Intermittent Fasting For Women: What You Need To Know – With Cynthia Thurlow

Dr. Mindy
I feel like the thing that keeps me up at night is truly how sick The world is. And I was putting together some notes for a YouTube video the other day, and it was on chronic disease. And when you look at the statistics on chronic disease right now, it’s like one out of three people worldwide have two or more chronic diseases. 60% of Americans have one or more and 90% of our health care costs are on chronic disease. And then I come over here and I look at fasting, and I’m like, this is ridiculous. If all we did is get people fasting, we could end chronic disease. So I want to start the conversation there. How do we take somebody who’s in the western standard American diet, and we get them intermittent fasting? What how do we speak to them? What’s the first step that they make? Yeah, and

CYNTHIA THURLOW
that’s a great question. You know, if you look at like 88% of Americans are now metabolically unhealthy. So that means, like, 12% of us are metabolically healthy, which is totally unacceptable. And I think we really have to start with encouraging people not to snack because the not encouraging people to snack will move to people, people being forced to restructure their macros, because you can’t just have a croissant for breakfast and a piece of pizza for lunch, you’re going to have to change your diet. So I think, in many ways, removing the snacking, and just saying, there is no more snacking, you’re not a two year old. You’re not a five year old. You’re not a teenager who has crazy hormones and play sports and you know, needs to eat constantly. You’re a grown ass adult. And part of getting really tough and being really transparent is saying, Listen, we got it all wrong. Like everything I learned during my medical training is completely wrong as it pertains to meal frequency, how we are supposed to be eating and what we should be focusing on, we should all be focusing on protein with some healthy fats and lowering our carbohydrate intake. And I think removing the fats and restructuring macros are two really important pieces. I think the other thing is really encouraging people and thinking strategically about educating healthcare providers and saying, Listen, if your patient does nothing else, but eat less frequently, they are going to get improvement in all these metabolic markers. in cardiology, I worked in cardiology, for 16 years as an MP, I got tired of writing prescriptions. And I got frustrated because we were not given the tools slash time to be able to talk to our patients about the things that matter most we’ve conditioned our patient population to ask for pills, instead of doing the work. So I think it really starts from the point of, if someone’s on a standard American diet, and they’re couch potato, the most important thing they can do right away is to remove their snacks because they will be forced to restructure their meals, like I almost feel like it’s like rip the band aid off, get real. I think the other piece that’s really important is getting very honest with people about a lot of these liquid calories that people are consuming. They think Diet Coke is benign. They think their frappuccino was benign. And I’m like, Okay, well, the frappuccinos dessert in liquid form. And your Your Diet Coke is destroying your healthy gut microbiome. And so, you know, it’s like, let’s try to find alternatives. But I think it all starts with food. And it all starts with this nonsense as I know you preach. No one should be snacking, You’re a grown ass adult and no one should be snacking. And that’s the hard truth. I think we have unfortunately been, you know, we’ve been told that meal frequency is not an issue that we want to stoke our metabolism. And both you and I know that the more frequently you eat and drink these sugary but sweetened beverages, the more frequently you’re co creating insulin, which is going to you know, put a complete, you know, kibosh on your fat burning potential. And so, you know, just understanding the basics, but people, you know, on that readiness to change scale, they have to be in a position like maybe they’ve gotten a diagnosis of diabetes, maybe they have a loved one who got a heart had a heart attack, maybe they’re nearing the age that a parent got very sick or passed away. So I almost feel like there has to be some pain point oftentimes to get them motivated enough to make those changes. But I am a believer that if we can get more healthcare professionals embracing the intermittent fasting concept, it will make the world a much better place and unfortunately, as I’m sure you see, as well, there are a lot of healthcare providers that are they themselves are very unhealthy. It’s hard to take diet and nutrition advice from someone who is metabolically unhealthy themselves. You know, I used to laugh there was a emergency room that it worked out in Baltimore years ago. And the joke at this time, it tells you how long ago this was. Physicians could still smoke on property and so the cardiovascular surgeons would sit outside have their fried chicken and smoke And I see saving them like, what type of example are you setting for your patients, you’re telling them not to smoke, and then they see you smoking. So we really do need to be an example to our patients for sure.

Dr. Mindy
So I’m laughing because I think what we’re gonna do when this episode comes out, we’re gonna make a little square that says, Your grown ass adult stops sucking. And we’ll call you on it to do well make that it’s it’s, you know, it’s really true. Here’s what I hear. And everything that you’re saying is that if I have a diagnosis, then my motivation to push through the pain of not set snacking will be higher. But what do we do with those people in the middle where, you know, the motivation isn’t as high and I maybe I’m just losing some energy, I don’t have the brain function I used to have maybe I just want to lose some weight. Are there tricks we can give those people for when they take the snacks out? And now they’re hungry? How do we help those people?

CYNTHIA THURLOW
I think that it’s meeting people where they are it’s finding what are they willing to compromise on? Some people might be willing to take their for example, they may be willing to swap out their sugar sweetened soda for a non a non sugar option, they may be willing, and I think you just capitalize on what one change can you do today, maybe it’s not snacking after meal times, maybe it’s having a salad with their lunch with a piece of protein, I mean, trying to really meet them where they are, because I find that when people aren’t quite as motivated, I’ll say, let’s pick one thing, like, and it’s always with their input, because I could give them 100 options, and then they’re just overwhelmed. So so you know, give them five or six options, what one of these sounds the most appealing, and I usually go with that. And it’s almost like peeling an onion, you get an onion layer back, and they feel so much better. They’re like, okay, now I’m willing to do the next thing. And the next thing and the next thing. And I think more often than not, even if people are not willing to change their diet, just eating less frequently, they feel so much better. All of a sudden, they’re not bloated, their digestion is improved. They don’t need their reflux medication, right. They’re sleeping without symptoms.

Dr. Mindy
So they see the changes. Yes, yeah. So that makes a big. Okay, so in the meals, so they take snacks out. Now, are they eating three meals a day? And if so, is there are there foods that they can lean into, that will make like the next day easier? And then the next day easier?

