Lifestyle Factors and Final Recommendations

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 This is the start of a new Thursday series called The Midlife Minute that is really designed to address listeners' questions in a little bit longer length of time and or deeper dive into topics Ideally, we're gonna keep these podcasts under twenty minutes. occasionally we make over to thirty But I'm trying to reinforce some key concepts and ensure that I'm addressing listeners' questions in a way that's really helpful. So the questions that I will be addressing, topics are gonna be items that I'm being asked over and over and over again. I hope you enjoy this series. Please share with your friends. And as you know, you can always send your questions to support at Cynthia Thurlo. com. I appreciate each and every listener latest midlight minute and when I polled you all on Instagram and Facebook, You all were very interested in hearing How have I been able to maintain muscle the past six months despite the stress and the crush of a book launch a lot of travel I did over a hundred podcasts. I mean, I was not able to lift as consistently as I normally do. and I just had a bio impedance reading done. and I can confirm with both my personal trainer and my personal Integrative medicine physician, Dr. Aaron Hartman that I have maintained my muscle. Now this is not to suggest. I want to be really clear. I'm not suggesting that you work out less I'm just saying that this is where targeted supplementation, I think can be incredibly influential. in maintaining muscle mass and Had I not had the objective ability to assess my fat free mass to muscle mass This might just be completely just arbitrary observation. So I have objective evidence, which is exciting and Today I'm going to unpack this. Now, the Midlife Mute is designed to be short So if you are hearing this and it's on a regular podcast on Wednesday or Saturday, you understand that I realized this was such a long discussion that I wanted to put it in a regular podcast slot. So if you're wondering or you're at all confused I'm going to see how long it takes me to get through all this information. I have six pages of notes because I pulled up research for every single thing I'm going to talk about And there's over twenty four references that be part of the show notes I'm not even sure the show notes can actually accommodate all twenty four, but we'll make sure we have it accessible for those that are like me. that like to look at the research. Okaykay So As I've said to everyone, we know that maintaining muscle mass is critically important, not just for insulin sensitivity, not just for improved body composition, but also to ensure we do not develop frailty And I was reflecting on The media's portrayal of specific celebrities and how their arms looked to't They don't look toned, they look emaciated. So what we don't want is to lose muscle mass. and then make ourselves at risk for frailty. We think about the tiny little grandma who trips and falls, breaks her hip and never goes home again. We don't want that. So maintaining muscle mass and strength training and eating enough protein and targeted supplementation are all things that are going to be important. And I would also layer in there the conversation around hormone replacement therapy, all super important gettingetting enough sleep, managing your stress, etceter. Okay So We know that maintaining muscle mass in a life is a nonnegotiable, and we know that we lose anywhere from three percent to eight percent of our muscle mass each decade. So If you have a good amount of muscle mass in your twenties and thirties, heading into your forties, you might be on the lower end. If you're someone that never was consistent with strength training or never even thought about it, or if you grew up in my generation where the focus was on thin is in, honest to God, we were just Praised for being skinny And even I think I've told this story before in the podcast, but if I haven't, here you go When I went to college, my father sat me down and said to me Do you want me to get you a gym membership? And I said I think I'll be fine And he said, I just don't want you to gain the freshman fifteen. So I had direct messaging from my parents to not gain weight in college. I just remember thinking My parents weren't talking to me about avoiding premarital sex or sexually transmitted, they were called sexually transmitted diseases back in the nineties. Now they're called STIs, sexually transmitted infections or pregnancy. They were concerned about weight gain, and they were concerned about the freshman fifteen. So the messaging when I was growing up was thin as end. Lots of people from my generation, myself included, probably were not developing muscle the way that we should have been because we didn't know any better. But younger generations now know better, right? Like I talk to my adult sons about this all the time and they both enjoy lifting weight and they're both very athletic. But for anyone listening, part of my generation, you get it. Those submissive and also direct messages were very much communicated. I'm not suggesting they were right. I'm just suggesting that there was this expectation that was set for us. And we know that In menopause, muscle loss without intervention can lead to one to two percent per year of muscle loss compounding over decades into a significant functional