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.

In this episode, we’re featuring MitoQ, a company whose research around antioxidant support for mitochondrial function has been of particular interest to me. I’m thrilled to welcome Dr. Siobhan Mitchell, the Chief Scientific Officer at MitoQ. Dr. Mitchell completed her PhD at SUNY Albany and a postdoctoral fellowship on brain aging at the University of Washington. She has held roles at multinational food companies, leading research on brain nutrition, metabolism, cardiovascular health, and weight loss. She has published clinical research demonstrating the effects of stress on women’s heart health and the importance of nutrients such as polyphenols, omega-3s, probiotics, and amino acids for brain health, authored dozens of clinical studies and more than 80 papers, and given talks on nutritional neuroscience at conferences worldwide. She also holds eight patents for products related to aging, cognition, and mood. In today’s conversation, Dr. Mitchell and I discuss mitochondrial physiology, energy, and dysfunction, exploring the impact of MitoQ and supplementation for supporting health. We examine research on menopause, how estrogen influences mitochondria, the roles of oxidative stress, antioxidants, and zombie cells, highlighting how mitochondria impact our cardiovascular health, the value of MitoQ in supporting vascular function in females, the importance of polyphenols and spices, and signs of mitochondrial dysfunction. This is a truly invaluable conversation- one you’ll likely want to revisit. Stay tuned for today’s informative discussion on supporting our mitochondria and reducing oxidative stress with MitoQ. IN THIS EPISODE, YOU WILL LEARN: How our mitochondrial function changes as we get older, and what those changes might look like How antioxidants protect the mitochondria from free radicals and oxidative stress The early signs of mitochondrial dysfunction  How women who have damaged their mitochondria earlier in life can proactively support their mitochondria Why some oxidative stress may be beneficial and when it could become problematic How mitochondrial dysfunction impacts heart function, blood glucose regulation, insulin resistance, and metabolic syndrome What Dr. Mitchell recommends for women learning about mitochondrial support for the first time Dr. Mitchell shares the daily practices she uses to support her brain and metabolic health. How long you may need to take MitoQ before noticing improvements, and what those improvements might look like Bio: Dr. Siobhan Mitchell Siobhan Mitchell is the chief scientific officer of MitoQ. She completed her PhD at SUNY Albany and a post-doctoral fellowship on brain aging at the University of Washington. Siobhan has held roles at multinational food companies leading research on brain nutrition, metabolism, cardiovascular health and weight loss. Siobhan has published clinical research showing the effects of stress on women's heart health, and the importance of nutrients such as polyphenols, omega-3 oils, probiotics and amino acids for brain health. She has authored over a dozen clinical studies on best practices for weight management and prevention of chronic diseases during her time as senior director for Noom. Siobhan is passionate about the intersection of nutrition and lifestyle factors, such as exercise, sleep, and mental well-being, to extend health span. Siobhan has given talks on nutritional neuroscience at conferences all over the world. She's authored over 80 papers and holds eight patents for aging, cognition, and mood products. 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. Siobhan Mitchell MitoQ  The Mitochondrial Collaborative Research Programme (MCRP)  Email Dr. Siobhan Mitchell: [email protected]

