tend to offer sales throughout the year as well.

[00:06:09]
So, instead of branch chain amino acids, I’m now recommending essential amino acids. But I think what is most important, Diana and everyone else listening, the most important thing is that you are getting enough protein into your feeding window, you’re getting enough protein into your day, aiming for no less than 100 grams of protein a day. That is what is most important much more so than whether you have branch chain amino acids or essential amino acids, making sure you’re eating enough protein.

[00:06:35]
Next is a question from Kristen. “Does Berberine work similar to metformin? I am borderline prediabetic. In addition to adding more exercise and fasting, I’m looking for a natural alternative.”

[00:06:44]
Kristen, it’s a great question. There’s a lot of good research talking about the efficacy. Berberine, which is a supplement, it’s actually from a class of compounds called alkaloids. It is popular in Chinese medicine and it has become quite popular for people to take this to help with blood sugar support, to increase AMPK, which helps with ATP, which is an energy molecule in the cell. A lot of people are taking it also for blood sugar support. It has some potent antimicrobial properties. So, I incorporate it into antimicrobial properties so if we’re working on a specific gut pathogen or something that does not belong. There’s also good research to also demonstrate it helps with reducing oxidative stress and inflammation, as well as NAFLD, which is non-alcoholic fatty liver disease. Now, my understanding of berberine if taken specifically for blood sugar support or insulin sensitivity, is that you cycle it on and off. So, Dr. Sara Gottfried and I have talked about this and she and I are both in agreement as are many other clinicians. You cycle it on for about three months and cycle it off.

[00:07:50]
Now, it’s interesting, Mike Mutzel fairly recently talked about some research indicating that it’s much more efficacious to take berberine regularly, as opposed to, “Oh, I just had a big blowout, carbohydrate-laden meal and I’m trying to buffer some of the impact of the carbohydrate load.” So, I think that in a lot of different ways, berberine can be part of a supplement stack. Berberine can be helpful for those that are looking to improve insulin sensitivity. I would be remiss if I didn’t also say there’s a lot of other things that can help with insulin sensitivity. I like myo-inositol, I’ll be honest. I think it’s better tolerated. It may not be as strong or potent, but I have women that have been on berberine, have been on Glucophage or Metformin, didn’t tolerate the Glucophage and metformin because of significant nausea, didn’t tolerate the Berberine because of the gut effects and then I have others that do really well with it. So, I think that there’s a little bit of a need for the N of 1, meaning doing some degree of experimentation to find what works best for you and then working backwards. But, yes, I do think berberine can be helpful. I think you should have a conversation with your healthcare practitioner, especially if you’re thinking about doing that in lieu of a prescription medication. Make sure that they’re on board and they’re in agreement with that.

[00:08:58]
Next question is from Linda. “Do you have to cycle berberine and serrapeptase?” well, I just touched on the Berberine piece. I can’t speak to serrapeptase. I use serrapeptase and antimicrobial programs, generally speaking, I use it as a biofilm breaker. I know that colleagues of mine use it differently, but I haven’t read anything that suggests that cycling it makes it more efficacious, but I would definitely discuss that with your practitioner if it’s something they recommended to you to use.

[00:09:25]
Next is Carol. “There are so many products that you recommend to take. It’s hard to financially keep up with everything. Is there a specific product that you feel is most important?” Now, Carol, I’m really glad that you asked this question. This is something that I talk to friends and family members about because my mom is now in retirement and when my mom was still working full time, she would try everything and now she’ll actually say to me, “What is the supplement that you think is most efficacious?” I think it really depends on you. I think that when we’re talking about being budget conscious, then the most important thing we can do is the quality of our food is the most important thing. I would say then you are really being laser focused on hydration and sleep and stress and then filling in the gaps of supplements.

[00:10:15]
Now, obviously for me, sleep is always the biggest hierarchy of most of the complaints of my patients and clients. So, myo-inositol is something I would never give up for me personally. I do think that it is very beneficial. I think that it has multiple effects, meaning that myo-inositol can help with blood sugar regulation, it can help with sleep support, it can help with mood. There’s just a lot of beneficial effects and it’s cost effective because it’s in a powder so you can determine when and how much you want to take of it. I think electrolytes and whether you choose to do LMNT, which is always my favorite, or if you have another brand that you are a fan of or really enjoy, I think electrolytes, salting your food is also very helpful.

[00:10:55]
And then, I would say the other piece of that is really thinking about like a lot of what I talk about is metabolic health. A lot of what I talk about is talking about maintaining muscle. So, I think creatine, again, also can be very inexpensive. Creatine is also something that can be very helpful. And in a couple of days from now, which will be after this comes out or before this comes out, I have a podcast with a creatine researcher, and he is going to talk about the impact of creatine on things like sleep deprivation, jet lag, bone health. There are many of you that have written in and have said, “I can’t take HRT because I’m a breast cancer survivor and my physician’s not comfortable prescribing HRT. What are my options?” There’s a lot of things that you can do, but there’s some solid research that’s coming out.

[00:11:35]
So, to answer your question, Carol, I’m completely sensitive that I would say really hone in on the nutrition piece, buy the best quality food that you can afford, really make sure that you’re physically active, that you are sleeping, having high quality sleep, and managing your stress. And then, I would backfill things. I would say other things that can be helpful, that are more budget-conscious, adaptogenic herbs, things like ashwagandha. We know that once we go through menopause, we are less stress resilient. It’s not that we’re incapable, it’s just our adrenals go through adrenal pause. Our thyroid goes through thyroid pause. Because of these things, it means we have to work a little bit more effortlessly at making sure that we are managing our stress. So, some of those adaptogenic herbs, I think, can be very helpful, things to help with sleep. You get L-Theanine from green tea as an example. L-Theanine is in a calming amino acid. So, there’s a lot of ways to work around that. And no, you do not need to take every recommendation. There are many of you out there that love trying new things, but we bring on podcast sponsors that are in alignment with our principles and our integrity and never feel pressured to have to purchase anything. But those are what I would say, objectively, the things that I think are the most helpful for most individuals. And then, I would go from there.

[00:12:44]
Okay, “Does AG1 and vital proteins break a fast? Can I take it with black coffee while fasting in the morning? And what time should I take the second dose to help with sleep?” This is from Georgette. So, AG1 and vital proteins, I would take in a fed state. AG1 is a greens powder, but it does have a little bit of flavoring in it. Collagen peptides, vital proteins, that’s what that is. Collagen peptides will break a fast, especially a clean fast. So, I would recommend taking those in a feeding window. “Could you take them with black coffee?” Well, you could, but you would be breaking your fast and that’s something that’s important. If you struggle with the taste of black coffee, you could add things like Redmond salt, you could add cinnamon which will help with insulin sensitivity. Neither of those will break a fast. And when you’re asking about the second dose to help with sleep, I’m assuming you’re talking about inositol. You could take it before bed. I typically take myo- inositol usually in the evening. I don’t take it right before I go to bed, but I usually take it in the evening and that works really well for me. And for many of my patients and clients, they’ll kind of adjust. Some nights they need two scoops, one night they might have one. So, I think that can be very helpful and certainly really helpful.

[00:13:49]
Next question is from Abby. “What brand of collagen to use? I order from Fullscript Designs for Health and have that at home.” I’ve been trying out some new brands. For full disclosure, these were gifted to me, but I am enjoying them and I’m speaking objectively. Organifi, I’ve been using their collagen. I don’t use collagen every day. I use it a couple of times a week. This is 10 grams per scoop. And this is sourced from pasture-raised cows, wild-caught fish, eggshell, membrane collagen, chicken bone broth. And this is unflavored. So, this can kind of fit in effortlessly. That is Organifi.