decline. So When I say that I do not want anyone listening to ever have to be come frail It's because I know what happens. I know where the seequeli is. I know what it's like seeing patients in a hospital. that are not that much older than me, they can't get off a bedside toilet. We call it the bedside commode or they end up having to go to long term care, or they end up in rehab for weeks and weeks and weeks because they are not strong enough to be able to go home and be independent We don't want that to be an issue. So I'm looking at paperwork to keep myself organized And another thing to consider is that Muscle produces something called myokines and these are signaling molecules that regulate inflammation, brain health, bone density, immune function, and cardiovascular disease resilience. And another thing to consider is that grip strength is a proxy for overall strength. So those little You know, hand gadgets, sometometimes you see them at the gym. I was doing occupational therapy for several months after I trip fell did not have a broken bone, but hadad some like ligamentous issues with my right arm which were preventing me from being able to lift as heavy as I had been. And so grips during the muscle mass are the strongest predictors of longevity in the research literature Bull stop stronger than many traditional biomarkers. And we know the loss of muscle accelerates fat gain, changes in body composition, insulin resistance, bone loss, cognitive decline, and all cause mortality risk. So this is not just the physicality piece. This is really about longevity And the other thing to consider is that It's not impossible to create muscle in perimenopause and menopause. It's just a little harder We know estrogen decline reduces anabolic sensitivity, so we become more catabolic And we need more stimulus to actually achieve the same response as younger women. This is why I talk so much about making sure you're getting at least thirty to forty. Preferably fifty grams of protein and a meal. We need a larger stimulus, a larger intake of protein to trigger muscle protein synthesis. We also know that it' more easily injured. It takes longer to recover. And this is where targeted supplementation and certainly for myself, I'll be totally transparent and tell you that twenty twenty four into twenty twenty five was the hardest M stressful in my adult life. I've talked openly about this. This is no surprise, both personally, professionally More stress than any one person should have to shoulder in a short span of time Parental deaths Husband getting sick pitching a book all the same time, pitching a book, writing a book, babying the book, and then birthing the book. suuper stressful. So let's talk about creatine monohydrate. There's no surprises. I have my own product for full transparency. You want to make sure that you use Creatine. Monohydrate, that is what is best tested. and the highest quality creatine is either Kria pure or Kria Vitalis. They come from the same company. Transparently, even I am stuck with dealing the semantics of the supplement industry and the German company that I have to license this product through. is now forcing everyone in the health and wellness industry to buy Creaitalis, which is a little fluffier. So for anyone who has my product When the new formulation comes out with this Cria vitalis, not Kriaure Again, highest quality creatine monohydrate on the market it may seem a little fluffier, may be less dense. And so I just interject that to say creaitalis is equivalent to coreaure. It's just slightly altered, I think, structurally. But we know that creatine is a naturally occurring compound synthesized in the body from amino acids, things like argginine glycine and methanine primarily in the liver and the kidneys, and it's stored in skeletal muscle as phosphoccreatine and serves as a primary rapid energy source for high intensity muscular movement And we know that most dietary creatine comes from red meat and fish. So if you are vegan or vegetarian Your creatine stores are probably suboptimal, if not poor. And women eat less of these foods tend to have lower baseline levels. So If you are someone that does need enough protein predominantly getting your protein from Plant based sources, vegan, et cetera, you probably it's even more of an indication. But I find most women benefit from creatine intake consistently. It's not just on the days that you lift And so we know that Creatine is important for anabolic signaling. Creatine increases the hydration of muscle cells. You know that word monohydrate which is cellular swelling from creatine loading, is a direct anabolic signal that stimulates muscle protein synthesis, pathways, including MTOR activation. So sometimes women will say Oh my gosh, I gained two pounds. I gained pounds andince I started creatine. It's probably the hydration of your muscle. In fact, when I consume creatine, I have to be really conscientious about my hydration throughout the day because I find I have to hydrate more than I do when I'm not taking creatine And research shows creatine's supplementation increases the satellite cell response to resistance exercise And the satellite cells are the muscle stem cells responsible for repair and growth after training stress. So for me I am typically getting creatine either in my water or around training or I'm getting it in a protein shake. And we could talk more about