CYNTHIA THURLOW
Yeah, I think animal based protein is going to be what I’m going to recommend. I know that there are probably some plant based individuals listening, but we know that that is the most satiating macronutrient, we want to have sufficient amounts of protein. And I tend to be someone that will say to clients, like have that piece of salmon because you’ve got your healthy fats right in the salmon that is gonna be much more satiating than a dry chicken breast, you’re probably going to feel a whole lot more satisfied. So really leaning into making sure that you’re hitting those protein macros, and not to be afraid of protein. And unfortunately, I think there are people who have been conditioned to believe that, you know, I don’t want to eat more protein because I’ll be too full Well, no, generally speaking, it’s the most satiating macronutrient. And it’s very easy for people to overdo it with healthy fats. So, you know, the cheese and nuts brigade like that is that is like the bane of my existence, trying to encourage people, yes, healthy fats are good, but you can overdo it on the healthy fat. So really encouraging people to have proper portions. And that could look different for each one of us proper portions of proteins, that will be fully satiated. And when they’re hitting those protein thresholds. They’re not going to be hungry between their meals. And that’s something that I think for a lot of people is surprised and they’ve been so carb dense. You know, they’ve been focusing on rice and pasta and I always say, listen, protein healthy fats first, and then you know, the carbs should really come from non starchy options. Yeah, not to suggest I’m anti carb, but if we know 88% of the population is metabolically unstable, we all need to be eating less carbohydrates. And that’s the unfortunate truth. And that’s not to suggest I don’t enjoy berries on occasion, or I don’t have spaghetti squash or a root vegetable, but my portions are small. And I don’t do that every day. And I think that for anyone that’s listening saying, Okay, that sounds reasonable. I can have a fattier cut of meat that’s going to give me to, you know, give me a great bang for the buck, if you will, or a piece of fatty fish. And I think when people start making those cumulative changes, it’s the domino effect. Now are there people who have struggled to make any changes? Yes. And I think a lot of that involves, you know, really doing some soul searching really thinking about what are they ready for what what are they capable of making a change with and it might actually not start with the meal frequency, and the food piece and maybe that they’re going to go to bed earlier. You know, you I know you talk very, very openly as I do about the the value of high quality sleep, the value of moving your body everyday connection to nature. It’s like, okay, let’s let’s come out from a different angle, like what is reasonable and feasible for you right now, especially as people are starting to return to work again, what what are you capable of doing? And let’s really focus on you know, the positives, like, what can we do right now? It’s never I always say like, let’s reframe. When people say they can’t do something, I’m like, Okay, what can we do? Because there’s always something we can do. It’s just, it’s a choice.

Dr. Mindy
I think, also, do you find that people the way we’re living right now in the modern world is so out of alignment with how the human body was designed. I had an aha a couple years ago of like, if you just think about the telephone when I was in high school, my sister and I were so excited because we could get a telephone with a really long cord around the whole house, with our rotary phone that had this long cord. And now I’ve got a phone sitting next to me. But so we’ve had all these advances in technology, but we’re living in the same body that our cave ancestors lived in. Yeah. But we’re treating it drastically different. So do you find that when you get people fasting, you’re really reconnecting them to the way that their body was designed to be? So the easier the more they do these principles, the easier it gets?

CYNTHIA THURLOW
Yeah, absolutely. And I, again, I think it’s that domino effect that, you know, one good decision begets another good decision, you know, they they stop eating the same meal frequency, they change their macros, they start losing a little bit of weight that encourages them further, they’re more interested in when I say, you know, get outside and get some light exposure in the morning, you know, you want to be thinking about sleep in the morning, and not just at night. And they’re more receptive to it, because they’re like, you know what, that sounds a little crazy. But I’m willing to do that, because I feel so much better. And I do agree with you that when we really look at ancestral health patterns, we went to bed when it was dark, and we got up when a sun came out. And we’re now in an existence where we are stimulated 24 seven, you know, it’s not like when you and I were growing up, and the TV would shut off at one o’clock in the morning, and there was no, there’s no programming until the morning. Yeah, now there, it’s an endless summer, we can, you know, be exposed and bathed in artificial light all day long, all night long. And it’s so completely the antithesis of the way that our bodies are designed to thrive. And I think that’s a huge detriment and just thinking, you know, you’re mentioning your phone, I have my phone and my iPad sitting next to me and I’m on I’m on a computer. Just thinking about the cumulative Net Impact of all this exposure to blue light all day long. And what it does to you know, suppresses melatonin and for me I’m on the East Coast so I’m a couple hours rides

Dr. Mindy
nighttime there, oh bus or the dark right now I feel like I’m just warming up

CYNTHIA THURLOW
amazing how that works, but really goes against the way that our bodies are designed to thrive. And so I think when we are more aligned with that, it just makes sense. Like, the cravings go away, we lose a little bit of weight, we sleep better, we have better interpersonal personal, you know, skills, we’re making a bigger effort to connect with nature and these things seems so simplistic, but it’s really that’s the basics. That’s really what’s most important. Not a lot of other noise and flash that goes on in our lives that it really kind of, you know, detract it really distracts us from what’s truly important.

Dr. Mindy
Yeah, yeah, I was we also had to wait a whole week before the next episode of something came out. So parents knew

CYNTHIA THURLOW
instant gratification of bingeing on TV shows, they’re trying to explain it to my kids, my teenagers were like, what? And I was like, there was no Netflix or Hulu, or Amazon Prime, you just sucked it up. And that’s just the way things were. But I said, I also think that is, you know, to me, it’s so highly indicative of, you know, a time when our lives are a little slower, and not in a bad way. You know, there was no email when I was in college and really dating myself. There was no email we would I was in a big sorority, and we would have a communication patter. We leave notes for people, I’m sure that’s not even done any more. There was no female. I mean, I think about this now I’m like, it really was a sweet time. Not everything was captured on social media, we probably had a bit more privacy. And that’s not necessarily a bad thing,

Dr. Mindy
but a great so before we jump into women and fasting, which we’ve got to talk about, how long do you think it takes somebody to go from I’m eating eight times a day, I’m eating before I go to bed, I eat when I wake up. I’m eating standard American diet. Now I’m not snacking. Okay, now I’m changing my proteins. Okay, now I’m intermittent fasting, like, what does that trajectory look like?