[00:14:25]
And then MindBodyGreen has a product that I like as well that has 17.7 grams of grass-fed collagen, but it also has hyaluronic acid, vitamin C and E, biotin, L-glutamine, turmeric and sulforaphane. So, this is kind of a comprehensive beauty and gut collagen. It is also unflavored and that is really nice. Objectively, again, they were given to me, but I have tried them and I do like them. I’ve used other products. MD Logic has a marine collagen that’s really nice. And I would say that over time, like Primal Kitchen, I’ve used some of their products. I have a 15-year-old who loves– they have like a snickerdoodle and he just likes it in his coffee. And so, he knows that it’s not an issue breaking his fast. But those are definitely some nice options. There’s lots of options that are out there. Just find one that works for you and your budget.

[00:15:09]
Okay, this is a question from Liz. “I’ve been taking your brand of creatine for a few weeks now. I’m a recovered vegan, was vegan for 12 years. I strength train three to four days a week and fast on average 16 to 20 hours a day. I’m 52. When is the best time to take creatine and does it break a fast?” I’ve done two podcasts on creatine. We will make sure we link the creatine podcast so that you’ll have them as a resource with this podcast. Typically, you want to take it in a feeding window depending on who you talk to. Some people feel like you need to take it immediately after exercise. I think it’s just if you’re intermittent fasting, the most important thing you can do is make sure you’re getting enough protein in a very tight feeding window. If you have a four hour or six-hour feeding window, I always get concerned that you’re not going to be eating enough protein. So, creatine in your feeding window is absolutely fine.

[00:15:55]
“Is it true that it can cause some bloating and weight gain?” I think this is very bio individual. I’ll be honest with you, we occasionally will field questions or concerns from people that will say, “Oh, I think I’m gaining water weight,” and then when they stop, they lose the water weight. But creatine monohydrate, you hear that word “hydrate,” it’s hydrating those muscles, so what it is water weight gain. Some people do need to divide their doses. I think a lot of it really just depends on the individual. But I found for me, it has allowed me to not only lift heavier in the gym, which I think is important, but it has also helped with sleep architecture. On the days that I remember to take creatine, I try every day, but some days I don’t, I always sleep better. So, it definitely helps with sleep architecture. And we know that creatine also has other net impact. There’s a podcast with Dr. Darren Candow that will be out later this week, which again will precede this podcast coming out. And he talks about the research on brain stress, traumatic brain injuries, jet lag, sleep deprivation, bone health. I mean, these are other research that’s coming out that’s showing that creatine is one of the safest, most efficacious supplements that’s out there. And I think you don’t know until you try the product. So, that would be my best recommendation, just kind of see how you feel with it.

[00:17:05]
For me, my entire family takes Creatine. My teenagers, my husband. And what’s interesting is Dr. Candow talks about one particular research that was done. It was a randomized controlled trial of menopausal women not on HRT. So, they were within the first two years of menopause without HRT so that they could have a real sense of where their bone health was. And for two years, the control side took creatine every day and exercised with 10 grams a day of creatine. So, my creatine, the current dose is 3 grams. We recommend 5 grams for people that are vegetarian, vegan men. So, for women, 3 grams is the minimum. These women were taking 10 grams a day for two years with no issues related to liver or kidney renal function. So, when people express concerns about hydration with creatine or potentially having health issues, the research doesn’t support that. So, please don’t let that be a concern. But I would say creatine in the feeding window is always what we’re aiming for.

[00:18:03]
Next question is from Reena. “Can your creatine denature when added to hot food, like soup, stew, or curry?” It’s interesting. I’ve asked this question of a couple people. Now, Darren Candow, who’s the researcher, doesn’t love creatine in hot food. He does feel like it has the potential to impact the efficacy of the creatine. He said that it’s not as if it would blunt all of it, but he prefers that it’s in either room temperature or cold water. So, that’s just a thought.

[00:18:36]
Other question, “Is creatine beneficial at any time, not just being centered on workouts and strength training?” Yes, and definitely reference that podcast that I did with Dr. Candow, which will be out on October 4th, which again will precede this coming out. This will be out in October.

[00:18:46]
Next question is from Karen, “I take your creatine, but many sources seem to caution about hydration when taking it. I work out, but not every day. Should this only be taken on workout days?” Karen, as I mentioned, I have just interviewed Darren, and Darren based on all the research, and this is his area of expertise, there’s nothing to suggest that creatine is at all potentially damaging to liver or kidney function at all. I think that taking it daily is probably the best way to take it, even though sometimes probably five days out of seven, I take it. A lot of it has to do with how busy my morning is, just for full transparency. But I do think that there’s value in taking it daily. And what’s interesting is, when I spoke with Darren, he mentioned that if you take creatine and you don’t exercise, like, let’s say you’re a couch potato, but you take creatine for the benefits, you don’t get the benefits. Like, you actually need to be exercising with some consistency to get the most benefits out of creatine. That doesn’t mean that if you take a day off that you shouldn’t take it. But if you are sedentary for six months and you think taking creatine is going to offset that, that’s not going to actually happen. So just kind of keep that in mind.

[00:19:51]
Next question is from Karen. “I’ve been using LMNT. Is a 1000 mg too much salt in general, coupled with everything else consumed on a daily basis? Should it only be taken on workout days when I’m bound to drink more water?” This is a very bio, individual question. Obviously, we have bastardized salt for a very long time. I say we as in healthcare providers, there’s a lot of misinformation put out in the lay press about salt. Salt is not what causes hypertension. It is not what causes a lot of health problems. It is hyperprocessed, hyperpalatable crappy food. And I think the most recent statistic I read was somewhere between 60% to 70% of Americans eat predominantly a highly processed hyperpalatable diet.

[00:20:33]
So, back to your question. “Do I think taking 1000 milligrams of high-quality salt is problematic?” No, I don’t. I think there are those of us that need more. I think there are those of us that may tolerate less. I drink LMNT all day long. Admittedly, I have very mild dysautonomia, which means that my body needs more electrolytes, not less. And I’ve always realized that about myself, but I didn’t realize why. So, I think for each one of you out there, sometimes when you’re first using electrolytes, it may seem really salty. I always say just dilute it with more water, no harm done. Maybe you do half a packet and 20oz of water, and then you save the other half a pack for later in the day. I think a degree of experimentation can be beneficial. I think it’s also helpful to try different flavors so that you find what you like. I personally am a fan of orange. In my house, grapefruit and citrus are also very popular.

[00:21:19]
Sherry said, “What inositol do you recommend for glucose control and balance?” Generally speaking, myo-inositol, which is the product that I have created in conjunction with MD Logic. Sherry mentions, “I’ve been reading about in different forums and I want to make sure I recommending the right inositol for sleep and the right one for improving glucose control”. The reason why I like myo-inositol is the one that appears to be most efficacious for both. I’m all about a two for one. If something’s going to help you with sleep, you might just need 1 gram at night. If you have blood sugar control problems, you may need 2 grams in the morning and 2 grams at night and that can also help with sleep. There’s a lot of other benefits to myo-inositol, and we’ve done two podcasts on myo-inositol which we will link as well just so you have it as a resource point. There is D-chiro-inositol. You know, we looked at that, but just based on all the research that were looking at, we were trying to look at the form of inositol that had the most benefits so that we could keep it as simple as possible. And that’s also why it’s powdered. Someone asked me recently, why is it powdered, not a capsule? Because it allows you to customize and it makes it a bit more cost effective when it’s not in a capsule and when it’s in a pouch where you can just scoop it, depending on what your needs are.

