Today I am honored to connect with my good friend and multiple-time past guest, Ben Azadi!
Ben was most recently with me on Podcasts #149 and #101. He is a prolific social media star and a fasting and ketogenic dieting expert. He is known as “The Health Detective” because he investigates dysfunction and educates, not medicates, to return the body to normal function. Ben is the founder of Keto Kamp and the popular Keto Kamp podcast.
Today, Ben and I use an Ask Me Anything format and dive into listener questions. We talk about the nuances of macronutrients, fasting, and supplements. We discuss gut health and how changing your diet and intermittent fasting can help the body realign and be better balanced.
We get into troubleshooting with fasting, including insomnia-related issues, and we also discuss the DUTCH test and how it can be beneficial in conjunction with other lab tests.
I love doing AMAs, and I hope you will enjoy listening to my conversation with Ben Azadi.
IN THIS EPISODE YOU WILL LEARN:
Serita asks how to keep her energy up while on a keto diet and fasting.
Mary Julie wants to know what is happening inside her body when her ketones are 1.8, but her glucose is 115, 19 hours into a fast.
How does losing sex hormones when approaching perimenopause and menopause make women less metabolically flexible?
Why is it essential to stay hydrated and get enough good quality sleep every night?
How circadian rhythm impacts our metabolic flexibility.
How breathing exercises can help us get into the parasympathetic state.
Janie would like to know how much protein her body can absorb at once and how much protein she should consume over a 24-hour period.
Suzanne lives a clean lifestyle and wants to know if there is a way to shift the metabolism of estrogen away from the 4OH pathway. (She is referring to the DUTCH test.
A listener asks how to use fasting to help with candida.
Michaela was recently diagnosed with gallstones and has one blocked duct. She read that saturated fat is not good for her condition, so she wants to know what she can eat to stay on keto.
Lena has been doing strict keto with OMAD for three months, but her GGT is very high. She asks if that could be due to fasting.
Why we tend to experience insomnia while doing a ketogenic diet, and how to address chronic insomnia patterns.
Mary Jo wants to know when to take my creatine supplement powder.
Ben and I discuss the supplements we use.
I wouldn't practice OMAD, one meal a day. I wouldn't even do two meals a day with two big meals of fats. I would have three to four, maybe even five meals that are smaller and give your gallbladder, give your liver time to adapt.
-Ben Azadi
Connect with Cynthia Thurlow
Check out Cynthia’s website
Connect with Ben Azadi
Transcript:
Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
Today, I had the honor of connecting with my good friend and past guest multiple times, most recently on Podcast 149 and also 101 my dear friend, Ben Azadi. He is the prolific social media star and both a fasting and ketogenic diet expert. He is known as The Health Detective because he investigates dysfunction and he educates not medicates, to bring the body back to normal function. He is the founder of Keto Kamp, as well as a very popular podcast. And today, we used a different format. We did an Ask Me Anything where Ben and I dove into listener questions. We had so much fun talking about the nuances of macronutrients, fasting, and supplements. As well as the role of gut health, and how changing your diet and intermittent fasting can be instrumental in realigning the body's intrinsic desire to be better balanced. We spoke about troubleshooting with fasting, including insomnia-related issues and we also spoke at great length about one of our favorite tests, the DUTCH. And specifically, to this estrogen metabolism, and how this test can be incredibly beneficial in conjunction with other lab testing for yourself and your loved ones. I hope you will enjoy this conversation as much as I did recording it. I'm loving these AMAs and I know you are too.
Cynthia Thurlow: Welcome back to the podcast.
Ben Azadi: Cynthia, I love that we're doing this today. We're going to have some fun.
Cynthia Thurlow: Absolutely. For listeners, I think many of you probably know this, but Ben and I are genuinely really good close friends inside the podcast and outside and so it's always a pleasure to have our communities come together and foster question and answer session. I was just telling you before we started recording that I think this has really become a favorite thing to do, is to record with people that have been on the podcast multiple times. There's so much synergy, there's so much alignment and I think we're agreeing to agree on this. We'll have to dive into all these amazing questions that people submitted.
