272: How Women Can Maximize the Benefits of Fasting
with Dr. Felice Gersh
Today I am joined by Dr. Felice Gersh, who is an award-winning board certified OB/GYN, as well as fellowship trained and board certified in integrative medicine. She is here today to talk about fasting, particularly in women’s health. There are amazing ways nature works to preserve female fertility and optimize success through the application of fasting, and you’ll hear how and why.
More about Dr. Felice Gersh:
Felice L. Gersh, M.D.'s educational background includes an undergraduate degree in history from Princeton University, a medical degree from the University of Southern California School of Medicine, OB/GYN specialty training at the prestigious Kaiser Hospital in Los Angeles, and graduation from the 2-year Fellowship in Integrative Medicine at the University of Arizona School of Medicine. Additionally, she has been trained extensively in functional and environmental medicine.
Dr. Gersh has a strong focus on the role of women’s unique rhythms and hormones, emphasizing the impact on female health of nutrition, timed eating, intermittent fasting, fitness, stress management, emotions, sleep, electromagnetic energy, and endocrine disruptors.
Hello, everyone. Welcome to Cellular Healing TV. I’m Ashley Smith. Today, we are joined by Dr. Felice Gersh who is an award-winning, board-certified OB/GYN as well as fellowship trained and board-certified in integrative medicine. She is here today to talk about fasting, particularly in women’s health. Dr. Gersh has a strong focus on the role of women’s unique rhythms and hormones emphasizing the impact on female health of nutrition, timed eating, intermittent fasting, fitness, stress management, emotions, sleep, electromagnetic energy, and endocrine disruptors.
Dr. Pompa and Felice Gersh, welcome to the show. I know this is one of your favorite topics, Dr. Pompa, as well as our audience, one that they love as well. Let’s get started. Welcome to you both.
Yeah, thanks for being here Dr. Felice. I appreciate it. This is one of my favorite topics. Matter of fact, I just got back from Bulletproof conference speaking on this topic. A chapter in my book honestly called, Beyond Fasting.
Look, I get excited about this because when I started the lecture at Bulletproof, I asked the women in the room, how many of you struggle to intermittent fast, struggle on low carb diets, or even longer fasts. Most of the hands went up. I talked about, look, my diet variation principles and why it’s more imperative. Fortunately, I had some women in the room who were doing that and said, look, this was me; now, I’m successfully fasting, etc. and how much it’s changed their lives. That was helpful.
Listen, you’re coming at it from even a different perspective. Clinically, I stumbled upon this with the doctors that I train. I can’t wait to hear how you stumbled upon some of these finds. I want to start off here then. You’re an MD. How did you find fasting and fall in love with fasting? I have to start there. Mine happened in the ‘90s.
I was a much later comer than you. I actually did not find fasting; it found me. It was serendipity. What happened was a researcher—actually a market researcher contacted me several years ago and asked my office staff if I would be open to doing an interview to talk about something interesting called fasting. I’m always open to new things. After all, I’m an integrative doctor, so clearly, I left the conventional path quite a while ago. I didn’t completely abandon it, but I expanded everything that I do to try to be the most efficacious and safest. I look at all new potential treatment options.
I said of course. I always say yes because if you say no, you’ve closed doors, doors maybe forever. It turned out that this marketer had two agendas: one was a secret agenda and one was the open one. The open one was just to find about 150 integrative doctors, functional medicine doctors across the entire US and interview them about potential use of a fasting mimicking diet. Something that no one had heard of, it was not marketed. It was only used in clinical studies and before that, mostly with mice and such. It turned out that was the open agenda. The secret agenda was to find a doctor that would be the test site for use of this fasting mimicking diet to introduce it as a commercial product.
To my great please, I ended up being the selected doctor. I went through a whole series of interviews. The last one was with Professor Valter Longo over at his research center at the USC campus. We had lunch which he usually doesn’t have. He had that just specially for me.
By my feedback, they made some modifications, made some flavor changes. I convinced them to make it gluten-free. We made some changes and then it became a company. I continued to work with them. It was completely voluntary. I was a volunteer and I was happy to do it. For about another year and a half, I was working as a volunteer using the product myself, so I was one of the earliest users.
Then after about a year and a half, they asked me to be officially on their medical advisory board for their startup company, L-Nutra. That opened a whole new world for me, the whole relationship. I learned all about fasting and all the different types of fasting and time restricted eating. I became just totally enamored with everything circadian. I’ve never looked back since.
