0:00
There's this very strong, like, vagus nerve connection between the gut and the brain,
0:03
so we talk about the gut brain access.
0:05
Whether it's alterations in sore bones, like estrogen, testosterone, progesterone,
0:09
or, you know, taking medication like an antibiotic that is going to alter the neurotransmitter,
0:14
so the bulk of our neurotransmitters are produced in the gut.
0:17
A lot of the medications we give, like the SSRI's Paxylchrozac work in the brain
0:22
on those neurotransmitter pathways.
0:24
I think in a lot of different ways, there's many things that come together.
0:27
It will cause someone to develop mood disorders,
0:28
whether it's depression, anxiety, OCD.
0:30
It can be mitigated by a lot of different things.
0:39
Okay, guys, we're here at A4M.
0:40
We got Cynthia Thurlow here today.
0:42
Right before she gets on stage, thanks for stopping in.
0:45
Thanks for having me.
0:46
What are you going to talk about here at A4M this year?
0:48
Gut microbiome and menopause, which there's a complex kind of interplay there that,
0:53
you know, a lot of people were starting to talk more about how important
0:57
they've got microbiomes, especially as we're kind of navigating midlife.
1:01
Yeah, I'm just realizing past few months how important the gut is.
1:04
I feel like growing up, no one even talked about it.
1:07
No, now, and it's, I mean, even in my medical training,
1:09
we didn't talk about the microbiome.
1:11
And now in the last five, 10 years, it's an explosion of information.
1:14
Yeah, it seems like you really need to get that in order because it helps with everything.
1:17
Yeah, I mean, there's a microbiome connection to every organ system.
1:21
And I remind people all the time, I'm like, the lung, the bone, the brain.
1:24
And I mean, every single ovaries, gonads, everything you can imagine.
1:28
Wow, it's all linked to the gut.
1:30
It's all linked to the gut.
1:30
Holy crap. I didn't know that.
1:32
When did you start like really finding out about this?
1:35
Um, I mean, obviously, I've been aware of like the emerging research,
1:38
but I would say the last two or three years on the podcast.
1:40
I just felt like every time I had a researcher or a clinician that was talking about it,
1:44
and I was like, huh, there's all these connections that no one's making together.
1:47
And so when my editor reached out and said,
1:50
you have an idea for a second book and I was like, well,
1:52
and I kind of pitched it and she said, oh, my God, run with it.
1:55
So it was, it was definitely like a game on, you know, topic and very, very timely.
2:00
Yeah, and everyone's guts destroyed these days because of everything.
2:03
Yeah, we can dive into all of it, but yeah,
2:05
Center American Diet, antibiotic stress, all of it,
2:09
And it's affecting our kids too.
2:11
That's what that's going on.
2:12
And that's, it's like, there's that epigenetic signaling.
2:15
So you have like parents who might not be totally healthy,
2:17
who go on to have kids who have like this imprinting of less health.
2:21
And yes, it just does this massive trickle down effect.
2:24
And it's interesting because I look at my kids and their friends
2:27
and the conversations that we're having with other parents.
2:30
And it's like, oh my gosh, you know, we have to be thinking about it more proactively
2:34
because it ultimately ends up picking up and being addressed in other generations.
2:38
What are the biggest things you're seeing impacting the cut health?
2:42
I would say without a doubt, you know,
2:44
inappropriately prescribed antibiotics.
2:46
And I want to be very clear.
2:47
I mean, there's a time and a place for them,
2:49
but I think that antibiotics are used over judiciously.
2:52
And that, you know, one dose of antibiotics can impact the microbiome.
2:56
I think your rate of, with one dose of antibiotics,
2:59
your rate of depression can go up by 25%.
3:02
One round of antibiotics.
3:05
So antibiotics, number one, I would say,
3:09
you know, our toxic food culture.
3:10
I mean, we have a very ultra processed food culture.
3:15
We know that, you know, even when we consume ultra processed foods,
3:18
as an example, we consume 500 to 1,000 additional calories.
3:22
So over time, that really is quite significant.
3:25
I would say the other thing is just chronic stress.
3:27
You know, since the pandemic, I think all of us would make the argument that, you know,
3:31
trying to manage the pandemic and the post-pandemic, what came out of that,
3:35
it jokingly, people say you either became a hunk, a drunk or a chunk.
3:39
And some people have just kind of continued with these kind of maladaptive patterns.
