Hello, everyone! It’s that time again, and today, I am delighted to bring you AMA number six.
In this edition of our AMA series, I dive into an eclectic mix of questions, all related to intermittent fasting, pregnancy supplements, working out, and what breaks a fast.
As I have mentioned before, I thoroughly enjoy this format. Your wealth of inquiries offers me valuable insight into your areas of interest and curiosity. So please keep those questions flowing!
“When women are in middle age- perimenopause and beyond, it really comes down to lifestyle.”
– Cynthia Thurlow, NP
IN THIS EPISODE YOU WILL LEARN:
- How does age impact intermittent fasting?
- What vegans and vegetarians could consider incorporating into their diets to help meet their protein requirements
- How fasting while in consultation with a healthcare provider can benefit people with chronic illnesses
- I recommend longer fasts for deep cellular cleansing; but only with medical supervision.
- The benefits of night-time aids like medicinal mushrooms and golden milk while in a fasted state
- Why I advise against fasting while pregnant, breastfeeding, or trying to conceive
- Is it okay to take supplements during a fasting period?
- Why is it essential for perimenopausal and menopausal women to find balance in their exercise routines?
- Experimenting with feeding windows to find what works best
- Why is hormone replacement therapy essential for women who go into menopause before turning 45
Connect with Cynthia Thurlow
- Check out Cynthia’s website
- Submit your questions to email@example.com
Related Podcast Episodes:
Cynthia Thurlow: [00:00:02] 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.
[00:00:29] Hello. Hello. This is AMA #6. This is a grab bag compilation of questions related to intermittent fasting, pregnancy, supplements, what breaks a fast, working out. Hopefully, this should be an enlightening conversation. Like I’ve said in other iterations, please keep your questions coming. I’m loving these formats, all these questions, it really gives me a sense of what you’re interested in learning about.
[00:00:54] Let’s start with a question from Julie, “Are there different fasting windows based on your age? For instance, I’m 55 and fast 16 hours with an eight-hour feeding window. Is that optimal for my age or does age matter when fasting?” Well, Julie, I wrote a whole book about how we can approach fasting, whether we are in our peak fertile years, perimenopause, or menopause. And so, my general prevailing feeling is when women are in middle age, so perimenopause and beyond, it really comes down to lifestyle. So, what is your sleep like? How are you managing stress? Are you exercising? Can you get enough protein into your feeding window? Those are all really important considerations. Now, most women in an eight-hour feeding window do pretty well, hitting at least 40, 50, 60 g of protein in a meal and they can help trigger muscle protein synthesis.
[00:01:45] As I’ve talked about in other AMAs and other podcasts that we have to consume at least 30 g of protein in a meal. That is the minimum for this leucine threshold that will trigger muscle protein synthesis and mTOR and help go on to build muscle. So, if you’re eating 15 g of protein, 20 g of protein here and there, it’s not enough. And we know that muscle loss with aging is a real thing. Sarcopenia is a real thing. We know that as we get older, especially if you’re not on hormone replacement therapy, the low estrogen or low estradiol in the body with high follicular stimulating hormone will really catabolize muscle at the expense of our metabolic health. And so, I share that just to give you context.
[00:02:29] So, I think that the answer to your question is, it really depends. It depends on do you lift? Are you able to sleep through the night? Do you manage your stress? And as I’ve talked about before, we go through adrenal pause, thyroid pause. menopause. It is not just about our sex hormones. It impacts us systemically and we become less stress resilient. So that’s why I think it’s so, so imperative that we are having those conversations about are you meeting the minimum threshold of protein a day, which should be no less than 100 g of protein a day, and if you’re able to get in in enough protein, I think intermittent fasting can be a great strategy. What I always get concerned about is women that over fast, over restrict food and over exercise. So, making sure you don’t fit into any of those concerning areas. But yes, I do think that intermittent fasting is really dependent on where a woman is in her lifestyle, where she is in her menstrual cycle, and if she’s no longer menstruating, really leaning into the lifestyle piece as well. That’s a great question.
