Today, we have AMA number 10.
In this session, I answer many of your questions regarding the supplements I travel with and those I recommend. I dive into the benefits of Vitamin B12 and adaptogenic herbs, looking at ways to support low cortisol and PMS and various supplements that support sleep, brain fog, joint pain, and aching muscles.
My team and I love receiving your questions and offering all the support you require. Please continue submitting your questions, and consider joining the supportive community on my free and gimmick-free Facebook group, where I answer questions several times each week.
Stay tuned for more!
IN THIS EPISODE YOU WILL LEARN:
My favorite supplements to use when traveling
How to get back on track after overindulging
The supplements I recommend for improving brain health and cognition
The importance of fresh fruits and vegetables
Which supplements are best for teenagers?
What I recommend for removing toxins from the body
The best supplements to use during perimenopause
Some natural ways to support low cortisol levels
How to support PMS naturally
Supplements for supporting menopause symptoms, hormone balance, inflammation, sleep, and brain fog
The benefits of HRT for joint pain and muscle cramps in postmenopausal women
“Creatine is my number one non-negotiable for traveling with because I almost always traverse time zones.”
-Cynthia Thurlow
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Submit your questions to support@cynthiathurlow.com
Transcript:
Cynthia Thurlow: [00:00:02] 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.
[00:00:29] Hey, this is AMA #9 with many of your pressing questions surrounding how I travel with supplements, questions about specific supplementation, key things that I think are worth consuming, vitamin B12, adaptogenic herbs, low cortisol, PMS, supplements to support sleep, brain fog, joint pains, muscle aches and more. This is AMA #9. Remember, for submission of questions it is support@cynthiathurlow.com. My team and I love supporting you. We love getting your questions. There's also a free Facebook group, no gimmicks in the group. It's a very supportive community. I answer questions several days a week. That is Intermittent Fasting Lifestyle/Cynthia Thurlow. That's another great place to be connected.
[00:01:23] Okay, I'm back with AMA #9, diving into supplement questions, PMS, etc. We're going to see how many I get through. Whatever I don't get through, I will address on the next AMA.
[00:01:34] First question is from Cathy, “What supplements do I prioritize while traveling? It seems impossible to bring them all. So, what are your non-negotiables?” This is my honest answer. Number one is creatine, because almost always I'm traversing time zones, whether I'm going east or west. Mitopure, that is a foundational supplement for me. I don't ever miss it. I would say magnesium. I take chelated magnesium during the day, I take magnesium L-threonate at night. And then beyond that, I would say that depending on how much stress I'm experiencing, like if I'm going to an event and I'm speaking, I'm probably going to add in some adaptogenic herbs.
[00:02:16] And me personally, it just depends on how I'm feeling. If I feel wired and excited, I might do Ashwagandha. If I feel like I need more sleep support, I may add in something like seriphos, which is technically not an adaptogen, but has a very effective way of lowering cortisol. I also like rhodiola as an example of something that's adaptogenic that I can take at night or even Relora or which is magnolia bark. Those are great questions. I would say that the other things that I'm pretty consistent about taking, I always bring electrolytes. I do a combination of BEAM and LMNT. And because of my dysautonomia, the LMNT aspect is non-negotiable. I absolutely need the electrolytes, especially if I'm doing a lot of flying. But I would just say hydration and making sure that I'm prioritizing protein. Those are usually the things I always consistently bring, and I just try to keep it simplified because to me it gets very stressful if I have to preplan a lot of supplements to take. And I think for listeners as well, certainly what I'm hearing from you all, you feel the same way. So, I just try to keep it really curtailed to the things that are most important. And then, of course, melatonin and HRT. I don't ever forget those.
[00:03:34] Next is Laura, “Detox after vacation with foods or supplements.” Here's my prevailing thought about detox. You know, when people go on vacation and maybe they've gone off the rails, maybe you've drank too much, maybe you've eaten too much sugar, maybe you just haven't focused on protein. You just don't feel good. You come home, you're bloated. I think more about getting back on track. So, the things that are most helpful getting back on track, hydration, eating lots of green leafy vegetables, ensuring you're getting electrolytes, making sure you're getting enough sleep. Getting back to protein centric meals, eating less processed food. If you went on a Sugar Bender and I know a lot of people do, I like to enjoy eating dessert on vacation myself. But I think when I come back and I'm feeling like I've overdone it, I just focus back on the basics, getting back to exercise, sweating, infrared sauna, even if the sweating involved is not in the sauna, maybe it's just general exercise, but I don't beat myself up.