3:43
But chronic stress, whether it's about people being stressed about politics,
3:46
or economics, or tariffs, you know, and that's at a very like, you know,
3:51
upper level and then just, you know, the dynamics that people have in their day-to-day life.
3:54
I think stress plays a huge role.
3:56
And we can unpack what stress actually does to the gut.
3:59
But, you know, chronic stress, cortisol will lead to morally,
4:02
he got leads to more immune system depression.
4:05
You know, if you, you know, I think about like,
4:07
college students around exam times, why do they get sick?
4:09
And it's because their stress levels are high.
4:11
They're probably not eating the way they should.
4:13
They're not sleeping enough and certainly can make you more susceptible
4:17
to opportunistic infections.
4:19
And the other thing is stress is catabolic.
4:20
So it's breaking down muscle and lots of health issues that people aren't thinking of.
4:24
But I would say those are probably the top three.
4:26
And then maybe we loop in toxins like endocrimemic in chemicals and things like that.
4:32
Yeah, I used to always get sick around final season.
4:35
Now when I fly, I get a runny nose.
4:36
I wonder if that's stress related to.
4:38
Yeah, I mean, it could be.
4:39
I mean, it could also be, you know, just the stress of travel.
4:42
Yeah, you know, I think about, you know, you can get like a
4:45
vasomotor rhinitis where you just get a runny nose.
4:48
But I also think that travel can be incredibly stressful.
4:51
So I'll say within the US, yes.
4:54
Because TSA is like up your ass.
4:55
People are screaming at you with your luggage.
4:57
I just traveled overseas and it was like super chill.
5:01
I went to Maldives in Australia.
5:03
No one was yelling at me at the airport.
5:05
Never felt like I was in a rush.
5:06
Yeah, it's a big difference.
5:07
I mean, I think TSA pre-check and global entry help enormously.
5:10
But I would agree with you.
5:12
You know, I live in a smaller city in my state.
5:14
And so I know it's rare that I get direct flights anywhere.
5:18
And I was saying like, you know, if your flight's delayed
5:20
and then you're rushing through an airport,
5:23
Yeah, that's the worst.
5:24
Yeah, it's like travel can be very stressful just for that purpose.
5:27
Why are you just get around, you know, people who are like,
5:29
I sat next to a woman,
5:32
And she was literally like,
5:35
cock-eyed in her chair.
5:36
So like, I was scrunched like this.
5:38
And you know, she was on her phone the entire time.
5:40
And I literally was like, her leg was like, clearly in my feet.
5:45
And I was like, seriously, like just be cognizant
5:47
of where you are in time and space.
5:49
And it wasn't that she couldn't not be in her own seat.
5:51
She just, that's wild.
5:53
A portion of my seat.
5:55
I literally was like, thank God this is a short flight
5:57
because this is obnoxious.
6:00
Our people don't have that just self-awareness.
6:02
Right. Well, it's like just like the same people
6:04
that speak on speaker phone on their plane,
6:06
like on the plane on their phone.
6:07
You're like, seriously?
6:08
Like she's literally on a phone now.
6:10
What? Until the stewardess came up and said,
6:12
you need to get off your phone.
6:14
Miss some AirPods or something.
6:16
Or not even AirPods because those of you
6:17
are my favorite, get the wired ones.
6:20
No, my kids laugh at me because I'm wired for everything.
6:22
Like I'm the person that like plugs into my iPad
6:25
They're like, what are you doing?
6:26
I'm like, I only use wired on the car.
6:28
Yeah. It's actually cheaper too.
6:30
Airpods are expensive.
6:33
And you lose them so easily.
6:34
Yeah. Well, and it's like, I have like a child size ear
6:37
so they don't even fit my ears.
6:39
You're still eating a lot of protein every meal?
6:41
Definitely a lot of protein.
6:43
30 to 50 grams is the goal.
6:45
And a lot of that has to do with the fact
6:47
that we need more protein with aging and not less.
6:49
So when my 18 and 20 year olds
6:51
can you have 10 grams of protein
6:52
and stimulate muscle proteins that this is?
6:54
When you get older, you need more
6:56
because we're more catabolic.
6:57
So we're our bodies readily kind of breaking down muscle.
7:00
Yeah, there's a lot of debate on social media
7:02
with how much protein you need here right now,
7:03
especially with vegans and carnivores.
