Episode #116 Featuring Cynthia Thurlow PART 2! THE MENOPAUSE GUT: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond

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to save today. All right, everybody. Welcome back to the Dillinchemeli podcast. So I say this often about how blessed I am to have certain people and how much fun that I have doing this

because it's a fact, and I get to talk to some of the most amazing people in the world. But my

guest today is literally the epitome of what I'm talking about. So I actually, I didn't tell

“her this before I'm going to surprise her now. I looked back because she was one of my first”

guests on the show episode number 15 filmed April 1st of 2025. No. And we are filming today. I know this isn't publishing today. April 1st of 2026, and I did not know that I just told my wife Queenie right now before I walked to an area, so I'm not going to tell her until we get on. Well, do you want to know the significance of today? Yeah. April 1st 2016, I left traditional allopathic medicine. So it's been 10 years. Wow. Yeah. It's like I was remembering saying,

if I'm like, I've been talking about on the podcast and how this is a big milestone. But if you'd asked me 10 years ago where I'd be right now, I don't know if I would have been able to wrap my head around it. Unbelievable. Well, I feel extra blast not only to just have you, but to celebrate this with you and celebrate all the things that you have going on and

everything. It's always so nice to see you and talk to you. And I don't have an intro to

do you justice. I'll give you a little rundown here to everybody, but it's not nearly enough. But she is a nurse practitioner. She's the host of the amazing everyday wellness podcast. She's an author. She's an international speaker. She's been a TEDx talker. She's got 25 years of experience in health and wellness. You can't miss her when you see her face. And even if you're listening to audio, you probably recognize her voice. So without further ado, Cynthia Thurlow.

Thank you, Dylan. It's such an honor to be back. And thank you for being as incredibly gracious and accommodating as you've been given the demands of my travel schedule up to this book launch. So thank you for that. Well, as I told you before, I will help you and take a advantage of any opportunity. And I have to even speak with you whenever I can. So it is my pleasure to do this with you today. And we have some big news to get into for you today. You know, we

definitely want to talk about your your book that's coming out. I know the amount of time and effort that you put into this, but beyond the time and effort, the meaning and the purpose behind it,

“I think is the most important aspect of it. So what I would like to do is get into some of that.”

You know, I have learned the past year how difficult it is to write a book, the task that it really takes on the time, the effort, the dedication, but also the meaning behind it. So I'd like

to start first, just give us the title of the book and give a little bit of background on the

purpose of it before we get into some of the parts of it. Yeah. So the book is called the menopause God. And it's really unpacking the changes in the gut microbiome that women go through navigating the Perry menopause to menopause transition. There's a lot of attention right now on Perry menopause and menopause topics, which is fantastic. But there's more to this middle age transition than most would lead you to believe. And so when I say that it's really speaking to the gut microbiome

interfaces with every single organ system in our bodies, men and women, but it takes a dramatic shift in the response to a decline in hormones. And so I oftentimes say to patients that there's more to hormonal replacement therapy than bone health and brain health and heart health. There's a lot to the microbiome that is equally important. And I think because I have my own podcast

and clinicians have said to me that let me to believe in 2024. My editor came to me and said,

"Do you think you have a second book?" And you, and after I wrote my first, I swear, I wouldn't

do it again. You know, you get it. This beautiful amnesic effect. Much like when you have childbirth women say, "Yes, I want a second or third child." And then you forget until you're in the midst of it that the birthing process is a whole lot harder than you anticipated today. And so I pitched this idea to my editor. She gave me a green light. She said, "Start writing immediately." And the really cool thing is that I was able to really synthesize an entire trajectory of my career as a clinician

as a woman in middle age myself, but also really spotlighting really interesting voices in the space that have contributed to my knowledge base. And my evolution is a clinician and a female. And so this is easily the thing I've done professionally that I'm most proud of. This book was really

hard to write because you know, we all know life imitates art but in the midst of writing this book,

I had family tragedy. I had a loss of two loved ones. My husband got sick and writing became a distraction from a lot of the sad things because all of us, I mean, we're in the sandwich generation, we have aging parents and if we have children or children and getting older so your responsibilities are pulled in different directions and that's life. And so in the midst of life, life being a Sean Stevenson says, "I was writing this book." So I'm pretty excited that it's almost here. The whole

process just it seems like it's gone by in a blink of an eye but it really has and it has really been like tears worth of work to bring it to fruition. And so I'm really excited about it. Well, I'm glad that you had that outlet because I understand what it's like when things go on because it's just inevitable and then to have an outlet and to kind of be able to let it out on paper and to take your mind off of it, I'm sure it was soothing for you or at least like you said

distracting and do you feel like during those distractions in those moments that may have actually brought out the best in you in what you were doing to pull you away from what's going on and to put that down. Yeah, because I was forced to be very present. I mean, when you're writing it's really

“hard to write if you're not focused and so I think because of my background and the events that I”

I had as a child and young adult, I think I have an ability to focus under pressure, unlike a lot of other people. And so my husband kept saying, if I ever needed to have acknowledgement that I know what you do when, you know, you put your blinders on and just focus. And so I would spend anywhere from eight to 12 to 15 hours a day writing in the midst of taking care of everything else. And it really was a distraction, but it was hard. I mean, I think there are people out there that

right easily and effortlessly and I think it can be incredibly challenging to take complicated concepts and make them really accessible. Like I had my editor in my ear saying, you're not writing a science textbook and don't have to go into that much detail. I know you know that much, but let's just dilute it a little bit so that we can make the information accessible and actionable and we'll just continue adding to your 20 pages of references, which are now

housed on my website because they didn't want to add 20 more pages to the book. So I say with great, you know, with great appreciation, I really made sure that this book is really our

“reflection of the science, but also making the information actionable, which I think in many instances”

and we have books that are out there that I have to be unique to the health and wellness space, but sometimes the information is just information and there's nothing tangible that people can take away from it and so that ends up being, you know, I think it just makes it more practical and therefore people know what to do with it as opposed to just for girls saying a bunch of facts and people are like, "Well, that's great. What do I do with that?" So you know what I'd like to do with you

is just get a little behind the scenes on what goes on when you actually write your own book as opposed to like a ghost writer doing it or you talking and telling somebody because sometimes people have this idea or this thought and then they gain a bigger appreciation of the book itself when

people are critical of things or make comments and they don't realize the time and effort and work

it went into that. So I got a couple like spitfire questions for you, I guess, so to speak. So the first thing that that comes to mind for me that I think a lot of people do is, well,

“is it difficult to pack in two 300 pages or do you find that it's so long that you have to”

condense it down? Because some people you know this are like when they go on and on and on when they talk, I'm like, "Oh, man, if they wrote a book." So for you, did you find it difficult or was it like, "Man, we got a short in this up?" You know, it's interesting. I had a I guess in the podcast

I can tell you transparently as we were getting towards the end of me writing, I felt like we were

trying to think of things to make sure that we struck the right chord. So my book is over 300 pages, which to me is about right. Any less, it might feel a little short, any more, it might feel really

“lengthy, and then people might not be quite as apt to read it. I think that there's this constant”

balance of making sure that you're not short-changing anyone chapter, you know, the bulk of the book is really focused on actionable items. And so I think when we got down to it, we ended up adding some recipes just to kind of round out, providing people with some tangible ideas of things that you could eat, that reinforce the tenants of the book. So I think the recipe is kind of rounded it out, but not in a way that that's be honest. A lot of books when they throw in recipes, it's because

they're struggling to hit their 80,000 word limits, or that's the benchmark they have to hit. I think for a lot of people, that's kind of what they're working towards, but we really try to make it practical and actionable. So I think that what I would say to you is it's hard to get started, and then it's hard to end. Like those are the two points that I think are most difficult. Once I get started, I'm good. And then at the end, you're so tired of writing and you're so tired of looking

at the manuscript, you're like, I don't want to look at it one more time. I don't want to see anything the copy editor's written. I don't want to review anything. Don't ask me to explain it. You're just