that, but I've been really consistent with two solid meals, sometimes three and definitely having a third protein bol list usually with way protein, couple days a week plus or minus bone broth protein, and then I take essential aminos, and we'll talk more about essential aminos. We know that creatine up regulates insulin like growth factor Within muscle tissue, which is a primary driver of muscle protein synthesis independent of training load We know that Creatine also helps preserve muscle during reduced training. So a la, that is me, creatine reduces myostatin expression. So this means that myostatin is the protein that limits muscle growth and is up regulated when training stimulus drops That has been made for the past six months withithout question. Like I think my trainer and I were looking at how many times I've worked with her per month And in some instances, it was once a week, like at best, that was as much as I could do. with the volume of travel I was doing And we know by suppressing myostone, creatine essentially tells the muscle to hold what it has even when the training signal is quieter. This is important because so many of you have said you're stressed, thinking about not training as hard maybe You're in the midst of a move. Maybe your loved one is sick, maybe you're going through a divorce and just life has forced you to get simple. and by that I mean you have to do less. You know, sometometimes less is actually more And This is why I think creatine pairs so well with another supplement that I will talk about called forordotropin because they have the same pathway and complementary mechanisms. I will make sure at the end of this podcast, I run through these products that I'm sitting next to me. I'll actually if you're watching the video, I'll actually show them The other thing about creatine that I think many people don't know, if you take a large enough dose, it can actually be brain protective. And we know creatine is one of the brain's primary energy substrates, and the brain uses phosphocreatine for the same rapid ATP regeneration that muscle does. So ATP is this energy currency, and emerging research shows that creatine improves working memory reduces mental fatigue and may have neuroprotective effects. That to me is one of many reasons why I think creatine monohydrate is a foundational supplement for everyone My adult children take it. They started taking it as teenagers. My husband takes it, I take it I try to talk about it all the time because I'm like, it's a supplement that does a lot of things. that is not just one use And the neuroprotective effects are particularly relevant, obviously for women in perimenopause and menopause experiencing cognitive changes. We know those cognitive changes can be related to a lot of things. It could just be you're not getting enough sleep, you're chronically stressed. Your amygdala is overriding your prefrontal cortex, so you can't think as clearly. It could be changes in estrogen. It could be where you are in your cycle It could be actually gut health derived because the bulk of the information via the vagus nerve is going from the gut to the brain. So I would say if your gut is inflamed, the brain will be inflamed There's lots and lots of reasons why you can have changes in cognition. And a twenty twenty one review and Nutrients found that creatine supplementation may be even more effective for females given hormone related changes to creatine kinetics across the lifespan So yes, there's solid research talking about where in a menstrual cycle women might need more creatine. There's research talking about how post menopausal women For argument' sake we'll say menopaususeal women, post menopausal women actually benefit from this additional support And it's interesting With the question around post menopause and women, estrogen has a creatine sparing effect in premenopausal women. Females exhibit seventycent to eighty percent lower endogenous creatine stores compared to men, making dietary and supplemental creatine even more critical Do not buy into the BS that women don't need creatine. I would make the argument that I really think it's an essential supplement for everyone. After menopause, we know that endogenous creatine synthesis and muscle creatine stores decline further. Again, at a little bit of a disadvantage of menopause, but it is not something that we cannot overcome. And there are several randomized controled trials specifically in menopausal women Creatine supplementation combined with resistance training produces significantly greater improvements in lean mass, strength, and functional performance than resistance training alone And the research overwhelmingly supports creatine monohydrate as the gold standard form, not creatine HDL nor buffered creatine, nor any proprietary form. Mohydrate is what the thousands of studies have used You don't necessarily need a loading dose. I've talked to Dct. Darren Canda about this multiple times. I think that if you want to cross the blood brain barrier, you're obviously going to need more than five grams. You're probably going to need eight to ten And sometometimes when I'm traveling and I have jet lag, I will actually take twenty grams. I will actually front load. I will start taking higher doses heading into that trip and then continue it while I'm traveling and then you, back down when I get home I think that You take the creat teine when