[00:04:32] I think that for most of us, if we eat healthy 80% of the time, when you go on vacation, you shouldn't have to do a lot to get back on track. I don't drink alcohol anymore. I've never had a problem with it, but I used to sometimes recommend when people were trying to recover from hangovers that they consider things like glutathione and NAC binders, things like chlorella or charcoal can beneficial. I don't drink alcohol anymore, so that's never an issue. But if someone that's listening does consume alcohol and maybe you feel like you've overdone it again, go back to basics. Don't beat yourself up. Give yourself grace. Move forward. I think that's the most important thing. I think unfortunately, we have conditioned people to feel like they have to self-flagellate, that they have to beat themselves up if they have overindulged. It happens to all of us.
[00:05:22] I think I was very transparent the beginning part of the year that I overdid it with sugar around the holidays. I don't typically do that and I didn't feel good. I said to my husband, “It is so evident to me that my body is reminding me why I don't consume a lot of baked goods.” Like, I jokingly talk about how a gluten-free cookie or a gluten-free brownie is like kryptonite. So, I just don't keep those things in my house. And so, getting back to the original question, if there are kryptonite-like foods in your house, get rid of them, donate them, throw them in the garbage. I'm not at all opposed to just throwing things in the trash, but if you think someone else can benefit from it, maybe donate it or give it to a friend or hand it off to a loved one.
[00:06:02] Next question is from Leah. This is a long one. Hi Cynthia, “Absolutely love your podcast. I found you about a year ago and have been a faithful listener ever since.” Thank you, Leah. “I had a question regarding supplementation and if there is a potential to overcompensate with everything that our bodies are deficient in, minerals, amino acids, collagen, magnesium, I become more aware of what our bodies lack as far as proper nutrition and absorption. I'm a healthy 29-year-old female who strength trains five days a week with two 15-minutes HIIT sessions per week and walk at least 30 minutes every day. I try my best to follow a whole foods diet and aim for at least 30 g of protein at every meal.” First and foremost, Leah, you are doing an amazing job. I want you to take the opportunity just to acknowledge how disciplined and conscientious you are. I'm sure listeners would agree with me when I say that.
[00:06:49] Leah goes on to say “I supplement with LMNT for electrolytes, I try to stay on top of my water intake and aim for 8 hours of sleep. I currently take Kion Aminos and creatine, Promix whey isolate protein, Armor Up, Symbiotics colostrum, magnesium L-threonate, and your inositol. I also wanted to start incorporating other supplements such as DHEA, alpha-GPC, DAKE, which is the fat-soluble vitamins or B minerals. Is this overkill for my age, would you recommend cutting anything out or perhaps adding additional? I'm curious to hear your opinion. I know most people would say to consult a healthcare professional, but I have rather lost faith in western medicine. Thank you for your help and all that you do.”
[00:07:27] Okay. I love how conscientious you are and these are great questions. I would say I'll just go through the things you asked me about DHEA. Unless you are showing low DHEA on lab work, as a 29-year-old female, I would not proactively supplement with DHEA, so that's number one. Alpha-GPC I think is great. It's great for brain health and cognition. For me, when I'm home, I do take alpha-GPC and I generally try to take it every day, but if I'm traveling, I may not. That might not be part of my supplement stack. I do think it can beneficial and maybe you just take that as needed. If you have a day where you're just tired, maybe it's you're in the luteal phase of your cycle and you're just kind of dragging, not having as much energy. That might be an opportunity to take that. When we're looking at fat soluble vitamins, same thing. Is your vitamin D levels low? Have you tested your vitamin A levels? I find most people that live north of Atlanta at some point during the year do benefit from supplementation for vitamin D. Again, if your levels are subtherapeutic, typically if they're under 60, I think they do need some degree of supplementation. I take vitamin D most months out of the year and that's just because I don't synthesize enough on my own. And then B minerals I think are great. But I think if you're already doing all those other things, I wouldn't keep adding maybe, you do a cycle of-- you mentioned you're taking colostrum. Colostrum is great. I don't think necessarily we have to take colostrum every day. Maybe you just cycle some things in and out. Maybe you do them for a couple months, take a break, go back to them.