[00:03:29] Next question is from Marissa. “I work with a lot of vegans and vegetarians. Is there no chance they can benefit from intermittent fasting without incorporating meat?” Marissa, I would say that if you are working with vegetarians and vegans, vegetarians in particular, if they’re open to dairy and consuming eggs and/or fish or poultry, I think that you are going to get a whole lot farther. I find for most vegetarians and vegans that they really undereat protein more often than not. If they’re eating plant-based protein, it’s at the expense of having too much carbohydrate. And I know Dr. Gabrielle Lyon speaks a great deal about this, that we’re really aiming for 30 g of protein in a meal to trigger muscle protein synthesis. What ends up happening and can be problematic is that a lot of people, in order to get enough plant-based protein, hit that 30 g. They’re consuming quite a bit of carbohydrate. And I just find that most women quite honestly overconsume carbohydrates and underconsume protein. So, I think it can be challenging, not impossible. I think if you’re working with someone that’s open minded to expanding their repertoire beyond vegetables and plant-based sources, I think if they can incorporate some eggs and possibly fish and dairy, they may be able to reach those thresholds.
[00:04:44] Next is from Maria. “As a type 1 diabetic and a female in her 40s, would you recommend fasting for longer than 24 hours? Or do you see intermittent fasting as a better option for someone with type 1 diabetes?” Maria, this is a really great question for your healthcare provider. Since you’re not my patient, I can’t provide medical advice but what I will say is type 1 diabetics, which is an autoimmune condition. It is not a lifestyle-mediated form of diabetes. They can be very well managed on insulin and do very well and be very aware of their blood sugar. I know just as many other type 1 diabetics that have very brittle diabetes and are not aware of when their blood sugar is low and that can be a source of concern. So I think this is a question that is better directed to your healthcare practitioner, who knows your labs, knows your symptoms, knows how you’re doing. Definitely want to open up that conversation. And I would say a great resource in terms of a book that’s really focused on this specifically is Dr. Jason Fung. He has a book called Obesity Code. He also has Diabetes Code. Those are great resources not just for you, but also for your healthcare provider.
[00:05:47] Next is Dana. “I was recently diagnosed with hypothyroidism, which is likely Hashimoto’s. I started Armour Thyroid and will start on hormone replacement therapy next week. Can I safely use Armour Thyroid and still do therapeutic fasting of 24 to 48 hours once per week or alternate day fasting, or is that too much with my current hormonal issues?” That’s a really great question. I think that’s a question I would ask your healthcare provider largely because I don’t know your labs and I don’t know you and it makes it kind of awkward to provide medical advice in a big public forum. So, I will just speak from generalities. Do I think that people who have an underactive thyroid and Hashimoto’s is an autoimmune thyroid disorder. It is the most common reason why people develop thyroid issues here in the United States. It can be very well managed with medication. I think it’s very dependent on the individual. It’s very important to make sure that what is being corrected are things that are contributing to this. Is it a deficiency in selenium? Is it a deficiency in iron? Are there other things that are going on, latent infections that aren’t being addressed, etc.
[00:06:51] I’m sure whomever you’re seeing will be very conscientious about this. We know at the basis of any thyroid issue is mitochondrial dysfunction. Mitochondrial dysfunction is very common to see north of 40 years old. Also, common to see this around the time that women are going through perimenopause and menopause. So, I think there’re many things that can confound that. The question is, how is your sleep? How is your stress? A lot of it has to do based on symptoms. If your symptoms are stable and you’re stable on medication, that’s very different than someone who’s newly diagnosed and over fasting would provide more stress, more hormetic stress than their body can manage. So, this is really a great conversation for your provider. Obviously, I have very stable Hashimoto’s, very stable on medication. But if I were in a position where I was newly diagnosed and I was not feeling good and wasn’t sleeping, that would not be the time to add more stress to my body. And so I think you have to have an honest conversation with yourself and then have a conversation with your provider so that you can both determine when it is safe for you to proceed.
