The Liz Moody Podcast - Daily Habits For Energy, Hormones, Inflammation, Longevity & More With Dr. Amy Shah

Episode Date: April 26, 2023

The daily practices that Dr. Amy Shah recommends for energy, healthy hormone levels, gut health, weight loss, longevity, & more.  one daily habit that instantly gives you more energy & focus  why you might want to delay your morning cup of coffee exactly what to eat for breakfast for all day energy the truth about high protein diets  signs that your stress hormones might be at less than ideal levels  the one habit you should prioritize for healthy cortisol levels exactly what to do to feel your best at each phase of your menstrual cycle  the critical components of a healthy nighttime routine (+ a quick hack for falling asleep) Dr. Shah’s exact personal morning and evening routine  the best daily practice for inflammation, burnout, fertility, pregnancy, gut health, longevity, and menopause  and so much more!  For more from Dr. Shah, head to amymdwellness.com, find her on Instagram at @fastingmd, and check out her new book I'm So Effing Hungry: Why We Crave What We Crave – and What to Do About It.  To join the Healthier Together Podcast Club Facebook group, go to https://www.facebook.com/groups/healthiertogetherpodcast. Take advantage of Healthy Convo Co’s Mother’s Day sale! Go to healthyconvo.co and use code MOTHERSDAY for 15% off your entire order.  This episode is sponsored by: GreenPan: visit GreenPan.us and use code HEALTHIER30 to get 30% off your entire order plus free shipping on orders over $99.  LMNT: go to DrinkLMNT.com/Liz a to get a free LMNT sample pack with any order.   AG1 by Athletic Greens: visit athleticgreens.com/healthiertogether and get your FREE year supply of Vitamin D and 5 free travel packs today.  Kion Aminos: save 20% on monthly deliveries and 10% on one-time purchases by going to getkion.com/LIZMOODY.  Healthier Together cover art by Zack. Healthier Together music by Alex Ruimy. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello, friends, and welcome back to the Healthier Together podcast. I'm your host, Liz Moody, and I'm a best-selling author and long-time journalist. This podcast is all about helping you live your healthiest, happiest life, whether we're learning science-backed tips for becoming smarter, identifying and overcoming burnout, or getting all of the latest epigenetic research to live as long as possible. And yes, those are all real episodes, so if any of those topics sound good to you, scroll on back in the archives. I am so excited to welcome Dr. Amy Shaw to the podcast. Dr. Shaw is a double board certified

medical doctor and nutrition expert with training from Cornell, Columbia, and Harvard University as she is a very impressive human. Drawing from her background in internal medicine and immunology, she has dedicated her own practice to helping patients feel better and live healthier through her integrative and holistic approach to wellness. Outside of her practice, she shares her tips for living a healthier life with her hundreds of thousands of social media followers and through her hit books, I am so effing tired and I'm so effing hungry. I've known Dr. Shaw personally for years and she is an absolute font of wisdom. So today, I thought it would be really fun to have Dr. Shaw go through all sorts of

recommended daily routines and habits that we should be incorporating based on our specific needs. I have personally wanted an episode like this for years. I've personally wanted an episode like this for years. I feel like we see all of these different practices on social media or we hear about them in podcast episodes, but it's like, okay, what should I focus on right now to get the most bang for my buck given my personal goals? We all only have so much time and so much money. So if you have that question too, you will love this episode. We get into one daily habit that instantly gives you more energy and focus, while you might want to delay your morning cup of coffee, exactly what to eat for breakfast for all day energy, the truth about high protein diets, signs that

your stress hormones might be at less than ideal levels, the one habit that you should prioritize for healthy cortisol levels, exactly what to do to feel your best at each phase of your menstrual cycle, the critical components of a healthy nighttime routine, plus a quick hack for falling asleep, Dr. Shaw's exact personal morning and evening routine, and the best daily practice for inflammation, for burnout, for fertility, for pregnancy, for gut health, for longevity, for menopause, and so much more. We would both love to hear your thoughts and your biggest takeaways as you're listening to the episode. So definitely screenshot and tag me. I am at Liz Moody and Dr. Shaw. She is at Fasting MD on Instagram. Dr. Shaw is so full of knowledge, but she's also

so realistic when it comes to her recommendations in this episode, which I love because I feel like all of the typical morning or nighttime routine advice that I see trending online includes like 25 steps and it takes five hours and that is just not something that I'm going to do personally. If you want to do it, more power to you, but that does not fit into my best life. I want all of her incredible tips in the hands of everyone who can benefit. So please send a link to a friend, a family member, a coworker, a neighbor, anyone in your life. Send them a Slack message. Send them a text message.

and shoot somebody in email. I am so, so, so grateful to every single person who is helping to spread the word and grow this beautiful community. Okay, let's get right into it with Dr. Amy Shaw. Amy, it is so fun to have you on the podcast here today. I have known you for years and years and years and years, and I've always been wowed by all of the wisdom that you have to share on these topics. I was reaching out to you for quotes and insights and things like five years ago, MindBody Green.

I know it's so fun to see you in such a different setting. So today we're going to get into all things daily routines. Like how do we craft the daily routines that help us achieve the goals that we want in our health and in our life? Let's just start the moment we wake up, can you walk us through what you would consider the ideal morning routine? Kind of like the bare minimum, the basic steps that everybody, even people who are working, busy jobs, who have families, families, what should they definitely try to include in there? I'm going to include a couple of things that are bonus and a couple of things that I think are essential.

One of the bonus things that I've been really working on because I believe that circadian rhythms, the sun and dark cycles that run our bodies are so important. So when I wake up in the morning, I try to guess what time it is. You want to, like, sink yourself to the earth. You want to know, like, from that little bit of light that's seeping through the curtains, So I can usually tell exactly what time it is in the morning because I've been working on my circadian rhythm. So first thing I do is I try not to wake up to an alarm.