“tired of looking at it. So I would say it's always the extremes beginning and end. I think you're”

definitely hardest in the process. But once I get started, I'm usually pretty good. I would think the beginning would be very, very difficult, like, yeah, it's because you don't, so I can tell you the first time I wrote a book, I had a hundred page book proposal, which is a lot of work. Second time around, my book proposal was one page. Wow, that made a order because I did not fleshed out like this is going to be chapter one. This is going to be

chapter two. Instead, I was looking at the computer going, where do I want to start? How do I want to

start? What's the most important thing to start with? And so, you know, you start having those

conversations. I think it took me two months to really get a solid outline done. Like, it took that long. Well, that was why next question. The process of doing this, you come up with the idea, give it to somebody, then they shoot you either back like they like it. Let's work with this and then make edits or like, how does this process work? So you can see how long it takes to even get writing because I know it's a big process to even start. Because I think people just think you

get down to the type where I'm going to start typing random stuff and that's just not it. I think that I think everyone has a different process. I mean, for me, I actually have to like, I literally have legal paths. I mean, that is how I flesh out ideas like in general in my life. So I generally don't sit down and start typing out a draft. It's more like, what are the high-level ideas? How do I organize it? And so, for me, there's a certain degree of, you know, that fine

motor skills of actually putting your idea to paper that really helps me solidify the direction I want to go in. But the cool thing is that my editor tends to be, she's there and accessible, but she's not, she's not someone that my career manages me thank God. But it's more like she'll touch base there. Are we on target to meet this deadline? Are we on target to do this? I think for a lot of people, it depends on how you work. Some people do best under pressure,

and admittedly, because so much life stuff was happening throughout the fall in the summer of 2024. It just got harder and harder and harder to get started. And so by the time I really got started in September, I was very much under the gun because, you know, you have a time frame,

are you going to bring the manuscript in on time? And you always want to, I mean, at least I want to,

because I want the monkey off my back. But I recall in February thinking, like, oh my God, if we don't get this done, I need, like, I felt like I needed more bandwidth. I felt like everything gets compressed in the midst of writing a book. Like the luxury of friends of mine that have a year to write a book. I'm like, oh, the next time I do this, I'm going to negotiate differently. Like, I, I've asked them, I need more time than the first time. And then this time, I was like, I want more time,

but the time got eaten up by life happening. You know, the loss of my father and then caring for my stepmother. And it was like, every time I sat down, I didn't feel like writing.

“So you have to be, you have to want to write. Otherwise, it feels like you were, it just feels,”

it just adds another, another layer of complexity and challenge to the writing process. And so I think that we all know ourselves. Some people do better under pressure. Some people need a lot of time to daydream and moly gag and, you know, walk around and try to, you know, for me, I was very much,

I would exercise. I would shower and eat. And then I would start writing because I needed to get all of that self care stuff done. It's, I have friends that would like get up in the morning and then just write furiously for hours and hours and hours and then they'd forget about taking care of themselves and exercising and eating. And I just knew that I was going to be much better off if I could start the day with a degree of self care as opposed to just jumping into writing where I,

I always feel like I'm not, or my brain's not organized yet. It's like, I have to do all these

other things before I'm ready to work. So the process, and before I go, I'm sorry about you doubt. I know what that feels like. And I, and I, and I just, I want to say that before I even go on, of course. So the process start to finish. And I'm talking the idea for the book, all of the BS you got to do before and then the writing and everything to publish date. Is that like a two-year thing, a one-year thing for you on this one? Yeah, I would say it started June of 2024 and then my

“publication is April of 2026. So almost two years. But you have to remember my first manuscript was”

submitted in February of 2025. And then there were edits and edits and edits. And then the manuscript was officially accepted in July of 2025. So even though you're done doing the bulk

of the writing, the process just never ends because you have copy editors like people that are far

better writers than I am going into massage and manipulate words to make it sound better. Like, I always say, like, that's a skill I do not have. Like, I bow with their temples because they just make your writing stronger. And they're making very subtle changes. Every time there was an iteration and edit something that needed my eyes on it. And in towards the end, I was like, I don't want to see this manuscript anymore. I'm done. Like, I literally put in my very last edited manuscript,

the last manuscript from Cynthia because I was tired of looking at the manuscript because you get to a point where you're no longer objective. You're just so immersed in your work that you're like, I don't even, I'm not even objective anymore. I'm just so subjective while I'm reviewing my work for the 1,000th time. And the irony is, I just finished my audiobook. I just finished the edits.

“And as I was saying, the words out loud, I was like, oh, I didn't, why didn't I say that differently?”

And then you can't say it differently in the 30 in written form. But there's, I think there's

constantly an iteration. You're maybe you're never 100% satisfied, but you realize that

you get to a point where you can't have those perfectionistic tendencies because I think that they can be destructive. So I always say good is better than perfect. And so I think this is the best work I've ever done. But when I was doing the audio book, I was like, oh, I would have said that differently. Sometimes when you say words out loud, they hit differently than when you write them. You and I are so like every post I do, I can't tell I'm just Instagram posts. I've gone

back a bit like, oh, I got to fix that. Okay. And then I stop doing that because it is, it actually it degrades the work if you do it too much and overanalyze plus it's not good for your

“mental stability. But no, analysis paralysis. I think that's the best of us. So okay. And I remember”

when I was trying to get in touch with you when I was in the early stages of my podcast, you had this going on because I remember being brought up to me how busy you were and at that time a year ago. So we are at crunch time. So that then that brings me to this. So I had the opportunity to look at bits and pieces of your book. On first, I didn't get it till more recently. However, when I bred, and of course, is very impressive. But I want to kind of touch on some of the

topics because you and I talked about some of these before, but not all of them. And you have talked quite intricately on many podcasts about things and your knowledge is always appreciated, appreciated. But let's talk about some of the parts in the in the book that maybe you and I haven't talked about together and you don't talk about as much when you're out and about I would rather get into that and really showcase your knowledge base a little bit and intrigue other people because like

you said, I've talked about menopause a ton. So of you way more than me, but you know, you got some things in your book that that I saw. Sinescence was one. You talked about gone got brain access. We did some circadian rhythm and sleep disruption. I'd like to get into some of some of those topics with you. But first, how did you select the different topic pieces that you were going to go through? Like, what was your process in saying? Well, to me, this is the most important was that

through what you've seen and gotten feedback from people that you've observed or your experiences

book off talking about this, you know, romantic, teen-thwedding anniversary trip to Morocco and how

I got definitely ill from food poisoning. But my husband didn't, even though we didn't the same food. And so I'm kind of setting the book up to say, these are the things I didn't know about Perry menopause that are already changing how opportunistic infections impact us as our hormones are declining. So when I was setting up kind of the infrastructure for the book, it was like, okay, we start with the story because I guess people context. And then we talk about like, what's the

most mitochondrial dense organ in a woman's body are ovaries? What drives aging in a woman's body are ovaries? But the decline in ovarian function is the hallmark of that Perry menopause

“menopause transition. And I think for a lot of people, they don't know that the health of our”

gut microbiome is connected to the ovaries. There's a gut ovarian access. Just like there's a gut brain access. But the gut ovarian access, there are specific things that women do in their lifetime that can accelerate the aging of their ovaries, be severe, also accelerating their cycling instrument. So things like smoking, trauma, chronic stress, certain toxicants in our lifestyles, you know, the things that were told cumulatively over time don't matter, exposure to plastic and estrogen,

mimicking chemicals, smoking decreases, blood circulation to the ovaries, chronic stress, imprints the body, and also imprints the ovaries. And those are the things that I kind of started from and then moved on to aging in the immune system, which is immune SNS. That's the big fancy word, but the aging of the immune system also accelerates aging. And so it really kind of walks you through, you know, these kind of key players. And the immune system is super complicated.

