Cynthia Thurlow

And so what you are essentially doing is you are making that progressive loss of muscle, which is sarcopenia. It exacerbates that. It magnifies it. And so if you look at all the longevity researchers versus the individuals like Dr. Don Lehman, Dr. Gabrielle Lyon, who were very big proponents of

And so what you are essentially doing is you are making that progressive loss of muscle, which is sarcopenia. It exacerbates that. It magnifies it. And so if you look at all the longevity researchers versus the individuals like Dr. Don Lehman, Dr. Gabrielle Lyon, who were very big proponents of

consuming adequate protein to offset sarcopenia frailty falls etc you start to understand that ultimately you decide for yourself which path you want to take and as someone who's as both as a clinician and as a an individual watching people that are doing omad over time you know watching people track their macros talk to us in programs talk to us in one-on-one environments

consuming adequate protein to offset sarcopenia frailty falls etc you start to understand that ultimately you decide for yourself which path you want to take and as someone who's as both as a clinician and as a an individual watching people that are doing omad over time you know watching people track their macros talk to us in programs talk to us in one-on-one environments

consistently what I see happening is this progressive loss of muscle. The loss of muscle leads to not just frailty over time, but also leads to a loss of insulin sensitivity. So really understanding that our muscles are a metabolic sink and helping people understand that you're not getting enough protein into your diet. You are just going to worsen that unraveling of this loss of muscle.

consistently what I see happening is this progressive loss of muscle. The loss of muscle leads to not just frailty over time, but also leads to a loss of insulin sensitivity. So really understanding that our muscles are a metabolic sink and helping people understand that you're not getting enough protein into your diet. You are just going to worsen that unraveling of this loss of muscle.

I'm a very visual person, so I always like to provide comparisons. So young, healthy muscle looks like filet. We all know what that looks like. Versus a delicious ribeye, still equally delicious, but it has a lot of marbling. It has a lot of fat infiltration. That is what older muscle looks like. We want to remain looking like a filet over time.

I'm a very visual person, so I always like to provide comparisons. So young, healthy muscle looks like filet. We all know what that looks like. Versus a delicious ribeye, still equally delicious, but it has a lot of marbling. It has a lot of fat infiltration. That is what older muscle looks like. We want to remain looking like a filet over time.

So my concern about OMAD is, number one, if it's an occasional thing, not a big deal. You've overindulged. You came back from vacation. You just ate too much. That's very different than a sustained OMAD effort. And there are people in the health and wellness space that do OMAD in perpetuity, many of whom have lost a significant amount of weight. And I don't want to take away from that.

So my concern about OMAD is, number one, if it's an occasional thing, not a big deal. You've overindulged. You came back from vacation. You just ate too much. That's very different than a sustained OMAD effort. And there are people in the health and wellness space that do OMAD in perpetuity, many of whom have lost a significant amount of weight. And I don't want to take away from that.

On the contrary of that, male or female, if you have someone that is not metabolically healthy, someone that is maybe just getting started on their health and wellness journey, an individual who's consuming snacks and mini meals, someone that's eating a lot of ultra processed foods, maybe they're not as physically active as they would like to be.

On the contrary of that, male or female, if you have someone that is not metabolically healthy, someone that is maybe just getting started on their health and wellness journey, an individual who's consuming snacks and mini meals, someone that's eating a lot of ultra processed foods, maybe they're not as physically active as they would like to be.

But I also don't think in many instances they're really fully understanding the long-term impact of that loss of muscle. It is significant and quite profound. And so that is always where my concern goes is, you know, are you getting enough protein? Can you get 100 grams of protein in a meal? I can't. I'm sure there are people out there that might be able to.

But I also don't think in many instances they're really fully understanding the long-term impact of that loss of muscle. It is significant and quite profound. And so that is always where my concern goes is, you know, are you getting enough protein? Can you get 100 grams of protein in a meal? I can't. I'm sure there are people out there that might be able to.

In fact, I have one female friend who does, and I just call her the unicorn. But in terms of everyone else, most of us are not getting 100 grams of protein into one meal. And if you're not getting at least 100 grams of protein in a day, You're just making that whole process of muscle loss. You're just magnifying it.

In fact, I have one female friend who does, and I just call her the unicorn. But in terms of everyone else, most of us are not getting 100 grams of protein into one meal. And if you're not getting at least 100 grams of protein in a day, You're just making that whole process of muscle loss. You're just magnifying it.

I'm going to put it as a D. As a D, not an F. Not an F. I'm sure there'll be other things that will get an F, but it's always that cautionary. Like I understand the utility of it.

I'm going to put it as a D. As a D, not an F. Not an F. I'm sure there'll be other things that will get an F, but it's always that cautionary. Like I understand the utility of it.

And what's interesting, Drew, is that I can assure you if I take any heat for this interview, it'll be about that. About OMAD. About that, without question. Without question.

And what's interesting, Drew, is that I can assure you if I take any heat for this interview, it'll be about that. About OMAD. About that, without question. Without question.

Yeah, well, I would say I would back up and say our gut microbiome has a tremendous amount to do with the health of our gut microbiome, whether or not we can or cannot lose weight. And I know this because I just wrote a book on it. So I feel like this is a uniquely perfect time to have this conversation. So number one.

Yeah, well, I would say I would back up and say our gut microbiome has a tremendous amount to do with the health of our gut microbiome, whether or not we can or cannot lose weight. And I know this because I just wrote a book on it. So I feel like this is a uniquely perfect time to have this conversation. So number one.

opportunistic infections whether it be a parasite h pylori candida dysbiotic organisms all of those things are opportunistic and so when someone says to me i think it's the parasite that is making me weight loss resistant and i'm like there's so many other things that happen first i think that it is a sign that there is a significant gut microbiome shift And it is not per se the parasite.

opportunistic infections whether it be a parasite h pylori candida dysbiotic organisms all of those things are opportunistic and so when someone says to me i think it's the parasite that is making me weight loss resistant and i'm like there's so many other things that happen first i think that it is a sign that there is a significant gut microbiome shift And it is not per se the parasite.

having a compressed feeding window for an individual like that in particular can help jumpstart a lot of health benefits.

having a compressed feeding window for an individual like that in particular can help jumpstart a lot of health benefits.

The parasite is kind of the symptom, if you will. But there's other things that are going on below the surface. So when I think about this, it just it brings me back to understanding. And I'll give you an example. So when young boys and girls are born and they're growing up up until puberty, our microbiomes are very similar.

The parasite is kind of the symptom, if you will. But there's other things that are going on below the surface. So when I think about this, it just it brings me back to understanding. And I'll give you an example. So when young boys and girls are born and they're growing up up until puberty, our microbiomes are very similar.

It's only the advent of puberty that we start seeing differentiation in the microbiome. Obviously, men predominantly with testosterone, women predominantly with estrogen, but also progesterone and a little bit of testosterone. And up until we go through puberty, if someone chooses to get pregnant, they go through pregnancy. There's a shift in the microbiome. And then we get to perimenopause.

It's only the advent of puberty that we start seeing differentiation in the microbiome. Obviously, men predominantly with testosterone, women predominantly with estrogen, but also progesterone and a little bit of testosterone. And up until we go through puberty, if someone chooses to get pregnant, they go through pregnancy. There's a shift in the microbiome. And then we get to perimenopause.

And it's these three big shifts in our lives as women in particular. And then ironically enough, we go into menopause and our gut microbiomes resemble men's. And so the reason why I'm bringing this up is when women in, you know, north of 40 perimenopause menopause suddenly have aberrancies or weird or unusual things that come up on stool testing is one example.

And it's these three big shifts in our lives as women in particular. And then ironically enough, we go into menopause and our gut microbiomes resemble men's. And so the reason why I'm bringing this up is when women in, you know, north of 40 perimenopause menopause suddenly have aberrancies or weird or unusual things that come up on stool testing is one example.

Most of the health benefits that we talk about in terms of intermittent fasting, improved biophysical markers, a degree of reduction in inflammation, improvement in brain health and brain cognition, reduction in specific types of cancers, having the ability to evoke this process called autophagy where we have this waste and recycling process going on. So it's always in the context of

Most of the health benefits that we talk about in terms of intermittent fasting, improved biophysical markers, a degree of reduction in inflammation, improvement in brain health and brain cognition, reduction in specific types of cancers, having the ability to evoke this process called autophagy where we have this waste and recycling process going on. So it's always in the context of

I'm like, it's really a reflection of what's going on at the gut microbiome, both with the differentiation with immune function, things that are changing there. It speaks to individuals that are making less hydrochloric acid. So all of us are exposed to parasites and other type of organisms on a daily basis.

I'm like, it's really a reflection of what's going on at the gut microbiome, both with the differentiation with immune function, things that are changing there. It speaks to individuals that are making less hydrochloric acid. So all of us are exposed to parasites and other type of organisms on a daily basis.

If you eat lettuce, I mean, you are exposed to things because you can only scrub the lettuce or clean the lettuce so well. But we have...

If you eat lettuce, I mean, you are exposed to things because you can only scrub the lettuce or clean the lettuce so well. But we have...

lines of defenses in our body that are designed to do away with these things hydrochloric acid in the stomach um you know you've got other uh you know bicarbonate other things that go on in the microbiome and and beyond that are designed to to help um you know these defenses systems that are designed to get rid of what does not belong. Now, how does a parasite come about?

lines of defenses in our body that are designed to do away with these things hydrochloric acid in the stomach um you know you've got other uh you know bicarbonate other things that go on in the microbiome and and beyond that are designed to to help um you know these defenses systems that are designed to get rid of what does not belong. Now, how does a parasite come about?

There's a couple of different things that happen. You know, it could be you're a certain life stage. You're more susceptible. You make less hydrochloric acid. You're an individual that in many instances, you have chronic stress. You're not sleeping. Your nutrition is terrible. We know 70% of us as Americans alone are eating ultra processed foods.

There's a couple of different things that happen. You know, it could be you're a certain life stage. You're more susceptible. You make less hydrochloric acid. You're an individual that in many instances, you have chronic stress. You're not sleeping. Your nutrition is terrible. We know 70% of us as Americans alone are eating ultra processed foods.

You're not even eating food that has much nutrient quality to it. And so do I think parasites are the reason why people are gaining weight or weight loss resistant? I think it is many other things contributing a degree of inflammation, oxidative stress. There can be so many things that are going on with that. The parasite per se, I would say is just a symptom of a bigger issue.

You're not even eating food that has much nutrient quality to it. And so do I think parasites are the reason why people are gaining weight or weight loss resistant? I think it is many other things contributing a degree of inflammation, oxidative stress. There can be so many things that are going on with that. The parasite per se, I would say is just a symptom of a bigger issue.

So that's where I would leave that. It's, it's not that the parasite is what drove it. It's that there were a lot of other dominoes that had already fallen over. And that just happened to be the one thing that someone did some testing. They figured out there was something else going on, but Many, many things contribute to that. I don't think it is solely from the parasite.

So that's where I would leave that. It's, it's not that the parasite is what drove it. It's that there were a lot of other dominoes that had already fallen over. And that just happened to be the one thing that someone did some testing. They figured out there was something else going on, but Many, many things contribute to that. I don't think it is solely from the parasite.

And by no means am I saying that people don't go through this.

And by no means am I saying that people don't go through this.

It's usually other things that are contributing. And it's usually that is, it's like the red herring. It's like, okay, so we do stool testing. Then we pick up, oh, you have a parasite or you've got significant dysbiosis. Oh, by the way, you have H. pylori or you've got SIBO. I mean, there's many things that can create this domino effect. It's usually multifactorial.

It's usually other things that are contributing. And it's usually that is, it's like the red herring. It's like, okay, so we do stool testing. Then we pick up, oh, you have a parasite or you've got significant dysbiosis. Oh, by the way, you have H. pylori or you've got SIBO. I mean, there's many things that can create this domino effect. It's usually multifactorial.

Like why are we weight loss resistance? It's never just one thing. things.

Like why are we weight loss resistance? It's never just one thing. things.

It depends on the patient. I do still like and embrace the concept of intermittent fasting, but it's always in the context of understanding that fasting is one of many types of hormetic stressors, you know, beneficial stress in the right amount at the right time. And for some people, it's too much stress over time that can be problematic.

It depends on the patient. I do still like and embrace the concept of intermittent fasting, but it's always in the context of understanding that fasting is one of many types of hormetic stressors, you know, beneficial stress in the right amount at the right time. And for some people, it's too much stress over time that can be problematic.

I mean, I think you have to take it in context. What are the patient's symptoms? What are they experiencing? What does their blood work look like? Are they dealing with underlying food sensitivities? Are they female or male? Where are they on their female journey? Are they in perimenopause or menopause? I mean, there's a lot that can impact the interpretation of testing?

I mean, I think you have to take it in context. What are the patient's symptoms? What are they experiencing? What does their blood work look like? Are they dealing with underlying food sensitivities? Are they female or male? Where are they on their female journey? Are they in perimenopause or menopause? I mean, there's a lot that can impact the interpretation of testing?

Do I think there are better companies than others? Absolutely. I think that from my perspective, I have found them to be incredibly invaluable and very validating in terms of the symptoms that someone's experiencing and then working through a protocol to address exactly what we're finding.

Do I think there are better companies than others? Absolutely. I think that from my perspective, I have found them to be incredibly invaluable and very validating in terms of the symptoms that someone's experiencing and then working through a protocol to address exactly what we're finding.

I think that in many instances, there are circumstances where we need antibiotic therapy for things that we find. As an example, I've had people who've had C. diff, which is an opportunistic infection. Sometimes we just see it in the hospital, but you can see it in the community as well. So I think for a lot of individuals, it is, it is really taking a good history.

I think that in many instances, there are circumstances where we need antibiotic therapy for things that we find. As an example, I've had people who've had C. diff, which is an opportunistic infection. Sometimes we just see it in the hospital, but you can see it in the community as well. So I think for a lot of individuals, it is, it is really taking a good history.

That's number one, like any clinician should be. And I'm sure they, the good ones do really good history because it helps tease out what direction you're going to go in. And then using testing to kind of rule out or rule out, rule in or rule out other things that you're concerned about. I think that is helpful, but you know, there's no one test that is perfect. I mean, it just doesn't exist.

That's number one, like any clinician should be. And I'm sure they, the good ones do really good history because it helps tease out what direction you're going to go in. And then using testing to kind of rule out or rule out, rule in or rule out other things that you're concerned about. I think that is helpful, but you know, there's no one test that is perfect. I mean, it just doesn't exist.

And so I think when I start to zero in on, you know, how my thought process has changed over the past 10 years about fasting and

And so I think when I start to zero in on, you know, how my thought process has changed over the past 10 years about fasting and

Do I sometimes run tests on people that I'm convinced they have SIBO or they have significant candida or some other issue or even something more significant than that? And that's when I refer them to a specialist. But I think in many, many instances, if I'm having great concerns about, you know, do they have colorectal cancer? Could there be something quite significant going on?

Do I sometimes run tests on people that I'm convinced they have SIBO or they have significant candida or some other issue or even something more significant than that? And that's when I refer them to a specialist. But I think in many, many instances, if I'm having great concerns about, you know, do they have colorectal cancer? Could there be something quite significant going on?

But I think a lot of it is the interpretation based on the clinician's experience, taking a good history, and then also working with companies where you feel like there's a degree of reliability. There's one company that will remain nameless that since the pandemic, almost every one of my patients was showing up as having H. pylori. And I called the company. I said, how is this even possible?

But I think a lot of it is the interpretation based on the clinician's experience, taking a good history, and then also working with companies where you feel like there's a degree of reliability. There's one company that will remain nameless that since the pandemic, almost every one of my patients was showing up as having H. pylori. And I called the company. I said, how is this even possible?

Because this wasn't happening pre-pandemic. And that required me to do a little bit of course correction. It was like, okay, I'm going to start working with other companies because I'm concerned that this may be an aberrancy. This may be something that It just doesn't make sense that every single person's test would be positive for H. pylori.

Because this wasn't happening pre-pandemic. And that required me to do a little bit of course correction. It was like, okay, I'm going to start working with other companies because I'm concerned that this may be an aberrancy. This may be something that It just doesn't make sense that every single person's test would be positive for H. pylori.

it has gotten a much more nuanced and just having patients get really honest with themselves are you struggling to build muscle are you someone that's not sleeping at night and this could be male or female helping them understand you know intermittent fasting might be something you do on a couple days out of the week it might be on the days you're not lifting weights it might be something that you entertain around your cycle specific times around your cycle

it has gotten a much more nuanced and just having patients get really honest with themselves are you struggling to build muscle are you someone that's not sleeping at night and this could be male or female helping them understand you know intermittent fasting might be something you do on a couple days out of the week it might be on the days you're not lifting weights it might be something that you entertain around your cycle specific times around your cycle

When you look at a broad section of the population, it was like that just doesn't make sense. So I think it's it's a bit of provider preference, provider comfort, getting that good history and then deciding what does that patient specifically need? Like there's no one size fits all in my world.

When you look at a broad section of the population, it was like that just doesn't make sense. So I think it's it's a bit of provider preference, provider comfort, getting that good history and then deciding what does that patient specifically need? Like there's no one size fits all in my world.

Yeah. I mean, I think the biggest thing is understanding that we start in in one place. kind of realm, and we understand the influence of sex hormones are significant and profound. So it's not just immune function and why women in middle age suddenly start becoming more susceptible to parasites and other type of opportunistic infections, but it's bone health.

Yeah. I mean, I think the biggest thing is understanding that we start in in one place. kind of realm, and we understand the influence of sex hormones are significant and profound. So it's not just immune function and why women in middle age suddenly start becoming more susceptible to parasites and other type of opportunistic infections, but it's bone health.

The gut microbiome and bone health are intricately related. Our mood is intricately related to the type of neurotransmitters we're able to create in the gut microbiome. There is literally next to nothing that is not impacted positively or negatively by the microbiome, including when we go into menopause.

The gut microbiome and bone health are intricately related. Our mood is intricately related to the type of neurotransmitters we're able to create in the gut microbiome. There is literally next to nothing that is not impacted positively or negatively by the microbiome, including when we go into menopause.

Ovarian senescence is the concept that probably hasn't been talked about a lot, but it's like now that I've kind of opened that Pandora's box, helping us understand that the role of childhood adverse events can impact when we go into menopause and vis-a-vis communication between the microbiome.

Ovarian senescence is the concept that probably hasn't been talked about a lot, but it's like now that I've kind of opened that Pandora's box, helping us understand that the role of childhood adverse events can impact when we go into menopause and vis-a-vis communication between the microbiome.

and the ovaries and you know it is utterly fascinating so expect it to come out that everything is interconnected you know traditional allopathic medicine tends to think about health care in silos you know the heart is in one bucket the brain's in another And the one thing that I've learned over the past 10 years is that everything is interconnected.

and the ovaries and you know it is utterly fascinating so expect it to come out that everything is interconnected you know traditional allopathic medicine tends to think about health care in silos you know the heart is in one bucket the brain's in another And the one thing that I've learned over the past 10 years is that everything is interconnected.

And the more that we understand about the gut microbiome, the more that I am impressed, the fact that we function day to day, but also understanding how important all this hormone signaling, polyphenol signaling from things like urolithin A, from nitric oxide, all of these signaling molecules communicating within the body, within the gut microbiome to get things to work and be optimal is incredibly humbling.