[00:22:33]
Next question is from Michelle. “Is there a product similar to Mitopure that I could take? It’s way out of my budget, but you and JJ have convinced me that it is a great supplement to add.” Michelle, this is a question we got multiple times, so I want to make sure I answer it really as concisely as possible. Yes, Mitopure is expensive. I am sensitive to that. My mom is now taking it and so what we have done for her because there is nothing specifically per se that is going to replicate the concentrated benefits of Urolithin A. And I’ve done a podcast with the chief medical officer with Mitopure, which we’ll also link up so that you have that as a resource, that kind of induces the degree of mitogenesis and mitophagy, meaning it’s really clearing out– Not only is it helping with production, but also clearing up of diseased, disordered mitochondria. And so, my answer to your question is there’s nothing specifically that I have seen; however, I do think that consuming polyphenol-rich compounds, things like pomegranates, cranberries can be helpful, but I think it’s trying to find that happy balance. I think that a lot of what we see in terms of the benefits from Mitopure that I’ve reported from patients and certainly things I have seen, muscle strength and endurance. As a menopausal woman, I’ve definitely seen that in conjunction with creatine. Improve cellular health.

[00:23:58]
The other thing that I was thinking about as I was approaching this question is maybe think about creatine as a starting point because that will help with muscle strength and endurance. It’ll also help with brain health, bone health, etc. I’m hopeful that we’re going to get to a point where maybe we’ll have bigger discounts that we can offer to listeners. I haven’t gotten there yet. I’m continuing to push for that. And just for everyone that may not be familiar, Urolithin A is a metabolic product that is created through ellagic acid into urolithin and it’s produced in the gut. So, it is this beneficial property. You’ve probably have seen a lot of ads for it. I use it. I have some of their skincare products, which are really nice as well. But I do acknowledge that it is expensive.

[00:24:46]
So, go back to that question I answered for someone else earlier. Really start focusing on the basics and then add things in as you can, and as your budget permits. It is far more important that you’re eating really high-quality food. Like, if you can afford organic fruits and vegetables based on the Dirty Dozen, Clean Fifteen and pastured eggs, or the highest quality meat you can afford like that is certainly going to be very helpful and that would be my first layer of focus. Which is not suggesting that there’s not benefits from taking supplements, but if you’re trying to be as conscientious as possible about cost, those are things that I would definitely consider.

[00:25:19]
Next question is from Julie. “I’m about to start using AG1 powders, optimize nutrition. I also purchased your Creatine and inositol. Can I mix all three of them together in one power drink, or is that not recommended?” You absolutely can. I would say that if you’re trying to use inositol to help with sleep, you may notice you do best taking that in the evening, but I think during the day, it is definitely– it’s not going to make you sleepy, but it can help with relaxation, but I think if your way of remembering to take it is to put them all together, I think that’s absolutely fine. Obviously, one of the next questions I will get is, “Will it break my fast?” Definitely, I think creatine and I think that AG1 should be taken in a fed state. Inositol, you can take in an unfed state without concerns.

[00:26:03]
Next question is from Murana. “Hi, Cynthia. I have low testosterone, and somebody told me that taking myo-inositol is counter indicated for people with low testosterone. Can you please clarify?” You know I thought about this question for a few minutes when I read it. Here’s the thing. I’m in menopause. If I don’t take testosterone, my testosterone levels are low. I’ve been taking myo-inositol for several years, and I have robust testosterone levels right now. So, I don’t understand the mechanism of action. If someone was saying to you, that’s going to be harmful, because that’s not the way myo-inositol works. It’s not going to lower your testosterone levels. Your testosterone levels, about 75% of us, as we navigate perimenopause and a menopause, they’re going to be lower because we’re making less endogenous testosterone as we’re getting older. So more often than not, individuals will have lowered levels of testosterone heading into late perimenopause and into menopause. And it’s kind of a gradual decline. It’s not that cliff that you get shoved off of in terms of estradiol or the slow, steady decline of progesterone. So, I don’t see any mechanism of action that would amplify or exacerbate low testosterone.

[00:27:18]
Now, low testosterone can be a byproduct of insulin resistance. It can be a byproduct of chronic stress, and a lot of women have out-of-control stress. I know because I look at a lot of labs that can definitely be a contributor. I don’t understand why that would have been stated to you, because it doesn’t make any mechanistic sense to me. So, I think you can safely take myo-inositol and not worry about your testosterone levels lowering. Now, what happens for a lot of people is, as they’re navigating their perimenopause and menopause years, they have less circulating testosterone, which can show up as belly fat, changes in body composition, low libido, low motivation, etc.

[00:28:05]
Okay, Jacqueline asked, “Do you feel that myo-inositol is safe for children? My stepson is 8.5 and seems to struggle with mood swings, I manage his sugar intake when he’s with us. I feed him healthy fats and protein throughout the day. I know his biological mom struggles to manage his diet. I’m wondering if giving him myo-inositol could help him with the lack of management of diet and also therefore improve his mood swings. I’m looking for your thoughts on this before presenting it to his biological mom and pediatrician as an alternative to Concerta.” Jacqueline, this is a really great question. I actually did a podcast with Dr. Roseann Capanna-Hodge. She is a pediatric mental health specialist. She’s a clinical psychologist, and we spoke about a lot of the research surrounding mood disorders, ADHD, etc. I do think it’s something that you could discuss with your stepson’s pediatrician, his biological mother, your husband, and see if that’s an option.

[00:29:05]
Now, obviously we’ll link up that podcast so you have it as a resource. Dr. Roseann talks about the fact that mood support requires higher levels than what we talk about for blood sugar or sleep support. Meaning, in some instances, I think, as an example, some of the studies she referenced were 10 to 15 grams a day for mental health versus one to four grams for sleep and blood sugar. Just to kind of caveat, obviously that would be weight dependent on the child, and this would need to be utilized in conjunction with the pediatrician’s blessings as well. But Dr. Roseanne has an amazing website, and I’m sure that you could find some resources there as well, maybe have a consult with her practitioners to get their input as well. So, I think that is certainly something worth discussing with your family and the pediatrician as well.

[00:29:52]
Next question is from Karen. “What are some of the first signs in your body that you are benefiting from Mitopure or the Urolithin A?” A lot of what I’ve seen personally as well as family members is just feeling like they’re stronger. And some of my family members are using creatine, some are using Mitopure, some are using both. And if you look at the research on Mitopure, it’s looking like 12 to 16 weeks is that time frame that you start seeing a lot of the clinical benefits. I’ve even had some patients tell me that they felt like they had more mental clarity. I think this is also in conjunction with other lifestyle related changes that I think make a really big shift. But that’s typically what I have seen, is improvement in strength and endurance, muscle endurance, and then also mental clarity. And feeling like you know if the scale has been stuck as an example, feeling like they’re finally making some headway. For a lot of middle-aged women, they feel like, “Okay, finally, I’m seeing something change on the scale. There’s a shift on the scale. Maybe my thyroid is finally coming back in line in conjunction with all the other lifestyle changes I’m making.” But that is typically what has been self-reported to me.

[00:31:03]
Okay, “Is there a protein powder you would recommend as someone who is dairy free?” This is from Lisa. I think this is always challenging because a lot of the dairy-free protein powders can be gritty. I can tell you that of the plant-based protein powders, one that patients have reported that they really like is Truvani, that’s Food Babe’s product, so it’s T-R-U-V-A-N-I. That is certainly an option. Of course, there’s bone broth proteins, although those aren’t a fully complete protein. Paleovalley makes some nice options. If you do tolerate whey, like MariGold, also Paleovalley makes a really nice option. Those are usually the ones that I typically will recommend the most. But I always remind people that if you’re using an incomplete form of protein, just making sure you’re rounding that out with something else in your diet, that’s going to help buffer some of that.