you can remember to take it. I don't think that there's like an optimal time. I just know that I do a better job taking it around training. plus or minus when I take a protein shake. Something I hear constantly from women in our community and something I understand personally is this. Nothing about your effort has changed and yet our bodies are responding differently Your midsection feels different. Y blood sugar is much less stable and your cravings may have shifted And let's be honest, your energy probably isn't what it used to be As a nurse practitioner with over twenty five years of experience, I want to be completely transparent with you about why Estrogen is one of the body's master regulators of metabolic health. It influences how we store fat, how our tissues respond to blood sugar changes, and how efficiently our metabolism functions at the cellular level Eestrogen shifts during perimenopause and menopause, the same lifestyle choices, diet, exercise, sleep, genuinely do not produce the same results. This isn't a failure of effort. It's a precise biological transition, and most solutions don't address the root causes That's why I want to tell you about m acute hormonal metabolic control It's formulated with S equL, which is a highly bioavailable phytoestrogen that supports healthy estrogen signaling. We know that eighty percent of women cannot produce S equL naturally because it requires specific gut bacteria most of us just do not have This formula bypasses this entirely. It also includes a particular bacterial strain B breve, which works via the gut hormone access to support estrogen pathways and help ease occasional bloating and chromium to support healthy blood sugar balance This is a targeted cellular support for the transition we are all in and it's designed specifically for women in perimenopausea menopause and built around what actually is effective Go to wWW dot mitoQ d. com slash Cynthia and get ten percent off your first order Again, that's mIT oq dot com slash Cynthia to get ten percent off your first order Okay, we're gonna to move on from creatine. So when I was talking about creatine, this is my team plus. we're going to move on to essential aminos. And essential aminos are different than branch chain amino acids. And this is important because I think Probably two or three years ago, I did a YouTube video talking about like five supplements that aren't worth buying. and I think BCAAs are one of them Just to give you some context, there are twenty amino acids in the body. eleven are non essential, meaning the body can make them on our own. and then there are nine that are essential Pistodine, isoucine, Lucine Lysine, methionine, phenyolalanine three hundredineine, tryptophant and valine, and they must come from our diet. So the nine essential aminos become very important And branch chain amino acids are only three of the nine. Lucine, isolucine, and vealing. And this is why I feel like branch in amino acids are not worth your time. Like if you're going to take essential aminos and I've been taking them regularly, probablybably the past eight or nine months. I've been really good about it because every time I I interview a specific expert talking about this and you start thinking about the degree of anabolic resistance we are dealing with in midlife, you're like, oh, well, this is such an easy way to buffer my Potein intake or the way to think about it is protein breaks down into amino acid. So it's a very bioavailable form So we know that muscle protein synthesis requires all nine, so the essential aminos And branched amino acids can stimulate the initiation of muscle protein synthesis through Lucine's activation of MR. but Without the remaining essential amino acids, the process stalls like starting a car with no fuel on the tank. So a really good analogy to say this is why it makes sense to be thoughtful about essential aminos, Multiple headhead studies show that EAAs produce significantly greater muscle protein synthesis responses than equivalent doses of BCAAs And this becomes particularly important during periods of reduced training A la, the last six months, when the anabolic stimulus from exercise is lower So we want to think about mechanistically how these work. and for those that are like interested, This is how EAAs preserve muscle. So number one, We know leucine is the primary trigger for muscle protein synthesis. It directly activates MTR the master regulator of cellular protein production, And we know that we have to get at least two to three grams of leucine in a serving And most quality essential aminos are designed around this threshold. So if you're getting a good quality product, that should be helpful. I will talk about the product that I personally use. In reduced training states, Lucine driven MOR activation provides a training independent, anabolic signal that helps maintain the rate of muscle protein synthesis, even when mechanical loading is lower That would be me. Okay We know that reducing muscle protein breakdown is important. So EAAs, particularly leucine and lysine suppress a particular pathway They suppress a particular pathway that is primarily involved in breaking down muscle protein. And this is critical during periods of reduced training. I'm just going to keep saying this over and over again. Even if synthesis does not increase dramatically, reducing breakdown produces positive net protein