I’m delighted to connect with academic physician-scientist Dr. Majid Fotuhi today. Dr. Fotuhi is a professor of neuroscience at Johns Hopkins Mind Brain Institute, an adjunct professor of psychological and brain sciences at GW, and the medical director of NeuroGrow Brain Fitness Center. He is a Harvard- and Hopkins-trained physician and researcher and is making great strides in changing how we think about brain health. In our conversation, we explore purpose in life as a factor in brain resilience, how our belief systems and function can help lower cortisol, and why middle-aged people, especially women going through perimenopause and menopause, forget things. We discuss the impact of hormone replacement therapy, common types of cognitive impairment, the dynamic polygon hypothesis, the influence of proper labeling in medicine, and the 2024 Lancet Commission study that demonstrated 45% of dementia is preventable, looking at why the hippocampus truly matters for learning and memory, how stress is cumulative over time, how high A scores can create epigenetic changes, and how the liver and brain are connected, especially for metabolic health. We also explore the importance of parasympathetic tone, anti-inflammatory foods, and brain-supportive supplements, and Dr. Fotuhi shares his personal opinion on GLP-1 drugs. Stay tuned for today’s fascinating conversation with Dr. Majid Fotuhi, one of the USA’s leading neuroscientists. IN THIS EPISODE, YOU WILL LEARN: How having a sense of purpose or feeling passionate about something can reduce stress and lower cortisol Factors that may contribute to memory-related issues in midlife women How the 2002 Women’s Health Initiative changed the conversation around HRT How Dr. Fotuhi evaluates patients for cognitive impairment What motivated Dr. Fotuhi to develop his Brain Fitness program? Modifiable risk factors that can contribute to cognitive decline Why the hippocampus is so critically important for learning and memory How years of high stress can contribute to hippocampus shrinkage How liver health is connected to brain health Dr. Fotuhi shares his thoughts about GLP-1s Bio: Dr. Majid Fotuhi earned his PhD in Neuroscience from Johns Hopkins University in 1992 and his Medical Degree from Harvard Medical School in 1997. He currently serves as an adjunct professor at the Mind/Brain Institute at Johns Hopkins University and teaches at George Washington University and Harvard Medical School. With 37 years of experience in teaching, clinical practice, and neuroscience research, Dr. Fotuhi has pioneered a multidisciplinary approach to enhancing brain vitality and cognitive performance at any age. His groundbreaking “Brain Fitness Program” combines a comprehensive baseline “Brain Portfolio” assessment with 12 bi-weekly brain training sessions. This program targets lifestyle optimization and cognitive stimulation to improve memory, focus, and overall brain health. Dr. Fotuhi’s program has delivered measurable success for patients dealing with memory loss due to aging, concussions, and ADHD, as documented in several peer-reviewed journals. He has also authored three books, including the highly acclaimed Boost Your Brain: The New Art and Science Behind Enhanced Brain Performance. Recognized as a leading expert in memory and successful aging, Dr. Fotuhi has delivered lectures at academic institutions and major organizations in over 20 countries, including a TEDx presentation in the Philippines. Passionate about sharing the latest discoveries in brain rehabilitation and neuroplasticity, he has been featured in interviews with more than 50 prominent media outlets in the United States and around the globe. Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Dr. Majid Fotuhi On his website Instagram, LinkedIn The Invincible Brain (Free app) Dr. Fotuhi’s latest book, The Invincible Brain Dr. Fotuhi’s books 

Welcome to this week's Midlife Minute episode! Have you ever been told your fasting glucose and A1c are normal, yet you still feel that something is off with your metabolic health? Today, we begin a new series exploring metabolic health during perimenopause and menopause. We take a closer look at the metabolic changes that can occur as estrogen declines, why traditional screening may miss early signs of insulin resistance, and which additional lab tests may offer a more complete picture of your health. Drawing on research and clinical experience, I explain how hormonal changes can affect insulin sensitivity, body composition, and cardiovascular risk. We also explore why it's important to look beyond the number on the scale, understand the differences between standard and advanced metabolic testing, and advocate for more comprehensive conversations with your healthcare practitioner. Stay tuned to learn which metabolic markers deserve your attention and how a proactive approach to testing can help you better understand your health during midlife. IN THIS EPISODE, YOU WILL LEARN: Why normal fasting glucose and A1c levels may not reveal early insulin resistance How declining estrogen affects insulin sensitivity, body composition, and cardiovascular health Why visceral fat and changes in muscle mass matter, even when your weight stays the same Which foundational metabolic markers to discuss with your healthcare practitioner, including ApoB, fasting glucose, A1c, blood pressure, and waist circumference How fasting insulin, HOMA-IR, and the triglyceride-glucose (TyG) index can provide additional insight into insulin resistance Why a two-hour oral glucose tolerance test may identify changes missed by fasting measurements What NMR lipoprotein profiling and C-peptide testing can reveal, and why they are considered additional tools rather than first-line screening How to approach metabolic testing in a practical, step-by-step way Why understanding your metabolic health during midlife requires looking beyond standard laboratory results Connect with Cynthia Thurlow Cynthia's website: https://cynthiathurlow.com/ Everyday Wellness Podcast on Instagram: https://www.instagram.com/everydaywellnesspodcast/ Follow Cynthia on Instagram: https://www.instagram.com/cynthia_thurlow_/ Submit your questions: [email protected] Join The Midlife Pause community: https://www.facebook.com/groups/themidlifepause Cynthia's book, The Menopause Gut: https://www.penguinrandomhouse.com/books/777129/the-menopause-gut-by-cynthia-thurlow-np/ Intermittent Fasting Transformation: https://www.penguinrandomhouse.com/books/678861/intermittent-fasting-transformation-by-cynthia-thurlow-np/ The Midlife Pause Supplement Line: https://themidlifepause.com/ ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. References: El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention. AHA Scientific Statement. Circulation. 2020. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T. Menopause: A Cardiometabolic Transition. Lancet Diabetes Endocrinol. 2022. D'Costa Z, Spertus E, Hingorany S, et al. Cardiovascular Risk Associated with Menopause and Menopause Hormone Therapy. Curr Atheroscler Rep. 2025. Cybulska AM, Schneider-Matyka D, Wieder-Huszla S, et al. Diagnostic Markers of Insulin Resistance to Discriminate Between Prediabetes and Diabetes in Menopausal Women. Eur Rev Med Pharmacol Sci. 2023. Song Y, Manson JE, Tinker L, et al. Insulin Sensitivity and Insulin Secretion by HOMA and Risk of Diabetes in a Multiethnic Cohort of Women: WHI. Diabetes Care. 2007. Tsai SF, Yang CT, Liu WJ, Lee CL. Development and Validation of an Insulin Resistance Model for a Population Without Diabetes Mellitus. EClinicalMedicine. 2023. Doi SA, Ward GM. Examination of the fasting and 2-h plasma glucose in light of impaired beta-cell function. Endocrine. 2015. Abbasi F, Silvers A, Viren J, Reaven GM. Relationship Between Several Surrogate Estimates of Insulin Resistance and a Direct Measure of Insulin-Mediated Glucose Disposal. Diabetes Res Clin Pract. 2018. Piché ME, Lemieux S, Corneau L, et al. Measuring Insulin Sensitivity in Postmenopausal Women Covering a Range of Glucose Tolerance. Metabolism. 2007. Bhasin G, Dafale RS, Kamath SU, et al. Comparative performance of invasive, semi-invasive, and non-invasive insulin resistance-related indices. PLoS One. 2025. Wang Q, Ferreira DLS, Nelson SM, et al. Metabolic characterization of menopause: cross-sectional and longitudinal evidence. BMC Med. 2018.

Today, I’m delighted to connect with Dr. Zach Spiritos. A double board-certified gastroenterologist in internal medicine with a fellowship in neurogastroenterology, he founded Ever Better Medicine, a practice built around treating complex, chronic, and often underrecognized conditions at the intersection of the gut and the nervous system. In today’s conversation, Dr. Spiritos and I speak at length about how patients get dismissed by the medical system. We explore irritable bowel syndrome as immune dysregulation and common symptoms that he sees with this diagnosis. We discuss hypermobility and the 13 subtypes of Ehlers-Danlos syndrome, with hypermobility closely linked to inflammation, MCAS, and immune dysregulation. We cover several commonly missed GI complications in hypermobile patients, including how POTS and MCAS often overlap with GI dysmotility, MALS, and how nutrition and stress influence symptoms. Dr. Spiritos also shares his views on constipation and the importance of staying curious.   Stay tuned for today’s fascinating conversation with Dr. Zach Spiritos about complex medical conditions and how they intersect with the gut. IN THIS EPISODE, YOU WILL LEARN: How Dr. Spiritos recognizes when symptoms may reflect underlying physiology rather than being purely psychological Common symptoms that point toward dysautonomia, POTS, or MCAS in women How connective tissue laxity and hypermobility can contribute to gut dysfunction GI complications that may be missed when patients do not fit neatly into an IBS diagnosis How POTS fits within the broader picture of dysautonomia, hypermobility, and MCAS Meal-related patterns that may point to abnormal gastric motility associated with dysautonomia The value of using a food and symptom diary when appropriate, and treating elimination diets as trials rather than permanent restriction How fixating on bowel symptoms can create cycles of anxiety and GI distress How Dr. Spiritos approaches constipation in patients Why clinicians should remain open-minded when patients present with multiple medication sensitivities, allergies, and complex symptoms Bio: Dr. Zachary Spiritos, MD, MPH, is a neurogastroenterologist who specializes in treating patients with complex and chronic conditions, including disorders of the brain-gut interaction (DBGI), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), Ehlers-Danlos syndrome (EDS), and gastrointestinal dysmotility. He earned his medical degree and Master of Public Health (MPH) from the University of North Carolina at Chapel Hill, where he developed a passion for addressing the systemic challenges patients with underrecognized illnesses face. He completed his Internal Medicine residency at Emory University and his Gastroenterology fellowship at Duke University, where he focused on neurogastroenterology and disorders of gut-brain interaction. Dr. Spiritos is particularly dedicated to supporting patients who have been dismissed, misdiagnosed, or lost in the medical system. He takes a whole-person approach to care, combining the best of conventional medicine with targeted interventions to regulate the nervous system, improve sleep and movement patterns, address nutritional imbalances, and manage stress physiology. He works primarily with patients whose symptoms span multiple systems and don’t fit neatly into one diagnosis—individuals who require time, nuance, and interdisciplinary collaboration. Dr. Spiritos partners closely with his patients to build individualized, sustainable care plans that address both symptoms and underlying causes—helping them reclaim their health and quality of life. ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Zachary Spiritos On the Ever Better Medicine website Instagram

This episode is another in a series of interviews with highly vetted companies that I consider tremendously beneficial for my Everyday Wellness community. Today, I’m honored to welcome Katie Emerson, Senior Manager of Scientific Affairs at Kyowa Hakko USA. Katie is a registered dietitian and certified sports nutritionist, and she completed her doctoral work in nutritional science. In today’s conversation, we discuss women’s mental clarity through midlife, including focus, memory, attention, and mental energy during perimenopause and menopause. We explore how everyday distractions and mental fatigue differ from true cognitive concerns, and Katie explains how citicoline supports brain cell membranes and neurotransmitter production, its key physiologic benefits, and how it works, especially concerning estrogen and phosphatidylcholine synthesis. We also discuss caffeine, citicoline, and creatine, looking at citicoline’s peak efficacy and half-life, key benefits for athletes, students, and the elderly, what glutathione is, and how Setria can support healthy aging through detoxification. We also explain how to choose high-quality glutathione products, how branded ingredients differ from generic ingredients, and why reading supplement labels actually matters. Stay tuned for an invaluable conversation you will likely revisit more than once. IN THIS EPISODE, YOU WILL LEARN: How estrogen fluctuations and declining estrogen levels can affect women’s mental clarity, focus, memory, and attention How sleep disruption, stress, hot flashes, and mood changes can influence women’s cognitive performance in midlife How to distinguish everyday distractions and mental fatigue from cognitive concerns When memory, attention, language, and orientation changes need to be evaluated by a healthcare practitioner How citicoline supports brain cell structure and communication How to use citicoline for short-term focus and longer-term cognitive support How glutathione helps protect cells and support the body’s natural detoxification pathways How to evaluate the quality of supplements, ingredients, and brands Bio: Katie Emerson, PhD(c), RD, CISSN Katie Emerson's role sits deliberately at a crossing point that didn't used to exist in the supplement industry: performance nutrition used to mean muscle and endurance almost exclusively, and now includes focus, attention, and mental energy as an equally serious category. She leads the scientific communication behind Kyowa Hakko's branded ingredients, primarily Cognizin citicoline, translating the same underlying clinical research for three distinct audiences: brand teams deciding what to formulate, clinicians evaluating whether the evidence holds up, and consumers trying to figure out what a supplement label means. That translation work, moving between technical, clinical, and consumer registers without losing accuracy in any direction, is the throughline of her role. Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Katie Emerson Kyowa Hakko USA Kyowa Hakko USA on Facebook and LinkedIn Cognizin Citicoline on Instagram Katie on Instagram

Today, I’m delighted to welcome Dr. Florence Comite, a clinician, scientist, endocrinologist, and global authority on healthy longevity. She founded the Comite Center for Precision Medicine and Healthy Longevity, with locations in New York, Palo Alto, and Miami Beach, and spent 25 years as a graduate and faculty member at Yale School of Medicine. She is also the author of Invincible, one of my must-read books for 2026. In our conversation, we discuss why medicine focuses on urgent care, the missing provider relationship, and the hallmarks of aging. We explore how our biological function peaks between 27 and 30, why testosterone is the first hormone to decline in both men and women, bio-individuality, testosterone in women, optimal ranges, and heart disease risk. We explain why midlife is one of our biggest metabolic shifts, how to track it, and why heart disease diagnostics are important. We also cover sarcopenia, GLP-1s for longevity, and the relevance of bioimpedance readings versus BMI. Stay tuned for today’s fascinating conversation. It’s one of my favorite conversations of the year, and I know you’ll want to listen more than once. IN THIS EPISODE, YOU WILL LEARN: Why modern medicine focuses on urgent and emergency care How the missing provider relationship influences patient care How genetically similar people can have different health risks, body composition, and responses to medications What testosterone does for memory, cognition, executive function, bone, muscle, and the heart, and what women need to understand about testosterone ranges Changes in metabolic health women should be paying attention to in midlife Dr. Comite compares CAC, CCTA, Cleerly, and HeartFlow, and explains how these diagnostics contribute to heart evaluation  What women need to consider when assessing heart disease risk Why Dr. Comite suggests starting with small lifestyle changes initially How to maintain muscle mass, particularly when using GLP-1s Why BMI does not provide an adequate reflection of body composition Bio: Florence Comite MD is a Yale- and National Institutes of Health-trained physician-scientist, a pioneering force in precision medicine, and the world’s leading expert in longevity and endocrinology, who is renowned for her expertise in leveraging proprietary clinical and wearable data collected at her private clinical and virtual practice to detect, predict, and reverse biological aging, disorders of aging, and optimize healthspan and vitality for life. A graduate of Yale School of Medicine, where she was a faculty member for twenty-five years with a triple appointment in Endocrinology (Internal Medicine and Pediatrics) and Reproductive Endocrinology (Gynecology and Andrology), Dr. Comite trained at the National Institutes of Health and founded Women’s Health at Yale, the nation’s first women-only clinic. In 2005, Dr. Comite founded the Comite Center for Precision Medicine & Healthy Longevity in New York City, establishing a clinically proven, academic approach to personalized healthcare structured around the individualized clinical process known as Nof1TM, where each patient is treated as a single-subject clinical trial. Her global clientele spans the population, from forward-thinking physicians to industry-disrupting executives and health-enthusiastic entrepreneurs. Each patient benefits from insights and interventions tailored to their physiological make-up. The Center has expanded to Palo Alto and Miami Beach in the last several years. Dr. Comite has published original research and articles in numerous clinical journals, including the New England Journal of Medicine, JAMA: The Journal of the American Medical Association, and the Journal of the Endocrine Society. She is known for her seminal research on children, women, and men, recognizing that our entire system is critical in aging and disease. In 2013, she authored the bestselling book Keep It Up: The Power of Precision Medicine to Conquer Low T and Revitalize Your Life, focusing on androgen deficiency and vitality in aging men. Her clinical research data and decades of clinical practice informed Dr. Comite’s new book, Invincible: Defy Your Genetic Destiny to Live Better, Longer, available in bookstores everywhere! Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Dr. Florence Comite On Instagram, TikTok, LinkedIn, X, YouTube, Facebook, and Substack Healthy Longevity Podcast Book: Invincible 