I have an oh shit alarm set in case something happens and God forbid I slept through everything. Wait, did you call it an oh shit alarm? Yes. It's like the one where you're like, you're going to miss everything if you don't wake up at this point. So I do that. But then I try to wake up on my own because I think it's really important to wake up without an alarm when you can and get some sunlight pretty quickly. I want to stop on the alarm point briefly because I also wake up without an alarm and I'm always explaining it to people, but I would love your

doctor perspective. The way I explain it is that if you are waking up without an alarm, you're letting your sleep cycle complete itself. So you're getting the benefits of all of the phases of sleep. Whereas if you even just cut that off a little bit with an alarm, you might not get all the benefits. So you might even be talking about like 10 minutes here, 10 minutes there, but you're getting the benefits of all the sleep cycle. So you're going to feel far less drowsy. That's my understanding. What is your take on that? Absolutely. And also, I hate to break it to all of our friends and family and husbands and spouses and wives that you snooze a million times. But the more you use snooze, the worse you're going to feel when you wake up. You think it's because you're so tired,

but it's actually because of exactly what you're saying. You're going into another cycle of sleep and then you're being woken up again. It's like being woken up twice or three times or four times. And you have a lot of sleep inertia when you wake up and it could take three, four hours to shake that. And similarly, like you said, your cortisol basically spikes to wake you up and you get that normal sense of awakeness and adrenaline and your hormones are produced. when you wake up, when you weren't really met to wake up, you don't have that big spike of adrenaline and cortisol. You might feel a little less attentive. When you get used to waking up on your own, you see the difference in your attention, in your level of focus in the morning.

So for me, it's worth it. And that means the sleep routine and the hygiene of the day, morning routine starts from the night before, you know, because to ensure that you wake up is really hard. You have to be adequately rested and have a good sleep hygiene in place so that you can wake up without an alarm. And we're going to get into all of the nighttime routine stuff. But I do think that the idea of setting an oh shit alarm is really smart because I think a lot of people are like, well, I have to get to work. I don't want to be late.

How do I wake up for that? And I think instead of setting it at this early time and being like, I'll give myself 20 minutes of snooze time, et cetera. etc. What is the absolute latest where you definitely will have to just run out the door and set it for then? So you have that as a fail safe, but you can start to train yourself to wake up more naturally. Yeah. And if you get sunlight within 30 minutes of waking up, you are setting that internal alarm clock so that it's going to be easier for you to wake up the next morning. So for me, it usually means going to the bathroom because first thing, you have to pee, right? And then you usually, you usually

I brush my teeth too. Like, that's like a habit that I have right after I go to bath and wash my face. And then I immediately walk out my back patio door. There's like a little peak of sky that I can see. If it's cold, I stand within my doorway and look at the sky. If it's warmer, I go outside and I do a full stretch or I stay and do some mindfulness there. And then I usually do just a little bit of gratitude if I have no other time. Sometimes I'm just racing like with the book launch.

It was more like podcasts and interviews or it's like dropping the kids or going to work. So usually it's pretty short. And then I get dressed for the day. And I usually don't have my first food or drink at least 60 to 90 minutes after I wake up, only because all of that stuff takes a while. And then I get dressed. I get ready for work. I get all my lunch stuff ready.

And then I'll have my first caffeine and food for the day. And that it's also intentional because I know that. When you have caffeine, you want to kind of time it a little bit later after you wake up to get the best benefits. And then it sounds like I do a lot of things, but it's really just very simple stuff. The other thing I'm really trying is sky before screens. So instead of rolling over and checking my phone, checking everything and checking Instagram, I say to myself, I'm going to check the front screen in my phone, make sure there's no emergency text messages because I am a mom. I'm a doctor and I, there are times where you get emergency text messages overnight or early

in the morning. So I just make sure there's nothing there. But I don't go into my email. I'm not going into my messages, my Instagram. And what happens, Liz, you're a super creative person too. And what happens to me is when I start to read other people stuff or I start to scroll, now when I get up and I go to the bathroom and I'm doing my brush my teeth and I go out to the sun, you're thinking about all the things you just consumed.

instead of your own thoughts. And when I don't do that, I have so much clarity about my own day. And sometimes I just write it down on a piece of paper because putting it down on a piece of paper helps you kind of organize your thoughts in the morning. So sky before screens is like game changer. I'm telling you, I don't do New Year's resolutions, but that was one of the things that I felt like changed my day. So I do that. I love that. I have some follow up questions. What is the gratitude practice specifically? Specifically, I just am thankful for something. And whatever comes to my mind, that's why I don't like to look at the screen as much as possible. Because I wanted to come from an organic thought that I had in the morning. Sometimes it's about work and being able to spread the message or sometimes it's just like, I'm so happy that I have the ability to go for a workout right now. I get a lot of gratitude from all of our problems. So many of our problems are so minute compared.

to so many people in the world. And I think that sometimes we get caught up in our problems, thinking that it's like the end of your life. And especially when I have a lot of things on my plate, because I'm a physician and a clinic, and I have a practice. And then I'm a mom. And then I'm trying to do all this book writing and I do content. Sometimes I get caught up in all of the things that are going wrong.

And I think giving perspective of, wow, I get to do this amazing thing. I get to work on my true passion. Who has that opportunity? So putting it into perspective, actually we're going on the Inca Trail, Machu Picchu hike tomorrow. Tomorrow? Yeah, like leading for Peru tomorrow. Amazing.

And the reason came out of my gratitude practice, because when I did it about almost seven or eight years ago, my kids were really young, so we didn't bring them. Me and my husband went with a group of friends without Wi-Fi and camping. and just being in nature. I remember coming out of that experience being like a different person because you get an appreciation for nature, for people, for life outside of what we're used to.