Yeah, no; like I said, it was back in the ‘90s that I found fasting. Then eventually, I found partial fasting. Again, it was haphazardly into it whereas we were—I was doing a lot more water fasting at that point, and still do, but found that when people carried on in a partial fast that they all of a sudden kicked back into the results. I found this French guy, [Albert Mezier]. He just talked all about partial fasting. That got me going with the partial fast years ago. As a group of doctors, we utilize water fasting, partial fasting. Then Longo, his work basically becomes [00:06:08]. I know about this: restriction of calories down below 1,000; restricting proteins exactly.
Anyways, I was like, oh my gosh, he made it so easy. He put it in boxes. Of course, I was actually reading some of Longo’s work before I actually knew that he was associated with ProLon which is basically the partial fast in a box. Anyways, now we utilize this amazing tool which takes literally—I wish I had one here to show; maybe you do. It’s literally a box of food for here’s Day One; here’s Day Two, Day Three, Day Four, Day Five.
One of the things that we had found is five days was a sweet spot. Gosh, five days we’ve been doing for years. We didn’t have the science. It was just: look, it takes people about three days to overcome hunger, fat adapt. Day Four, they see most people feel better, so let’s ride it out one more day. That was always the theory: let’s keep things going. We had no clue. Then Longo comes around as says, oh, five days is actually a magic number because you get this massive rise in stem cells.
Anyways, okay, so fast mimicking diet is something that we both love. The ProLon has made it really easy with the boxes. I know that with your expertise as an OB/GYN, fertility is one of the things that you have found that really fasting can transform in women. Talk about that and then other benefits that you—now that you’re doing a lot of this type of fasting, talk about some of the other benefits as well.
One of the things that has not gotten anywhere near the emphasis that it deserves is having women become healthy before they actually conceive. There’s a growing epidemic of infertility and of just unhealthy women who actually are successful in getting pregnant. We now know that if you’re unhealthy when you are pregnant, you epigenetically modify the baby. The baby’s genes are altered in their expression. You’re actually changing your grandchildren as well because everything changes if you’re unhealthy when you’re actually making a baby and the baby is developing within the uterus. We must help women to become healthy before they get pregnant.
Now we live in a world where something like 70% of people are overweight and obese. It creates leaky gut. We now know that obesity itself will create circadian rhythm dysfunction, will give you leaky gut. Most people who are really overweight are actually very malnourished as well, so they have nutrient deficiencies.
When you are in this state, you also have more difficulty with your detoxification pathways. The master organ of detoxification is the liver. We also know the kidneys and the skin are also involved, but especially the liver. What we have when we have a lot of obese, unhealthy people is that they develop fatty liver which is something that will change how the body can detoxify. We have altered gut microbiomes which are key as well to detoxification.
There’s now data that shows that fasting can actually alter the way genes are expressed in the detoxification pathways so that you can actually detoxify it better. There’s actually studies of people from Ramadan where they’re fasting all day. They’ve shown that they dramatically lower their heavy metal load: the cadmium, and the lead, and the mercury, and so forth, arsenic. Their levels go down with the fasting or the 40-day Ramadan. We now know that fasting can help lower our toxic load which is a huge problem for women who are pregnant. When babies are born, they test their cord blood and they find over 200 different toxins; nothing is tested. Yet, we just act like nothings happening, but these are changing the metabolic processes of these children forever.
Fasting in a pre-conceptual way—now not when women are actively trying to get pregnant, but we have to prepare for pregnancy preferably years ahead but at least one year ahead if you haven’t really given thought to it to give time to lower the toxic load. Also, we do fatty liver, improve the gut microbiome, and just overall improve the entire metabolic state of the woman, her nutritional status. I really believe that the vast majority of women say age 21 and over should incorporate fasting regiments and time restricted eating way before they become even interested in becoming pregnant. We will have much lower complication rates during pregnancy which are just crazy.
Look at the C-section rate. The C-section rate isn’t astronomically high and rising because all obstetricians are lazy, good for nothings, and they all want to go home. That’s not really what’s happening because now they have in hospitals what they call laborists, doctors who are in the hospital 24 hours a day. They have someone covering labor and delivery. It’s not that they’re trying to go and out and do something; the women are having abnormal labors. They’re having large babies. They’re ending up with high levels of C-sections which then begins life on the wrong foot because they don’t have the right microbiome from the smearing of all the lactobacillus as they exit the uterus and enter the world. It’s so important to get women healthy.