I’m delighted to connect with Dr. Lanna Cheuck today. She’s a board-certified urologic surgeon who transitioned from academic medicine into a distinctive career in medical esthetics. In today’s conversation, Dr. Lanna shares her inspiring origin story, and we explore the influence of sexual health and genitourinary syndrome of menopause, common symptoms women experience, and why so few women receive treatment despite how common the condition is. Dr. Lanna explains non-surgical treatment options that improve blood flow, increase orgasms, and improve pelvic floor health, and discusses the influence of senescent cells, the celebrity non-surgical facelift, and how GLP-1 medications influence facial aging. She also shares interesting insights on Korean skincare benefits versus a concierge U.S.-based system, clarifies what biostimulators are and how they stimulate collagen production over time, and explains the influence of PDGF growth factors, cadaver fat transfers, energy devices, and estrogen used on our faces. Stay tuned for a fascinating conversation filled with practical insights into women’s health, medical esthetics, and healthy aging.  IN THIS EPISODE, YOU WILL LEARN: How the continuum of symptoms associated with genitourinary syndrome of menopause is often dismissed as something women simply have to live with The value of vaginal estrogen, and how many women are still denied that treatment due to outdated concerns following the WHI study Non-surgical procedures that can improve blood flow, collagen, elastin, lubrication, sensitivity, orgasms, and pelvic floor health, and why Dr. Lanna considers them regenerative sexual health rather than cosmetic procedures Why it’s essential to seek practitioners with extensive training for intimate procedures Dr. Lanna’s celebrity non-surgical facelift combines multiple approaches to address every layer of facial aging. How rapid weight loss associated with GLP-1 medications can accelerate facial aging The advantages and limitations of Korean esthetics, and how it differs from a concierge U.S.-based approach What biostimulators are, and how they stimulate collagen production Why Dr. Lanna introduces energy-based devices according to skin quality rather than age alone Dr. Lanna shares her perspective on using topical estriol or estradiol for facial skin Bio: Dr. Lanna Cheuck, DO, FACS, is the CEO, Founder, and Medical Director of LC Medical PLLC with multiple locations and her flagship in the heart of midtown Manhattan. She is a board-certified, Ivy League-trained surgeon and self-taught businesswoman who built her brand into multi-million dollar companies in less than five years. She is the CEO and Founder of FACE Med-Spa Training, where she has over 30K injectors in her community. She is also the CEO and Co-Founder of FACE Med Store, a seven-figure online shop specializing in the distribution of medical supplies, equipment, and skincare. 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. Lanna Cheuck On her website Instagram

I am delighted to connect with Michael Rubino today. Michael is the founder and CEO of Home Cleanse and the chair of Change the Air Foundation, a nonprofit dedicated to improving indoor environments and public health. He is widely recognized as the leading authority on mold remediation and indoor air quality. In our conversation, we explore the connection between indoor air quality, gut permeability, and systemic inflammation. Michael explains how modern building practices, energy efficiency measures, and newer building materials may be contributing to health challenges. We discuss the types of tests he uses in his business, the symptoms he often sees in middle-aged women, considerations for frequent travelers, and why a bio-individual, data-driven approach matters for remediation. We also examine the role of genetics; the link between poor indoor air quality, leaky gut, and inflammation; practical interventions; the influence of social media; and what to look out for when contemplating a home addition or renovation. Mold exposure is, in my view, one of the most commonly overlooked contributors to chronic health issues in functional medicine. Its effects on the gut impact the health of the microbiome, increasing susceptibility to leaky gut, which can fuel neuroinflammation, and impair detoxification pathways. Stay tuned for a truly insightful discussion on indoor air quality, mold exposure, and the hidden environmental factors that may be influencing your health. IN THIS EPISODE, YOU WILL LEARN: How energy-efficient building practices may be contributing to indoor air quality concerns Why traditional air sampling may not provide a complete picture of mold exposure Testing options for evaluating mold and mycotoxin exposure Symptoms associated with mold and indoor environmental exposures How to reduce the likelihood of  mold exposure while traveling Factors to consider when developing a remediation plan How poor indoor air quality can contribute to gut dysbiosis, leaky gut, and inflammation How genetics can influence susceptibility to mold and environmental exposures Why recommendations such as dehumidification and opening windows can only be helpful when applied appropriately Practical ways to improve indoor air quality and reduce mold exposure Bio:  Michael Rubino Michael Rubino is an air quality expert and environmental wellness advocate. He is the founder of HomeCleanse, a company specializing in science-based remediation of toxic indoor environments, and chair & co-founder of the Change the Air Foundation, a nonprofit dedicated to education and policy advancement around indoor air health. Michael hosts the podcast Never Been Sicker and is a published author and sought-after speaker on mold and environmental wellness. 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 Michael Rubino HomeCleanse The Dust Test Change The Air Foundation