And the more that we understand about the gut microbiome, the more that I am impressed, the fact that we function day to day, but also understanding how important all this hormone signaling, polyphenol signaling from things like urolithin A, from nitric oxide, all of these signaling molecules communicating within the body, within the gut microbiome to get things to work and be optimal is incredibly humbling.

It can absolutely contribute. And the greatest concern that I have is traditional allopathic medicine has a very narrow-minded perspective on thyroid testing. And therefore, many, many women outside of a traditional allopathic world are oftentimes not properly diagnosed.

It can absolutely contribute. And the greatest concern that I have is traditional allopathic medicine has a very narrow-minded perspective on thyroid testing. And therefore, many, many women outside of a traditional allopathic world are oftentimes not properly diagnosed.

And so I think that it's always a nuanced conversation when it comes to fasting. So if I'm thinking about a ranking, I'd probably make it a B or C. So something in that kind of average range really depends on the individual still has merits. But if you are that type of woman that is middle aged and you are over fasting, under eating, over exercising, you're not doing yourself any benefits.

And so I think that it's always a nuanced conversation when it comes to fasting. So if I'm thinking about a ranking, I'd probably make it a B or C. So something in that kind of average range really depends on the individual still has merits. But if you are that type of woman that is middle aged and you are over fasting, under eating, over exercising, you're not doing yourself any benefits.

So let's back it up and talk about the fact that when I was working in traditional allopathic medicine, we probably did two blood tests to look at thyroid function, which does not encompass everything.

So let's back it up and talk about the fact that when I was working in traditional allopathic medicine, we probably did two blood tests to look at thyroid function, which does not encompass everything.

you add on top of that that just like we go through menopause perimenopause we go through thyroid pause there is absolutely positively most often than not women that are navigating that perimenopause to menopause transition are experiencing some degree of underactive thyroid now The allopathic physicians would say that's bunk, that doesn't actually happen. I've seen it thousands of times.

you add on top of that that just like we go through menopause perimenopause we go through thyroid pause there is absolutely positively most often than not women that are navigating that perimenopause to menopause transition are experiencing some degree of underactive thyroid now The allopathic physicians would say that's bunk, that doesn't actually happen. I've seen it thousands of times.

If you look at trends over time of lab work, looking at like where was their TSH and their free T3, free T4, et cetera, over time, what is happening is they have this loss of sex hormones. So number one, the most common thing we will see in perimenopause and menopause is this underactive thyroid, hypothyroidism, typically caused by an autoimmune condition called Hashimoto's.

If you look at trends over time of lab work, looking at like where was their TSH and their free T3, free T4, et cetera, over time, what is happening is they have this loss of sex hormones. So number one, the most common thing we will see in perimenopause and menopause is this underactive thyroid, hypothyroidism, typically caused by an autoimmune condition called Hashimoto's.

less commonly by Graves, which is where it's overactive. So I find for a lot of women, it is not just this subjective, I'm tired, I'm gaining weight, I'm constipated, my skin is dry. It is the thyroid is just not optimal. It's not optimal. It's not in a position where they even feel like they have enough energy to get out of bed.

less commonly by Graves, which is where it's overactive. So I find for a lot of women, it is not just this subjective, I'm tired, I'm gaining weight, I'm constipated, my skin is dry. It is the thyroid is just not optimal. It's not optimal. It's not in a position where they even feel like they have enough energy to get out of bed.

So it can be very complicated when we start talking about not just thyroid. It's also the sex hormones piece. It can be lack of sleep. It can be chronic stress. But I find for a lot of individuals, thyroid mismanagement or thyroid under management is absolutely contributing to weight loss resistance. When I find most women.

So it can be very complicated when we start talking about not just thyroid. It's also the sex hormones piece. It can be lack of sleep. It can be chronic stress. But I find for a lot of individuals, thyroid mismanagement or thyroid under management is absolutely contributing to weight loss resistance. When I find most women.

even if they're on a very low dose, it's compounded or even traditional things like armor thyroid and things like that, they get started on thyroid medicine and they feel like their brain works better. They feel like they can get out of bed. They may not lose weight immediately, but they will start feeling like they have the energy to go to the gym.

even if they're on a very low dose, it's compounded or even traditional things like armor thyroid and things like that, they get started on thyroid medicine and they feel like their brain works better. They feel like they can get out of bed. They may not lose weight immediately, but they will start feeling like they have the energy to go to the gym.

They're making better food choices because they have more energy to cook. And so I would say that when it comes to thyroid, it is absolutely contributory to weight loss resistance, shifts in body composition. This is absolutely a B.

They're making better food choices because they have more energy to cook. And so I would say that when it comes to thyroid, it is absolutely contributory to weight loss resistance, shifts in body composition. This is absolutely a B.

it's not i'm not hearing from you and correct me if i'm wrong that it's probably more of the indirect things but it can play some role in some of the direct things as well is that i'm hearing that appropriately absolutely and i i always like to be fully transparent that it was probably eight years ago and my primary care provider checked my thyroid and i i was that typical perimenopausal woman i was exhausted i was tired i was weight loss resistant i couldn't sleep my skin was dry my hair was dry i mean everything

it's not i'm not hearing from you and correct me if i'm wrong that it's probably more of the indirect things but it can play some role in some of the direct things as well is that i'm hearing that appropriately absolutely and i i always like to be fully transparent that it was probably eight years ago and my primary care provider checked my thyroid and i i was that typical perimenopausal woman i was exhausted i was tired i was weight loss resistant i couldn't sleep my skin was dry my hair was dry i mean everything

And she pointed out, you know, your thyroid's underactive. And I was like, I don't want to take a medication for the rest of my life. And so for about three months, I fought this. And then I finally went to her one day and said, I'm absolutely exhausted. I cannot function. And within three days of starting medication, I felt like a light bulb had been turned back on in my brain.

And she pointed out, you know, your thyroid's underactive. And I was like, I don't want to take a medication for the rest of my life. And so for about three months, I fought this. And then I finally went to her one day and said, I'm absolutely exhausted. I cannot function. And within three days of starting medication, I felt like a light bulb had been turned back on in my brain.

And so I think it's important to share that even I was resistant because I didn't want to take a medication every day. But I happily take said medication every day because it has made such a significant difference. Now, did I go from, you know, having brain fog and not feeling great and not having energy to instantly losing weight? Absolutely not, because it's like peeling an onion.

And so I think it's important to share that even I was resistant because I didn't want to take a medication every day. But I happily take said medication every day because it has made such a significant difference. Now, did I go from, you know, having brain fog and not feeling great and not having energy to instantly losing weight? Absolutely not, because it's like peeling an onion.

You have to keep peeling and peeling and peeling. But I think for a lot of individuals that are listening to this that suspect they might have an underactive thyroid, everything slows down in the body. So you get constipated. Your cycles may change. You may have dry skin. You may feel like you're not mentating well, meaning you're just not feeling like you're as clear cognitively.

You have to keep peeling and peeling and peeling. But I think for a lot of individuals that are listening to this that suspect they might have an underactive thyroid, everything slows down in the body. So you get constipated. Your cycles may change. You may have dry skin. You may feel like you're not mentating well, meaning you're just not feeling like you're as clear cognitively.

People may have slowed heart rate. They may have brittle nails. There's a lot of things that can happen. Everything slows down. And so for a lot of individuals, it's getting tested to figure out what's going on.

People may have slowed heart rate. They may have brittle nails. There's a lot of things that can happen. Everything slows down. And so for a lot of individuals, it's getting tested to figure out what's going on.

And so the types of tests that I recommend, TSH, which is thyroid secreting hormone, looking at a free T3 and a free T4, that's the actual, especially the T3 is important because that's the actual active form of the hormone. Looking at reverse T3, which sometimes the allopathic community screams about. It can be a sign if you're dealing with chronic stress, if that is high.

And so the types of tests that I recommend, TSH, which is thyroid secreting hormone, looking at a free T3 and a free T4, that's the actual, especially the T3 is important because that's the actual active form of the hormone. Looking at reverse T3, which sometimes the allopathic community screams about. It can be a sign if you're dealing with chronic stress, if that is high.

Looking at antibodies, super important to look at antibodies because just like I mentioned earlier, the number one reason women will develop an underactive thyroid is related to Hashimoto's. Now, I've never had a positive antibody, but I do have Hashimoto's. So I think for a lot of people, it's helping them understand, like, why do we get more susceptible to autoimmunity as we get older?

Looking at antibodies, super important to look at antibodies because just like I mentioned earlier, the number one reason women will develop an underactive thyroid is related to Hashimoto's. Now, I've never had a positive antibody, but I do have Hashimoto's. So I think for a lot of people, it's helping them understand, like, why do we get more susceptible to autoimmunity as we get older?

It goes back to that immune system dysregulation that happens with those sex hormone changes in middle age. And women are much more likely to develop autoimmune conditions just by virtue of our gender.

It goes back to that immune system dysregulation that happens with those sex hormone changes in middle age. And women are much more likely to develop autoimmune conditions just by virtue of our gender.

We tend to have a more hyper responsive immune system, which is what protects the fetus when we're pregnant, but also can be problematic as we're getting older because our immune system just tends to be more easily provoked. And so when I think about thyroid function, it's helping people understand there are far more people undertreated for thyroid than should be the case.

We tend to have a more hyper responsive immune system, which is what protects the fetus when we're pregnant, but also can be problematic as we're getting older because our immune system just tends to be more easily provoked. And so when I think about thyroid function, it's helping people understand there are far more people undertreated for thyroid than should be the case.

And a lot of women suffer needlessly in middle age for this reason. And men are not immune to it. I have plenty of male family members, people that I know personally who are otherwise healthy, who just have underactive thyroid. It's almost like it's like a spark plug that has just kind of lost its ability to generate enough ATP, enough energy. And so helping people understand that

And a lot of women suffer needlessly in middle age for this reason. And men are not immune to it. I have plenty of male family members, people that I know personally who are otherwise healthy, who just have underactive thyroid. It's almost like it's like a spark plug that has just kind of lost its ability to generate enough ATP, enough energy. And so helping people understand that

It's not that you've done anything wrong. It's like many things. I hate to use the analogy to a car as the aging process, but just like we have to replace things in the car over time, there are things that just don't work as effectively or as efficiently over time.

It's not that you've done anything wrong. It's like many things. I hate to use the analogy to a car as the aging process, but just like we have to replace things in the car over time, there are things that just don't work as effectively or as efficiently over time.

Yeah. So I think it goes back to bio-individuality. You're going to have people that will tell you, I tolerate zero fiber. I get gassy. I get bloated. I feel terrible. I don't like it. And then I have other people who thrive on higher fiber diets. So let's talk about the biggest issue is most, if not all of us, are not eating enough fiber.

Yeah. So I think it goes back to bio-individuality. You're going to have people that will tell you, I tolerate zero fiber. I get gassy. I get bloated. I feel terrible. I don't like it. And then I have other people who thrive on higher fiber diets. So let's talk about the biggest issue is most, if not all of us, are not eating enough fiber.

And if you look at the research on the gut microbiome, fiber feeds the good bacteria in the gut. I mean, it's simply stated. If you look at the research, I think bioindividuality plays a large role in here. I know that I was full carnivore for nine months after being hospitalized. I tolerated zero fiber for a long period of time.

And if you look at the research on the gut microbiome, fiber feeds the good bacteria in the gut. I mean, it's simply stated. If you look at the research, I think bioindividuality plays a large role in here. I know that I was full carnivore for nine months after being hospitalized. I tolerated zero fiber for a long period of time.

When patients tell me they tolerate no fiber, I start to think about what's going on in your microbiome that is driving these intolerances or this discomfort or your symptoms. More often than not, I'm a bigger believer of the fact that some fiber is better than none. For each one of us, it might look a little bit differently. The guidelines say 25 to 30 grams a day.

When patients tell me they tolerate no fiber, I start to think about what's going on in your microbiome that is driving these intolerances or this discomfort or your symptoms. More often than not, I'm a bigger believer of the fact that some fiber is better than none. For each one of us, it might look a little bit differently. The guidelines say 25 to 30 grams a day.

I would imagine most of us are not getting even half of that. So I think that I go into this saying bioindividuality rules. If you look at the research, though, the research absolutely supports the need for fiber to feed the healthy gut microbiome and to look at

I would imagine most of us are not getting even half of that. So I think that I go into this saying bioindividuality rules. If you look at the research, though, the research absolutely supports the need for fiber to feed the healthy gut microbiome and to look at

know these prebiotics and and probiotics and what feeds you know short chain fatty acid production and all these very important things that go on in the gut and i know far more now than i ever thought i would but with that being said this is very much a bio individual because i feel like there's enough people that don't tolerate fiber that i i try very hard to get a little bit into their diet you know whether it's with a supplement

know these prebiotics and and probiotics and what feeds you know short chain fatty acid production and all these very important things that go on in the gut and i know far more now than i ever thought i would but with that being said this is very much a bio individual because i feel like there's enough people that don't tolerate fiber that i i try very hard to get a little bit into their diet you know whether it's with a supplement

Yeah, it's a great question. I think the first thing that I would actually have them do is track their macros because that gives me a sense right there of, are you able to meet your protein targets of where you should be? That's number one, because that'll allow me to see, could you get away with having a compressed feeding window or do you struggle to get in

Yeah, it's a great question. I think the first thing that I would actually have them do is track their macros because that gives me a sense right there of, are you able to meet your protein targets of where you should be? That's number one, because that'll allow me to see, could you get away with having a compressed feeding window or do you struggle to get in

Or we dip our toe in the pond and we try just, you know, you have an eighth of a cup of lentils one day and maybe another day you're having, you know, a small amount of greens. And then the day after you might introduce some, you know, low glycemic berries just to be getting something into the diet.

Or we dip our toe in the pond and we try just, you know, you have an eighth of a cup of lentils one day and maybe another day you're having, you know, a small amount of greens. And then the day after you might introduce some, you know, low glycemic berries just to be getting something into the diet.

But I think more often than not, if someone is completely intolerant of fiber, it's a reflection of what's going on in their microbiome.

But I think more often than not, if someone is completely intolerant of fiber, it's a reflection of what's going on in their microbiome.

I think it's quite important. I would say I'm going to probably going to get in trouble for saying this. I'm going to put it up as a name.

I think it's quite important. I would say I'm going to probably going to get in trouble for saying this. I'm going to put it up as a name.

I think it's actually important. And the irony is over time, because I've had patients try inulin and psyllium and I mean, all sorts of different, it is as individual as the patient. And we start in some instances, we're starting with an eighth of a teaspoon a day just to see, you know, what can we build them up to? It's that important to at least try it.

I think it's actually important. And the irony is over time, because I've had patients try inulin and psyllium and I mean, all sorts of different, it is as individual as the patient. And we start in some instances, we're starting with an eighth of a teaspoon a day just to see, you know, what can we build them up to? It's that important to at least try it.

And I think it's an important, you know, it's a bit of experimentation. And certainly I've had patients who've had SIBO and we've had them on very low FODMAP diets. And there's all sorts of great resources online where you can see it's like a traffic light, you know, green, yellow and red from like lowest to highest FODMAP. I think for a lot of individuals that can be very, very helpful.

And I think it's an important, you know, it's a bit of experimentation. And certainly I've had patients who've had SIBO and we've had them on very low FODMAP diets. And there's all sorts of great resources online where you can see it's like a traffic light, you know, green, yellow and red from like lowest to highest FODMAP. I think for a lot of individuals that can be very, very helpful.

The other thing that's really interesting is it goes back to reflecting on The health of your microbiome has a lot to do with what you can or cannot tolerate. And I don't say that to be shaming because I think my gut microbiome has been all over the place over the last 10 years. But I think for a lot of people, as they start healing, they will find that they are more tolerant.

The other thing that's really interesting is it goes back to reflecting on The health of your microbiome has a lot to do with what you can or cannot tolerate. And I don't say that to be shaming because I think my gut microbiome has been all over the place over the last 10 years. But I think for a lot of people, as they start healing, they will find that they are more tolerant.

50 grams of protein a day, because that is a totally separate issue. I think when it's five or 10 pounds, I find for most people, it is the discretionary fun foods. It's the alcohol on the weekends. It's the desserts. It's maybe having that extra portion of ultra processed foods that are adding to you know, the trouble with losing weight or weight loss resistance.

50 grams of protein a day, because that is a totally separate issue. I think when it's five or 10 pounds, I find for most people, it is the discretionary fun foods. It's the alcohol on the weekends. It's the desserts. It's maybe having that extra portion of ultra processed foods that are adding to you know, the trouble with losing weight or weight loss resistance.

I mean, I do think cumulatively over time we are exposed to a lot. So our toxin bucket over time can get filled. And I think by middle age, most, if not all of us have, whether it's between environmental exposures, food exposures, personal care products exposures, which I think are not probably talked about enough.

I mean, I do think cumulatively over time we are exposed to a lot. So our toxin bucket over time can get filled. And I think by middle age, most, if not all of us have, whether it's between environmental exposures, food exposures, personal care products exposures, which I think are not probably talked about enough.

mercury amalgams, I don't want to get controversial, like vaccines, just everything, cumulatively over time, depending on our genetics, depending on who we are, we can be exposed to a lot. I am a fan of looking at specific testing to determine, and based on symptoms and getting that good history, determine if someone actually needs something like that.

mercury amalgams, I don't want to get controversial, like vaccines, just everything, cumulatively over time, depending on our genetics, depending on who we are, we can be exposed to a lot. I am a fan of looking at specific testing to determine, and based on symptoms and getting that good history, determine if someone actually needs something like that.

Now, do I do testing where it is evident to me that someone has been exposed to a lot of plastics? Yes. Do I see people that are not breaking down their estrogens properly? Absolutely. Are there people that don't detox well? And by that, I mean not just detox in a box.

Now, do I do testing where it is evident to me that someone has been exposed to a lot of plastics? Yes. Do I see people that are not breaking down their estrogens properly? Absolutely. Are there people that don't detox well? And by that, I mean not just detox in a box.

They have the genetic SNPs that either it's phase one and phase two, which occur in the liver, or maybe they just recirculate their estrogen because their gut's a disaster. Do I see plenty of people like that? Absolutely. I think that if we have this one size fits all methodology that everyone needs X, that can be problematic.

They have the genetic SNPs that either it's phase one and phase two, which occur in the liver, or maybe they just recirculate their estrogen because their gut's a disaster. Do I see plenty of people like that? Absolutely. I think that if we have this one size fits all methodology that everyone needs X, that can be problematic.

And so I think that I would go back to say, I think this is kind of a mediocre recommendation in the context of everyone needs it and everyone needs the same, you know, everyone needs the same binder and everyone needs the same detox program and everyone needs everything. You know, you know, there's there are programs out there that have hundreds, if not thousands of people in them.

And so I think that I would go back to say, I think this is kind of a mediocre recommendation in the context of everyone needs it and everyone needs the same, you know, everyone needs the same binder and everyone needs the same detox program and everyone needs everything. You know, you know, there's there are programs out there that have hundreds, if not thousands of people in them.