As well, women now are using a lot of contraceptives that actually are endocrine disruptors. Women have to deal with that before they get pregnant. We now know that fasting regiments can improve the microbiome and actually like I said help the liver. There’s so many reasons why reproductive-aged women, even thin ones, as long as you’re not too thin, not the ones that are below like a BMI of 18, that they should all be incorporating because we’re all exposed to toxins. We all eat food that is sometimes nutritionally deficient. This really should be part of everyone’s health regiment I think starting from about age 21 up.
I agree. One of the things you said, you said a few important things, Number One: if you talk to myself and the doctors I train, we’d agree, we don’t fix these bad guts that everybody has, the microbiome meaning, with just giving bacteria. It doesn’t really fix the gut. It can help certain symptoms no doubt. However, we do it with fasting regiments and fasting strategies to your point. Then you talked about something that I don’t want to brief over because we’ve been talking about the five-day fasting mimicking diet, etc. I want you to talk more about how you’re using that in your practice.
Let’s back up to something that you said. It’s basically eating within a certain eating window, basically timed eating. Let’s talk about that, better known as intermittent fasting. How are you using that in your practice? Then we’ll move on more to these five-day fasts.
Yes, well, something happened a number of years ago. I don’t know who started it, but we have to stop it. That was this notion that you should eat about two hours to somehow maintain your blood sugar. I say if humans had needed to eat every two hours, we would have been extinct a long time ago. It’s actually the exact opposite. We should eat less frequently, but we should get all our nutrients in. It’s not about nutrient deficiency; it’s about not eating all the time.
We have situations where our insulin and our glucose levels are spiking up and down all day long. We now know that it’s not just the average like when you get a hemoglobin A1C level and you’re looking at a representation of your average glucose; that doesn’t tell the whole story. What you don’t want are these high incursions up and down all day long of high glucose, high insulin, then it drops. Those are terrible. They’re bad for your brain, your entire neurological system. We have to have a steady, low, but healthy level of insulin and glucose all day long.
Nature has everything planned. Most of our genes are either clock genes or related to clock genes. It is who we are. We are genetically programmed a certain way. We have this beautiful circadian rhythm of cortisol which a lot of people have heard of. Our cortisol is very high in the morning when we get up. Cortisol causes our body to breakdown because after all, you should be coming off a whole nighttime long of fasting. Actually, when you have the high cortisol in the morning, you are now starting to breakdown your—some of your body fat. You’re going to start making all the glucose from your liver, the gluconeogenesis.
Yeah, it releases the glucose.
Right, so that’s right in the morning so that you wake up, you get this surge of morning glucose. Then you also become a little bit insulin resistant. Cortisol is going to make you a little bit insulin resistant. That’s because we evolve to that, what if no food did come in, that we will be able to have the glucose around for our brain. It makes it harder for other tissues to get the glucose, but our brain can get it.
The right thing to do is to eat within two hours of getting up. I know a lot of people are fasting well into the afternoon, but that really isn’t well aligned with our—the way our circadian rhythm and our genes are put together. You can do it, but it’s not optimal. Humans are very adaptable to many circumstances. That’s why we’re still here and we didn’t become extinct like Neanderthals. They were not as good as famines as we are. Our homo sapien genes are very great in that they can really deal with famines. That what we should harness: our amazing adaptability to not having food, but we want to have it at certain intervals.
There was a study out of Israel using women who have polycystic ovary syndrome which is so dramatic. Women with polycystic ovary syndrome are very emblematic for people with metabolic syndrome, menopausal women because they have all these same metabolic dysfunctions. What they showed is that if you ate two-thirds of your intake of food for breakfast, and approximately one-third for lunch, and that leaves almost nothing, but they had a tiny, little dinner. I’ll tell you what Professor Valter Longo has suggested as an alternative for people who can’t do this where they finish their food for the day when it was lunch. What happened with those women in that just one month, their insulin levels went down by 50%. There is no drug that does that.
I read that study, the first one you mentioned. One of the things that we discovered is in our group, we actually do it a little—we have a test. We test glucose and ketones in the morning. We see the dawn effect as it’s called, cortisol brings it up. Then we’ve learned to test people before their third meal and to see if glucose is trending down and ketones are trending up. What we found is we can actually adjust their eating windows based on what their body is metabolically doing.