Welcome to today’s MLM episode! This week, I take a closer look at three supplements that come up regularly in questions I receive from my community: NMN, urolithin A, and CoQ10. Stay tuned as I walk through what the research says about each one, how they differ, and how I think about targeted supplementation based on individual needs. IN THIS EPISODE, YOU WILL LEARN: Why NMN, urolithin A, and CoQ10 need to be looked at differently when considering supplementation What NMN is and what it does How urolithin A relates to mitophagy Where CoQ10 works and the role it plays How NMN, urolithin A, and CoQ10 relate to different areas of health Why some people are unable to produce enough urolithin A What the research tells us about combining NMN, urolithin A, or CoQ10 with resistance exercise Why supplementation should be targeted rather than automatic ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Cited References: [1]  Fukamizu Y, et al. Sci Rep. 2022. Randomized trial: oral NMN safety in healthy men and women. [2]  Forman DE, et al. J Am Coll Cardiol. 2023. Scientific statement: geroscience and cardiovascular disease in older adults. [3]  Kuerec AH, et al. Aging Res Rev. 2024. Systematic review: urolithin A in humans. [4]  Yoshino M, et al. Science. 2021. Randomized trial: NMN and muscle insulin sensitivity in women with prediabetes. [5]  Song Q, et al. Adv Nutr. 2023. Review: NMN safety and anti-aging effects in human trials. [6]  Katayoshi T, et al. Sci Rep. 2023. Randomized trial: long-term NMN, NAD+ metabolism, and arterial stiffness. [7]  Alp Arici EC, et al. Mini Rev Med Chem. 2026. Review: NAD+, longevity, and menopause. [8]  Jarrin-Orozco MP, et al. Food Funct. 2026. Randomized crossover trial: polyphenols, TMAO, and urolithin A and equol metabotypes in women in menopause. [9]  Hasheminezhad SH, et al. Phytother Res. 2022. Review: mechanisms of urolithins. [10]  D'Amico D, et al. Trends Mol Med. 2021. Review: urolithin A in health, disease, and aging. [11]  Zhang Z, et al. J Diabetes Res. 2026. Systematic review and meta-analysis: CoQ10 and lipid, glycemic, and inflammatory markers in metabolic disorders. [12]  Pan T, et al. J Nutr Biochem. 2025. Animal study: CoQ10, white adipose browning, and mitochondrial dynamics in ovariectomized rats on a high-fat diet. [13]  Gasmi A, et al. Crit Rev Food Sci Nutr. 2024. Review: CoQ10 in aging and disease. [14]  Freeberg KA, et al. J Gerontol A Biol Sci Med Sci. 2023. Review: NAD+-boosting supplements in humans.  https://pubmed.ncbi.nlm.nih.gov/37068054 [15]  Bhasin S, et al. Endocr Rev. 2023. Review: NAD in aging biology. [16]  Lippi L, et al. Aging Clin Exp Res. 2022. Systematic review of randomized trials: nutraceuticals and dietary supplements and mitochondria in healthy aging.  https://doi.org/10.1007/s40520-022-02203-y [17]  Visioli F, et al. Free Radic Biol Med. 2022. Review: natural products and age-related mitochondrial decay.  https://pubmed.ncbi.nlm.nih.gov/34890770 [18]  Ghosh N, et al. Sci Rep. 2020. Preclinical study: urolithin A, NAD+, SIRT1, and angiogenic pathways in mouse skeletal muscle.  https://doi.org/10.1038/s41598-020-76564-7 [19]  Amorim JA, et al. Nat Rev Endocrinol. 2022. Review: mitochondrial and metabolic dysfunction in aging and age-related diseases.  https://doi.org/10.1038/s41574-021-00626-7 [20]  Prokopidis K, et al. J Cachexia Sarcopenia Muscle. 2025. Systematic review and meta-analysis: NMN and NR and skeletal muscle mass and function. [21]  Broome SC, et al. Sports Med. 2024. Review: mitochondria as nutritional targets for muscle health and physical function in aging. [22]  Connell NJ, et al. J Nutr. 2021. Randomized trial: NAD+ precursors (L-tryptophan, nicotinic acid, nicotinamide) in physically compromised older adults. [23]  Jiang Z, et al. Free Radic Biol Med. 2024. Review: NAD+ homeostasis and exercise adaptation. [24]  Liu S, et al. JAMA Netw Open. 2022. Randomized trial: urolithin A, muscle endurance, and mitochondrial health in older adults. [25]  Andreani C, et al. Oxid Med Cell Longev. 2018. Animal study: CoQ10 intake with moderate physical activity in a SAMP8 mouse model. [26]  Deng H, et al. Br J Nutr. 2025. Systematic review and meta-analysis: CoQ10 and exercise performance. [27]  Bolt J, et al. J Nutr Health Aging. 2023. Scoping review: CoQ10 in sarcopenia, frailty, and falls. [28]  Guescini M, et al. Oxid Med Cell Longev. 2017. Review: exercise combined with muscle-directed antioxidants (creatine and CoQ10) against sarcopenia. [29]  Migliavacca E, et al. Nat Commun. 2019. Study: mitochondrial oxidative capacity and NAD+ biosynthesis in human sarcopenia across ethnicities. [30]  BMC Cardiovasc Disord. 2024. Meta-analysis of randomized trials: CoQ10 in heart failure. Authors were not included in the pasted text. [31]  Curr Diab Rep. 2024. Systematic review and meta-analysis of randomized trials: NMN and glucose and lipid metabolism in adults. Authors were not included in the pasted text.

Today, I’m honored to speak with Dr. Eleonora Teplinsky, a board-certified medical oncologist specializing in breast and gynecologic cancer, with over a decade of practice. She is Head of Breast and Gynecologic Medical Oncology at Valley Mount Sinai Comprehensive Cancer Center in Paramus, New Jersey, and a clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai. She also hosts the Interlude podcast, where she shares stories from people affected by cancer, and is the author of Beyond the Pink: Navigating Life, Health, and Breast Cancer. In our conversation, we discuss breast cancer risk, genetic testing, cancer incidence in older and younger women, and treatment options following a new diagnosis, including surgery, chemo, and medication therapies. Dr. Teplinsky shares her approach to fertility preservation, menopause after cancer, body image, and the emotional aspects of diagnoses and care. We also explore lifestyle factors, survivorship, long-term cardiovascular risk after cancer treatment, DEXA scans, lipids, coronary artery calcification scoring, and the importance of advocacy, quality of life, and long-term goals. Stay tuned for a thoughtful conversation about breast cancer and breast cancer survivorship, informed by Dr. Teplinsky’s expansive approach to care. Her book, Beyond the Pink, is one of the most thoughtful books I’ve read on breast cancer and survivorship, and a beautiful testament to the quality of care she provides. IN THIS EPISODE, YOU WILL LEARN: Common misconceptions about breast cancer risk The future of personalized breast cancer screening How genetic testing can help clarify breast cancer risk and inform screening decisions What may be contributing to the increase in breast cancer among younger women How Dr. Teplinsky approaches a new breast cancer diagnosis and treatment planning How Dr. Teplinsky helps patients navigate body image, grief, and surgery How Dr. Teplinsky approaches fertility preservation and treatment for younger women Which options are available, and which remain debated, when navigating menopause after breast cancer How cancer treatment side effects can make it difficult to start or maintain an exercise program How patients can advocate for themselves and how loved ones can provide support Bio: Dr. Eleonora Teplinsky is a board-certified medical oncologist specializing in breast and gynecologic cancers. Through her clinical work, media presence, and digital platforms, she has built a reputation for translating complex medical information into clear, compassionate, and actionable insights—empowering women to navigate cancer, survivorship, and long-term health with confidence. Her forthcoming book, Beyond the Pink, represents a critical shift in how breast cancer is understood, discussed, and lived through—moving beyond diagnosis and treatment to address the full scope of survivorship and long-term health. The book fills a significant gap in patient education by focusing on what happens after cancer care ends. Blending clinical expertise with patient-centered guidance, Beyond the Pink offers a comprehensive, actionable roadmap for navigating menopause, fertility, cardiovascular health, sexual health, mental well-being, and life after cancer. ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow  Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Eleonora Teplinsky On all social media: @drteplinsky Beyond the Pink: Navigating Life, Health, and Breast Cancer is HERE.

I am honored to connect with Esther Blum today! She is the bestselling author of "Cavewomen Don’t Get Fat," "Eat, Drink and Be Gorgeous," and most recently, "See Ya Later, Ovulator!" Esther currently maintains a busy virtual practice where she helps women balance hormones, lose stubborn body fat, and treat the root cause of health struggles.  Today we speak about medical gaslighting, how weight gain does not have to be a part of aging, andropause and menopause, and the Women’s Health Initiative. We dive into physical changes and significant symptoms during perimenopause and menopause, the role of the pelvic floor, deciphering what the dreaded “menopot” is, what does not work, and advocacy in terms of testing and hormones. We also address constipation, weight loss resistance, and how our tolerance for alcohol changes as we age, especially when using bioidenticals or hormone replacement therapy.  I hope you love today’s conversation with Esther Blum as much as I did! IN THIS EPISODE YOU WILL LEARN: How women can redefine their experience and continue having an active sex life after menopause. How to surrender, lean in, and take the pressure off yourself while going through perimenopause and menopause. Why is there so much misinformation and medical gaslighting in our society? Why Esther wrote See Ya Later, Ovulator! Some common symptoms of perimenopause. Risks women may face after a hysterectomy. Changes that happen in the vaginal canal and pelvic floor during menopause. The significant and profound impact of the decline of sex hormones. How to avoid weight gain in menopause. What can menopausal women do to prevent fatty liver and digestive problems? Lab tests women should ask their healthcare providers for. Why should perimenopausal women avoid alcohol?  Some simple ways to address constipation. Esther’s quotes: “You don’t have to gain weight in menopause.” “The better your gut health, the better your transition through menopause will be.” “Hormones are like a symphony. They’re not a solo act.” “Even if you have gained weight, even if you have cellulite and wrinkles and hair loss, it does not have to be permanent at all.” “You can have an active sex life, you can have absolute arousal, you can still have raging orgasms, even after menopause!” Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Esther Blum On her website Facebook, Instagram, LinkedIn Get your free copy of Esther’s Happy Hormone Cocktail Esther’s books, including See Ya Later, Ovulator!, are available HERE.

Today, I’m delighted to reconnect with Dr. Bill Rawls, a physician with over 30 years of medical experience. His personal battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He founded Vital Plan, where he developed the RESTORE180 Herbal Protocol to help others reclaim their health, and he is the best-selling author of Unlocking Lyme and The Cellular Wellness Solution. In our conversation, Dr. Rawls and I discuss midlife vulnerability, including the loss of stress resilience, the impact of peak fertile years, perimenopause, and menopause, and how these directly impact cellular and lifestyle stressors. We explore chronic illness as a cellular problem, how we live in a state of managed illness, and five stress factors that add to cumulative cellular stress. We discuss tick-borne illnesses, adaptations and dormancy, how autophagy may impact cellular stress, detoxification, inflammation, sympathetic tone, and key herbs to support detoxification. Dr. Rawls also shares his love for adaptogens, especially ashwagandha, and their impact on stress resilience, along with his recommendations for nutrition, intermittent fasting, and books. Stay tuned for a truly invaluable conversation about why many women in midlife, despite being on optimal hormone therapies, still don’t feel any better—and how it all goes back to cellular stress and mitochondrial health. IN THIS EPISODE, YOU WILL LEARN: How mitochondrial dysfunction and cellular aging contribute to symptoms midlife women and men may experience Why perimenopause may cause cellular stress and dysfunctional cellular messaging What happens to our cells and mitochondria as we begin to age? Dr. Rawls explains why he describes chronic illness as a cellular problem The five major stress factors that impact cellular health How certain microbes, including tick-borne microbes and herpes viruses, can remain dormant in the body and reactivate with stress, menopause, or aging Why Dr. Rawls describes autophagy as an essential cellular housekeeping process  Why detoxification requires far more than a periodic cleanse or detox Dr. Rawls describes his process for integrating adaptogens into the lifestyles or protocols of midlife women and men Dr. Rawls shares some critical strategies for healthy aging Bio:  Dr. Bill Rawls is a physician with over 30 years in medicine whose own battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He is the bestselling author of Unlocking Lyme and The Cellular Wellness Solution, and the founder of Vital Plan, where he developed the RESTORE180 herbal protocol to help others reclaim vibrant health. ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.   Purchase Cynthia’s book, The Menopause Gut.  Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Bill Rawls On his website Vital Plan Dr. Rawls’s most recent book, The Cellular Wellness Solution Recommended Books:  Adaptogens: Herbs for Strength, Stamina, and Stress Relief by David Winston Adaptogens in Medical Herbalism: Elite Herbs and Natural Compounds for Mastering Stress, Aging, and Chronic Disease by Donald Yance  Books by Rosemary Gladstar

Welcome to the latest Midlife Minute. In today’s episode, I answer listeners' questions about cortisol testing, trauma, and the HPA axis. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How generalized stress-related dysregulation differs from clinical conditions involving cortisol excess or deficiency Why cortisol testing should be anchored to a person's actual sleep schedule rather than the clock Why a single random cortisol blood draw means almost nothing when assessing HPA axis function How cortisol can shift from an elevated response to a lower, blunted response as stress and trauma persist Why a low or flat cortisol curve in someone with trauma or PTSD does not automatically mean adrenal insufficiency How chronic stress can disrupt the negative feedback loop that keeps cortisol regulated The adaptogen with the strongest evidence for lowering morning cortisol How chronic psychological stress is associated with measurably lower ovarian reserve ** For more information about Cynthia's upcoming retreat, visit https://www.cynthiathurlow.com/ and click the Events tab. Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

Today, I’m excited to connect with Dr. Tanya Beaubrun, a family medicine physician specializing in functional integrative medicine, and a certified wellness and transformational coach. Dr. Beaubrun is also a motivational speaker and the author of Held and Healed. In our conversation, we discuss burnout and hormones, exploring how many women treat being busy as a badge of honor, and why it's important to reframe midlife and beyond. We unpack how the HPA axis regulates the body’s stress response, and look at metabolic health, the importance of advocacy, and the markers Dr. Beaubrun uses to manage her patients’ metabolic health. We also cover nutrition, Doctor TikTok, reframing menopause as power, and how this empowering time in women’s lives can help them come to terms with aging and longevity, and allow the younger generations to see what is possible. Stay tuned for today’s delightfully personal and highly informative conversation with Dr. Tanya Beaubrun. IN THIS EPISODE, YOU WILL LEARN: Why burnout can often go unrecognized in high-functioning women Dr. Beaubrun explains how she assesses metabolic health and the testing she uses How hormonal decline in midlife can affect the way women experience stress What the HPA axis is designed to do in the body How women need to be listened to by their clinicians without judgment  The metabolic and cardiovascular changes that women experience in midlife How Dr. Beaubrun helps women to focus on protein and nutrient density when they are busy Why healthy eating does not mean you have to avoid all the foods you love How healthcare providers can move from a paternalistic approach to a collaborative relationship with patients Reframing menopause as a powerful stage of life Bio: Dr. Tanya Beaubrun is a Functional and Integrative Medicine physician, wellness educator, speaker and author of Held and Healed. After more than 30 years in medicine—and following her own journey through burnout and recovery—she now helps women reconnect with their health by addressing the root causes of stress, hormonal imbalance and metabolic dysfunction.  Through her signature More Joy Method®, Dr. Tanya combines evidence-based medicine with compassionate whole-person care, empowering women to realize they are not broken—they simply need the right support to heal, thrive and rediscover joy. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Tanya Beaubrun On her website Instagram Dr. Beaubrun’s new book, Held and Healed