Ben Azadi: Some great questions. We reviewed them beforehand. I love that we got these different dynamics with the questions. And, yeah, it's a great day when we could emerge the Everyday Wellness Podcast and the Keto Kamp Podcast all in one session. So, let's dive right in Cynthia.
Cynthia Thurlow: Exactly. So, we're going to start with Serita. She asked how to keep your energy up. I'm on keto and fasting, but still tired after a month of ketosis.
Ben Azadi: Yeah, this could happen. The body is still going through an adaptation period Serita, and for most people that adaptation period is about seven to fourteen days. For others, it could be a little bit longer, it sounds like you're in the latter category. Serita, is actually a student in my academy. So, I would recommend to just keep working on that metabolic flexibility, keep incorporating those healthy fats, those saturated fats, monounsaturated fats, and then eventually pair it with intermittent fasting when your body's ready. As you know Cynthia, the intermittent fasting part would be a great way to give your body some energy, because when you're in a fasted state, the body wants to survive. It's going to raise those counter regulatory hormones. So, you go out there and hunt and kill, but what can you do in the meantime until you get that switch. I would recommend a few things. This is where I would strategically use something like exogenous ketones. In general, I'm not a huge fan of exogenous ketones because people just like to drink them and not actually do the work. But Serita, you're doing the work. So, just supplement with exogenous ketones, like the one from Kenetik or H.V.M.N are two of my go-to could just be a good way to flood the body, the blood, the brain with some ketones, and you might feel better.
There're also some things you can do with MCT oil, which is kind of an exogenous ketone, although it's not. But a C8 caprylic acid is the one that's most researched when it comes to energy production and ketone production. The cool thing about these medium chain fats is that there's no bile required to break it down, no stomach enzymes. It goes right into the mitochondria for energy. I would just caveat this and say go very slow and low with MCT oil. A lot of people hear about the benefits and I'm sure you see this all the time, Cynthia. They will take two tablespoons and then they're running to the bathroom like stomach distress disaster pants as Dave Asprey calls it. So, start with maybe one teaspoon and then if you feel good the next day, two teaspoons and work your way up to one to two tablespoons eventually. The last thing I'll add here is L-carnitine. This could be a great time to add in L-carnitine. The way that I use it is, it's kind of like a mechanism for shuttling some fat to your mitochondria, which also helps with ketone production. Then, of course, looking at the fundamentals, like sleep and stress, and all that good stuff, which I'm sure you'll touch upon in a second. But those are my initial thoughts Serita, your body's adapting, you might want to throw in those supplements to see if it does the trick short term until you fully achieve that metabolic flexibility. But Cynthia, what would you add to this conversation here?
Cynthia Thurlow: Great responses. Ironically, some of the things you talked about, I was like, oh, L-carnitine in particular a definitely favorite supplement. Serita, I would say as you are transitioning to becoming more metabolically flexible, you know for some people it does take longer, sometimes it's four to six weeks or even longer to be able to effectively utilize stored fats as a fuel source. I think about leaning into the lifestyle. Ben's done a really nice job of identifying some things that you could do in terms of supplementation. I would make sure you're getting high quality sleep. I would ensure you're properly hydrated with electrolytes. I feel like so many individuals, when they go lower carb or even ketogenic, they don't realize that electrolyte loss can actually contribute to what we sometimes call keto flu. It's this loss of electrolytes that will actually mimic some of the fatigue, nausea, malaise, just not feeling great. High quality options like LMNT or Redmond's are really nice ways to support your body. There are unflavored electrolytes for when you're in a fasted state and you can use the other ones in your feeding window. I also think about where are you in your menstrual cycle? I don't know your age. The threshold of the average age of menopause is 51. If you're still in perimenopause or peak cycling years, understanding that there are going to be times in your menstrual cycle when it's going to be easier to effectively utilize a low carb or a ketogenic diet and fast.