And I want that for my teenage kids who are living a much different life than what even I lived. I want them to be disconnected and connect with the people there and the nature and us. That came out of my gratitude because I was thinking, wow, we don't even realize how lucky we are sometimes. Okay, question two. Is there a minimum amount of time that you are aiming to be outside in the natural daylight? Two minutes is my goal. And why two minutes? Just because 90 seconds seems to be the minimum amount of time you'll get sunlight and you want to get it through your retina. So it goes to your super chiosmatic nucleus in your hypothalamus. It starts to release all the different hormones. In my book, I'm so effing hungry, I concentrate on feeling full or feeling satisfied and happy. And all of the, things happen through your hypothalamus and sun potentiates that. Alpha MSH is a hormone that

makes you feel fuller all day, then have dopamine and serotonin that gets released with seeing sunlight. So you get all these amazing effects because our body is wired to try to like check what time it is at all times and that retina gives that input. So that's why it's so good. That's why it's a non-negotiable for me now. And the research shows that you start to see those benefits as quickly as 90 seconds. Yeah. Love that. That's amazing. You're not even drinking water for the first 90 minutes of your day? No, I'll drink water. Okay. I'll drink water. I'm so dehydrated when I wake up by my... Yeah, I drink water, but I don't have food or caffeine. And the caffeine, is that because of adenosine? Can you explain the reasoning behind that? A lot of people think caffeine or drinking your coffee is like free energy,

but really, it's not. All it's doing is blocking the adenosine receptors in your brain, and it's blocking them from binding, but then when the caffeine wears off, the adenosine quickly binds to those receptors and then you get really tired mid-morning. And especially if you have excessive caffeine use and caffeine dependence to the point where your adenosine is so high in your brain, it's not able to clear out efficiently even in the morning. It's because you're starting your caffeine early in the morning and you're continuing it throughout the day. You know when you wake up and you have that little bit of groginess, that's that adenosine. It kind of clears out.

And then you can have your caffeine. It also makes you realize, like, if you're that caffeine dependent, for me, it's always like a game of having enough caffeine to get the benefits of never feeling like you need it to survive. Like, you should be able to go a day or a couple of days or a vacation day without that morning coffee. And so it's always a game for me to be like, okay, do I really need it? Should I push it a little more?

Like maybe I don't have my coffee too. That's pretty much why I delay it, both for the health benefits and also just for the dopamine training. Coffee releases dopamine and all of these things that release dopamine, you always want to kind of pull back a little bit to let your receptors reset. I love that. I'm always telling Zach, because I don't drink any caffeine or consume any caffeine, that I would be better than him on a desert island because I wouldn't have to go through like the

caffeine withdrawal. And he's like, have you like seen yourself? on a day. He's like, I don't think it's just about the caffeine. And I'm like, yes, but I wouldn't have a headache. And he's like out, you know, chopping down a tree to make a shelter. But he would have a headache and I wouldn't. I say the same thing with these energy drinks because my husband, he never used to drink caffeine before now. He has all these energy drinks all the time, like before a workout. It's like a pre-workout. Oh my God, Liz, you would die. I felt like I took some kind of like like speed. Like cocaine. Yeah, like I don't even know. I was just like, I think. I

couldn't even drive. Like, I felt like so out of, you feel like so jittery that it's like, you don't know if it's anxiety or energy, you know, like that very fine line. That's me every time I take any caffeine, but I know that when people take too much, that's very much the experience. Wow. So that's why I routinely get off of caffeine when I go on these trips or I go out of town just to like train myself to get off of caffeine. I've had different guests talk about larger breakfast, savory breakfast, sweet breakfasts, sweet breakfast, like all these different things. If you had to say an ideal breakfast from your perspective, what components would it include? I love this one because I love to do everything in the

morning. So in the morning, I try to have 30 grams of high quality protein in my breakfast because there is an amino acid called tyrosine that converts into dopamine. And dopamine is very closely related to norephenephrine, which is like epinephrine of the energy. So you're not only boosting your mood and motivation, but also your energy levels. So you want to have dopamine producing food. So those are like dairy products, high quality protein nuts, berries, something like that, like a cottage cheese with nuts and berries is my dopamine like starting breakfast. It's my ideal breakfast. There's been a lot of talk about high, high protein diets these days, like having significantly more protein than has ever been recommended before. And that's the way to be more

satiated and have more energy and feel stronger and better in our bodies. Do you agree with that? Or what's the amount of protein you think we should be aiming for? Yeah, I think it's really interesting because I used to be very anti-protein because of this rhetoric that, oh, just any type of protein, just more protein is better. And obviously it's the quality of protein. But then started to look at my own diet and the diet of the females that I was consulting for or working with. And I realized that not only are we not even close to high protein, it was like abysmally low. I mean, it was like I was eating salads and smoothies, but there was no protein. I thought it was protein because I thought, oh, I'm having a little bit of nut butter, but it's really abysmal. So I realized that. And as I was

working on my own fitness, as I'm getting older, I thought to myself, okay, I'm losing this muscle mass, you lose up to 3% of your muscle mass every decade and up to 3% per year after 65%. So you're really on the decline. And I'm already a smaller person. So I decided to work on increasing my lean muscle mass, which meant I had to change my diet. And one of the things I realized when examining my own diet was that, yes, I believe that high protein with poor quality protein diets are really bad for you. But on the other hand, a lot of us are probably airing on the other side of things, which is that we are not even getting

close to enough. When I have 30 grams of protein in the morning, like that in my old life would have been half the protein I would get in the whole day. Like I would get 50 to 60 grams. So I'm aiming for the 1.8 to 1 per pound, which is on the higher side if you're trying to build muscle. Sometimes I'm 0.5. So it's basically you want to be half your weight to your weight in grams of protein. That makes sense. And then another thing you mentioned is that you want that cortisol and that adrenaline in the morning. And I think there's this common misconception about things like cortisol and adrenaline in a society where we're very burnt out, we're stressed, and we're like, we want to get our cortisol down. We want to get our adrenaline down. But in fact,

we want to have it up and down at the right parts of our day, correct? Yes. So can you walk us through what an ideal cortisol and adrenaline curve throughout the day would look like? So first thing in the morning should be your big cortisol adrenaline spike. Some people argue like, oh, that's why you shouldn't have your coffee first thing in the morning because if you're doing things right, then you already have that cortisol and adrenaline. you let that work before you hit it with some more.