CYNTHIA THURLOW
Um, I think it can take a couple months. I don’t. And I want to be really clear. I think people are accustomed to instantaneous gratification. You know, they, they buy the latest protein powder, they buy the latest Gizmo that’s going to fix them in a week or two. Yeah. And so having a degree of patience and explaining to them this is the long game. This is not a quick fix. This is The long game and unfortunately, in our diet focused, obsessed culture, that can be a little unsettling for people. But I think once they understand that this is a journey, not a race, then they are apt to be much more successful. But you have to set those expectations almost immediately. And I think even more so for women, because I’m sure you have the same scenario, women come to intermittent fasting because they want to change their body composition, they want to lose weight. And when that doesn’t happen instantaneously, they’re instantly they want to be mad, they want to be angry, they want to be upset with someone and I just remind them like, Listen, it’s that onion analogy, I hate to use the onion analogy, but it really is it’s peeling back layers, and some people it is going to require more effort and more time to be able to see those kinds of results. And that doesn’t mean you’re not doing benefits for your body. So I think it’s Yeah, the constant kind of reframing so that we understand that weight loss. Weight loss is important. But it’s also like all the other things that are happening in our body that maybe we don’t see that are probably more important. We were looking for the exterior validation, and really the interior validation of what’s going on. And the benefits we’re doing is really what’s most important.

Dr. Mindy
Yeah, it feels a little bit like when I listen to women, it’s like they’ve they’ve been burned by a boyfriend over and over and over again, they’ve been burned by a diet over and over again. So if the results not there quick enough, they’re quick to make, go back into that amygdala brain and be like, hey, this isn’t going to work. So have you ever seen it not just so weak? I’m very curious, your thought on this? Have you ever seen fasting not work for somebody? Yes. Oh, absolutely.

CYNTHIA THURLOW
And that’s usually because of specific reasons. It can be gut health, it can be sleep quality, and I’m sure you have these women to their sleep is terrible. And what do they want to do they want to they think if they fast, longer, and they eat less food, and they over exercise, they’re going to make that process easier. And so I would say, Okay, let’s dial back, let’s figure this out. There are probably 10 things that I can think of, and I’m sure they’re the same things that you think about, that can hinder someone’s ability to lose weight. And it could be as simple as your hormones, which we know weight loss is all about hormones. Yeah, it could be toxins you’re exposed to it could be, you know, you find out your leptin is 20 Well, guess what, if you’re insulin resistant, and you’re leptin resistant, that’s going to make that more challenging, and maybe your body in response to a toxin exposure, like mold, is trying to protect you. And so it’s really acknowledging that it might not be as easy as just fast, we may have to do testing, you may have to work with a specialist, you may have to change medication, you may have to do a variety of different things. And I tell people all the time, if I and I’m sure you’re the same way, if someone sat down with me, and I talked about the journey of fasting, I would say it’s not a straight line, it’s like you go one direction, and down and up and down, and up and down. And that is that I think that’s more common than women talk about,

Dr. Mindy
Okay, we got to dive into women and fasting, because I think that’s what everybody’s gonna want to hear. And women need to do it different. So now that we’ve kind of thought about, okay, how do we help somebody gets out of the standard American diet, we get them into intermittent fasting. Now, how do we help the women? What do women need to know about fasting that is different than what men need to do?

CYNTHIA THURLOW
Yeah, I mean, I think the first thing is just acknowledging that we have a whole lot more hormone flocks than they do, you know, up until we, you know, go into menopause, and we have 12 months of no longer having cycles, I think it’s important for women to really take advantage of periods of time, no pun intended, of the month where they can fast and they can do it effortlessly, and they probably have more energy, and they probably can do a harder workout, and they might be able to push the envelope with their nutrition. And then there are times during our cycle where we have to back off. And intuitively The thing I find amazing, even this happens with my health care professional friends, I’ll get a text Oh my God, I can barely get to 14 hours. I’m like, Where are you in your cycle? Um, just to get my cycle tomorrow, right? Bingo. So your body will intuitively let you know when you’re doing too much. You know, I would say you know, the beautiful thing about hormetic stress is that too much of any one thing is not a good thing. So first and foremost, we have to acknowledge where we are in our cycle and you know, capitalize on where we are and then you know, acknowledge that we probably have a week, every cycle if we’ve got 28 or 30 day cycles, that we shouldn’t be fasting that doesn’t mean you don’t have digestive rest. That doesn’t mean that you don’t go 12 hours you know, you go from eating dinner to eating breakfast in the morning, but enjoy that five or seven days. I think that’s you know, the first thing and I would say the second thing always kind of pertains your perimenopause is a weird time. Yes, it is. Oh, Your time. I think you and I have both openly talked about how we you know, at least for me, I hit perimenopause, like I hit a wall. I was at a western medicine trained NP. No one’s ever talked to me about what this is. I mean, I remember I looked in the eye was like, I went back and look through my because I’m a dork and I still have some of my medical textbooks. And I was like, there’s no mention of perimenopause. It’s like you have a cycle. And then you stop having a cycle. There’s no in between. Yeah. And I think it’s acknowledging that expect the unexpected that you know, when you go into perimenopause, some people have a breezy time. Although let’s be honest, that’s probably not most people. But all of a sudden, you realize what you did before doesn’t work for you anymore. Yeah, you know, hardcore exercise, the not getting enough sleep, the out of control stress. And so I think it’s mother nature’s way of forcing us to slow down a little bit to be a little more introspective. And, and so many levels. I think perimenopause is also this time where we’re sandwiched between your kids are a little older, your parents are a little older, you know, you’re probably you know, accelerating if you’re if you’re working outside the home. As moms, we always have at least one if not two jobs. You know, it’s it’s a lot to manage, and we just don’t, we aren’t as resilient with stress. And it’s just acknowledging that the better we take care of ourselves, and perimenopause and this is the theme of what I’m trying to say, the better we take care of ourselves in perimenopause, the easier that transition into menopause will be. And I think, unfortunately, a lot of women and there’s a huge and I’m not anti white, let me be clear, I think that having a nice glass of wine is a wonderful thing. But there’s this wine culture. And I think on many levels, women start drinking more wine during this period, because on many levels, they’re not sleeping as well. They’re stressed, they’re starting to gain a little bit of weight. They don’t understand why they’re like, Okay, I’m just going to eat less food, I’m going to exercise harder. And I’m not going to go to bed when I need to because I have to catch up on all the things. And it’s a recipe for disaster. I’m not sure that for you with your you know, with your clients as well. But I tell people I use perimenopause is a barometer for how well someone’s taking care of themselves. Because if someone’s having hot flashes and doesn’t sleep every single night, and they put on 30 pounds, and they’ve got terrible brain fog, I always say, you know, let’s think back to what do these hormones do? It’s like reverse puberty, but it’s almost cruel, because you don’t know it’s coming. You know, we all go through puberty, and we accept that there are all these changes that go on with our bodies, but we’re also working towards something whereas we’re, you know, kind of do climb the hill. And now we’re on the backside of the hill. And it’s not to suggest that women can’t thrive in perimenopause and menopause, but we don’t as healthcare providers do a good job of educating women about what is to come. And I agree, I think that really does women a huge disservice.