[00:07:53] Next question is from Jill. Is fasting helpful for people with chronic illnesses like Lyme, mold, MCAS, or CIRS?” So, for anyone that’s listening and they’re saying, “I understand Lyme and mold, what in the heck is MCAS and CIRS?” These are chronic inflammatory response syndromes. I did an amazing podcast with Dr. Aaron Hartman last year. He is a recognized expert in this area. I’ve interviewed other experts in this area as well. I do think fasting can be very therapeutic. I think it is always in the context of the individual. If someone is really metabolically broken or fragile and can’t sleep and their bodies are just wrecked and ravaged, it may very well be that they need to get back to a level of homeostasis before they’re going to be ready to add in a bit of hormetic stress from fasting. Do I think that most people listening benefit from eating in a 12-hour feeding window if they’re not intermittent fasting absolutely. My teenagers can do that. They’re still growing. I think most of us eat too frequently.
[00:08:52] But I think this is really in the context of your question, really a great question for your healthcare practitioner so that they can collectively help you decide when is the right time to do that. Again, as I’ve mentioned before, intermittent fasting is particularly beneficial for mitophagy, mitochondrial dysfunction, etc., because we’re getting rid of disease and disordered cells. I’ve done several recent YouTube videos on autophagy that would also probably be beneficial. Autophagy is that waste and recycling process that goes on in an unfed state. And obviously, the longer you fast, the more autophagy. So, a 24-hour fast is going to have more autophagy than if you just do 12 hours of digestive rest. Different benefits, different time periods in which we’re not eating. But it’s always in the context of what are you looking for? If you’re looking to really have deep cellular cleansing, then fasting longer. Of course, in conjunction with the permission. discussion, and collaboration of your primary care provider or specialist is what I would definitely recommend.
[00:09:52] This is a question from Danielle. “Why are longer fasts not helpful for thyroid issues? What is the right amount of time to fast for thyroid issues? Can I do a 36-hour fast to get the benefits of healing?” You all, you’re going to hear a lot of themes for me today. So much of this is the context of the individual. I personally, as someone with very stable Hashimoto’s, I do not do more than 24-hour fasts. I just don’t like doing them anymore. I used to do them for a long period of time. I think that it’s always in the context of why are you doing the fast? I think that there’s a very fine line between if you’re already lean and thin, there’s a very fine line between losing muscle mass, which I’m not willing to lose, just to fast a little longer. So, if you’re someone that is weight loss resistant, your doctor, your NP, your PA is like, “Yes, let’s do some longer fast to kind of break through these plateaus that is very different than people who just continuously do long fasts every single week at the expense of losing muscle.” And muscle as we get older is really like gold. We don’t want to lose it. We want to maintain it and build upon it and strengthen it because that’s our metabolic currency.
[00:11:02] And so the way to answer your question is really to say that for you, I don’t know what the right amount of time is to fast because you’re not my patient. So, it’s always, are your labs stable? How do you feel? How are you sleeping? Are you metabolically healthy? Are you exhausted? Is your hair falling out? You really have to think about intermittent fasting as one of many strategies that can help, but it may not be the right strategy at the right time. It’s a different lever. It might be that you are strong enough to be able to start exercising and that might be the next best thing for you to do as opposed to having a compressed feeding window. So, I don’t mean to not answer the question, but I think this is a really great question to have with your primary care provider or your specialist. Ask them when is the appropriate timing. And then, of course, if your thyroid function is stable, you’re feeling good. Doing an occasional longer fast, I think is fine, but not at the expense of losing muscle.
[00:11:55] Okay. Nighttime supplements. This is from Kathleen. We have lots of Kathleens, all different Kathleens. “How are you supposed to ingest nighttime aids such as Reishi, golden milk, MagChem, etc., if you’re in a fasted state?” Well, some things like medicinal mushrooms, like Reishi, Cordyceps by themselves they’re not going to break a fast. Obviously, golden milk, especially if it’s sweetened, if its turmeric milk sweetened, yes that will break a fast. MagChem depending on how it’s sweetened, yes, technically, that will break a fast. So, if people are saying to me like, “I absolutely love golden milk, it’s part of my thing that I do every day.” Have it at the end of your feeding window, don’t stress out about it. There’re so many forms of magnesium that will not break a fast. So if you find that powdered magnesium’s work better, I mean, I like magnesium L-threonate. Admittedly, I will be coming out with my own formulation. I’ve been talking about this for about six months. It’ll be out in January.