Understanding from the day you start menstruating up until roughly around ovulation, that's your superpower estrogen predominates and you certainly have more metabolic flexibility, and the ability to fast and go lower carbohydrate, push your workouts, etc., is optimized. And then kind of backing off on the fasting piece and adjusting your carbohydrate intake as you're heading into the luteal phase when progesterone predominates. The other thing that I would think about is if you're having significant fatigue and this is persistent, is to consider touching base with your internist or primary care provider to get some labs drawn, especially in women that are still in their peak fertile years. Iron loss, thyroid issues can all exacerbate these things and really looking at your sex hormones, I think that's always the last recommendation. If you're still having debilitating fatigue is really what else could be contributing to it. Certainly, touching base with your primary care provider if you find that it's persistent. But as Ben said, a lot of times this is this acclimatization process where you are getting your body primed and ready to be able to effectively utilize carbohydrates and fats as a fuel source. That can be a little bumpy and rocky, but I know you've got great support, certainly with Ben's program, and therefore, I think just giving yourself a little bit more time and then revisiting this if this persists with your doctor.
Ben Azadi: Yeah. That's a great addition to the conversation. Let's say Serita, you are doing all of these things. You got the electrolytes up, you're taking L-carnitine, you've experimented with exogenous ketones, your sleep is pretty good, and you're still not feeling well, then I do agree with Cynthia. It's probably a good time to maybe get a full thyroid panel, maybe do something like a DUTCH test and maybe even explore, like, an environmental issue. It could be potentially I'm not saying it is, but we might want to explore this. It might be a mold situation where there's black mold or some sort of mold in your environment, or even more of like a heavy metal toxicity issue. I'm not saying that's what you need to focus on right now, but if you're doing all the things right, and you're still not getting to the point where you feel good, because you
should really feel great with keto and fasting, then you might want to explore those other avenues.
Cynthia Thurlow: That's such a good point and it's interesting because I did a podcast with Dr. Aaron Hartman last year and 25% of the population is more susceptible to mycotoxins and mold and that was something I didn't actually realize. I happen to be one of those people.
Ben Azadi: Yeah.
Cynthia Thurlow: You can get cumulative mold exposure, and for some people they may never really persist with symptoms, but others can. It could be like, over time, cumulatively, that could be a problem. Definitely something to kind of think about in the future if your symptoms persist, but you bring up a great, great addition with the heavy metals and mold or mycotoxins.
Ben Azadi: It's always important to explore that. When you're doing everything right and you're just not feeling well, you got to think environmental toxicity. I know that it takes time and it takes money to do all that, but just focus one thing, check it off, and then get to the next thing. So, start with the low hanging fruit here, the salt, the electrolytes. I don't know where you're at with your menstrual cycle either, but fine tuning that, and then you could explore the other avenues and go upstream if you need to.
Cynthia Thurlow: Absolutely. Mary Dooley submitted a question. What is going on inside my body when my ketones are 1.8, but my glucose is 115, 19 hours into a fast?
Ben Azadi: Yes, Mary, this is a common question I see. So, a couple of things. Number one, your ketones are in a really good range at 1.8 and I know that you're testing blood, so that's going to be your finger prick millimole or so, 1.8 is terrific. It's showing that your body is using fat for fuel. Now, the glucose is a little bit elevated, and my question would be this, is it trending up or is that glucose at 115 and trending back down? Because you said 19 hours into a fast, it's at 115. But I'm curious to know, what was it 14 hours into a fast? 12 hours into it just was the trend going up? Was it staying at 115 or is it going down from a higher level? If you see the trend going up, because what we want to see during a fast is we want to see a gradual increase in ketones, which means your body's burning fat, which is what you want to do and then you want to see a gradual decrease in your blood glucose.
If you're seeing your ketones maybe staying the same or going up, the glucoses are going up too can mean a couple of things. Number one, it could be that you might have a really stressful day. It could be mental stress and glucose is following the cortisol and that might be what's happening there. Number two, you could be going into gluconeogenesis and breaking down some protein maybe you're not as metabolically flexible yet. So, you might want to just decrease the fasting window, and work more on getting more fat adapted and then bring back the fasting window. But I would need more specific numbers so I would recommend doing that test where you test right when you wake up in the morning and then maybe 3 hours into your fast, and then right before you break the fast and see where it's trending and do it three days in a row to get an average.