And they're servicing thousands and thousands of people all doing exactly the same exact thing. Now, with that being said, are there things that I think that can facilitate natural detoxification processes in our body that all of us can do? Absolutely. Like sauna. sauna exercise, dry brushing, lymphatic massage. I mean, you think about how do we detox optimally?

And they're servicing thousands and thousands of people all doing exactly the same exact thing. Now, with that being said, are there things that I think that can facilitate natural detoxification processes in our body that all of us can do? Absolutely. Like sauna. sauna exercise, dry brushing, lymphatic massage. I mean, you think about how do we detox optimally?

We poop, we pee, we sweat, we breathe. I mean, that is how it's supposed to be optimally happening. But there are a lot of lifestyle things, you know, whether it's, you know, certain types of vegetables, whether it's You know, certain types of, you know, hydration. I mean, simple things, hydration, sleep, dry brushing, sauna, infrared sauna.

We poop, we pee, we sweat, we breathe. I mean, that is how it's supposed to be optimally happening. But there are a lot of lifestyle things, you know, whether it's, you know, certain types of vegetables, whether it's You know, certain types of, you know, hydration. I mean, simple things, hydration, sleep, dry brushing, sauna, infrared sauna.

Yes, absolutely. I mean, you talk about DIM as a molecule that you can find in specific compounds of vegetables like your crucifers. Absolutely. Absolutely. And then, you know, it's just thinking about just testing, demonstrate that you actually need X, Y, or Z. Like I have MTHFR, I have two copies. I am a terrible phase two detoxifier.

Yes, absolutely. I mean, you talk about DIM as a molecule that you can find in specific compounds of vegetables like your crucifers. Absolutely. Absolutely. And then, you know, it's just thinking about just testing, demonstrate that you actually need X, Y, or Z. Like I have MTHFR, I have two copies. I am a terrible phase two detoxifier.

So in my body, there are certain nutrients that I need more of, but I eat plenty of those vegetables that have those things. But I also take a specific supplement to facilitate that, but it would not be the recommendation I would make to everyone, which is why I don't love these one size fits all detox in a box supplements.

So in my body, there are certain nutrients that I need more of, but I eat plenty of those vegetables that have those things. But I also take a specific supplement to facilitate that, but it would not be the recommendation I would make to everyone, which is why I don't love these one size fits all detox in a box supplements.

So sometimes it's starting there, like the transparency piece, and I'm a data geek. So it's like, let's track your macros for a couple of days just to see what you're doing. And then we can decide if you're already getting in 120 grams of protein a day,

So sometimes it's starting there, like the transparency piece, and I'm a data geek. So it's like, let's track your macros for a couple of days just to see what you're doing. And then we can decide if you're already getting in 120 grams of protein a day,

I think I'm trying to sway you.

I think I'm trying to sway you.

I think I think there's an F in there. I just haven't hit it yet. Although I do. I do. The cautionary thing is I think there are very well-meaning people out there. Yes. And that's kind of my prevailing thought process in life.

I think I think there's an F in there. I just haven't hit it yet. Although I do. I do. The cautionary thing is I think there are very well-meaning people out there. Yes. And that's kind of my prevailing thought process in life.

I have to believe that. But there are charlatans and the charlatans are going to convince the thousands of people out there need exactly the detox in a box. And I'm here to tell you that that's probably not the case.

I have to believe that. But there are charlatans and the charlatans are going to convince the thousands of people out there need exactly the detox in a box. And I'm here to tell you that that's probably not the case.

I'm going to give it a D and it's context of why I'm saying this.

I'm going to give it a D and it's context of why I'm saying this.

Intense daily cardio. Right. So I think zone two cardio, which is designed to keep your heart rate at a certain level, is very different than chronic, unrelenting, hardcore cardio, which is very different than high intensity interval training. We know that burst training is important for women in particular, but burst training is Five to 10 minutes. It is not 30 minutes.

Intense daily cardio. Right. So I think zone two cardio, which is designed to keep your heart rate at a certain level, is very different than chronic, unrelenting, hardcore cardio, which is very different than high intensity interval training. We know that burst training is important for women in particular, but burst training is Five to 10 minutes. It is not 30 minutes.

I think it depends. So when I talk about the desire to intermittent fast and the health benefits that come from it, It's always with the dovetail caveat of it depends. And because intermittent fasting is not new or novel, despite what the media would like us to think, it is designed to be able to help us utilize stored fat as energy, ideally.

I think it depends. So when I talk about the desire to intermittent fast and the health benefits that come from it, It's always with the dovetail caveat of it depends. And because intermittent fasting is not new or novel, despite what the media would like us to think, it is designed to be able to help us utilize stored fat as energy, ideally.

It is not an hour long slog where you're killing yourself on a bike or you are, you know, doing and I'm going to take a lot of heat for this CrossFit or Orange Theory Fitness five days a week with no breaks. That is not what we're talking about. And so I think that there's a place for strength training. There's a place for zone two training, which is designed to be done where you're not panting.

It is not an hour long slog where you're killing yourself on a bike or you are, you know, doing and I'm going to take a lot of heat for this CrossFit or Orange Theory Fitness five days a week with no breaks. That is not what we're talking about. And so I think that there's a place for strength training. There's a place for zone two training, which is designed to be done where you're not panting.

Having a compressed feeding window is probably not a big deal, but if you're someone struggling to get 50 or 60 a day, you're the last person that I want you to have an ultra compressed feeding window. I find for a lot of patients, it's cutting out alcohol, it's cutting out the sweets, it's cutting out processed carbs that have a huge net impact on those last 5, 10, 15 pounds.

Having a compressed feeding window is probably not a big deal, but if you're someone struggling to get 50 or 60 a day, you're the last person that I want you to have an ultra compressed feeding window. I find for a lot of patients, it's cutting out alcohol, it's cutting out the sweets, it's cutting out processed carbs that have a huge net impact on those last 5, 10, 15 pounds.

You're able to carry on a conversation. You could be walking up hills in your neighborhood. As an example, I live in a very hilly part of my state. very different than chronic cardio. And I think my generation has been convinced. Number one, we want to be skinny and not strong.

You're able to carry on a conversation. You could be walking up hills in your neighborhood. As an example, I live in a very hilly part of my state. very different than chronic cardio. And I think my generation has been convinced. Number one, we want to be skinny and not strong.

And the other thing that I think about quite a bit is that we were the generation that was convinced that we wanted to do all these aerobic activities and That's probably not what is going to allow us to lose weight over time. Now, are there exceptions?

And the other thing that I think about quite a bit is that we were the generation that was convinced that we wanted to do all these aerobic activities and That's probably not what is going to allow us to lose weight over time. Now, are there exceptions?

Probably, but I find more often than not, the amount of cortisol that you are eliciting with that chronic, unrelenting, hardcore cardio is not the cortisol that is going to be your friend. I think when we're talking about that intense cardio that we've been conditioned to believe is what's going to allow us to lose weight, we know that exercise is actually a poor way to lose weight.

Probably, but I find more often than not, the amount of cortisol that you are eliciting with that chronic, unrelenting, hardcore cardio is not the cortisol that is going to be your friend. I think when we're talking about that intense cardio that we've been conditioned to believe is what's going to allow us to lose weight, we know that exercise is actually a poor way to lose weight.

It does many other benefits, but if you're purely doing hardcore cardio to lose weight, that's actually not particularly effective and that's looking at the science. So when I'm helping women understand how to restructure their exercise, it's like, I'm not telling you not to exercise, but let's exercise smarter. Put your time into strength training, do some zone two training,

It does many other benefits, but if you're purely doing hardcore cardio to lose weight, that's actually not particularly effective and that's looking at the science. So when I'm helping women understand how to restructure their exercise, it's like, I'm not telling you not to exercise, but let's exercise smarter. Put your time into strength training, do some zone two training,

High-intensity interval training or burst training is important, but that's not an hour-long activity. That's like 10 or 12 minutes of activity. This is where people have gotten hit and Tabata all wrong. It's not a 30-minute class. It is designed to be short durations.

High-intensity interval training or burst training is important, but that's not an hour-long activity. That's like 10 or 12 minutes of activity. This is where people have gotten hit and Tabata all wrong. It's not a 30-minute class. It is designed to be short durations.

Like when I work out with my trainer, which I do twice a week to torture myself, it is 12 to 15 minutes most of burst training, and it is very intense training. And then you you take two minutes off and it's like that is what you are doing.

Like when I work out with my trainer, which I do twice a week to torture myself, it is 12 to 15 minutes most of burst training, and it is very intense training. And then you you take two minutes off and it's like that is what you are doing.

So I think many women that come to or have been doing chronic, you know, they just want to run 10, 15 miles every day or they want to get on that bike for two hours. It's helping them understand that those types of activities over time will actually work against us. They will break down muscle. They will raise cortisol.

So I think many women that come to or have been doing chronic, you know, they just want to run 10, 15 miles every day or they want to get on that bike for two hours. It's helping them understand that those types of activities over time will actually work against us. They will break down muscle. They will raise cortisol.

which just fuels these, this breakdown in inflammation, gut health, muscle breakdown, you know, even Dr. Stacey Sims talks about, you know, why we have to exercise smarter as we're getting older.

which just fuels these, this breakdown in inflammation, gut health, muscle breakdown, you know, even Dr. Stacey Sims talks about, you know, why we have to exercise smarter as we're getting older.

And it's just helping people understand we have to find that reframe because we've been conditioned, at least my generation, skinny over strong, you know, do all the chronic cardio, because that's going to help you lose weight. And that's actually not the case.

And it's just helping people understand we have to find that reframe because we've been conditioned, at least my generation, skinny over strong, you know, do all the chronic cardio, because that's going to help you lose weight. And that's actually not the case.

I'm talking about strength training and zone two. Zone two is the kind of training where you are still able to carry on a conversation. It's designed to be... You know, when I think about what I do for zone two, it is usually walking hills because there's so many of them.

I'm talking about strength training and zone two. Zone two is the kind of training where you are still able to carry on a conversation. It's designed to be... You know, when I think about what I do for zone two, it is usually walking hills because there's so many of them.

And then, you know, two days a week, 10 or 15 minutes of burst training or high intensity emerald training, that is very different. And I think for many individuals, that becomes... something that is sustainable as opposed to like, oh gosh, I've got to go run and mile. I've got to run for the next hour.

And then, you know, two days a week, 10 or 15 minutes of burst training or high intensity emerald training, that is very different. And I think for many individuals, that becomes... something that is sustainable as opposed to like, oh gosh, I've got to go run and mile. I've got to run for the next hour.

No. And that's important. So I think for a lot of, I would say this is, this is actually an S.

No. And that's important. So I think for a lot of, I would say this is, this is actually an S.

I personally am a big walker. Like I actually like that non-exercise induced thermogenesis. So just being active throughout the day. Do I think that every person realistically is going to hit 10,000 steps every day? Probably not. I have three dogs, so it's pretty easy.

I personally am a big walker. Like I actually like that non-exercise induced thermogenesis. So just being active throughout the day. Do I think that every person realistically is going to hit 10,000 steps every day? Probably not. I have three dogs, so it's pretty easy.

But I think for a lot of individuals, like if they can just build it into they after a meal, they walk, you know, they park a little farther out at the grocery store or at the mall, if anyone still goes to malls or, you know, you're just doing some type of physical activity. Like for me, I can just walk hills up and down my street and get plenty of steps in.

But I think for a lot of individuals, like if they can just build it into they after a meal, they walk, you know, they park a little farther out at the grocery store or at the mall, if anyone still goes to malls or, you know, you're just doing some type of physical activity. Like for me, I can just walk hills up and down my street and get plenty of steps in.

So I think what it's encouraging people to do, like the prevailing theme is, Be physically active. This is in addition to the other types of exercise that you're doing. And I know that a friend of mine recently was talking about how she does not feel that walking is exercise.

So I think what it's encouraging people to do, like the prevailing theme is, Be physically active. This is in addition to the other types of exercise that you're doing. And I know that a friend of mine recently was talking about how she does not feel that walking is exercise.

I think it's important because you have to meet people where they are. For some people, getting 5,000 steps a day is a lot. So I look at it as 10,000 is great. Do I think that it's important to be, you know, for locomotion purposes, for being physically active? Absolutely. And I think for a lot of people, I go back to tracking macros.

I think it's important because you have to meet people where they are. For some people, getting 5,000 steps a day is a lot. So I look at it as 10,000 is great. Do I think that it's important to be, you know, for locomotion purposes, for being physically active? Absolutely. And I think for a lot of people, I go back to tracking macros.

For a lot of people, they just don't realize how sedentary they are. Like when I started tracking how far I was walking back when I was still seeing patients in the hospital, in the office, I was shocked. I was like, oh, I'm all over the hospital. I'm getting in 10,000 steps a day. No, I wasn't, even though I was in a big hospital.

For a lot of people, they just don't realize how sedentary they are. Like when I started tracking how far I was walking back when I was still seeing patients in the hospital, in the office, I was shocked. I was like, oh, I'm all over the hospital. I'm getting in 10,000 steps a day. No, I wasn't, even though I was in a big hospital.

So I think for a lot of people building awareness of what are the things I can do, whether it's maybe you get up a little earlier in the morning to walk for 15 minutes before you go to work. Maybe you walk after lunch. Maybe you and your spouse, you know, now we're heading into spring and summer. You know, it's it's lighter later walking with your spouse or your kids or whomever your pet.

So I think for a lot of people building awareness of what are the things I can do, whether it's maybe you get up a little earlier in the morning to walk for 15 minutes before you go to work. Maybe you walk after lunch. Maybe you and your spouse, you know, now we're heading into spring and summer. You know, it's it's lighter later walking with your spouse or your kids or whomever your pet.

after dinner, you know, just getting opportunities to become more physically active, I think is very important, the emphasis on activity.

after dinner, you know, just getting opportunities to become more physically active, I think is very important, the emphasis on activity.

And so walking is something you don't need a lot of special equipment for, you don't have to do a lot of special things for, for people that are dealing with mobility issues, sometimes getting in a pool, like if your gym has a pool, you can get in the pool and just, you know, you can do water laps, going back and forth, you don't necessarily have to swim. But I think for every

And so walking is something you don't need a lot of special equipment for, you don't have to do a lot of special things for, for people that are dealing with mobility issues, sometimes getting in a pool, like if your gym has a pool, you can get in the pool and just, you know, you can do water laps, going back and forth, you don't necessarily have to swim. But I think for every

reason i've been given by patients over the years of why they don't they're not more physically active i try to come up with alternatives and so i would say being more physically active plus or minus those 10 000 steps is a b it's important i think it's very important that's great you know on that note i saw a tweet recently from an episode that rhonda patrick did where she said okay we want physical activity for sure like we want a lot of movement throughout the day and

reason i've been given by patients over the years of why they don't they're not more physically active i try to come up with alternatives and so i would say being more physically active plus or minus those 10 000 steps is a b it's important i think it's very important that's great you know on that note i saw a tweet recently from an episode that rhonda patrick did where she said okay we want physical activity for sure like we want a lot of movement throughout the day and

Yeah, and it's interesting because even burst training can be helpful for visceral fat. So for a lot of people, we know visceral fat is the fat accumulation around our vital organs. That burst training can be very effective at...

Yeah, and it's interesting because even burst training can be helpful for visceral fat. So for a lot of people, we know visceral fat is the fat accumulation around our vital organs. That burst training can be very effective at...

improving the degree of visceral fat we have and we know again it's like this this little switch that goes off north of 40 we are much more prone to fat deposition there especially as women than we are in other areas where maybe it's more pesky if it's on our rear ends or on the back of our arms but that visceral fat is the stuff we want to avoid so burst training can be helpful for that as well

improving the degree of visceral fat we have and we know again it's like this this little switch that goes off north of 40 we are much more prone to fat deposition there especially as women than we are in other areas where maybe it's more pesky if it's on our rear ends or on the back of our arms but that visceral fat is the stuff we want to avoid so burst training can be helpful for that as well

I think alcohol is one of the hidden reasons for why people are weight loss resistant. Because it can be very triggering to have a conversation. We use a cage questionnaire in traditional medicine to talk about habits around alcohol. And sometimes it's like poking a tiger.

I think alcohol is one of the hidden reasons for why people are weight loss resistant. Because it can be very triggering to have a conversation. We use a cage questionnaire in traditional medicine to talk about habits around alcohol. And sometimes it's like poking a tiger.

Okay. So I'm going to give it a B. Because I do see merit in it. And I'll be fully transparent and tell you, I hate counting macros, but there is utility in it. And for some of my patients, they need that quantitative information to say, this is how much protein you're consuming. These are your carbohydrates. This is how much fat you're consuming.

Okay. So I'm going to give it a B. Because I do see merit in it. And I'll be fully transparent and tell you, I hate counting macros, but there is utility in it. And for some of my patients, they need that quantitative information to say, this is how much protein you're consuming. These are your carbohydrates. This is how much fat you're consuming.

You know you probably suspect this patient or this individual probably is drinking more than they're comfortable sharing with you. And coming from a place of no judgment, I think that alcohol is... is challenging because it is one of the few socially acceptable drugs that we can use. And I think a lot of people feel uncomfortable not choosing not to drink if that's what they choose to do.

You know you probably suspect this patient or this individual probably is drinking more than they're comfortable sharing with you. And coming from a place of no judgment, I think that alcohol is... is challenging because it is one of the few socially acceptable drugs that we can use. And I think a lot of people feel uncomfortable not choosing not to drink if that's what they choose to do.

I think there are equally a lot of people that feel completely uninhibited that they can drink as much as they want. And I'm not talking about like the teenagers and young adults and college age kids that are just experimenting. I think when you look at alcohol as a toxin, It's particularly harmful to many issues or many systems in the body.

I think there are equally a lot of people that feel completely uninhibited that they can drink as much as they want. And I'm not talking about like the teenagers and young adults and college age kids that are just experimenting. I think when you look at alcohol as a toxin, It's particularly harmful to many issues or many systems in the body.

So I think that when we talk about alcohol, I'm by no means am I saying be a teetotaler, don't enjoy a glass of wine on your birthday or a celebration. But I think for many individuals, it's reexamining that relationship because we know that one glass of alcohol in a woman is going to raise her estrogen levels for up to eight hours after consumption. If you're on HRT, guess what?

So I think that when we talk about alcohol, I'm by no means am I saying be a teetotaler, don't enjoy a glass of wine on your birthday or a celebration. But I think for many individuals, it's reexamining that relationship because we know that one glass of alcohol in a woman is going to raise her estrogen levels for up to eight hours after consumption. If you're on HRT, guess what?

It's going to magnify that.

It's going to magnify that.

Helping people understand the way that our body detoxifies it is it's detoxified as a toxin. Your body will prioritize processing the alcohol first before anything else. We know it can be toxic to our brains. It can shrink our hippocampus. We know it can increase our risk of breast cancer.

Helping people understand the way that our body detoxifies it is it's detoxified as a toxin. Your body will prioritize processing the alcohol first before anything else. We know it can be toxic to our brains. It can shrink our hippocampus. We know it can increase our risk of breast cancer.

I think that for anyone that's listening, that's thinking that maybe it could be contributing to one of the reasons why they're struggling to lose weight, I would say there's absolutely nothing wrong with cutting back, reducing what you're consuming. I think for some individuals, it's they want to numb themselves from actually experiencing difficult feelings.