balance. So it's helpful to just kind of reiterate, it's helping to kind of stabilize where you are. We know that EAAs are also connected to gut health. so EAs support the integrity of the gut lining. This is important It's only one cell layer thick. It is so easily breached by stress, by alcohol, by antibiotics, all these things that we think about, chronic stress. And so we know that supporting the integrity of the gut lining, glutamine and other amino acids are primary fuel sources for these intestinal epithelial cells. Remember, one cell layer thick. And in the context of my book, The Menopause Gut, this is a meaningful cross system benefit supporting muscle and gut simultaneously. So again, as I've said over and over again, I like supplements that have multiple effects. To me, there is I don't know one woman I've worked with in the past ten years that does not have some degree of Leaky eye. and the need to support her gut So you know, you can think about dosing anywhere from ten to fifteen grams per serving. You can do it around meals or around training. I just usually take it with my protein shake, especially on the days that I'm not having why protein because I'm still a little dairy sensitive, so I don't push it. Or you, sometimes if I have I'm doing a lot of travel, I may take the essential amminos with me and just buffer a meal. likeike if I have to do a makeshift meal in an airport, like I've got beef jerky, I've salta pistachios or salta macadamia nuts, maybe I have a subpar protein bar just trying to piece together a meal because the airport doesn't have anythingthing that I want to eat Or quite frankly, most airports have crap food and that's not what I want to eat And so it's interesting on non training days EAA supplementation is arguably more important on rest days and reduced training days than on training days. This is when dietary protein alone may be insufficient to maintain protein balance. So just something to think about that you from a perspective, I talked about creatine monohydrate, I talked about essential aminos. Now we're going to talk about maybe something that some of you have not thought about And acknowledging that when I was growing up, my mother, who is fifty percent Italiian, that makes me twenty five percent, my mother fed us liver. This was organ meats were not a thing in the seventies and eighties. Like my brother and I dreaded when my mother would make us liver. She would make us liver. and tell us how good it was for us. and then she would try to cook it with bacon. And of course, my brother and I would generally eat the bacon and not eat the liver. But there are ways to get organ meates and specifically beef liver supplements into your diet without having to have I'm just speaking from personal experience, I don't like the way organ meat tastes. I'm a hypertaster. When I was in undergrad years ago, it was part of a research experiment. And Honest to God, I actually have super sensitive taste buds. so I never liked extremes. I didn't like extreme taste. so you know, I never liked stinky cheese. I I really had to struggle to you know develop a like for drinking black tea and green tea because of the benefits because something that's particularly strong for me just is magnified. So to me, organ meats and for those that love them, I'm like, you do you I don't, but I do like the benefit. So We know that freezes died desiccated beef liver from grass fed cattle whether it's concentrated in a capsule or in a powder form without heat processing is really thinking of it as a multivitamin. That is like nature's multivitamin, liver, you know, really thinking about animal based liver. and ancestrally orgamates were the most prized part of the animal. L this is something my mother would talk about, like spleen and pancreas and Good Lord. I'm like, if you love those things, that's great. I just have never had an affinity for them at all And so I think our ancestors intuitively recognized the intrinsic value and bioavailability because, you know, Ancestrally, we didn't have all these supplements around. People just ate more nutrient dense food by virtue of the fact there was a lot less processed food. And so this is where I think that nutrient profiles cannot be particularly relevant for muscle maintenance. So thinking about bioavailable hem iron We know iron is required for oxygen transport via hemoglobin and myoglobin. And myoglobin is the oxygen storing protein within muscle tissue itself There are a lot of women listening that have shared with me and my team that you have low iron stores or you have low ferritin, which is an iron storage marker. And we know iron deficiency, even subclinical iron deficiency without overt anemia impairs exercise performance, reduces muscular endurance, and Cinge contributes to fatigue that limits training capacity. So if you have a ferritin of twenty, And maybe you aren't overtly anemic. That could explain why you feel like you are really struggling with energy hair loss, etc. Heem iron from beef liver is absorbed at fifteencent to thirty five percent efficiency, compared to two percent to twenty percent for non hem plant iron, making liver one of the most efficient dietary iron sources available And we know in perimenopause I used to refer them affectionately as the crime scene periods, we know that women are at risk for significant iron loss. This is why many women end up having ablations