7:05
And they're saying the vegans are saying
7:07
you actually don't need as much as I guess carnivores eat.
7:10
But yeah, I mean, and I always say like respectfully,
7:14
I think people can be rigidly dogmatic
7:16
about their own nutritional paradigms
7:18
that they fall within.
7:19
I think it's better to be nutrient-dense,
7:21
whole foods, a combination of animal and plant-based protein,
7:25
you know, a good amount of fiber and vegetables and fruit,
7:28
I think are reasonable.
7:29
But I think when you get rigidly dogmatic,
7:31
you sometimes just forget that what works for you
7:34
may not necessarily work for everyone else.
7:36
And so, if someone goes from a standard American diet to vegan,
7:40
They're going to be eating healthier than they were before.
7:41
If someone has an autoimmune condition,
7:43
a lot of gut issues, maybe going carnivore
7:45
is going to be beneficial short-term.
7:47
Yeah, that's something I got to figure out.
7:48
My recent blood work, they said I might have an autoimmune.
7:53
So I got to figure out when it comes to diet,
7:54
what to eat for them.
7:55
Yeah, I mean, usually it's more like nutrient density.
7:58
I mean, it's also like kind of tracking of
8:01
if certain foods provoke symptoms,
8:03
like if you get bloating or digestive issues,
8:06
you know, kind of tracking it to what it might be.
8:08
I have to empty it so far.
8:09
So I think certain grains do that to me, bloating.
8:12
Yeah, are you homozygous?
8:14
That means you have two copies.
8:17
I mean, most of the population has at least one.
8:20
So I always tell people like, it might mean you might need
8:22
a little bit more help with detoxification.
8:24
But I don't know if there's necessarily a clear cut indication
8:27
between a particular SNP and developing autoimmune.
8:31
We know that autoimmune can be related to like leaky gut.
8:35
And so it's like going back to like,
8:37
did you ever dose a band of biotics?
8:38
Like a lot of people get, yeah, get traded for a lime
8:41
and then they end up developing leaky gut.
8:42
And so that's really what it speaks to.
8:44
Is at some point you had a leaky gut.
8:46
I think I ruined my gut when I was on antibiotics for sure,
8:50
but also, what's the one for acne?
8:54
Yeah, yeah, it was on that for seven months.
8:57
They had to test my blood once a month to make sure
8:59
it wasn't like dying basically.
9:01
Yeah, it's pretty toxic.
9:02
Like I know when young women are on it,
9:03
they have them on two forms of birth control.
9:05
Because it's so serratogenic.
9:07
So try to genic means has a potential to cause birth to facts.
9:10
But yeah, those are, that's a pretty serious drug.
9:12
Has there any been any liquid birth control issues?
9:18
Doesn't surprise me.
9:19
I mean, so you're giving yourself essentially an endocrine
9:22
mimicking chemical and can alter the terrain
9:26
of the microbiome quite significantly.
9:28
And let me be really clear,
9:29
like these aren't necessarily things that we knew before.
9:32
Certainly my generation and myself
9:34
were on oral contraceptives for years.
9:36
But now that we know more about it,
9:38
it's like, you know, contraception is very important.
9:41
I don't want that not to be the message,
9:43
but understanding that certain medications
9:45
can definitely alter that terrain
9:46
and do it so quite significantly.
9:48
Like we know even the research suggests
9:49
that women they're on oral contraceptives
9:52
actually won't pick.
9:53
Like it alters their, their hormones.
9:56
And so they might not attract the partners
9:58
that they would have if they weren't on birth control.
10:00
So you think about like, you know,
10:02
people that maybe when they partner up
10:04
and get married, they're on oral contraceptives
10:06
and then they go off and they're suddenly looking
10:08
at their partner going, huh?
10:09
That's, that must suck.
10:11
Like you think he's the one and then.
10:13
You're like, nope, not the one.
10:15
Hopefully that doesn't happen all that often.
10:17
If 50% of, 50% of marriage is ended divorced,
10:20
I mean, the potentiality certainly exists.
10:22
Definitely contribute.
10:23
Yeah, I remember girls in my high school in college
10:26
were pumped when they got the prescription
10:28
to get to get on those, you know, they were excited.
10:30
Well, it's, I mean, I understand.
10:31
Like people want reliable birth control.
10:33
And if that's, you know, your ability
10:36
to be able to utilize that and feel comfortable
10:39
and confident that you're not going to get pregnant,
10:41
I think that's important.