Dr. Mindy
Yeah, somebody I was at a conference a couple weeks ago, speaking, and the guy came up to me afterwards, and was really adamant about disagreeing with me around HRT and bio identicals. And I said, for me, I’m just saying, for me, I need the barometer of my hormones to know if my lifestyle is working or not. So I prefer to not do HRT and bioidenticals, just for me, because I would like to use my lifestyle to be able to tell me if I need to course correct or not. Do you? Are you finding the same thing since we’re on the perimenopause? And again, this is not like I think everybody should do what feels right for them. Right. I do not think HRT or bioidenticals is a free pass to not working on your lifestyle. But I think we all have to figure out our own comfort level. And then make sure we don’t numb ourselves out by using medications like that. What what are your thoughts on that?

CYNTHIA THURLOW
No, I think that’s an excellent point. And I’d be the first person to say, all the hormones in the world are not going to help you, if you aren’t willing to put in the work about proper sleep, and nutrition and eating less often and not over exercising, and for full transparency. And I don’t I haven’t talked a lot about this on social media yet, but I think it’s important to be fully transparent with your listeners. Two years ago, I got very sick and lost a bunch of weight. And that kind of threw me into early menopause. I didn’t realize it at the time, but certainly earlier than I had expected. So I haven’t had a period since December of 2018. And I was not mentally prepared to go into menopause so early. And initially I was even though I was doing all the right things. I was like, I’m not sure what I want to do. And then for me personally, some things started to shift. I had a dexa scan done I was already osteopenic you know, thin Caucasian woman with a genetic susceptibility and I already left and I already plenty of protein and I already do wait but I mean, I’m doing all the things. And then it was you know, I started having some personal disclosure. Some women are more susceptible To the loss of estrogen in certain parts of their body. And so that was number two. And then my sleep quality, no matter what I did, was really suffering and it was becoming a problem. So for me, I made the decision to start HRT, and almost instantly my, my sleep improved, like 150%, that was the first indication for me that I was kind of on the right path. And then taking estrogen and testosterone, I just felt so much better. Like I didn’t realize I had had an ache and a knee from an injury from field hockey, you know, 30 plus years ago, but all of a sudden, I felt better, but much to your point, if you don’t get the lifestyle piece dialed in, it is going to make it impossible. And what happens for so many women is they start with hormones. And again, we’re not anti hormone, it’s really about what works for you and have a conversation with your provider. But if you start with hormones, typically what happens is you haven’t done all the other bait like the foundational work. And then what happens is someone comes in, they’re like, I went on, you know, estrogen patch, and some progesterone and I gained 20 pounds. And I don’t doubt that happens. I mean, there’s clearly but it also speaks to a hormone imbalance. And it also speaks to the fact that there’s, I mean, so much to unpack there that could potentially be happening, but I was like, You can’t put the cart before the horse, you really have to do the foundational work to ensure that your body is ready to accept that replacement of hormones. And for every one of us, it might look completely different. And I think that’s also important. Like I don’t like to see shaming on either side. And I do see some of that I see shaming by the people taking the hormones of people not taking the hormones, or I have women that are so terrified to take any hormone, even progesterone, they’re terrified. And I’m like, I don’t want anyone to be scared. You just need to be educated. And that’s great. I think so much of our role. I think that’s what women are women are hoping and praying that we’re going to be honest and open. And for me, I think the thing I struggled with the most Monday of all, I was so ashamed of paramount pause. I remember thinking, I didn’t want to talk about it. I was so embarrassed. And I was like, why is this happening? I’m a very open, honest, gosh, I’m a health care professional. And for God’s sakes, I should be able to talk about these things. And then I felt the shame to be able to say I’m no longer getting a menstrual cycle, not because of the HPS. But it just suicidally, it’s like somehow there’s this thought process that women of a certain age, you know, the lack of fertility, whatever it is, we don’t want to talk about it. And yet, what that tells me is that we need to be talking Oh, yeah. the good, the bad, the ugly, and I’ll be happy to, you know, tell anyone the bad, the ugly, but really being in an environment where women feel like, let’s do the Kumbaya. Let’s talk about these things, so that other women don’t feel ashamed. So other women aren’t feeling uncomfortable. And maybe it’s because I live in such a conservative part of the country. You know, I jokingly say, there’s a lovely woman that I’ve become friends with. And she is, you know, one of those menopause people that’s, you know, doing a great job educating women. And jokingly, she talks a lot about the Dr. vagina issue. And I jokingly always say, like, I love that you are comfortable talking about the things that even some healthcare professionals don’t want to talk about this the reality when you take hormones away. For some people, they’re going to have more symptoms than others. But I am happy to say that I’m in a position now where I don’t get a hot flash, I sleep better, I feel good. And so therefore, for me, at this point, in my life, this is working well. But much to your point, you have to do the foundational work, because if you don’t do that, first, you are not going to have a good, you know, like long term result, you just won’t.

Dr. Mindy
I think it’s the same with all hormones. I mean, thyroid, you can say the same thing. You know, we have this understanding that medication is going to cure it. And I feel like one of the the concepts I’ve been wanting to bring to the surface is this idea of lifestyle medicine. So we’ve got, you know, allopathic traditional medicine, we have alternative medicine, and we have lifestyle medicine. So if you choose to do HRT, like you said, it’s like, awesome. And let’s still work on our lifestyle medicine, and that you compare with anything. And I don’t feel like that discussion happens enough, especially for women, because we’re the ones that are dealing with so much so many hormonal problems.

