Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Today, I’m delighted to connect with Dr. Zach Spiritos. A double board-certified gastroenterologist in internal medicine with a fellowship in neurogastroenterology, he founded Ever Better Medicine, a practice built around treating complex, chronic, and often underrecognized conditions at the intersection of the gut and the nervous system.

In today’s conversation, Dr. Spiritos and I speak at length about how patients get dismissed by the medical system. We explore irritable bowel syndrome as immune dysregulation and common symptoms that he sees with this diagnosis. We discuss hypermobility and the 13 subtypes of Ehlers-Danlos syndrome, with hypermobility closely linked to inflammation, MCAS, and immune dysregulation. We cover several commonly missed GI complications in hypermobile patients, including how POTS and MCAS often overlap with GI dysmotility, MALS, and how nutrition and stress influence symptoms. Dr. Spiritos also shares his views on constipation and the importance of staying curious.

Stay tuned for today’s fascinating conversation with Dr. Zach Spiritos about complex medical conditions and how they intersect with the gut.

IN THIS EPISODE, YOU WILL LEARN:

How Dr. Spiritos recognizes when symptoms may reflect underlying physiology rather than being purely psychological

Common symptoms that point toward dysautonomia, POTS, or MCAS in women

How connective tissue laxity and hypermobility can contribute to gut dysfunction

GI complications that may be missed when patients do not fit neatly into an IBS diagnosis

How POTS fits within the broader picture of dysautonomia, hypermobility, and MCAS

Meal-related patterns that may point to abnormal gastric motility associated with dysautonomia

The value of using a food and symptom diary when appropriate, and treating elimination diets as trials rather than permanent restriction

How fixating on bowel symptoms can create cycles of anxiety and GI distress

How Dr. Spiritos approaches constipation in patients

Why clinicians should remain open-minded when patients present with multiple medication sensitivities, allergies, and complex symptoms

Bio:

Dr. Zachary Spiritos, MD, MPH, is a neurogastroenterologist who specializes in treating patients with complex and chronic conditions, including disorders of the brain-gut interaction (DBGI), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), Ehlers-Danlos syndrome (EDS), and gastrointestinal dysmotility.

He earned his medical degree and Master of Public Health (MPH) from the University of North Carolina at Chapel Hill, where he developed a passion for addressing the systemic challenges patients with underrecognized illnesses face. He completed his Internal Medicine residency at Emory University and his Gastroenterology fellowship at Duke University, where he focused on neurogastroenterology and disorders of gut-brain interaction.

Dr. Spiritos is particularly dedicated to supporting patients who have been dismissed, misdiagnosed, or lost in the medical system. He takes a whole-person approach to care, combining the best of conventional medicine with targeted interventions to regulate the nervous system, improve sleep and movement patterns, address nutritional imbalances, and manage stress physiology.

He works primarily with patients whose symptoms span multiple systems and don’t fit neatly into one diagnosis—individuals who require time, nuance, and interdisciplinary collaboration. Dr. Spiritos partners closely with his patients to build individualized, sustainable care plans that address both symptoms and underlying causes—helping them reclaim their health and quality of life.

** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab.

Connect with Cynthia Thurlow

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Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

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Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Dr. Zachary Spiritos

On the Ever Better Medicine website

Instagram

This episode is another in a series of interviews with highly vetted companies that I consider tremendously beneficial for my Everyday Wellness community.

Today, I’m honored to welcome Katie Emerson, Senior Manager of Scientific Affairs at Kyowa Hakko USA. Katie is a registered dietitian and certified sports nutritionist, and she completed her doctoral work in nutritional science.

In today’s conversation, we discuss women’s mental clarity through midlife, including focus, memory, attention, and mental energy during perimenopause and menopause. We explore how everyday distractions and mental fatigue differ from true cognitive concerns, and Katie explains how citicoline supports brain cell membranes and neurotransmitter production, its key physiologic benefits, and how it works, especially concerning estrogen and phosphatidylcholine synthesis. We also discuss caffeine, citicoline, and creatine, looking at citicoline’s peak efficacy and half-life, key benefits for athletes, students, and the elderly, what glutathione is, and how Setria can support healthy aging through detoxification. We also explain how to choose high-quality glutathione products, how branded ingredients differ from generic ingredients, and why reading supplement labels actually matters.