I'm the first person to say, I'm not an immunologist, but I had a big white board out so that I

could be able to talk about the key players in the immune system and make the information still accessible. So I use a lot of analogies in the book. And then we kind of move on to, you know, the gut bone access. I think a lot of people don't know that the health of our bones is largely dependent on the health of our gut. And then we move their hormones. And then, you know, we kind of move through different stages in the book. But to me, it's what made sense to unpack, you know, the story,

the aging in our bodies, how the microbiome ages, what drives aging, just giving people like really salient details so that they can better understand their physiology.

“Because I think the biggest takeaway for women is that you have to change your lifestyle to match”

your physiology and middle age. So what we can get away with in our teens 20s is no longer works and our 40s, 50s and beyond. And that isn't just ingest that in the health and wellness space, you know, I obviously know lots of people who are the magical unicorns. They're the outliers. But that's not just accessible to those of us in the space. It's accessible to everyone if they're willing to learn and understand what are the things you need to change about your lifestyle

that impact either accelerating or slowing the aging process. And in the way that the book is also structured is that we start with foundational elements. We start with sleep. We start with stress management. We start with nutrition and exercise before we even talk about hormones, before we talk about supplements. And I think the biggest takeaway, Dylan, that I wanted listeners to

“your podcast as well as others to take away, is that there's no magic pill. There is no magic pill.”

It's not an, it's not a peptide. It's not just taking a warm on. You still have to still do the work. And so if you think you can live like you were 18 when you're 45, that's not going to work for you. As sad as that is, I people tell me all the time. I don't want to hear that. I want to still like eat pizza three o'clock in the morning and I'm like, no, you really don't. You really do need to alter your lifestyle to match your physiology. And that happens from then too, although it's

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That's peaklife.com/dillon. I couldn't agree more. You know it. And the people that say those

comments are like we should have never been eating pizza three in the morning like we did. We really

weren't getting away with it. Maybe on weight, but not internally, right? And that's the thing that people don't understand. They think they're getting away with something, but then reality they're not. Actually, they're causing accumulation of issues that are going to hit them later

“on down the road. And I think that bringing awareness to people younger is imperative too. And”

I think that this book should resonate with more than people that are just mid like this should be an eye-opening experience and understanding for people younger to prepare for what's coming and to understand what happens and how to prevent things from happening. And I think that that is

an audience that I really hope listens and really takes note of this. And I really want to draw

awareness to people of all ages because one of the things I've personally learned especially is thinking long-term and developing that thought process and starting young on all of this. See, this is part of the problem. And I'm curious what you think about this before we get into some of these topics. There's so many things that were told like you don't need to worry about this because you're this age. You don't need to do that until you get a little bit older.

My thought is we start this a hell of a lot younger with the education, the changing of habits, everything. And that way we can have a healthier aging process. And we don't have to worry about a lot of these things being inevitable because we've already started the process of taking care of it. Yeah, and I was telling someone the other day I recall in my, I have adult sons now. They're 18 and 20, which is hard for me to wrap my head around because it's gone by so fast. But I recall when

they were probably just the same as it was for you and I for the great issues when you have sex

“ad. They separate the girls, they separate the boys. I think there needs to be mandatory compulsory”

equal information that the GYN or the internist is required to kind of start people way before we get to 35 or 40. So that men and women, well, especially women because it's a little more dramatic for us, but just basic information because if I think if women could plan and know a head of time, they'd probably make better decision. I think that for so many of us, like when I look at men, I mean male factor infertility is increasingly on the rise, largely a by-product of insulin resistance,

poor metabolic health and exposure to estrogen-mimicking chemicals. But we have escalating rates of infertility in both men and women and I was just interviewing a fertility specialist and we were talking about this and I just said our modern day lifestyles are not superimposed with our physiology and I think there just needs to be greater awareness because I think most people don't want to have trouble with

“infertility if they want to have children. I think most people don't want to be dealing with poor metabolic”

health issues as young people. I think most people do genuinely want to make good choices,

lifestyle-wise. They've just never been given the information and if the parents don't

invent that in their children, then you have another kind of lost generation. I'll use an example so my older son is a sophomore in college and he has food allergies so he has to be somewhat conscientious about what he's eating and we were having a conversation that you know he plays college lacrosse, he's in a frat, he's an engineering student he's living his best life and we were having a conversation about one night you know the guys ate pizza really late at night after a

frat party and he just said mom I felt so bad like so bad physically that he was like it just isn't worth it he's like I'm just starting to make these connections and certainly like living at home my husband and I cook real nutrient dance foods my kids have an abundance of protein options they're both very athletic very fit so they can tolerate a good amount of rice or pasta the joke in our house is that they like a pound of meat along with you know an equal amount

of rice because they're trying to build muscle so they're spiking their insulin but the point why I'm sharing this is if we're not helping our children learn how to cook if we're not talking to them about protein and carbohydrates and unprocessed foods and hydration and being mindful of the

example for them and I think it really becomes a stamina fact so I look at my kids who are both very leaned very athletic very healthy and I was saying my husband like I know we did a great job with them because everything that we talk about and we embrace and we prioritize has really been embedded in them and the irony is my older son is lives in a door not in dormitory lives in an apartment with for three friends so there's four guys all four of these guys their mom's taught

them how to cook which I love I was like this is fantastic I mean this is like a lost art because we have generations that are taught that they don't add a cook and so if they don't add a cook then they need to buy food outside the house all the time they need fast food they need the processed stuff and you know when I were talking before we started reporting that when you travel you don't even go to true food kitchen you're like oh forget it I buy my own pots and

pans and I cook for myself everywhere it go and you just start to understand that you know this habits have been embedded in you and they probably make a big difference over time being able to cook

“yourself as opposed to having someone else cook for you I think I just got off on a tangent but it was”

no no the tangents are the best information that's the best part here's my problem with some things

and I'm curious as to what you think about this well one of my big issues that I've always said

is when we're going through schooling we don't really get taught the things that we need to know how to live they don't teach you about credit how to balance checkbooks how to do accounting and the importance of having credit and they certainly don't teach us about what you just said about the importance of nutrition the different types of foods the different micro and macro nutrients which we should learn all about they don't teach you how to read food levels there's nothing there's

absolutely nothing and the other thing that bothers me a ton is when I would always and I stop taking personal clients now because I don't have time but one of the big things I would always get with parents well you know I have to my diet because I have to feed the kids pizza macaroni cheese and

and my response was always no I don't know why are you feeding them that why and and if you are

“going to feed them that why do you have to eat that so there's a well there one is you shouldn't”

be feeding them that crap you should be teaching them how to eat properly when they're young I'm not saying you know run a boot camp and never let them have anything that's not ideal or smart either because then that'll help actually develop bad habits later but I'm saying teach them young and you certainly don't have to just eat that or do that see I don't I don't fall in line or or understand or grasp that whole mindset so I'm wondering about you know especially since you

have kids and and everything your thoughts on that yeah no it's it's funny I recall you know my kids have traveled quite a bit internationally and you know they've been to over 20 some odd

countries and so people would always remark oh your kids don't want like the kids play and like

no first older boys they had a lot of food so the kids play it stop working when they were probably four or five but you know I think that I never cooked two separate meals I made it very clear like we make one meal now this isn't a suggestion my kids hated a vegetable I forced them to eat it but in my house there's no someone gets one set of food and someone gets another and I saw a lot of my friends who were just incredibly accommodating of quirky things and I would say you know

you're not instilling in your kids that you know it's not adult food and kid food it's food and that's kind of the what should be conveyed like my kids of when they've traveled the world they've had all different kinds of foods and I think they've been really open-minded and I'm proud of

“that because I think that life is far more interesting when our kids eat more than chicken fingers”

in french fries now I'm sure Dylan honestly if my husband bought a bag of chicken fingers right now it would be gone and it got immediately because that would be a treat but with that being said I think then in many ways we facilitate kids being really picky and only choosing to have three foods or five foods or two foods that they refuse to eat I I've had friends say you know my kid will need the chicken fingers in french fries and I was like well when your kid gets hungry

enough they'll eat more than that exactly and you are the parent and I say this lovingly you are the parent just remember that like yes your kids can be well full I have a second child who's super willful older son a little less willful one is a little more food adventures than the other but we didn't accommodate much like I have one child who prefers raw fish not cooked fish and I don't make a big deal about that I'm just like fine preferences ever vegetables fine you know