I wouldn't put too much value and too much emphasis on just one day. There are so many variables as Cynthia teaches us, hormones are fluctuating, different emotional stressors are going on. So, I would do three days in a row, get an average, but track it throughout the fast and see where it's trending. If you do see it continuously trend up the glucose, then you might want to have a smaller fasting window, maybe clean up your stress and your sleep little bit, work a little bit more on fat adaptation and then give it another shot. That would be my recommendation. What about you, Cynthia?
Cynthia Thurlow: Yeah. I totally agree with you. I would tell my own patients this, one metric does not give me the full clinical picture. And so, my first question would be getting a better representation of what your blood sugar is doing over the course of a day. Where are you in your menstrual cycle if you're still menstruating? What other lifestyle variables could have contributed? So, did you go through a day where you had higher carbs and this is afterwards? Were you not as physically active, which we know we really have to think about our muscles as a glucose disposal unit. And so, understanding that that can play a role, physical activity is one of the biggest predictors of insulin sensitivity. Also thinking about stress management, we know when cortisol goes up, blood sugar goes up, insulin goes up as a counter regulatory response. And then the other piece of it is really looking collaboratively what other lifestyle factors could be impacting? Have you had high quality sleep? Are you getting seven to eight hours a night of sleep? What else is going on in your personal history? Are you going through a move, a divorce, other variables that can impact things?
Lastly, I would say that as I say to all women, we start losing insulin sensitivity as we are getting closer to perimenopause and menopause. As we are losing estrogen or estradiol, which is our predominant form of estrogen prior to going through menopause, we become less insulin sensitive. We're also losing muscle mass and so it is not at all uncommon for people to start seeing this loss of insulin sensitivity, which in many ways we'll see this blood sugar variability. But I'm not per se suggesting this is the case. I'm just giving you this kind of full clinical picture of what could be precipitating what's going on. So, I see a lot of women who are doing a lot of really good things, and then they're not realizing that as we're losing some of these sex hormones, it makes us less metabolically flexible.
Just to really be thinking again, to recap, what stage of life are you in? What stage are you in your menstrual cycle if you're still getting a menstrual cycle? Thinking about even a continuous glucose monitor, which would give you really a good snapshot if that's within your budget, if you are insulin resistant, that's generally covered by insurance. I'm really a huge fan of NutriSense. I love their app for interpreting data from a continuous glucose monitor. They use the FreeStyle Libre, which oftentimes you can have prescribed for you by your physician or a nurse practitioner, treating provider if you are indeed insulin resistant or diabetic. Again, as Ben mentioned and I completely agree with one or two measurements, don't give us a full clinical picture, so we definitely would want to see more data. I'm a data nerd. I'd love to see more data to be able to provide additional guidance. But thus far, your ketones look great. I would say your blood sugar could be a couple of different things that are impacting. It doesn't necessarily mean it's something that's negative.
Ben Azadi: Yeah. You touched upon it with the sleep thing. It could just be that. It could be a sleep issue right now because we know, I mean, I recorded an Instagram reel that I'm going to post shortly about this. The study showed that in healthy adult men after just seven days of getting 5 hours of sleep or less, they had blood sugar levels of somebody who is prediabetic and you know 115 or whatever the marker was. What was it? 115. Yeah. That's prediabetic blood markers, so it could be that. It's not really the total amount of sleep, it's the quality. If you're not tracking how much deep and REM you're getting, and you're just saying, but I get 7 hours or 8 hours sleep per night, you might be kind of missing if you're getting the quality sleep. So, that's where like an Oura Ring or a Whoop band or whatever kind of a sleep tracker would give you those totals. I would say and I'm curious to hear your thoughts. I would say, in general, for most people, it's a good idea to get about 90 minutes to 2 hours of deep and about the same thing, 2 hours or so of REM sleep and if you're hitting that, then that should help with those blood sugar numbers. If you're not, then I would work on that sleep component. Would you say, Cynthia, those are like good numbers to hit for REM.