Stay tuned for an invaluable conversation you will likely revisit more than once.

IN THIS EPISODE, YOU WILL LEARN:

How estrogen fluctuations and declining estrogen levels can affect women’s mental clarity, focus, memory, and attention

How sleep disruption, stress, hot flashes, and mood changes can influence women’s cognitive performance in midlife

How to distinguish everyday distractions and mental fatigue from cognitive concerns

When memory, attention, language, and orientation changes need to be evaluated by a healthcare practitioner

How citicoline supports brain cell structure and communication

How to use citicoline for short-term focus and longer-term cognitive support

How glutathione helps protect cells and support the body’s natural detoxification pathways

How to evaluate the quality of supplements, ingredients, and brands

Bio: Katie Emerson, PhD(c), RD, CISSN

Katie Emerson's role sits deliberately at a crossing point that didn't used to exist in the supplement industry: performance nutrition used to mean muscle and endurance almost exclusively, and now includes focus, attention, and mental energy as an equally serious category. She leads the scientific communication behind Kyowa Hakko's branded ingredients, primarily Cognizin citicoline, translating the same underlying clinical research for three distinct audiences: brand teams deciding what to formulate, clinicians evaluating whether the evidence holds up, and consumers trying to figure out what a supplement label means. That translation work, moving between technical, clinical, and consumer registers without losing accuracy in any direction, is the throughline of her role.

Connect with Cynthia Thurlow

Cynthia’s website.

Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab.

Connect with Katie Emerson

Kyowa Hakko USA

Kyowa Hakko USA on Facebook and LinkedIn

Cognizin Citicoline on Instagram

Katie on Instagram

Today, I’m delighted to welcome Dr. Florence Comite, a clinician, scientist, endocrinologist, and global authority on healthy longevity. She founded the Comite Center for Precision Medicine and Healthy Longevity, with locations in New York, Palo Alto, and Miami Beach, and spent 25 years as a graduate and faculty member at Yale School of Medicine. She is also the author of Invincible, one of my must-read books for 2026.

In our conversation, we discuss why medicine focuses on urgent care, the missing provider relationship, and the hallmarks of aging. We explore how our biological function peaks between 27 and 30, why testosterone is the first hormone to decline in both men and women, bio-individuality, testosterone in women, optimal ranges, and heart disease risk. We explain why midlife is one of our biggest metabolic shifts, how to track it, and why heart disease diagnostics are important. We also cover sarcopenia, GLP-1s for longevity, and the relevance of bioimpedance readings versus BMI.

Stay tuned for today’s fascinating conversation. It’s one of my favorite conversations of the year, and I know you’ll want to listen more than once.

IN THIS EPISODE, YOU WILL LEARN:

Why modern medicine focuses on urgent and emergency care

How the missing provider relationship influences patient care

How genetically similar people can have different health risks, body composition, and responses to medications

What testosterone does for memory, cognition, executive function, bone, muscle, and the heart, and what women need to understand about testosterone ranges

Changes in metabolic health women should be paying attention to in midlife

Dr. Comite compares CAC, CCTA, Cleerly, and HeartFlow, and explains how these diagnostics contribute to heart evaluation

What women need to consider when assessing heart disease risk

Why Dr. Comite suggests starting with small lifestyle changes initially

How to maintain muscle mass, particularly when using GLP-1s

Why BMI does not provide an adequate reflection of body composition

Bio:

Florence Comite MD is a Yale- and National Institutes of Health-trained physician-scientist, a pioneering force in precision medicine, and the world’s leading expert in longevity and endocrinology, who is renowned for her expertise in leveraging proprietary clinical and wearable data collected at her private clinical and virtual practice to detect, predict, and reverse biological aging, disorders of aging, and optimize healthspan and vitality for life.

A graduate of Yale School of Medicine, where she was a faculty member for twenty-five years with a triple appointment in Endocrinology (Internal Medicine and Pediatrics) and Reproductive Endocrinology (Gynecology and Andrology), Dr. Comite trained at the National Institutes of Health and founded Women’s Health at Yale, the nation’s first women-only clinic.