I'd give them a couple options I say what would you like tonight here's three options pick one you're going to have one on your plate it's not a question of if it's it's a question of

to when I I worked part time as an MP when the boys were young and the wonderful woman who took

“care of them in my absence made whole cooked food like she didn't scamp there was no junky stuff she”

didn't cook hot dogs and beans and for anyone who loves hot dogs I'm just using that as an example but she would make real food for them and so like the reinforcement consistently was beat real food we at the same food is mom and dad we don't get special food and occasionally you might have a chicken nugget but that's like a rarity but when we would go out to eat my kids generally did not eat off the kids menu they would off the regular menu they'd have the steak they'd have the

chicken they'd have piece of fish maybe not the kid who doesn't like the cook fish but the point being they were fairly food inventors because we set that expectation and you set like routines of eating good and then you get used to it you can't live without the food you're eating and I have perfect testament to that because I the foods that I eat now I can't go without I would I would up told you before I wouldn't touch or I didn't like without even trying them you know and it's like

the whole list of my top five foods that I can't live without even just a few years ago I would even touch them and it's it's all about developing the habit and of course fun you're the parent you know so the kid shouldn't be running the house but two if that's all you're given them of course that's all they're going to want yeah I wouldn't they their problem is as you know and as you age especially those foods they sound great they smell great but as soon as you eat them

within five or ten minutes you're it's like the night after you drank oh I wish I wouldn't have done that you know what I mean and the same with the meal you wish you wouldn't have done it because you feel horrible well I'm not you mentioned the fact I mean the ultra-processed foods trick your brain into thinking you have an eating as much as you have you know anywhere from 500 to 1000 additional calories you're consuming per day you know you wonder how we end up having poor metabolic health

it's not helped by you know making food choices and it's not just like when I travel generally I'll either fast or I can make a jokingly I can put together a makeshift meal of you know beef jerky salt and macadamia nuts or salt and pistachios and maybe one other thing like a boy like a hard-boiled egg or a piece of cheese I mean I can make a makeshift I'm starving meal but it's not it's not glamorous but I can do it but I think for a lot of people it's easier

to say it's too hard so I'll just eat the burger like the you know the burger with 95 pieces of bread on it and crappy American cheese and everything else it's just about having the desire to take care of yourself you know I don't think I told you this but every single event I go to I have a set time and it's normally about two o'clock where I don't take anything from two to at least three because I'm leaving and I'm going home to cook and then I'm coming back and that's yeah I block it off

and I that's just that's the way it's gonna be and I don't care where I matter what I'm doing

“but you know you have to you have to have that within you and the want and to me it's like that”

is a priority you know and I think priority number one or for me is always God but then it should

be your health and it taking care of yourself so what you're eating what you're doing if you're moving I don't care if you're traveling or not get up early and go walk doesn't matter I don't like excuses because I know you know through things that I've encountered in men through my life you can do whatever the hell you want if it's a priority absolutely I was saying to an earlier podcast guest that I could choose to stand while I'm podcasting virtually but I actually sit because

it allows me to stay really focused but when I'm done podcasting what do I do I said in my part of my state there are not many basements so everyone builds up so we have a three story house that goes up very tall and I said I'll walk up and down the stairs a few times just to kind of you know clear my head take that one of my three dogs take one of the dogs for a walk it's really important to not just put those blinders on and convince yourself that movement's not important it's important

for so many things not just digestion not just skeletal muscle movements brain health and I think people make things far too complicated if I'm traveling dillin and I can't get it like a regular

workout in I'll just walk around outside like I'm never gonna put my shoes on and I'll have my

“exercise close on and I just you know that's why that one hotel in LA is perfect because there's”

a mall around the corner and I'm not at it's an outside mall because it's California but I'll just do a couple loops inside there I can get a couple miles and just walking around and I'm like okay I'm outside the sunshine I'm not doing any shopping I'm admiring all the crazy things I see I just put my sunglasses on and I'm moving my body which I think we sometimes forget that just something

is I go on these trips and I have to those normally because I don't really rest very much I kind

of overtrain a little bit so those days I just get up and go walk well the other day we were in we were in Pasadena and I started walking and I had to be home at a certain time and Queenie's like where are you and I'm like shit I don't know I'm lost you know hope because I just started walking and then I was talking to my mom on the phone and then I started to do some prayers and before I knew what I was like looking around and I thought okay that's not the right street that's

not the right street and just like oh shit you know and started to run home but okay so you know you and I have interviewed a lot of similar people you've far you've interviewed far more than I have but we have had some similar people and you brought up a couple things earlier that I want to touch on that are in your book that I just kind of learned about and I'm gonna throw a couple names out in your probably gonna smile and say yes yes but Dr. William Lee, Dr. Jeffrey Blan,

Coleen Cut Cliff, the story I just spoke with recently and so these three to me were the ones that made the most sense that actually got deep into the gut the microbiome where they actually

“explained things that didn't just tell me oh the gut is important and it controls everything”

or this they actually broke it down for me and one of the things that you said that you wrote

about that I wasn't first on was about the immune system that I really gained a lot from those three

individuals and that's where I got the more intricate side of understanding the importance of microbiome and the relation it had to our overall health in terms of why are we getting six or easy you know and why do we not recover well from illness or sickness why is this lingering so could you touch on that because I know it's a big part of your book and I'd really love to get some insight from you on that yeah those are three great guests calling and I were both at

Hopkins at the same time although we did not know each other and William is brilliant as is Jeff and just such nice downy earth clinicians and researchers so the immune system as I mentioned ages right along with us but what's interesting is that with this decline in estrogen we start seeing immune system devolution if you will so I mentioned that the immune system immunists in essence inflammation all kind of correlates with these decline in hormones and estrogen in the immune system

“are intricately intertwined with one another as estrogen declines and I think everyone”

acknowledges that estrogen is an important hormone actually for men and for women we start seeing more leaky gut if you think about the small intestinal lining it's one cell layer of thick and if you think about a brick and mortar analogy estrogen is the mortar in the bricks and as estrogen's declining we start seeing more tight junction opening and we will leak food particles into the bloodstream will trigger an immune response so this is when women will say gosh foods I used to eat just don't

land the same way with names suddenly sensitive to dairy or they get provocation of histamine responses and they suddenly start developing rashes or even allergic reactions to foods that

had otherwise always been tolerated there's something called the thymus gland and it's kind of

by the time we get to be adults it's kind of a fatty blob of tissue but what's interesting is in the immune system we have these tea helper cells we have tea helper one and tea helper two and what happens to women in the setting of a decline in estrogen in particular we start seeing more opportunistic infection we have less of a reaction to vaccine so when you go to CVS and they offer you a shingles vaccine a flu vaccine and a pneumonia vaccine number one they're acknowledging

that as you are aging you are more susceptible to these things but it's also acknowledging that we just have an immune system as women that is more provoked women women are four to five times more likely to develop autoimmune conditions in middle age so things like celiac rheumatoid Hashimoto's when I finished my medical training I was talking to a colleague recently I said