Today’s episode is another in our podcast series featuring companies I genuinely feel aligned with. Today, I’m delighted to welcome Lucy Goff, the founder of Lyma, a pioneering wellness brand transforming beauty and health through science-backed innovation. Before launching Lyma, Lucy built a successful career as a journalist and luxury-sector publicist, during which she honed her expertise in brand storytelling and consumer engagement. I’ve been using the Lyma laser for several months now, and I’ve noticed significant improvements in my neck, jawline, and even my knees. Today’s conversation centers around Lucy’s near-death experience and the origins of Lyma. We explore the differences between cold and hot laser technology, the influence of sirtuins and longevity pathways, what constitutes a clinical-grade device, and the FDA approval process. Lucy explains how skin ages differently during perimenopause and menopause, why the Lyma laser is safe for all skin types, and how it requires no protective goggles and is completely pain-free. We also discuss gut health, HRT, and hormones, the influence of IDO2, and the role of probiotic fibers. Lucy highlights how simplifying can enhance your health in midlife, how using GLP-1 drugs can lead to weight loss and reduce skin laxity, and how the Lyma device can help improve skin quality. I know you will enjoy today’s enlightening discussion with Lucy Goff as much as I did while recording it. IN THIS EPISODE, YOU WILL LEARN: How Lucy's near-death experience led to the creation of Lyma How cold laser technology differs from heat-based skin treatments Why LED, red light therapy, and laser technology should not be grouped, and how LED and laser differ in their biological effects and gene expression Lucy explains the extensive testing required for FDA clearance How women’s skin changes during perimenopause and menopause The role of the gut microbiome during perimenopause and menopause What inspired the development of Lyma's IDO2 formulation  Why Lucy encourages a simpler approach to supporting your health in midlife  How the Lyma laser can help improve skin laxity following rapid weight loss with GLP-1 medications 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 Lucy Goff Lyma - Use the code CYNTHIA 10 for a 10% discount on the Lyma device and products on the Lyma website

Today, I am delighted to connect with Dr. Elisa Port, a talented breast surgeon with a passion for helping women better understand breast cancer, breast health, and the science behind screening, diagnosis, and treatment. She’s the chief of breast surgery for Mount Sinai Health System in New York, a professor of surgery at Mount Sinai's Icahn School of Medicine, and the author of The Breast Advice. In our conversation, we explore breast cancer risk factors, various screening mechanisms and their impact on dense breasts, and the role of diagnosis and pathology, including DCIS. We also discuss menopause symptom management, anti-hormone and targeted treatments, immunotherapy, de-escalation, and why a personalized approach to breast cancer treatment is so important.  Stay tuned for a truly informative conversation with Dr. Port. With her infectious optimism, she has a wonderful way of translating the science and the research in her book, making it accessible and putting the statistics into context so the information feels far less scary than it otherwise might. IN THIS EPISODE, YOU WILL LEARN: How 90% of women diagnosed with breast cancer have no family cancer history How body weight and alcohol can influence breast cancer risk Why Dr. Port recommends annual mammograms beginning at age 40 for most women Dr. Port may disagree with recommendations against breast self-exams Why women with dense breasts may benefit from supplemental ultrasound or MRI in addition to mammography Unvalidated breast screening tests may lead to false positives, unnecessary testing, procedures, anxiety, and expense. What DCIS is, and how it influences treatment decisions Why an individualized approach is essential when using SERMs, SERDs, and aromatase inhibitors How Oncotype testing helps to identify women who may safely avoid chemotherapy Bio: Dr Elisa Port Dr. Elisa Port, MD, is chief of breast surgery at Mount Sinai Health System, which encompasses seven different breast centers. Her team performs over a thousand breast surgical procedures each year. She is also the director of the Dubin Breast Center, a state-of-the-art breast center in Manhattan that opened in April 2011. She personally consults with thousands of patients and performs hundreds of operations each year. Dr. Port is a trusted voice in the media and a sought-after speaker. She has been featured in The New York Times, NPR, CBS, Today, Mornings with Maria, and Pix11. In addition to her media presence, Dr. Port regularly speaks at public events and is invited to present at conferences and panels across the country. She lives in Manhattan with her husband and two dogs. 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. Elisa Port On her website On her personal Instagram  Breast Advice MD on Instagram The Breast Advice Substack