And that's also why sleeping adequately and waking up at adequate parts of your sleep cycle can be so healing to our hormones because our hormonal reserves are created overnight. And then we get that nice big burst of cortisol in the morning, setting things off in the right way in both our brains and our ovaries for women, testes for men. and we're right on the track for the typical peaks and valleys. Everybody knows that valley that we get after lunch. Usually people get it later in the afternoon and that's natural, gets exaggerated for people.

But it's natural to feel more alert in the morning than lose that alertness late in the afternoon. And then, of course, everybody knows that you really want to calm that cortisol and adrenaline later in the evening. there is a little spike in the middle of the night. It's very tiny. However, if you're like me and you hold a lot of stress inside, and if you have a lot of things on your plate, like a lot of people will tell me,

oh, I'm waking up between the hours of two and four or two and five. There's a little bump there that's enough to wake you. If you're already kind of wired up, that's another sign that you need to work on your stress levels or your hormones in general, because you will get that night awakening. And for me, I know when I have a lot of things going on and I'm not doing a good job of handling it,

when I start to have that little, you wake up and it's like a rush because it's that cortisol and adrenaline, that's hard to fall back asleep and the whole thing. So that's how it goes usually. Things work well. If you have headaches, allergies, brain fog, skin irritation, or you've been dealing with hormone issues, you are especially going to want to listen to this ad.

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Go to birchliving.com slash Liz Moody for 20% off. That is birchliving.com slash Liz Moody. and you're going to get 20% off birchliving.com slash Liz Moody. Do you do anything in the moment when that happens, or do you think it's more about managing everything throughout the day so it doesn't happen in the first place? It's both, but in the moment, I do my best. The best thing you can do is not do too much,

meaning don't turn on all the lights and look at your phone and think about all the things you have to do tomorrow because that's a surefire way of keeping yourself up for next 90 to 120 minutes. The best things I've noticed is to really just take that time to work on your breathing or meditation or go to the bathroom but keep it really dark and don't really like put a lot of light in your eyes even though you're awake and that helps you fall back faster. I had the thought this could be completely wrong. But I was like, should I not be meditating in the morning because I'm quelling that natural

cortisol surge that I want? I would say when that adrenaline and cortisol are lower, like late in the afternoon or before bed in the evening, actually a person who I went on that Machu Picchu hike the first time, he was a big meditator and he would say that he never took afternoon naps, but during work he would go into the meditation room after lunch, that kind of lull time and take a few minutes to meditate in lieu of like a nap or a break or whatever it is. And I thought that was a great idea. Now, I don't work in a setting that has that option. So that's not a great option. But if I ever have a really poor night of sleep, I always feel like taking a quick

nap in the afternoon or meditation, even for 20 minutes is so restorative. I think that's a really nice time if you have the option. My favorite time to meditate is that 2. 3 p.m. time. And it is because I don't drink caffeine, and I find that that's 100% the best alternative. Yes. If you were going to pick one daily practice that we could add in to support healthy cortisol levels throughout the day, what would be the one that you would choose? I think the sky before screen is the sunlight in the morning. And I guess it's like a combo answer for two reasons, both to support our hormones

and to support the frontal lobe of our brain, as women especially, our brains are very, very busy. And starting your day off with a little quiet, a little sunlight and no phone computer use is one of the best ways to calm that part of the brain. They say like women tend to be very good at decision making and stopping themselves from impulses and all of those things because our frontal lobe is so strong, but it's also very busy. So the hard part for many of us, not all of us, is really calming that chatter. And for me, it's like that chatter sometimes clouds all the other thoughts that I want to have. That's the number one thing for me is like if I start my day out like that, things just become

clear all day. Are there any daily or weekly practices that you would either add in or take away at different points in our menstrual cycle? I love that question because we don't talk enough about our menstrual cycles. Late ludial phase, for people who have never. heard these terms. The ludial phase is what happens after you ovulate. So day 14 on average, a woman ovulates. And then that last part of the cycle, the last two weeks is the ludial phase. And that last week, which we so affectionately call PMS, is the late Luteal phase. And that's

when our progesterone drops and our estrogen drops. And progesterone is like our calming and sleep hormone. So you'll feel more anxious. You'll have more trouble sleeping. And then estrogen is kind of like our insulin sensitizer. And it also makes us stronger and more emotionally stable and able to tolerate more cortisol. So at the end of our cycle, like PMS, like right before your period, that's the time you're going to feel a little more irritable. You might feel a little less energetic. You might have poor sleep. You might have a combination of these things. But you may have all of those things. So the practices that I do in my late ludial phase are really different.

I really try to support that low progester and low estrogen state by getting more sunlight, getting more walks rather than the high intensity workouts, getting more sleep, maybe even taking a nap because I haven't slept well, especially on the weekend. And really nourishing your body instead of, I used to think to myself, oh my God, I can't stop eating. It's right before my period. I felt so awful inside and out. And now I realize, oh, it's just a time where our body needs nourishment and we need more carbohydrates and we want more things that produce serotonin. Progesterone also helps us produce serotonin. So eating foods like sweet potato, for example, help us create more serotonin because those kind of

foods are serotonin promoting foods. And that's why you want to reach for the bread and the cookies and the crackers is your body is craving that serotonin. Your serotonin is low. That's why your mood is low. And instead of beating yourself up, just give it the nourishing foods it needs without feeling guilty about it. I love that. Okay. So that is the time right before your cycle. What practices or routines are you adding in or taking out in the other times of the month? So everybody on the internet gets it wrong. Okay, all these men, they say, oh, your period, you should not be exercising on your period. You should not be doing anything stressful on your period. But every woman realizes, and it makes sense hormonally, that yes, day one and day two, you're still recovering. Your hormones

are just starting to rise again. But around day three, you feel really good. Yes, you may still be bleeding, but your energy levels up. All of a sudden, you don't want to kill it. You don't want to kill everyone anymore, your progesterone starts to rise, so you're less anxious and you're sleeping better. So that is the time where you really start to exercise. You can start your intermittent fasting if you'd like. You can start eating like an athlete, training like an athlete program. If that's, you know, what you're going for. This is the time to try all the things, to put all the things in place that you've wanted, even going for it at work or in your creative endeavors or asking for the things that you need.