Because once people become extremely fat adapted, we find that we get a better result by riding out the fasting window, but it can—it’s not for everybody. That’s why we test their numbers so we can see actually what their body is able to do, wants to do, and how it’s read within the lines. The irony is this: we find it’s different for everybody. When we test it, we go with where that eating window wants to be.
Then we can even watch as people get healthier. Then we can watch that their eating windows actually even get better. Then when they’re not eating—which we don’t do this every day. I have a principle called diet variation. Then we can go without food and the body actually succeeds. Again, we don’t want to do that too often because you’ll have too much autophagy and the body can actually work against you. Anyways, yeah, a little something to think about.
I love that. Actually, doing the individual variation and looking at what we call precision medicine, individualized medicine, is really very key. Very few people are able to do what you’re doing. That’s fabulous and fascinating. We know that probably the future is that everybody will be wearing the continuous glucose monitors because we now know that some people can eat exactly the same food and have dramatic differences in their glucose response. The human body is so amazing that how it can adapt and do very well under different circumstances. For the average person—and in your group is clearly far above average in terms of your keto-adaption.
You talked about the eating every two hours or five, six meals a day. By the way, to your point, it’s been said that the average American is eating between 7 and 21 times. Okay, now, everyone would say, okay, that’s not me. You have to understand that every time they drink the kombucha, have a handful of raw nuts, the health—you don’t realize that every one of those little things spikes your insulin and glucose.
To your point, if you want to die sooner, just spike your insulin and glucose more immediate. Meaning the more often you eat, the more chances of disease and the shortening of your life. The opposite is true; if you want to live long, eat less. However, we know chronic long-term caloric restriction doesn’t work. These short-term caloric restrictions actually work. I’ve coined this term of don’t eat less, eat less often. You will absolutely—
That’s exactly what I say. That’s why I make it so clear to my patients we’re not trying to make you nutrient deficient or food deficient; we just want to time it during the day so that you’re not eating all the time. That you stop eating—we now know from looking at the way that our clocks are arranged in our bodies regarding our insulin, our pancreas actually goes to sleep. It wants to rest after 7, 8 at night. No matter what you’re eating late at night, it’s not going to be good for you because your pancreas is really—you’re stressing out your pancreas at that point.
Especially people who are already metabolically challenged. Then you have the sleep thing if you’re eating an hour or two before bed. I have a ring that I’m able to measure my deep sleep and REM sleep. There’s nothing that affects my deep sleep more than eating before bed. Not even right before bed; even if I eat two hours before bed, I get half the amount of deep sleep.
Folks, that’s the recovery sleep that we all need to feel good the next day. You may sleep eight hours, but if your deep sleep is under an hour, I promise you, you didn’t recover the way your body needs to. The worst thing you can do is eat too late at night to your point.
Yeah, and as we age, we know our growth hormone, of course, does go down. That’s predominately a night phenomenon. We don’t want growth hormone high all the time; we know that can increase cancer, but if we have no growth hormone—it’s always this beautiful balance that we’re trying to create. Then we can’t grow and heal new tissue. That’s the beauty of going in and out of these different types of phases. It’s like the yin and yang. I don’t know how the Chinese got it so correct so many thousands of years ago that there is a time for autophagy and then there is also a time for regrowth and rebooting. We have to let our bodies do those beautiful rhythms—
I’m a believer in that. I know there’s a lot of criticism about a pathway called mTOR. No doubt, long-term stimulation in mTOR, eating all the time, eating high protein will absolutely age you and cause disease. However, short bursts of mTOR is actually really healthy for you.
Yes, mTOR, I hate it; I’m always going around having to defend the defenseless. A lot of times I’m going—like defend hormones because it’s like—now they’re like terrible testosterone, terrible estrogen. It’s like, no. Then poor mTOR is getting it now. It’s like, we need mTOR. Then all these pathways are there for a purpose. Cancer is upregulated mTOR, but that’s a dysfunction of a beautiful, normal pathway. We have to do everything so that the bodies don’t get dysregulated and go down those aberrational pathways distorting our normal, beautiful rhythms and functions.
That’s beautiful and you’re right. One of the things that we had learned to is if we do five days a month of say a fasting mimicking diet and then we also do five days a month especially a week before a woman’s period where we eat higher, healthy carbs, it’s magic for them. During the high, healthy carbs, you get a little mTOR stimulation. The five days in the fasting mimicking diet, you’re stimulating autophagy. Again, it’s this balance that we’ve learned to create that works for women’s hormones. Tell me how you’re using the fasting mimicking diet in your practice. I want to hear more, especially for women.