I think that for anyone that's listening, that's thinking that maybe it could be contributing to one of the reasons why they're struggling to lose weight, I would say there's absolutely nothing wrong with cutting back, reducing what you're consuming. I think for some individuals, it's they want to numb themselves from actually experiencing difficult feelings.

And so alcohol, just like a lot of other vices in life, is something that allows them to come home, decompress, have a couple of glasses of wine, fall asleep. Maybe their sleep isn't so great. And I can make the argument that if you're already not getting good sleep, this isn't going to help. But alcohol is good. definitely contributory to weight loss resistant without question.

And so alcohol, just like a lot of other vices in life, is something that allows them to come home, decompress, have a couple of glasses of wine, fall asleep. Maybe their sleep isn't so great. And I can make the argument that if you're already not getting good sleep, this isn't going to help. But alcohol is good. definitely contributory to weight loss resistant without question.

And I think that if you're trying to lose weight and you're trying to figure out why you're not losing weight and maybe all the other things are dialed in, maybe look at the alcohol piece.

And I think that if you're trying to lose weight and you're trying to figure out why you're not losing weight and maybe all the other things are dialed in, maybe look at the alcohol piece.

Because I think for a lot of people, they mindlessly go about their day, not realizing that, you know, that half an avocado or sometimes that whole avocado a day is Could be, yes, it's a healthy fat. Yes, it's a healthy monounsaturated fat. But if you're over consuming healthy fats, that can impact your weight loss resistance. So number one, I like to track macros short term.

Because I think for a lot of people, they mindlessly go about their day, not realizing that, you know, that half an avocado or sometimes that whole avocado a day is Could be, yes, it's a healthy fat. Yes, it's a healthy monounsaturated fat. But if you're over consuming healthy fats, that can impact your weight loss resistance. So number one, I like to track macros short term.

Yeah, I would say regular sodas with high fructose corn syrup. That is enough. That's enough.

Yeah, I would say regular sodas with high fructose corn syrup. That is enough. That's enough.

Well, there's no therapeutic benefit. But if you're someone that really enjoys a soda and that's your vice, then I would say having a diet soda is going to be better than having the real thing. Now, we have a lot of people talking about the role of artificial sweeteners, whether it's sucralose, aspartame. People even sometimes will lump stevia, saccharin.

Well, there's no therapeutic benefit. But if you're someone that really enjoys a soda and that's your vice, then I would say having a diet soda is going to be better than having the real thing. Now, we have a lot of people talking about the role of artificial sweeteners, whether it's sucralose, aspartame. People even sometimes will lump stevia, saccharin.

I don't know anyone that uses saccharin in their drinks, but that always comes up. If you look at the research, there's research to suggest in some rodent models that these artificial sweeteners can be

I don't know anyone that uses saccharin in their drinks, but that always comes up. If you look at the research, there's research to suggest in some rodent models that these artificial sweeteners can be

impactful on insulin sensitivity as well as impacting the gut microbiome within 28 to 30 days so that is significant but in the grand scheme of things i think that we have to think about what is realistic for our patients like i'm a realist and i want people say to me whether it's the diet soda or a protein bar or a protein shake i'm like listen i'm a realist if that is how you're going to be able to get through the day if you've been consuming eight cans of coke a day

impactful on insulin sensitivity as well as impacting the gut microbiome within 28 to 30 days so that is significant but in the grand scheme of things i think that we have to think about what is realistic for our patients like i'm a realist and i want people say to me whether it's the diet soda or a protein bar or a protein shake i'm like listen i'm a realist if that is how you're going to be able to get through the day if you've been consuming eight cans of coke a day

for 20 years, if I can get you to stop consuming eight cans of Coke a day and get you transitioned onto something else, maybe we go from eight cans down to four cans, down to two, down to one. And then we transition you to a diet soda and you get acclimated to that taste that is infinitely better for you than that high fructose corn syrup is.

for 20 years, if I can get you to stop consuming eight cans of Coke a day and get you transitioned onto something else, maybe we go from eight cans down to four cans, down to two, down to one. And then we transition you to a diet soda and you get acclimated to that taste that is infinitely better for you than that high fructose corn syrup is.

And the net impact that we know that our body effectively fructose in general is processed very differently in the body than other types of sugars. And I think soda is one of those kind of It's a really bad idea. I think in terms of impact on health, it's so profound and significant that a diet soda here and there, I'm not particularly worried about in the grand scheme of things.

And the net impact that we know that our body effectively fructose in general is processed very differently in the body than other types of sugars. And I think soda is one of those kind of It's a really bad idea. I think in terms of impact on health, it's so profound and significant that a diet soda here and there, I'm not particularly worried about in the grand scheme of things.

Are there people out there that are absolutists? Yes. And I just think that that's not necessarily reasonable for most individuals.

Are there people out there that are absolutists? Yes. And I just think that that's not necessarily reasonable for most individuals.

So some people I'll say, let's track it for a week. A week is something everyone can do. Now, if I have someone who has eating disordered behavior, That sometimes can be triggering. And so there's other ways. I'll say, let's just track protein. Let's just track one metric. I think it is that important. Then you can also track hydration. You can track your discretionary macros.

So some people I'll say, let's track it for a week. A week is something everyone can do. Now, if I have someone who has eating disordered behavior, That sometimes can be triggering. And so there's other ways. I'll say, let's just track protein. Let's just track one metric. I think it is that important. Then you can also track hydration. You can track your discretionary macros.

Well, and I think it's interesting to me, you know, being in a position much like you that, you know, I've interviewed some amazing people and met and interacted with so many health and wellness experts. I sometimes think that we're shooting ourselves in our feet if we are too absolutist and too not accepting of where people are in time and space. Because that diet soda to me is not a big deal.

Well, and I think it's interesting to me, you know, being in a position much like you that, you know, I've interviewed some amazing people and met and interacted with so many health and wellness experts. I sometimes think that we're shooting ourselves in our feet if we are too absolutist and too not accepting of where people are in time and space. Because that diet soda to me is not a big deal.

I have a husband who used to drink, I don't know, four or five diet Pepsis a day when I first met him. Now he doesn't drink any. Now it's kind of a every once in a while I'll laugh. I'll find some diet Pepsi in the outside refrigerator. And I'm like, I don't care. It makes them happy. But I think for a lot of people, it's like the journey that we're on.

I have a husband who used to drink, I don't know, four or five diet Pepsis a day when I first met him. Now he doesn't drink any. Now it's kind of a every once in a while I'll laugh. I'll find some diet Pepsi in the outside refrigerator. And I'm like, I don't care. It makes them happy. But I think for a lot of people, it's like the journey that we're on.

I mean, I'm sure the way I ate 15 years ago is very different than how I eat now. And so it's like just, you know, what decisions can we make day to day that over time are going to have the largest impact? And that to me, a diet soda is not that big of a deal.

I mean, I'm sure the way I ate 15 years ago is very different than how I eat now. And so it's like just, you know, what decisions can we make day to day that over time are going to have the largest impact? And that to me, a diet soda is not that big of a deal.

I think it's one of the most important things because ultimately that's what you fall back on every day. You know, you have a good day, you have a bad day. Ultimately, your mindset and the way you view the world has everything to do with decisions that you make, perspectives that you embrace or reject.

I think it's one of the most important things because ultimately that's what you fall back on every day. You know, you have a good day, you have a bad day. Ultimately, your mindset and the way you view the world has everything to do with decisions that you make, perspectives that you embrace or reject.

And so I think the only way I've gotten to where I am today is by consistently investing in my mindset and coaching and

And so I think the only way I've gotten to where I am today is by consistently investing in my mindset and coaching and

We can track where you are. If you're still menstruating, we can track that too. But I find even for men, very beneficial for transparency to see, are you getting enough protein in that meal? Do you understand that you have to hit this protein threshold to be able to trigger muscle protein synthesis, which I'm sure we'll probably talk about?

We can track where you are. If you're still menstruating, we can track that too. But I find even for men, very beneficial for transparency to see, are you getting enough protein in that meal? Do you understand that you have to hit this protein threshold to be able to trigger muscle protein synthesis, which I'm sure we'll probably talk about?

and being able to share what i learn on the podcast or books i'm reading or people i interact with because ultimately i mean ultimately that's the most important thing that's the only thing that's gotten me from you know birth until 53 years old and being a super positive opt you know optimistic individual and when i look at Colleagues of mine that are doing amazing things.

and being able to share what i learn on the podcast or books i'm reading or people i interact with because ultimately i mean ultimately that's the most important thing that's the only thing that's gotten me from you know birth until 53 years old and being a super positive opt you know optimistic individual and when i look at Colleagues of mine that are doing amazing things.

They are constantly fine tuning. It's like fine tuning a piece of sculpture. They are constantly working on it. And it's not to suggest that I never have a bad day or bad things don't happen. I mean, they do. But I'm always looking for the reframe. You know, how can I look at this differently? Like, what's the lesson here?

They are constantly fine tuning. It's like fine tuning a piece of sculpture. They are constantly working on it. And it's not to suggest that I never have a bad day or bad things don't happen. I mean, they do. But I'm always looking for the reframe. You know, how can I look at this differently? Like, what's the lesson here?

And what can I take from this moving forward that's going to make me stronger, a better person, a better showing up as a better mom, better wife, better entrepreneur, better nurse practitioner? What are the things that I need to do? Because it's very easy in life to get caught up in, you know, the yuck of day to day living. It's so easy to get caught up in that.

And what can I take from this moving forward that's going to make me stronger, a better person, a better showing up as a better mom, better wife, better entrepreneur, better nurse practitioner? What are the things that I need to do? Because it's very easy in life to get caught up in, you know, the yuck of day to day living. It's so easy to get caught up in that.

And the people that I see that are thriving, irrespective of age right now, are the people that are constantly working on personal development. I mean, without question.

And the people that I see that are thriving, irrespective of age right now, are the people that are constantly working on personal development. I mean, without question.

Yeah, I mean, I think first it's it's deciding like what like I'm a reader. I think that that's reading books is what really appeals to me. And then maybe secondarily to that, listening to podcasts. So I would say Dr. Wayne Dwyer's work has just been on my mind a lot recently, largely because it's always like looking at this reframe.

Yeah, I mean, I think first it's it's deciding like what like I'm a reader. I think that that's reading books is what really appeals to me. And then maybe secondarily to that, listening to podcasts. So I would say Dr. Wayne Dwyer's work has just been on my mind a lot recently, largely because it's always like looking at this reframe.

I think Atomic Habits is a particular book that I think there's a reason why it's on the New York Times bestselling list week after week after week. I think a great deal about, you know, having some type of, you know, connection to whether it's God or the universe. I mean, having some degree of spirituality, I think is so important.

I think Atomic Habits is a particular book that I think there's a reason why it's on the New York Times bestselling list week after week after week. I think a great deal about, you know, having some type of, you know, connection to whether it's God or the universe. I mean, having some degree of spirituality, I think is so important.

How you choose to practice is obviously as unique as each one of us are. I think that, you know, having close friends, we know that loneliness is as hard on our bodies as smoking. And so, you know, the research is coming out from the pandemic era, right? showing how a lot of people essentially died of loneliness is heartbreaking. And so having a support system, I think, is important.

How you choose to practice is obviously as unique as each one of us are. I think that, you know, having close friends, we know that loneliness is as hard on our bodies as smoking. And so, you know, the research is coming out from the pandemic era, right? showing how a lot of people essentially died of loneliness is heartbreaking. And so having a support system, I think, is important.

And so number one, I think tracking macros can be beneficial for the short term. In no ways do I recommend anyone be tracking macros in perpetuity. For the same reason, I think weighing yourself daily for a lot of people can be very triggering. So it's a short-term benefit, short-term effort for a long-term benefit.

And so number one, I think tracking macros can be beneficial for the short term. In no ways do I recommend anyone be tracking macros in perpetuity. For the same reason, I think weighing yourself daily for a lot of people can be very triggering. So it's a short-term benefit, short-term effort for a long-term benefit.

It doesn't necessarily have to be a lot of people. It just has to be people that, you know, you can go to and talk to about things that you find concerning. Having a mentor, I think that's important. I would say the best coaches are being coached constantly. So, you know, throughout the last nine, 10 years, I've always had

It doesn't necessarily have to be a lot of people. It just has to be people that, you know, you can go to and talk to about things that you find concerning. Having a mentor, I think that's important. I would say the best coaches are being coached constantly. So, you know, throughout the last nine, 10 years, I've always had

some type of mentorship or some type of coaching where I've been having someone I've been paying and I've been participating and looking at it as an investment in my mindset. And depending on what I'm working on in my business might be working on messaging or something else. But I think for each one of us, it's like, just be open to the possibility that there's probably someone's work out there

some type of mentorship or some type of coaching where I've been having someone I've been paying and I've been participating and looking at it as an investment in my mindset. And depending on what I'm working on in my business might be working on messaging or something else. But I think for each one of us, it's like, just be open to the possibility that there's probably someone's work out there

that will appeal to you. And I think it's important to just experience different things, like whether it's Dr. Joe Dispenza, whether it's Dr. Wayne Dwyer, whether it's, you know, Mel Robbins. I'm just using these as examples. Like these are people that have kind of got larger than life personas and have different prevailing philosophies about how they see the world.

that will appeal to you. And I think it's important to just experience different things, like whether it's Dr. Joe Dispenza, whether it's Dr. Wayne Dwyer, whether it's, you know, Mel Robbins. I'm just using these as examples. Like these are people that have kind of got larger than life personas and have different prevailing philosophies about how they see the world.

But, you know, just being open to the possibility that there's more to learn, I think is important. Having a curious mind and a curious spirit.

But, you know, just being open to the possibility that there's more to learn, I think is important. Having a curious mind and a curious spirit.

Any that you want to name? I mean, I think having that kind of scarcity mindset, I was talking to someone the other day and I just said, well, I think the most important thing we can do right now is just find a reframe for what you experienced. I'm not diminishing what you experienced.

Any that you want to name? I mean, I think having that kind of scarcity mindset, I was talking to someone the other day and I just said, well, I think the most important thing we can do right now is just find a reframe for what you experienced. I'm not diminishing what you experienced.

But I think if you can't look beyond your circumstances right now, and this is something that had happened to this individual months before, if you don't have the ability to kind of reflect and say, what is the lesson here? So that's always the way when stuff happens and it always does because that's part of life. What is the lesson that I need to learn here?

But I think if you can't look beyond your circumstances right now, and this is something that had happened to this individual months before, if you don't have the ability to kind of reflect and say, what is the lesson here? So that's always the way when stuff happens and it always does because that's part of life. What is the lesson that I need to learn here?

So I think having a scarcity mindset, and we're all guilty of this, whether it's, you know, you're going through tough financial times or, you know, someone in your family's health is going sideways, or maybe you have an argument with someone you're very close to. It's like working through those tough times and just trying to figure out like, what is the lesson? What can I learn from this? Or

So I think having a scarcity mindset, and we're all guilty of this, whether it's, you know, you're going through tough financial times or, you know, someone in your family's health is going sideways, or maybe you have an argument with someone you're very close to. It's like working through those tough times and just trying to figure out like, what is the lesson? What can I learn from this? Or

The other side of that, Drew, quite frankly, is therapy in general. I've been in therapy, some form of therapy for the last 30 years. I had a wonderful college roommate who took a look at me and said, I think you would benefit from some therapy. And so we still laugh about it.

The other side of that, Drew, quite frankly, is therapy in general. I've been in therapy, some form of therapy for the last 30 years. I had a wonderful college roommate who took a look at me and said, I think you would benefit from some therapy. And so we still laugh about it.

I'm like, that is a real friend that says to you, I think you could benefit from talking to someone about the things you're struggling with. And so I think that therapy, whether that is with a traditional therapist or you are doing... you know, MDMA therapy with a licensed provider or you are, you know, going to a meditation retreat.

I'm like, that is a real friend that says to you, I think you could benefit from talking to someone about the things you're struggling with. And so I think that therapy, whether that is with a traditional therapist or you are doing... you know, MDMA therapy with a licensed provider or you are, you know, going to a meditation retreat.

I just think it's really important to acknowledge the stuff that you need to work on. I always say it's again, it's like a sculpture. You're constantly fine tuning things. If I get triggered, it's like, OK, there's something there that I need to work on. And so I think therapy, if people are open to that, is also very important with the right practitioner, the right person. Very, very helpful.

I just think it's really important to acknowledge the stuff that you need to work on. I always say it's again, it's like a sculpture. You're constantly fine tuning things. If I get triggered, it's like, OK, there's something there that I need to work on. And so I think therapy, if people are open to that, is also very important with the right practitioner, the right person. Very, very helpful.

And when I think about kind of high-level concepts, it's, are you having enough protein? What are you doing with your carbohydrates? And I'm not anti-carb. I think, unfortunately, because I've been someone that's been aligned with intermittent fasting for a long period of time, people assume I'm ketogenic or I'm low-carb. That is not the case.

And when I think about kind of high-level concepts, it's, are you having enough protein? What are you doing with your carbohydrates? And I'm not anti-carb. I think, unfortunately, because I've been someone that's been aligned with intermittent fasting for a long period of time, people assume I'm ketogenic or I'm low-carb. That is not the case.

So creatine monohydrate is the type of creatine that we're

So creatine monohydrate is the type of creatine that we're

of alluding to and speaking to that is the best research that is the one that the only type that i consume and i've been on the creatine bandwagon for about four years now so i was i was a scooch ahead of this big curve of people that are taking a lot of interest and what's amazing to me is that on my own even without speaking to uh the wonderful researcher i've had on the podcast multiple times darren kandow who i think is amazing um

of alluding to and speaking to that is the best research that is the one that the only type that i consume and i've been on the creatine bandwagon for about four years now so i was i was a scooch ahead of this big curve of people that are taking a lot of interest and what's amazing to me is that on my own even without speaking to uh the wonderful researcher i've had on the podcast multiple times darren kandow who i think is amazing um

You know, is that on my own, I've been able to figure out that creatine is not just helpful for strength and sleep architecture, but helps with jet lag. And so for me, with all the time changes that I'm doing, like this week I'm in LA and next week I'll be in Barcelona. So like my body's gone three hours in one direction and then it's going to go nine hours in another.

You know, is that on my own, I've been able to figure out that creatine is not just helpful for strength and sleep architecture, but helps with jet lag. And so for me, with all the time changes that I'm doing, like this week I'm in LA and next week I'll be in Barcelona. So like my body's gone three hours in one direction and then it's going to go nine hours in another.

And so how do I, how do I deal with jet lag? One of the things I do is I increase my creatine. So it's helpful for jet lag. There's research emerging, talking about brain health as well as bone health. Really important because we know women make 70 to 80 percent less creatine. We have less storage than men. So we actually need more than men.

And so how do I, how do I deal with jet lag? One of the things I do is I increase my creatine. So it's helpful for jet lag. There's research emerging, talking about brain health as well as bone health. Really important because we know women make 70 to 80 percent less creatine. We have less storage than men. So we actually need more than men.