In 2005, Dr. Comite founded the Comite Center for Precision Medicine & Healthy Longevity in New York City, establishing a clinically proven, academic approach to personalized healthcare structured around the individualized clinical process known as Nof1TM, where each patient is treated as a single-subject clinical trial. Her global clientele spans the population, from forward-thinking physicians to industry-disrupting executives and health-enthusiastic entrepreneurs. Each patient benefits from insights and interventions tailored to their physiological make-up. The Center has expanded to Palo Alto and Miami Beach in the last several years.

Dr. Comite has published original research and articles in numerous clinical journals, including the New England Journal of Medicine, JAMA: The Journal of the American Medical Association, and the Journal of the Endocrine Society. She is known for her seminal research on children, women, and men, recognizing that our entire system is critical in aging and disease. In 2013, she authored the bestselling book Keep It Up: The Power of Precision Medicine to Conquer Low T and Revitalize Your Life, focusing on androgen deficiency and vitality in aging men. Her clinical research data and decades of clinical practice informed Dr. Comite’s new book, Invincible: Defy Your Genetic Destiny to Live Better, Longer, available in bookstores everywhere!

Connect with Cynthia Thurlow

Cynthia’s website.

Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab.

Connect with Dr. Florence Comite

On Instagram, TikTok, LinkedIn, X, YouTube, Facebook, and Substack

Healthy Longevity Podcast

Book: Invincible

Welcome to today’s MLM episode!

This week, I take a closer look at three supplements that come up regularly in questions I receive from my community: NMN, urolithin A, and CoQ10.

Stay tuned as I walk through what the research says about each one, how they differ, and how I think about targeted supplementation based on individual needs.

IN THIS EPISODE, YOU WILL LEARN:

Why NMN, urolithin A, and CoQ10 need to be looked at differently when considering supplementation

What NMN is and what it does

How urolithin A relates to mitophagy

Where CoQ10 works and the role it plays

How NMN, urolithin A, and CoQ10 relate to different areas of health

Why some people are unable to produce enough urolithin A

What the research tells us about combining NMN, urolithin A, or CoQ10 with resistance exercise

Why supplementation should be targeted rather than automatic

** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab.

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Cited References:

[1] Fukamizu Y, et al. Sci Rep. 2022. Randomized trial: oral NMN safety in healthy men and women.

[2] Forman DE, et al. J Am Coll Cardiol. 2023. Scientific statement: geroscience and cardiovascular disease in older adults.

[3] Kuerec AH, et al. Aging Res Rev. 2024. Systematic review: urolithin A in humans.

[4] Yoshino M, et al. Science. 2021. Randomized trial: NMN and muscle insulin sensitivity in women with prediabetes.

[5] Song Q, et al. Adv Nutr. 2023. Review: NMN safety and anti-aging effects in human trials.

[6] Katayoshi T, et al. Sci Rep. 2023. Randomized trial: long-term NMN, NAD+ metabolism, and arterial stiffness.

[7] Alp Arici EC, et al. Mini Rev Med Chem. 2026. Review: NAD+, longevity, and menopause.

[8] Jarrin-Orozco MP, et al. Food Funct. 2026. Randomized crossover trial: polyphenols, TMAO, and urolithin A and equol metabotypes in women in menopause.

[9] Hasheminezhad SH, et al. Phytother Res. 2022. Review: mechanisms of urolithins.

[10] D'Amico D, et al. Trends Mol Med. 2021. Review: urolithin A in health, disease, and aging.

[11] Zhang Z, et al. J Diabetes Res. 2026. Systematic review and meta-analysis: CoQ10 and lipid, glycemic, and inflammatory markers in metabolic disorders.

[12] Pan T, et al. J Nutr Biochem. 2025. Animal study: CoQ10, white adipose browning, and mitochondrial dynamics in ovariectomized rats on a high-fat diet.

[13] Gasmi A, et al. Crit Rev Food Sci Nutr. 2024. Review: CoQ10 in aging and disease.