I am thrilled to welcome the extraordinary Dr. Stephanie Estima back to the show today to join me in facilitating many questions from listeners. She was with me last on Episode 272, and before that, on Episode 123. Dr. Estima’s perspective aligns very closely with mine within the health and wellness space. She is an exceptionally knowledgeable and well-informed clinician specializing in female metabolism and body composition. She authored the invaluable resource known as the Betty Body and hosts The Better! podcast, where I have had the privilege of being her guest.   Today, we answer questions from both our communities, covering topics ranging from managing hormones during breastfeeding while coping with insufficient sleep to issues concerning preconception and methods for cycle tracking. We dive into the best contraceptives for younger women, strategies for supporting detoxification, addressing fibrocystic breasts, navigating autoimmune conditions and fibromyalgia, and determining the intensity of workout routines. There were also many questions about weight training, preferred pre-workouts, favorite supplements tailored for perimenopause and menopause, hormesis, and much more.  Dr. Estima's insights are as enlightening as ever, making today’s conversation a must-listen for anyone on a journey toward optimal well-being. IN THIS EPISODE YOU WILL LEARN: How breastfeeding can delay menstrual cycles without causing infertility Dr. Stephanie discusses fertility and the importance of evaluating both male and female factors Contraceptive options for younger women The importance of understanding the side effects and implications of long-term oral contraceptives The benefits of green leafy vegetables for fibrocystic breasts Supplements for breast health  The potential drawbacks of mammograms Perimenopause and autoimmune conditions, including Hashimoto's, thyroiditis, and fibromyalgia How trauma contributes to the dysregulation of the immune system and autoimmune conditions Supplements for middle-aged women How cold plunges and saunas benefit physical and mental well-being Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Stephanie Estima On ⁠Instagram⁠  On her weekly podcast, ⁠Better! With Dr. Stephanie⁠, where she explores the human potential, hormones, metabolism, and a life well-lived. Get a copy of Dr. Stephanie Estima’s #1 bestselling book, ⁠The Betty Body:⁠ A Geeky Goddess’ Guide to Intuitive Eating, Balanced Hormones, and Transformative Sex Previous Episodes featuring Dr. Stephanie ⁠Ep. 123 – Menstruation, Muscle, Maternity, & Metabolism: What Every Woman Should Know with Dr. Stephanie Estima⁠ ⁠Ep. 272 Understanding Women’s Health: Answering Your FAQs⁠ featuring Dr. Stephanie Estima

I am thrilled to welcome board-certified neurologist and six-time New York Times best-selling author Dr. David Perlmutter back to the Everyday Wellness Podcast for the third time. He is a fellow of the American Nutrition Association and serves on the board of directors. His most recent book is Brain Defenders. In this conversation, we discuss microglia, the brain’s immune cells, and explore their role in immune regulation, metabolism, and immunometabolism. We also examine why brain health prevention needs to start decades earlier, environmental threats, emerging therapies, lifestyle influences, especially alcohol consumption, and current brain-health research. Stay tuned for another invaluable conversation with Dr. David Perlmutter. I loved his latest book, which clarifies the role of immunometabolism — especially in midlife. IN THIS EPISODE, YOU WILL LEARN: How microglia support the neurons and nurture synaptic connections Why microglia can shift from being supportive to becoming destructive Dr. Perlmutter explains what immunometabolism means How metabolic issues can affect brain health decades before any cognitive symptoms appear Why Dr. Perlmutter considers exercise “brain medicine” The value of aerobics and resistance training for supporting brain health How chronic stress and environmental threats can affect brain health Dr. Perlmutter shares practical ways to reduce environmental threats to brain health The link between alcohol consumption and Alzheimer’s risk What emerging research shows about GLP-1s and neurodegenerative diseases Bio: About Dr. Perlmutter: Dr. David Perlmutter is a Board-Certified Neurologist and seven-time New York Times bestselling author whose work focuses on the intersection of neurology, nutrition, and brain health. A Fellow of the American College of Nutrition, he serves on its Board of Directors and on the Editorial Board of the Journal of Alzheimer’s Disease. His books, including the #1 bestseller Grain Brain, have been published in 32 languages and sold over a million copies. Dr. Perlmutter lectures globally at leading institutions and has been featured on major media outlets including 20/20, CNN, The Today Show, and Oprah. His contributions have earned him numerous national and international awards for clinical innovation and leadership. His upcoming book,⁠ Brain Defenders⁠, focuses on the pivotal role of microglia, the brain’s immune cells, in protecting, repairing, and reprogramming the brain for lifelong resilience, and is available now. ABOUT THE BOOK: Brain Defenders New York Times bestseller⁠ Brain Defenders⁠ reveals the powerful story of your brain's immune guardians (microglia) and how lifestyle choices can turn them into either fierce protectors or hidden saboteurs. The book directly challenges the notion that we now have meaningful treatments for diseases like Parkinson’s and Alzheimer’s. Despite FDA approval for drugs that reduce beta-amyloid, the book reveals that these drugs are not impactful and are actually profoundly dangerous. Packed with cutting-edge science and practical steps, Brain Defenders helps readers take charge of their long-term brain health and unlock lasting cognitive vitality. Connect with Cynthia Thurlow   Cynthia’s⁠ website⁠. Check out the Everyday Podcast on Instagram!⁠ www.instagram.com/everydaywellnesspodcast⁠ Follow on⁠ X⁠,⁠ Instagram⁠ &⁠ LinkedIn⁠ Submit your questions to ⁠[email protected]⁠  Join other like-minded women in a supportive, nurturing community:⁠ The Midlife Pause/Cynthia Thurlow⁠.  Purchase Cynthia’s book,⁠ The Menopause Gut⁠. Cynthia’s⁠ Intermittent Fasting Transformation⁠ Book ⁠The Midlife Pause Supplement Line⁠ Connect with Dr. David Perlmutter ⁠Brain Defenders⁠ Book On his⁠ website⁠

Welcome to this week’s Midlife Minute. Today I’m answering listeners’ questions related to acne, melasma, and neurotoxins.  Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: Why acne is usually hormonal even when blood work looks normal The mechanism that lies behind the connection between sugar, dairy, and acne  The circumstances where blood testing is warranted for acne How women can have acne and completely normal-looking labs and regular cycles, and still have PMOS-level hormone activity occurring The value of screening for PMOS rather than just treating the skin How melasma differs from acne Two factors that cause melasma when both are present  Can Botox trigger autoimmune disease or cause autoimmune flares? How to reduce the risk of problems when using Botox Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Reference List: Acne, Melasma, and Neurotoxins  Acne References A1. Elhassan YS, Hawley JM, Cussen L, et al. Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women. Clinical Endocrinology. 2025. A2. Bienenfeld A, Azarchi S, Lo Sicco K, et al. Androgens in Women: Androgen-Mediated Skin Disease and Patient Evaluation. Journal of the American Academy of Dermatology. 2019. A3. Briganti S, Flori E, Mastrofrancesco A, Ottaviani M. Acne as an altered dermato-endocrine response problem. Experimental Dermatology. 2020. A4. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of Care for the Management of Acne Vulgaris. Journal of the American Academy of Dermatology. 2024. A5. Moradi Tuchayi S, Makrantonaki E, Ganceviciene R, et al. Acne vulgaris. Nature Reviews Disease Primers. 2015. (Sentinel reference for acne pathophysiology) A6. Liu YT, Wang YW, Tu C, et al. Recommendations for managing adult acne and adolescent acne based on an epidemiological study conducted in China. Scientific Reports. 2024. A7. Xia J, Ding L, Liu G. Metabolic syndrome and dermatological diseases: association and treatment. Nutrition & Metabolism. 2025. A8. Cussen L, McDonnell T, Bennett G, et al. Approach to androgen excess in women: Clinical and biochemical insights. Clinical Endocrinology. 2022. A9. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Experimental Dermatology. 2009. A10. Chang J, Nock MR, Cohen JM, Bunick CG. Acne accounts for an almost 2.5-fold higher proportion of dermatology visits among adult females compared to adult males in the United States. PLoS One. 2022. A11. Rao Y, Lei Z, Chen S, et al. Differential plasma proteome analysis reveals key proteins associated with insulin resistance in acne vulgaris patients. Scientific Reports. 2025. A12. Roster K, Fleshner L, Karatas TB, et al. Menopause and Common Dermatoses: A Systematic Review. American Journal of Clinical Dermatology. 2026. (Shared reference, also cited in melasma section) A13. Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris. The Journal of the American Medical Association. 2021. A14. Costa CS, Bagatin E, Yang Z, et al. Systemic pharmacological treatments for acne: an overview of systematic reviews. Cochrane Database of Systematic Reviews. 2021. A15. Hebert A, Thiboutot D, Stein Gold L, et al. Efficacy and Safety of Topical Clascoterone Cream, 1%, for Treatment in Patients With Facial Acne: Two Phase 3 Randomized Clinical Trials. JAMA Dermatology. 2020. A16. Zaenglein AL. Acne Vulgaris. The New England Journal of Medicine. 2018. A17. Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology and Metabolism. 2023. A18. Yesiladali M, Unluhizarci K, Attar E, Kelestimur F. Where are we in the diagnosis and treatment of hirsutism? A narrative review. Reviews in Endocrine & Metabolic Disorders. 2026. A19. Committee on Practice Bulletins, Gynecology. ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstetrics and Gynecology. 2018. A20. Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2018. (See full list of references at https: https://www.cynthiathurlow.com/.

Today, I’m delighted to continue my conversation with Dr. Shivani Gupta about curcumin's science and its impact on mitochondrial and brain health. Dr. Gupta is the founder and CEO of Fusionary Formulas and the author of The Inflammation Code. She holds a master's degree and a PhD in Vedic sciences, and her dissertation focused on turmeric's role in inflammation, joint health, and cardiovascular health. In this conversation, we explore Ayurvedic medicine and daily rituals, body types and the five elements, and how they shape how we navigate our lives. We also spend significant time discussing how to find balance in midlife and the rituals Dr. Gupta has found particularly impactful for midlife women. This is another truly invaluable conversation with Dr. Shivani Gupta — one you will most likely want to revisit more than once. IN THIS EPISODE, YOU WILL LEARN: How much turmeric or curcumin you need to take daily to buffer inflammation  How curcumin supports the creation of new mitochondria as we age Dr. Gupta explains how Ayurveda uses the Vata, Pitta, and Kapha body types to understand individual differences How trauma or a major change can shift your Ayurvedic constitution The shift toward Vata many women tend to experience during the perimenopause to menopause transition, and how that may show up How to strengthen weak digestive fire  Dr. Gupta describes an Ayurvedic morning routine The value of using dry brushing as a simple daily ritual to support circulation and lymphatic flow The benefits of using abhyang massage as an Ayurvedic self-care ritual during menopause How stress and dysregulation affect the vagus nerve Bio: Dr. Shivani Gupta is an Ayurvedic practitioner, turmeric researcher, and founder of Fusionary Formulas. She holds a Master's degree in Ayurvedic Sciences and completed her PhD dissertation on turmeric, making her one of the world's foremost experts on its pharmacology and clinical application. She is the author of The Inflammation Code, published by Hay House, bridging ancient Ayurvedic wisdom with modern inflammation science. Dr. Gupta is known for making complex science accessible without dumbing it down — her work speaks equally to the everyday health-conscious woman and to clinicians who want to go deeper. ***Use the code CYNTHIA for 15% off at FusionaryFormulas.com. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Shivani Gupta On her website Use the code CYNTHIA for 15% off at FusionaryFormulas.com Instagram YouTube Facebook Pinterest Fusionary Formulas  The Inflammation Code (Book Website) The Inflammation Code Podcast

Today’s podcast episode is brought to you by CrowdHealth. I’m delighted to sit down with Andy Schoonover, co-founder and CEO of CrowdHealth, today. CrowdHealth is a community-powered alternative to health insurance, offering a revolutionary way to pay healthcare bills through crowdfunding. Previously, Andy was CEO of VRI, a healthcare technology company that focused on monitoring patients with chronic conditions out of their homes. He is a proud graduate of the University of Virginia and Stanford University's Graduate School of Business. Andy and I discuss the scale of medical debt in the United States, including claim denials and at-risk vulnerable populations. We examine the impact of hospital takeovers and the medical system, looking at how insurance companies and hospitals, which are actually oligopolies, drive price increases that directly affect our insurance premiums and out-of-pocket costs. We discuss how hospitals influence private practice, and how this is actually a microcosm of much larger challenges. Andy also shares his origin story, explains how clinicians need to encourage patients to take care of their health in their 20s and 30s to avoid developing chronic diseases, and clarifies how CrowdHealth works, who it’s for, and how it is a growing response to our broken medical system. This conversation is particularly important due to the poor understanding of how health insurance works in the United States, while medical debt is becoming a huge issue for millions of Americans today. It may even get you thinking about your own medical insurance and how much coverage you actually receive. IN THIS EPISODE, YOU WILL LEARN: Why CrowdHealth encourages members to know their metabolic markers The importance of taking autonomy over your own healthcare How CrowdHealth works as an alternative to the traditional medical-model insurance system How CrowdHealth members can decide who they contribute toward What screening looks like within the CrowdHealth community Andy describes CrowdHealth’s Exit Diabetes program How CrowdHealth’s health coaches and care advocates support members How CrowdHealth is bringing the care back to healthcare Bio:  Andy Schoonover is the founder and CEO of CrowdHealth, a healthcare freedom company built to help Americans escape the broken health insurance system. After spending years watching families get crushed by skyrocketing premiums, confusing policies, and surprise medical bills, Andy launched CrowdHealth to create a simpler, more human alternative to traditional insurance. Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Andy Schoonover Join CrowdHealth CrowdHealth on Instagram and X CrowdHealth on all Social Media: @JoinCrowdHealth