[00:31:51]
Okay, this is from Elaine. “I’m curious to know if you have any recommendation to help support aging hair. I’m a healthy 58-year-old, and like many, my hair has become thin and dull. I’m trying a new shampoo and a biotin supplement, but I’m not sure if either will make any difference. Any recommendations?” So, Elaine, I always think about labs like a full iron panel, so a serum ferritin, a TIBC, a percent sed, serum iron, looking at a full thyroid panel, looking at free and total testosterone, looking at progesterone. Those sex hormones have a lot. Like, the progesterone and testosterone have a lot to do with hair. And so, as someone who even though I’m in menopause, I’ve been able to kind of buffer some of the expected changes, but I think because I’m on HRT, that helps. I also have a thyroid that’s fully optimized. So, making sure that your primary care provider, internist, or GYN will check those things for you, I think that’s the first thing I would double check to see, because if any of those are not optimized, that can definitely impact not only the hair follicle cycle, but it can also impact how full your hair is. I think a lot about women after they’ve had a baby and their hair falls out and then everyone panics because they think they’re going to lose all their hair and they realize everything stabilizes. I think some things very similar can happen in that perimenopause to menopause transition, and this is where that nutrient piece becomes important, stress management, sleep, etc. But definitely, Elaine, have your primary, your internist, your GYN, check those for you just to make sure that they don’t require some attention.

[00:33:24]
Okay, Kathleen said, “How do I simplify and assess what supplements we need? It’s so easy when reading, listening to podcasts to all of a sudden be taking 20 supplements. It gets both cumbersome and cost prohibitive. Thanks so much for all you do.” Kathleen, I’ve definitely have given some suggestions throughout this. I think that it needs to be whatever your biggest pain point is. A lot of my female clients, it’s sleep. So, we really have to hone in on sleep first. And this is where it might be one or two things that we start with. Like, maybe it’s myo-inositol or maybe it’s GABA or L-theanine or magnesium as a starting point. And then, really having honest conversations with yourself about what are the things I need to change as my day kind of goes on to get myself ready for sleep. If it’s stress, like if you wake up really anxious in the morning, well, maybe you need some adaptogenic herbs. If you feel like you’re losing muscle mass and a lot of us do, I mean, I feel like it has become a full-time job trying to figure out how to build muscle as a middle-aged woman. I am one of those people, I’m going to have to work extra, extra hard because I need– I’m thin. And I don’t say that to sound like I’m not sensitive to what other people are experiencing, but I have to work harder to get the muscle to show up. Like, it seems like it’s effortless for some friends and it’s harder for others, but really understanding what is your area of focus and that’s where I probably would spend my dollars.

[00:34:51]
I think, like I’ve said multiple times, not just in this AMA, but other ones, I never want anyone to walk away and feel like anything’s being pushed on them that they have to purchase. The reality is, podcasting is very expensive. It is a free resource that I put out in the world because I love podcasting, I love interviewing people, I love helping people. But podcasters allow me to continue podcasting, and I get benefits from that. But I’m also very conscientious about who we use as a podcaster sponsor. Meaning, right now, we’re vetting all the 2024 people and we’re being even more conscientious this year because we have the ability to do that. So, what I’m saying is, please don’t ever feel pressured. Number 2, what do you need help with? That’s where I would really hone in on.

[00:35:44]
And then, number three, sometimes we just need things temporarily. We might not need to take them forever. Right now, I’m taking a special supplement that had to be compounded and my functional medicine doctor said, “We’re just taking this for a month.” I was like, “Great.” I feel fantastic on it. It was expensive, but it was worth it, but I know it’s one month, so I think that’s the way to think about it. Is this something I’m going to take long term or is this something short term? If it’s short term, it’s probably not as big of a deal. If it’s long term, then you have to kind of figure out what’s the most efficacious way to do that. That’s as honest as I can be.

[00:36:06]
Okay, next question is from Janet. “There seems to be a lot of recommendations for supplements. However, I’m on a limited budget which supplements are most important.?” So, you see there’s a theme here with what’s most important. Janet is 71. She’s IN menopause. She’s been intermittent fasting. She’s lost 10 pounds over eight weeks. She’s very active. Again, I’m going to go back to the basics. Are you eating enough protein? Are you eating high-quality protein? Are you eating enough brightly pigmented fruits and vegetables? I just did an amazing podcast with Deanna Minich, and I can’t wait to share that with everyone. It was just really mind blowing. She talks a lot about the power of brightly pigmented fruits and vegetables in the context of a healthy diet. And so, I think about sleep, stress, nutrition quality, and then adding in where you need things. I feel like most women need help with sleep, they need help with building muscle mass, they need help with stress management. And that’s usually where I would say that’s probably where I would start, as opposed to feeling a sense of pressure to have to do a lot of other things.

[00:37:07]
Okay, y’all, that was the supplement. I tried to get through as many questions as possible. That was a lot of fun. I love answering questions about supplements. Please keep your questions coming. I would really love to be able to do an AMA every month. Just keep it short and sweet. Really focused in on the things that you want to learn more about. The other thing that it really helps me with is it allows me to see what are you interested in learning about. Because that’s the one thing. We broke these hundreds of questions into sections and each one of these sections is subcategorized into subjects and then I can see what types of experts are you looking for me to bring on the podcast. We got a lot of questions interestingly enough. Many of you don’t drink alcohol, as an example, and many of you are asking, could you please bring on an expert who talks about either recovery and or the benefits of an alcohol-free lifestyle. So, I do have an expert coming on in December who has a new book coming out and I’m really excited to bring Dr. Brooke on. But keep the questions coming. I love interacting with each one of you. I really value and appreciate each one of you. And the next AMA is going to be all about fasting.

[00:38:16]

[music]

If you love this podcast episode, please leave a rating and review subscribe and tell a friend.

Transcript:

[00:00:01]
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.

Well, hello there, my Everyday Wellness listeners. This is AMA #5, and as promised, you all have given me so many questions to be able to create content around. Today, we’re really going to focus deep on supplements. I got a plethora of questions. I tried my very best to paraphrase as much as I can and get through as many questions as I can. The goal of the AMAs is to really keep them under 35-40 minutes, to make them quick and digestible. I think moving into 2024, we might make them longer, just depending on what direction your questions are going in.

[00:01:04]
So today, we’re going to start with Diana. Her question is about branch chain amino acids or BCAAs. And she says, “I am a lean, postmenopausal woman of 56, living with Hashimoto’s thyroiditis for 20 years, for which I take T4 and T3.” For those listening, if you’re not familiar, T4 is the inactive form of thyroid hormone and T3 is the active form. “And I follow mainly a paleo diet with low carbs added in and have an exercise regimen which comprises strength training, three days per week, zone two, gentle cycling, three days per week, and Plyo ten minutes twice a week, in addition to daily yoga nidra, meditations, and slow daily walks with my dog. Would taking BCAAs daily benefit me? And if so, how and when would I take the supplement each day?”

[00:01:49]
This is a really great question, Diana. I actually just did a YouTube video, and my team will link this up. There’s a YouTube video that I talked about three supplements that I think are probably not worth your time and money. And I do go into some detail about why I’m now recommending essential amino acids instead of branch chain amino acids. And for consistency’s sake, let’s talk about what these represent. So, essential amino acids are building– well, all amino acids are essential building blocks of protein. Protein is broken down into amino acids. There are 20 total, 9 of which are essential. So, when we talk about the essential amino acids, these are the ones that your bodies cannot make on their own and you need to ingest protein in order to extract these amino acids.