So that time between days right after your period, like day two, day three, all the way to ovulation, you are in your prime, strong woman's date. So this is when you want to do all the things, which makes sense because everybody should be cycling their training, their dietary practices, the things they do at work. So if you can save your big projects or big stress-inducing but also good things for the that period of time, it can really change your life. Like I've noticed, at least for myself, the late Luteal phase is not the time for me to stack the projects, to stack the workouts, to stack the intermittent fasting.

I try to think, okay, that week I might be a little more down, less energetic. I may need a little more sleep. I may just plan for that in case, right? So then you know that usually in the first week and a half, two weeks after your period, you feel good. And that's the time to go for all the big tasks, if you can. Okay. So ask for a raise on one of the last days of your period or just shortly after. And even closer to ovulation, like day 12, say, day 12, 13, 14, your testosterone is really high. So that's a part where you want to like, if you need like the guts and the muscle to like,

you know, the gall, you know, when you, this is really mean to say. But I used to be. able to tell the men who are injecting steroids or testosterone because they would walk into the office and they would have this bravado and they would be slightly rude or something. Sometimes they're just very confident, but almost edging on like rude. And I used to say, oh my God, it's like I can almost tell that they have really high levels of testosterone. And that's kind of how you should think of it. Women need testosterone, right?

We have testosterone. And just that little boost towards ovulation makes us have some of those qualities. And if you're someone, for me especially, I know, I tend to be like a little scared, a little shy, a little wanting to like, I don't want to like ruffle feathers too much. That's the time that I like to do those things. Okay, so right around ovulation. Yeah. Is that when if we wanted to like have the best sex of our lives and have that feel amazing,

Would that be right around then too? I mean, think about it. Mother Nature's so smart. They're like, okay, she should get pregnant right now. She's going to be the most attracted to her partner. She's going to be the most likely to want sex or to enjoy it. So that's the time that you get that little burst of testosterone, desire, all of it. And that's also the time that you're most likely to get pregnant.

So depending on your goals, like approach sex with caution, but it might feel especially good during that time. I've also found that sex feels really good during my period. And I don't know if there's like a pain relieving element to that or a hormonal element to that. But that would be my second favorite time. Yeah. Actually, I've heard a lot of people say that. And there's so many theories that finally when your hormones start to rise again, that last week before your cycle, you don't want anyone to touch you, be near you.

And then once you get your period, those hormones start to rise again. like oxytocin. So that is probably the second best time. And is that all of the times or is there any other phases of your cycle that we haven't covered? So it's period. And then we didn't name it, but it's called the follicular phase, which is that first 14 days from date one of your period all the way to ovulation. And then the second phase is called the ludial phase. And so that's the whole cycle. A lot of women message me and say, well, I've never had a cycle or I've, I've on oral contraceptives, and I don't know my cycle. I know it's really difficult because it's harder to track if you don't get a period,

but a lot of people do get a period. So just the day one of your period is day one of that part of the cycle. You still go through all the phases even if you're on oral birth control. I've always wondered that because I know that your period is quote unquote kind of fake if you're on hormonal birth control. So I didn't know if all of the phases of your cycle were still there. What happens is instead of getting these steep rises and drops, you get kind of even. Because if you're taking a pill, it's not going to mimic it exactly.

When people get steep rises and falls, that's when they get acne or they might get some side effects of hormones. And so sometimes people are on hormonal birth control just to make their hormones a little less up and down. But as you know, you can argue both ways. You can say, well, why would you want to take away the spikes in the valleys? Because the way we're talking about it, hey, we kind of want that spike. That's almost like a nice time for us to be doing all the things that we want to do. And then we manage the valley. But if you were someone who's like, that valley is just too low for me. I can't handle it. Then oral birth control or hormonal therapy can help you regulate those levels.

Yeah, I think it just depends on your specific needs and your specific goals. Yeah, back in the day, when I was a kid, every single person was put on hormonal birth control either for acne or for mood issues. And now I think people are realizing like, hey, maybe it's not so bad to have that normal kind of up and down cycle, which has been around for thousands of years. Yeah, 100%. I think it is the right decision for a lot of people, but I think people are making it with a lot more intention. I know when I was like 15, I went to the doctor. And I think I had mild cramps. And they were like, oh, here, just go on birth control. And I wasn't having sex. And I was on it for over a decade after that with nobody asking about it. So I do think it's a decision that is a powerful

tool that we have available to us, but should be used with a lot of intention. Yeah. And on the other hand, now there's all this debate about women taking hormones for menopause. And now that I'm in this paramenopausal worlds, I realize like they're not as bad as they were once made out to be. When I was first in medical school, hormonal therapy for menopause was like taboo because there was all this data that said that it causes cancer. It's like really bad. And now the tide has turned a little bit. And they're saying like, actually it can really help with a lot of the symptoms of menopause.

And it doesn't have to be one size or tall and it doesn't have to be really high doses. So it's so nuanced the conversation. about hormones. Do you think that you're going to take hormones? I will if I need to. I hear horror stories about menopause, but I also hear people being able to manage it through lifestyle and diet. It's kind of like the whole argument about any of these medications that you can use lifestyle and diet. Like, I'm going to do my best and then see what happens, but I'm not opposed to it by any means. I love that. Okay, let's talk about nighttime routine. What are some critical components to a nighttime routine that are still realistic that we can all kind of experiment with.

I love evening, nature viewing as well. One of the biggest things we've gone wrong in modernization is our time we spend indoors. So I try to just even for a quick stroll or a phone call, whatever, it may be something short, but getting some evening input. Their brains know the difference between evening light and morning light. So that can help with the sleep because they'll be like, oh, it's evening light, so start to shut that down. I stopped eating two to three hours before bed. I turn down the lights. I try not to go to Target or high overhead lighting places late at night.