Cynthia Thurlow: I have a smirk on my face, Ben, because I get asked this question so often. I usually say 90 minutes of both at a minimum and for those watching both have Oura Rings on, and I'm the first person to say I'm not using the beta data. [ Ben laughs] There's this new beta test and I'm like that's messing up my deep and my REM sleep numbers. I'm just going to stay with the old school. But I think it's very, very important to understand what impacts REM and deep sleep and understanding that one really is for the brain, one is for the body. But if you're not getting 90 minutes whether it's a Whoop band or an Oura, really working diligently. For me, I find that a lot of my women need to tap more into the parasympathetic, so more into the rest and repose side. We're so sympathetic dominant, we're go, go, go, go, we're those big taskmasters and so for me connection with nature in the morning is very helpful for this.
I have a PEMF mat, which Mindy actually recommended and I completely love it. And everyone I talk to, I'm like, it's one of my favorite things I do every day to honor my body. You don't necessarily have to have a PEMF map, but finding things that slow you down are going to be very, very helpful for helping your body get into that parasympathetic, so that you're going to get high quality sleep. One other thing that I find really can impact my sleep is hydration. I was just back from a trip and it was amazing to see. I can tell when I'm well hydrated because my HRV is better and my sleep scores are better. So, hydration is something that's pretty benign that we don't even think about. I just wanted to kind of add that into the sleep piece. If you have those metrics, if you can look at those metrics, they keep me honest. They really, really do. I think they do for a lot of us.
Ben Azadi: Yeah, they do. Also like a data nerd like you Cynthia, so I like looking at that. It inspires me to want to improve those. It's like a game that I play with myself. There's one thing to put value on those numbers, but there's also another thing to actually put value on your intuition and how you feel. So, I don't want to let my Oura Ring tell me how I should feel today, but I also use it as a gauge and it's a pretty good gauge. I like the Oura Ring, so I love that you mentioned the parasympathetic nervous system because that is so important, not just for women, but for men. People out there in this day and age, we're just so sympathetic dominant. That PEMF mat is a great idea. I have two of them myself from HigherDOSE. That who you have them from too?
Cynthia Thurlow: I do. The embarrassing thing is that my entire family now uses it. So, when I get on it, my dogs get on it with me.
Ben Azadi: Yes.
Cynthia Thurlow: I found my husband asleep on it one night and he was like, "This is fantastic." So, he gets on it every day. He does jujitsu sometimes in the evening, showers, comes home and then he takes a nap in the corner. It's kind of funny. [Ben, laughs]
Ben Azadi: I love it. Yeah. Same thing in my household every morning it's part of my morning routine. First Natassia does it and she does meditation while she lays on it. And the cats love it, so they are actually there on the mat before she comes in here waiting for her to turn it on with the red light. And then I do it. I have my dog lay on it throughout the day as well. Now, that does cost money, but you could get similar benefits by grounding outside, just walking barefoot on grass or dirt. But I also love that you brought up the circadian rhythm part of this with the glucose. That's very important, we don't want to negate what Cynthia said there is undervalue what Cynthia said there because morning sunshine and just syncing your circadian rhythm is going to help with pretty much every area of health, especially the blood glucose. I know that what we don't recommend is eating too close to bed. Having about at least three to 4 hours of fasting. Something that's interesting, I'm reading a book from Dr. Satchin Panda, not The Circadian Code, but a more recent one called The Circadian Diabetes Code, which he's making the case, and he's making a pretty good case that most of these insulin-resistant diabetes cases are a result of a mismatch in their circadian rhythm. There's a study in the book that was fascinating. It was done on mice, but mice have this what is it called, suprachiasmatic nucleus, it's an internal clock in our brain. Mice have it, humans have it. In the study, they found that mice were in the habit in the labs of sleeping during the day, eating at night and following their natural circadian pattern, they had pretty good glucose levels. The only thing they changed in the study is they actually removed the, I always have trouble saying that word, suprachiasmatic nucleus from their brain. I know it sounds awful, but they survive and it distorted them. So, their internal clock distorted them where they were eating during the day and they developed diabetes as a result and that's essentially what's happening to us. We are having mismatches like us removing this part of our brain. We want to get back to our natural circadian rhythm and morning sunlight is a fantastic way to do that.
Cynthia Thurlow: It's really interesting. I haven't read his newest book, but I'm super familiar with his research and I think it just provides further validation that we are designed to eat when it's light outside, not eat before bedtime. It's aligned with the way that we've thrived over thousands and thousands of years. But it's only since the advent of light, and the processed food industry that all of a sudden people are doing exactly the opposite and in many ways to the detriment of our metabolic health.