[00:02:40]
And I think it’s important to kind of touch on a broad subject. Podcast with Dr. Lyon will be out in a couple of days. It’ll actually be out prior to this podcast coming out, so you can reference that. Dr Gabrielle Lyon is a dear friend, has heavily influenced my perspective on protein intake. And we know as we get older, we need more protein with age. We need so much more because as we are losing estrogen, as our follicular stimulating hormone is going up, our body goes into a catabolic state. That means that our muscles will get broken down as a byproduct of these hormonal fluctuations and changes. And so, this is where it becomes even more critically important to get adequate protein in. If you are listening and you intermittent fast and you don’t eat enough protein,

[00:03:20] I really want you to really pay heed to what I’m saying now. Our protein needs increase with age. That means that if you got by with 20 grams of protein in a meal at 20 years of age that probably was sufficient. We know that younger people need less protein to stimulate muscle protein synthesis. As we get older, we need more protein to stimulate muscle protein synthesis. Why is this important? Because this is what drives the anabolic process of building muscle. We’ll touch on what leucine thresholds are, etc., but you can also reference that podcast that I did with Dr. Lyon. So, we need to be getting at least 100 grams of protein into our diet daily. If you’re not there yet, do not panic. There’s something called the protein leverage hypothesis that also talks about the fact that if we don’t get enough protein into our diet, this is why a lot of late perimenopausal women, menopausal women, will complain of cravings. They’ll say, “I ate a good dinner and I’m still craving more food,” has a lot to do with this protein leverage hypothesis. If you’re not hitting those protein macros, your body is looking for more caloric intake and generally you are going to get it from carbs and fat. Carbs and fat are not bad, but protein really needs to be the mainstay of maintaining lean muscle mass, maintaining metabolic flexibility, etc.

[00:04:30]
So, Diana’s question is specific to branch chain amino acids. I think that if you’re getting at least 100 grams of protein plus 1 gram per pound of ideal body weight is what we’re aiming for, but at least 100 grams of protein a day considering essential amino acids is not unreasonable. I am now recommending essential amino acids over branch chain amino acids. Branch chain amino acids are just three. They’re leucine, isoleucine, and valine versus the nine essential amino acids that are a compilation of those and six others. I touched on a very important amino acid very briefly called leucine. Leucine is a specific amino acid that is critically important to trigger muscle protein synthesis, and something called mTOR. Dr Donald Layman is the individual that actually discovered this and you need 2.5 grams of leucine in a meal to trigger this. This is why we talk about 30 grams minimum of protein in a meal. And I would probably argue most of you need more than that, especially as you’re getting older. And especially if you’re intermittent fasting.

[00:05:28]
I don’t want to kick a hornet’s nest because it’s not the impetus for this conversation to talk about not eating enough protein. But a lot of people that are intermittent fasting are not eating enough protein and you’re really putting yourself with risk for losing muscle mass, losing metabolic flexibility and being skinny fat, which we don’t want. So, I have no proprietary relationship with Kion, K-I-O-N, but I’ve been using their essential amino acids. I use them in my feeding window, I put them into my water. Yes, I put a lot of things in my water” but I’m very kind of conscientious about, “Okay, now it’s time to add the essential amino acids.” They have a lot of different flavors. I don’t get any kickback from recommending them. That’s just the product I’ve been using. And I think there’s lots of options and they tend to offer sales throughout the year as well.

[00:06:09]
So, instead of branch chain amino acids, I’m now recommending essential amino acids. But I think what is most important, Diana and everyone else listening, the most important thing is that you are getting enough protein into your feeding window, you’re getting enough protein into your day, aiming for no less than 100 grams of protein a day. That is what is most important much more so than whether you have branch chain amino acids or essential amino acids, making sure you’re eating enough protein.

[00:06:35]
Next is a question from Kristen. “Does Berberine work similar to metformin? I am borderline prediabetic. In addition to adding more exercise and fasting, I’m looking for a natural alternative.”

[00:06:44]
Kristen, it’s a great question. There’s a lot of good research talking about the efficacy. Berberine, which is a supplement, it’s actually from a class of compounds called alkaloids. It is popular in Chinese medicine and it has become quite popular for people to take this to help with blood sugar support, to increase AMPK, which helps with ATP, which is an energy molecule in the cell. A lot of people are taking it also for blood sugar support. It has some potent antimicrobial properties. So, I incorporate it into antimicrobial properties so if we’re working on a specific gut pathogen or something that does not belong. There’s also good research to also demonstrate it helps with reducing oxidative stress and inflammation, as well as NAFLD, which is non-alcoholic fatty liver disease. Now, my understanding of berberine if taken specifically for blood sugar support or insulin sensitivity, is that you cycle it on and off. So, Dr. Sara Gottfried and I have talked about this and she and I are both in agreement as are many other clinicians. You cycle it on for about three months and cycle it off.

[00:07:50]
Now, it’s interesting, Mike Mutzel fairly recently talked about some research indicating that it’s much more efficacious to take berberine regularly, as opposed to, “Oh, I just had a big blowout, carbohydrate-laden meal and I’m trying to buffer some of the impact of the carbohydrate load.” So, I think that in a lot of different ways, berberine can be part of a supplement stack. Berberine can be helpful for those that are looking to improve insulin sensitivity. I would be remiss if I didn’t also say there’s a lot of other things that can help with insulin sensitivity. I like myo-inositol, I’ll be honest. I think it’s better tolerated. It may not be as strong or potent, but I have women that have been on berberine, have been on Glucophage or Metformin, didn’t tolerate the Glucophage and metformin because of significant nausea, didn’t tolerate the Berberine because of the gut effects and then I have others that do really well with it. So, I think that there’s a little bit of a need for the N of 1, meaning doing some degree of experimentation to find what works best for you and then working backwards. But, yes, I do think berberine can be helpful. I think you should have a conversation with your healthcare practitioner, especially if you’re thinking about doing that in lieu of a prescription medication. Make sure that they’re on board and they’re in agreement with that.

[00:08:58]
Next question is from Linda. “Do you have to cycle berberine and serrapeptase?” well, I just touched on the Berberine piece. I can’t speak to serrapeptase. I use serrapeptase and antimicrobial programs, generally speaking, I use it as a biofilm breaker. I know that colleagues of mine use it differently, but I haven’t read anything that suggests that cycling it makes it more efficacious, but I would definitely discuss that with your practitioner if it’s something they recommended to you to use.

[00:09:25]
Next is Carol. “There are so many products that you recommend to take. It’s hard to financially keep up with everything. Is there a specific product that you feel is most important?” Now, Carol, I’m really glad that you asked this question. This is something that I talk to friends and family members about because my mom is now in retirement and when my mom was still working full time, she would try everything and now she’ll actually say to me, “What is the supplement that you think is most efficacious?” I think it really depends on you. I think that when we’re talking about being budget conscious, then the most important thing we can do is the quality of our food is the most important thing. I would say then you are really being laser focused on hydration and sleep and stress and then filling in the gaps of supplements.

[00:10:15]
Now, obviously for me, sleep is always the biggest hierarchy of most of the complaints of my patients and clients. So, myo-inositol is something I would never give up for me personally. I do think that it is very beneficial. I think that it has multiple effects, meaning that myo-inositol can help with blood sugar regulation, it can help with sleep support, it can help with mood. There’s just a lot of beneficial effects and it’s cost effective because it’s in a powder so you can determine when and how much you want to take of it. I think electrolytes and whether you choose to do LMNT, which is always my favorite, or if you have another brand that you are a fan of or really enjoy, I think electrolytes, salting your food is also very helpful.

[00:10:55]
And then, I would say the other piece of that is really thinking about like a lot of what I talk about is metabolic health. A lot of what I talk about is talking about maintaining muscle. So, I think creatine, again, also can be very inexpensive. Creatine is also something that can be very helpful. And in a couple of days from now, which will be after this comes out or before this comes out, I have a podcast with a creatine researcher, and he is going to talk about the impact of creatine on things like sleep deprivation, jet lag, bone health. There are many of you that have written in and have said, “I can’t take HRT because I’m a breast cancer survivor and my physician’s not comfortable prescribing HRT. What are my options?” There’s a lot of things that you can do, but there’s some solid research that’s coming out.