Welcome to this week’s Midlife Minute. This episode is dedicated to the overwhelming number of HRT-related questions I’ve received from my community in 2026. Hormone replacement therapy has generated more questions than almost any other midlife topic, especially regarding timing, progesterone, testing, and special situations. IN THIS EPISODE, YOU WILL LEARN: Women can still benefit from HRT later in menopause. The importance of working with a knowledgeable prescriber when making hormone replacement therapy decisions How progesterone tolerance can vary from one woman to another Why your blood work should be timed according to when you apply your estradiol patch, and why I prefer to focus on estradiol rather than routinely monitoring progesterone levels How the synthetic hormones used in oral contraceptives differ from the bioidentical hormones used in HRT How your medical history can influence your hormone replacement therapy plan Fear and outdated information may continue to create confusion about hormone replacement therapy. 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’m delighted to reconnect with Dr. Tabatha Barber, also known as The Gutsy Gynecologist. She is a triple board-certified OB-GYN specializing in perimenopause, menopause, and functional medicine. In today’s discussion, we explore why supporting your hormones involves much more than simply replacing them. Dr. Barber explains how our nervous system, internal dialogue, cellular health, stress response, and lifestyle work together to influence our hormones, energy, and overall health during midlife. We also discuss why addressing root causes is essential for lasting improvements, the role of mitochondrial health, and practical ways to better support your nervous system. If you're looking for a more comprehensive approach to navigating perimenopause and menopause, you will not want to miss today’s insightful conversation with Dr. Tabatha Barber. IN THIS EPISODE, YOU WILL LEARN: Why regulating your nervous system is essential for lasting hormone and health improvements Why the conversations you have with yourself matter more than external circumstances Why Dr. Barber prefers to focus on identifying the root causes of health issues instead of repeatedly treating downstream symptoms How sympathetic dominance and unresolved stress patterns can influence hormone function Other factors, apart from HRT, that are essential for improving women’s health during midlife How oxidative stress, lack of sunlight, and disrupted circadian rhythms can contribute to fatigue and reduced cellular energy How hormone changes in midlife often coincide with greater self-awareness, stronger boundaries, and less people-pleasing How faith, prayer, and gratitude can support nervous system regulation Practical ways to support and regulate your nervous system Bio: Tabatha Barber Dr. Tabatha Barber is a triple board-certified physician — and one of the most distinctive voices in faith-based women's health today. Her story begins where most would have stopped. A teenage mother and high school dropout, she rebuilt her life through faith and perseverance — earning her doctorate and certifications before realizing the very system she trained in was missing the whole point. Today, as owner and medical director of Her Higher Health, creator of the Fast to Faith Coaching Academy, 40 Day program, supplement line, and international bestselling book Fast to Faith, Dr. Tabatha brings one message to every stage and microphone: your body is not broken — your approach is. She is known for doing what no one else does: mapping Scripture directly with how the body works — showing women that Romans 12:2 is the original neuroplasticity protocol, that Genesis 2:7 describes the gut-brain connection, and that God designed healing to happen in community. 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. Tabatha Barber Fast To Faith  On Instagram

Today, I am delighted to reconnect with Dr. Darren Candow. Dr. Candow is a distinguished professor and an internationally renowned researcher on creatine monohydrate, nutrition, and physical activity who joined me before on Episode 301, where we spoke about creatine.  We are doing an AMA session today, delving into various themes surrounding creatine, from debunking outdated RDA recommendations to exploring the combined effects of strength training and creatine efficacy. We look into the cognitive benefits of creatine, exploring how it interacts with caffeine and its implications for bone health, hydration, anabolic resistance, and metabolic health.  I trust you will find today's AMA session as enlightening and enriching as I did while recording it. IN THIS EPISODE YOU WILL LEARN: The safety and efficacy of creatine as a supplement How creatine increases muscle mass and reduces protein catabolism Benefits of combining creatine with protein  Is it better to take creatine before or after a workout? How creatine supplementation may improve brain performance and mental clarity Why exercise is essential for those who want to experience the benefits of creatine for maintaining their bone health Resistance-band workouts for post-menopausal women Are there any age-related limits for creatine supplementation? Bio: Dr. Darren Candow Dr. Darren Candow, PhD, CSEP-CEP, is Professor and Director of the Aging Muscle and Bone Health Laboratory in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada. The overall objectives of Dr. Candow’s research program are to develop effective lifestyle interventions involving nutrition (primarily creatine monohydrate) and physical activity (resistance training) that are clinically and practically relevant for improving musculoskeletal aging and reducing the risk of falls and fractures. Dr. Candow has published over 120 peer-reviewed journal manuscripts, supervised over 20 MSc and PhD students, and received research funding from the Canadian Institutes of Health Research, Canada Foundation for Innovation, the Saskatchewan Health Research Foundation, the National Institute of Health, and the Nutricia Research Foundation. In addition, Dr. Candow serves on the editorial review boards for the Journal of the International Society of Sports Nutrition, Nutrients, and Frontiers. 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. Darren Candow On⁠ Instagram⁠ X  Previous Episode Mentioned: ⁠Ep. 301 Creatine: The Best Supplement for Better Bones & Brain Health with Darren Candow, PhD, CSEP-CEP⁠