“more with like 20 30 diagnoses that's what we knew of now there's over a hundred including things”

like long haul COVID and chronic Lyme so autoimmune conditions and women will start seeing an uptick and I remind women all the time that once you have one autoimmune condition you're likely to have more and so the immune system is there to protect us we have kind of a basic immune system you know the barriers like silly and or no our skin is designed to be a barrier and then there's a more targeted immune system that develops antibodies is more sophisticated both of them start to change

as we are navigating this decline in hormones when it may stay things like the autoimmune condition we can get as their microbiome and their vagin they may have more urinary tract infections they may have painful sex pelvic four issues they may be getting up at night more often to pee not a fun thing that can also happen to men but obviously it can be from an enlarged prostate

a bit less effectively we can't mount the same immune response immediately when we are younger we become less responsive vaccines we start seeing more autoimmune conditions as I mentioned not an exhaustive list but there are quite a few and what I find for a lot of women

the first sign that something is changing in their digestive system is the bloating alterations

and bowel habits the feeling like they have more reflux more heartburn and that could all be a sign of alterations in the immune system along with some other changes that happen with whatever referred to as digestive fire and I'm sure we'll probably talk about what that is yeah I mean there's a lot there that goes on how prevalent of a problem do you think this is for women at this stage of life and then just women or men in general but specifically at this stage

of life because as time has gone on we've actually accumulated and developed this into a much bigger problem and if it's not addressed then it turns into a full-blown disaster yeah I mean

“I think there's many things I always say pairing menopause is a litmus test for how well we take”

care of ourselves because irrespective of how we grow up we get away with a lot in our teens 20 and 30s as hormones start declining there are transmitters start shifting our coping skills that were at one point adaptive can become maladaptive meaning you know that not enough sleep the over exercising the two low carbohydrate or you know food restriction or those things can start to backfire in fact oftentimes I'm telling women do less do less not more because our standard kind of prevailing

thought is if I start gaining weight in middle age I just need to eat less and exercise more I just need to fast more in eat less carbohydrate because carbohydrates must be the problem and it's helping them understand that as our physiology is changing less skeletal muscle mass decline in estrogen decline in progesterone decline in testosterone not in every person some women about 25% still making up testosterone but with those alterations changes in the

immune system more susceptibility to stress like one thing about women in middle age is that what you can get away with in terms of hormotic stress or just stress of life starts to shift so you don't cope quite as well when you're not sleeping seven eight hours a night you don't cope quite as well with this really intense exercise so I usually use the example of orange theory fitness or crossfit if you think you can do that six days a week with no recovery you're going

“to crash and burn a middle age right I think for a lot of women maybe they were doing a”

little bit of intermittent fasting at certain times during their cycle all of a sudden like compressing their feeding window means they can't get enough protein in can't get it if they can't get enough protein in and they're not lifting regularly they're going to get this unwinding of skeletal muscle and so sarcopenia is a real issue that also makes us lose insulin sensitivities

metabolic health peace this weight loss resistance peace is never just one issue it is generally

multiple issues that are contributing not to mention the fact as we're getting older we produce less stomach acid stomach acids what helps break protein down into amino acids so it can be absorbed we generally also have less digestive enzymes so we're not breaking down protein fat carbs so not able to absorb as much across that small intestinal lining and then as estrogen's declining this is kind of one of those nerdy things as

like down in a multipy fats it with multiple angles of what can impact digestion and how they feel and there's certainly lots of you know tips and tricks that I talk about in the menopause

“God but I think for a lot of individuals they're surprised they're like hairy menopause snuck”

up on me and no one told me that bloating was normal like I think downloaded in my first symptom

and I was like what is this you know I wake up of the flat stomach and I go to bed looking six months pregnant and there's no woman out there who wants to look six months pregnant when they're not pregnant like let's be very clear you know it's like what is going on with my body so I think in a lot of different ways women start to feel like their body is working against them and not for them you said something there and it's very natural to assume to just start training when

you see anything wrong especially somebody like me and there's a lot of people out there like that that's just the first answer and you brought up overtraining so I would I would love to

adverse effect on what you're actually hoping for yeah I mean I I think it is human nature that

“the solution to the problem is more work right I mean I think that's human nature I certainly”

was guilty of this in period minutes pause I was like I'm weight lossers and I just have to work out harder right what people need to understand is that exercise is one of many types of traumatic stress beneficial stress in the right amount at the right time so for these women and parry menopause in particular you know they start game weight you know they're frustrated they're like okay I just need to get up earlier for the gym and work out twice as hard as I did before

and then I'm going to intermittent fast and not eat for six hours after I finished exercising and then by the time I get home I can't settle down so I'm not getting enough sleep it's really important to understand that exercise is a formative stress so if you are really tired after exercise that's a sign you might be overtraining if you don't work cover from an injury that might be a sign you're not training if you're still getting a menstrual cycle and you stop getting a

menstrual cycle that might be a sign you're not your overtraining I think you know persistent soreness especially persistent fatigue it could also be signs of other things but one tough work

out is one thing one tough workout that you never seem to recover from you're getting sick more often

but we know if you're overtaxing your immune system that's always my tell throughout this book launch timeline that was always my tell I would tell my team oh my god I'm losing my voice

“again and they're like oh you need to make sure that you do more self care and get to better”

layer but I think for a lot of women we've been conditioned to believe that when we don't have the output that we want and gently that changes in body composition our weight loss the solution is to work harder and I'm here to tell you oftentimes it's to do less less fasting less exercise more sleep more recovery and that can be a little bit of a mind screw for women because that is not what we've been conditioned to believe and I think there's a very fine line between

relative energy deficiency or rents which I think there are a lot of women out there that never

properly fueled their bodies so you're not going to get the recovery that someone else is getting because they're eating the proper macros they're being conscientious about their protein they're being conscientious about their fiber they're being conscientious about their carbohydrate and take versus someone that's like oh I've got a four hour feeding window and I just had really really intense exercise last three days and I'm going to eat in the super compress feeding window

so maybe I'll eat one meal and and that'll be my recovery that doesn't work no and so more often than not I'm encouraging women to stop overtraining to listen to their bodies like the me from 10 years ago maybe 12 years ago was up at four o'clock in the morning I would take really intense conditioning classes I would shower at the gym race time to get my kids on the bus get them ready get them on the bus and I would go to the hospital and that was my life for a long time

I can't think of something I'd want to do less now I would love to go back and be mom for little kids for a couple days but the point of what I'm making is I got up before a clock in the morning it didn't matter what time I went to bed it didn't matter if I slept well or not I was still waking up and so oftentimes the things I tell women that they need to stop or things

“I had done myself so I understand what it's like to hear someone say I think you need to do less”

it's nice to hear it's hard to comprehend and especially as you get older a lot of times less is more it's more the quality of how you do it and what you do it and the way that you do it it's just like anything else man it's like the athlete that they have to train smart or they got to place smart you got to lift smarter I run into this all the time where oh you've got to lift heavy

weights all the time and I always tell people what's the point in lifting heavy weights all the

time you're always injured because you're gonna get injured as you get older it's inevitable yeah I would rather lift consistently and you know I'd say you know good hard work I'm not crazy or anything but be able to do it I mean yeah I lifted so heavy today and now I'm screwed up for three weeks I mean you know it kind of defeats the purpose so it's it's just I think a lot of it is so much up here and all of us even us that do this or talk about it it's not easy

you know this about me is my background is a lot in hormones and so I really have a knack for understanding what women go through but also don't understand and I think that women are always gonna be a little bit more in tune with their bodies than men because they go through so much more she kind of have to be it's not it's just it's just the way it is and not that meant

and especially as you get older so here's my my wonder and my question to you because as I've

really gotten more versed in this and talked with more experts and experienced more that the whole testosterone aspect with women is becoming more widely recognized as like one of the biggest issues during menopause and of course progesterone and estrogen balance is there but I think part of it is a lack of understanding why you need it or what it is because in there just everybody just thinks it's a male thing just like a men don't often understand unless their