hysterectomies, they're put on oral contraceptives, they might get an IUD in an effort to control the degree of bleeding they're experiencing. And some people are quite anemic and quite miserable. I have several friends, nurse practitioner friends who got hysterectomies when we were in grad school because they were like, I just can't, I'm so anemic, I'm miserable. I can't tolerate the degree of blood loss that I have every month. So just in that context Chem bioavailable iron is a chief constituent of these organ products. Next is vitamin B and B twelve. Beef liver is one of the most concentrated food sources of B twelve on the planet. B twelve is essential for DNA synthesis, red blood cell production, nerve function, and the methylation cycle. As someone who's a poor methylator By virtue of the fact I have a genetic mutation, as I know seventy percent of the population does, I have two copies, not just one So I think a great deal about how methylation impairs muscle cell turnover and repair as well as detoxification patterns. And B twelve deficiencies are very common. And then thinking about it Liver is also one of the most meaningful dietary sources of CoU ten. This is a mitochondrial electron transport chain cofactor essential for ATP production. So again, we go back to why this is so important. muscle tissue is mitochondrial rich, not surprisingly, and energy hungry. and CQ ten supports the mitochondrial density and efficiency that determines a muscle's capacity to sustain work and recover from it. So if you're having poor recovery There's a lot of different reasons why this can happen. And we know that CQ ten levels decline with age. And if you're prescribed to statin, as so many of my patients in cardiology were, this can worsen it. So we know that beef heart contains the highest concentration of any CQ ten of any food. And if mitochondrial support is the primary goal, sometimes a combined liver and heart organ supplement addresses both nutrient density and also that CQ ten content Just real quickly, I'm also thinking about vitamin A as a retinal. Beef liver provides preformed vitamin A is retinol, not beta carotene, which requires conversion Vitamin A directly regulates the mitochondria and muscle stem cells Copper in zinc liver is one of the richest dietary sources of copper and provides meaningful zinc Freeze dered liver supplements also contribute directly to amino acid intakes. Remember I said a lot of these things are overlapping. Liver protein is complete and highly bioavailable. Qality matters enormously. so if we're going to take it and I will talk about the product that I take because it's super high quality. You want to look for one hundred percent grass fed, grass finished, freeze dried liver from a transparent supply chain I've been using ancestral supplements, their grass fed beef liver. In fact, I now have this on Autoship. I've been really happy with this. It has Hormone pesticide and GMO free, absolutely no fillers. I've really, really been happy. And like I said, I think all of these things coming together has contributed to me being able to maintain muscle mass. And so I think for some people just thinking thoughtfully about the fact that You know, for some individuals, it's the recognition that it's multiple things coming together. Like for me, the serving size for this is six capitals a day Does it mean that every single day I'm perfect with it? No. But I always say, eighty, twenty, eighty percent of the time I'm doing a really good job with supplementation and sometimes I might not be. You wantna take you can take it with or without food. Okay Next is a product called forortotropin, which is fertilized egg yolks. So if you have a sensitivity or an allergy to egg, I'm sorry, this won't work for you The brand name is called yoked. And I want to be really transparent and share with you that JJ Virgin is to put this on my radar And for me personally I think it's a total game changer. I actually have one of my dogs on it who is taking a medication that has kind of accelerated his muscle loss He doesn't love it as a dog. He doesn't love it because I just have to put the powder in his food. But for me, I put it in my shake and it's super easy. Yolked is derived from fertilized egg yolk, specifically a concentrated bioactive egg yolk extract that has been carefully processed The act of compound is called forortotropin. And it's a proteol lipid complex found in fertilized egg yolk that has been studied for its effect on myostatin and muscle metabolism. So really solid science. Fertilized egg yolk is one of the most biologically complex substances in nature. It contains everything needed to support rapid cellular differentiation, tissue development and growth which is why it's so beneficial for muscles. This is not providing amino acids the way a protein powder does, it is providing the regulatory signaling environment that influences muscle cell function and repair Again, I did not believe. I've been taking it for a year, but I did not believe when I started. I was kind of like, I'm open to the possibility that I might learn a lot here And so I think this is like, you know, the ninja. you know, you have all these products and then you slip in the ninja. What's interesting and makes it distinct from other supplements is that the active compounds in yolk are not primarily structural proteins They are lipoproteins, phospholipids, growth