Today, I’m honored to reconnect with Dr. Tommy Wood. He is a neuroscientist, a performance coach, and an elite-level professional nerd. He's also currently an associate professor of pediatrics and neuroscience at the University of Washington. He received his bachelor's in biochemistry from the University of Cambridge, a medical degree from the University of Oxford, and a PhD in physiology and neuroscience from the University of Oslo. In our conversation, we discuss his new book, The Stimulated Mind, and he explains how dementia is a confluence of factors that accumulate over decades, important contributors to dementia, and ways we can help prevent it. We explore the concept of headroom, specific risk factors for neurocognitive decline, brain fog in midlife, the 10-year HRT timing window, and the evidence supporting these concepts. Dr. Tommy shares what we can learn from his work with elite-level athletes, along with some of the biggest misconceptions in the brain health space, and his 3s model of stimulation, sleep, and nutrient supply. He also explains why nutritional status matters for neurocognitive function. Stay tuned for today’s insightful conversation with Dr. Tommy Wood. I loved his new book, The Stimulated Mind, and it will definitely be part of my must-reads for 2026! IN THIS EPISODE, YOU WILL LEARN: Why dementia is not one single disease but a clinical outcome with multiple causes How sleep, oral health, nutritional status, and chronic inflammation may all influence dementia risk What headroom is, and the factors that help maintain it and protect cognitive function How the disease processes leading to dementia often begin decades before symptoms appear What the research suggests about the best time to start hormone therapy for brain health How Formula One drivers and elite athletes tend to prioritize sleep, nutrition, recovery, and focused work over chasing perfection How frequent notifications and interruptions train the brain to expect distraction, making sustained concentration more difficult How both overeating and chronic under-fueling can impair brain health How lifestyle changes can reduce dementia risk, even in people with APOE4 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. Tommy Wood On his website On Instagram The Stimulated Mind Substack

I’m delighted to reconnect with my dear friend Ben Azadi today, in honor of his newly revised book, Keto Flex. Ben is a leading authority on metabolic health, an international Keystone speaker, and the New York Times best-selling author of Metabolic Freedom. In today’s conversation, we discuss why women fail on keto. We examine how women’s menstrual cycles and various life stages influence both the ketogenic diet and intermittent fasting, and the importance of coming out of ketosis and incorporating feast days. We explain what the Randall cycle is, why we need to be finely tuned to it, how to support healthy cortisol regulation, particularly the HPA axis, and tools to determine whether we are balanced within the autonomic nervous system, including heart rate variability, sleep, and whether our glucose and ketones are within range. We also explore the effects of anti-nutrients and elimination diets, and Ben shares his approach for women who feel keto hasn't worked for them, explaining why keto should be viewed as a process rather than a diet. This is, as always, a truly invaluable conversation with my dear friend Ben Azadi. Stay tuned, as we will also be offering giveaways to listeners of Ben's new book, Keto Flex. IN THIS EPISODE, YOU WILL LEARN: Various factors that could influence how women respond to a ketogenic diet How women need to adjust keto and fasting according to their menstrual cycle, perimenopause, and postmenopausal years, rather than continuously following the same approach Why Ben encourages women to have intentional feast days instead of remaining in ketosis indefinitely  What a feast day looks like,  and how it differs from a cheat day Why fasting should be adapted to how well your body tolerates stress Factors that can help to determine whether fasting is working for you Why you should adjust your training intensity and focus more on recovery as you get older How a temporary carnivore elimination diet can help identify foods your body doesn't tolerate Why Ben views keto as a metabolic process rather than a diet, and why he prioritizes lifestyle before medication Bio: Ben Azadi Ben Azadi, FDN-P, is a leading authority on metabolic health, an international keynote speaker, and the New York Times bestselling author of Metabolic Freedom. After facing his own health challenges, Ben transformed his life in 2008—losing 80 pounds and stepping into metabolic freedom. That turning point sparked a global mission: to help 1 billion people break free from physical and mental obesity through education, not medication. With 18+ years in the health and wellness space, Ben is now leading a bold 10-year initiative to naturally reverse type 2 diabetes in 1 million people. Through his work, Ben has reached millions worldwide and personally coached thousands to reclaim their health. His audience includes nearly 3M+ on digital platforms, more than 1M YouTube subscribers with over 100M views, and his top-ranked podcast, The Ben Azadi Show, which has surpassed 100 million downloads. 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 Ben Azadi On his website Pre-order a revised-version copy of Keto Flex and claim your bonuses