CYNTHIA THURLOW
Yeah. And I think I think it’s really important for us to talk about the fact that there is this. I don’t want to use the term lack of consensus, but I do feel like there’s a lack of consensus in terms of looking at like a traditional allopathic perspective, looking at an alternative perspective. I like to look at it like we just need to marry it all together. You know, the lifestyle medicine piece should be part of preventative health care. Yeah, I was talking clinically trained as a primary care and P but I never actually practice as a primary care MP because I was in the hospital dealing with sick assisting people, which I loved at the time. But the point is, is that we don’t have the opportunities to be able to have these conversations. And yet, I feel so grateful. And I know you do as well to be to have a platform where you can actually, you know, be the voice for people who maybe don’t have the ability to, you know, connect with individuals that are going to be able to share openly and honestly, because I think Unfortunately, the way that the kind of allopathic medical route is going is shorter appointments, you get one problem that we can discuss, your your your options are going to be whatever has been done in a randomized, double placebo controlled study. And if it falls outside of that, it’s not evidence based, it doesn’t work, which always makes me which kind of gets me even though I’m returning to big research institution always is a source of irritation for me, because I’m like, you know, life is messy. It’s not convenient. Yeah. And have an anecdotal evidence of I’ve worked with 1000s of women, do I necessarily find a lot of trials that represent women and fasting? No. Does that mean we don’t know what we’re talking about? Absolutely not. And so, you know, on many levels, I think we need to get out of our own way. I think it’s so critically important that we be the voice so that, you know, we have opportunities to connect people to get information and to stop being so fixated on variables that are not realistic. And that’s, that’s a whole other

Dr. Mindy
stretch. That’s a whole nother Yeah, another podcast. Let’s do that. Let’s do this. So for women who have a cycle, and this would be really fun just for me to do this with somebody who has looked at the fasting research and looked at women’s hormone as in depth as I have, I think you may be the only other person on the planet that has looked at this as closely. Let’s go through the different phases of a woman’s menstrual cycle. And I, and because I really, when I started to understand fasting, I was like, okay, so estrogen when estrogen comes in, it does really well, when we’re insulin sensitive. Okay, testosterone will the studies on testosterone when testosterone comes in, it needs a really it does well with with a longer fast in men, we know that, but we don’t know this in women. And we know that estrogen needs to be broken down by the gut microbiome. And you start to just look at the whole cycle and see what the needs of women are. So So let’s start through the different phases and kind of break down what are some of the foods what are some of the fast? What are some of the considerations we would make? So starting with day one? What do you think that first section we need to focus on?

CYNTHIA THURLOW
Yeah, so day one is when you start bleeding, and for some people that could be heavy, some other people, it could be light. And so this is when you can start fasting again. And this is the point in your cycle where you have estrogen to, you know, provide this buffering and so you can do longer fasts that might be a time that you’re going to do a 24 hour fast. Maybe one day out of the week, you identify a Thursday is gonna be my 24 hour fast day. And maybe the rest of the week, you’re cycling between 16 or 20 hour fast depending on what works for you. You’re able to go to the gym, you’re able to push your workouts, you know, when we have more circulating estrogen. I’m a huge proponent of cruciferous vegetables. I always tell people that you know, brussel sprouts are your friend. Maybe not kale. I think it depends on the individual

Dr. Mindy
kale a bad day. I

CYNTHIA THURLOW
know I know. It’s funny. I I have a colleague who calls kale killer kale just because of the oxalate load and so I was doing my individuality. Terry Cochrane okay. Yeah. So you know, really looking at those cruciferous vegetables if we know your you know, we want to make sure you’re having a healthy productive bowel movement every day. I always suggesting sometimes we can add in some fresh ground flaxseed if we know that you’re metabolizing your estrogen properly. And you alluded to the estro bolong, which is a horrible name.

Unknown Speaker
It’s a horrible name. Yeah,

CYNTHIA THURLOW
I always say like, I stumble over it. I like I

Dr. Mindy
got the Astra below. I might get an Astra below and then everybody calls it something different. I’m like, whatever it is, it breaks down after again.

CYNTHIA THURLOW
Yeah, I said and so you know, really focusing in on you know, liver support. You know, I think about beets and dandelion greens and, you know, bitter greens, which I always say, depending on the individual, you may or may not tolerate a lot of these but put them in toss a little bit in a salad and, you know, throw in some beets, but really focusing in on helping to package up that extra estrogen that we know is you know, can recirculate and we don’t want that to happen. Yeah. You know, there are two main sites of estrogen detoxification starts in the liver and then ends in the gut. And so if you’re not having a bowel movement every day, that is that something you need to definitely work on. And so during this follicular phase when our body is, you know, kind of getting closer to ovulation gives you more flexibility. This is again a time in your psyche, you may have more energy, you have the ability to, you know, do longer fasts, and then you get closer to ovulation really depends on the individual, in terms of you’re getting these fluctuations of estrogen and progesterone, your libido may pick up, you may feel like you know, you can kind of get away with being a little more sassy. You may wear something more revealing, you know, whatever type of pheromones are being produced in our bodies, you may be more attracted to your partner or your significant other. And then, you know, and I’m oversimplifying, and then you kind of ebb and flow into the luteal phase after ovulation.

Dr. Mindy
Can we stop at ovulation for a minute? Because I have a, I have a question on this, because I’ve been thinking about this a lot. So what fascinates me about oscillation is it’s really the major time that we get testosterone. And I’ve thought a lot about this. I actually talked to Carrie Jones about this. I was like, so does that mean, I mean, there can be a mismatch of testosterone in all different types of couples. But when we look at the fasting research, you know, that shows 13 100% increase in men that do intermittent fasting 2,000% increase in testosterone, if you do a 24 hour fast, do you think we can look at a study like that, and like, use it as a tool to say, okay, women, when you’re an oscillation, if you want to increase testosterone, that might be a time to go into more of a 24 hour fast.