[00:12:48] But I think for a lot of individuals, it’s the amount of stressing about what does and doesn’t break a fast makes us lose sight of what’s most important. If you need to take medicinal mushrooms, you really love golden milk. That’s like, part of your thing that you do. And for those that aren’t familiar with it can be anti-inflammatory beverage that for a lot of people, they really enjoy with turmeric or curcumin. And it’s called golden milk because it has that beautiful gold color. There’re so many other forms of magnesium that don’t have sugars and flavorings in them that you can certainly ingest in a fasted state and that will not be problematic. So, I usually encourage people to kind of do their diligence about finding clean products in a fasted state. And then if they absolutely love something, and if you say, “Cynthia, I love MagChem,” I don’t want to stop taking it. Then take it at the end of your feeding window and don’t stress about it.
[00:13:36] Okay. A question about pregnancy. This is from Marina, “I will be trying to conceive in the next few months. Is there any type of fasting I should not be doing once I start trying to conceive? For reference, I currently do two 24-hour fasts per week, one meal per day and one 36-hour fast, one no meal day. The rest I do 16:8 two meals per day. Once I’m pregnant is doing a 16:8 fasting appropriate? I know anything longer is absolutely not appropriate. I’m considering keeping that schedule and doing two to three meals and of course, being flexible if I’m hungry.” I think I’m pretty outspoken about this. I don’t like intermittent fasting for those trying to conceive. I don’t like intermittent fasting for pregnant women. I don’t like it for women that are breastfeeding. It is one of the very few times in your life that you are either trying to conceive a human, grow a human, or feed a human.
[00:14:22] And I think restricting your food intake has the potential to be problematic. I encounter many individuals across social media that really struggle with the restrictions on them during pregnancy. And I think you have to be really honest with yourself. And I say this without judgment, no judgment whatsoever, because ultimately, I want you to have good information. I do not like women to restrict their food while they are pregnant. I do not like women to restrict their food when they’re breastfeeding or when they’re trying to conceive. I think it’s very different. If you were to say, “Could I still do 12 hours of digestive rest?” Absolutely, I was never as hungry as I was when I was breastfeeding. I breastfed each one of my boys for a year. I felt like I could eat like a linebacker.
[00:15:07] I was definitely hungry and appropriately so while pregnant. And between my first and my second pregnancy, I definitely gained more weight in my first trimester with my second. And that was because unknowingly I got so thin because I breastfed for an entire year and I was working a crazy hospital job. And oftentimes my option was to pump or eat and I would eat protein bars, which I don’t recommend. The point why I’m sharing this is just to be fully transparent, know better, do better. I think that women, it is such a blessing to be pregnant. It is such a blessing to be able to breastfeed if you are able to do that. I really don’t want you restricting your food intake because ultimately you are limiting nutrients available to your baby and even to yourself. And so, I would just cap that off and say, have a conversation with your OB. Share with them what your fasting schedule is like prior to trying to conceive. Be honest about what you are struggling with because that’s the best way that they can help you. But I am not a fan of fasting during those three time periods in a woman’s life, trying to conceive, pregnancy, or breastfeeding.
[00:16:17] Ruth says, “I have heart palpitations and sometimes I get a sore throat when I’m fasting at 20 hours to 24 hours on the keto diet, why is that?” Ruth, “I don’t know.” The things that I think about are, are you not hydrating when you are doing these longer fasts? Are you not utilizing electrolytes? That might be why you’re having palpitations. It could be too much stress on your body. This is definitely something I would discuss with your primary care provider or internist. There might be value in checking some electrolytes, especially magnesium and potassium. But the first things that I think about are the low-lying fruit. Are you hydrating sufficiently? Are you resting? Are you using electrolytes? It is absolutely imperative if you are fasting that you consume electrolytes and you salt your food, really, really important.
[00:17:02] From Katie. “I’m having trouble with staying on intermittent fasting and eating correctly. With high stress, I immediately fall back into bad eating habits. Any recommendations on how to stay on track?” This would be an instance where I would say my book would be a really great resource because I do some troubleshooting, but just not knowing your age, I think about like where are you in your menstrual cycle, especially if you’re having a lot of stress. Are you over fasting? Are you not fueling your body in that feeding window enough? Those are the things I start to think about, especially if you’re stressed because stress oftentimes influences us to consume foods we would not otherwise consume. And so, make sure you’re getting enough protein, make sure you’re getting enough rest, make sure you know where you are in your menstrual cycle. Because from the day of bleeding until midway through your cycle during the follicular phase, you should be able to get away, should, again, bio-individuality rules. You should be able to get away with a bit more fasting than the week preceding your menstrual cycle, which is the luteal phase. So, I would kind of run through some of those questions and if you don’t have my book as a reference, I would definitely recommend it.