factors, and peptides that influence signaling pathways And You know, thinking about it from this perspective, there was a twenty nineteen peer reviewed human study published in the Journal of the American College of Nutrition that examined Vortatropin supplementation and found favorable factects on body composition, strength, and power and identified the mechanism of action in a rodent model as involving the up regulation of MTO and a reduction of protein breakdown markers. So, you know, from my perspective This is, you know, super helpful and beneficial from the perspective of I think when we're looking at how these things layer in together, so first thinking thoughtfully about Creatine. So obviously, number one, creatine monohydrate B formulations, Krea pure or Ka Vitalis The German based company that I license from forced everyone in the health and wellness industry to have to start using Criaitalas. If you take my product, you will notice When we get our new packaging, it will say Ca Vitalis It is the same quality, but it is a little bit of differentiation from where we were before Next are essential aminos and actually I really like keons. That's what I've been taking. They have powders too, but I'll be honest with you, I don't like the way the powders taste. I've tried every single powder option I Kon as well as others, I don't like the way they taste. There's just something about it that's unpleasant. So the capsules are easy You know, there's seven. you take seven capsules, You can take them with a couple sips of water Next is the grass fed beef liver And then last is yolked Here are some other benefits of yolked It has myostatin modulation, which is the primary negative regulator of skeletal muscle mass Early research on forordotropin showed that reduced myostatin expression and support for muscle hypertrophy pathways, including MTOR activation And there's also some growth factor signaling fertilized agggo contains insulin like growth factor, epidermal growth factor, and even biologically active peptides that support cell proliferation. And lastly, the nutritional cofactors in egg yolks, beyond the signaling compounds that I've talked about, egg yolk provides fat soluble vitamins, including vitamin D, vitamin K two, and vitamin A in very bioavailable forms And egg yolk is one of the most concentrated dietary sources of choline, which is really important for cognition. I want to be really clear. There's pretty solid research on all of the other products I talked about. The human evidence for forbotropin is promising but limited. I want to be very clear about that The most relevant human study is a single published trial and larger scale replication is needed. But one study in dogs found no significant reduction in serum myostin at the dose is tested highlighting that bioavailability and mechanistic questions are not fully resolved. There's a supplement with a compelling biological rationale early supportive human data and an excellent safety profile. So something I feel safe taking and suggesting The most intellectually honest framing is this The mechanism is real, the target is legitimate. The early data is encouraging, and more research is needed to confirm the magnitude on humans That does not in any way make me feel uncomfortable recommending it. I think for me, it has been instrumental in addition to these other things I've been talking about. Now to kind of round out the conversation I want to talk about how these work synergistically. So This is what I think is most relevant. I think most of you know that I really like to be science grounded and Like I mentioned earlier, I wanted to wait until I had the opportunity to get objective data on myself in terms of body composition. So we know creatine addresses the energy system in the body. It helps keep our muscles fueled for effective training, even a lower volume and suppressing myostatin and maintaining anabolic signaling through both MTO and IGF one. We know essential aminos address the building block supply. So proteins break into essential amino acids They're ensuring the cellular machinery for muscle protein synthesis has all the raw materials it needs while simultaneously reducing protein breakdown, Grass fed beef liver addresses the micronutrient infrastructure. And for anyone that's listening, micronutrient deficiencies are so common. In fact, I now really like to do micronutrient testing on my patients because it sometimes avails itself of little deficiencies that one person might have. for me trace minerals are something that I have to add. I have to be really conscientious about choline, even though I eat eggs So grasshead beef lever addresses iron B twelve, C Q ten and retinol And Yoke addresses the regulatory signaling environment And I think that in many ways, the egg yolk supports muscle cell integrity and the anabolic signaling environment. And the synergy is really what I think matters most. You know fromom my perspective, creatine and yolk both target myostatin, essential aminos and creatine work in concert on the ETR pathway Beef liver provides the micronutrient cofactors And this is all important, right? I think that they all work together to be very effective I want to be clear, however, I don't want the takeway to be don't lift weights because we know that's important. That is so important. That is the most important thing, one of the most important things that you