“bodybuilders the important of estrogen yeah but I think too that women are kind of scared of it”

and fairly sure of that because they have a one track thought of well that's gonna make me big

or give me make me talk like a man or you know whatever but could you speak on on why

that it hits women so hard and too how big of a problem this isn't and why are more women either in tune with that are checking it yeah I mean I think there's there's a twofold issue number one there's this misconception that women are going to get masculinized with testosterone and women make one temp of the amount of testosterone is men so it's a very potent hormone and women but without being said in you know the proper range you're not going to get masculinized I mean you

would have to be taking a you'd have to be hitting doses of where men would be on a normal kind of distribution curve I think a lot of clinicians because technically testosterone is not FDA per which is complete the us because women make it 75% of us make it up until menopause and then

most of us benefit from replenishment but a lot of clinicians are never trained you know they're not

trained to check hormones you know looking at a free and total testosterone is a starting point I think that people tend to think about testosterone in a very myopic way it's just about libido no it's sure executive function hormone it's the get off your ass and go to the gym it's seeing

“get things done hormone it also impacts body composition and so I think for a lot of women”

they get fixated on oh it must be because my cortisol is higher my estrogen is not optimal very likely is that your testosterone is not optimized either and so I think a lot of different levels like as the black box morning was removed from estrogen and Mario McCarray's working diligently to kind of speed things through the FDA or make changes and this is not a political statement I'm just saying I think that it's good that you know he seems to be doing a meek before

the women's health initiative that came out in 2002 but I think for a lot of individuals it's helping them understand the number one you deserve to have testosterone replacement therapy if your testosterone levels are not optimal yes and and full stop this is for men and for women and I think that you know I I'm doing an end of one experiment for a long time I've been taking compound and testosterone I just got tired of rubbing compound it creams on my body because they're ridiculous expensive

let's be transparent so I said to my primary I was like can you just give me some android gel and I'll just squirt out a piece size amount I'll try that and see how I do it is super cost effective it's like five bucks for a big bag I mean the last bag I received from CVS I've had it since

“October yes it'll list six months five dollars that's how it should be right well and women”

so for men when they use android gel it requires so much more especially if they're severely high per go nadle and it's not very effective but for women it's like a dream because it doesn't take much at all and it's so good in terms of how it'll work for you and it's like it's perfectly suited for you because let me tell you something it does get old injecting because I I put my self on it like a fool and that's a whole other story like too young because of the the work

that I was doing in the environment I was in and I teach people to not do that and it sucks but for women you guys could make it severely easy like like you just said in a costume nothing and it takes like a piece size to actually work so in that regard I think more it's it's we need to be reliant on people like you to deliver the message of the importance of because it's one thing to hear from a guy but it's a whole other thing to hear from a woman that is you know looked upon

as an expert or really respected explaining this to them because you can relate more with a female going through it and I understand how it can be in your head oh it's going to do this and that but factually it is so so so important because without that balance it that is the lowest quality of life possible to have that testosterone gone even for women yeah well and I think for a lot of people it precipitates moon disorders I think so much of it is thought it's just you know progesterone

much this bio individual approach that for each one of us that's something might sound a little different

because that is as unique as our bodies are so you know my hope in my intent is that we'll start seeing testosterone being properly evaluated for each patient and not being told like there are some people in the menopause space that they want the lowest dose available for hormones not

“optimization just baseline replenishment and I think that you know patients will sometimes say to”

me I feel really good when my free testosterone is x I feel really good when my total testosterone is y and I really think that that space is very much this bio individual approach like there should be a range you know there should be an optimal range now I will be totally transparent and tell you that I've interviewed enough experts on the podcast some of whom doom pellets most of them don't because of the super physiologic dosing that comes with pellet therapy yeah and I've had women

say to me I feel like I was chasing a high over and over and over again like the first high I got

from testosterone I never felt that good again and so I always am unfortunately that is because you

got a super physiologic dosing keep it really high because you're you're getting a pellet placed every three to four months and if they overdose you or put you too high you're stuck like they

“can't remove it and so I think that you know there's kind of a graduated approach you know”

transdermal approaches for women that may be subcutaneous then you know maybe I am but that's probably not my favorite either and then the other thing transparently is there's a lot of people in the health and wellness space that are women they're using antibiotics and you can tell yeah I've seen it all and I've been through it all and I will tell you in my experiences and I say this as somebody that has been in the trenches for 15 years there are

so many doctors and people that go to their books or go to something that have no clue about understanding ester chains that are attached to testosterone and the highs and lows the peaks and trops and they don't grasp and they put people on different methods like you said with the pellets which I would never be an agreement with for anyone there's too many other options and then there is and every time I say that I get a message from someone saying it's awesome and then you know

a couple months later they'll say oh you're so right I feel terrible now so I think that's I know they're very profitable and I know the people that are doing them I think that they believe that they're giving women what they're asking for but I like predictability when it comes to replenishing replacing hormones and so I think there's better options and I'll share

with you transparently when I first started HRT there was a provider who's never been a podcast guest

so I'll just put it to my your community that way because people then always want to know

“where are they in Texas they've never been a podcast guest but I think it's important and significant”

to say that this individual convinced me that I am administration of estrogen and testosterone was the way to go always well for me it wasn't and I mean it was a little bit of a disaster and so I said I think some of us are really sensitive to replacing hormones and so this individual was because I was not fitting the way that he wanted me to fit within his kind of practice paradigm we had to part ways but for me I don't need to have superficial logic dosing to feel good and so

I think if anyone's listening and they haven't yet met the right provider I promise you they're out there it took me a little bit of bits and starts to get to the right people but I think you'll know when your hormones are optimized within the range that you want them to be in because you'll your brain will work and I think Dylan and I'm sure you would agree with this when you're a podcast host and you're speaking on stages I have to feel like all my cylinders are firing and then some

so if my her and not optimized I'm going to know that's all right Rowan you know the my one town this is funny I did a little in-storey about this I was sitting in the airport and I was irritated I was irritated by someone who was chewing their gum like a cow and I made it comment so I like put it and I was like clearly my estrogen patch needs to be changed tomorrow because I'm so irritable and sure enough then when all these people were commenting they're like oh my god same with me

that's exactly what happens to me the day before I change my patch and I was like otherwise I'm like whatever you know what I'm traveling it's like go with the flow but this woman was chewing like a cow with her gum like popping and now I was like I kept looking at her like do you really as you're disturbing all of us I don't care how balanced I am I would have been annoyed I don't even care

somebody that you were dealing with that is not the the best way to get it into your system and to absorb it without a shadow of it out is I am however that does not make it suitable for everybody and every single person is different on what they need and can handle and just because that's the

“most efficient way does it mean it's the most effective way no I think I had this massive peak and”

then I would have this massive trough and so for listeners peak is when you have the highest level and trough is it generally your lowest level and for me I just I mean within two weeks I was like holy cow I just I it was not a good feeling so for me personally not the right decision for me I know that other people have done well with subcutaneous or even I am injections but that wasn't the right one for me my question would be to and this is probably his ignorance is it depends

too on the ester chain and when you're doing it so for instance test sipping it has the perfect half life for tr t given the half life however a lot of people like to take it once a week the problem is as you take it at the start of the week and by the time the end of the week hits if you

look at a level on somebody they were at 7800 here and then it's down to once you I've always

“always said that you need to do it twice a week you hit it right in the middle and you take your”

like I take 75 milligrams Monday and Friday and I'm always in a straight line where I need to be where it's perfect right people don't understand esters in the release and how it works and you know misguided information is everywhere unfortunately yeah I mean I recall him saying to me yeah your levels are great now and I'm like I don't feel great yeah that's a broad like I'm not you know it's so for women to have a sense like your ester dial levels which is our predominant

for a vestigine our body makes until menopause there's probably two or three days where your ester gene levels like 300 he had me climb like I was there for weeks and I kept saying I felt terrible and he was not listening and I just said this is not sustainable I'm developing fluff and no woman out there wants to feel fluffy that's not a good feeling like we like our pancakes fluffy if we yeah he had you on too much for sure so you know one of the other things

that you talked about was circadian rhythm and I have really stressed I don't know the past six months especially the importance of sleep and and I've got a greater understanding and value as I've gotten older especially that doing the five and six hour thing does it it's not something to brag about it's it's it's it's degrading your life would you talk about the importance of that in general the sleep and also how do we develop and fix circadian rhythm when it's kind