CYNTHIA THURLOW
I think that’s really interesting. And, you know, testosterone is one of these hormones that depending on the individual, certainly, if someone is more prone to like, pcls, if they’ve got more circulating testosterone, I mean, it would be interesting to kind of look at the involvement of, you know, insulin resistance, which you know, can also impact testosterone levels. So, yeah, I mean, intrinsically, and empirically, I think that seems very reasonable, especially because the whole concept of ovulation, your body really wants to fertilize an egg. So make sense that your libidos is is kind of waxing and waning, and your testosterone levels that were up that would certainly be really interesting. And this is the kind of stuff that drives me crazy is that there’s this fear mongering that goes on about menstruating women and how they shouldn’t fast and and i think of a couple people in particular, which I will remain unnamed during this conversation. But I think it’s really important, like how do we really know the net impact because we are not lab animals. And you know, the the gestational cycle of a rat is very different than a human being. And that’s another thing like people say, oh, but this study, blah, blah, blah. I’m like, No, but like a rat can have a litter of rodents. I don’t know. It’s like they have a very short gestational cycle. So how can you extrapolate that and say that, because this happens in rats, that we extrapolate it to humans? So really looking at the research, but I think that there’s not enough research being done on women throughout their cycle? And that is to our detriment? Because we really don’t know we just have people that are surmising and making assumptions, are they cherry pick a study and they say, Oh, kisspeptin is impacted, and therefore this is bad. And that I always find really troubling. And so I’m sure you’re very savvy listeners already know that the bulk of the research has been done on men, lab animals and menopausal obese females and kind of in between as everyone else. But I do I do think that’s a great question.

Dr. Mindy
Yeah. And do you think that it gets us in the ballpark? When we look at a mouse study versus an a mat and a male study? Like, do you feel like, Well, it’s interesting, it gets us in the ballpark. It’s not a woman study. But at least I mean, testosterone is one that I have really analyzed over and over again, because I think it’s so fascinating that we really get one big blurb of it, and then we don’t get a lot the rest of I think there’s a lot of marriages that might have been might be healed if they understood that. So but then the male studies are so encouraging. So the way my brain thinks is, well, it gets us in the ballpark. It’s not a woman study, but it does help us sort of get an idea of what might be possible. Do you think that that is a truism? Or like, would you disagree?

CYNTHIA THURLOW
I think that’s reasonable. But again, like thinking back to the statistic that if 88% of the population is metabolically unhealthy, and I start thinking they’re leaning towards insulin resistance, which means they’re going to have imbalances between estrogen and testosterone to begin with. It’s like let’s think about the 12% of the population that is metabolically healthy. And yes, I do think that that is a great way of reflecting on testosterone. It also explains like when testosterone is high, we feel sexy. We want to get back Yeah, you know, it makes complete sense. You know why that would happen at that point during our menstrual cycle, but also explains why you know, when that drops rather precipitously, people aren’t we’re kind of like yeah, whatever, right mom?

Dr. Mindy
Yeah, you know, that’s why I’m like I think everybody should like every couple, their partner should have their track their menstrual cycle and then you would understand so much about your your Partner So, but go ahead continue on. I just that was just something that I’ve recently been geeking out on. And I’m like, Yeah, and it’s you know, I’ve looked at so much fasting research that I’m like, I got to ask Cynthia this because you’ve done same.

CYNTHIA THURLOW
That’s a great so so we oscillate or not. And then the next transitional phase is into the luteal phase. And you know, in the beginning estrogen progesterone are lower. But over the course of the luteal phase, you’ll get your highest levels of progesterone and progesterone is the it’s a good hormone, it’s meant to mellow us out. You might not be able to know

Dr. Mindy
Daisy hormone. What do you mean? It’s a good one. It’s like I, I want it I love just,

CYNTHIA THURLOW
I love progesterone. It makes me fall asleep at night. It’s really nice. It feels so good. Yeah, no. So progesterone is like our mellow. I always say it’s like, I think about my earthy, I have a wonderful and who’s just chill and relaxed and just so earthy, and she’s loving and warm. And it’s just you know, it’s like a big hug. Yeah, well, I think I think about progesterone, it’s designed to kind of slow us down a little bit, we might feel more bloated, we, you know, certainly might be in a position. And we know as we get closer to menstruation, I think it’s between 100 150 more calories per day. And so we become producer makes us a little more insulin resistant. So this is when we have all those cravings, and I marvel at the human body and how these desires and cravings aren’t there just because they’re either related to an unmet need, or it is really because our body is looking for a little bit more. I know that, you know, when I think about increasing carbohydrate intake around the menstrual cycle, I like the whole food carbohydrates, like I usually say, I’d rather you have a sweet potato, or, or some squash, as opposed to going nuts with a lot of grains and a lot of gluten and unfortunately, what do we gravitate towards? We’re really grabbed like, we’ll have like chocolate cake, and we want a pie and we want a cookie. And that’s just a disaster. You know, we already are a little, we’re at that point where becoming a little more insulin was, you know, insulin resistant, you got to be careful. And that’s when people will just say like, I’m bloated and I’m tired. And I’m grumpy. And, you know, I have a couple women that I’m working with right now they’ll say, okay, let, let’s try for the five to seven days preceding your menstrual cycle, let’s try something different. And inevitably, increasing their their portion. So let’s say they have a little more sweet potato, and they put some butter on that sweet potato or some ghee, all of a sudden, they’re satiated, they feel great, their sleep improves. They feel a whole lot better. But the bloating can definitely end because there’s this slight anti diuretic impact of progesterone. So it’s not at all uncommon that people can have not only can they feel bloated, but they can also have like loose stools. And ironically, my GYN pointed out to me that a lot of times when women have loose stools, right before their menstrual cycle, it’s actually because of the position of their uterus, which I never knew before. That’s like, amazing, yeah,