[00:18:08] Tina asked, “How do you take your supplements when you intermittent fast? Is it okay to take supplements during the fasting period?” How do I personally take my supplements? Right now, I am pretty conscientious because I’m working through a gut protocol with my personal functional medicine doctor who advises me on the things that he wants me taking, and then I kind of fill in when I need to be taking them. So, things like magnesium I can take in a fasted state, a lot of my adaptogenic herbs, because they’re just the herbs I can take in a fasted state. Most things I take in a fed state. And so, when I open up my feeding window, that’s when I get creatine on board. That’s when I’m getting, oh, I can take alpha-GPC in a fasted state. That’s when I’m taking calcium D-glucarate because I have a methylation issue so I work a lot of my detox pathways, specific types of electrolytes, like I take trace minerals, I take iodine. These are things that work for me. I’m not suggesting these are what will work for you.
[00:19:04] There are specific supplements. I take glutathione during the day in a fed state because this is what makes the most sense. Things that I take in an unfed state, like in the evening, I will take, if I need it, GABA, L-theanine, or magnesium L-threonate or myo-inositol. I take those in an unfed state before I go to bed. I think so much of supplements is really about when in doubt, leave it out. That’s an easy thing to keep in mind and don’t stress about it too much. I think there is so much stress that goes on about what people should and shouldn’t be taking when and when they should take it, that I think that is just another layer of stress that most of us don’t need. So, when in doubt, leave it out. Most things, if you think that it might break a fast, it probably will. Like collagen peptides, essential amino acids. I take creatine in a fed state. All those things I take in a fed state. So again, when in doubt, leave it out. If there’s any concern, take it in your feeding window. A lot of other things like minerals or adaptogenic herbs or inositol, you can take in an unfed state.
[00:20:07] This is from Michelle. “I’ve been intermittent fasting for four months with good results. I typically do a 16:8 fast five to six days a week. I’m confused on the different opinions about what breaks a fast. I drink coffee in the morning with one tablespoon of MCT oil in the first cup. I also put electrolytes and creatine in my water bottle before my workout. They have zero sugar and zero calories. Why do you consider this breaking the fast?” Okay, coffee is fine. I find most women are weight loss resistant and so fatty coffees are generally things that I will say to them, if you’re struggling to lose weight, added fat is not helping. If you are someone that cannot get through to your morning without that MCT oil. I don’t really have a big issue with MCT oil, although there is a law of diminishing returns, like a tablespoon, a teaspoon is probably not going to make a big difference. But if you are weight loss resistant and you want to pull some things out of your diet, that might be one of the things that you want to just not be consuming in a fasted state.
[00:21:05] electrolytes generally are fine unless they have flavoring, unless they have stevia in them. Creatine I take in a fed state, I believe and after talking to experts, I feel pretty comfortable saying that creatine should be taken in a feeding window because I do believe that it will break a fast. That’s a clean fast. If you don’t want to clean fast or you prefer to do things differently, that’s entirely your choice. But I’m a fervent proponent for a clean fast and that’s why I try to teach people how to clean fast. Which means we’re not doing zero energy drinks in a fasted state. We’re not using copious amounts of sweeteners that “have little to no impact on blood sugar.” If you need to break your fast, break your fast. If you’re starving, break your fast. But I think if you are not weight loss resistant, I think having some MCT oil is not a big deal. If you are weight loss resistant, then that might be something you might want to admit.