“of often we're having trouble sleeping what are some of your tips yeah so number one I think”

of sleep is being foundational so if you're not sleeping through the night that's the first thing we have to work on not to mention the fact that if you look at the microbiome research

we have circadian clocks that are digestive system you know people always talk about

the super chi is magic necklace in our brain and I'm like yes that is the master clock however if you need a large bowl of sapita at two o'clock in the morning guess what happens you are disrupting secretion of melatonin you are disrupting circadian rhythm you are not as insulin sensitive in the evening there's so many things that happen but when we're talking about circadian biology in a 101 it's really we are awake when it's light outside and we go to sleep when

it's dark outside meat eats earlier in the day when we are more insulin sensitive in our bodies are primed for food is opposed to not eating two to three hours before bedtime so a lot of the things you know light exposure meal timing sleep awareness are all in alignment with this circadian rhythm and this circadian rhythm gets off due to meal timing travel I mean that's one of the big ones you are on PSC PST and I'm on EST when I travel to the west coast I stay on

the east coast time and I'll be out there next week and I will stay on east coast time the entire time I'm out there and I look like a loon and I'm in bed early but I do so much better but having said that I think for anyone that's listening things that disrupts circadian biology impact our health in very profound ways we talk about shift workers or gray risk for cardiovascular disease poor metabolic health certain types of cancers all from the disruption

of the circadian rhythm and alignment so when we're out of alignment due to jet lag or travel or stress or shift work there are things that we have to do to kind of bring things back into

alignment you know some of my patients I had them get off the night shift that was like the first

thing that we did because it was wrecking their metabolic health it was wrecking everything about their lives so the microbiome actually adjusts to sleep so when you're not getting enough sleep you're

sometimes you have more inflammatory bacteria sometimes it can interrupt the astrobleum which is

“the estrogen processing center of the microbiome but when I think about very tangible things”

that everyone can do the don't require any gadgets light exposure in the morning can help with circadian realignment meal timing so eating earlier in the day not later in the day getting exercise wearing blue blockers so technically right now because it's starting to the sun starting to go down I should be wearing blue blockers because I'm under very bright lights right now which is very stimulating suppressors melatonin increases cortisol to keep me alert I also think about

hydration you know for a lot of people we underestimate the value of hydration but dehydration can exacerbate just about anything I also think thoughtfully about the meal timing piece not eating three to four hours before bed and then we start layering it other things if you are a parry menopause a woman you may benefit from oral micronized progesterone wanted to eat prior to your menstrual cycle if you're later in a parry menopause you may benefit from estrogen therapy because

progesterone helps us fall asleep and also upgrade your late scaba which is this inhibitory neurotransmitter from progesterone our body will make aloe pregnant alone which has a sedating effect and then estrogen can help us sleep so I start thinking about modulating hormones I also think a great deal about supportive supplements so things like adaptogenic herbs, remora, ashwaganda, rodeo I think about supplementing with magnesium I think about e vitamins although usually me dose them

in the morning I think a great deal about my own awesome which for me is that the game change or nutrient that most of us need more of anyway and I kind of titrate that depending on what I'm doing then we move on to like vagal training things to get us out of fight or flight so whether it's humming singing putting legs up a wall breath work reading a physical book those are all things before we ever talk about gadgets because inevitably what people do is they're not sleeping they're

like oh I need the ore ring and I don't mean to pick on ore ring I live my ore ring I'm wearing one right now but I think for a lot of people they focused on the loop band ore ring the vagal devices which are great and awesome but I would say don't add the devices until you dialed in on

“the lifestyle measures that really make the biggest impact and here's the thing Dylan”

when someone's doing everything and they're still not sleeping I'm like it's gut health it's unresolved trauma it's chronic stress show me a woman who doesn't sleep well and show me a woman

who doesn't manage her stress full stop is never an exception to them and I think for a lot of women

they think they're managing their stress but they're actually not you know whatever you need to do to manage your stress be do something that you like and do it often so for me I can do breath work anywhere and that's usually my go to that's how I you know I can slow my heart rate down I stimulate my biggest nerve I'll get myself out of fight or flight I do things before bedtime once you've mastered all the basics then you can layer another things but I think for a lot of

women it's diagnostic stool testing really looking at what's going on far too many women have a lot of issues in the gut that are deriving a lot of the symptoms they experience you know the Bayesian motor symptoms the night sweats which are really unpleasant for women to experience

plus or minus the underlying trauma that many of us don't deal with and I always feel like

perimenopause of the litmus test that's in the wheels fall off the bus that's when women suddenly all those adaptive strategies they've used their entire lives becoming incredibly

“maladaptive so you have to deal with your stuff and the research demonstrates”

if you have adverse childhood event scores you know anyone listening it was a joint venture between Kaiser Permanente and the CDC you can go online very quick quiz if you have a high a score you are more likely to have poor metabolic health sort of relationships with food higher risk for cancer earlier menopause more likely to have autoimmune conditions so for a lot of women and I'm one of them my a scores quite high I think perimenopause was far harder and I say that lovingly and

respectfully my parents did the best they could but when you grew up with a lot of neglect and abuse and addiction and you know physical and verbal abuse that imprints your nervous system my nervous system tends to run hot meaning it's much more reactive and there are a lot of women listening that we convince ourselves that what we grew up on was normal and in many instances it's not so just understand that if you're still struggling with sleep the gut microbiome is part of the as part of the

equation addressing your underlying stress and trauma as part of the equation it's not just about replenishing hormones that estrogen patch is important but it's not the only solution right well said so one more question for you I'm curious this is more of a personal question but in a

think are more I don't want to even say imperative but helpful when you are going through these

different stages of menopause that you really stand behind or that you personally used I always

talked about creatine is one of those being very very important and you and I got into that last time quite a bit about you know the right forms of creatine and the basic importance of it but I I'm very curious as to your thoughts on certain recommendations and I want to prep us that by saying you made it very clear already don't rely on these before so people listening she's not saying these are magic these are extra added beneficial things after you've done everything else that

that she talks about in her book and this is just something extra yeah I would say the things

“it stand out that I think every woman needs to know you need to know your vitamin D levels”

very likely need to replenish magnesium there's over 400 enzymatic reactions in the body and you need to read blood cell magnesium because that is actually more accurate than a standard magnesium level and it's not an unusual test I drew it all the time in cardiology and I've been at a cardiology for 10 years so I'll just put it to you that way magnesium is absolutely something that I think about adaptogenicers because we become less stress resilience so I think more about

B vitamins I think about adrenal nutrients the adrenal nutrients are the magnesium the vitamin C the B vitamins there's a lot of nice formulations that are out there of course creatine model hydrate and there's more to creatine like the research is evolving about the microbiome there's another indication for helping with small intestinal permeability there's so much about creatine

mono hydrate it is a total game changer everyone listening should be taking creatine mono hydrate

and leave me very clear you want to make sure it is create pure or creative italics unfortunately the darned German company now is forcing all of us and help them on the space to use creative italics so it's a more expensive investment exactly it's exactly what your facial expression was exactly mine I was like a what so that's the highest quality your less likely to be reactive you want to be conscientious about sourcing it from reliable companies it does not have to be

my own it can be there many good companies that use that I think the other things that I consider is really dependent on what you personally need so you know I feel like a lot of my patients need