Today, I’m honored to speak with Dr. Kumkum Patel, a double board-certified gastroenterologist and neurogastroenterologist who specializes in the gut-brain-pelvic floor connection. In our conversation, we talk about IBS and stress in midlife, exploring the impact of the enteric nervous system, key risk factors for colorectal cancer, and how stress affects women differently in perimenopause and menopause. We discuss the influence of proton pump inhibitors, bile acid diarrhea after gallbladder removal, how women’s microbiome changes through the menopausal transition, and clues that indicate the estrobulome is optimized. Dr. Patel explains visceral hypersensitivity, the influence of motility, pelvic floor dysfunction, constipation, and why constipation should not be normalized. She also explains how she addresses tears, hemorrhoids, and fissures; what to do when standard approaches stop working; nutritional interventions; and how she uses microbiome testing. Stay tuned for today’s insightful conversation with Dr. Kumkum Patel about IBS, the gut-brain axis, and the menopausal transition. IN THIS EPISODE, YOU WILL LEARN: How stress affects the gut-brain axis The red flags that help Dr. Patel distinguish IBS from colorectal cancer or other conditions, and why midlife bowel changes should be evaluated How long-term PPI use can create additional problems, and how automatic refills contribute to prolonged use How bile acid diarrhea can occur after gallbladder removal, and other causes that may explain persistent diarrhea Symptoms that could indicate that a woman’s gut microbiome and estrobolome may not be functioning optimally How gastrointestinal and pelvic symptoms change during the menstrual cycle as women approach menopause How pelvic-floor dysfunction contributes to constipation Lifestyle changes that can help manage hemorrhoids and fissures and reduce further irritation How people who can eat most foods can improve their diet before adding supplements Where microbiome testing fits into Dr. Patel’s practice and why she uses it cautiously Bio: Dr. Kumkum Sarkar Patel is a double-board-certified gastroenterologist practicing in Orange County, California. She specializes in irritable bowel syndrome, swallowing disorders, pelvic floor disorders, and women's GI health. She graduated Magna Cum Laude with honors, with a Bachelor of Science degree in Biomedical Engineering from Virginia Commonwealth University. She earned a Master's degree in Public Health from Dartmouth Medical School at the Dartmouth Institute for Health Policy and Clinical Practice, and her medical degree from St. George’s University School of Medicine. She completed her internal medicine residency at NYU Winthrop Hospital and then did a Gastroenterology fellowship at the University of Illinois in Chicago. Dr. Patel completed specialized training in GI motility disorders at Washington University in St. Louis through the American Neurogastroenterology and Motility Society.  Dr. Patel moved to Southern California with her husband and two young sons in July 2020. Dr. Patel currently serves as a healthcare consultant and speaker for medical device and pharmaceutical companies. She also serves on the American College of Gastroenterology's Women in GI Committee to promote advancement for women in GI. Additionally, she is a passionate motivational speaker who has spoken nationally about women's health, work-life balance, postpartum depression, and gut health related to stress and mental health. In September 2022, Dr. Patel hosted the Equity and Levity Summit in Orange County, California, the first-of-its-kind women's empowerment conference. She was named the 2023 Healthcare Innovator of the Year by the Irvine Chamber of Commerce and named a 40 Under 40 Top Leader in Irvine in 2024. She has been featured on KTLA5 News, CBS8, NBC California Live, as well as in print in Good Housekeeping, Popsugar Wellness, Authority magazine, and VoyageLA magazine for her expertise in gut health, IBS, and lifestyle tips. In 2024, Dr. Patel opened her own concierge solo private gastroenterology and wellness practice with 3 offices in Orange County and telehealth available nationwide. She aims to help each patient take charge of their gut and overall health through an integrative mind-body approach. She works closely with pelvic floor physical therapists, dietitians, surgeons, and other practitioners to provide comprehensive GI care. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Kumkum Patel On her website Instagram

Welcome to the latest Midlife Minute. In this episode, I answer questions related to disordered relationships with food, relative energy deficiency, bone health, and intermittent fasting.  Stay tuned to learn what can happen to your body when you’re undernourished, and how to approach intermittent fasting in a way that supports your health instead of adding more stress. IN THIS EPISODE, YOU WILL LEARN: How fasting culture can sometimes intersect with undernourishing the body The link between a lifetime of anorexia, fasting, and restrictive eating and lower bone mineral density in midlife The importance of restoring energy availability The endocrine and metabolic changes that can accompany loss of the menstrual cycle When transdermal estradiol and progesterone may be appropriate if menstrual recovery does not occur The importance of getting enough protein, fiber, healthy fats, and overall nourishment when fasting intermittently What to consider when using electrolytes during a fast Connect with Cynthia Thurlow   Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: 1. Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and TreatmentsEndocrine Reviews, 2024. Angelidi AM, Stefanakis K, Chou SH, et al. Review. 2. The IOC Consensus Statement: Beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)British Journal of Sports Medicine, 2014. Mountjoy M, Sundgot-Borgen J, Burke L, et al. 3. Eating DisordersThe Lancet, 2020. Treasure J, Duarte TA, Schmidt U. Review. 4. Eating DisordersThe Journal of the American Medical Association, 2025. Attia E, Walsh BT. Review. 5. All-Cause and Cause-Specific Mortality Risk in Individuals With Eating Disorders: Systematic Review and Meta-Analysis of Relative Risk and Aggravating or Attenuating FactorsWorld Psychiatry, 2026. Semchishen SN, Højlund M, Lemaire D, et al. Recent. 6. ACOG Committee Opinion No. 740: Gynecologic Care for Adolescents and Young Women With Eating DisordersObstetrics & Gynecology, 2018. Committee on Adolescent Health Care. Guideline. 7. Fractures in Women With Eating Disorders—Incidence, Predictive Factors, and the Impact of Disease Remission: Cohort Study With Background Population ControlsInternational Journal of Eating Disorders, 2020. Frølich J, Winkler LA, Abrahamsen B, et al. 8. A Systematic Review and Meta-Analysis of the Association Between Eating Disorders and Bone DensityOsteoporosis International, 2016. Robinson L, Aldridge V, Clark EM, Misra M, Micali N. Systematic Review. 9. Bone Health in Adult Women With ED: A Longitudinal Community-Based StudyJournal of Psychosomatic Research, 2019. Robinson L, Aldridge VK, Clark EM, Misra M, Micali N. 10. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-AnalysisSports Medicine, 2025. Gallant TL, Ong LF, Wong L, et al. Systematic Review. 11. Impact of Relative Energy Deficiency in Sport (REDs) on Bone Health in Elite Athletes: A Retrospective AnalysisJournal of Cachexia, Sarcopenia and Muscle, 2025. von Brackel FN, Munzinger R, Bartosik M, et al. Recent. 12. Medical Complications of Anorexia NervosaPediatrics, 2025. Trapani S, Rubino C. 13. Screening for Eating Disorders in Adolescents and AdultsThe Journal of the American Medical Association, 2022. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Review.

Today, I’m delighted to connect with registered dietitian and certified diabetes care and education specialist, Kara Siedman. Her broad clinical experience spans inpatient oncology, diabetes, and gastroenterology. She is currently the Vice President of Science and Partnerships at Resbiotic.   In today’s conversation, we focus on the value of nutrition at the intersection of the microbiome and overall health. We discuss nutritional dogma, the impact of gastroparesis, IBS, IBD, SIBO, and other similar diagnoses. We explore midlife risk factors and medications that impact the microbiome, the influence of low FODMAP diets and irritable bowel syndrome management, food fears, and disordered food relationships. We also examine the influence of probiotics and prebiotics, clarify why constipation is multifactorial, discuss the hallmarks of aging related to the microbiome and midlife changes, and review evolving research on the microbiome and responses to GLP-1 drugs. This conversation with Kara Siedman is truly invaluable, so stay tuned! IN THIS EPISODE, YOU WILL LEARN: How nutrition has shifted away from hard science toward influencer opinions and social media dogma  Why nutrition should be personalized rather than treated as one-size-fits-all Why carbohydrates should not be demonized, and the important role each macronutrient plays Why Kara views nutrition as a bridge between conventional and functional medicine Why supporting the microbiome is about building stability and resilience through multiple foundational factors rather than one isolated intervention Medications that can disrupt the microbiome Why a low FODMAP diet should be viewed as a bridge for symptom management, and not as a treatment for IBS or something that should necessarily be followed indefinitely How the microbiome changes with aging and menopause Multiple factors that can contribute to constipation What research has revealed about the gut microbiome as a potential factor in GLP-1 responses Bio: Kara Siedman is a registered dietitian and certified diabetes care and education specialist with over 15 years of clinical experience in inpatient care, outpatient program development, and integrative/functional nutrition. Kara’s work in a leading gastroenterology practice sparked her transition into functional nutrition, where she integrated root-cause approaches into GI care and became a mentor and key opinion leader in the field. Her passion for the gut microbiome evolved into a professional specialty, leading her to collaborate with top biotech and microbiome-focused companies. As Senior Director of Science & Partnerships at resbiotic, Kara educates healthcare providers on microbiome science and the clinical application of targeted microbiome therapies. Known for her ability to simplify complex research, she brings clarity, credibility, and passion to gut health education. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Kara Siedman, RD, CDCES Resbiotic On Instagram Resbiotic on LinkedIn

I am thrilled to have Gary Taubes back on the show today. (He was with me before on episode 137. Gary is an investigative science and health journalist whose work has been pivotal in catalyzing the low-carb keto movement. He has written many books, including his most recent, Rethinking Diabetes, and his articles are in many of the best anthologies. He has also received many science awards. Today's discussion is particularly significant, given the recent report from the American Diabetes Association revealing that the annual cost of diabetes in the United States reached a staggering $412.9 billion in 2022, with individuals diagnosed with diabetes now representing one in every four dollars spent on healthcare.  In our discussion today, we dive into the history of diabetes, pertinent statistics, the prevailing standard of care, and the transformative influence of insulin on diabetes management and reactive hypoglycemia. Gary provides insights into his reactions to GLP-1s, the integration of medical and nutritional science into medicine, and the influence of organizations such as the American Diabetes Association, AHA, USDA, and NIH. Our discussion also extends to the effects of pharmaceuticals, the shortcomings of our approach to diabetes management and of existing models, and the challenges the low-carb community faces. Stay tuned for today's eye-opening conversation, where we shed light on the complexities of diabetes care and explain how simple lifestyle changes can tremendously improve quality of life. IN THIS EPISODE YOU WILL LEARN: Rethinking Diabetes is a groundbreaking exploration of diabetes diagnosis, management, and treatment Gary discusses the evolution of evidence-based medicine Why the traditional medical approach to treating diabetes is inadequate How the guidelines of the American Diabetes Association were based on outdated assumptions  How medical treatments compare with lifestyle changes for managing diabetes Controversies surrounding how the pharmaceutical industry has influenced the way medical associations have shaped their diabetes management policies How medical guidelines and dietary advice have evolved What constitutes a healthy diet? How patients often have trouble following diet recommendations, despite their best intentions Is obesity a hormonal disorder or caused by overeating?  Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Gary Taubes On his ⁠website⁠ ⁠Twitter⁠ ⁠Facebook⁠ Previous Episode Mentioned ⁠Ep. 137 – High Blood Sugar Levels and Long-Term Damage with Gary Taubes⁠ Book Mentioned: Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments is available from most bookstores or on ⁠Amazon⁠.

Today, I’m honored to reconnect with Dr. Jolene Brighten. She’s an award-winning, board-certified naturopathic endocrinologist, nutrition scientist, and leading voice in women’s health. She’s the author of Beyond the Pill, Healing Your Body Naturally After Childbirth, and her latest book, ADHD and Women: A Guide to Optimizing Your Hormones and Thriving with ADHD, which represents an expansion of her core thesis that women’s symptoms get chronically misattributed when the hormone piece is left out of the picture, which she now applies to ADHD. She also hosts The Dr. Brighten Show. In today’s conversation, we look at why ADHD symptoms surface or worsen at hormonal transitions, the mental health effects of oral contraceptives and synthetic hormones, and the gut-brain connection to ADHD. We explore how gut dysbiosis dysregulates vagal nerve signaling; how butyrate and other short-chain fatty acids influence it; what endobelly is and how it affects histamine and mast cell degranulation; and emerging research on GLP-1s and endometriosis. We also discuss rejection sensitivity disorder and masking, nutritional and o lifestyle recommendations for improving symptomatology, and how key supplements like cytochrome and saffron can improve memory and mitochondrial health. Stay tuned for a truly insightful conversation with Dr. Jolene Brighten and a deeper look at ADHD and Women. IN THIS EPISODE, YOU WILL LEARN: How perimenopause can amplify ADHD symptoms Why ADHD in some women remains unidentified until midlife How gut dysbiosis can influence vagal nerve signaling in the ADHD brain Why butyrate and resistant starches may be important for the ADHD brain The connection between endometriosis, ADHD, and the gut How Dr. Brighten guides neurodivergent women through HRT conversations  How rejection sensitivity dysphoria can affect women with ADHD Dr. Brighten shares lifestyle recommendations for women with ADHD Bio:  Dr. Jolene Brighten is a hormone expert, nutrition scientist, and founder of Dr. Brighten Essentials. Board-certified in naturopathic endocrinology, a certified menopause specialist, and sex counselor, she is the bestselling author of Beyond the Pill, Is This Normal?, and the forthcoming ADHD and Women. She is dedicated to helping women optimize their hormone, brain, and sexual health through evidence-based education. Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Jolene Brighten Website Pre-order bonuses for ADHD and Women (Meal plans to help optimize hormones and a PMDD workshop) On Social Media: @DrJoleneBrighten The Dr. Brighten Show

Welcome to this week’s Midlife Minute! Today, I examine partial and full hysterectomies and what we know about their potential long-term effects, clarifying what the research tells us about bone, brain, and cardiovascular health, and what women should discuss with their healthcare providers before and after surgery. IN THIS EPISODE, YOU WILL LEARN: How a partial hysterectomy differs from a full hysterectomy, and the abrupt estrogen changes ovarian removal can produce  Why having a hysterectomy before ages 40-45 can have a greater impact than having surgery closer to natural menopausal age. How a hysterectomy can impact women’s bone health What the research reveals about the connection between surgical menopause at a younger age, cognitive decline, and Alzheimer’s pathology How a hysterectomy can affect women’s cardiovascular health Why starting HRT early after an early-age hysterectomy could be important for your long-term health Why younger women who experience surgical menopause may require higher estradiol doses than the standard menopausal regimens The importance of advocating for yourself, understanding your personal risk, and talking with your clinician about estrogen and other hormone therapy before undergoing surgery Quotes: “Start those conversations early- before you ever have surgery.” “If you are having these surgeries done before 45, before 40, you need HRT!” “We have to manage our stress.” “We have to get enough sleep.” “We should be strength training.” “We should be physically active.” “We should be eating an anti-inflammatory diet.” Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: Increased Risk of Osteoporosis With Hysterectomy: A Longitudinal Follow-Up Study Using a National Sample Cohort. American Journal of Obstetrics and Gynecology. 2019. Choi HG, Jung YJ, Lee SW.  Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al. Cardiovascular Disease After Hysterectomy in the Nurses' Health Study and Nurses' Health Study II. Obstetrics and Gynecology. 2025. Thao V, Borah B, Stewart EA, et al. Treatment of Women After Bilateral Salpingo-oophorectomy Performed Prior to Natural Menopause. The Journal of the American Medical Association. 2021. Kaunitz AM, Kapoor E, Faubion S. Hysterectomy, Oophorectomy, and Bone Health: A Systematic Review and Meta-Analysis. European Journal of Endocrinology. 2025. Shariful Islam M, Tuesley KM, Wilson LF, et al. Risk of Osteoporosis and Fracture After Hysterectomies Without Oophorectomies: A Systematic Review and Pooled Analysis. Osteoporosis International. 2022. Xu W, Wu W, Yang S, et al. Hysterectomies Are Associated With an Increased Risk of Osteoporosis and Bone Fracture: A Population-Based Cohort Study. PloS One. 2020. Yeh YT, Li PC, Wu KC, et al. Age at Surgical Menopause Influences Cognitive Decline and Alzheimer Pathology in Older Women. Neurology. 2014. Bove R, Secor E, Chibnik LB, et al. Reproductive Period and Risk of Dementia in a Diverse Cohort of Health Care Members. Neurology. 2019. Gilsanz P, Lee C, Corrada MM, et al.  Examining the Association of Hysterectomy With and Without Oophorectomy on Cardiovascular Disease and All-Cause, Cardiovascular or Cancer Mortality: A Systematic Review and Meta-Analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2024. Chen Y, Li F, Liang L, et al. Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. The Journal of the American Medical Association. 2019. Honigberg MC, Zekavat SM, Aragam K, et al Optimizing Health After Early Menopause. Lancet. 2024. Mishra GD, Davies MC, Hillman S, et al. Hormone Replacement Therapy for Women Previously Treated for Endometrial Cancer. The Cochrane Database of Systematic Reviews. 2018. Edey KA, Rundle S, Hickey M.