Dr. Mindy
our bodies are amazing. Yeah, the body

CYNTHIA THURLOW
is amazing. But this is also when you may want to do yoga, and you may want to do walking in nature, you’re just not going to feel as motivated to do these hardcore hit exercises are heavy strength training, and it’s not in your head. It’s not a lack of motivation. I think it’s really validating to know that our bodies running things that way, because in an ideal circumstance, that it gets fertilized, and now your body is kind of creating this ovum and is getting ready to, you know, put you in a position where you’re going to have this pregnancy. And so the one thing that I find really interesting, and I had a woman yesterday, I was looking at her touch, and I suspected she had PCs just based on polycystic ovarian syndrome, just based on what she had shared with me about her pregnancies and how she had trouble conceiving. I was like she probably has a luteal phase defect. And sure enough, her progesterone was very low. And so you know, I think because your androgen levels or testosterone levels were higher than they should have been. And I was explaining to her, I said, you probably have never had someone explained this to you. But when your progesterone levels don’t ever get high enough, your body’s not in a position where it’s going to want to have a healthy pregnancy. I mean, you’re going to be in a position where you might just have a later period because you know, you have this minor miscarriage but you’re not even aware of it, where your body’s just not optimally balanced. And I think the big thing when we’re talking about sex hormones, it’s all about balance. You know, it’s not an all or nothing phenomenon. Yes, progesterone predominates in the second half of the menstrual cycle. Yes, estrogen predominates in the beginning, when we’re a little more insulin sensitive, we can get away with a whole lot more and I always feel like progesterone just reminds us that we have to be grounded and balanced. Now critically important that is, and not enough is talked about, like I am sure maybe it was different in your house. My mom was a nurse but I don’t think I ever learned all the nuances of the menstrual cycle until I was a whole lot older like way beyond what I should have known. I just kind of You know, manipulated my my periods with oral contraceptives because my periods were never regular. And you know, didn’t think anything of it. And so I decided to come off oral contraceptives and I was like, Oh, I don’t think I’ve ever had a regular cycle in my entire life. Yeah, but it’s endlessly fascinating.

Dr. Mindy
What do you what do you think? Are you finding with women that the more a woman fast, the more she wants to fast there becomes like this craving to fast even longer? And do you feel like there’s a benefit to women going into three day water fasts and doing those? Or do you think women should avoid all that?

CYNTHIA THURLOW
Uh, well, I think it depends on someone’s goals. I think if you’re a lean female already at your goal weight, and you’re cycling, you know, it’s the law of diminishing returns, I tend to be I err a little bit more conservatively and say if you’re, you know, 24 hours or less, I think it’s fine. I think when we’re doing these really long fasts, and you’re already lean, I think it can put your body in a state where it’s that hormetic stressor can be a little bit too much. I think that you really have to think strategically, what are your goals? Are you already lean, and if you’re already lean, it makes it a little more challenging to make things a little more challenging to do those prolonged fast, but I find that most people do have weight to lose, or they do have body composition changes. And so can they get away with an every other day fast? Can they get away with a two or three day water fast? Yes. You know, I think that when you’re perimenopausal transitioning into menopause, I think sometimes that might be the easiest. And yes, I do think women get to a point where they’re like, I get a lot of like, I’m not hungry. And I’m like, okay, that’s a problem, you know, you should get hungry at some point, you should get hungry. If not, then we have other things we need to work on. But I do think women can get into a mindset where they’re, like, have a little bit of fasting works, I want to do more, a little bit of fasting works, I want to do a whole lot more. And so I always say like, it’s really checking in with yourself. If you’re still getting your period and you fast for a long time and your cycles get wonky, it’s a sign it’s too much. If you no longer have cycles, and you’re able to sleep through the night and you feel good, your energy is great. If you’re perimenopausal it really depends on the individual. And sometimes I think people don’t know until they experiment and there’s nothing wrong with experimentation. Yeah, um, I think it’s so nuanced with women. That’s what I always say. Like, I wish I could say, if you’re 47 to 52, you know, 46 to 36. And this is what you’re going to expect. And it’s you know, we’re all our own individuals. And so they’re trying to pry provide parameters, I always say like men and postmenopausal women, it’s a little more predictable, but everything else in between, it’s like all bets are off. But I do find that women can almost get, I don’t use the term addicted because that’s the wrong terminology. But I think people can get preoccupied and be in a position where they’re excessively focusing on a per separating over, you know, if a little bit of fasting words that I want to do a lot more fasting.

Dr. Mindy
Yeah. Yeah. And I, you know, I think, yeah, there’s so many wonderful benefits of fasting, but women need to cycle it so much more. And if you’re not aware of that, that can be a problem. One other thought, and then I have a couple questions for you here at the end. What do you think and this is just purely like a fun, a fun question. What do you think about men? There’s so many men on social media, writing books, that are giving fasting advice? Do you feel like we’re we’re women are being left out of the conversation. And and let me give you the example that I thought of was, when Dave wrote his book, I thought, you know, it’s a great book. He’s got lots of bio hacks. He’s dedicated a chapter to women. And the first thing and I love Dave, this is not a you know, Dave, if you’re listening is not a nada, nada, criticism, but I feel like women continue to be guided by male doctors, male health influencers. And until you’ve lived in a woman’s body, and you’ve looked at the science, it’s very difficult to understand the nuance that women need. Do you feel like we’re missing leaders in the fast scan world? Yes,

CYNTHIA THURLOW
I do. And I think, from the same token that as a woman, I can’t speak definitively on what it’s like for a man to fast and unfortunately, feel like there are a lot of emerging or emergent male experts in this space and not as many women and I don’t know if that’s because we’ve, some women have just chosen to focus on other areas in anti aging or regenerative medicine and things like that. But I do feel like women want to hear from women. You want to have an understanding of what it’s like. And I think it’s also critically important they have women that are not 22. Yeah, talking about fasting because I will be the first person to say what I did in my 20s. And what I did in my 30s is very different than what I’ve been doing, and my Our endeavors and I would not at 49 be able to speak on what I can now, had I not experienced what went on from 37 to 49. And so I think, you know, being middle aged women, we’ve lived long enough to be able to say, Hey, I know what it’s like in your 20s and 30s, and 40s. And now,

Dr. Mindy
guys, you can just say it were really, really wise. When said

CYNTHIA THURLOW
mature the other day, they were like, I think what you’re trying to speak to as mature women, and I said, Sure, I was

Dr. Mindy
thinking you just come a middle age. Wait a second, I’m not middle age.