And from my perspective, I think it's very exciting that the research is demonstrating that at higher doses, eight to 10 milligrams to help cross that blood brain barrier is can be helpful for jet lag, for brain health, for bone health, which that to me is like emerging research, but very exciting because not every person can take HRT.

And from my perspective, I think it's very exciting that the research is demonstrating that at higher doses, eight to 10 milligrams to help cross that blood brain barrier is can be helpful for jet lag, for brain health, for bone health, which that to me is like emerging research, but very exciting because not every person can take HRT.

And so we know that that loss of estrogen and progesterone signaling on bone can make women much more susceptible to osteopenia, and then ultimately osteoporosis. So from my perspective, something that's relatively inexpensive, well-tolerated, it's a foundational supplement. I mean, to me, it is probably the most important supplement in my supplement stack without question.

And so we know that that loss of estrogen and progesterone signaling on bone can make women much more susceptible to osteopenia, and then ultimately osteoporosis. So from my perspective, something that's relatively inexpensive, well-tolerated, it's a foundational supplement. I mean, to me, it is probably the most important supplement in my supplement stack without question.

I think it's important to have high quality carbohydrates, looking at the types of fats you're consuming and understanding that as a differentiator, that protein and carbohydrates are four calories per gram and fat is nine. Yeah, it's nine. And so helping people understand that if you're trying to lose weight,

I think it's important to have high quality carbohydrates, looking at the types of fats you're consuming and understanding that as a differentiator, that protein and carbohydrates are four calories per gram and fat is nine. Yeah, it's nine. And so helping people understand that if you're trying to lose weight,

You want to get a little plug for that? Yeah. So it's the midlife pause creatine. So what's exciting about it is, you know, it's, it's, we added things to the creatine monohydrate that allows us to get better crossage across the blood brain barrier. So alpha GPC, which is a nootropic, some B vitamins, but it's exciting because I have so many people that it's really changed their lives. I have

You want to get a little plug for that? Yeah. So it's the midlife pause creatine. So what's exciting about it is, you know, it's, it's, we added things to the creatine monohydrate that allows us to get better crossage across the blood brain barrier. So alpha GPC, which is a nootropic, some B vitamins, but it's exciting because I have so many people that it's really changed their lives. I have

All my kids take it. My husband takes it. I have my mother taking it. My mother's 79 years old and, you know, retired and she loves it. And so, you know, from my perspective, it's an easy thing that plays well with other supplements. So it's not like you take this and you can't take other things. You know, from my perspective, something that's multipurposeful is really exciting.

All my kids take it. My husband takes it. I have my mother taking it. My mother's 79 years old and, you know, retired and she loves it. And so, you know, from my perspective, it's an easy thing that plays well with other supplements. So it's not like you take this and you can't take other things. You know, from my perspective, something that's multipurposeful is really exciting.

Yes, and so people still say, if I take creatine, is my hair going to fall out? No, there's no research to that. If I take creatine, is it going to damage my kidneys? No, if you have healthy kidneys, it's not going to damage your kidneys. But helping people understand the way it works and why it's important to look for creatine

Yes, and so people still say, if I take creatine, is my hair going to fall out? No, there's no research to that. If I take creatine, is it going to damage my kidneys? No, if you have healthy kidneys, it's not going to damage your kidneys. But helping people understand the way it works and why it's important to look for creatine

The purest form, which is CreaPure, which is the stuff that you have to license that is processed in a way that it's less likely to cause side effects. Some people get bloating and GI upset, and that's usually from the cheap stuff.

The purest form, which is CreaPure, which is the stuff that you have to license that is processed in a way that it's less likely to cause side effects. Some people get bloating and GI upset, and that's usually from the cheap stuff.

Again, it goes back to being a realist and probably twice a week I have protein powder. So I think it's important if you tolerate whey, that is going to be, whey is going to be a complete protein, really well tolerated, but you don't want 15 or 16 ingredients. It should really be

Again, it goes back to being a realist and probably twice a week I have protein powder. So I think it's important if you tolerate whey, that is going to be, whey is going to be a complete protein, really well tolerated, but you don't want 15 or 16 ingredients. It should really be

The whey protein may be like a clean sweetener if you tolerate stevia or monk fruit, or if you don't like it flavored, totally unflavored. But you definitely want to make sure it's a short ingredient list, preferably sourced by grass-fed cows. But if that's not doable, just keep the ingredient list short. Beef protein isolate is fine. It's just not a complete protein.

The whey protein may be like a clean sweetener if you tolerate stevia or monk fruit, or if you don't like it flavored, totally unflavored. But you definitely want to make sure it's a short ingredient list, preferably sourced by grass-fed cows. But if that's not doable, just keep the ingredient list short. Beef protein isolate is fine. It's just not a complete protein.

So if that's something, and I do have some of that in my house, I'll just round it out with some essential amino acids. And then the plant-based, if you find one that you like, again, short ingredient list, tolerable. Sometimes some of the products I've tried have been, it's been more of a consistency. And for me, if it's chalky or gritty, it's hard for me to get it down.

So if that's something, and I do have some of that in my house, I'll just round it out with some essential amino acids. And then the plant-based, if you find one that you like, again, short ingredient list, tolerable. Sometimes some of the products I've tried have been, it's been more of a consistency. And for me, if it's chalky or gritty, it's hard for me to get it down.

But I know that there are some good brands that are out there. I'm a realist. I think it's fine if you're having one a day. But sometimes I meet women that are having two a day. And I'm like, okay, we need to figure out how to get another meal into your diet. And if you're using that last ingredient, You know, that last bolus of protein just to buffer your protein intake. I think that's fine.

But I know that there are some good brands that are out there. I'm a realist. I think it's fine if you're having one a day. But sometimes I meet women that are having two a day. And I'm like, okay, we need to figure out how to get another meal into your diet. And if you're using that last ingredient, You know, that last bolus of protein just to buffer your protein intake. I think that's fine.

And you think you can have all the fatty meat and have two sticks of butter a day and three avocados. And I have met people who insist that's what they consume. And I'm like, if that works for you, great. But for the vast majority of us, it would not. And so once you can quantitatively look at that information, it allows you to make very specific recommendations for patients.

And you think you can have all the fatty meat and have two sticks of butter a day and three avocados. And I have met people who insist that's what they consume. And I'm like, if that works for you, great. But for the vast majority of us, it would not. And so once you can quantitatively look at that information, it allows you to make very specific recommendations for patients.

But we ideally want to actually get the protein from real whole food sources. Again, ideally, like tomorrow I'm traveling. It might not be a day that I hit 100 grams of protein, but, you know, it might be a day I buffer it a little bit.

But we ideally want to actually get the protein from real whole food sources. Again, ideally, like tomorrow I'm traveling. It might not be a day that I hit 100 grams of protein, but, you know, it might be a day I buffer it a little bit.

I think it's a B or a C, meaning like I'll be totally transparent. I had a protein shake yesterday because there's just no way I was going to be able to buffer out that protein. And I think that's fine. You know, sometimes you're stuck with filtered water in a shaker bottle and that's what you got. But when I'm at home, I get a little more creative.

I think it's a B or a C, meaning like I'll be totally transparent. I had a protein shake yesterday because there's just no way I was going to be able to buffer out that protein. And I think that's fine. You know, sometimes you're stuck with filtered water in a shaker bottle and that's what you got. But when I'm at home, I get a little more creative.

You know, it's interesting. When I think about what is going to drive inflammation, oxidative stress, etc., it is probably more the processed food. And as a byproduct is cooked or is consumed with seed oils, it is probably more problematic.

You know, it's interesting. When I think about what is going to drive inflammation, oxidative stress, etc., it is probably more the processed food. And as a byproduct is cooked or is consumed with seed oils, it is probably more problematic.

Again, because we know that if you're consuming processed foods, you're consuming an additional 500,000 calories a day because your body doesn't register that you are full. So do I think seed oils are less than ideal? Of course. But with that being said, I think if we aim to consume less seed oils, it means we aim to consume less processed food.

Again, because we know that if you're consuming processed foods, you're consuming an additional 500,000 calories a day because your body doesn't register that you are full. So do I think seed oils are less than ideal? Of course. But with that being said, I think if we aim to consume less seed oils, it means we aim to consume less processed food.

And that's where I find tracking macros helpful. Let me be very clear. I'm not suggesting you do this for the rest of your life. It is not meant to be feeling like you're tethered to your app on your phone. It is really just to help you build awareness about portion sizes and quantity of macronutrients that you're consuming. And what I like about

And that's where I find tracking macros helpful. Let me be very clear. I'm not suggesting you do this for the rest of your life. It is not meant to be feeling like you're tethered to your app on your phone. It is really just to help you build awareness about portion sizes and quantity of macronutrients that you're consuming. And what I like about

So I think the processed food piece is the most important. If I look at the research, and certainly I know we both have had Dr. Kate Shanahan on, I've read her books, which certainly paint a really ugly, dark picture of the impact, oxidative stress on the cell, how it damages the cellular membrane. can lead to carbohydrate cravings and weight gain.

So I think the processed food piece is the most important. If I look at the research, and certainly I know we both have had Dr. Kate Shanahan on, I've read her books, which certainly paint a really ugly, dark picture of the impact, oxidative stress on the cell, how it damages the cellular membrane. can lead to carbohydrate cravings and weight gain.

I think it has more to do with the actual processed food consumption and less about the CETOs. I'm by no means saying like, you know, go out and buy that big canola oil canister because I don't have any of that in my house. But I think it's the bigger picture sometimes we forget about. It's like really the message should be eat less processed foods.

I think it has more to do with the actual processed food consumption and less about the CETOs. I'm by no means saying like, you know, go out and buy that big canola oil canister because I don't have any of that in my house. But I think it's the bigger picture sometimes we forget about. It's like really the message should be eat less processed foods.

And by virtue of just eating less processed foods, you will consume less seed oils. I don't go to restaurants and I stress about seed oils. I think that I eat out so sporadically that if I eat a meal with seed oils, I'm like in the grand scheme of things. For me personally, this is not going to be a make or break situation for me.

And by virtue of just eating less processed foods, you will consume less seed oils. I don't go to restaurants and I stress about seed oils. I think that I eat out so sporadically that if I eat a meal with seed oils, I'm like in the grand scheme of things. For me personally, this is not going to be a make or break situation for me.

Now, I think if all you're doing is eating out in restaurants and you're not looking at food labels, you probably are getting quite a bit of inflammatory rancid seed oils, probably more than what you should. And just a lot of extra calories. Correct. Again, that same thing, 500. This is average 500 to additional 1000 calories a day if you're eating a lot of ultra processed foods.

Now, I think if all you're doing is eating out in restaurants and you're not looking at food labels, you probably are getting quite a bit of inflammatory rancid seed oils, probably more than what you should. And just a lot of extra calories. Correct. Again, that same thing, 500. This is average 500 to additional 1000 calories a day if you're eating a lot of ultra processed foods.

So I think if we look at it from that perspective, it yields that we understand that, you know, Aim for less processed foods. By virtue of eating less processed foods and reading some food labels, you will become more aware. You will try to avoid maybe make some swaps. I mean, I still laugh.

So I think if we look at it from that perspective, it yields that we understand that, you know, Aim for less processed foods. By virtue of eating less processed foods and reading some food labels, you will become more aware. You will try to avoid maybe make some swaps. I mean, I still laugh.

I think I went to visit my mother-in-law and I opened up her cabinet and it was just like, my husband's like, don't say it. Don't say it. She's 80 years old. She's not going to change anything she's doing. And I was like, I'm keeping my mouth shut. But I think that from the perspective, like know better, do better.

I think I went to visit my mother-in-law and I opened up her cabinet and it was just like, my husband's like, don't say it. Don't say it. She's 80 years old. She's not going to change anything she's doing. And I was like, I'm keeping my mouth shut. But I think that from the perspective, like know better, do better.

it's just trying to be very conscientious about, you know, what we're consuming and swapping it out, reading the, reading the food labels piece, which you can pretty much be guaranteed that most, if not all, I mean, it's insane how much seed oils and things, I mean, it's most of the protein bars that are out there. I've got sunflower or safflower oil on them or canola.

it's just trying to be very conscientious about, you know, what we're consuming and swapping it out, reading the, reading the food labels piece, which you can pretty much be guaranteed that most, if not all, I mean, it's insane how much seed oils and things, I mean, it's most of the protein bars that are out there. I've got sunflower or safflower oil on them or canola.

I mean, just you're in a airport and you're starving and you're like, I don't have time to eat a meal, but I'm going to grab a protein bar. And you realize that, You're like, all right, I can eat the protein bar or I can just fast. Those are my two options right now because neither of these are super healthy.

I mean, just you're in a airport and you're starving and you're like, I don't have time to eat a meal, but I'm going to grab a protein bar. And you realize that, You're like, all right, I can eat the protein bar or I can just fast. Those are my two options right now because neither of these are super healthy.

One particular app that I have no affiliation with is chronometer. It also gives you micronutrients. So you'll be able to see, you know, what's your magnesium or potassium chloride, all these micronutrients that do impact food cravings, satiety, et cetera.

One particular app that I have no affiliation with is chronometer. It also gives you micronutrients. So you'll be able to see, you know, what's your magnesium or potassium chloride, all these micronutrients that do impact food cravings, satiety, et cetera.

Unfortunately, in kind of our modern day culture, many of us are no longer able to access stored fat as a fuel source because of how frequently we eat and the types of foods that we consume. So when I think about intermittent fasting and whether or not where it should tier on this list, it really depends on the individual. And I'll give you a specific example.

Unfortunately, in kind of our modern day culture, many of us are no longer able to access stored fat as a fuel source because of how frequently we eat and the types of foods that we consume. So when I think about intermittent fasting and whether or not where it should tier on this list, it really depends on the individual. And I'll give you a specific example.

Well, it's interesting. You said you're a hyper absorber, right? Of cholesterol.

Well, it's interesting. You said you're a hyper absorber, right? Of cholesterol.

So I'm the same.

So I'm the same.

And what I found interesting was every time you go to these really nice restaurants and you'd have a steak and you'd have steak and frites.

And what I found interesting was every time you go to these really nice restaurants and you'd have a steak and you'd have steak and frites.

And I'm like, I'm going to enjoy my French fries because they're cooked in duck fat. And then I would be sick. So sick. And I finally realized I was like, I never tolerated a lot of heavy animal based fats. That's why I gravitated towards lean meats and did so much better not having like lard and tallow and duck fat stuff.

And I'm like, I'm going to enjoy my French fries because they're cooked in duck fat. And then I would be sick. So sick. And I finally realized I was like, I never tolerated a lot of heavy animal based fats. That's why I gravitated towards lean meats and did so much better not having like lard and tallow and duck fat stuff.

And I was like, oh, it's because I hate it's like my body just soaks it up like a sponge. No wonder why I was so like sick to my stomach. Whereas the average person doesn't process cholesterol that way. And so it finally made sense. So when, when we finally did that Boston heart cholesterol balance test, my doc looked at me and he goes, your body knew all the way along.

And I was like, oh, it's because I hate it's like my body just soaks it up like a sponge. No wonder why I was so like sick to my stomach. Whereas the average person doesn't process cholesterol that way. And so it finally made sense. So when, when we finally did that Boston heart cholesterol balance test, my doc looked at me and he goes, your body knew all the way along.

Cause I never tolerated fried foods. I just, I think it's because my body just soaked up everything that was there. It just made me sick.

Cause I never tolerated fried foods. I just, I think it's because my body just soaked up everything that was there. It just made me sick.

And so I would give this a solid B more as a, I think this is an important tool to have in the toolbox, but not something that I'm suggesting people do for the rest of their lives. But I think it can be very, very insightful. Yeah.

And so I would give this a solid B more as a, I think this is an important tool to have in the toolbox, but not something that I'm suggesting people do for the rest of their lives. But I think it can be very, very insightful. Yeah.

Well, my husband makes fun of me because when I travel, there's usually a few restaurants that I trust that I can order food from and I don't have to worry about overconsumption of stuff I wouldn't normally eat. Yeah. And so it becomes this running joke. Oh, is there a true food kitchen anywhere? Oh, I love true food kitchen. Yeah. Well, every, my hotel is literally around the corner.

Well, my husband makes fun of me because when I travel, there's usually a few restaurants that I trust that I can order food from and I don't have to worry about overconsumption of stuff I wouldn't normally eat. Yeah. And so it becomes this running joke. Oh, is there a true food kitchen anywhere? Oh, I love true food kitchen. Yeah. Well, every, my hotel is literally around the corner.

And so he was, he said, did you plan that? I said, no, I didn't even realize it, but it's like, I know I can get a clean meal and I don't have to worry about it. But yeah, I think that for those of us that, that eat out very sporadically, I mean, when I'm traveling, I it's, it's a given that I'm going to have to eat out, but At home, and we rarely eat out. Like, rarely eat out.

And so he was, he said, did you plan that? I said, no, I didn't even realize it, but it's like, I know I can get a clean meal and I don't have to worry about it. But yeah, I think that for those of us that, that eat out very sporadically, I mean, when I'm traveling, I it's, it's a given that I'm going to have to eat out, but At home, and we rarely eat out. Like, rarely eat out.

Well, the one thing that we started doing were masa chips.

Well, the one thing that we started doing were masa chips.

But I can tolerate because they're not greasy. It's like I can have a couple of those chips and I feel like it's being super indulgent.

But I can tolerate because they're not greasy. It's like I can have a couple of those chips and I feel like it's being super indulgent.

And I'm like, They're handmade. And I was trying to explain to my husband, I was like, there are as many people in that organization working on their kind of, you know, hand doing all their process as in all of Frito-Lay. Oh my gosh. Because one is a massive, massive manufacturing facility and one is not.

And I'm like, They're handmade. And I was trying to explain to my husband, I was like, there are as many people in that organization working on their kind of, you know, hand doing all their process as in all of Frito-Lay. Oh my gosh. Because one is a massive, massive manufacturing facility and one is not.

Yeah, and absolutely. I mean, sometimes I'll suggest to some of the patients, I'm like, just measure out a serving, like whether nuts are a big one. Nuts are so easy to overeat. It's like if it's a quarter cup is the serving of pistachios, measure it out and put the bag away. Like, don't leave the temptation out there.

Yeah, and absolutely. I mean, sometimes I'll suggest to some of the patients, I'm like, just measure out a serving, like whether nuts are a big one. Nuts are so easy to overeat. It's like if it's a quarter cup is the serving of pistachios, measure it out and put the bag away. Like, don't leave the temptation out there.

If you know that that's your kryptonite, either don't keep it in the house or just measure a portion and like put the rest of it away.

If you know that that's your kryptonite, either don't keep it in the house or just measure a portion and like put the rest of it away.

Yeah. I mean, I'll just share transparently. I think I've done a 360. I think the more I interview experts and see the incredible results in my own patients, the more I realize like some of these patients I've been working with for four or five years. And so I know them very well. And when we get to a point where I'm like, I think it's time to add in terzepatide, which is a GLP-1.

Yeah. I mean, I'll just share transparently. I think I've done a 360. I think the more I interview experts and see the incredible results in my own patients, the more I realize like some of these patients I've been working with for four or five years. And so I know them very well. And when we get to a point where I'm like, I think it's time to add in terzepatide, which is a GLP-1.