[00:22:01] Next question is from Louise. “I’m still unsure about fasting and working out. I work out pretty hard at Orangetheory every morning. I’ve been told I need to eat protein after I work out if I want to build muscle, but that would break my fast.” Okay, Louise, I don’t know how old you are. I find that Orangetheory fitness tends to be pretty intense. I think that we have to find balance. If you are perimenopausal or menopausal, we have to find some balance. And that doesn’t mean that you can’t go to Orangetheory fitness a couple of days a week. But I find a lot of the women that go, they do that five or six days a week and they never have recovery days and their bodies are really stressed, meaning that they’ve got really high cortisol. If cortisol is up, it can make it harder to lose weight. I do think it’s important if you’re really hungry and you’re working out five or six days a week at Orangetheory fitness, you may not need to be fasting. You may actually need to eat more food in your feeding window. So, I think that you have to ask yourself the questions, “Where are you in your menstrual cycle? Are you still getting menstrual cycle? Are you recovering? How is your sleep? What is your appetite like?”
[00:23:00] Do I think that you need to eat immediately after working out? No, but I find a lot of people feel better when they do. Meaning, let’s say you work out at 9 o’clock in the morning and at 10:30 you want to eat. That’s okay. I never want the message to be not to eat. If you are starving, eat. I never want people to be in a state of chronic deprivation where they’re miserable because that also doesn’t make a lot of sense. Hopefully that helps. But knowing where you are in perimenopause or menopause is also helpful. We do want to balance true strength training with Zone 2 and some degree of recovery. Like I lift heavy two to three days a week, I do Zone 2, I do Pilates not for strength training, but for balance and flexibility and posterior chain work. I don’t think I would be where I am if I were doing five or six days a week of Orangetheory fitness. It would just be too much stress on my body. It does not mean that there are other people out there that maybe you do Orangetheory fitness on Monday and you do it again on Thursday and you do things in between to be physically active. But I just find that a lot of women get on a slippery slope in middle age by overdoing the intensity of their exercise.
[00:24:13] Susan asks. “I’m a 65-year-old water aerobics instructor who, based on Fitbit stats, averages 450 to 500 Zone minutes a week. I’ve been fasting for two and a half years. Is it okay to fast prior to exercise when at a high level of exercise?” It’s interesting, Susan, if you look at the research, a lot of the research suggests that women perform better if they’re fed. And I talk to a lot of my colleagues, many women that are fitness experts, that are kinesiologists, people that are very well versed in the literature, and we’re always having these conversations. And if you look at the research, a lot of women do better in a fed state. I am not someone who likes having food jostling around in my stomach when I exercise. I know other people may feel differently. It might be that prior to you doing your high level of exercise, maybe you just have a small piece of chicken and a piece of fruit. I mean, it might be something small that you eat, but I would do some degree of experimentation to see how you feel and objectively see how you feel and then make decisions based on how you feel. I think that would be my best recommendation.
[00:25:15] Now, I’ve been doing more experimenting about my feeding windows, my exercise intensity. I’m probably not ready to share all because I’m still in this experimentation phase. But what I’m finding is, on the days that I do more intense physical activity, I have a wider feeding window, and I have more food, more protein. And I’m finding that’s helping with my recovery. Now, I will be happy to share all when I get to that point, but I’m still in the midst of this experimental phase. And I do think that there’s some value in women having some type of food in their stomach if they feel better, especially if it’s intense exercise. Like, there’s a colleague of mine and we are always having these wonderful discussions about how should women fuel prior to exercise and what makes the most benefit. I think it’s a very bio-individual. I would throw up if I did really intense exercise and I had food in my stomach. That’s me personally. I’ve always been that way since high school. I think that there are other people who do need to sit down and have a meal before they exercise. So, I think it’s a bit of knowing yourself, a degree of experimentation, and being open to changing what you’re doing if you feel better eating before that physical activity.
[00:26:23] Next question is from Mary Ellen. “I exercise in the morning before breaking my 16-hour fast, so I don’t eat right after exercising. I’m wondering if this is as wise as I have read I should be replacing the energy used with protein within 30 to 40 minutes. So, is it okay to work out during your fast?” Mary Allen, great question. I just interviewed Dr. Lyon. This podcast will be out way after her podcast comes out, so you’ll be able to reference that. I think it really comes down to what we consume in a 24-hour period of time. Although there is some research to suggest that closer to when we exercise may be more beneficial. So, let’s say you exercise at 07:00 AM and then you eat at 10:00. I don’t think that’s the deal breaker. But if you exercise at 06:00 and then you don’t eat till 04:00, I think the potential exists that you may miss out on opportunities to kind of really trigger some muscle protein synthesis.