Today, I’m delighted to connect with Dr. Erin Kinney. She’s a naturopathic medicine doctor and the founder of the Kinney Clinic, which focuses on hormone replacement therapy, nutrition, adrenal health, thyroid, and lymphatic system issues. Dr. Kinney is also the stress reset expert and author of The Cortisol Cure. In our conversation, we explore cortisol debt, how to recognize it through self-assessment, and why Dr. Kinney believes we need to change the narrative around stress. We discuss ways to modulate the autonomic nervous system, specifically the parasympathetic, the true drivers of low cortisol, including sleep and circadian rhythm disruption, overtraining without adequate recovery, nutrient depletion, chronic or stealth infections, and unresolved trauma. Dr. Kinney explains how Lyme disease, Epstein-Barr virus, and mold and mycotoxin exposure can contribute to more pronounced stress responses, and we examine the influence of caffeine, alcohol, and stimulants; calming supplements for stress and sleep; the gut-brain axis and gut immune dysfunction. Dr. Kinney also shares her preferred strategies to regulate cortisol easily and effectively. Stay tuned for a truly enjoyable conversation with the delightful Dr. Kinney. Her book, The Cortisol Cure, is a great resource for anyone suffering from multiple stress-related issues. IN THIS EPISODE, YOU WILL LEARN: What “cortisol debt” means The value of short, intentional periods of rest for training the “relaxed muscle” How low cortisol can involve both external and internal stressors How early trauma can train the nervous system to stay activated  Why alcohol may lead to disrupted sleep and anxiety  How caffeine and stimulants can increase your energy debt Why supplements cannot replace foundational practices that support stress-response regulation Dr. Kinney’s preferred supplements for calming the autonomic nervous system How a poorly functioning gut can impact immune cells, thyroid-hormone conversion, and the body’s immune response Dr. Kinney shares three repeatable practices to begin regulating cortisol Bio: Dr. Erin Kinney is a naturopathic doctor, author, and speaker specializing in hormonal health and the effects of chronic stress. She is the creator of the “Cortisol Bank Account” framework, the foundation of her book The Cortisol Cure, which breaks down complex stress and hormone science into a simple, accessible approach that helps readers understand what’s happening in their bodies and how to start feeling better. She founded The Kinney Clinic in Annapolis, Maryland, where she helps high-functioning men and women get to the root of fatigue, hormone imbalance, and chronic health issues so they can reset their stress response, boost their energy, and feel better than ever. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Erin Kinney The Kinney Clinic  On Instagram The Dr. Kinney Show

This episode is sponsored by Life Extension. I am delighted to have Dr. Crystal Gossard, the Manager of Education at Life Extension, joining me today. Dr. Gossard is a Doctor of Clinical Nutrition with over 15 years of experience in nutrition, fitness, dietary supplements, and integrative functional medicine. In our conversation today, Dr. Gossard and I discuss uncommon heart health testing, including gaps in care for women in perimenopause and menopause, and clarify the critical importance of a bioindividual personalized approach. We dive into specifics on labs, including ApoB as a direct measurement, the influence of glycation, insulin resistance and insulin sensitivity, LP(a), and high-sensitivity CRP as both a marker of systemic inflammation and a targeted inflammatory profile marker. We also cover oxidized LDL, inflammation and oxidative stress, the importance of CoQ10, and screening modalities like coronary artery calcium scoring, CCTA, CT angio, and Cleerly, and minerals, including magnesium and its role in over 600 enzymatic reactions in the body. ***Try Life Extension https://www.lifeextension.com/Cynthia10labs @LifeExtensionWelleness and save $10 on orders of $50 or more, plus free shipping, with code: Cynthia10 IN THIS EPISODE, YOU WILL LEARN: The importance of advanced lab testing for cardiovascular and metabolic health in women, particularly during perimenopause and menopause What ApoB reveals about cardiovascular risk Why Dr. Gossard considers LP(a) a one-and-done test How elevated high-sensitivity CRP can indicate inflammation “simmering” in the background How to manage inflammation through nutrition How Dr. Gossard explains oxidized LDL The value of CoQ10 for oxidized LDL When should someone move beyond lab work to cardiovascular screening? What magnesium testing can reveal How magnesium supports the body  Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Crystal Gossard Life Extension Instagram  LinkedIn Live Foreverish Podcast Try Life Extension and save $10 on orders of $50 or more, plus free shipping, with code: CYNTHIA10.

I’m thrilled to reconnect with microbiome expert Kiran Krishnan today. Kiran co-founded Just Thrive and previously served as Chief Scientific Officer at Microbiome Labs. He has more than 16 years of experience in the dietary supplement and nutrition industry, with postgraduate research experience in molecular biology and virology. In today’s conversation, we take a deep dive into the science of spore-based probiotics, their ecological impact, how they interact with the existing gut microbiome, their potential to address dysbiosis, and why standard probiotics fail to survive stomach acid in meaningful numbers. We explore research on osteoarthritis, catabolism, and the gut-hormone connection, discussing how declining bacterial diversity may influence the metabolic and hormonal changes associated with perimenopause and menopause. Kiran explains the role of the pathobiome and endotoxemia, how the gut-brain axis can influence inflammation, and the importance of gut-barrier integrity, neurotransmitter production, and vagal nerve signaling in regulating the immune system. We also discuss the differences between fiber, resistant starch, polyphenols, fermented foods, prebiotics, and postbiotics, and Kiran shares his perspective on the carnivore diet, its potential impact on the microbiome, and key insights into SIBO. Stay tuned for today’s fascinating and informative conversation with Kiran Krishnan. IN THIS EPISODE, YOU WILL LEARN: Kiran explains the science behind spore-based probiotics Why spore-based probiotics can survive stomach acid better than many standard probiotics  How inflammation can inhibit the growth of beneficial gut bacteria How bacterial diversity in the gut decreases during perimenopause and menopause Why awareness of endotoxemia remains limited within the broader medical community Kiran explains how the gut-brain axis helps the body respond to its environment What prebiotics and postbiotics actually do Why an inability to tolerate fiber may point to a problem with the underlying biology rather than the food itself How SIBO and SIFO can be symptoms of a more complex underlying problem Bio: Kiran Krishman, Ph.D. Kiran is a research microbiologist and a health and wellness expert who aims to make complex information understandable to all. He has founded several successful health and supplement companies over the last 15 years, including co-founding and leading Microbiome Labs, a preeminent microbiome therapeutics-focused brand among healthcare professionals. He is currently a co-founder and partner in 3 other companies that aim to revolutionize wellness care. He has conducted and published several research studies in scientific journals, published chapters in scientific textbooks/references books, holds global patents, and is a sought-after speaker on human health and the microbiome. Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Wellness Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Kiran Krishnan The Biome Learning Center: Join Kiran’s circle community to download his free leaky gut guide and 5 pillars for building a resilient gut.

Welcome to the latest Midlife Minute. Today, I answer some listener questions about bone health, osteoporosis, HRT, and the menopause transition. Stay tuned to learn more about bone loss, bone health, and proactive ways to protect your bone mass. IN THIS EPISODE, YOU WILL LEARN: Bone density loss during perimenopause Value of HRT for protecting bone mass during the menopause transition  If you’re using an estrogen patch and your estrogen levels are still low, what should you consider? How women with osteoporosis can continue strength training with guidance from a licensed medical provider What highly-active women who consistently under-fuel their bodies may experience Conditions and medications that could contribute to low bone density The value of DEXA scans and bone health markers Bone loss may accelerate during menopause  How HRT for osteoporosis prevention differs from HRT for established osteoporosis The benefit of AMH and FSH labs for identifying women who may benefit from earlier intervention Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

I’m thrilled to reconnect with Roseann Capanna-Hodge, Ed.D., today. She's a licensed clinical psychologist, board-certified in neurofeedback, and mom of two neurodivergent children. She's also the author of the upcoming book, The Dysregulated Kid. Today, we discuss how midlife women become stressed and how stress is an event and dysregulation is a physiological state. We also explore emotional regulation, hypervigilance, midlife’s invisible load, strategies to stimulate the vagus nerve, and ways to address both over- and under-stimulated behavior. Stay tuned for today’s insightful and informative conversation with Roseann Capanna-Hodge. You’ll walk away with tangible strategies for yourself and your family members, too! IN THIS EPISODE, YOU WILL LEARN: How stress “creeps in” through everyday pressures and affects the nervous system Why some coping strategies that worked earlier in life may become less effective or maladaptive amid midlife hormonal and neurological changes  The value of practicing belly breathing and other regulation strategies in “micro little bits” throughout the day How emotional regulation can help change dysregulated patterns passed down through families. How explaining regulation through science can reduce shame and help children become more receptive to these strategies. Why caring for a dysregulated child can be especially triggering for parents with difficult childhoods or histories of dysregulated parenting How women carrying an “invisible load” can find small openings to practice regulation strategies throughout the day How nutrition can support emotional regulation and affect focus, motivation, irritability, anger, and hyperactivity How using brief regulation practices, movement, breathing, touch, and daily routines can help manage chronic stress.  Why regulating the nervous system should come before, or support, other interventions Bio: Roseann Capanna-Hodge. Ed.D. is a leading expert in emotional and behavioral dysregulation with more than 30 years of experience helping families transform chaos into calm. As the creator of Regulation First Parenting® and the CALMS Dysregulation Protocol®, she bridges clinical science with everyday parenting so families can finally understand what’s really driving their child’s struggles. Specializing in nervous system dysregulation, the root cause of challenges like ADHD, anxiety, OCD, mood disorders, and PANS/PANDAS, Roseann gives parents and professionals brain-based tools that create lasting change without blame, shame, or guesswork. Through her bestselling books, upcoming book The Dysregulated Kid, and top 1% podcast, Dysregulated Kids, she has helped thousands of families support their child’s brain, behavior, and emotional well-being in practical, hopeful ways. Featured in The New York Times, Forbes, and Parents Magazine, Roseann is on a mission to bring Regulation First Parenting™ to every home so that children can thrive and families can finally feel calm again. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Roseann Capanna-Hodge, Ed.D Website Social media: @Dr Roseann Order Roseann’s NEW book, The Dysregulated Kid.

I’m honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health. Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women’s Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We cover the importance of thyroid function, the pro-inflammatory state associated with estrogen loss in perimenopause and menopause, and the role of nutrition and exercise in metabolism. We also discuss lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes.  I plan to invite Dr. Gersh back to discuss women and mitochondrial health, and then again to talk about her latest book, Menopause: The Fifty Things You Need to Know.  Stay tuned to find out what menopause really is, and what it does to a woman’s metabolic system. IN THIS EPISODE YOU WILL LEARN: Dr. Gersh discusses the Women’s Health Initiative study and its devastating effects. The difference between synthetic and bioidentical hormones. How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements. What do hormones do? Why every immune cell in the body has receptors for vital hormones. Menopause may not be defined by a specific moment in time. Physiological changes that occur during the perimenopause years How hormones can change the perimenopause paradigm entirely. Perimenopause and sleep issues Phytoestrogens - nature’s gift to women Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Felice Gersh Website:⁠ Integrative Medical Group of Irvine⁠ Instagram⁠ Dr. Gersh’s books are available on ⁠Amazon⁠ Previous Episode Mentioned ⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

Today, I’m honored to reconnect with fan favorite, Dr. Tom Dayspring. Dr. Dayspring is a fellow of both the American College of Physicians and the National Lipid Association, and is certified in internal medicine and clinical lipidology with extensive experience in perimenopause and menopause management. He has been a frequent contributor and educator at Everyday Wellness. In this episode, we discuss labs that help to monitor changes in insulin resistance (specifically the LPIR score), the clinical practice limitations Dr. Dayspring believes stem from a lack of humility, and aspects of women’s medical histories that may indicate greater heart disease risk. We examine statin therapy and other treatment modalities, premature menopause and cardiovascular disease risks, Lp(a) as the primary inherited risk factor for heart disease, and current guidelines, treatment goals, and recommendations. Dr. Dayspring also shares his thoughts on estrogen patch shortages and oral estradiol therapy challenges with elevated triglycerides. As always, this is an invaluable conversation with Dr. Tom Dayspring. Stay tuned for an upcoming podcast with Dr. Dayspring, where we'll focus on lipids and brain health. IN THIS EPISODE, YOU WILL LEARN: Lipoprotein changes and how they can reveal insulin resistance before fasting insulin or glucose begin to rise Why someone can be insulin resistant while showing normal triglyceride levels The importance of looking at a woman’s broader medical history to find potential cardiovascular risk signals Why premature menopause and premature ovarian failure should be taken seriously as cardiovascular and long-term health risk factors How Lp(a) is the most inherited risk factor for atherosclerotic heart disease across the population Why women may benefit from repeat Lp(a) testing around the menopausal transition What clinicians may address when Lp(a) is elevated, including other modifiable cardiovascular risk factors Oral estrogen may have a beneficial effect on Lp(a). How epidemiological evidence has linked endometriosis with heart disease Why Dr. Dayspring recommends checking ApoB when triglycerides are elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Tom Dayspring On X (@DrLipid) LinkedIn