And then all of a sudden I start seeing their fasting insulin finally going down and their glucose finally going down, their inflammation finally going down, they're sleeping better and they feel better. I think if used judiciously and used appropriately, I think they can be really powerful. I don't believe in shaming people because they choose to take a GLP-1.

And then all of a sudden I start seeing their fasting insulin finally going down and their glucose finally going down, their inflammation finally going down, they're sleeping better and they feel better. I think if used judiciously and used appropriately, I think they can be really powerful. I don't believe in shaming people because they choose to take a GLP-1.

Because I think that we have enough issues here in the United States that we don't need to add to it by, you know, whether it's someone in social media pointing out a celebrity and saying, oh, they have Ozempic face. I'm like, even if they use Ozempic, why is that our business? I just have seen incredible improvement in biophysical markers, inflammatory markers.

Because I think that we have enough issues here in the United States that we don't need to add to it by, you know, whether it's someone in social media pointing out a celebrity and saying, oh, they have Ozempic face. I'm like, even if they use Ozempic, why is that our business? I just have seen incredible improvement in biophysical markers, inflammatory markers.

especially in people in many instances who've been dealing with weight loss resistance for quite a bit of time. Now I can share, and I've been given permission to disclose, my husband last year, we were starting to see some trends in the wrong direction. And so I had spoken to his functional med doc and I said, you know, maybe interject a conversation about a GLP-1.

especially in people in many instances who've been dealing with weight loss resistance for quite a bit of time. Now I can share, and I've been given permission to disclose, my husband last year, we were starting to see some trends in the wrong direction. And so I had spoken to his functional med doc and I said, you know, maybe interject a conversation about a GLP-1.

And the one thing that my husband said was, He was never overweight, but what was interesting was he said it quieted all the food noise. Like on a Friday or Saturday night when he'd have a glass of alcohol and he might have some chips, he said, I had no desire to have a glass of alcohol or even have any chips. And he said, one day out of the week, he might have a drink.

And the one thing that my husband said was, He was never overweight, but what was interesting was he said it quieted all the food noise. Like on a Friday or Saturday night when he'd have a glass of alcohol and he might have some chips, he said, I had no desire to have a glass of alcohol or even have any chips. And he said, one day out of the week, he might have a drink.

But he was saying to me, it was almost like someone came in and just erased all these cravings that I used to have on Friday and Saturday nights because I was home and we were just socializing.

But he was saying to me, it was almost like someone came in and just erased all these cravings that I used to have on Friday and Saturday nights because I was home and we were just socializing.

And so I think for a lot of people, the more I understand about these drugs, and especially the second generation GLP-1s where they've got both the GLP-1 and the GIP, so they've got a different mechanism of action. We know we have GLP-1 receptors in the brain, but for a lot of people, they're really struggling with food noise. I think this is going to revolutionize what we're doing.

And so I think for a lot of people, the more I understand about these drugs, and especially the second generation GLP-1s where they've got both the GLP-1 and the GIP, so they've got a different mechanism of action. We know we have GLP-1 receptors in the brain, but for a lot of people, they're really struggling with food noise. I think this is going to revolutionize what we're doing.

I think that initially when they came out, when we were hearing a lot of reports of people developing an ileus or people developing irretractable vomiting or I think there still are practitioners out there that go too fast, too high, too quickly, and you have patients that aren't able to tolerate the drugs.

I think that initially when they came out, when we were hearing a lot of reports of people developing an ileus or people developing irretractable vomiting or I think there still are practitioners out there that go too fast, too high, too quickly, and you have patients that aren't able to tolerate the drugs.

I have interviewed some experts who feel like they're lifelong drugs, and I think that conversation needs to be had with patients if that is indeed the case of, you know, they'll need to be on the drug lifelong to keep things balanced. But in my circumstance, most of the people that I have worked with, it's been a short term thing to kind of get on top of worsening metabolic health.

I have interviewed some experts who feel like they're lifelong drugs, and I think that conversation needs to be had with patients if that is indeed the case of, you know, they'll need to be on the drug lifelong to keep things balanced. But in my circumstance, most of the people that I have worked with, it's been a short term thing to kind of get on top of worsening metabolic health.

But what I think is really interesting is. This is just the tip of the iceberg in terms of how we're seeing them being utilized with adults. I'm not talking about it for any other population, but how they're being used with adults, which I think is encouraging.

But what I think is really interesting is. This is just the tip of the iceberg in terms of how we're seeing them being utilized with adults. I'm not talking about it for any other population, but how they're being used with adults, which I think is encouraging.

I think that I was part of an event last fall and there was a whole I wasn't part of this conversation, but there were a bunch of experts on stage with varying backgrounds and it got very contentious. And so I kept saying, I think we're missing we're missing the boat on ultimately what are we trying to do? We're trying to help people.

I think that I was part of an event last fall and there was a whole I wasn't part of this conversation, but there were a bunch of experts on stage with varying backgrounds and it got very contentious. And so I kept saying, I think we're missing we're missing the boat on ultimately what are we trying to do? We're trying to help people.

And if we're trying to help people, and we know this drug can be beneficial to improve metabolic health, if it's only 7% to 8% of us are metabolically healthy, really, we need to do something differently. I mean, there's a lot of things that go into this conversation, but I'm not opposed to GLP-1s, but I think they have to be dosed judiciously with fully informed consent.

And if we're trying to help people, and we know this drug can be beneficial to improve metabolic health, if it's only 7% to 8% of us are metabolically healthy, really, we need to do something differently. I mean, there's a lot of things that go into this conversation, but I'm not opposed to GLP-1s, but I think they have to be dosed judiciously with fully informed consent.

I think those two pieces, along with getting some type of a contract that says you will lift weights and you will eat enough protein because those two things must go hand in hand because with changes in body composition, it is more often than not, not just fat loss. There's also muscle loss that occurs.

I think those two pieces, along with getting some type of a contract that says you will lift weights and you will eat enough protein because those two things must go hand in hand because with changes in body composition, it is more often than not, not just fat loss. There's also muscle loss that occurs.

And as we've talked about how important muscle is for longevity, metabolic health, it's important that we not lose that too.

And as we've talked about how important muscle is for longevity, metabolic health, it's important that we not lose that too.

Yeah. And I think it's also it's one of those things like my husband and I laugh about this because he's a former college athlete. He thinks he doesn't ever have to track anything. And I said, I actually want you to track for an entire week. So I know exactly how much protein you're consuming.

Yeah. And I think it's also it's one of those things like my husband and I laugh about this because he's a former college athlete. He thinks he doesn't ever have to track anything. And I said, I actually want you to track for an entire week. So I know exactly how much protein you're consuming.

To his credit, he was getting plenty of protein, but he was surprised about the carbohydrates, how much carbohydrate he was consuming. And he was finding that when he looked at the data over time, he's like, when do I eat the most of my carbs? Friday and Saturday night. And so it was like, okay, are you not eating enough food on Friday? Or are you just allowing yourself to indulge?

To his credit, he was getting plenty of protein, but he was surprised about the carbohydrates, how much carbohydrate he was consuming. And he was finding that when he looked at the data over time, he's like, when do I eat the most of my carbs? Friday and Saturday night. And so it was like, okay, are you not eating enough food on Friday? Or are you just allowing yourself to indulge?

Yes, but it appears to be more the rarity. I think it has more to do with if you are taking the drugs and you're not changing the lifestyle pieces, when you come off the drug, the weight is going to come back on because you haven't changed whether you're types of foods that you're eating or focusing on stress management or getting enough sleep or weight training.

Yes, but it appears to be more the rarity. I think it has more to do with if you are taking the drugs and you're not changing the lifestyle pieces, when you come off the drug, the weight is going to come back on because you haven't changed whether you're types of foods that you're eating or focusing on stress management or getting enough sleep or weight training.

I mean, those things that we know are so critically important. I think that for some people, depending on how much weight they had to lose, I think for those that lost a tremendous amount of weight, it's probably more of a tenuous stepping off point. It may be like a very slow taper down, you know, they may slowly taper up and then slowly taper down and see how they do and monitor.

I mean, those things that we know are so critically important. I think that for some people, depending on how much weight they had to lose, I think for those that lost a tremendous amount of weight, it's probably more of a tenuous stepping off point. It may be like a very slow taper down, you know, they may slowly taper up and then slowly taper down and see how they do and monitor.

What I find interesting is just socially, I know several healthcare professionals who take micro doses, so sub therapeutic doses of GLP ones, and some of them have lost so much weight, they're like, I'm never going to stop because I'm just not I'm just not willing to run the risk of gaining the weight back. So I think it's a twofold issue.

What I find interesting is just socially, I know several healthcare professionals who take micro doses, so sub therapeutic doses of GLP ones, and some of them have lost so much weight, they're like, I'm never going to stop because I'm just not I'm just not willing to run the risk of gaining the weight back. So I think it's a twofold issue.

I think if someone is able to successfully come off and keep the weight off, they are very likely making significant lifestyle changes either before they come off or around that same time. I think if you go back to the same habits, you will very likely put weight back on.

I think if someone is able to successfully come off and keep the weight off, they are very likely making significant lifestyle changes either before they come off or around that same time. I think if you go back to the same habits, you will very likely put weight back on.

Now, I'm not familiar enough with the research to know how quickly that would occur, but we do know yo-yo dieting is something that can be hugely problematic. Now, obviously with GLP-1, most people are not losing 10 pounds in a week, but I do think for a lot of people who've had a lifetime of yo-yo dieting, I think their metabolism in many ways is already

Now, I'm not familiar enough with the research to know how quickly that would occur, but we do know yo-yo dieting is something that can be hugely problematic. Now, obviously with GLP-1, most people are not losing 10 pounds in a week, but I do think for a lot of people who've had a lifetime of yo-yo dieting, I think their metabolism in many ways is already

dysregulated or damaged to a degree that they're probably more susceptible to that.

dysregulated or damaged to a degree that they're probably more susceptible to that.

It just builds that awareness so that you can get back on track if you need to. It's not designed to be punitive. And I think that's sometimes the common misconception is that tracking is designed to be punitive. And I'm like, oh, no, we're just data mining. We are just information gathering. And I think that that allows us to make better decisions overall.

It just builds that awareness so that you can get back on track if you need to. It's not designed to be punitive. And I think that's sometimes the common misconception is that tracking is designed to be punitive. And I'm like, oh, no, we're just data mining. We are just information gathering. And I think that that allows us to make better decisions overall.

to be able to improve their metabolic health.

to be able to improve their metabolic health.

I would say A, if not S. I think it is that impactful. So number one, before women were living to be into their 80s and life expectancy 100 years ago was like in our late 40s. A lot of people have made the conversation, well, if we were meant to live this long, then we don't need more hormones. But what many people don't realize, and this applies to men as well, is just not nearly as dramatic.

I would say A, if not S. I think it is that impactful. So number one, before women were living to be into their 80s and life expectancy 100 years ago was like in our late 40s. A lot of people have made the conversation, well, if we were meant to live this long, then we don't need more hormones. But what many people don't realize, and this applies to men as well, is just not nearly as dramatic.

Men go through andropause. Women go into menopause. But for women, it is a catastrophic decline in hormones. You know, you go from what hearkens the beginning of perimenopause and the beginning of ovarian senescence is this loss of progesterone. And you get a relative estrogen dominance, which explains a lot of the symptoms that women experience in perimenopause.

Men go through andropause. Women go into menopause. But for women, it is a catastrophic decline in hormones. You know, you go from what hearkens the beginning of perimenopause and the beginning of ovarian senescence is this loss of progesterone. And you get a relative estrogen dominance, which explains a lot of the symptoms that women experience in perimenopause.

And so we initially have low progesterone. At the end of perimenopause, we also have low estrogen. Depending on the individual, about 25% of us still make a good amount of testosterone in menopause. I'm not one of them. But for me, being on hormone replacement therapy personally has been life-changing. In most of my patients, life-changing in terms of sleep.

And so we initially have low progesterone. At the end of perimenopause, we also have low estrogen. Depending on the individual, about 25% of us still make a good amount of testosterone in menopause. I'm not one of them. But for me, being on hormone replacement therapy personally has been life-changing. In most of my patients, life-changing in terms of sleep.

libido, energy, cognition, bone health, heart health. There's just so many benefits if dosed properly. And that is the caveat is that we still have clinicians that are in many instances fearful to prescribe hormones, aka oral contraceptives are not hormone replacement therapy. Number one, for anyone who thinks like we have women that will write into the podcast, I'm like, I'm so excited for you.

libido, energy, cognition, bone health, heart health. There's just so many benefits if dosed properly. And that is the caveat is that we still have clinicians that are in many instances fearful to prescribe hormones, aka oral contraceptives are not hormone replacement therapy. Number one, for anyone who thinks like we have women that will write into the podcast, I'm like, I'm so excited for you.

And then I'm like, no, that's not it. Yeah. So oral contraceptives or combined oral contraceptives are not HRT. But helping women understand that, you know, the differentiator in sleep quality is unbelievable. When we do intake forms, I know who's on HRT. They are the people that are sleeping better, have more energy, have more vitality. Their hair is still vibrant.

And then I'm like, no, that's not it. Yeah. So oral contraceptives or combined oral contraceptives are not HRT. But helping women understand that, you know, the differentiator in sleep quality is unbelievable. When we do intake forms, I know who's on HRT. They are the people that are sleeping better, have more energy, have more vitality. Their hair is still vibrant.

And I think all of us have opportunities where we have things we need to clean up. I'm going through that myself right now. I'm like, OK, time to get back on the saddle.

And I think all of us have opportunities where we have things we need to clean up. I'm going through that myself right now. I'm like, OK, time to get back on the saddle.

They feel like their skin is glowing. They just feel so much better. And it allows them to show up, you know, uniquely in their personal and professional lives. So from my perspective, having a conversation, every woman and frankly, every male deserves to have a conversation with their partner. hormone proficient provider about what is needed and necessary.

They feel like their skin is glowing. They just feel so much better. And it allows them to show up, you know, uniquely in their personal and professional lives. So from my perspective, having a conversation, every woman and frankly, every male deserves to have a conversation with their partner. hormone proficient provider about what is needed and necessary.

And for women, that could be, it could be progesterone, estrogen. It could be testosterone. It could include thyroid replacement. If that's what you need, it could include things like pregnenolone, which is important for memory and DHEA, depending on what you yourself need. And then in addition to that, just helping people navigate their choices.

And for women, that could be, it could be progesterone, estrogen. It could be testosterone. It could include thyroid replacement. If that's what you need, it could include things like pregnenolone, which is important for memory and DHEA, depending on what you yourself need. And then in addition to that, just helping people navigate their choices.

But understand that you do have choices and there are providers that are out there that can help you navigate what choices and options are available. They run the gamut from stuff that's covered by insurance, as well as compounded options. And obviously the compounded options are more expensive. I always transparently share that I have an estrogen patch, which is $5 a month.

But understand that you do have choices and there are providers that are out there that can help you navigate what choices and options are available. They run the gamut from stuff that's covered by insurance, as well as compounded options. And obviously the compounded options are more expensive. I always transparently share that I have an estrogen patch, which is $5 a month.

And then I take compounded progesterone, which is I think $90 for three months. And then I take testosterone, which is about $100 for three months. So relatively inexpensive. And no, you do not have to spend $150 a month on an estrogen patch. There are some online companies that will remain nameless that charge an arm and a leg for their products, which I think is, I'm all for people making money.

And then I take compounded progesterone, which is I think $90 for three months. And then I take testosterone, which is about $100 for three months. So relatively inexpensive. And no, you do not have to spend $150 a month on an estrogen patch. There are some online companies that will remain nameless that charge an arm and a leg for their products, which I think is, I'm all for people making money.

But I think that for a lot of individuals, they need stuff that's more affordable. But I think HRT is a total game changer. And every woman and man, for that matter, deserves to have a conversation with a a hormone savvy provider that can start things low and slow. You know, a lot of the concerns that women express to me is I know if it's not dosed properly, I'm going to gain weight.

But I think that for a lot of individuals, they need stuff that's more affordable. But I think HRT is a total game changer. And every woman and man, for that matter, deserves to have a conversation with a a hormone savvy provider that can start things low and slow. You know, a lot of the concerns that women express to me is I know if it's not dosed properly, I'm going to gain weight.

That's a huge concern and a huge fear. And I, I, I feel that in my bones because I know how frustrating that would be. But if it's dosed slowly and appropriately, you know, starting with some progesterone and adding in some estrogen, then eventually if needed, adding in testosterone and

That's a huge concern and a huge fear. And I, I, I feel that in my bones because I know how frustrating that would be. But if it's dosed slowly and appropriately, you know, starting with some progesterone and adding in some estrogen, then eventually if needed, adding in testosterone and

If done at the proper doses, people should not be gaining 5, 10, 15, 20 pounds like I hear across social media that occur on occasion. But HRT, absolutely a game changer.

If done at the proper doses, people should not be gaining 5, 10, 15, 20 pounds like I hear across social media that occur on occasion. But HRT, absolutely a game changer.

Yeah.

Yeah.

Well, I think that's an important question. There's also an important caveat. We know, if we look at research, that as a woman's estradiol, which is the predominant form of estrogen, is lowering in late perimenopause into menopause, and as our FSH, which is follicular stimulating hormone, is going up, In our bodies, if we are not getting enough protein, so it goes back to the protein.

Well, I think that's an important question. There's also an important caveat. We know, if we look at research, that as a woman's estradiol, which is the predominant form of estrogen, is lowering in late perimenopause into menopause, and as our FSH, which is follicular stimulating hormone, is going up, In our bodies, if we are not getting enough protein, so it goes back to the protein.

So this is physiologically what is happening. If we don't eat enough protein, that change in those two hormones will drive us to continue eating. So when women say to me and they we look again, one week's look at their what they're taking in in terms of macronutrients. And they say to me at 7, 8 o'clock at night, the pantry is calling to me. It's just calling to me.

So this is physiologically what is happening. If we don't eat enough protein, that change in those two hormones will drive us to continue eating. So when women say to me and they we look again, one week's look at their what they're taking in in terms of macronutrients. And they say to me at 7, 8 o'clock at night, the pantry is calling to me. It's just calling to me.

I just go in there and I start eating. It's because they haven't eaten enough food throughout the day. So that protein piece becomes even more important. So I'll just dovetail that. This protein leverage hypothesis is very important. You don't get enough protein, your body will seek out calories from fat and carbohydrates and other ways.

I just go in there and I start eating. It's because they haven't eaten enough food throughout the day. So that protein piece becomes even more important. So I'll just dovetail that. This protein leverage hypothesis is very important. You don't get enough protein, your body will seek out calories from fat and carbohydrates and other ways.

Number two, I think that there's many things that contribute to weight loss resistance.