[00:08:56] I think that most people can get supplement fatigue. And I think a lot of people also have budgets and you can't take everything forever. So, if something is very effective and you feel like it's really beneficial, continue. And if not, take a break and just see how you feel. I think that would probably be my best answer. Certainly, as a 29-year-old, you're doing far more than I ever knew or did at that stage of life, I was in graduate school and I was probably doing the opposite of everything I needed to be doing. So, bravo to you for taking such good care of your health and I hope that helps.
[00:09:27] Kate asked, “I know you have teen boys, so I'd love to know your recommendations for multivitamins for teens.” Okay, my teens do not like taking a lot of supplements. I'll just preface that. On occasion, they will take supplements like as an example, my older son is working off of having been on antibiotics in December, appropriately dosed and so he has been on colostrum and he has been taking some gut healing protocols that I've been working on with him. I think that it's helpful. Even as teenagers, my younger son takes vitamin D. He uses myo-inositol, helps him with sleep. He will occasionally take melatonin, always with supervision. As a general rule, for my kids. I don't per se recommend a multivitamin. I just really hope that they are consuming plenty of fresh fruits and vegetables in addition to protein. My kids eat a lot of protein. That's never the concern.
[00:10:19] But I think that if anyone that's listening has teenagers or young adults, you know this, you can only do so much like my kids are receptive to a point and then they don't want to be dosed with a bunch of supplements. So older son is taking the colostrum and I think Armor makes a wonderful product. Equip also makes a nice product. He is on some gut healing protocol which I'm happy to review on another episode if people are interested in what we're doing for that to heal his gut post antibiotics. And then again, my younger son takes myo-inositol, vitamin D. His vitamin D was low and so we supplemented with that. My older son's vitamin D was okay. He plays a lot of sports outside year-round and so his vitamin D levels were okay. So, I think it's always in the context of what does your child need? And then beyond that, having a conversation with your pediatrician to see what their recommendations are.
[00:11:05] A traditional allopathic trained pediatrician is probably not going to recommend a lot of supplements. I think if you can get your kids to take a greens powder if they don’t like vegetables. And some kids don’t. You know, the joke was I think you had to introduce your child to something 20 or 30 times before they liked it sometimes because their tastebuds are not as evolved and they can be-- things that are, can be bitter, can be really magnified. I do have friends that give their kids greens powders. And I think that's another nice option, but it has to be in conjunction with what your kid is willing to do. And for me, I pick my battles, and this is not something I want to battle them over. It's like if they're receptive to a point, then we work with it, see if there are any deficiencies and supplement from there.
[00:11:47] Trisha asked, “I'm focusing on a detox and reading that vitamin B12 supports detox. Do I get enough for my diet, or how do I know when I need a supplement and when I can get enough from my diet? Okay, so test your B12 levels. This is a standard allopathic screening. Most allopathic people will talk about that they think 200 or higher is fine. I like 400 or higher, so 400 pg/mL. So you're looking for a value ahead of 400. I think that's helpful. We know that B12 can be impacted by alcohol. It can be impacted by low stomach acid. By age 50, I think I read that we have about a 40% reduction in B12. So many people do need to have it checked, and many people do need to supplement. But before you supplement, find out if you're indeed low, that would be my best recommendation.