I'm not doing like a big workout late in the evening unless it's like yoga or a walk or something. And then the thing that I haven't been able to get rid of, which is really, really difficult since I've gotten rid of it in the morning, is the phone. What happens to me is like I know I'm not going to be able to look at it in the morning. I still go 30 minutes without it before bed, but I usually, that's the last thing to be off. And I put all the lockers on and the darkness and then I try to go 30 minutes without it. But that's something I'm actively working on. What do you do to actually fall asleep? Like, do you read?

Do you meditate? Do you just lay there? Yeah, that's a great question too. I learned this really amazing sleep technique that the military used to use for. their soldiers because they would have to sleep. Sometimes on the field, like in the middle of war or like lots of lights or overhead sound, it's basically relaxing your muscles and lowering your heart rate by doing breathing. I have it on my Instagram account.

But it's basically like getting out of your to-do list and being aware of your body, your breathing. One of the things I learned is your body has to both drop its core body temperature and your heart rate has to drop near 80, or below 80, to really be able to fall asleep. So getting yourself cold and slowing the heart rate as much as possible. And for me, the easiest way to do that is after you breathe, inhale, the exhale, slow down that exhale,

and that will help you really target that vagus nerve, which slows down your heart rate. And that usually helps me fall asleep. The times when I cannot fall asleep, it's because I'm stuck in the to-do list or the things that I'm worried about or that didn't happen or that will happen, the excitement or the disappointment. So my whole goal is if I'm in that state where if I know I'm going to bed and I have a lot of things in my mind, I try to write it down before bed or read a book that completely takes me away from there. So that's what the strategy I do if my mind is really full. But if I've done a good job all day, then sometimes I don't even need any of that. And I just put my phone away.

And then I spend 30 minutes just getting ready for bed, which means nighttime routine. I wash my face. I put on my creams. I get my workout clothes ready for the next day. Kind of spending 30 minutes just getting ready for the next day without any exciting or disappointing conversations, emails, phone calls, anything like that. that. Wait, so is it bad to have sex right before bed because you're kind of getting excited and hyping yourself up a little bit? No, because after you have sex, you have that big oxytocin release,

you have the calming hormone. So although you have that big climax per se, and you have that very long, relaxed let down. Some people, that's the only way they can fall asleep because they need that relaxation part of it to help them fall asleep. It's exciting, but then calming. If you are going to say the best time of day to have sex, but like literally just from a health hormonal perspective, what would you say? I think before bed, because it's the time that you really do want those calming hormones. You want to get out of your to do list.

That's really the issue, right? For most women or men, when they don't have a lot of desire or they don't want to have sex, it's because they are caught up that to-do list. It's because they are so stressed or so worried about something. But the antidote to that would be to get out of your to-do list and do something to get yourself out of it. I love that. And then the not eating for two to three hours before bed, is that because of the circadian

rhythm of your microbiome? That's exactly right. So when melatonin is released, it's not just telling your brain that it's time for bed. It's telling your pancreas. it's telling your gallbladder. It's telling your intestines. So what you're doing when you're eating really late at night, especially a big meal, say 11, 12 o'clock, is that it's like waking your body up in the middle of the night and asking your brain to do a very complicated math problem in the middle of the night. Not only are you going to get that wrong or take longer

to answer the problem, you're going to be irritated and tired the next. morning. That's really what we're doing when we're eating these late meals. Think about it for thousands of years since the beginning of time. We didn't have Uber Eats, 24-hour meals. Like, you could maybe have a small snack, but even up to 100 years ago, there wasn't a lot of options to eat late at night. And our bodies are really built to not eat. And you'll see blood sugar, inflammation level, GI symptoms, all of those things are connected to the timing of your last meal. So I don't believe in intermittent fasting. Like, I don't think that everybody needs to be fasting 24 hours or three days or even 16

hours. But I do think that the common practice of having wine or a big meal, like right till you turn off the light and then waking up and like literally rolling out of bed and having your first meal, like that is not good for our metabolism, our hormones, and so much more. The number one rule of habits is to make the things that you want easier and the things that you don't want harder. Yet so many of us want to eat healthier, but so few of us actually take the steps to make eating healthier easier. That's where Marley Spoon comes in. What I love about this company and what's different than all of the other companies out there that are doing like stuff in

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every step, every workout, every muscle contraction depends on energy produced at the cellular level. And at the center of that is your mitochondria. Here's the thing that nobody tells you, certainly nobody told me. Starting around age 30, our mitochondria naturally become less efficient. More get damaged, more become sluggish. And over time, that is. impacts your energy, your strength, your recovery, and your resilience. Most of us respond by pushing more. We're like noticing these things and we're adding in more protein. We're trying to fix it with more supplements.

We're trying to do harder workouts. And those things do help. But timelines research suggests that we also need to be supporting the cellular machinery underneath. And that is exactly what their supplement mitopure does. It contains urolithin A, which helps your body clear out damage mitochondria and support healthier ones so that your cells can produce energy more efficiently. Because this is happening to your cells, it's going to impact your entire body, your immune system, your muscles. One study

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They want to lower inflammation. I would get a sunny walk in, like it doesn't have to be sunny. I just say sunny meaning nature walk first thing in the morning. And why is that going to help with inflammation? It's going to move your body. It's going to give you input to your circadian roots. of them, it's going to move that lymph. Our bodies need to see sunlight move to work properly.

What one practice they should add in if they're feeling burnt out? The sky before screens. Try not to look at your phone first thing in the morning. Give yourself some time to be just in your own space. It's like the biggest antidote to burn out, at least health-wise, I can tell you, besides quitting your job. Is that something you recommend in your practice? Quitting your job?