Number two, I think that there's many things that contribute to weight loss resistance.

being in a low estrogen or low testosterone state can exacerbate that it is usually never just the change in sex hormones usually multiple things it's probably your stress isn't being managed we know stress think about it like the primary thing that happens with cortisol is your blood sugar goes up your blood sugar goes up your insulin goes up so helping people understand that not getting good sleep not managing your stress the loss of muscle um

being in a low estrogen or low testosterone state can exacerbate that it is usually never just the change in sex hormones usually multiple things it's probably your stress isn't being managed we know stress think about it like the primary thing that happens with cortisol is your blood sugar goes up your blood sugar goes up your insulin goes up so helping people understand that not getting good sleep not managing your stress the loss of muscle um

your macronutrients being a disaster, all these things, and then add in all the other nuances about gut health, toxin exposure. I mean, all these things can contribute to weight loss resistance. It is never just one thing, but I think once we get your hormones properly balanced and by balanced hormones, You know, we can define what that is. Sometimes that can be elusive. That includes thyroid.

your macronutrients being a disaster, all these things, and then add in all the other nuances about gut health, toxin exposure. I mean, all these things can contribute to weight loss resistance. It is never just one thing, but I think once we get your hormones properly balanced and by balanced hormones, You know, we can define what that is. Sometimes that can be elusive. That includes thyroid.

That includes making sure your adrenals are supported. I know we didn't touch on this, but adrenal pause is a real thing that happens. So if you're not managing your stress, your cortisol is going to be a disaster. And so I remind women that doing something quantifiably every day to support stress management is important.

That includes making sure your adrenals are supported. I know we didn't touch on this, but adrenal pause is a real thing that happens. So if you're not managing your stress, your cortisol is going to be a disaster. And so I remind women that doing something quantifiably every day to support stress management is important.

you will be on the road to losing weight but it may not be you get put on the patch you get start some estrogen you start testosterone it happens automatically rarely does that happen but you'll be heading in the right direction as those hormones are better balanced that's great love that the thing about you cynthia that i always so appreciate is you are

you will be on the road to losing weight but it may not be you get put on the patch you get start some estrogen you start testosterone it happens automatically rarely does that happen but you'll be heading in the right direction as those hormones are better balanced that's great love that the thing about you cynthia that i always so appreciate is you are

I would say number one, it's understand that each one of us are our own individuals. So what may work for five patients may not work for 10 others. So when I'm talking to someone, it's taking that history to really get to know them, to figure out what is their motivation for getting healthier. That's number one.

I would say number one, it's understand that each one of us are our own individuals. So what may work for five patients may not work for 10 others. So when I'm talking to someone, it's taking that history to really get to know them, to figure out what is their motivation for getting healthier. That's number one.

And then number two, figuring out what are the lowest lying fruit that we can work on first that are going to yield results. Improvements in how they feel so that I can get them more motivated to take further action. Because like I stated, everyone is their own individual. And I think weight loss resistance is just a sign of a larger problem. It's an imbalance that we have to figure out.

And then number two, figuring out what are the lowest lying fruit that we can work on first that are going to yield results. Improvements in how they feel so that I can get them more motivated to take further action. Because like I stated, everyone is their own individual. And I think weight loss resistance is just a sign of a larger problem. It's an imbalance that we have to figure out.

The more often than not is related to sleep and stress and loss of muscle and hormones, multiple hormones. And then add in the other things that make us who we are as individuals, whether it's long-term stress, whether it's trauma from our childhood. I mean, these things really do become problematic toxins we're exposed to in our personal care products, environment, and food.

The more often than not is related to sleep and stress and loss of muscle and hormones, multiple hormones. And then add in the other things that make us who we are as individuals, whether it's long-term stress, whether it's trauma from our childhood. I mean, these things really do become problematic toxins we're exposed to in our personal care products, environment, and food.

All these things can ultimately impact how well we do or do not lose weight.

All these things can ultimately impact how well we do or do not lose weight.

Absolutely.

Absolutely.

Thank you for having me. Always an honor.

Thank you for having me. Always an honor.

many women that are in my practice and programs that are clients within our business are individuals that are super type a they exercise really hard they don't sleep enough they don't eat enough food they're probably have a very compressed feeding window and those are typically the patients that i will actually suggest to them especially because they come to me they're tired they're weight loss resistant they're trying to figure out why things aren't working for them

many women that are in my practice and programs that are clients within our business are individuals that are super type a they exercise really hard they don't sleep enough they don't eat enough food they're probably have a very compressed feeding window and those are typically the patients that i will actually suggest to them especially because they come to me they're tired they're weight loss resistant they're trying to figure out why things aren't working for them

Yeah. So OMAD means one meal a day. And I think that, again, it also gets kind of lumped in with the intermittent fasting community, that that is, you know, a strategy, one of many strategies that you can utilize. I think my greatest concerns about OMAD, and I've been very open about this from the very beginning, is it's the concept of food intake over time.

Yeah. So OMAD means one meal a day. And I think that, again, it also gets kind of lumped in with the intermittent fasting community, that that is, you know, a strategy, one of many strategies that you can utilize. I think my greatest concerns about OMAD, and I've been very open about this from the very beginning, is it's the concept of food intake over time.

Now, if you go on vacation and you come home, you're like, I just totally, you know, enjoyed myself, indulged in everything. I'm coming back home and I'm going to get back on track and I'm going to have a day of one meal a day so that I can kind of reset myself and move forward.

Now, if you go on vacation and you come home, you're like, I just totally, you know, enjoyed myself, indulged in everything. I'm coming back home and I'm going to get back on track and I'm going to have a day of one meal a day so that I can kind of reset myself and move forward.

That is very different than most individuals that are doing OMAD and they're barely getting close to their protein threshold for the day. So my concern over time is that, yes, a lot of people want to do OMAD because they want to lose weight. They're like, this will be effective. I'm not going to be hungry for a second meal. I don't need a second meal.

That is very different than most individuals that are doing OMAD and they're barely getting close to their protein threshold for the day. So my concern over time is that, yes, a lot of people want to do OMAD because they want to lose weight. They're like, this will be effective. I'm not going to be hungry for a second meal. I don't need a second meal.

More often than not, I will ask them to do a gentler form of intermittent fasting. I would have them do something called digestive rest, which is 12 hours of when you have a feeding window of 12 hours and 12 hours of not eating.

More often than not, I will ask them to do a gentler form of intermittent fasting. I would have them do something called digestive rest, which is 12 hours of when you have a feeding window of 12 hours and 12 hours of not eating.

And then helping them understand is that over time, if you start tracking those macros, at least with my female patients, that what I start to see is someone who's eating 50, 60 grams of of protein per day. And over time, what are the things that happen after the age of 40? This progressive loss of muscle.

And then helping them understand is that over time, if you start tracking those macros, at least with my female patients, that what I start to see is someone who's eating 50, 60 grams of of protein per day. And over time, what are the things that happen after the age of 40? This progressive loss of muscle.

And so what you are essentially doing is you are making that progressive loss of muscle, which is sarcopenia. It exacerbates that. It magnifies it. And so if you look at all the longevity researchers versus the individuals like Dr. Don Lehman, Dr. Gabrielle Lyon, who were very big proponents of

consuming adequate protein to offset sarcopenia frailty falls etc you start to understand that ultimately you decide for yourself which path you want to take and as someone who's as both as a clinician and as a an individual watching people that are doing omad over time you know watching people track their macros talk to us in programs talk to us in one-on-one environments

consistently what I see happening is this progressive loss of muscle. The loss of muscle leads to not just frailty over time, but also leads to a loss of insulin sensitivity. So really understanding that our muscles are a metabolic sink and helping people understand that you're not getting enough protein into your diet. You are just going to worsen that unraveling of this loss of muscle.

I'm a very visual person, so I always like to provide comparisons. So young, healthy muscle looks like filet. We all know what that looks like. Versus a delicious ribeye, still equally delicious, but it has a lot of marbling. It has a lot of fat infiltration. That is what older muscle looks like. We want to remain looking like a filet over time.

So my concern about OMAD is, number one, if it's an occasional thing, not a big deal. You've overindulged. You came back from vacation. You just ate too much. That's very different than a sustained OMAD effort. And there are people in the health and wellness space that do OMAD in perpetuity, many of whom have lost a significant amount of weight. And I don't want to take away from that.

On the contrary of that, male or female, if you have someone that is not metabolically healthy, someone that is maybe just getting started on their health and wellness journey, an individual who's consuming snacks and mini meals, someone that's eating a lot of ultra processed foods, maybe they're not as physically active as they would like to be.

But I also don't think in many instances they're really fully understanding the long-term impact of that loss of muscle. It is significant and quite profound. And so that is always where my concern goes is, you know, are you getting enough protein? Can you get 100 grams of protein in a meal? I can't. I'm sure there are people out there that might be able to.

In fact, I have one female friend who does, and I just call her the unicorn. But in terms of everyone else, most of us are not getting 100 grams of protein into one meal. And if you're not getting at least 100 grams of protein in a day, You're just making that whole process of muscle loss. You're just magnifying it.

I'm going to put it as a D. As a D, not an F. Not an F. I'm sure there'll be other things that will get an F, but it's always that cautionary. Like I understand the utility of it.

And what's interesting, Drew, is that I can assure you if I take any heat for this interview, it'll be about that. About OMAD. About that, without question. Without question.

Yeah, well, I would say I would back up and say our gut microbiome has a tremendous amount to do with the health of our gut microbiome, whether or not we can or cannot lose weight. And I know this because I just wrote a book on it. So I feel like this is a uniquely perfect time to have this conversation. So number one.

opportunistic infections whether it be a parasite h pylori candida dysbiotic organisms all of those things are opportunistic and so when someone says to me i think it's the parasite that is making me weight loss resistant and i'm like there's so many other things that happen first i think that it is a sign that there is a significant gut microbiome shift And it is not per se the parasite.

having a compressed feeding window for an individual like that in particular can help jumpstart a lot of health benefits.

The parasite is kind of the symptom, if you will. But there's other things that are going on below the surface. So when I think about this, it just it brings me back to understanding. And I'll give you an example. So when young boys and girls are born and they're growing up up until puberty, our microbiomes are very similar.

It's only the advent of puberty that we start seeing differentiation in the microbiome. Obviously, men predominantly with testosterone, women predominantly with estrogen, but also progesterone and a little bit of testosterone. And up until we go through puberty, if someone chooses to get pregnant, they go through pregnancy. There's a shift in the microbiome. And then we get to perimenopause.

And it's these three big shifts in our lives as women in particular. And then ironically enough, we go into menopause and our gut microbiomes resemble men's. And so the reason why I'm bringing this up is when women in, you know, north of 40 perimenopause menopause suddenly have aberrancies or weird or unusual things that come up on stool testing is one example.

Most of the health benefits that we talk about in terms of intermittent fasting, improved biophysical markers, a degree of reduction in inflammation, improvement in brain health and brain cognition, reduction in specific types of cancers, having the ability to evoke this process called autophagy where we have this waste and recycling process going on. So it's always in the context of

I'm like, it's really a reflection of what's going on at the gut microbiome, both with the differentiation with immune function, things that are changing there. It speaks to individuals that are making less hydrochloric acid. So all of us are exposed to parasites and other type of organisms on a daily basis.

If you eat lettuce, I mean, you are exposed to things because you can only scrub the lettuce or clean the lettuce so well. But we have...

lines of defenses in our body that are designed to do away with these things hydrochloric acid in the stomach um you know you've got other uh you know bicarbonate other things that go on in the microbiome and and beyond that are designed to to help um you know these defenses systems that are designed to get rid of what does not belong. Now, how does a parasite come about?

There's a couple of different things that happen. You know, it could be you're a certain life stage. You're more susceptible. You make less hydrochloric acid. You're an individual that in many instances, you have chronic stress. You're not sleeping. Your nutrition is terrible. We know 70% of us as Americans alone are eating ultra processed foods.

You're not even eating food that has much nutrient quality to it. And so do I think parasites are the reason why people are gaining weight or weight loss resistant? I think it is many other things contributing a degree of inflammation, oxidative stress. There can be so many things that are going on with that. The parasite per se, I would say is just a symptom of a bigger issue.

So that's where I would leave that. It's, it's not that the parasite is what drove it. It's that there were a lot of other dominoes that had already fallen over. And that just happened to be the one thing that someone did some testing. They figured out there was something else going on, but Many, many things contribute to that. I don't think it is solely from the parasite.

And by no means am I saying that people don't go through this.

It's usually other things that are contributing. And it's usually that is, it's like the red herring. It's like, okay, so we do stool testing. Then we pick up, oh, you have a parasite or you've got significant dysbiosis. Oh, by the way, you have H. pylori or you've got SIBO. I mean, there's many things that can create this domino effect. It's usually multifactorial.

Like why are we weight loss resistance? It's never just one thing. things.

It depends on the patient. I do still like and embrace the concept of intermittent fasting, but it's always in the context of understanding that fasting is one of many types of hormetic stressors, you know, beneficial stress in the right amount at the right time. And for some people, it's too much stress over time that can be problematic.

I mean, I think you have to take it in context. What are the patient's symptoms? What are they experiencing? What does their blood work look like? Are they dealing with underlying food sensitivities? Are they female or male? Where are they on their female journey? Are they in perimenopause or menopause? I mean, there's a lot that can impact the interpretation of testing?

Do I think there are better companies than others? Absolutely. I think that from my perspective, I have found them to be incredibly invaluable and very validating in terms of the symptoms that someone's experiencing and then working through a protocol to address exactly what we're finding.

I think that in many instances, there are circumstances where we need antibiotic therapy for things that we find. As an example, I've had people who've had C. diff, which is an opportunistic infection. Sometimes we just see it in the hospital, but you can see it in the community as well. So I think for a lot of individuals, it is, it is really taking a good history.

That's number one, like any clinician should be. And I'm sure they, the good ones do really good history because it helps tease out what direction you're going to go in. And then using testing to kind of rule out or rule out, rule in or rule out other things that you're concerned about. I think that is helpful, but you know, there's no one test that is perfect. I mean, it just doesn't exist.

And so I think when I start to zero in on, you know, how my thought process has changed over the past 10 years about fasting and

Do I sometimes run tests on people that I'm convinced they have SIBO or they have significant candida or some other issue or even something more significant than that? And that's when I refer them to a specialist. But I think in many, many instances, if I'm having great concerns about, you know, do they have colorectal cancer? Could there be something quite significant going on?

But I think a lot of it is the interpretation based on the clinician's experience, taking a good history, and then also working with companies where you feel like there's a degree of reliability. There's one company that will remain nameless that since the pandemic, almost every one of my patients was showing up as having H. pylori. And I called the company. I said, how is this even possible?

Because this wasn't happening pre-pandemic. And that required me to do a little bit of course correction. It was like, okay, I'm going to start working with other companies because I'm concerned that this may be an aberrancy. This may be something that It just doesn't make sense that every single person's test would be positive for H. pylori.

it has gotten a much more nuanced and just having patients get really honest with themselves are you struggling to build muscle are you someone that's not sleeping at night and this could be male or female helping them understand you know intermittent fasting might be something you do on a couple days out of the week it might be on the days you're not lifting weights it might be something that you entertain around your cycle specific times around your cycle

When you look at a broad section of the population, it was like that just doesn't make sense. So I think it's it's a bit of provider preference, provider comfort, getting that good history and then deciding what does that patient specifically need? Like there's no one size fits all in my world.

Yeah. I mean, I think the biggest thing is understanding that we start in in one place. kind of realm, and we understand the influence of sex hormones are significant and profound. So it's not just immune function and why women in middle age suddenly start becoming more susceptible to parasites and other type of opportunistic infections, but it's bone health.

The gut microbiome and bone health are intricately related. Our mood is intricately related to the type of neurotransmitters we're able to create in the gut microbiome. There is literally next to nothing that is not impacted positively or negatively by the microbiome, including when we go into menopause.

Ovarian senescence is the concept that probably hasn't been talked about a lot, but it's like now that I've kind of opened that Pandora's box, helping us understand that the role of childhood adverse events can impact when we go into menopause and vis-a-vis communication between the microbiome.

and the ovaries and you know it is utterly fascinating so expect it to come out that everything is interconnected you know traditional allopathic medicine tends to think about health care in silos you know the heart is in one bucket the brain's in another And the one thing that I've learned over the past 10 years is that everything is interconnected.

And the more that we understand about the gut microbiome, the more that I am impressed, the fact that we function day to day, but also understanding how important all this hormone signaling, polyphenol signaling from things like urolithin A, from nitric oxide, all of these signaling molecules communicating within the body, within the gut microbiome to get things to work and be optimal is incredibly humbling.

It can absolutely contribute. And the greatest concern that I have is traditional allopathic medicine has a very narrow-minded perspective on thyroid testing. And therefore, many, many women outside of a traditional allopathic world are oftentimes not properly diagnosed.

And so I think that it's always a nuanced conversation when it comes to fasting. So if I'm thinking about a ranking, I'd probably make it a B or C. So something in that kind of average range really depends on the individual still has merits. But if you are that type of woman that is middle aged and you are over fasting, under eating, over exercising, you're not doing yourself any benefits.

So let's back it up and talk about the fact that when I was working in traditional allopathic medicine, we probably did two blood tests to look at thyroid function, which does not encompass everything.

you add on top of that that just like we go through menopause perimenopause we go through thyroid pause there is absolutely positively most often than not women that are navigating that perimenopause to menopause transition are experiencing some degree of underactive thyroid now The allopathic physicians would say that's bunk, that doesn't actually happen. I've seen it thousands of times.

If you look at trends over time of lab work, looking at like where was their TSH and their free T3, free T4, et cetera, over time, what is happening is they have this loss of sex hormones. So number one, the most common thing we will see in perimenopause and menopause is this underactive thyroid, hypothyroidism, typically caused by an autoimmune condition called Hashimoto's.

less commonly by Graves, which is where it's overactive. So I find for a lot of women, it is not just this subjective, I'm tired, I'm gaining weight, I'm constipated, my skin is dry. It is the thyroid is just not optimal. It's not optimal. It's not in a position where they even feel like they have enough energy to get out of bed.

So it can be very complicated when we start talking about not just thyroid. It's also the sex hormones piece. It can be lack of sleep. It can be chronic stress. But I find for a lot of individuals, thyroid mismanagement or thyroid under management is absolutely contributing to weight loss resistance. When I find most women.

even if they're on a very low dose, it's compounded or even traditional things like armor thyroid and things like that, they get started on thyroid medicine and they feel like their brain works better. They feel like they can get out of bed. They may not lose weight immediately, but they will start feeling like they have the energy to go to the gym.

They're making better food choices because they have more energy to cook. And so I would say that when it comes to thyroid, it is absolutely contributory to weight loss resistance, shifts in body composition. This is absolutely a B.

it's not i'm not hearing from you and correct me if i'm wrong that it's probably more of the indirect things but it can play some role in some of the direct things as well is that i'm hearing that appropriately absolutely and i i always like to be fully transparent that it was probably eight years ago and my primary care provider checked my thyroid and i i was that typical perimenopausal woman i was exhausted i was tired i was weight loss resistant i couldn't sleep my skin was dry my hair was dry i mean everything

And she pointed out, you know, your thyroid's underactive. And I was like, I don't want to take a medication for the rest of my life. And so for about three months, I fought this. And then I finally went to her one day and said, I'm absolutely exhausted. I cannot function. And within three days of starting medication, I felt like a light bulb had been turned back on in my brain.

And so I think it's important to share that even I was resistant because I didn't want to take a medication every day. But I happily take said medication every day because it has made such a significant difference. Now, did I go from, you know, having brain fog and not feeling great and not having energy to instantly losing weight? Absolutely not, because it's like peeling an onion.