[00:12:35] Tammy asked, “I've heard about taking a supplement that is a binder for toxins. Do you have any information on this?” So, binders can be used for different things. When I'm doing antimicrobial protocol, like if I'm addressing Candida or we're working on H. pylori or any of these opportunistic infections, I will add in a binder to help with getting rid of biofilms in the body. And biofilms are kind of like plaque on your teeth. You want to get rid of them so that you can get rid of the opportunistic bacteria, virus, etc. Having said that, some people will take binders when they're traveling. Sometimes people will take binders if they're sick. I think that it's always in the context of what does your body need? And this is where I think working with a practitioner to determine if this is appropriate for you. I don't want to dodge the question. I just think that not everyone needs to take binders all the time, and you have to take them away from other medications and supplements because they will do exactly that. They will bind to whatever else you are taking. So, if you take thyroid medicine, don't take a binder at the same time, it's going to bind to your medication. Kind of think of it as a catcher's mitt. It's going to bind to whatever's there. Examples of binders are things like chlorella, apple pectin, charcoal are all examples, and bentonite clay and there's certainly products I like to use, but always in the conjunction with testing, figuring out what's going on with someone. So, this is a really great question. If you're working with a functional integrative medicine provider, might be a great question for them.
[00:13:56] Wilma said, “Thoughts on rhodiola for perimenopause and weight loss?” So, this is one of these adaptogenic herbs that I mentioned earlier that I really like. Rhodiola is very calming to the autonomic nervous system, can help buffer cortisol. I haven't read any reports that it per se is going to work directly on weight loss. But if someone's cortisol levels are high and you can get their cortisol levels better balanced or lowered, the potentiality exists that it may help fuel weight loss. I have had maybe one patient in 10 years that rhodiola did the opposite. It was stimulating. So, if you're going to start rhodiola, I would recommend trying it in the morning to make sure it is not stimulating.
[00:14:37] Anna said, the DUTCH showed-- So, the DUTCH is a dried urine and saliva test. “The DUTCH showed I was low cortisol throughout the day. I have friends talking about the supplement Adren-All by orthomolecular. Are you familiar with the product and what it makes it support the adrenals? So many supplements I'm leery to purchase.” So the first thing I would say is, whoever interpreted your DUTCH would be the person I would ask the question of, because you are not my patient and therefore I'm not providing medical advice, I'm going to talk about some high level things that I think about when someone has low cortisol. So always lifestyle first, sleep quality, stress management, the right types of exercise, making sure you are connecting to nature, sleep is paramount. I talk about how sleep is foundational to our health. A lot of women just don't sleep and they don't think it's a big deal. And maybe we get away with that in our 20s and 30s, and then when we're in perimenopause and menopause, all your symptoms get magnified.
[00:15:32] So working on sleep, thinking about social connection, so talking to your loved ones, talking to friends, those are really important because we know that oxytocin, which is one of these very beneficial hormones for bonding and connection, nature, yoga, breath work, meditation, eating the right food. So, making sure you're having a nutrient dense whole food diet and enough protein. So, 30 to 40 g of protein, the right types of carbohydrates. I'm not anti-carb, but the bread, the pasta, the rice, that should not be the main stand of carbohydrates that we're eating, especially in perimenopause and menopause, where we become a little less insulin sensitive and the quantity of carbohydrates can be problematic. You want to give estimations of how much carbohydrate in a meal no more than 30, especially if you are not insulin sensitive and limiting or eliminating ultra-processed foods.
[00:16:24] What are ultra-processed foods? Foods that are made in a factory, in a bag, a can, things that have very lengthy ingredient lists where you can't pronounce, let alone spell some of the ingredients. Thinking about getting sunlight in the morning, so supporting our circadian rhythm. So, a lot of women, you get up in the morning, they're tired, they go immediately from, they wake up out of bed, they jump in the shower, they get in a car, they go right to work. Taking 5, 10, 15 minutes in the morning to get some sunlight on your retinas can help support our circadian rhythms. And then I'm thinking about adaptogens and in some instances glandular products can be very beneficial. Whether it's from a cow or a pig, this is part of their adrenal gland and it's processed properly. I think about biotics as a good example. They have a high-quality product that I sometimes will use Cytozyme-AD short term, it's not forever, but it can be bolster help support people while they're working through the lifestyle piece. I think that whoever ordered your DUTCH test is the person most appropriate to direct these questions to. But those are things I think about from a high-level perspective about low cortisol.