Welcome to the latest Midlife Minute. This episode unpacks ongoing research on Lp(a), explores how women’s lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging Why women should have their Lp(a) checked both before and after menopause How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently Why I recommend including ApoB when checking your lipids during the perimenopause window How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a) Why supplements are not replacements for statins in genuinely high-risk patients  I review the various PCSK9 inhibitors currently available, how they are administered, and their effects  How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline 2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review 3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview 4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML. 5. Lipid Metabolism in Women: A Review. Atherosclerosis. 2025. van Oortmerssen JAE, Mulder JWCM, Kavousi M, Roeters van Lennep JE.Review 6. Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition?. Journal of the American College of Cardiology. 2009. Matthews KA, Crawford SL, Chae CU, et al.Observational 7. Trajectories of Lipids Around the Menopause Transition in Chinese Women: Results of the Kailuan Cohort Study. Fertility and Sterility. 2023. Dai Q, Wu S, Cao Z, et al. 8. Lipid Management in Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2020. Newman CB, Blaha MJ, Boord JB, et al.Guideline 9. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Frontiers in Pharmacology. 2022. Nie G, Yang X, Wang Y, et al.SR 10. Perspectives on Dyslipidemia and Coronary Heart Disease in Women. Journal of the American College of Cardiology. 2005. Bittner V.Review 11. Dyslipidemia in Midlife Women: Approach and Considerations During the Menopausal Transition. Maturitas. 2022. Torosyan N, Visrodia P, Torbati T, Minissian MB, Shufelt CL.Review 12. Effects of gender, age and menopausal status on serum apolipoprotein concentrations.13.Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg     14. Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications. Diabetes, Obesity & Metabolism. 2025. Razavi AC, Bhatia HS, Blumenthal RS, Shapiro MD, Mehta A.RecentReview 15. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. Journal of the American College of Cardiology. 2021. Cicero AFG, Fogacci F, Zambon A.Review 16. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs. 2023. Blais JE, Huang X, Zhao JV.SR 17. Non-Genetic Influences on Lipoprotein(a) Concentrations. Atherosclerosis. 2022. Enkhmaa B, Berglund L.Review 18. NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Stenosis. Journal of the American College of Cardiology. 2018. Tsimikas S, Fazio S, Ferdinand KC, et al.Review 19. Consumption of a defined, plant‐based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeks. Clinical Cardiology. 2018. Najjar RS, Moore CE, Montgomery BD. 20. Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies. Clinical Therapeutics. 2019. Santos HO, Kones R, Rumana U, et al.Review 21. Effect of Lipid-Lowering Therapies on Lipoprotein(a) Levels: A Comprehensive Meta-Analysis of Randomized Controlled Trials. Atherosclerosis. 2025. Xie S, Galimberti F, Olmastroni E, et al.Recent 22. Effect of Omega-3 Fatty Acid Supplementation on the Postprandial Metabolism of Apolipoprotein(a) in Familial Hypercholesterolemia. Journal of Atherosclerosis and Thrombosis. 2023. Ying Q, Croyal M, Chan DC, et al.RCT 23.Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024. Nordestgaard BG, Langsted A.Review 24. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022. Reyes-Soffer G, Ginsberg HN, Berglund L, et al.Guideline 25.Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.Journal of the American College of Cardiology. 2023. Malick WA, Goonewardena SN, Koenig W, Rosenson RS.Review 26.2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026. Writing Committee Members, Blumenthal RS, Morris PB, et al.Guideline 27. Noninvasive Coronary Atherosclerotic Plaque Imaging. JACC. Cardiovascular Imaging. 2023. Kwiecinski J, Tzolos E, Williams MC, et al.Review 28. Computed Tomography Angiography Versus Agatston Score for Diagnosis of Coronary Artery Disease in Patients With Stable Chest Pain: Individual Patient Data Meta-Analysis of the International COME-CCT Consortium. European Radiology. 2022. Wieske V, Walther M, Dubourg B, et al.SR 29. Association of Coronary Artery Calcium Score With Qualitatively and Quantitatively Assessed Adverse Plaque on Coronary CT Angiography in the SCOT-HEART Trial. European Heart Journal. Cardiovascular Imaging. 2022. Osborne-Grinter M, Kwiecinski J, Doris M, et al.Clinical Trial 30. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. JACC. Cardiovascular Imaging. 2024. Nurmohamed NS, Bom MJ, Jukema RA, et al.Observational 31. The Lancet Commission on Rethinking Coronary Artery Disease: Moving From Ischemia to Atheroma. Lancet. 2025. Zaman S, Wasfy JH, Kapil V, et al.Review 32. Efficacy and safety of novel lipoprotein(a)‐targeted therapies: A systematic review and meta‐analysis of randomized controlled trials. Diabetes, Obesity & Metabolism. 2026. Santana AUL, Yusufzai MO, Freitas APS, et al. Recent Opinion

Today, I am honored to connect with Dr. Zaldy Tan, a geriatric medicine and memory disorder specialist whose research career has centered on the Framingham Heart Studies Offspring Cohort. Dr. Tan currently directs Cedar Sinai’s memory and healthy aging programs, after previously leading the memory clinic at Beth Israel and Harvard Medical School. His book, Age Proof Your Mind, translates his clinical and research background into a practical framework for people trying to assess and protect their own cognitive trajectory. In our conversation, Dr. Tan explains why middle age is the old age of youth and the youth of old age. We discuss common symptoms of memory issues and those that are reversible. We explore the Framingham Offspring Study and its impact on brain health over time,  looking at the effects of sleep, depression, vitamin deficiencies, alcohol, loneliness, and nutrition, and Dr. Tan shares the three Ds, dementia, delirium, and depression- the red flags he sees in his clinical practice, explains how he helps prepare caregivers for caring for loved ones with neurocognitive memory loss, and discusses late-stage issues, medications, blood-based biomarkers, and the role of genetics in brain health. Stay tuned for a truly fascinating discussion with Dr. Zaldy Tan. IN THIS EPISODE, YOU WILL LEARN: The importance of being sensitive to how your memory changes over time Various factors that could contribute to memory problems The profound effect alcohol has on the brain and neurologic function How social isolation can increase the risk of dementia in future years Dr. Tan discusses the Framingham Offspring Study and the links between metabolic dysregulation and brain MRI markers of brain aging. How the 3 Ds, delirium, dementia, and depression, can overlap The red flags in a patient’s history that lead Dr. Tan to believe there may be a more serious issue What care partners should be aware of when a family member is experiencing dementia  The importance of protecting sleep and maintaining consistent sleep patterns for those with memory problems How genetic testing is incorporated into Dr. Tan’s care model Bio:  Dr. Zaldy Tan is the Director of the Memory & Healthy Aging Program at Cedars-Sinai Medical Center, which U.S. News & World Report ranked in 2024 as the best hospital on the U.S. West Coast and among the top hospitals in the country. He holds the Carmen & Louis Warschaw Endowed Chair in Neurology and is a professor at the David Geffen School of Medicine, University of California, Los Angeles. Dr. Tan was the founding director of the Memory Disorders Clinic at Harvard Medical School/Beth Israel Deaconess Medical Center. Dr. Tan performs aging and dementia research covered by The New York Times, Time, CNN, The Wall Street Journal, NPR, The Washington Post, The Chicago Tribune, Reuters, ABC News, and NBC News. He regularly speaks at major national and international conferences and is the author of Age-Proof Your Mind and What to Remember When You Are Forgetting. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Zaldy Tan Dr. Tan at Cedars Sinai (Los Angeles)   On Instagram Dr. Tan’s book, What to Remember When You Are Forgetting, is coming out on September 15th, 2026. Pre-order HERE.

Welcome to the latest episode in our series of highly vetted companies I like to share with my Everyday Wellness community. Today, I’m delighted to connect with Leslie Kenny, Founder and CEO of Oxford Healthspan. After being diagnosed with multiple autoimmune conditions and being told she was unlikely to have any biological children, Leslie put her autoimmune conditions into remission through nutrition and lifestyle changes and later went on to conceive naturally at 43. Her personal experience led her into a research collaboration with Oxford immunologist Professor Katya Simon, where she was introduced to spermidine, a naturally occurring polyamine studied for its role in autophagy—our cells’ internal recycling and cleanup process. She later founded Oxford Healthspan to bring a whole-food Japan-sourced spermidine supplement, Primadine, to market. She also co-founded the non-profit Oxford Longevity Project alongside Oxford scientists to educate the public more broadly on healthspan research. In our conversation, we discuss self-advocacy, autoimmunity, infertility, and empowerment, exploring how modern life affects perimenopause and menopause, as well as spermidine research and its mechanisms of action. We discuss intermittent fasting, autophagy, mitophagy, gut health, food-based sources of spermidine, how our spermidine levels decrease with age, and why supplementation is truly beneficial. Leslie also shares feedback on how Primadine impacts memory, cognition, hair, skin, and nails; how clock genes and circadian biology work; and biological versus chronological age. Stay tuned for a truly fascinating conversation with Leslie Kenny- one you’ll most likely want to revisit more than once. IN THIS EPISODE, YOU WILL LEARN: The changes Leslie implemented after being diagnosed with rheumatoid arthritis and lupus  How patients need to ask questions and collaborate with their clinicians rather than simply following instructions  Leslie describes how she worked with doctors to monitor her symptoms and address problems early during the perimenopause-to-menopause transition. How Leslie came to learn about spermidine and its connection to autophagy and mitophagy How spermidine can support healthy aging How ultra-processed foods can affect the gut, and foods that contain natural sources of spermidine  The types of improvements customers taking Primadine have reported Leslie explains the distinction between biological and chronological age Why intermittent fasting, although beneficial, may not work the same way for all women Bio:  Leslie Kenny is an Oxford-based longevity entrepreneur, TEDx Oxford speaker, and healthspan advocate. She is the founder of Oxford Healthspan, creator of Primeadine®, co-founder of the Oxford Longevity Project, and Global Executive Ambassador for the Japan Autophagy Consortium, whose senior adviser is Yoshinori Ohsumi, recipient of the 2016 Nobel Prize in Physiology or Medicine for his pioneering research on autophagy. She is a frequent international speaker and moderator on longevity, biological aging, and the future of preventive medicine, with a particular focus on translating emerging research into practical, evidence-based strategies for extending healthspan. Leslie has been an early advocate for the role of autophagy, cellular renewal, and nutrition in healthy aging, helping to pioneer broader awareness of spermidine and its relevance to longevity pathways. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Leslie Kenny Oxford Longevity Project Oxford Healthspan - Use discount code CYNTHIATHURLOW for 20% off your first Oxford Healthspan order Leslie’s New Prime

I am delighted to welcome Dr. Shivani Gupta today for the first of two interviews. Dr. Gupta is the founder and CEO of Fusionary Formulas and the author of The Inflammation Code. She has both a master's degree and a PhD in Vedic sciences, where her dissertation focused on turmeric's role in inflammation, joint health, and cardiovascular health. In today’s conversation, we explore the physical effects of chronic inflammation, habits to support stress reduction, the differences between inflammaging and normal physiologic aging, and ways to nurture ourselves in midlife (which Dr. Gupta calls the Vata season). We also discuss how ama can contribute to inflammatory processes in the body, digestive fire, constipation and strategies to address it, the importance of curcumin, and the research surrounding it. Dr. Gupta and I will continue our conversation on our next podcast together. Stay tuned for part two! IN THIS EPISODE, YOU WILL LEARN: Dr. Gupta shares the personal experiences that motivated her to write The Inflammation Code Environmental and lifestyle factors that contribute to the body’s inflammatory burden Why inflammation can become more difficult to manage during the perimenopause and menopause transition How the symptoms of normal aging could actually be signs of inflammaging Dr. Gupta explains the Ayurvedic concept of Agni, or digestive fire, and shares ways to support digestion Practical Ayurvedic ways to support regular bowel movements How Dr. Gupta approaches gut and immune health after repeated antibiotic exposure The Ayurvedic approach to diet differs from restrictive or extreme eating patterns.  The potential anti-inflammatory benefits of turmeric, curcumin, and other polyphenol-rich spices    How culinary turmeric differs from concentrated curcumin extracts Bio: Dr. Shivani Gupta is an Ayurvedic practitioner, turmeric researcher, and founder of Fusionary Formulas. She holds a Master's degree in Ayurvedic Sciences and completed her PhD dissertation- specifically on turmeric making her one of the world's foremost experts on its pharmacology and clinical application. She is the author of The Inflammation Code, published by Hay House, bridging ancient Ayurvedic wisdom with modern inflammation science. Dr. Gupta is known for making complex science accessible without dumbing it down — her work speaks equally to the everyday health-conscious woman and to clinicians who want to go deeper. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Shivani Gupta FusionaryFormulas.com - Use the code CYNTHIA for 15% off! Website Instagram YouTube Facebook Pinterest The Inflammation Code (Book Website) The Inflammation Code Podcast

Welcome to the latest Midlife Minute. Today, I’m answering listeners’ questions about cardiovascular risk, focusing on Lp(a), LDL, statins, and the changes women experience after menopause. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: Why women should have their Lp(a) checked both before and after menopause How Lp(a) works as a risk enhancer, and how cardiovascular risk becomes more significant when elevated Lp(a) occurs alongside high LDL Why family history is particularly helpful for women with a 10-year calculated cardiovascular risk that looks reassuringly low I review the current guidelines for primary prevention Why, even though research has shown reductions in major cardiac events with GLP-1s, GLP-1s do not replace statins for lowering LDL  What a CAC score can reveal about coronary artery calcification, and what it cannot detect How AI-assisted CT angiography (such as Clearly) can map, quantify, and characterize plaque throughout the coronary branches Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1.  ​Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML.Recent 2.  ​Sex Differences of Lipoprotein(a) Levels and Associated Risk of Morbidity and Mortality by Age: The Copenhagen General Population Study. Atherosclerosis. 2022. Simony SB, Mortensen MB, Langsted A, et al. 3. Managing Atherosclerotic Cardiovascular Risk in Young Adults: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2022. Stone NJ, Smith SC, Orringer CE, et al.Review 4. Thirty-Year Risk of Cardiovascular Disease Among Healthy Women According to Clinical Thresholds of Lipoprotein(a). JAMA Cardiology. 2026. Nordestgaard AT, Chasman DI, Moorthy V, et al.RecentObservational 5.  ​Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg  6. Clinical Practice Guideline on Lipid Management for Cardiovascular Disease Risk Reduction. Department of Veterans Affairs (2026). 2026. Paul Heidenreich, Lance Spacek, Neil Gregor, et al. Guideline 7. Lipoprotein(a) and Family History Predict Cardiovascular Disease Risk. Journal of the American College of Cardiology. 2020. Mehta A, Virani SS, Ayers CR, et al.Observational 8. 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2010. Greenland P, Alpert JS, Beller GA, et al.Guideline 9. Prevalence and Prognostic Implications of Coronary Artery Calcification in Low-Risk Women. The Journal of the American Medical Association. 2016. Kavousi M, Desai CS, Ayers C, et al.SR 10. ​Coronary Artery Calcium Scores and Risk for Cardiovascular Events in Women Classified as “Low Risk” Based on Framingham Risk Score: The Multi-Ethnic Study of Atherosclerosis (MESA). Archives of Internal Medicine. 2007. Lakoski SG, Greenland P, Wong ND, et al.Observational 11. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2019. Arnett DK, Blumenthal RS, Albert MA, et al.Guideline 12. HOPE for Rational Statin Allocation for Primary Prevention: A Coronary Artery Calcium Picture Is Worth 1000 Words. Mayo Clinic Proceedings. 2020. Orringer CE, Maki KC.Review 13. Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020. Cho L, Davis M, Elgendy I, et al.Review 14. Health Maintenance in Postmenopausal Women. American Family Physician. 2025. Plesa M, Wong A, Katsaggelos E.Guideline 15.  ​Semaglutide and Cardiovascular Outcomes by Baseline HbA1c and Change in HbA1c in People With Overweight or Obesity but Without Diabetes in SELECT. Diabetes Care. 2024. Lingvay I, Deanfield J, Kahn SE, et al.RCT 16.  ​Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. The New England Journal of Medicine. 2023. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.RCT 17. Long-Term Weight Loss Effects of Semaglutide in Obesity Without Diabetes in the SELECT Trial. Nature Medicine. 2024. Ryan DH, Lingvay I, Deanfield J, et al.RCT 18. Interventions for the Prevention and Management of Cardiometabolic Multiple Long-Term Conditions. Lancet. 2026. Valabhji J, Hope D, Sayed NE, et al.RecentReview 19. Glucagon‐Like Peptide‐1 Receptor Agonists and Major Adverse Cardiovascular Events in Patients With and Without Diabetes: A Meta‐Analysis of Randomized‐Controlled Trials. Clinical Cardiology. 2024. Hosseinpour A, Sood A, Kamalpour J, et al.SR 20. ​FDA Orange Book. FDA Orange Book. 2026. 21. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026. Diabetes Care. 2026. American Diabetes Association Professional Practice Committee for Diabetes*.RecentGuideline 22. Premature Coronary Artery Disease in Women: Sex-Specific Risk Factors, Pathogenetic Mechanisms and Clinical Implications. Annals of Medicine. 2026. Li F, Hong D, Yang M, et al.RecentReview 23. Cardiovascular Disease Risk Factors in Women: The Impact of Race and Ethnicity: A Scientific Statement From the American Heart Association. Circulation. 2023. Mehta LS, Velarde GP, Lewey J, et al.Guideline 24. Preventing CVD in Women: Common Questions and Answers. American Family Physician. 2023. Westfall E, Viere AB, Genewick JE.Review 25. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline

I’m honored to connect with Dr. John La Puma today. Dr. La Puma spent three decades building the case that food, nature, and light are clinical tools, not just lifestyle add-ons. He was the first physician to complete a professional cooking curriculum, and he used that training to co-develop the first cooking and nutrition course taught in a U.S. medical school, a course now adapted across roughly 80% of U.S. medical schools. He later did the same thing for Nature, co-developing and teaching the first skills-based Nature as Medicine CME course for physicians with UCLA. His most recent work extends the same logic to the built environment, coining the phrase "digital obesity and indoor epidemic" to describe a specific underdiagnosed driver of modern fatigue tied to how little time people spend outdoors and how much artificial light and screen exposure they get instead. In our conversation, Dr. La Puma discusses how we went from chefs' training to co-developing the first culinary medicine course; the indoor epidemic and digital obesity; how most people spend about 93% of their lives indoors; how light impacts bone health; and deep sleep metrics. We also explore how poor air quality can reduce cognitive performance, the significance of phthalate exposure and other endocrine-mimicking chemicals, and green dopamine. Dr. La Puma highlights the health benefits of gardening, explaining how it exposes us to microbes and stimulates serotonin. We also cover nervous system awe, movement, how forest bathing can boost your immune system while reducing inflammatory markers, how exercise can help us live longer, nighttime red light therapy exposure, sleep and recovery, and animal companionship as a health intervention. Stay tuned for today’s interesting and highly informative conversation about lifestyle as medicine with Dr. John La Puma. I highly recommend his book, The Indoor Epidemic, with the actionable information it contains. IN THIS EPISODE, YOU WILL LEARN: Dr. La Puma shares his motivation for bringing nutritional science and cooking into his medical practice How spending much of your life indoors can affect your nervous system, circadian biology, and metabolism The value of morning light for supporting sleep and rebuilding bones during perimenopause, menopause, and andropause How indoor air quality impacts cognitive performance Dr. La Puma shares his approach to reducing exposure to chemicals from household cleaning products The potential benefits of gardening and spending time with your hands in the soil How intentional time outdoors can support sleep, mood, energy, and memory A bright blue-white light at night may interfere with restorative sleep. Animal companionship and how it can improve our health and wellbeing Bio: John La Puma, MD, ChefMD™ is a two-time New York Times bestselling author, board-certified internist, and professionally trained chef who pioneered Culinary Medicine. He now pioneers EcoMedicine from his small regenerative teaching farm. His upcoming book, Indoor Epidemic, reveals how spending 93% of life indoors steals sleep, focus, and years, and how reclaiming just 7% outdoors can restore them using the evidence-based Outdoor Rx framework. This is a clinically validated intervention, presenting nature as foundational medicine, an essential component of health and the missing pillar in optimizing longevity and healthspan. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. John La Puma On his website The (Indoor Epidemic) book website

This episode is another in our podcast series of conversations with highly vetted brands I feel confident recommending to my community. Today, I was delighted to connect with Julie Sawaya, Co-founder and Co-CEO of Needed, a women's health company advancing nutrition standards across the mother span, from fertility through menopause. Julie holds a degree from Northwestern and an MBA from Stanford. In our conversation, Julie and I discuss the silent epidemic of nutritional deficiency. We explore how oral contraceptives and food restriction can contribute to nutrient depletion, current RDA standards, and the impact of pregnancy, breastfeeding, the postpartum period, and perimenopause on women's nutritional needs. We examine the MTHFR SNP and its variants, explain how to read supplement labels and what pixie dusting is, and discuss why it's important to know your omega-3 index and how this can influence both food choices and supplementation. Julie also shares a "repletion, not restriction" reframe for midlife and discusses the policies and standards she would like to see improved, including updated recommendations for pregnant and breastfeeding women and a straightforward perimenopause RDA. We also discuss practical takeaways, including specific supplement recommendations and testing that may be helpful. Stay tuned for another conversation you'll likely want to listen to more than once. IN THIS EPISODE, YOU WILL LEARN: How depleted food, environmental toxins, and normalized fatigue have contributed to the silent nutrient deficiency epidemic among women How oral contraceptives can deplete key vitamins and minerals, and how pregnancy, breastfeeding, postpartum, and perimenopause increase women’s nutritional needs What the current RDA standards were developed for—and how the research underpinning them largely excluded women of reproductive age How symptoms and cycle changes can overlap between perimenopause and nutrient depletion Nutrients that are essential for bone health, cognitive function, energy, nutrient absorption, and overall health during the menopause transition Julie reviews the evidence surrounding MTHFR variants What to look for on supplement labels Why nourishing your body properly can support your metabolism more effectively than food restriction How your omega-3 index can help you decide whether supplementation is needed Julie shares practical recommendations for supporting your nutritional health during perimenopause. Bio: Julie Sawaya is the Co-Founder and Co-CEO of Needed, a women’s health company advancing nutrition standards across the motherspan—from fertility through menopause. Julie earned departmental honors in Economics at Northwestern University for her work on nutritional access and her MBA from the Stanford Graduate School of Business. She is a frequent speaker and writer on women’s health and modern motherhood. Julie is a trained nutritionist and a mother of three. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Julie Sawaya Needed Instagram TikTok

Today, I’m thrilled to connect with Dr. Aleksandra Gajer. Dr. Gajer was previously an academic emergency medicine physician who pivoted after realizing ER medicine was functioning less as a place that saves lives and more as a place that manages chronic conditions that should have been caught and addressed years earlier. That observation led her to leave ER medicine and take over an established Northern Virginia internal medicine practice focusing on hormone optimization, peptide therapy, and preventative longevity-oriented care. In our conversation today, we discuss how perimenopause is treatable and suffering through it is optional. Dr. Gajer explains how she manages body composition changes, weight loss resistance, bone health, and orthopedic-related complaints in midlife. We take a deep dive into the sourcing and research limitations of peptides, exploring healing peptides, growth hormone-promoting peptides, and thymic peptides, and also discussing immunosenescence, bioregulators, mitochondrial RNA-coded peptides, pheno age testing, and using low-dose ketamine, when appropriate, for mental health challenges. Stay tuned for a fascinating conversation about the science and limitations of research on peptide therapies, and what Dr. Gajer is looking forward to in the near future. IN THIS EPISODE, YOU WILL LEARN: The health struggles Dr. Gajer experienced that led her to explore integrative therapies Why women may wake up at 2 or 3 a.m. during perimenopause How hormone changes in midlife can contribute to weight loss resistance Why Dr. Gajer encourages women to have their bone mass assessed earlier than conventionally recommended How declining estrogen and estradiol can contribute to orthopedic-related symptoms during perimenopause and menopause What women need to understand about sourcing peptides and the limitations of peptide research The different ways in which growth hormone-promoting peptides, thymic peptides, epitalon, and MOTC work How GLP-1s can be helpful for midlife women beyond changing their body composition and assisting with weight loss How Dr. Gajer uses low-dose ketamine lozenges for treatment-resistant anxiety and depression   Bio: Dr. Aleksandra Gajer is a board-certified physician and founder of The Gajer Practice. In this precision and longevity medicine clinic, she helps high-performing patients optimize their healthspan through a whole-person, root-cause approach. Trained in emergency medicine at the University of Maryland and George Washington University, she brings rigorous clinical thinking to hormone optimization, peptide therapy, metabolic health, and gut healing. Her own journey through Lyme, alongside more than twenty years of contemplative practice, shapes her belief that emotional and spiritual health underlie physical wellness. A recurring Fox 5 DC health expert with more than fifty podcast appearances, she is also building physician education around the responsible, evidence-based use of peptides. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected].  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Aleksandra Gajer The Gajer Practice 

Welcome to this week’s Midlife Minute episode. Today, we’re diving into listener questions about HRT dosing and the confusion surrounding administration. We explore several key themes, including absorption issues, lab draws, and cycling versus daily continuous dosing. I also compare oral progesterone with vaginal and transdermal progesterone. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: The estradiol dosage range I prefer, for bone protection How heart disease risk can influence the route you select for HRT I clarify the “start low and slow” approach to HRT dosing Why women with uteruses need progesterone when taking estrogen  Why HRT dosing can become more complicated during perimenopause How FDA-approved bioidentical hormones differ from compounded preparations Various factors to consider when using an estradiol patch Alternative routes of administration for women who feel unwell when taking progesterone orally How providers can safely transition women from transdermal estradiol patches to other options Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: Please visit https://www.cynthiathurlow.com/podcast for research.

We have an extra-special podcast today with my husband, Todd, where we answer many listeners' questions about our relationship, how we met, and our shared interests. In this episode, Todd and I discuss ways to support your partner through perimenopause and menopause, the importance of shared interests and connections, and why communication is essential in midlife relationships. Todd shares his views on fatherhood and marriage, how physical activity and food are integral to our relationship, and the empty-nest/open door season of our lives. He also describes his own health and daily lifestyle, the bigger picture in our relationship, and we share some lighthearted and fun discussions. I love the interest this topic has generated, and I truly hope you and your significant other will find it an invaluable conversation about navigating midlife as a couple. IN THIS EPISODE, YOU WILL LEARN: What Todd came to understand about my perimenopause to menopause experience   How education and communication can help couples navigate the menopause experience The changes Todd has noticed in my personality since my 30s  How our shared values have influenced our business decisions What Todd values most about being a husband and father How, over time, Todd came to understand more about my childhood experiences and appreciate how I focused on creating a different environment for our children How the prospect of having both boys leave home is affecting us, both as individuals, and as a couple How Todd’s approach to his health has changed due to my influence What Todd believes men should understand as their partners navigate the perimenopause-menopause transition Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

Today, I am thrilled to reconnect with a previous guest, Dr. Mary Claire Haver.  Dr. Haver is a board-certified OBGYN, a certified menopause provider, and the founder of Mary Claire Wellness, a private medical practice focusing on women in midlife. Her best-selling book, the Galveston Diet, and her latest New York Times best-seller, The New Menopause, are fabulous resources for middle-aged women. In today's discussion, we dive into various aspects of perimenopause and the associated challenges. We discuss factors accelerating ovarian aging, the role of contraception, mental health shifts, and the often delayed diagnosis of premature ovarian insufficiency. We examine the differences between hormone replacement therapy and oral contraceptives, discussing the importance of advocacy for women's health and the benefits of vaginal estrogen. We explore the disparity in federal funding for women's health research, the impact of the Women's Health Initiative, body composition changes, the estrabolome, the 30 Plant Challenge, and the advantages of HRT. Dr. Haver also talks about her preferred supplements.  I'm sure you will find this conversation a valuable resource that you will likely revisit several times. IN THIS EPISODE YOU WILL LEARN: Why perimenopause is so fraught with chaos Some of the factors that hasten ovarian aging How perimenopause causes significant changes in neurotransmitters, leading to cognitive changes The differences between HRT and oral contraceptives How estrogen loss during menopause affects vaginal tissue The benefits of vaginal estrogen for symptoms of menopause  How women's health research funding prioritizes reproduction over menopause and perimenopause How HRT can help with fat loss and muscle mass in postmenopausal women The emergence of eating-disordered behaviors in menopausal women Some of the lesser-known symptoms of menopause and ways to overcome them How HRT could impact the longevity and cognitive health of women Bio: Dr Mary Claire Haver Dr. Mary Claire Haver is a board-certified OB-GYN who has devoted her adult life to women's health. When she began experiencing the changes of menopause and midlife weight gain, she created her online program, The Galveston Diet, which currently has over 80,000 students. The Galveston Diet is the first and only nutrition program in the world created by a female OB-GYN, designed for women in menopause. As part of her ongoing research, she became certified in Culinary Medicine in 2019, specializing in medical nutrition. In 2021, Dr. Haver opened Mary Claire Wellness; the clinic grew out of repeated requests from Galveston Diet students and Dr. Haver's social media followers for personal guidance.  Dr. Haver lives with her husband and two daughters in Galveston, Texas. She is the author of The Galveston Diet (Rodale; January 10th, 2023). Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Mary Claire Haver On the⁠ Mary Claire Wellness website⁠ ⁠Instagram⁠ ⁠TikTok⁠ ⁠Facebook⁠ ⁠YouTube⁠ Books Mentioned Dr. Haver’s books, ⁠The Galveston Diet⁠ and ⁠The New Menopause ⁠ ⁠The Menopause Brain⁠ and the⁠ XX Brain⁠ by Lisa Mosconi Previous Episode Mentioned ⁠Ep. 308 Dr. Mary Claire Haver: Weight Gain in Middle Age, Perimenopause and Inflammation

Today, I’m honored to connect with Dr. Salome Masghati, founder of Precision Gynecology, which provides the unhurried, root-cause-oriented care often missing in a system where women are rushed through short appointments, focusing on bioidentical hormone therapy, perimenopause, and menopause. Dr. Masghati has extensive surgical training and specializes in longevity medicine. In today’s discussion, we explore the ovary as a signaling hub, not just a reproductive timer, and Dr. Masghati shares her views on hormone replacement therapy timing, intrinsic and infradian rhythm, ovarian function, and the differentiators between PCOS and PMOS in midlife women. We also cover oral versus transdermal estradiol therapy, FSH testing as an independent risk factor for bone and heart health, hysterectomies, ferritin and iron deficiency, coronary vasospasm, elevated Lp(a), estradiol and thyroid therapy, peptides, regenerative and esthetic offerings. Dr. Masghati also offers her personal perspective on what influences orgasms. Stay tuned for today’s invaluable conversation with Dr. Salome Masghati on optimizing women’s health in midlife and beyond. IN THIS EPISODE, YOU WILL LEARN: How a hysterectomy, partial hysterectomy, and other surgical interventions can impact ovarian function Dr. Masghati shares her approach to hormone replacement therapy for women going through premature or early menopause How elevated androgen levels, insulin resistance, and inflammation can affect the response to hormone replacement therapy in women with PCOS/PMOS Why Dr. Masghati generally prefers transdermal rather than oral estradiol How optimizing hormone levels can improve libido when women’s hormones change  Women may have low ferritin even when their serum iron looks good. Declining estrogen may contribute to coronary vasospasm in women. What women should know about regenerative therapies using PRP Why the source of peptides matters, and why Dr. Masghati specifically advises against using research peptides Bio:  Dr. Salome Masghati is a board-certified gynecologic surgeon who now focuses on hormonal wellbeing, functional medicine, and disease prevention. She specializes in women’s health conditions including perimenopause, PCOS, endometriosis, gut health, and metabolic dysfunction, using a root-cause and physiologic approach to help women restore balance and optimize their health. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Salome Masghati On her website On Instagram Email: [email protected] 

Welcome to this week’s Midlife Minute episode! Statistically, one in three women will die of heart disease. So, today, we’re answering some of the many questions I received about lipids and heart health. Although I’ve done other lipid-focused Midlife Minutes before, this episode is yet another dedicated to Dr. Tom Dayspring, as I’ve received such a vast number of questions on this particular topic.    IN THIS EPISODE, YOU WILL LEARN: Why understanding your ApoB and Lp(a) is an essential part of assessing your cardiovascular risk Why treatments for lipid abnormalities should be individualized to fit each specific abnormality  Essential lifestyle measures for supporting overall cardiovascular health How CAC scoring, CT coronary angiography, and Clearly AI-assisted imaging differ, what each test measures, and their limitations  How cardiovascular disease can sometimes present differently in women  Why are premature atrial contractions and premature ventricular contractions often benign when the heart is structurally normal? How the roles of statins, ezetimibe, PCSK9 inhibitors, GLP-1 medications, and emerging RNA therapies differ, and why they should not be considered interchangeable How declining estrogen impacts cardiovascular health Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