Ben Azadi: That's so true. Especially, when you think about all these artificial lights that are everywhere and it serves the purpose. Like, thank God, we could light ourselves up in an indoor environment, but we want to do our best to get outside. Even I know what you're thinking, those listening and watching, but Ben, you live in Miami, you got sun all the time. [Cynthia, laughs] That is true but even on an overcast day you could still get the benefits. Just take off your sunglasses and just get that morning sunshine. But you all not eat at least 3 hours before bed. Just doing that alone will make a big difference with your circadian rhythm.
Cynthia Thurlow: Absolutely. It's interesting because I was just 5 hours ahead so I was in London last week and one of the things that I was trying was different strategies going over and coming back to be able to address jet lag. So, I'm planning on doing an IG Live later today to actually talk about it. If not, it'll be over the weekend. But I think for so many people it's understanding that our body takes in so much information with these light and dark cues and how it impacts metabolic flexibility and insulin. It's so, so important. I love that you brought up Satchin's new book. I need to actually grab that.
Ben Azadi: Yeah, it's really good. I'm loving him, about halfway through. Have you interviewed him yet?
Cynthia Thurlow: I have not.
Ben Azadi: Yeah, me neither.
Cynthia Thurlow: [crosstalk] mental radar.
Ben Azadi: Yeah, me too. When I'm done with the book, I'm going to reach out. Yeah, his work is fantastic. Real quick back to the HRV piece. The Oura Ring gives you that heart rate variability score, which is great to get your baseline and work on building that up. The drawbacks though of Oura Ring is that it doesn't give your HRV throughout the day. They can't because they use light technology, and if you're moving, it's hard to capture HRV, but when you're sleeping, you're put so it doesn't give you a good score overnight. I don't know if you knew this, Cynthia, but there's a company out there called Hanu Health and they created a continuous heart rate variability monitor. I'm actually wearing one right now.
Cynthia Thurlow: I need to hear more about this, Ben.
Ben Azadi: Yeah. It's like a heart rate strap and on my phone, I could see exactly what my HRV is throughout the day, and it gives you different scores. That's pretty cool to gauge how your nervous system is. One of the things that I've learned with that app and I interviewed the gentleman who owns it, Dr. Jay T. Wiles, is that you could significantly get into parasympathetic with some simple breathing exercise, like, in a minute. I interviewed him yesterday and we did a 60-second breathing session and I raised my HRV to133% in a minute by just breathing in. It was like breathing in for about 5 seconds and then exhaling slowly for about 4 seconds for a minute. That might actually help with glucose numbers. Just getting into that parasympathetic state and just breathing through your nostrils and get out of the habit of mouth breathing.
Cynthia Thurlow: That's really interesting. A lot of that is stimulating the vagus nerve and that's always my cheat. Ben and I obviously do a lot of public speaking and sometimes I get excited before I'm doing a lot of public speaking. And so, my way of slowing my heart rate down and getting myself out of that fight or flight mode is to do rhythmic breathing. But I love that, I'll have to connect with you separately because I may be interested interviewing this individual as well. It sounds very exciting.
Ben Azadi: I think you'll love it. Yeah.
Cynthia Thurlow: Absolutely. Okay. Janie has asked. I'm always trying to get more protein within my fasting window. I try to have two protein-rich meals a day in an effort to reach the 100 grams per day goal, more on a really good day. My question is, how much protein can my body absorb at one time? I keep reading that the body can only absorb 30 grams of protein in any four-hour period or is it more important to have a certain amount of protein in a 24-hour period? Thank you.
Ben Azadi: Yeah, it's a great question. Cynthia, one of your close friends is Dr. Gabrielle Lyon, so I'll let you take the question first, and then I'll just add to whatever you share because I know you've done a lot of research on this topic. So, what is your answer?
Cynthia Thurlow: Yeah, absolutely. It's interesting. So, Janie, Gabrielle is indeed a good friend and I have had many conversations with her about this. It's the amount of protein over a 24 hours period of time. I think many years ago, there was some faulty recommendations that the protein bolus your body could handle at any one time was 30 grams, we know that's not the case. It's over a 24-hour period of time, so don't let that be a concern. I aim for no less than 50 to 60 grams per meal. I'm always aiming for-
Ben Azadi: Oh, wow!