[00:17:30] Brenda asked, “I have terrible PMS now. What can I do to naturally support myself? My GYN suggested I go on oral contraceptives.” Okay, so let's talk about some lifestyle, we'll talk about some supplements. Number one, reducing caffeine and alcohol. We know that these can actually antagonize B vitamins in the body. And we know a loss or low B vitamins can drive a lot of those PMS-related symptoms. I think a great deal about blood sugar regulation. “What's your diet like? Are you eating enough protein?” We know that in and of itself, sugar cravings can be a sign of a serotonin deficiency. Serotonin is this very important neurotransmitter and we know that eating carbohydrates can increase tryptophan, which can lead to more serotonin being produced in the body. But I think that thinking about it from the perspective of like what does my body need is going to be very important. Certainly, checking labs, so looking at your sex hormones, certainly estradiol and progesterone, also CRP to see if there's a lot of inflammation.
[00:18:28] Looking at your magnesium levels, looking at your B vitamin levels, because in many instances them being low in and of themselves can drive and exacerbate symptoms. I think about exercise being really beneficial for PMS. I think about adding B vitamins, magnesium, especially because vitamin B6 is a co-factor for more than 100 enzymatic reactions in the body. And it also helps with increasing the availability of magnesium. I think about omega-3 fatty acids, so not per se that everyone has to supplement, but getting high quality anti-inflammatory healthy fats from fatty fish can be helpful. Also thinking about other trace minerals like zinc, manganese, and calcium. And it's interesting, I was reading in Dr. Pam Smith's book that women with PMS may have a defect in the conversion of linoleic acid to gamma linoleic acid and things like evening primrose oil, which contains preformed gamma linoleic acid and double-blind studies have been shown that it improves symptoms of PMS in doses of 4 to 6 g a day.
[00:19:34] Other show studies did not show this, but something worth discussing with your GYN or your internist. And then I think a lot about botanicals. I've had really good success with botanicals. So, I think about Vitex or chasteberry. And it's interesting, this botanical acts like a diuretic. It binds opiate receptors, it stimulates follicular stimulating hormone, it also decreases luteinizing hormone and raises progesterone. So, for a lot of people that have bad PMS, it can be a sign of low progesterone. Not in everyone. In some people, the low progesterone is not the issue. It's actually their estrogen is not properly balanced. And it's interesting, in the study of 1500 women in Germany treated with Vitex revealed that 33% had complete resolution of symptoms and 57% reported signs of improvement with chasteberry or Vitex. So, something to consider. Definitely discuss it with your GYN. Hopefully they're familiarized with chasteberry. I found it to be really helpful. I've had a lot of women with like, endometriosis, which can have a tremendous emotional component to it. Something worth considering.
[00:20:37] Kim asks, “What are some supplements that help with sleep?” Check out AMA #8, where I addressed a lot of this. So, when I think about sleep, I think about sleep hygiene. So go back to that episode. But in terms of things that I think are helpful for sleep supplement wise, I think about magnesium L-threonate, which we know crosses the blood-brain barrier. I think about my myo-inositol. I think that's been one of the biggest things for sleep. Just depending on what you need. Some people need a little bit of L-theanine or GABA. Some people need those adaptogenic herbs to quiet their autonomic nervous system. And then just thinking about HRT. If you're not on HRT and that's appropriate for you, have the conversation, do not suffer. I talked to so many women that suffer needlessly in perimenopause and menopause not realizing that HRT is going to be a key improvement factor in sleep quality, both falling asleep and staying asleep.
[00:21:27] Caitlin asked, “My most frustrating symptom of menopause is the brain fog. It got better when I started using inositol, but I wonder what other supplements I can try. Is magnesium L-threonate better than a regular magnesium supplement GABA. As an aside, my B12 was really low, so I started monthly injections for consistency as remembering daily pills can be a challenge, even with a phone alarm.” Okay, so I think about like brain fog and your menopause, first and foremost like that sleep hygiene piece can be very helpful, because not getting good quality sleep can fuel those brain health issues and feeling brain fog. So, avoiding alcohol, if you're insulin resistant, obviously fixing that, doing things to support the autonomic nervous system, the HPA axis, hypothalamus-pituitary axis, exercising very helpful, considering HRT, this is where estradiol, which is the prominent form of estrogen our bodies make prior to menopause, you know it regulates inflammation, it supports a healthy circadian rhythm. So, we talk about that cortisol distribution throughout the day, boost serotonin.
