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In this episode of the Thyroid Pharmacist Healing Conversations podcast, I interview Cynthia Thurlow about a topic that doesn’t get nearly enough attention: what happens to your gut during perimenopause and menopause, and what you can do to support it.
Cynthia is a nurse practitioner, the host of the Everyday Wellness podcast, author, and international speaker, and her TED Talk on intermittent fasting has over 15 million views. She brings a deeply practical perspective that blends physiology, real-life midlife stress, and the “boring-but-life-changing” basics (sleep, protein, movement, boundaries) that really are foundational to feeling better.
If you’ve ever wondered why you suddenly feel more bloated, more reactive to foods, more constipated (or the opposite), more anxious, more foggy, or more weight loss resistant in your 40s (or even late 30s)… you’re not imagining things.
Hormones and the gut are in constant conversation – and hormones turn up the volume.
What you’ll learn in this episode:
- Why progesterone loss can hit your sleep, mood, and gut motility first. Cynthia explains how early perimenopause often begins with declining progesterone – which can reduce GABA (a calming neurotransmitter) and contribute to anxiety, sleep disruptions, and slower digestive movement.
- How estrogen shifts can drive bloating, brain fog, joint pain, and immune changes. Estradiol can fluctuate dramatically in perimenopause, and because estrogen is an immune-modulating hormone, shifting levels may influence inflammation, autoimmunity risk, and even leaky gut.
- The stress → gut → brain loop that keeps women stuck in symptoms. Chronic stress can impair digestion at the most basic level (your body won’t “rest and digest”), disrupt the vagus nerve, and increase inflammatory signals that impact the brain – which can worsen anxiety, depression, and brain fog.
- Why estrogen “recycling” can make perimenopause symptoms feel amplified. We discuss the estrobiome (gut-driven estrogen processing), beta-glucuronidase, and why constipation, poor detox pathways, and gut dysbiosis can lead to estrogen recirculation – contributing to weight-loss resistance, bloating, and mood changes.
- The overlooked connection between trauma, stress, and menopause timing. Cynthia shares research on adverse childhood experiences (ACEs) and how chronic stress may influence immune health, metabolic function, and the pace of ovarian aging.
- The foundational strategies that support gut and hormone health. Before complex protocols, simple interventions – breathwork before meals, sleep prioritization, hydration, walking after eating, and gradually increasing protein and fiber – can significantly improve symptoms.
I’m so happy to announce that Cynthia has a brand new book out on April 28th: The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond. The Menopause Gut discusses something many menopause resources skip: how the gut is impacted by hormonal transitions like perimenopause and menopause. Cynthia brings a gut-first approach to midlife health, translating emerging research into practical, realistic strategies that support metabolism, immune system, and overall well-being. This book will help you “connect the dots,” understand why your body feels different, and what you can do to feel better.
Guest Resources / Connect with Cynthia Thurlow
- The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond by Cynthia Thurlow – A gut-centric approach to women’s health through perimenopause and menopause from the author of Intermittent Fasting. Available April 28th.
- Learn more at Cynthia’s Website
- Listen to the Everyday Wellness Podcast and check out this episode where I was honored to be a guest: It’s Not Just Stress!” – The Two ‘Red Flag’ Symptoms You Should Never Ignore
- Cynthia’s TED Talk on Intermittent Fasting (15 M+ views)
- Follow Cynthia on Instagram, Facebook, YouTube, and LinkedIn
Supplements We Discussed
- Creatine (Creapure®-sourced) – Cynthia’s “one supplement” pick for muscle strength, bone support, and cognitive support; she notes higher doses may be used for brain/bone support (brand quality matters).
Other Tools and Resources
- Progesterone – Discussed as a potentially helpful support option for perimenopausal sleep and nervous system support when progesterone declines (work with a practitioner).
- ACEs Quiz – A tool to help assess trauma levels.
- Protein + macro tracking – Used as a starting point to personalize intake before making major dietary changes.
- Fiber “micro-dosing” approach – Increasing fiber slowly to avoid bloating; examples include flax/chia and well-prepared beans/lentils.
- Post-meal walking – A simple blood sugar support strategy (10 to 15 minutes after meals).
- Hydration + electrolytes – Foundational support for brain fog, energy, and digestion.
- Coffee enemas – Cynthia shares using them as an alternative approach to support mercury elimination (not for everyone; clinician-guided).
- Chelation therapy – Mentioned as an alternative to coffee enemas for mercury (heavy metal) removal; can be intense and not always well tolerated.
Books and Articles About Menopause, Gut Health, Stress, and Autoimmunity
- IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome by Dr. Izabella Wentz – This is the exact framework I wish I had years before my own IBS diagnosis.
- Hashimoto’s: The Root Cause book by Dr. Izabella Wentz – A roadmap to identify and remove the triggers associated with causing thyroid autoimmunity, Hashimoto’s, and hypothyroidism.
- Hashimoto’s Protocol book by Dr. Izabella Wentz – A practical pathway for healing and reversing the autoimmune damage at the root of the disease. It includes a quick-start two-week detox, advice on supplements to support the liver, an adrenal recovery plan, a personalized plan with foods, supplements, and other lifestyle interventions, tailored to each body’s own unique Hashimoto’s triggers.
- Adrenal Transformation Protocol: A 4-Week Plan to Release Stress Symptoms and Go from Surviving to Thriving book by Dr. Izabella Wentz – A protocol to help identify adrenal triggers, balance the stress response, and build resilience to prevent excess stress from overwhelming the adrenals in the future.
- The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture – A book about how trauma affects our health by Gabor Mate.
- Gut Microbiome Dysbiosis and Hashimoto’s
- 6 Root Causes Behind Leaky Gut and Autoimmunity
- Intestinal Permeability, Autoimmunity, and the Hashimoto’s Connection
- The Fundamental Gut Health Protocol
- Are Your Adrenals Sabotaging Your Health?
- Did Your Thyroid Condition Start or Worsen During Perimenopause?
- Estrogen Dominance as a Trigger for Hashimoto’s
Get the Full Episode Transcript
Let’s Connect!
- Follow me on Instagram: @izabellawentzpharmd
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Got questions? Drop them in the comments! 🙂
About Our Host
Dr. Izabella Wentz
Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of Hashimoto’s thyroiditis in 2009, following a decade of debilitating symptoms.
Dr. Izabella Wentz has written several best-selling books, including the New York Times bestseller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, the protocol-based #1 New York Times bestseller Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, the Wall Street Journal bestseller Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, and Adrenal Transformation Protocol. Her latest book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, is now out in the world, and available here!
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About Our Guest
Cynthia Thurlow is a nurse practitioner, host of the Everyday Wellness podcast, author and international speaker, with over 15 million views for her second TEDx talk (Intermittent Fasting: Transformational Technique). With over 25 years of experience in health and wellness, Cynthia is a globally recognized expert in perimenopause/menopause and intermittent fasting, and has been featured on ABC, FOX5, KTLA, CW, Medium, Entrepreneur, and The Megyn Kelly Show. Her mission is to help empower women to live their most optimal lives in perimenopause and beyond.
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