CYNTHIA THURLOW
But think of it this way, if the average individual lives into their 80s, like, when you hit 40, really, technically, that’s weird, but that’s okay. I mean, there’s no, there’s no judgment. In that terminology. It’s hard to say like, I’m not I’m not like, I don’t consider I consider myself youthful. I consider myself wise. But I think in many ways, it’s like, you know, how do you find a way to describe where we are life wise without like, doing a stamp label, and it’s like, you know, the, here’s the stamp, and this is what you fit into, this is the bucket you fit into now. But I really agree that there is not enough women, leaders talking about fasting, and I think it’s not to suggest that there aren’t individuals, whether they’re biohackers, or physicians, etc, that are incredibly knowledgeable, and, you know, they might know nuances that I’m unaware of, but I feel like women need to be leading women when it comes to talking about fasting strategies, in many ways, because we know what it’s like to have a menstrual cycle. We know what it’s like to be pregnant, we know what it’s like to be postpartum. We know what it’s like to be on contraception. We know what it’s like to, you know, be middle aged. And

Dr. Mindy
grade. Yeah, yeah. And I really feel that as well. And again, this is I applaud the men in the fasting arena. And I applaud you for standing up and and teaching women like I just feel like when, you know, we need to shout as loud as we possibly can. Because not only are we seeing the tools, but we’re living in the body that is applying the tools so 100% agree. Okay, I got five questions for you. Okay, I think Let me see. I don’t think any of what ones about fasting. Okay, the first one, we’re starting a book club, or what? Not really a club. We’re starting a book list of all of our podcast guests. What is the one book or you can say two books that you feel like really impacted your life and you would recommend everybody read

CYNTHIA THURLOW
the unhealthy truth by Robin O’Brian changed my life. That’s a book that was incredibly and profoundly impactful completely changed the trajectory of my career. I’m actually having an opportunity to bring her on the podcast. Oh, that’s a little special. I was like trying to geek out I’m like, I’m gonna try not to be a dragon.

Dr. Mindy
Alright, having that with I had that with Dr. Libby Weaver and rushing woman syndrome. And when I brought her on, I actually cried, and then she cried, and I was like, Oh, my God, your book changed my life. It’s awesome. So congrats.

CYNTHIA THURLOW
Yeah, no, no, I mean it. And it just goes to show you the power that a book can can embody. I would say most recently, I would say it’s a tie between two books. The xx brain by Lisa, Lisa discone, was incredibly impactful. I think we all want to think we really understand the net impact of estradiol and progesterone and testosterone, our brain function and neurodegenerative risks and etc, etc. that book really was impactful. Like as I was reading it, I was sent I sent a copy to my mom, I sent a copy to my best friend I was so cause like, you have to read this book. I would say the other book that I’ve read most recently that I really have been recommending, although it’s a little more dense, meaning it’s it’s a little more scientific, metabolically by Robert Lustig was excellent. That’s a book you read, you just get mad at the processed food industry. You’re like, dang, that was a really impactful book. So I would say those three, definitely the top two. The third one is a little bit more dense. But you know, he does a like a masterful, masterful way of just explaining the impact on the sugar industry, the processed food industry and our health and you know, it’s really destroyed it so very relevant to our conversation.

Dr. Mindy
Yeah, yeah. Okay, second question. If you could go back to your 20 year old self, and you could give her some advice. What would you tell her?

CYNTHIA THURLOW
Oh, gosh, I would tell her Be patient. I think I was always like, I couldn’t. I couldn’t wait to finish grad school. I couldn’t wait to you know, be working. I couldn’t wait to meet you know, my husband who I met when I was 30. I think I would just say Be patient. I mean, I was fortunate that my you know, my mom and my dad were ahead of their times in terms of there were my mom was crunchy before there was that was even though it was mine. Yeah. So you know, we ate organ meats growing up, and my mom baked bread and we had to have vegetables at every meal and how progressive we rarely ate out and we learned how to cook and so I say all the time like what a blessing and you know, strong Role of family so, my 20s I knew how to cook and I knew how to eat and I you know, I was way ahead of the curve that way but I would just tell myself to be patient. I think I was always felt like I was always rushing to finish something like, you know, check the box, move on to the next thing and I was like, gosh, savor your 20s have fun. More travel. Stop being so serious. Like, I think I look back. I was like, I was so serious in my 20s

Dr. Mindy
I tell my daughter this tonight. Yeah, love it. She’s 21 I keep saying the same thing. Like you figure stuff out in your 20s It’s so good.

CYNTHIA THURLOW
Yeah, it’s a beautiful thing.

Dr. Mindy
Okay, what is what is who’s somebody that you would just die to interview on your podcast?

CYNTHIA THURLOW
Hmm. Well, Robin O’Brien would have been top of the list and I’m gonna have an opportunity to connect with her. I would say, you know, it’s funny. Sometimes I can geek out over Katie Couric.

Dr. Mindy
I Oh, that’s funny.

CYNTHIA THURLOW
I think I’ve been following her on Instagram. And she’s done such a beautiful job. Just keeping keeping people abreast of what’s going on. You know, when that there was that condo collapse in Miami and everyday she was, you know, showcasing someone that had been one of the victims and I just feel like she really has done a great job navigating a lot of events over the last 18 months. I’ll just say that. Um, but I just think she you know, lately, I think I’ve been geeking out of her Katie Kirby

Dr. Mindy
invited her. Yeah. I got to try it.

CYNTHIA THURLOW
I decided that, you know, yeah, no, and it’s funny because you would think I would come up with, you know, some world leader or, but I just lately, I think it’s her humanity, humanitarianism, and just her big heart. And so that has really kind of appealed to me. And it’s also that Kumbaya. You know, we’re all middle aged or beyond women, and we need to be some more supportive of one another. And I think that’s so critically important. So probably Katie. Correct. Which I’m sure if my husband heard that he probably be like, what?

Dr. Mindy
This is your dream, this is your dream. Okay. Fourth question. What’s the craziest thing you’ve ever done for your house?

CYNTHIA THURLOW
Oh, oh, without question, coffee enemas.

Dr. Mindy
Okay, last question. If you had one message for the world, that you could get into everybody’s brain and help them see, what would that message be?

CYNTHIA THURLOW
Eat less often. I know, that’s probably, you know, trite, that if every single one of us ate less often, we would have a much healthier population than we do right now. And I think that’s, I know, for both of us, we probably embrace and love the whole concept. But that’s really where it starts from, you know, one of the best ways you can balance hormones, and all the other things that we’ve kind of alluded to and talk to, during our discussion. That’s the platform that is the sort I will die on is just encouraging people to eat less often. And to kind of question as I always say, I was taught and raised to question everything, and that includes antiquated dogma. And so that flies in the face of everything I trained with, and I just believe that we need to get back to more ancestral health perspectives and strategies to improve longevity, for sure.