“stress support so those adaptogenic herbs become more important I think that you know we're learning”

a whole lot more about short-chain fatty acids and we didn't even touch on the but as our hormones

are declining we start making less short-chain fatty acids and that's when fiber becomes important but I would like people to get fiber from food not fiber from a supplement and I guess the lesson that I would say is magnesium soaks I know this isn't going to be sexy but this is something I should teach my patients so not only do you need oral magnesium you need skin absorbed transdermal magnesium so this is my magnesium soak recipe two cups of magnesium so magnesium

sulfates soaks two cups of baking soda two tablespoons of borax that will help you absorb more and notice borax we're not talking about swallowing it we're just saying we're going to soak our feet in it or we're going to take a bath with it and that will really help your body absorb the magnesium now yes it requires a couple steps but I found that to be really effective because so many my patients were dealing with palpitations irregular heartbeat after we ruled out really serious things

and that was a way that I got their magnesium levels clenished in a way that they were sustainable over time it doesn't mean you need that every day maybe once or twice a week and we're heading into warmer weather where I am and there's no way in hack I'm taking a hot bath in the middle of summer so that's when I will sometimes sit at night with my husband I'll just soak my feet glad you brought that up because I'm having the same problem because I was taking jardians

and the palpitations have been like frequent and it's not anything else I've had every test I know the sun and I know what it is and I can't seem to get it back properly no matter how much I take you can also be hormones I mean that's one thing I'm depending on you know where your variances are I know for women that drop in estrogen and progesterone can provoke a lot of palpitations although for additional cardiologies just making sure you don't have a rib meat that's going to kill you it's like

we ruled it out okay so they're benign so stay away from caffeine stay hydrated that that rose recommendations only goes so far right so one more thing I'm going to ask you because you brought it up the fiber so I want to just quickly just talk about the absolute importance of fiber and then maybe

“a few good sources of the words people should be looking for it yep so fiber is important I”

mentioned these signaling molecules searching fatty acid production goes down they're important

one on the muterate crosses the blood-bring barrier so they're really really important they help

with the mucus lining of the digestive system so fiber becomes more important in middle age when we eat fiber fiber goes through digestive system gets the large intestine or a colon they're the colonocytes fermented and when they ferment it what comes out of that are short-chain fatty acids these are really important so I remind people this is why I'm in the carnivores insist that we don't need fiber I remind them the research now suggests that if you are not consuming fiber in the absence of

me I mean any carbohydrates you're just eating meat your body in a desperation will try to ferment the protein which is a bad thing future vacation is not a good thing you know protein is not

“designed to be fermented ideally I think about really easy ways to get more fiber into your”

diet number one track so that you know where you are average American diet is anywhere from five

date grams a day because process foods are really devoid of fiber so track where you are first

most recommendations are away from 20 to 30 grams a day so if you're currently eating five don't try to go to 30 you'll be very unhappy because your microbes need time to acclimate so when I think about in gentle things that we can do it's cooked vegetables lentils soaked beans if you feel like beans become problematic maybe you start with a tablespoon you know to start with five cups the other thing that I really like is fresh ground flax and chia seeds really really gentle and easy

I have it in a smoothie every day I will tell you it will give you gold star poop so when we talk about Bristol's stool shirt and we're looking at you know the ideal is a number four for a lot of my women that are either constipated or they have diarrhea adding a little bit of fiber into their diet will generally help normalize things jokingly in my house they call artichokes fartichokes but anything that is going to be beneficial you know think about

ferments fermentin vegetables or you know kind of good option we don't have to get complicated I think people automatically think now it and I'm like salads are fine but we want at least 30 plant species per week so sometimes a salad is a good idea if you're trying to get like 10 things in it one but thinking thoughtfully throughout the week I go through I go through stages where like certain vegetables and certain proteins more than others and jokingly I would say monogamy

is good but Fibnogamy we don't want so you don't want to be eating the same exact food every single day because those microbes in the gut need variety you know there's brightly pigmented fruits and

“vegetables that's valuable information there's polyphenols and other really important things so”

start simple don't ever think it before you even think about psyllium husk or any of these other varieties I know when I was writing the book my editor kept saying like we need to have some options and like yes but I still want people to genuinely eat the food like that is the goal to eat the food yes I can't as a nutritionist for so long and as somebody that really has studied food as long

as I have I will never be able to get behind the we don't need fiber thing I just can't I can't

get there and I've got some people that I really respect try to tell me that and I just I cannot I'll never get there I just I just don't grasp that one so I've glad you talked about that and brought up and different options too because a lot of people they do they just think psyllium husk or they just think oatmeal or something and that is just not it's just there's so many options you just

“have to get understand to be creative you know absolutely and I think you know when someone says to”

me I don't tolerate anything other than me it's like someone's going on the microbiome like I was hospitalized in 2019 and I talk about that in the book and I went nine months with eating boiled meat which I did not enjoy just eating meats but that was all my digestive system could tolerate because my gut microbiome had been decimated after six weeks of antibiotics so you know slowly over time and it has taken time to build that back up when someone tells me they do not tolerate fiber

sometimes it's quantity like I said don't eat five cups of beans if I eat five cuts of beans I would be really gassy but yeah you start with a tablespoon like sometimes it's quantity sometimes it's the quality you know don't start with the supplements start with the food because your body knows what to do with that and so people get caught up as soluble and soluble resistant starch I'm like just eat more fiber like stop getting so caught up in the nuance like just think high level and

again the health of your microbiome to me can demonstrate whether or not you're tolerating much fiber so trust me in 2019 my gut was a disaster I am now in you know 2026 and my gut is doing a whole lot better but it is taken time sometimes what you need is a tincture of time we talk about that medicine like sometimes you just need time and you know we're a society that's instant

you need to be more patient yeah you have to know it's perfectly said I swear to you I could I would

“I think you and I could write a book together on stuff right now because I could just keep going”

I know I said that I would be mindful of time and I just looked and I'm like oh shit well you know I cannot tell you Cynthia and I express this wholeheartedly how much I enjoy talking with you I think

it's always so fun and nice every time I see you or anytime we get to encounter each other it's

always great and I feel like we we convey a lot of great information so before I have you talk about your book or anything just thank you because I love this I really do thank you Dylan it's it's an honor and thank you for being so gracious for Dylan's community to let everyone know that Dylan is just doing in person podcasts right now and my schedule has gotten so compressed that very graciously Dylan's and I will make an exception for you so I'm truly very grateful and

appreciative that you're willing to to give me a little bit of a grace for that and and we'll

obviously have to do an in person podcast at some time yeah you're I want you to be my most

“frequent and guests so anytime you want you just tell me so everybody you have to get this book”

and more than that it's not just to go buy the book it's to educate yourself and it's to change your life and to listen to the the interviews that Cynthia gives and the people she has on and what we can extrapolate from all of these people and the conversations and the questions she asks it's absolutely phenomenal so if you would a publishing date when could we buy this be where do we get it and then where does everybody follow you and everything will be in the description.

Thank you Dylan so it's the menopause gut will be officially published on April 28th

sold where all fine books are sold Amazon Barnes and Noble Target books a million your local

bookstore you definitely want to check out and this is the kind of book you actually want the physical copy because there's so much information I've been encouraging people I'm like buy one for

“yourself and buy a couple for your friends this is a book that I think will end up being”

a groundbreaking book that's one of the things I've been hearing from the physicians I've been engaging with over the podcast or like no one else is talking about this this is so needed and so you can find me all across social media I'm probably most likely to be on Instagram or I have a private Facebook group called the midlife pause backslash my name and that was the original working title of the book when I submitted my book proposal but it became evident that we needed

to make the title very descriptive about what was contained in the book and my podcast is everyday wellness it's probably one of my favorite things I do in my walnut in my isn't but if you go to my website www.synthiathurolo.com there's a big banner at the top you can click on that it'll take you directly to pick the vendor of your choice to pick up a copy of the menopause gut. Well, all I ask of you is a signed copy of the book and your friendship that's all I want.

So thank you so much for the time it's going to be cool to go back and watch the difference and how we interview and do stuff now when I go back and compare which I'm certainly going to do but I really enjoyed this you know it's it's even a non-recording day for me and this was just fun I just had a good time it does not work at all it's just fun so thank you Cynthia for all that you do all of the information all the time you spend away from your family because I know I understand

I see it so thank you it's been a pleasure and an honor and hopefully we'll do this again soon Thanks, Dylan awesome all right everybody we'll get out and get this book Follow along follow Cynthia and stay tuned for plenty more to come Dylan Jimelli and Cynthia Thurlow sign it off