Okay, universally, every woman as she goes through the menopausal transition—this is universal—every woman becomes somewhat inflamed, develops some degree of insulin resistance. There’s research out of Harvard that shows that the gut microbiome becomes dysbiotic as women go through menopause because estrogen has a role in virtually every organ function, every organ, everything. It’s the master hormone of metabolic homeostasis of women. When you lose your peripheral estrogen production, the production of estrogen that’s done in a paraquinone way in individual organs for their own individual use does not increased to make up the loss. Women’s brains make less estrogen, have less estrogen available, and all the other organs like the gut which makes its own estrogen supply, but it doesn’t make enough to make up for the loss of the ovarian production. You have a state of metabolic distress and oxidative stress that develops in all women.
Except for the small exceptions for whatever reason they’re not a great candidate, I recommend it universally as my patients are going through the menopausal transition and into menopause up to around the age of 65. Then it has to be very individualized even up to 60 in case they’re very frail or have other metabolic dysfunctions that doesn’t really make it safe for them to do anything other than just get by every day because we don’t have data on fasting people who are already insulin dependent and so forth. I’m not such a maverick in using fasting in people who are really unhealthy.
We can prevent all that deterioration and maintain a good healthy female body if we add in periodic fasting like with the fasting mimicking diet ProLon starting in the menopausal transition. For me, you never know exactly when that’s happening. We know it’s a very gradual process around age 40, certainly by age 45. I don’t see any reason why every woman shouldn’t be on it about four times a year after they do their loading dose with ProLon with the three months in a row, be doing this on a regular basis for health maintenance.
Then when you look at the data on just stem cells alone, and people are running around the world paying a fortune to get stem cells, and here not only does it increase your basic stem cells, but actually, it increases—it doesn’t replace them; it actually increases your pool of stem cells. It’s phenomenal. It really improves your immune system. It’s such a boost to your immune system, so why would we not want to do that?
We know that as we age, our ability to deal with infections like sepsis really declines. There’s a reason why when there’s a flu epidemic that they always say, who are the most vulnerable. There’s the very young children and then there’s the older people because our immune systems age. They become less functional. We really want to do whatever we can to maintain a healthy immune system. We can do this in their 40s and in the 50s during the years that we now set the pace for what’s going to happen as we get older.
Do we have long-term—we don’t have long-term data, but we have a lot of data now that shows that when you do ProLon, when you do periodic fasting that you reduce inflammation. You reduce metabolic chaos. We do see inflammatory markers. We normalize lipids. We normalize blood pressure. We lower fatty liver. We reduce fat in the liver which is so hard to get rid of. Women after menopause are much more prone to developing fatty liver.
I think this is such a huge thing for women because I’m a big believer in hormone therapy in menopause. The problem is no matter how we give it, it’s not the same like replacing their ovaries. We don’t have that capability to—I know there are people trying to create stem cells for ovaries so that we can get an ovarian transplant in menopause, but we don’t have that yet. No matter what we do, it’s not the same as having ovaries, so we are still going to age. This is how we—
I think a part of natural aging in menopause though is we’re meant to produce less estrogen. Obviously, it’s the body going into the next stage. The body’s innate intelligence, it knows this balance. The thing nice about fasting is it—you’re not forcing the body one way or the other. The body’s basically saying, okay, this is going to help me be more balanced. It’s going to help me create more stem cells so I can make my own estrogen. It’s meant to drop, but not drop like it’s dropping in this country in modern day. It’s dropping so much that women, the bottom falls out. Now, they end up with hot flashes and too many symptoms.
To your point earlier, this is a normal process that women are supposed to go through. It will create some inflammation and some adjustments, but the body when it’s in homeostasis figures it out. I believe that our DNA is set up to fast. Fasting helps our body find homeostasis meaning this balance hormonally, microbiome, all these adjustments that need to be made.
My wife and I, we’re in our 50s. I tell you; we have de-aged. We fast, we do five-day fasts probably about four times a year. We do a combination of sometimes water, sometimes partial fasting, fasting mimicking diet. My spring fast coming up is going to be a fasting mimicking diet. I’ll tell you; nothing has worked better for us as far as—and even we measure something called telomeres which is biologic cellular age. We have both massively decreased our—I should say increased our telomeres and increased our age in a good way.