10:42
Well, they said it helped with periods too, right?
10:45
Well, I mean, yes, it does.
10:46
I mean, you're giving a synthetic hormone.
10:48
So they keep the hormones really low.
10:50
So essentially, you're kept in this very low estrogen state.
10:53
But for a lot of women,
10:54
they've got really heavy, painful periods
10:56
or they're just not getting cycles regularly.
10:58
And it doesn't per se fix it.
11:00
It just kind of mass it.
11:01
And, you know, I think for a lot of young women,
11:04
it's like they've got too many things they want to do.
11:06
Yeah, I'm hearing a lot
11:08
because my wife has female friends.
11:10
They're talking about their cycles being messed up.
11:11
Like sometimes they'll skip a whole month.
11:15
Yeah, I mean, some of that can be stressed.
11:16
I mean, there's a lot of things that can contribute.
11:18
You know, a lot of women are, you know,
11:20
overly restrictive of food.
11:22
There's a lot of things that can contribute
11:24
while they can get alterations and cycles.
11:26
But I think that's why, you know,
11:28
the pill has been so popular
11:30
because it can be used for, like, acne.
11:32
You know, some people take certain, certain birth control,
11:35
oral contraceptives that help with their skin.
11:38
Makes you wonder with all these prescriptions,
11:40
whether it's the pill or anxiety medication,
11:42
like what's happening to the gut
11:43
if we're just taking this stuff every day, you know?
11:46
Well, and there's this very strong,
11:47
like vagus nerve connection between the gut and the brain.
11:50
So we talk about the gut brain access.
11:52
And so whether it's alterations in sex hormones,
11:55
like estrogen testosterone, progesterone,
11:57
or, you know, taking, like, a medication,
11:59
like an antibiotic that is going to alter the neurotransmitter.
12:03
So the bulk of our neurotransmitters are produced in the gut.
12:06
And yet, a lot of the medications we give,
12:08
like the SSRI's Paxil Prozac work in the brain
12:11
on those neurotransmitter pathways.
12:13
So I think in a lot of different ways,
12:15
there's many things that come together
12:17
that will develop, that will cause someone to develop mood disorders,
12:20
whether it's depression, anxiety, OCD,
12:22
can be mitigated by a lot of different things.
12:24
Wow. Yeah, one out of two kids now
12:27
getting diagnosed with a mental health disorder.
12:29
I think it's so many different things coming together,
12:32
but I think the food has a lot to do with that.
12:34
And then, you know, rampant overuse of antibiotics,
12:36
as I know I mentioned, but that's a huge problem,
12:38
like antibiotics are there when we need them,
12:40
but we shouldn't be using them in discriminant lane.
12:43
I was thinking about it.
12:44
I was probably on them at least once a year
12:46
from, like, elementary school to college.
12:49
Probably like ear infection.
12:50
Ear infection, throat infection, anything.
12:54
Like, even during COVID, I got prescribed them right now.
12:59
And then, I mean, it's become,
13:00
it's become something that's normalized.
13:02
Like, if people go to urgent care,
13:03
they expect to get an antibiotic.
13:05
People go to the ER, they expect to get an antibiotic.
13:08
And a lot of the symptoms that people get,
13:10
like, I'm coming off of having like a cold virus.
13:13
And I was saying, you know, back when I was seeing patients
13:15
all the time, if they got a cold,
13:16
they expected a prescription to take away their symptoms.
13:20
And I would say more often than not,
13:21
it's a virus that's driving your symptoms.
13:22
If it lasts a week, it gets worse,
13:24
then, you know, maybe we need to think of that antibiotics.
13:26
But yeah, there's a lot of consumer demand for antibiotics.
13:31
Because they want to shorten the duration of symptoms.
13:33
Just for a cold, though, cold you got to just like.
13:36
Right. You got to ride it out.
13:37
Ride it out, take vitamin C, vitamin D.
13:42
Well, how would you want antibiotics for a cold
13:43
that blows my mind?
13:45
Now, I mean, it's interesting.
13:46
Like my youngest son is taking just finishing up antibiotics
13:51
And because he has confirmed Lyme,
13:53
it's like three months of antibiotics.
13:54
Well, we said he said the other day to me,
13:56
he's like, I feel like I'm developing anxiety.
13:58
And it's not normal for him.