[00:11:35]
So, to answer your question, Carol, I’m completely sensitive that I would say really hone in on the nutrition piece, buy the best quality food that you can afford, really make sure that you’re physically active, that you are sleeping, having high quality sleep, and managing your stress. And then, I would backfill things. I would say other things that can be helpful, that are more budget-conscious, adaptogenic herbs, things like ashwagandha. We know that once we go through menopause, we are less stress resilient. It’s not that we’re incapable, it’s just our adrenals go through adrenal pause. Our thyroid goes through thyroid pause. Because of these things, it means we have to work a little bit more effortlessly at making sure that we are managing our stress. So, some of those adaptogenic herbs, I think, can be very helpful, things to help with sleep. You get L-Theanine from green tea as an example. L-Theanine is in a calming amino acid. So, there’s a lot of ways to work around that. And no, you do not need to take every recommendation. There are many of you out there that love trying new things, but we bring on podcast sponsors that are in alignment with our principles and our integrity and never feel pressured to have to purchase anything. But those are what I would say, objectively, the things that I think are the most helpful for most individuals. And then, I would go from there.

[00:12:44]
Okay, “Does AG1 and vital proteins break a fast? Can I take it with black coffee while fasting in the morning? And what time should I take the second dose to help with sleep?” This is from Georgette. So, AG1 and vital proteins, I would take in a fed state. AG1 is a greens powder, but it does have a little bit of flavoring in it. Collagen peptides, vital proteins, that’s what that is. Collagen peptides will break a fast, especially a clean fast. So, I would recommend taking those in a feeding window. “Could you take them with black coffee?” Well, you could, but you would be breaking your fast and that’s something that’s important. If you struggle with the taste of black coffee, you could add things like Redmond salt, you could add cinnamon which will help with insulin sensitivity. Neither of those will break a fast. And when you’re asking about the second dose to help with sleep, I’m assuming you’re talking about inositol. You could take it before bed. I typically take myo- inositol usually in the evening. I don’t take it right before I go to bed, but I usually take it in the evening and that works really well for me. And for many of my patients and clients, they’ll kind of adjust. Some nights they need two scoops, one night they might have one. So, I think that can be very helpful and certainly really helpful.

[00:13:49]
Next question is from Abby. “What brand of collagen to use? I order from Fullscript Designs for Health and have that at home.” I’ve been trying out some new brands. For full disclosure, these were gifted to me, but I am enjoying them and I’m speaking objectively. Organifi, I’ve been using their collagen. I don’t use collagen every day. I use it a couple of times a week. This is 10 grams per scoop. And this is sourced from pasture-raised cows, wild-caught fish, eggshell, membrane collagen, chicken bone broth. And this is unflavored. So, this can kind of fit in effortlessly. That is Organifi.

[00:14:25]
And then MindBodyGreen has a product that I like as well that has 17.7 grams of grass-fed collagen, but it also has hyaluronic acid, vitamin C and E, biotin, L-glutamine, turmeric and sulforaphane. So, this is kind of a comprehensive beauty and gut collagen. It is also unflavored and that is really nice. Objectively, again, they were given to me, but I have tried them and I do like them. I’ve used other products. MD Logic has a marine collagen that’s really nice. And I would say that over time, like Primal Kitchen, I’ve used some of their products. I have a 15-year-old who loves– they have like a snickerdoodle and he just likes it in his coffee. And so, he knows that it’s not an issue breaking his fast. But those are definitely some nice options. There’s lots of options that are out there. Just find one that works for you and your budget.

[00:15:09]
Okay, this is a question from Liz. “I’ve been taking your brand of creatine for a few weeks now. I’m a recovered vegan, was vegan for 12 years. I strength train three to four days a week and fast on average 16 to 20 hours a day. I’m 52. When is the best time to take creatine and does it break a fast?” I’ve done two podcasts on creatine. We will make sure we link the creatine podcast so that you’ll have them as a resource with this podcast. Typically, you want to take it in a feeding window depending on who you talk to. Some people feel like you need to take it immediately after exercise. I think it’s just if you’re intermittent fasting, the most important thing you can do is make sure you’re getting enough protein in a very tight feeding window. If you have a four hour or six-hour feeding window, I always get concerned that you’re not going to be eating enough protein. So, creatine in your feeding window is absolutely fine.

[00:15:55]
“Is it true that it can cause some bloating and weight gain?” I think this is very bio individual. I’ll be honest with you, we occasionally will field questions or concerns from people that will say, “Oh, I think I’m gaining water weight,” and then when they stop, they lose the water weight. But creatine monohydrate, you hear that word “hydrate,” it’s hydrating those muscles, so what it is water weight gain. Some people do need to divide their doses. I think a lot of it really just depends on the individual. But I found for me, it has allowed me to not only lift heavier in the gym, which I think is important, but it has also helped with sleep architecture. On the days that I remember to take creatine, I try every day, but some days I don’t, I always sleep better. So, it definitely helps with sleep architecture. And we know that creatine also has other net impact. There’s a podcast with Dr. Darren Candow that will be out later this week, which again will precede this podcast coming out. And he talks about the research on brain stress, traumatic brain injuries, jet lag, sleep deprivation, bone health. I mean, these are other research that’s coming out that’s showing that creatine is one of the safest, most efficacious supplements that’s out there. And I think you don’t know until you try the product. So, that would be my best recommendation, just kind of see how you feel with it.

[00:17:05]
For me, my entire family takes Creatine. My teenagers, my husband. And what’s interesting is Dr. Candow talks about one particular research that was done. It was a randomized controlled trial of menopausal women not on HRT. So, they were within the first two years of menopause without HRT so that they could have a real sense of where their bone health was. And for two years, the control side took creatine every day and exercised with 10 grams a day of creatine. So, my creatine, the current dose is 3 grams. We recommend 5 grams for people that are vegetarian, vegan men. So, for women, 3 grams is the minimum. These women were taking 10 grams a day for two years with no issues related to liver or kidney renal function. So, when people express concerns about hydration with creatine or potentially having health issues, the research doesn’t support that. So, please don’t let that be a concern. But I would say creatine in the feeding window is always what we’re aiming for.

[00:18:03]
Next question is from Reena. “Can your creatine denature when added to hot food, like soup, stew, or curry?” It’s interesting. I’ve asked this question of a couple people. Now, Darren Candow, who’s the researcher, doesn’t love creatine in hot food. He does feel like it has the potential to impact the efficacy of the creatine. He said that it’s not as if it would blunt all of it, but he prefers that it’s in either room temperature or cold water. So, that’s just a thought.

[00:18:36]
Other question, “Is creatine beneficial at any time, not just being centered on workouts and strength training?” Yes, and definitely reference that podcast that I did with Dr. Candow, which will be out on October 4th, which again will precede this coming out. This will be out in October.

[00:18:46]
Next question is from Karen, “I take your creatine, but many sources seem to caution about hydration when taking it. I work out, but not every day. Should this only be taken on workout days?” Karen, as I mentioned, I have just interviewed Darren, and Darren based on all the research, and this is his area of expertise, there’s nothing to suggest that creatine is at all potentially damaging to liver or kidney function at all. I think that taking it daily is probably the best way to take it, even though sometimes probably five days out of seven, I take it. A lot of it has to do with how busy my morning is, just for full transparency. But I do think that there’s value in taking it daily. And what’s interesting is, when I spoke with Darren, he mentioned that if you take creatine and you don’t exercise, like, let’s say you’re a couch potato, but you take creatine for the benefits, you don’t get the benefits. Like, you actually need to be exercising with some consistency to get the most benefits out of creatine. That doesn’t mean that if you take a day off that you shouldn’t take it. But if you are sedentary for six months and you think taking creatine is going to offset that, that’s not going to actually happen. So just kind of keep that in mind.

[00:19:51]
Next question is from Karen. “I’ve been using LMNT. Is a 1000 mg too much salt in general, coupled with everything else consumed on a daily basis? Should it only be taken on workout days when I’m bound to drink more water?” This is a very bio, individual question. Obviously, we have bastardized salt for a very long time. I say we as in healthcare providers, there’s a lot of misinformation put out in the lay press about salt. Salt is not what causes hypertension. It is not what causes a lot of health problems. It is hyperprocessed, hyperpalatable crappy food. And I think the most recent statistic I read was somewhere between 60% to 70% of Americans eat predominantly a highly processed hyperpalatable diet.