I’m delighted to bring you a midlife metabolic health masterclass for women today, with experts Dr. Yael Joffe, Dr. Ben Bikman, Dr. Lara Briden, Dr. Felice Gersh, and Dr. Alexandra Sowa. In this masterclass, our panel of experts explores how women’s metabolisms change in perimenopause, how our fat cells change with age, and how those changes influence our estrogen, insulin, and body composition. We examine how muscle, estrogen, and satiety mechanisms can improve or worsen metabolic health, the roles of aging, stress, inflammation, and ovarian health, and how body changes become metabolic risks. Join us for today’s impactful masterclass with our insightful panel of metabolic health experts. IN THIS EPISODE, YOU WILL LEARN: Why the amount of body fat you carry does not necessarily determine your metabolic health How declining estrogen during menopause can change where women store their body fat Why women have to work harder to maintain and build muscle as estrogen declines in perimenopause and menopause How women can continue building muscle at any age Why progesterone is not only a reproductive hormone or something prescribed to protect the uterine lining The changes women may experience as their estradiol and progesterone production declines in midlife What women considering GLP-1 medications for menopausal weight gain should look at, beyond the number on the scale How to support your gut health and manage gastrointestinal symptoms when taking a GLP-1 The factors Dr. Joffe takes into account when evaluating women during their menopausal transition Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Yael Joffe 3X4 Genetics Instagram Facebook Connect with Dr. Ben Bikman On his website Social media: @benbikmanphd Connect with Dr. Lara Briden Website Social media: @Lara Briden Connect with Dr. Felice Gersh On her website: Integrative Medical Group of Irvine Instagram All of Dr. Gersh’s books are available on Amazon. Connect with Dr. Alexandra Sowa On her website   Social media: @alexandrasowamd  Purchase a copy of Dr. Sowa’s book, The Ozempic Revolution: A Doctor's Proven Plan for Success to Help You Reverse Obesity, End Yo-Yo Dieting, and Protect Yourself from Disease Podcast Episodes:  Ep. 558 Your DNA Isn’t Your Destiny – The Most Actionable Way to Use Genetics for Weight Loss with Dr. Yael Joffe  Ep. 316 The Impact of Age, Gender and Lifestyle on Metabolic Health with Dr. Ben Bikman Ep. 372 Metabolism Repair for Women: Strategies and Insights with Dr. Lara Briden Ep. 570 We’ve Been Wrong About Progesterone! – The Most Powerful Hormone for Heart, Brain & Longevity with Dr. Felice Gersh|Menopause & HRT Ep. 438 - The Rise of GLP-1s: Key to Weight Loss and Metabolic Health with Alexandra Sowa, MD

I’m excited to share another episode in our series of highly vetted companies. Today, I’m delighted to reconnect with Angelo Keely, the Co-founder and CEO of Kion, for our third conversation. I’ve been using essential aminos. I really leaned into them during my book launch, and I credit them with helping me maintain my muscle mass despite training at a lower volume. In today’s conversation, Angelo and I discuss GLP-1s and muscle loss, exploring protein intake, the leucine threshold hypothesis, the association between declining estrogen and blunted muscle protein synthesis, and using essential aminos to build and maintain muscle. We unpack the role of sleep and recovery for muscle health, daily versus as-needed creatine monohydrate and essential amino acid supplementation, what omega-3s are, why they matter, and how to supplement. We also cover midlife women's body composition, weight loss, and muscle building, and Angelo shares his take on the disconnect between body composition changes in midlife women and how companies actively market to midlife women, knowing the challenges we face in that area. Stay tuned for today’s insightful and informative discussion with Angelo Keely of Kion. IN THIS EPISODE, YOU WILL LEARN: How caloric restriction leads to fat loss but can also cause the body to break down muscle  How essential aminos can help preserve our muscles as we age The essential amino formula Angelo recommends for midlife women Hormone changes may affect muscle protein synthesis The huge impact poor sleep has on whole-body protein synthesis  Essential aminos vs. whey protein and how they differ Value of essential aminos for maintaining muscle during caloric deficits  How aminos and creatine both need to be taken consistently, but for different physiological reasons What to look for when choosing a quality omega-3 supplement How to make daily supplementation easier to maintain Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Angelo Keely Visit GetKION.com/Cynthia for 20% off!

Today, I’m delighted to connect with Sara Hirsh Bordo, an autoimmune-diagnosed, 15-times award-winning documentary filmmaker, the founder and CEO of Women Rising, and the author of Autoimmunity and the Good Girls. I loved Sara's book, and I love her work! I believe her message will resonate deeply with listeners with concurrent autoimmune conditions, and those who have grown up as people pleasers or have subjugated themselves over the course of their lives. Autoimmune conditions often tend to flare or first present during major hormonal transitions like postpartum, perimenopause, or menopause. So it’s important to understand the influence of chronic stress and how it intersects with our immune system function. In our conversation, Sara and I discuss how self-silencing makes us sick, and overgiving keeps us that way. We explore the influence of family and culture on our health and longevity, the effects of autoimmunity, people pleasing, good-girl conditioning, and authenticity versus dissociation. We also discuss Gabor Maté’s book, The Myth of Normal, liberation, the fear of disappointment, Sara’s research, her concept of the license to be sovereign, the act of receiving, the role of epigenetics and birth order, and Sara's framework of coherence, authenticity, epigenetics, and permission. Stay tuned for a wonderful conversation about autoimmunity, people-pleasing, authenticity, and permitting ourselves to be sovereign. Sarah's book, Autoimmunity and the Good Girls, will likely resonate deeply with many of you. IN THIS EPISODE, YOU WILL LEARN: How self-silencing, self-neglect, and self-betrayal can impact a woman’s health The connection between chronic stress, suppressed feelings, good girl conditioning, and autoimmunity What it feels like to reclaim your authenticity and be more aligned with yourself How the fear of disappointing others can make it difficult for some women to claim their power What Sara discovered about adverse girlhood experiences, birth order, and the caretaker role when compiling the research for her book How becoming more sovereign can help women advocate for their own needs Why receiving can be difficult for women who are accustomed to giving How stillness and silence helped Sara identify her needs and wants How girlhood experiences, self-silencing, and self-compromise can become epigenetic inputs, and what women can do to create more supportive environments Why permission is a key part of Sara’s framework for reclaiming authenticity Bio: Sara Hirsh Bordo Sara Hirsh Bordo (pronounced Bordeaux) is a 15-time award-winning filmmaker and Founder/CEO of Women Rising®, named "One of the Most Innovative, Interesting, and Purpose-Driven Women-Led Startups to Watch” by Inc. Magazine. Sara is currently directing short documentary films for Toyota and ESPN Women, and most recently, the executive producer of ConnectHer International Film Festival, consulting director for the Gates Foundation PitchFest Program, and the author and researcher behind the first proprietary quantitative survey at the intersection of female empowerment and health, Autoimmunity and the Good GirlsTM. Sara previously held positions in media and entertainment, including Executive Director of Interactive Marketing at Paramount Pictures, VP of Digital Marketing at MGM Studios, and CEO and Co-Founder of NowLive. Autoimmunity and the Good Girls is her first book. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Sara Hirsh Bordo  Website  Instagram Autoimmunity & The Good Girls Book

Today, we have a metabolic health masterclass, featuring Dr. Robert Lustig, Ben Azadi, Dr. Ben Bikman, Mark Sisson, and Dr. Nick Norwitz.  In today’s masterclass, we explore why metabolic dysfunction is not simply a calories-in, calories-out issue or a failure of willpower, how insulin and leptin influence appetite and behavior, how early signs of insulin resistance can appear years before a diabetes diagnosis, and the important relationship between muscle, glucose regulation, and insulin sensitivity. We also discuss how movement supports fat burning without sacrificing muscle, why chronic cardio may not produce the results many people expect, and how emerging technology could provide a far more personalized approach to metabolic care. Stay tuned for today’s informative discussion, where our panel of experts shares their valuable perspectives on metabolic health. IN THIS EPISODE, YOU WILL LEARN: Leptin resistance and how it can drive the overeating and inactivity commonly associated with obesity How elevated insulin blocks the effects of leptin Why it’s essential to pay attention to fasting insulin rather than waiting for blood glucose to rise  Ben Azadi highlights metabolic health markers that can provide information beyond fasting glucose. How our muscles help to regulate glucose and support insulin sensitivity The importance of building and preserving muscle to support insulin sensitivity as we age, and how even a brief period of inactivity can reduce insulin sensitivity Mark Sisson explains why running may not be the most effective fat loss strategy  How walking can increase your fat-burning capacity while also helping to preserve your muscles Dr. Nick Norwitz explains how type 2 diabetes can involve different underlying pathologies, and how CGM data and machine learning can eventually help to identify specific subphenotypes Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Robert Lustig Website  On Facebook, Instagram, and Twitter  Connect with Ben Azadi Website On Instagram, Facebook, LinkedIn, YouTube, TikTok Get a copy of Ben Azadi’s latest book, Metabolic Freedom. Connect with Dr. Ben Bikman Website On social media: @benbikmanphd Connect with Mark Sisson   Mark’s book, Born To Walk  Peluva Shoes Connect with Nick Norwitz On YouTube, X, and Instagram His Substack Previous Episodes: Ep. 161 Robert Lustig & Cynthia Thurlow Discussing The Nutritional Battlefield & Debunking Chronic Diseases Ep. 465 Metabolic Health 101: Fat Loss, Toxins, and Seed Oils with Dr. Ben Azadi Ep. 316 The Impact of Age, Gender and Lifestyle on Metabolic Health with Dr. Ben Bikman Ep. 422 Walking for Health: The Underrated Exercise You Need with Mark Sisson Ep. 525 We’ve Been Misled About Metabolic Health – The Shocking Truth About Cholesterol, GLP-1 & Aging with Dr. Nick Norwitz

I am delighted to have Jessie Inchauspe, the Glucose Goddess, joining me on the podcast today! Metabolic health is my passion! It is a huge focus of my work, and Jessie is truly a gift in this space! She is a rising-star author and biochemist with a clear, accessible way of explaining the science behind glucose metabolism.  Jessie joins me today to discuss the impact of glucose metabolism and spikes. We dive into her background and how an accident created her pain-to-purpose story. We discuss the role of continuous glucose monitors and how glucose spikes impact our mitochondria, inflammation, and oxidative stress. We get into glycation and aging, how weight gain is a protective aspect of glucose spikes- or hyperglycemia, and the role of vinegar, movement, and fiber. We also talk about Jessie’s new book, her opinions on fasting, and so much more.  I loved interviewing Jessie! Her enthusiasm is contagious, and it is easy to understand why she is such a beloved author in the health and wellness space! IN THIS EPISODE YOU WILL LEARN: Jessie shares how an accident led her to where she is today. How a continuous glucose monitor changed everything for Jessie. How Jessie developed her simple principles to steady glucose levels. What is the purpose of glucose in the body? How do glucose spikes impact our mitochondria? Jessie shares a fascinating vinegar hack to reduce the side effects and symptoms of glucose spikes. How being metabolically unhealthy impacts the aging process. The benefits of having savory breakfasts and eating vegetables first with every meal. Jessie talks about her new book, The Glucose Goddess Method. How gaining weight protects our bodies from the impact of glucose spikes. How walking or moving after meals balances blood sugar levels. Why is blood sugar so important? Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Jessie Inchauspe On her ⁠website⁠   ⁠Instagram⁠

I’m delighted to connect with Dr. Rachel Goldman today. She is a licensed clinical psychologist based in New York City and a clinical assistant professor in the Department of Psychiatry at NYU Grossman School of Medicine. She specializes in the mind-body connection using cognitive behavioral therapy, with a focus on stress management, burnout, distorted eating, bariatric surgery support, and health behavior changes. I was honored to meet Dr. Rachel in Miami at an event where we both spoke earlier this year. In our conversation, we discuss how to approach body image in midlife, how our families influence our relationships with food, what toxic positivity is, and how it invalidates our emotions. We also explore the vulnerability of midlife and parenting, the effects of GLP-1 drugs, obesity as a disease, and the impact of mindset. Dr. Rachel also defines burnout and shares the best ways to address it. Stay tuned for today’s invaluable conversation on body image, mindset, emotions, and navigating the challenges of midlife. IN THIS EPISODE, YOU WILL LEARN: Dr. Rachel shares her approach to helping midlife women struggling with body image and identity  How our thought processes around food can influence our emotions and behaviors Various factors that can influence our relationship with food How women with many rules around food can start changing their thinking How to navigate grief about your younger body and learn to appreciate the body you have now What toxic positivity is and how it invalidates our emotions How personal and professional role changes in midlife can affect a woman’s sense of identity Why Dr. Rachel recommends having more than one coping tool in your toolbox  The effects Dr. Rachel has been seeing in patients using GLP-1 medications What burnout is, and how to address it Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Rachel Goldman On social media: @DrRachelNYC   Purchase links for Dr. Rachel’s book are available HERE.

Welcome to the latest summer version of the Midlife Minute.  In this episode, we’re focusing on the gut. Even though I’ve written a book about the gut microbiome changes that occur in perimenopause and menopause, I’m often asked whether the gut is truly central to midlife. So today, I provide direct answers to the many questions I received on this topic.   IN THIS EPISODE, YOU WILL LEARN: How the gut microbiome and estrogen work together, and the importance of supporting both  How the estrobolome helps recycle estrogen, and why its function could decline during menopause How poor sleep, blood sugar instability, histamine issues, and dysbiosis tend to be interconnected The value of practitioner-guided microbiome testing when investigating histamine intolerance, dysbiosis, and weight loss resistance Various factors that could contribute to weight loss resistance How my approach to stool testing has evolved as newer microbiome testing technology has become available Essential lifestyle habits for supporting gut health Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

I am honored to connect with Dr. Eric Osansky today. He is a chiropractic physician, clinical nutritionist, and functional medicine provider. He is also an author who loves to write about hyperthyroidism and a lifestyle-focused approach to it. In today’s conversation, Dr. Osansky unpacks his own Graves diagnosis in 2008 and highlights the typical symptoms of hyperthyroidism, the unique physiology of thyroid dysfunction, and specific risk factors. We explore traditional treatment pathways, the influence of low-dose naltrexone and other immunomodulatory supplements, and the gut-thyroid axis. We also discuss how most of our immune system is located in the gut, the influence of leaky gut and autoimmune disease, perimenopause as a trigger window for symptoms, and how these often overlap with thyroid health. Stay tuned for an interesting and insightful conversation on thyroid health, Graves' disease, hyperthyroidism, and more. IN THIS EPISODE, YOU WILL LEARN: What Graves' disease is, and how it differs from other causes of hyperthyroidism The first symptom of Graves' disease that Dr. Osansky experienced, and other common symptoms of Graves’ disease Genetics, environmental triggers, and other factors that could contribute to autoimmune thyroid disease Conventional treatment options that are available for Graves’ disease, how they work, and why treatment decisions should be individualized Why Dr. Osansky recommends continuing to support immune and gut health after radioactive iodine or thyroid surgery How low-dose naltrexone may help some people with Graves’ disease modulate their immune systems Foods, lifestyle measures, and supplements that can support immune regulation alongside appropriate medical care The relationship between the gut microbiome, intestinal permeability ("leaky gut"), and autoimmunity How thyroid symptoms and hormone changes during midlife can overlap, and why laboratory testing is important when symptoms overlap Bio: Eric Osansky Dr. Eric Osansky is a chiropractor, clinical nutritionist, and certified functional medicine practitioner who has been helping people with hyperthyroidism and Hashimoto's since 2009. He is the author of the books "Natural Treatment Solutions for Hyperthyroidism and Graves' Disease", "The Hyperthyroid Healing Diet", and "Hashimoto's Triggers", and is the host of the Save My Thyroid podcast. Dr. Osansky was personally diagnosed with Graves’ disease in 2008 and was able to restore his health through a natural approach, and since then has helped others reverse their hyperthyroidism through his SAVED Thyroid framework. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Eric Osansky Website Save My Thyroid Project Substack Newsletter Dr. Osansky’s books, Natural Treatment Solutions for Hyperthyroidism and Graves' Disease, The Hyperthyroid Healing Diet, and Hashimoto’s Triggers, are available on Amazon.