Cynthia Thurlow: -100, 120, so I get some pretty large protein boluses and I'm not the least bit concerned because I can maintain muscle mass and build from where I am with that consumption. Ben, what would you say, what have been your experience?
Ben Azadi: Yeah, that's interesting. I didn't know you were doing 50 to 60 grams each meal. I like that. I agree that 30 grams is bogus, there's no truth to that. It's really over the 24-hour period. If you do consume excess protein, if you have healthy kidneys, you got to just filter it out. If you have a history of kidney disease, then you might want to take caution and of course, none of this is medical advice. But I know Gabrielle Lyon is a big fan of having enough protein at whatever that time that first meal is and whatever time that last meal. I think like her minimum recommendation is 40 grams. If you're at least doing that, let's say you're having two meals at noon and at 6:00 PM, if you're at least getting 40 grams of animal-based protein on each of those meals, you're probably going to be getting enough protein. Of course, if you could increase that, especially if you're strength training or over the age of, like, 60, that'll be even better.
Cynthia Thurlow: Yeah, absolutely. This is definitely an area of great interest, I think, to both of us, because so many of the people that we work with are north of 40, and so we know sarcopenia or muscle loss with aging is a real thing and we want to work against that. One of the ways we do that, other than strength training, is eating enough animal-based protein.
Ben Azadi: Suzanne says, this is not a keto question, so if it isn't relevant, don't ask it, but we will ask it. "I was wondering if there is anything you have found to help shift the metabolism of estrogen away from the 4-OH pathway." I have tried two different liver cleanses and live an extremely clean lifestyle, nothing seems to be changing it. Thank you.
Cynthia Thurlow: It's a great question. And for anyone that's listening that has zero familiarity with what Suzanne is referring to. She's referring to a test called the DUTCH, where you can incorporate dried urine and/or saliva, looking at many different variables. But she's specifically speaking to estrogen metabolism in the body and there are three key areas of estrogen metabolism that are looked at in this particular test. 2-OH, 4-OH, 16-OH. And rather than go down a massive rabbit hole of explaining in great detail what each of them demonstrate. We want the bulk of our estrogen to go down this beneficial 2-OH pathway and you want to think about the 16-OH it's kind of in the middle, not good nor bad, but 4-OH is obviously the one we get most concerned about. This is the one that has the potential. I'm going to emphasize potential to bind to and damage our DNA. So, I start really thinking about environmental exposure, I start thinking about the plastics in our environment, I start to think a great deal about things in our food, sourcing from clean areas.
I know that Suzanne mentioned that she eats a pretty clean diet, but really understanding that it's our cumulative exposure over time and then also personal care products. And this is why as much as it's a total bummer, they have to think so diligently about parabens and phthalates and all these estrogen-mimicking chemicals. I start to really think going down that additional rabbit hole and considering that you may need to clean up more in your diet. I do think there is some degree of genetic susceptibility. This in particular is the 4-OH when I've seen them really high. I do think it's a combination of genetic susceptibility, meaning you could have the genetics that are primed to make you more susceptible. I do think it's also a combination of personal care products, environment and food, and then just really realizing that you have to keep those detoxification pathways healthy and optimized. It may be that you do need to do purification programs with products that are going to support the liver, really leaning into foods that are going to support the liver, and then getting retested and obviously working with someone that can help support you in that process. Ben, are you doing DUTCH interpretation in your programs?
Ben Azadi: Yeah, we do. That's exactly what we look at, those 3 pathways and we see that a lot, actually, with the 4 pathways being a little bit high. So, your advice is spot on. I always talk about those environmental toxins, so get out of the habit of drinking water out of a plastic bottle as much as possible, go glass, think about the Tupperware, the cooking supplies, like the pans, everything in the household, and even like, your detergents and soaps and everything in the household. Just start chipping away and getting and replacing it with healthier alternatives. The good news is that there are healthy alternatives out there. You just have to kind of do some research to figure out which ones they are