Yeah. Yeah. I mean, I can't tell you how many people I've worked with that either switch careers or quit their job. When you examine your life, you start to see that there's a person or a pattern in your life that keeps you stuck. And if you can identify that. And if that's a person or if that's a job, it's something that you can change. That's actually really powerful. Do you have any other quick and dirty tips for burnout? I know you wrote an entire book about it. Yeah, burnout is boundaries. It's all about boundaries. When we feel like people are

encroaching our boundaries and we don't know the words for that is when we feel burnout. So if you have a toxic person in your life, and I used to do this all this time, I used to think, oh, we're born with our family and friends. Like, you don't have a choice, right? But you do have a choice. You have a choice of who you let in. You have a choice of who you spend time with. You have a choice. You have a choice of who gets your energy. If you want to have more energy for the right things and the right people, you're going to have to take it away from the wrong things and the wrong people. So I think that's the biggest antidote to burn out boundaries.

I love that. One daily practice to add in if you are trying to get pregnant. I think I would recommend them to change your diet. I know that's not one thing. For example, PCOS, we always talk about PCOS or it's high insulin levels or more insulin resistance. So changing your diet is something that you don't even think about, but this is the way to change your insulin resistance or to lower your cortisol level. So really having more minimally processed or unprocessed foods so that you can get those inflammation and those insulin levels

down is going to do leaps and bounds for your fertility. Are there any foods you would concentrate on adding in? Fibrous vegetables to kind of clear out those old hormones. Broccoli, cauliflower, Brussels, a cruciferous vegetables. They're called glucosinolates because they have this sulfur compound that also is anti-cancer and improves hormones. And so fertility really improves when you add in more fibrous vegetables. And I think, I used to think I used to eat healthy, but I really ate very little fibrous vegetables. And I think that really can help for someone who's like, what's the one thing I could be doing? What about if you are pregnant? Food practice or just practice in general? Any, like literally one thing. It can be a cold shower. It could be a sauna. It could be a fish oil.

Anything you want. When you're pregnant, I think the best thing you can do for your body is to keep it moving. A lot of people used to be scared. Like, oh, don't run or don't exercise when you're pregnant. But the best way to have a healthy pregnancy, to have an easy childbirth, to feel good in your body afterwards, is to stay really active, like lots of steps during the day. Do the yoga. Don't be afraid to move. What if you want to support your microbiome? The best thing to support your microbiome is eating your probiotics.

I would say coconut kefir, fermented cottage cheese, probiotic yogurt, even apple cider vinegar. or the raw fermented probiotic kind. These are amazing foods to get your body to start to create more bacteria. Liz, we have 40% less diversity than generations above us. So we pass down our bacteria to the next generation. So for, you know, when we're talking about women and pregnancy, and this is like generational changes that we're seeing. What about one daily practice or one thing to add in if somebody feels

tired all the time. That's really a good one. So you said cold shower and I hate, hate cold, but I think that's a really, really great way to have an energy boost. I remember in medical school, there was someone who used to, they put it up their face in like an ice bath saying like, oh, that made me feel so refreshed and energized. That's one of the biggest benefits. So that's one thing you can do.

Is there an optimal time of day to incorporate your cold exes? exposure? When you're feeling tired, like that afternoon or if you had a poor night of sleep, that's one of the biggest remedies you can do besides getting in a nap. Okay, somebody who is menopausal? The best thing I would do for someone who was menopausal or peri menopausal is what we call all those years that are kind of like gray area is incorporate more fiber and more protein into your diet. weight gain of menopause is not that metabolism is slowing per se. It's just that you have less muscle mass and you have more fat mass and your weight might be the same and your metabolism is the same, but your body type looks different. You are basically functionally burning less calories

because your muscle mass is less. So you want to counter that by doing more weight training, eating more protein and also more fiber because fiber will help you clear out some of those hormones and also slow down the passage of food in general that keeps your insulin levels lower. What about somebody who recently took antibiotics? Start to incorporate more probiotic and prebiotic foods into their diet. If somebody wanted to lose weight but do it in a way that was as supportive to their body's health as possible, what's one thing you would add in or take out? Increased your steps by far.

Like when I see perimenopausal women who are like, oh my God, I'm doing everything right, I'm eating right. Lots of times as we're getting older, we're just less mobile. Or you just got used to your desk job or you're having some issues with certain parts of your body like injuries. So you can't necessarily do the things you used to do. But stay active and move around. and also dietary changes to incorporate more fiber and protein, just like I said, for the menopausal women.

There are so many different daily routines and practices, and I think it can feel really overwhelming. And so I'm curious if, one, you have any advice for figuring out your absolute non-negotiables for a person individually. And then, two, I'm curious if there's any that you feel like are kind of trendy or a lot of people do that you don't really think are worth people's time. Yeah. I don't think all the supplements and all these people who are like, I take this and I take this. So there's a lot of trends. Every hormone account on Instagram that says like, you know, oh, take the seed to balance your hormones as if one seed was going to balance your hormones or this trick can, it's not that easy. It's like a way for someone to sell their own supplement or their own ideas. Hormone balancing. especially because I think that's an area that women are so desperate for information on. That's an area that's like ripe with all this misinformation and little hacks that just don't even work. If somebody did feel like their hormones were in balance, where would you have them

start in terms of trying to figure out that equation for their body? I know. It's so difficult and you bring up a really good point. In our medical training, there is very little. little information about hormones. When I did immunology fellowship, I did a research project on how the immune system interacts with hormones. And there were like very few studies in the world and none in humans, mostly in animals. So there's such a posity of research that even the experts don't really know. So I realize that we're in this space that there's no real

expert per se. And then there's not enough research. So you're left with all these people. I end up saying, we don't know or I don't know from the research. But this is what I would do. You know, because for example, with intermittent fasting, people ask me all the time, like intermittent fasting for women. Like, it's bad. And I'm like, no, it's not bad.