I am thrilled to connect with my friend and colleague, Dr. Anthony Youn today.  Dr. Youn is a nationally recognized board-certified plastic surgeon and the author of many best-selling books. He has a massive social media presence and hosts the widely acclaimed podcast The Holistic Plastic Surgery Show. In our conversation today, we dive into Dr. Youn’s new book, Younger for Life, and he offers valuable insights on skin health and overall well-being. We explore the aging process and address oxidative-free radical damage, chronic inflammation, autophagy, and the impact of processed foods. We also get into helpful supplements for skin support, examine the concept of greenwashing, and discuss sunscreen, exfoliation, in-office treatments, breast implant illness, and the power of lifestyle choices. Stay tuned for more! IN THIS EPISODE YOU WILL LEARN: How to avoid aging too quickly through nutrition and lifestyle changes How sugar and seed oils impact skin aging The benefits of collagen supplements for healthier skin  Hormonal changes that affect the metabolism and skin health after menopause The importance of screening the ingredients in skincare products How chemical sunscreens differ from physical sunblocks Using Retinol for anti-aging and skin health Non-invasive fat reduction treatments and their potential risks Dr. Youn discusses breast implant illness What you need to look out for 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 Connect with Dr. Anthony Youn On his ⁠website⁠ ⁠Youn Beauty⁠   ⁠Instagram⁠ ⁠YouTube⁠ ⁠TikTok

I am honored to connect with Dr. Sharon Stills today. She is a graduate of naturopathic medical school with extensive training in European biological medicine, bioidentical hormone replacement, and anti-aging therapies. In our conversation today, we explore terrain-based medicine and strategies to support women in perimenopause and beyond. We talk extensively about gut health, the estroblome, the microbiome, how European biological medicine views these as terrain, disruptive factors, and why they matter for women in midlife. We also examine the influence of the lymphatic system and how castor oil packs support it, bioidentical hormones as a lifelong tool rather than a temporary fix, and why menopause is a sacred second act in women's lives. Dr. Stills is thoughtful, insightful, and grounded, and I know you will enjoy this conversation with her as much as I did recording it. IN THIS EPISODE, YOU WILL LEARN: How European biological medicine emphasizes the extracellular matrix (terrain) rather than focusing only on individual cells or mitochondria How declining hormones during menopause often expose longstanding yet previously hidden aspects of women’s health Dr. Stills shares what she did to prepare herself for menopause in the preceding years  Dr. Stills encourages women to create meaningful challenges or experiences to mark their major life transitions How limiting beliefs about aging can influence how you experience midlife and beyond Factors that could influence the health of your terrain How supplements can play an important role, but work best alongside lifestyle habits, mindfulness, and supporting your body's natural healing processes Why Dr. Stills considers the lymphatic system an overlooked contributor to hormone balance, and some practical ways to support healthy lymphatic flow How simple daily habits often have a greater impact on your health than wellness gadgets The value of bioidentical hormones, and why hormone therapy should be individualized rather than one-size-fits-all Bio: Dr. Sharon Stills Dr. Sharon Stills, a licensed Naturopathic Medical Doctor and graduate of The Sonoran University (2001), has spent over two decades transforming women’s health, with a special focus on guiding women through perimenopause and menopause. Creator of the pioneering RED Hot Sexy Meno(pause) Program and host of the annual Mastering Your Meno(pause) Transition summit, she combines her expertise in European Biological Medicine, pro-aging therapies, and Bio-identical Hormone Replacement to help women rediscover vitality with natural methods. A respected voice in her field, Dr. Stills has lectured internationally at the Paracelsus Academy in Switzerland, contributed to Women’s Health Network, and served on the boards of the Bio-Regulatory Medicine Institute and UCLA’s Archive of Healing. She recently opened the Lasting Wellness Center in Scottsdale, AZ—alongside her son, Dr. Ben Stills—offering advanced diagnostic and therapeutic care for chronic illness and women’s 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. Sharon Stills On her website