14:00
And so we got on the phone with his provider.
14:03
And, you know, there's a particular IV that they give
14:06
that helps like replenish the cells.
14:08
And so we're fortunate that he goes to a functional med,
14:10
integrated med physician.
14:12
But I was like, this is exactly that statistic.
14:15
I just said you 25% of people one round of antibiotics
14:17
are going to develop depression.
14:20
And so you just start to think like domino effect
14:22
of what are the long term effects?
14:24
Three months is crazy.
14:26
And that's kind of standard for, you know, for Lyme.
14:29
So they're retesting him.
14:30
And hopefully he's been eradicated.
14:33
Wow. Did you have Lyme too?
14:35
Many years ago, I got it.
14:36
And ironically enough, this was so long ago
14:39
that I actually was seeing my college, like, college physician.
14:44
And I had a bug bite.
14:46
And she looked at me and she was like,
14:47
I don't even want to talk about what you came in for.
14:49
I want to talk about that.
14:50
And so I took a month of doxing.
14:52
And it probably saved my life.
14:53
Because back then there just wasn't as much awareness
14:56
But I had the classic folds I rash.
14:58
Most people don't get that.
15:00
So I wonder if it was passed down to him or?
15:04
They for sure knew that I cleared it.
15:06
But my son was, you know, like most kids in the woods
15:09
with his friends playing and stuff.
15:11
And probably got bit by a deer tick and didn't know it.
15:14
So we're in Demick, like where we live
15:16
and the country is in Demick for Lyme.
15:18
But they're seeing it now in other parts of the country.
15:20
That's just like everywhere now.
15:22
That in Lone Star Tick, which is a whole other.
15:25
It's a, it's a, it's another tick.
15:28
But a certain percentage of people
15:30
that are bit by Lone Star Tick will actually go on
15:33
to develop a mammalian meat allergy.
15:37
And so I had some patients, actually the University of Virginia,
15:40
which was close to where I practiced.
15:42
They started making that connection between the meat allergy
15:45
and getting bit by this, this tick.
15:47
And so it's not every person.
15:48
But I had some patients who couldn't have surgery
15:50
because they couldn't actually get heparin
15:52
and other drugs that are derived from pork
15:55
because they were worried.
15:56
They have an anaphylactic reaction.
15:58
So imagine if you suddenly couldn't eat mammals.
16:01
And that's permanent.
16:02
They haven't figured out how to fix them.
16:04
Well, I mean, in the cases that I've seen,
16:06
yes, because it's been so significant.
16:07
But I'm sure there are people researching it right now
16:10
to figure out ways to address it.
16:14
Yeah, I would be devastated.
16:15
I'd be, yeah, how do you get protein at that point?
16:17
Yeah, I'm like, I don't like chicken or fish enough.
16:19
I already have an estrogen issue.
16:21
I can't eat tofu and soy.
16:24
How did you find that out?
16:26
Yeah, my estrogen levels were high.
16:27
Oh, yeah, you definitely want to stay away from it.
16:30
Yeah, I don't know what was going on with that
16:32
because I don't even eat soy.
16:33
But could have been just estrogen mimicking chemicals.
16:36
So like water thinking about other things in your
16:39
plastic too, right?
16:40
Yeah, plastic, water.
16:44
Is the book you mentioned earlier?
16:46
Are you still working on it?
16:47
No, the menopause guide will be out on April 26th.
16:51
Actually, sorry, April 28th, 2026.
16:54
So it'll be out in four and a half months.
16:55
It's hard to believe.
16:57
Wow, books take a long time, huh?
16:59
Yeah, because the manuscript was officially submitted in March.
17:02
But then there's like this back-and-force process
17:05
over time about like the copy editors go through and
17:08
like everything you think is perfect.
17:10
And then they're like, no, this grammar of this one sentence
17:13
and this word is redundant.
17:14
And so the experts commit, the word experts come in
17:17
and have revisions.
17:18
And then you're waiting for book endorsements
17:20
from people that, you know, you respect and value.
17:22
And so things all kind of fall into place.
17:25
But the book is effectively done.
17:26
It's just, it'll be.
17:28
Yeah, final stages.
17:29
Well, thanks for your time, Cynthia.
17:30
I hope you've got your talk.
17:31
Anything else you want to end off with here?
17:33
No, thanks for having me.
17:34
We'll link your socials in the video.
17:38
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17:40
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17:41
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