can be doing. I don't want that to be the message. What I want to be is let's work out smarter, not harder So if you can get in the gym two days a week, great If you're doing that concurrently with taking the products that I'm mentioning or even a few of them, I think that that can take your results to another level Training stimulus is still required. I want to make sure that is a big takeaway. Even at reduced volume resistance exercise is the primary signal that tells all muscles to stay, supplements attenuate loss, but do not eliminate the need for strength training Big takeaway. Sleep and recovery are still really important for all of you that are struggling with sleep before you even worry about training volume and taking more supplements like Figure out why your sleep isn't optimal And that's not to suggest we don't all have times when our sleep is not optimal. I can tell you over this p six months, depending on you know what I was thinking about when I went to bed and I've had to work harder at managing stress so that it does not show up in sleep issues Hormone optimization also matters. Like I can honestly tell you that I think for me personally, estrogen is obviously very important. So as prodgeserone, but I think for me personally testosterone, for executive function, for motivation, for muscle building. testosterone is really, really, very vitally important. So if you have a practitioner that's not willing to talk about testosterone, we have an HRT provider guide With people across the United States, we also have many, many guests who are still taking patients. We will do our best to get you connected to someone. And I want you to think about the fact that stress and cortisol are catabolic So if you're chronically stressed, you are in a muscle breakdown mode. So I tell everyone Nabolism is when we're building up and catabolism is when we're breaking it down. and it's meant to be balanced. You know, we're not meant to be perfect But I think for a lot of individuals, they just don't take that stress piece into account and we become much less stress resilient inidlife. I think that's why as estrogen' declining, boundaries come up and like I have completely changed my interaction with some family members, like completely and utterly with no apologies. other than an explanation to say It's not in my best interest to spend time with you. And I understand that we are biologically related boundaries are really important. and I encourage all of you. it doesn't have to be that dramatic but Put those boundaries up because it helps protect your energy And so again, the reason why I wanted to make sure I did this particular podcast for you was to talk about the products that I think have really been helpful and instrumental Creatine monohydrate, either Ca pure or Criaitalis esssential amino acids, not branch chain amino acids, lookingooking thoughtfully at grass fed beef liver and then yolked, which is fortotropin. We will include all of the discounts that I have for each product These are the products that I use. I speak very openly about the things I like, the things I don't like. I don't like essential amino powders. I've tried multiple brands. I think they all taste like garbage No offense But I do like the capsules and they're easy to take. So for me, I take anywhere from five to twenty grams of creatine a day. I do at least one serving of essential aminos. and like if you're taking the kon brand That's seven capsules grass fed beef liver, I'm using the ancestral supplements option and that's six capsules and I don't necessarily take those every day, but I take the most days of the week. and then yoked, I do one container. So this is the littleittle box, they come in put it in a protein shake I don't prefer taking it just in water. That's not my preference. But I hope that you have found this valuable I hope that These kinds of personal shares are helpful for you. I don't like to complicate the regimens. I like to keep things pretty simple. but when something seems to be very effective I'm like the power of the N of one has a tremendous ripple effect. I think there's a lot of garbage that's out there that people take, not knowing that if they you know took their thirty supplements and curtailed it to ten, ten that they really need or five that they really need, it probably would be more efficacious. and then really concentrating on nutrition. I don't ever want anyone to have the message that nutrition isn't important. It is super important. And I would rather that you have two really, really solid meals a day And then maybe you're layering in a protein shake just to build up your protein intake. Maybe you're getting really conscientious about buffering with some essential amino acids. I certainly take them with me when I travel because Almost always if I'm going to the West Coast, I'm not getting in like two solid meals because I'm traveling for most of the day And then I get one good meal and then I'm full. So Be thoughtful. Let me know if you try any of these products, if you like them. My intention and hope is to be fully transparent about what's working well for me and my patients. This is part of a stack protocol that I think is really, really helpful. And a special thank you to my friend and colleague Thank you Virgin for introducing me to Fordotropin If you love this podcast episode, please leave a rating in review, subscribe and tell a friend