[00:22:30] So for many, many people, they keep supplementing with all these other products, and what they really need is HRT. We know that in menopause we see a 25% reduction in brain energy. So not everyone in perimenopause and menopause feels that brain fog, but those that do it is substantial and significant. Go back to the podcast that I did with Dr. Lisa Mosconi. I mean, she's a brain health researcher, and she talks a lot about this in her book. So, I think that those are things that I think about. I also think about Dr. Lara Briden and talks a lot about taurine. It's an amino acid it can be very calming to the brain and neurogenesis. So, lots of things to consider. But I would say, sleep hygiene, brain health hygiene. So, the things I've already mentioned, adding an HRT, if that's not already been on, and if you are a couple years into menopause and your brain has been starved of estrogen for a period of time, it may not get fixed immediately. It may be that you have three to six months where you start feeling like your brain is-- that fog is lifting and you're feeling more cognitively intact, but no one needs to suffer. And Caitlin, please, please, please make sure you are connected with your GYN or your functional medicine provider, your internist, so that you can work on this specifically.
[00:23:42] Adrienne said, “How do I address joint pain, muscle cramps and overall aches? I'm postmenopausal and I've tried electrolytes, potassium, magnesium. I strength train three to four days per week, have trouble with cardio now due to aches, but was an avid indoor rower.” So, I don't know if Adrienne is on HRT, but the first thing I hear over and over again is hormone replacement therapy because estradiol in and of itself has these potent anti-inflammatory effects. And I see a lot of women with joint pain, poor recovery, and a lot of it has to do with that loss of sex hormone. So, if you're not currently taking HRT, that's something you definitely want to think about. I also think a great deal, and looking at the research, women with fibromyalgia, which is this kind of diffuse achiness that can be related to underlying gut health issues. So, things like leaky gut, SIBO, which is small intestinal bacterial overgrowth. So, getting tested to determine what else is going on, it is never just one thing. It is oftentimes many things. We use the term multifactorial, but definitely something to consider that there might be something else going on. So just make sure gut health wise, you're doing really well and then managing stress. But again, HRT is probably going to be an important component, because it sounds like you want an endeavor to be more physically active. But that achiness and pain, and if it's diffuse and not localized to one joint, it could very well be that it is the changes in sex hormones that are driving some of that. And it can be a combination of estrogen, testosterone, and progesterone that can be helpful.
[00:25:12] Emily asked, “What are some things to do to help with muscle aches after a workout? I noticed that recovery is taking longer the older I get.” So go back to the question I just answered for Adrienne. But I think about, like if you're having trouble with recovery, are you over exercising. You probably need more rest days. And really, a lot of the trainers that I talk to say that they don't like to work the same muscle. They like to give themselves like 48 hours in between. So, people that are lifting five days a week and they're just not ever giving themselves sufficient rest days that can set that up. So, I think about yoga. So yin yoga, yoga nidra, anti-inflammatory diets and maybe taking out inflammatory foods, Whole30, which is designed to be for 30 days, not forever. But the most inflammatory foods, gluten, grains, dairy, sugar, alcohol, soy, take those out of your diet for a month and see if your achiness improves. I have women in programs that we literally have just eliminated a couple foods and suddenly they feel a thousand percent better.
[00:26:13] I think about sleep quality. I also think about hormone replacement therapy. I will be interviewing an orthopedic surgeon who’s a female and specifically works with menopausal women on the podcast. I think that will beneficial, really speaking to some of the things that she sees in clinical practice as an orthopedic surgeon in women in menopause. And I think this really speaks to the sex hormone changes that are occurring and the fact that in many instances these can be ameliorated just by changing some lifestyle pieces and also adding in some HRT.
[00:26:50] Keep those questions coming, support@cynthiathurlow.com. Don't forget to check out my free Facebook group. Intermittent Fasting Lifestyle/Cynthia Thurlow. We probably will be changing the name at some point in the near future. I will let everyone know. I personally answer questions three days a week. My team is in there in case there are any technical problems. But it really is a great place, a very supportive place. There are men and women in that group, but keep those questions coming. It allows me to continue doing these AMAs, which I love doing.
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