[00:20:33]
So, back to your question. “Do I think taking 1000 milligrams of high-quality salt is problematic?” No, I don’t. I think there are those of us that need more. I think there are those of us that may tolerate less. I drink LMNT all day long. Admittedly, I have very mild dysautonomia, which means that my body needs more electrolytes, not less. And I’ve always realized that about myself, but I didn’t realize why. So, I think for each one of you out there, sometimes when you’re first using electrolytes, it may seem really salty. I always say just dilute it with more water, no harm done. Maybe you do half a packet and 20oz of water, and then you save the other half a pack for later in the day. I think a degree of experimentation can be beneficial. I think it’s also helpful to try different flavors so that you find what you like. I personally am a fan of orange. In my house, grapefruit and citrus are also very popular.

[00:21:19]
Sherry said, “What inositol do you recommend for glucose control and balance?” Generally speaking, myo-inositol, which is the product that I have created in conjunction with MD Logic. Sherry mentions, “I’ve been reading about in different forums and I want to make sure I recommending the right inositol for sleep and the right one for improving glucose control”. The reason why I like myo-inositol is the one that appears to be most efficacious for both. I’m all about a two for one. If something’s going to help you with sleep, you might just need 1 gram at night. If you have blood sugar control problems, you may need 2 grams in the morning and 2 grams at night and that can also help with sleep. There’s a lot of other benefits to myo-inositol, and we’ve done two podcasts on myo-inositol which we will link as well just so you have it as a resource point. There is D-chiro-inositol. You know, we looked at that, but just based on all the research that were looking at, we were trying to look at the form of inositol that had the most benefits so that we could keep it as simple as possible. And that’s also why it’s powdered. Someone asked me recently, why is it powdered, not a capsule? Because it allows you to customize and it makes it a bit more cost effective when it’s not in a capsule and when it’s in a pouch where you can just scoop it, depending on what your needs are.

[00:22:33]
Next question is from Michelle. “Is there a product similar to Mitopure that I could take? It’s way out of my budget, but you and JJ have convinced me that it is a great supplement to add.” Michelle, this is a question we got multiple times, so I want to make sure I answer it really as concisely as possible. Yes, Mitopure is expensive. I am sensitive to that. My mom is now taking it and so what we have done for her because there is nothing specifically per se that is going to replicate the concentrated benefits of Urolithin A. And I’ve done a podcast with the chief medical officer with Mitopure, which we’ll also link up so that you have that as a resource, that kind of induces the degree of mitogenesis and mitophagy, meaning it’s really clearing out– Not only is it helping with production, but also clearing up of diseased, disordered mitochondria. And so, my answer to your question is there’s nothing specifically that I have seen; however, I do think that consuming polyphenol-rich compounds, things like pomegranates, cranberries can be helpful, but I think it’s trying to find that happy balance. I think that a lot of what we see in terms of the benefits from Mitopure that I’ve reported from patients and certainly things I have seen, muscle strength and endurance. As a menopausal woman, I’ve definitely seen that in conjunction with creatine. Improve cellular health.

[00:23:58]
The other thing that I was thinking about as I was approaching this question is maybe think about creatine as a starting point because that will help with muscle strength and endurance. It’ll also help with brain health, bone health, etc. I’m hopeful that we’re going to get to a point where maybe we’ll have bigger discounts that we can offer to listeners. I haven’t gotten there yet. I’m continuing to push for that. And just for everyone that may not be familiar, Urolithin A is a metabolic product that is created through ellagic acid into urolithin and it’s produced in the gut. So, it is this beneficial property. You’ve probably have seen a lot of ads for it. I use it. I have some of their skincare products, which are really nice as well. But I do acknowledge that it is expensive.

[00:24:46]
So, go back to that question I answered for someone else earlier. Really start focusing on the basics and then add things in as you can, and as your budget permits. It is far more important that you’re eating really high-quality food. Like, if you can afford organic fruits and vegetables based on the Dirty Dozen, Clean Fifteen and pastured eggs, or the highest quality meat you can afford like that is certainly going to be very helpful and that would be my first layer of focus. Which is not suggesting that there’s not benefits from taking supplements, but if you’re trying to be as conscientious as possible about cost, those are things that I would definitely consider.

[00:25:19]
Next question is from Julie. “I’m about to start using AG1 powders, optimize nutrition. I also purchased your Creatine and inositol. Can I mix all three of them together in one power drink, or is that not recommended?” You absolutely can. I would say that if you’re trying to use inositol to help with sleep, you may notice you do best taking that in the evening, but I think during the day, it is definitely– it’s not going to make you sleepy, but it can help with relaxation, but I think if your way of remembering to take it is to put them all together, I think that’s absolutely fine. Obviously, one of the next questions I will get is, “Will it break my fast?” Definitely, I think creatine and I think that AG1 should be taken in a fed state. Inositol, you can take in an unfed state without concerns.

[00:26:03]
Next question is from Murana. “Hi, Cynthia. I have low testosterone, and somebody told me that taking myo-inositol is counter indicated for people with low testosterone. Can you please clarify?” You know I thought about this question for a few minutes when I read it. Here’s the thing. I’m in menopause. If I don’t take testosterone, my testosterone levels are low. I’ve been taking myo-inositol for several years, and I have robust testosterone levels right now. So, I don’t understand the mechanism of action. If someone was saying to you, that’s going to be harmful, because that’s not the way myo-inositol works. It’s not going to lower your testosterone levels. Your testosterone levels, about 75% of us, as we navigate perimenopause and a menopause, they’re going to be lower because we’re making less endogenous testosterone as we’re getting older. So more often than not, individuals will have lowered levels of testosterone heading into late perimenopause and into menopause. And it’s kind of a gradual decline. It’s not that cliff that you get shoved off of in terms of estradiol or the slow, steady decline of progesterone. So, I don’t see any mechanism of action that would amplify or exacerbate low testosterone.

[00:27:18]
Now, low testosterone can be a byproduct of insulin resistance. It can be a byproduct of chronic stress, and a lot of women have out-of-control stress. I know because I look at a lot of labs that can definitely be a contributor. I don’t understand why that would have been stated to you, because it doesn’t make any mechanistic sense to me. So, I think you can safely take myo-inositol and not worry about your testosterone levels lowering. Now, what happens for a lot of people is, as they’re navigating their perimenopause and menopause years, they have less circulating testosterone, which can show up as belly fat, changes in body composition, low libido, low motivation, etc.

[00:28:05]
Okay, Jacqueline asked, “Do you feel that myo-inositol is safe for children? My stepson is 8.5 and seems to struggle with mood swings, I manage his sugar intake when he’s with us. I feed him healthy fats and protein throughout the day. I know his biological mom struggles to manage his diet. I’m wondering if giving him myo-inositol could help him with the lack of management of diet and also therefore improve his mood swings. I’m looking for your thoughts on this before presenting it to his biological mom and pediatrician as an alternative to Concerta.” Jacqueline, this is a really great question. I actually did a podcast with Dr. Roseann Capanna-Hodge. She is a pediatric mental health specialist. She’s a clinical psychologist, and we spoke about a lot of the research surrounding mood disorders, ADHD, etc. I do think it’s something that you could discuss with your stepson’s pediatrician, his biological mother, your husband, and see if that’s an option.