You have to keep peeling and peeling and peeling. But I think for a lot of individuals that are listening to this that suspect they might have an underactive thyroid, everything slows down in the body. So you get constipated. Your cycles may change. You may have dry skin. You may feel like you're not mentating well, meaning you're just not feeling like you're as clear cognitively.

People may have slowed heart rate. They may have brittle nails. There's a lot of things that can happen. Everything slows down. And so for a lot of individuals, it's getting tested to figure out what's going on.

And so the types of tests that I recommend, TSH, which is thyroid secreting hormone, looking at a free T3 and a free T4, that's the actual, especially the T3 is important because that's the actual active form of the hormone. Looking at reverse T3, which sometimes the allopathic community screams about. It can be a sign if you're dealing with chronic stress, if that is high.

Looking at antibodies, super important to look at antibodies because just like I mentioned earlier, the number one reason women will develop an underactive thyroid is related to Hashimoto's. Now, I've never had a positive antibody, but I do have Hashimoto's. So I think for a lot of people, it's helping them understand, like, why do we get more susceptible to autoimmunity as we get older?

It goes back to that immune system dysregulation that happens with those sex hormone changes in middle age. And women are much more likely to develop autoimmune conditions just by virtue of our gender.

We tend to have a more hyper responsive immune system, which is what protects the fetus when we're pregnant, but also can be problematic as we're getting older because our immune system just tends to be more easily provoked. And so when I think about thyroid function, it's helping people understand there are far more people undertreated for thyroid than should be the case.

And a lot of women suffer needlessly in middle age for this reason. And men are not immune to it. I have plenty of male family members, people that I know personally who are otherwise healthy, who just have underactive thyroid. It's almost like it's like a spark plug that has just kind of lost its ability to generate enough ATP, enough energy. And so helping people understand that

It's not that you've done anything wrong. It's like many things. I hate to use the analogy to a car as the aging process, but just like we have to replace things in the car over time, there are things that just don't work as effectively or as efficiently over time.

Yeah. So I think it goes back to bio-individuality. You're going to have people that will tell you, I tolerate zero fiber. I get gassy. I get bloated. I feel terrible. I don't like it. And then I have other people who thrive on higher fiber diets. So let's talk about the biggest issue is most, if not all of us, are not eating enough fiber.

And if you look at the research on the gut microbiome, fiber feeds the good bacteria in the gut. I mean, it's simply stated. If you look at the research, I think bioindividuality plays a large role in here. I know that I was full carnivore for nine months after being hospitalized. I tolerated zero fiber for a long period of time.

When patients tell me they tolerate no fiber, I start to think about what's going on in your microbiome that is driving these intolerances or this discomfort or your symptoms. More often than not, I'm a bigger believer of the fact that some fiber is better than none. For each one of us, it might look a little bit differently. The guidelines say 25 to 30 grams a day.

I would imagine most of us are not getting even half of that. So I think that I go into this saying bioindividuality rules. If you look at the research, though, the research absolutely supports the need for fiber to feed the healthy gut microbiome and to look at

know these prebiotics and and probiotics and what feeds you know short chain fatty acid production and all these very important things that go on in the gut and i know far more now than i ever thought i would but with that being said this is very much a bio individual because i feel like there's enough people that don't tolerate fiber that i i try very hard to get a little bit into their diet you know whether it's with a supplement

Yeah, it's a great question. I think the first thing that I would actually have them do is track their macros because that gives me a sense right there of, are you able to meet your protein targets of where you should be? That's number one, because that'll allow me to see, could you get away with having a compressed feeding window or do you struggle to get in

Or we dip our toe in the pond and we try just, you know, you have an eighth of a cup of lentils one day and maybe another day you're having, you know, a small amount of greens. And then the day after you might introduce some, you know, low glycemic berries just to be getting something into the diet.

But I think more often than not, if someone is completely intolerant of fiber, it's a reflection of what's going on in their microbiome.

I think it's quite important. I would say I'm going to probably going to get in trouble for saying this. I'm going to put it up as a name.

I think it's actually important. And the irony is over time, because I've had patients try inulin and psyllium and I mean, all sorts of different, it is as individual as the patient. And we start in some instances, we're starting with an eighth of a teaspoon a day just to see, you know, what can we build them up to? It's that important to at least try it.

And I think it's an important, you know, it's a bit of experimentation. And certainly I've had patients who've had SIBO and we've had them on very low FODMAP diets. And there's all sorts of great resources online where you can see it's like a traffic light, you know, green, yellow and red from like lowest to highest FODMAP. I think for a lot of individuals that can be very, very helpful.

The other thing that's really interesting is it goes back to reflecting on The health of your microbiome has a lot to do with what you can or cannot tolerate. And I don't say that to be shaming because I think my gut microbiome has been all over the place over the last 10 years. But I think for a lot of people, as they start healing, they will find that they are more tolerant.

50 grams of protein a day, because that is a totally separate issue. I think when it's five or 10 pounds, I find for most people, it is the discretionary fun foods. It's the alcohol on the weekends. It's the desserts. It's maybe having that extra portion of ultra processed foods that are adding to you know, the trouble with losing weight or weight loss resistance.

I mean, I do think cumulatively over time we are exposed to a lot. So our toxin bucket over time can get filled. And I think by middle age, most, if not all of us have, whether it's between environmental exposures, food exposures, personal care products exposures, which I think are not probably talked about enough.

mercury amalgams, I don't want to get controversial, like vaccines, just everything, cumulatively over time, depending on our genetics, depending on who we are, we can be exposed to a lot. I am a fan of looking at specific testing to determine, and based on symptoms and getting that good history, determine if someone actually needs something like that.

Now, do I do testing where it is evident to me that someone has been exposed to a lot of plastics? Yes. Do I see people that are not breaking down their estrogens properly? Absolutely. Are there people that don't detox well? And by that, I mean not just detox in a box.

They have the genetic SNPs that either it's phase one and phase two, which occur in the liver, or maybe they just recirculate their estrogen because their gut's a disaster. Do I see plenty of people like that? Absolutely. I think that if we have this one size fits all methodology that everyone needs X, that can be problematic.

And so I think that I would go back to say, I think this is kind of a mediocre recommendation in the context of everyone needs it and everyone needs the same, you know, everyone needs the same binder and everyone needs the same detox program and everyone needs everything. You know, you know, there's there are programs out there that have hundreds, if not thousands of people in them.

And they're servicing thousands and thousands of people all doing exactly the same exact thing. Now, with that being said, are there things that I think that can facilitate natural detoxification processes in our body that all of us can do? Absolutely. Like sauna. sauna exercise, dry brushing, lymphatic massage. I mean, you think about how do we detox optimally?

We poop, we pee, we sweat, we breathe. I mean, that is how it's supposed to be optimally happening. But there are a lot of lifestyle things, you know, whether it's, you know, certain types of vegetables, whether it's You know, certain types of, you know, hydration. I mean, simple things, hydration, sleep, dry brushing, sauna, infrared sauna.

Yes, absolutely. I mean, you talk about DIM as a molecule that you can find in specific compounds of vegetables like your crucifers. Absolutely. Absolutely. And then, you know, it's just thinking about just testing, demonstrate that you actually need X, Y, or Z. Like I have MTHFR, I have two copies. I am a terrible phase two detoxifier.

So in my body, there are certain nutrients that I need more of, but I eat plenty of those vegetables that have those things. But I also take a specific supplement to facilitate that, but it would not be the recommendation I would make to everyone, which is why I don't love these one size fits all detox in a box supplements.

So sometimes it's starting there, like the transparency piece, and I'm a data geek. So it's like, let's track your macros for a couple of days just to see what you're doing. And then we can decide if you're already getting in 120 grams of protein a day,

I think I'm trying to sway you.

I think I think there's an F in there. I just haven't hit it yet. Although I do. I do. The cautionary thing is I think there are very well-meaning people out there. Yes. And that's kind of my prevailing thought process in life.

I have to believe that. But there are charlatans and the charlatans are going to convince the thousands of people out there need exactly the detox in a box. And I'm here to tell you that that's probably not the case.

I'm going to give it a D and it's context of why I'm saying this.

Intense daily cardio. Right. So I think zone two cardio, which is designed to keep your heart rate at a certain level, is very different than chronic, unrelenting, hardcore cardio, which is very different than high intensity interval training. We know that burst training is important for women in particular, but burst training is Five to 10 minutes. It is not 30 minutes.

I think it depends. So when I talk about the desire to intermittent fast and the health benefits that come from it, It's always with the dovetail caveat of it depends. And because intermittent fasting is not new or novel, despite what the media would like us to think, it is designed to be able to help us utilize stored fat as energy, ideally.

It is not an hour long slog where you're killing yourself on a bike or you are, you know, doing and I'm going to take a lot of heat for this CrossFit or Orange Theory Fitness five days a week with no breaks. That is not what we're talking about. And so I think that there's a place for strength training. There's a place for zone two training, which is designed to be done where you're not panting.

Having a compressed feeding window is probably not a big deal, but if you're someone struggling to get 50 or 60 a day, you're the last person that I want you to have an ultra compressed feeding window. I find for a lot of patients, it's cutting out alcohol, it's cutting out the sweets, it's cutting out processed carbs that have a huge net impact on those last 5, 10, 15 pounds.

You're able to carry on a conversation. You could be walking up hills in your neighborhood. As an example, I live in a very hilly part of my state. very different than chronic cardio. And I think my generation has been convinced. Number one, we want to be skinny and not strong.

And the other thing that I think about quite a bit is that we were the generation that was convinced that we wanted to do all these aerobic activities and That's probably not what is going to allow us to lose weight over time. Now, are there exceptions?

Probably, but I find more often than not, the amount of cortisol that you are eliciting with that chronic, unrelenting, hardcore cardio is not the cortisol that is going to be your friend. I think when we're talking about that intense cardio that we've been conditioned to believe is what's going to allow us to lose weight, we know that exercise is actually a poor way to lose weight.

It does many other benefits, but if you're purely doing hardcore cardio to lose weight, that's actually not particularly effective and that's looking at the science. So when I'm helping women understand how to restructure their exercise, it's like, I'm not telling you not to exercise, but let's exercise smarter. Put your time into strength training, do some zone two training,

High-intensity interval training or burst training is important, but that's not an hour-long activity. That's like 10 or 12 minutes of activity. This is where people have gotten hit and Tabata all wrong. It's not a 30-minute class. It is designed to be short durations.

Like when I work out with my trainer, which I do twice a week to torture myself, it is 12 to 15 minutes most of burst training, and it is very intense training. And then you you take two minutes off and it's like that is what you are doing.

So I think many women that come to or have been doing chronic, you know, they just want to run 10, 15 miles every day or they want to get on that bike for two hours. It's helping them understand that those types of activities over time will actually work against us. They will break down muscle. They will raise cortisol.

which just fuels these, this breakdown in inflammation, gut health, muscle breakdown, you know, even Dr. Stacey Sims talks about, you know, why we have to exercise smarter as we're getting older.

And it's just helping people understand we have to find that reframe because we've been conditioned, at least my generation, skinny over strong, you know, do all the chronic cardio, because that's going to help you lose weight. And that's actually not the case.

I'm talking about strength training and zone two. Zone two is the kind of training where you are still able to carry on a conversation. It's designed to be... You know, when I think about what I do for zone two, it is usually walking hills because there's so many of them.

And then, you know, two days a week, 10 or 15 minutes of burst training or high intensity emerald training, that is very different. And I think for many individuals, that becomes... something that is sustainable as opposed to like, oh gosh, I've got to go run and mile. I've got to run for the next hour.

No. And that's important. So I think for a lot of, I would say this is, this is actually an S.

I personally am a big walker. Like I actually like that non-exercise induced thermogenesis. So just being active throughout the day. Do I think that every person realistically is going to hit 10,000 steps every day? Probably not. I have three dogs, so it's pretty easy.

But I think for a lot of individuals, like if they can just build it into they after a meal, they walk, you know, they park a little farther out at the grocery store or at the mall, if anyone still goes to malls or, you know, you're just doing some type of physical activity. Like for me, I can just walk hills up and down my street and get plenty of steps in.

So I think what it's encouraging people to do, like the prevailing theme is, Be physically active. This is in addition to the other types of exercise that you're doing. And I know that a friend of mine recently was talking about how she does not feel that walking is exercise.

I think it's important because you have to meet people where they are. For some people, getting 5,000 steps a day is a lot. So I look at it as 10,000 is great. Do I think that it's important to be, you know, for locomotion purposes, for being physically active? Absolutely. And I think for a lot of people, I go back to tracking macros.

For a lot of people, they just don't realize how sedentary they are. Like when I started tracking how far I was walking back when I was still seeing patients in the hospital, in the office, I was shocked. I was like, oh, I'm all over the hospital. I'm getting in 10,000 steps a day. No, I wasn't, even though I was in a big hospital.

So I think for a lot of people building awareness of what are the things I can do, whether it's maybe you get up a little earlier in the morning to walk for 15 minutes before you go to work. Maybe you walk after lunch. Maybe you and your spouse, you know, now we're heading into spring and summer. You know, it's it's lighter later walking with your spouse or your kids or whomever your pet.

after dinner, you know, just getting opportunities to become more physically active, I think is very important, the emphasis on activity.

And so walking is something you don't need a lot of special equipment for, you don't have to do a lot of special things for, for people that are dealing with mobility issues, sometimes getting in a pool, like if your gym has a pool, you can get in the pool and just, you know, you can do water laps, going back and forth, you don't necessarily have to swim. But I think for every

reason i've been given by patients over the years of why they don't they're not more physically active i try to come up with alternatives and so i would say being more physically active plus or minus those 10 000 steps is a b it's important i think it's very important that's great you know on that note i saw a tweet recently from an episode that rhonda patrick did where she said okay we want physical activity for sure like we want a lot of movement throughout the day and

Yeah, and it's interesting because even burst training can be helpful for visceral fat. So for a lot of people, we know visceral fat is the fat accumulation around our vital organs. That burst training can be very effective at...

improving the degree of visceral fat we have and we know again it's like this this little switch that goes off north of 40 we are much more prone to fat deposition there especially as women than we are in other areas where maybe it's more pesky if it's on our rear ends or on the back of our arms but that visceral fat is the stuff we want to avoid so burst training can be helpful for that as well

I think alcohol is one of the hidden reasons for why people are weight loss resistant. Because it can be very triggering to have a conversation. We use a cage questionnaire in traditional medicine to talk about habits around alcohol. And sometimes it's like poking a tiger.

Okay. So I'm going to give it a B. Because I do see merit in it. And I'll be fully transparent and tell you, I hate counting macros, but there is utility in it. And for some of my patients, they need that quantitative information to say, this is how much protein you're consuming. These are your carbohydrates. This is how much fat you're consuming.

You know you probably suspect this patient or this individual probably is drinking more than they're comfortable sharing with you. And coming from a place of no judgment, I think that alcohol is... is challenging because it is one of the few socially acceptable drugs that we can use. And I think a lot of people feel uncomfortable not choosing not to drink if that's what they choose to do.

I think there are equally a lot of people that feel completely uninhibited that they can drink as much as they want. And I'm not talking about like the teenagers and young adults and college age kids that are just experimenting. I think when you look at alcohol as a toxin, It's particularly harmful to many issues or many systems in the body.

So I think that when we talk about alcohol, I'm by no means am I saying be a teetotaler, don't enjoy a glass of wine on your birthday or a celebration. But I think for many individuals, it's reexamining that relationship because we know that one glass of alcohol in a woman is going to raise her estrogen levels for up to eight hours after consumption. If you're on HRT, guess what?

It's going to magnify that.

Helping people understand the way that our body detoxifies it is it's detoxified as a toxin. Your body will prioritize processing the alcohol first before anything else. We know it can be toxic to our brains. It can shrink our hippocampus. We know it can increase our risk of breast cancer.

I think that for anyone that's listening, that's thinking that maybe it could be contributing to one of the reasons why they're struggling to lose weight, I would say there's absolutely nothing wrong with cutting back, reducing what you're consuming. I think for some individuals, it's they want to numb themselves from actually experiencing difficult feelings.

And so alcohol, just like a lot of other vices in life, is something that allows them to come home, decompress, have a couple of glasses of wine, fall asleep. Maybe their sleep isn't so great. And I can make the argument that if you're already not getting good sleep, this isn't going to help. But alcohol is good. definitely contributory to weight loss resistant without question.

And I think that if you're trying to lose weight and you're trying to figure out why you're not losing weight and maybe all the other things are dialed in, maybe look at the alcohol piece.

Because I think for a lot of people, they mindlessly go about their day, not realizing that, you know, that half an avocado or sometimes that whole avocado a day is Could be, yes, it's a healthy fat. Yes, it's a healthy monounsaturated fat. But if you're over consuming healthy fats, that can impact your weight loss resistance. So number one, I like to track macros short term.

Yeah, I would say regular sodas with high fructose corn syrup. That is enough. That's enough.

Well, there's no therapeutic benefit. But if you're someone that really enjoys a soda and that's your vice, then I would say having a diet soda is going to be better than having the real thing. Now, we have a lot of people talking about the role of artificial sweeteners, whether it's sucralose, aspartame. People even sometimes will lump stevia, saccharin.

I don't know anyone that uses saccharin in their drinks, but that always comes up. If you look at the research, there's research to suggest in some rodent models that these artificial sweeteners can be

impactful on insulin sensitivity as well as impacting the gut microbiome within 28 to 30 days so that is significant but in the grand scheme of things i think that we have to think about what is realistic for our patients like i'm a realist and i want people say to me whether it's the diet soda or a protein bar or a protein shake i'm like listen i'm a realist if that is how you're going to be able to get through the day if you've been consuming eight cans of coke a day

for 20 years, if I can get you to stop consuming eight cans of Coke a day and get you transitioned onto something else, maybe we go from eight cans down to four cans, down to two, down to one. And then we transition you to a diet soda and you get acclimated to that taste that is infinitely better for you than that high fructose corn syrup is.

And the net impact that we know that our body effectively fructose in general is processed very differently in the body than other types of sugars. And I think soda is one of those kind of It's a really bad idea. I think in terms of impact on health, it's so profound and significant that a diet soda here and there, I'm not particularly worried about in the grand scheme of things.

Are there people out there that are absolutists? Yes. And I just think that that's not necessarily reasonable for most individuals.

So some people I'll say, let's track it for a week. A week is something everyone can do. Now, if I have someone who has eating disordered behavior, That sometimes can be triggering. And so there's other ways. I'll say, let's just track protein. Let's just track one metric. I think it is that important. Then you can also track hydration. You can track your discretionary macros.

Well, and I think it's interesting to me, you know, being in a position much like you that, you know, I've interviewed some amazing people and met and interacted with so many health and wellness experts. I sometimes think that we're shooting ourselves in our feet if we are too absolutist and too not accepting of where people are in time and space. Because that diet soda to me is not a big deal.

I have a husband who used to drink, I don't know, four or five diet Pepsis a day when I first met him. Now he doesn't drink any. Now it's kind of a every once in a while I'll laugh. I'll find some diet Pepsi in the outside refrigerator. And I'm like, I don't care. It makes them happy. But I think for a lot of people, it's like the journey that we're on.