We can't say it's bad or good because we have so few research articles to say either way. From what we know, it's like women running marathons. I would think of intermittent fasting in the same way. Like some women do amazingly. well running, you know, long periods of time. Some women have to do shorter runs and otherwise, if they do longer runs, they have hormonal issues. Long story short, there's really no hormone expert because if you're relying on evidence, there's just not enough evidence for giving out advice about hormones. So what we use is best clinical judgment and guide people that way because we

have no other choice. It's a kind of a sad situation. If people just want to feel better, what would you say to start? If you want to start to feel better in your hormones, you realize that your gut, so the things that you eat, the way that you live, like when you talk about circadian rhythms, that's all about hormones. When I talk about gut health, I'm talking about gut immune hormone health. And so when you want to balance your hormones, you're really talking about improving your microbiome, improving your circadian rhythms. So instead of calling it balancing your hormones, it's really just getting your estrogen, your progesterone, your cortisol, your insulin under control, which is we know a lot about how to get your insulin under control. We know a lot about

how to get your estrogen, progesterone, and cortisol more even. So concentrating on the things that we do know because we don't know. Like even the things I'm telling you about the cycle, this is all like very new stuff that has barely been studied. And then to the first part of the question, how do we decide, how do we figure out which are our daily non-negotiable practices when we're trying to build the practices and routines that work for us amongst so much information? And honestly, like it sometimes just feels like, oh my gosh, I need to have like five hours in the morning and five hours in the evening to feel my best and to be my healthiest self.

This is such a great question. Liz, I just posted a video and I'm not going to take credit. I think her name is Chow, Amber. She basically said that Western society has taken everything that would be naturally contained in a healthy community and taken it out in the name of like we're busy, we're more industrialized and then adding it back in as like a commodity that you have to now buy. So instead of having healthy foods with communities, it's like you have to get supplements and special superfoods. And instead of, of having just natural exercise during the day. Now you have to join a gym or go to CrossFit or go to whatever. She's like instead of having communities, now you have to buy therapy. It's like the society where we've taken out all the essentials to live a long, happy, healthy life. And now we have to purchase them and add them on to our day because our day doesn't contain any of that. And it's such a good point. So this is what I would say. The best day that you can remember or days that you can remember as far as you can remember, say, in the last year. What did you do that day that made it so great?

Like, what was it? And that's how I got my skies before screen habit because I thought to myself, like, wow, I feel like Monday and Tuesday just went so well. Like, what did I do differently Monday and Tuesday last week or this week that were so great? And I realized that's what I did. And that's how you can start to kind of add on the practice. So maybe you did a couple of things differently and you try all of those things. We're meant to feel good in our bodies.

We're meant to feel happy and energized in the morning. We're meant to feel sleepy at night. Like if you don't feel those things, start experimenting, start trying to find out what it is that you could be doing better. And maybe it doesn't require a cold plunge and a sauna and, you know, yoga session and all these extra supplements and foods. maybe it's just like a sunny walk and eating in healthy early dinner and spending more time with the people that make you feel good. Like maybe those things are non-negotiables. Like that could be it.

I love that. I kind of want to end on that. But when you said we're trying to live a long, healthy, happy life, I was like, I should have asked her a daily practice to add in or something to add in for longevity. If we're going to add one thing to our routine for longevity, which is an interesting one because you can't measure it right away. Like we're meant to sleep well, we're meant to feel energy. So those you can kind of attune your routine with and you can say, am I sleeping better?

Do I feel more energy? But when you're just trying to live as long as possible as well as possible, that's much harder to measure the effects of something on a daily basis. Yeah, 100%. This is my longevity trick. And this is the thing I've only started in the last five years is your relationships. So not only your partner, but the people you spend time with, what I realize is the long. longest living communities in the world, they have friends and they have people who they can count on. There was a researcher who said there's a couple of gates that determines this kind of longevity friend, you know, who helps you with longevity. It's like, would you call them with something

exciting? Would you call them with something disappointing? And would you call them for an inconvenient help? If they pass through all three or if they pass through one or if they pass through one or two. But if they don't pass through any of those, then that's not a friend that's going to really support your longevity. And so I thought, oh, my gosh, we spent so much time with people that we wouldn't call with good news because we'd think that they would be not excited or like even almost jealous, or not jealous, but just not happy for you. And then the same thing, like, you wouldn't want to call them with an inconvenient need for help because you'd feel awkward. But who are the people who you could call up at any time in an emergency situation and they would come to help you or they would send help?

Who are those people and surround yourself with those people? I absolutely love that. Amy, can you tell us a little bit about your books, both of them, where to find you on the internet, all of your beautiful work that you're doing? Thanks, Liz. At amymdwellness.com is my website. You can see both I'm so effing hungry and I'm so effing tired. There. I am on social media on Instagram. I'm at Fasting, MD. On Twitter and Facebook, I'm Amy Shaw, MD. Love that. Well, thank you so much. This was so helpful and such a lovely conversation.

Yeah, this is so fun. Thanks for having me. I know that was a lot of incredible information. I think an amazing starting point would be to just choose one of Dr. Shaw's tips, ideally one that focuses on optimizing an area of your life that you need some support in and then try to implement that one habit into your daily life. These small steps that you can actually stick to add up and ultimately make you feel so much healthier and so much happier. If you love this episode or any healthier together podcast episode, I would so appreciate a quick rating or review on Spotify or Apple podcast. It really helps other people both find the podcast and decide if they want to listen to the podcast. They're always like scrolling through the reviews and deciding, like,

is this podcast a good fit for me? So I massively appreciate you taking a quick second to do that. It literally takes less than a minute. If you're new here, make sure that you are following the podcast on whatever platform that you like to listen on. Just go to the main podcast page. That's the one that lists all of the healthier together episodes. You'll see the word follow under the logo on Spotify. And then there's a little follow with a plus sign button on the top right of that same page on Apple Podcasts. That way, all of the new episodes will show up right in your feed so you will never miss out on one. And you are definitely going to want to be in the loop because we have some amazing episodes coming up, including one outlining the best ways to manage your time

and another one diving into all of the latest circadian rhythm research, which is a really nice piggyback to some of the things that we started to talk about in this episode. So make sure that you're following so you do not miss out. Okay, I love you and I will see you next. Wednesday on the next episode of the Healthier Together podcast. I very rarely get genuinely excited about skincare, but this is one of the most innovative products that I have come across in years, and I am so obsessed with it. I've been telling all of my friends to get it, so now I need to tell you guys. Here's some science first.

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