No, I get it totally. I’m doing that as well. I’m doing the four times a year with the ProLon. I think it is—I sometimes feel like I’m de-aging as well. The reality is that you touched on it and that’s really very important. Woman today, when they hit menopause, they’re not as resilient. They don’t have the reserves that they had in former decades, in former generations because they—by the time they hit menopause, they’ve been exposed to many endocrine disruptors.
Many women have been on oral contraceptives often for decades which really takes its toll. It is what it is. It’s not a health food. That’s why they don’t give birth control pills to women if they have a heart attack because it’s not helping their metabolic state. Women have not been exercising the same. Their circadian rhythms are off because all the blue light and so on. Women have a disadvantage now when they hit menopause, so they need all the help they can get to get through it.
I think that’s why women are having more symptoms. We know that hot flashes are associated with a much worse prognosis in the long-term. If a woman has very bad hot flashes, that’s a really red flag that she really needs to get really fine-tuned and really look at her diet, her lifestyle, and incorporate fasting because she’s at much higher risk for developing many ills associated with aging.
You hit on something. We agree the amount of toxins, estrogen, hormone disruptors that we’re exposed to today, so many things, like you said, the light, we have so many things against us hormonally. Then I believe that genetically we’re set up for times of feast and famine. It’s a chapter in my book. Our DNA is set up to fast and we’re not fasting. It’s all feast. That too is destructive for the hormones.
We have this destructive for the hormones and we have this going on destructive for the hormones. Look, we can’t take all the endocrine disruptors out of your life; however, if you add these periodic fasts as we’re talking about—and my doctors would agree, the best place to start is a ProLon fasting mimicking diet. It’s in boxes. You don’t have to think. It’s easy. It’s safer than water fasting.
It’s easier. Forget about it; it’s easier than water fasting. I know many of you out there will be—have had massive transformations with water fasting and I’m a believer; however, without supervision, etc, it’s much harder. This is a place to start. Will change your life; it will.
Absolutely; and there is some people out there who are amazing in their determination. They’ll do long water fasts for several days, but I live in a world of average people and in terms of actually implementation of a fast. If I went and I told all of my patients that I think would benefit from a fasting mimicking diet or a water fast to actually do just the water fast, I would have compliance of about 1 to 2%. I have to be realistic because it doesn’t matter if you give good advice if it’s not taken. As a doctor, I need to not only give good advice; I have to help my patients to incorporate it into their lives. That’s where it’s so much better when I give them ProLon than I tell them to water fast.
It’s a personal thing. I go without food. I could do it all the time; it’s no big deal.
I know you can.
Yeah, my point is the average person goes, I can’t go without food. Here’s the question back: won’t I die? Literally, their brain is like I could die. That’s a hard jump to make. It’s eat this box of food, one every five days. Oh, I can do that. Okay, here it is. Yeah, that’s cool.
I get amazing success with ProLon and not with water fasting. That’s why they had to invent because you can’t get huge compliance if we’re talking about people.
I have to say something. For years, we put people on partial fasts. I have all the instructions and this and that. Me personally, I preferred water fasting then partial fasting. Here’s why: because once I would start eating, it was very difficult for me to stop. I would be like, oh; it was just emotionally—I was in my kitchen. I’m just better off not eating.
However, the first time I did the ProLon, the fasting mimicking diet, when here I had my box of food for the day, it was a completely different experience because this is what I had to eat. I didn’t find myself wanting to stop. Here’s what I had. I found the partial fast with this was a completely different fast. It is was easier for people.
Anyways, it’s a great thing. I think you kind of answered this, but when shouldn’t a woman fast? We talked about, hey this is the best thing for women, but what about the one that maybe shouldn’t?
There are sometimes when a woman shouldn’t fast. In terms of categories, if you’re very thin, then you really don’t have enough fat. We don’t want to take women who are under a BMI of 18. The other group would be if they’re actively trying to get pregnant.
The body doesn’t want women who are unhealthy to get pregnant. If the body thinks there’s not enough food coming in, it might actually stop you from ovulating. There are studies in—it’s interesting that you said that you started in the 1990s. There was a little flurry of studies in the 1990s on fasting and women. The NIH was supporting these studies and then it completely disappeared. Now, of course, we’ll bring it back.
Back in the 1990s, there was some studies of short-term fasting like two, three days. What they found was that if they took women that were very thin, they actually didn’t ovulate if they fasted them for like three days during the follicular phase, the phase before ovulation. They just didn’t ovulate.