[00:29:05]
Now, obviously we’ll link up that podcast so you have it as a resource. Dr. Roseann talks about the fact that mood support requires higher levels than what we talk about for blood sugar or sleep support. Meaning, in some instances, I think, as an example, some of the studies she referenced were 10 to 15 grams a day for mental health versus one to four grams for sleep and blood sugar. Just to kind of caveat, obviously that would be weight dependent on the child, and this would need to be utilized in conjunction with the pediatrician’s blessings as well. But Dr. Roseanne has an amazing website, and I’m sure that you could find some resources there as well, maybe have a consult with her practitioners to get their input as well. So, I think that is certainly something worth discussing with your family and the pediatrician as well.

[00:29:52]
Next question is from Karen. “What are some of the first signs in your body that you are benefiting from Mitopure or the Urolithin A?” A lot of what I’ve seen personally as well as family members is just feeling like they’re stronger. And some of my family members are using creatine, some are using Mitopure, some are using both. And if you look at the research on Mitopure, it’s looking like 12 to 16 weeks is that time frame that you start seeing a lot of the clinical benefits. I’ve even had some patients tell me that they felt like they had more mental clarity. I think this is also in conjunction with other lifestyle related changes that I think make a really big shift. But that’s typically what I have seen, is improvement in strength and endurance, muscle endurance, and then also mental clarity. And feeling like you know if the scale has been stuck as an example, feeling like they’re finally making some headway. For a lot of middle-aged women, they feel like, “Okay, finally, I’m seeing something change on the scale. There’s a shift on the scale. Maybe my thyroid is finally coming back in line in conjunction with all the other lifestyle changes I’m making.” But that is typically what has been self-reported to me.

[00:31:03]
Okay, “Is there a protein powder you would recommend as someone who is dairy free?” This is from Lisa. I think this is always challenging because a lot of the dairy-free protein powders can be gritty. I can tell you that of the plant-based protein powders, one that patients have reported that they really like is Truvani, that’s Food Babe’s product, so it’s T-R-U-V-A-N-I. That is certainly an option. Of course, there’s bone broth proteins, although those aren’t a fully complete protein. Paleovalley makes some nice options. If you do tolerate whey, like MariGold, also Paleovalley makes a really nice option. Those are usually the ones that I typically will recommend the most. But I always remind people that if you’re using an incomplete form of protein, just making sure you’re rounding that out with something else in your diet, that’s going to help buffer some of that.

[00:31:51]
Okay, this is from Elaine. “I’m curious to know if you have any recommendation to help support aging hair. I’m a healthy 58-year-old, and like many, my hair has become thin and dull. I’m trying a new shampoo and a biotin supplement, but I’m not sure if either will make any difference. Any recommendations?” So, Elaine, I always think about labs like a full iron panel, so a serum ferritin, a TIBC, a percent sed, serum iron, looking at a full thyroid panel, looking at free and total testosterone, looking at progesterone. Those sex hormones have a lot. Like, the progesterone and testosterone have a lot to do with hair. And so, as someone who even though I’m in menopause, I’ve been able to kind of buffer some of the expected changes, but I think because I’m on HRT, that helps. I also have a thyroid that’s fully optimized. So, making sure that your primary care provider, internist, or GYN will check those things for you, I think that’s the first thing I would double check to see, because if any of those are not optimized, that can definitely impact not only the hair follicle cycle, but it can also impact how full your hair is. I think a lot about women after they’ve had a baby and their hair falls out and then everyone panics because they think they’re going to lose all their hair and they realize everything stabilizes. I think some things very similar can happen in that perimenopause to menopause transition, and this is where that nutrient piece becomes important, stress management, sleep, etc. But definitely, Elaine, have your primary, your internist, your GYN, check those for you just to make sure that they don’t require some attention.

[00:33:24]
Okay, Kathleen said, “How do I simplify and assess what supplements we need? It’s so easy when reading, listening to podcasts to all of a sudden be taking 20 supplements. It gets both cumbersome and cost prohibitive. Thanks so much for all you do.” Kathleen, I’ve definitely have given some suggestions throughout this. I think that it needs to be whatever your biggest pain point is. A lot of my female clients, it’s sleep. So, we really have to hone in on sleep first. And this is where it might be one or two things that we start with. Like, maybe it’s myo-inositol or maybe it’s GABA or L-theanine or magnesium as a starting point. And then, really having honest conversations with yourself about what are the things I need to change as my day kind of goes on to get myself ready for sleep. If it’s stress, like if you wake up really anxious in the morning, well, maybe you need some adaptogenic herbs. If you feel like you’re losing muscle mass and a lot of us do, I mean, I feel like it has become a full-time job trying to figure out how to build muscle as a middle-aged woman. I am one of those people, I’m going to have to work extra, extra hard because I need– I’m thin. And I don’t say that to sound like I’m not sensitive to what other people are experiencing, but I have to work harder to get the muscle to show up. Like, it seems like it’s effortless for some friends and it’s harder for others, but really understanding what is your area of focus and that’s where I probably would spend my dollars.

[00:34:51]
I think, like I’ve said multiple times, not just in this AMA, but other ones, I never want anyone to walk away and feel like anything’s being pushed on them that they have to purchase. The reality is, podcasting is very expensive. It is a free resource that I put out in the world because I love podcasting, I love interviewing people, I love helping people. But podcasters allow me to continue podcasting, and I get benefits from that. But I’m also very conscientious about who we use as a podcaster sponsor. Meaning, right now, we’re vetting all the 2024 people and we’re being even more conscientious this year because we have the ability to do that. So, what I’m saying is, please don’t ever feel pressured. Number 2, what do you need help with? That’s where I would really hone in on.

[00:35:44]
And then, number three, sometimes we just need things temporarily. We might not need to take them forever. Right now, I’m taking a special supplement that had to be compounded and my functional medicine doctor said, “We’re just taking this for a month.” I was like, “Great.” I feel fantastic on it. It was expensive, but it was worth it, but I know it’s one month, so I think that’s the way to think about it. Is this something I’m going to take long term or is this something short term? If it’s short term, it’s probably not as big of a deal. If it’s long term, then you have to kind of figure out what’s the most efficacious way to do that. That’s as honest as I can be.

[00:36:06]
Okay, next question is from Janet. “There seems to be a lot of recommendations for supplements. However, I’m on a limited budget which supplements are most important.?” So, you see there’s a theme here with what’s most important. Janet is 71. She’s IN menopause. She’s been intermittent fasting. She’s lost 10 pounds over eight weeks. She’s very active. Again, I’m going to go back to the basics. Are you eating enough protein? Are you eating high-quality protein? Are you eating enough brightly pigmented fruits and vegetables? I just did an amazing podcast with Deanna Minich, and I can’t wait to share that with everyone. It was just really mind blowing. She talks a lot about the power of brightly pigmented fruits and vegetables in the context of a healthy diet. And so, I think about sleep, stress, nutrition quality, and then adding in where you need things. I feel like most women need help with sleep, they need help with building muscle mass, they need help with stress management. And that’s usually where I would say that’s probably where I would start, as opposed to feeling a sense of pressure to have to do a lot of other things.

[00:37:07]
Okay, y’all, that was the supplement. I tried to get through as many questions as possible. That was a lot of fun. I love answering questions about supplements. Please keep your questions coming. I would really love to be able to do an AMA every month. Just keep it short and sweet. Really focused in on the things that you want to learn more about. The other thing that it really helps me with is it allows me to see what are you interested in learning about. Because that’s the one thing. We broke these hundreds of questions into sections and each one of these sections is subcategorized into subjects and then I can see what types of experts are you looking for me to bring on the podcast. We got a lot of questions interestingly enough. Many of you don’t drink alcohol, as an example, and many of you are asking, could you please bring on an expert who talks about either recovery and or the benefits of an alcohol-free lifestyle. So, I do have an expert coming on in December who has a new book coming out and I’m really excited to bring Dr. Brooke on. But keep the questions coming. I love interacting with each one of you. I really value and appreciate each one of you. And the next AMA is going to be all about fasting.

[00:38:16]

[music]

If you love this podcast episode, please leave a rating and review subscribe and tell a friend.