[00:27:12] So, whether it’s creatine, whether it’s essential amino acids, whatever it is that you’re consuming, I think that we just have to be thoughtful. I would do some degree of experimentation, just like I think it’s important to flex how long we’re fasting. Today is a good example. I went to the gym and lifted legs. I did the infrared sauna. I did some Zone 2 training, and this is like a longer training day for me because it’s a weekend and I have the ability to do that. And I said to my husband, I was like, “I can already tell this is going to be a day that it’s going to be a wider feeding window.” I’ll have more protein and I’m starting to do some degree of experimentation. I would definitely encourage you to do it as well.
[00:27:50] Last question today is a grab bag question. It was one of those random questions that ended up on this spreadsheet that I’m working off of. It’s about menopause. And this is from Angie. This is a question about surgical menopause. “What do I need to do to be the most prepared for surgical menopause? My OB/GYN and I have just had discussions around estrogen to support me, such as creams or patches, and I was advised I won’t need progesterone due to not having any ovaries. As a 40-year-old woman, I’m also scared to lose my libido, start having weight gain and lose muscle mass. My goal is to maintain skeletal muscle, maintain an increased muscle mass, maintain flexibility, continue to be metabolically flexible, maintain a healthy libido and sex life and age with grace and strength. Besides HRT, protein, creatine, fish oil, vitamin D, magnesium, exercise, yoga and mindfulness, good sleep, time-restricted eating, healthy diet.” Angie has thought of everything. I’m so impressed. “Is there anything else that will ease the transition to a pretty drastic onset of menopause?”
[00:28:48] Angie, this is such a great question. By the time this is answered publicly, you probably will have gone through what sounds to be at least a partial hysterectomy or maybe a full hysterectomy. It wasn’t specified here. I think it’s important to talk about how significant it is to go into menopause before the age of 45. It is absolutely imperative that if you go into surgical menopause or menopause in general before the age of 45, that you be on hormone replacement therapy because you are at greatest risk of cognitive impact of that loss of estrogen and progesterone signaling. I’m going to recommend a book called the XX Brain by Dr. Lisa Mosconi. She will be a podcast guest, hopefully crossing my fingers, by the end of 2023. She has a new book coming out on menopause in March of 2024. With that being said, I’ve learned so much through her research and many other clinicians and I think it’s really important for people to understand we don’t just have progesterone receptors in our uteruses, we have them systemically, just like we have testosterone receptors systemically.
[00:29:51] It is important to understand the functionality of these sex hormones and how impacted we are head to toe, every endocrine gland and every single organ and tissue in our body is touched by sex hormones. That is why it is so important. So, you don’t just need estrogen, you need progesterone. And you very well may also need testosterone at some point. It’s important that they monitor your thyroid really carefully. It is important that you be really gentle and nourishing to your adrenal glands because you go through thyroid pause menopause, adrenal pause, all these things happen. It is a catastrophic shift in your body. And I’m glad that your physician is starting the conversation. But you do need progesterone. It’s kind of like estrogen and progesterone are like peanut butter and jelly. Terrible analogy, because I don’t eat peanut butter and jelly. But they’re so important that they go together. They balance each other out.
[00:30:49] Go back and listen to podcasts that I’ve done with Dr. Felice Gersh, podcasts that I’ve done with Dr. Anna Cabeca. There’re so many wonderful GYNs that I’ve spoken to on the podcast, and many of them talk about how important it is as we are navigating that transitional time in our lives. Dr. Lara Briden as well. Dr. Sara Gottfried, all really, really amazing resources on this time in a woman’s life. But to be your own best advocate, you need to advocate for a compilation of your sex hormones and not just estrogen.
[00:31:21] Well, y’all, this is AMA # 6. Keep your questions coming. I hope to be able to offer this every single month heading into 2024. I really enjoy this. And if you have other suggestions, if there are people you want me to interview, we’re starting to get more diverse requests. And so, I’m really pleased to see some of our podcast schedule is maxed out through the end of 2023. And starting into early 2024, and I’m really excited about the expanse of guests that we have coming and the quality of the guests and love and appreciate and support each one of you. Just let me know how we can continue to serve you on Everyday Wellness.
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