If they took average weight women, and this is the 1990s, they weren’t really working with the very overweight women, but if they took average weight women, they found that they did ovulate, but their spike of estradiol, that spike that proceeds ovulation was lower. We don’t know really what that means, but it doesn’t sound like what we’d want to do. I would not want to fast women during a cycle that they actually want to get pregnant because they may not ovulate or they may have a lower peak maybe that would affect their luteal phase. That would increase their risk of miscarriage. We don’t have any data on that, so that would be a definitely not.
The other times would be if they were ill. We know that when you are doing like ProLon, during the days that you’re on it, your immune system actually becomes less robust. Your white cell count goes down and then it springs back up to normal. Your stem cells actually—everything gets a little depleted because your body goes into a quiet mode. It’s a little bit lower. It doesn’t want to. You don’t want to stress your body out when you’re actually fasting.
If you’re coming off of a cold, or you’ve been ill, or say you’re a mom with a bunch of small children and they’re all sick, maybe that wouldn’t be the time to be having your own fast. You don’t want to—you want your own immune system to be healthy at the time that you’re doing this. Other than that, there’s—you don’t really if you’re having surgery. You do it right before surgery because—or something of that sort, or right after surgery, if your body has been traumatized, or say you’re doing a marathon. You don’t want to do it when you’re preparing right for a marathon because there’s no data on that, but we just want to be cautious. There’s very few exclusions as you can see.
Yeah, no, it’s true. I have to give Jason Fung credit for this. I believe it was him who—one who would say okay, someone who is underweight, don’t fast them. I think it was him; it might have been Thomas Seyfried. Said, listen, for people who actually are underweight, you can fast them. What will happen is you’ll find that they’ll lose five, six pounds. Then a month later, they actually gain muscle. Clinically, in my doctor group, we tried it and it worked.
I think it’s become a classic answer that you and I were giving that if you’re underweight because you intuitively say, yeah, that might not be a good idea. What we found was the exact opposite. I guess the only theory there is it’s the stem cell rise that—well, there’s two theories that I think Jason gave me is the stem cell rise is part of it. Being that’s why it takes a month or two and then the weight comes on because you start—the only protein you’re really getting rid of is the bad ones that aren’t recovering. You end up with new ones and there’s more recovery.
Then the second thing is the gut. It’s the microbiome changes. The gut gets a little better, so now your assimilation increases, and therefore, that could lead to weight gain a month later. Anyways, interesting clinical observation.
Yeah, no, the only thing that I would add based on that is that there is a little difference between men and women. I don’t know that data, but it’s really fascinating. With women, you have to be especially careful because of eating disorders.
Oh, that was my next question.
Okay, yeah, eating disorders are bad.
I thought of another one: eating orders and fasting do not mix.
Yes, exactly. I’m going to write that to my mind. It doesn’t matter what their eating disorder is: if it’s bulimia, if it’s purging, if it’s binge eating, if it’s anorexia nervosa. There are issues there, so we might actually trigger something.
We don’t have enough data. We have to be cautious because of lack of data. Women have double the incidents of insomnia, and depression, and anxiety. Women are a little different, so you’ve got to care—be very cautious about their emotional states and how these things can impact them.
I’d also add too for short that the reason why someone’s underweight is a big reason that you can’t just say something across the board. Another one is cancer. There’s certain cancers that respond amazing to cancer. Other cancers that could be causing someone to be cachexic and underweight do not.
I interviewed a scientist. They said look, if it’s a cancer that’s more metastatic or a tumor that has its own blood supply, fasting isn’t good. If it doesn’t have its own blood supply, fasting is great. Tumor differences make a difference whether fasting could be successful or not. Again, those listening, check with your doctor. There’s different conditions like this that can be different. Cancer is one of them. It’s not always a great thing. Sometimes it could be, but not always.
In menopausal women, one of the biggest risks for breast cancer recurrence is actually weight gain and obesity. What I would say and then recognizing that we don’t have a lot of data, if a woman is seen cured from her breast cancer, so now we just want to make sure she doesn’t have a recurrence of breast cancer, but everything else is fine, she’s not on any treatment, I would say that would be a candidate for—once again, we don’t have data on that, so we have to look at relative risk. We definitely don’t want women to become obese after menopause. That is a very big risk factor for cardiovascular disease, dementia, of course, diabetes, and breast cancer. Every case needs to be looked at individually. I 100% agree cancer we have to be cautious.
Yeah, exactly. Look, with any type of extended fast, work with a practitioner. That’s why we’re training more and more practitioners, Felice. Where do you practice? Can people visit your website?
Yes, I have a real brick and mortar practice. That’s mostly what I do. That’s my biggest job. I’m located in Irvine, California. It’s called the Integrative Medical Group of Irvine. We see men and women. My website is felicel—I have my middle initial in there—felicelgershmd.com.
Yeah, great. A wealth of knowledge here. It’s amazing what you said that you are heading the way here with not just fasting, but women in fasting where it’s more controversial I would say. To your point too is women do, they’re very different. The hormone challenges make not just fasting more difficult for women often, but just even low carb diets are harder for women. A lot of it’s hormonally driven some of these issues.
Yeah, absolutely because I have found yes, I think women are very different. Women’s bodies are designed to store fat much better and much more powerfully than men. If you think of a set of fraternal twins who are seven years old. They’re raised identically by their parents. Then you fast forward a dozen years; now they’re 19. Even though they’ve done everything the same for the past 12 years, their bodies are going to be very different. If you did a body composition, you’d find even though they ate exactly the same food, the female of the twins would have a lot more body fat.
We are meant to have babies whether—that’s our destiny; doesn’t have to be our true destiny, but it’s our biological pathway that nature wanted for us is to have babies and to store fat so that we could nurture babies, and have enough food for the famines that were inevitable, and breastfeed, and so forth. Our bodies are designed to grow and store fat a lot more than men. We do need more studies that are gender-specific. Until 2015 when they did studies, they didn’t even have to include women or even designate what the gender of the study subjects were. We have much more data on men then we do women. It would be great to accumulate data on women and how they respond differently to keto diets and fasting because we know it’s going to be different. We just need to get more data.
Do you find that—okay, you have a practice full of women. You’re helping them with hormones, bioidentical hormones, balancing their hormones. Obviously, in your practice, you’re getting them—I’m sure not all of them, but at least some of then to incorporate fasting into their lifestyle. Do you find that you have to really massively adjust bioidentical hormones? Meaning that the fasting has such an impact that it’s like okay, all of a sudden, their cells are becoming more sensitive to the hormones; they need less. The become more balanced. What are you finding there?
Yeah, I would say that the same is true if they’re on thyroid hormones that we can alter their sex hormone binding globulin, their metabolism. We know that estrogen is so key to the body that there’s actually a microbiome dedicated to detoxification of estrogen in the gut called the estrobolome. When you have the wrong microbiome, the wrong estrobolume, you can make different types of metabolic byproducts that are actually potentially carcinogens. By doing this, and we don’t have long-term data, so just my own experience, is that we actually help them to metabolize their estrogen better.
Yes, we do have to watch their estrogen levels because how they absorb it, how they process it may change. That can be true as well as I mentioned for a thyroid hormone because estrogen is actually very important for thyroid hormone receptor function. Many hormones in the body, they’re very interactive. It turns out that estrogen actually can help regulate the function of receptors for testosterone, and progesterone, and thyroid.
If you metabolize estrogen differently, if you absorb it differently, excrete it differently, yes, it can have an impact. That’s why everybody needs to be treated as they’re N of one because—and treated like we started out with that everyone needs to be looked at for person individualized medicine because we all are unique in our—in every aspect of our bodies. We have our own unique imprint, our own microbiome, and so forth.
Yeah, no doubt about it. We find the same thing clinically. Yeah, great information. I hope if people heard this: incorporate fasting into your life. Your life will change hormonally, your microbiome, the gut, every place that everyone is struggling with. It’s like, fasting is key; it really is. Our DNA is set up for this, and yet, all we’re doing is feasting.
We are animals of the animal kingdom. We are genetically programmed. The beautiful thing about fasting is that unlike pharmaceuticals, we’re harnessing our own innate mechanisms for healing, for maintaining health. As an integrative doctor, that is always my goal to try to do things to incorporate our own body processes, our own innate ability to heal, regenerate, and stay healthy, an optimize every aspect of our lives.
Yeah, well, Dr. Felice, thank you. You know what, folks; we’ve been talking about fasting mimicking diet, the ProLon. I’ll have Ashley put it in the note shows because we have how to get it, how to get an actual kit as we’ve been discussing the boxes of food for five days. We’ll make sure we provide that resource for you here in the note shows. Dr. Felice, thank you. I love this topic and you’ve added a lot to it. It was a great conversation. Thanks for being on Cell TV.
My pleasure, it’s been a lot of fun.
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