[14] Freeberg KA, et al. J Gerontol A Biol Sci Med Sci. 2023. Review: NAD+-boosting supplements in humans. https://pubmed.ncbi.nlm.nih.gov/37068054

[15] Bhasin S, et al. Endocr Rev. 2023. Review: NAD in aging biology.

[16] Lippi L, et al. Aging Clin Exp Res. 2022. Systematic review of randomized trials: nutraceuticals and dietary supplements and mitochondria in healthy aging. https://doi.org/10.1007/s40520-022-02203-y

[17] Visioli F, et al. Free Radic Biol Med. 2022. Review: natural products and age-related mitochondrial decay. https://pubmed.ncbi.nlm.nih.gov/34890770

[18] Ghosh N, et al. Sci Rep. 2020. Preclinical study: urolithin A, NAD+, SIRT1, and angiogenic pathways in mouse skeletal muscle. https://doi.org/10.1038/s41598-020-76564-7

[19] Amorim JA, et al. Nat Rev Endocrinol. 2022. Review: mitochondrial and metabolic dysfunction in aging and age-related diseases. https://doi.org/10.1038/s41574-021-00626-7

[20] Prokopidis K, et al. J Cachexia Sarcopenia Muscle. 2025. Systematic review and meta-analysis: NMN and NR and skeletal muscle mass and function.

[21] Broome SC, et al. Sports Med. 2024. Review: mitochondria as nutritional targets for muscle health and physical function in aging.

[22] Connell NJ, et al. J Nutr. 2021. Randomized trial: NAD+ precursors (L-tryptophan, nicotinic acid, nicotinamide) in physically compromised older adults.

[23] Jiang Z, et al. Free Radic Biol Med. 2024. Review: NAD+ homeostasis and exercise adaptation.

[24] Liu S, et al. JAMA Netw Open. 2022. Randomized trial: urolithin A, muscle endurance, and mitochondrial health in older adults.

[25] Andreani C, et al. Oxid Med Cell Longev. 2018. Animal study: CoQ10 intake with moderate physical activity in a SAMP8 mouse model.

[26] Deng H, et al. Br J Nutr. 2025. Systematic review and meta-analysis: CoQ10 and exercise performance.

[27] Bolt J, et al. J Nutr Health Aging. 2023. Scoping review: CoQ10 in sarcopenia, frailty, and falls.

[28] Guescini M, et al. Oxid Med Cell Longev. 2017. Review: exercise combined with muscle-directed antioxidants (creatine and CoQ10) against sarcopenia.

[29] Migliavacca E, et al. Nat Commun. 2019. Study: mitochondrial oxidative capacity and NAD+ biosynthesis in human sarcopenia across ethnicities.

[30] BMC Cardiovasc Disord. 2024. Meta-analysis of randomized trials: CoQ10 in heart failure. Authors were not included in the pasted text.

[31] Curr Diab Rep. 2024. Systematic review and meta-analysis of randomized trials: NMN and glucose and lipid metabolism in adults. Authors were not included in the pasted text.

Today, I’m honored to speak with Dr. Eleonora Teplinsky, a board-certified medical oncologist specializing in breast and gynecologic cancer, with over a decade of practice. She is Head of Breast and Gynecologic Medical Oncology at Valley Mount Sinai Comprehensive Cancer Center in Paramus, New Jersey, and a clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai. She also hosts the Interlude podcast, where she shares stories from people affected by cancer, and is the author of Beyond the Pink: Navigating Life, Health, and Breast Cancer.

In our conversation, we discuss breast cancer risk, genetic testing, cancer incidence in older and younger women, and treatment options following a new diagnosis, including surgery, chemo, and medication therapies. Dr. Teplinsky shares her approach to fertility preservation, menopause after cancer, body image, and the emotional aspects of diagnoses and care. We also explore lifestyle factors, survivorship, long-term cardiovascular risk after cancer treatment, DEXA scans, lipids, coronary artery calcification scoring, and the importance of advocacy, quality of life, and long-term goals.

Stay tuned for a thoughtful conversation about breast cancer and breast cancer survivorship, informed by Dr. Teplinsky’s expansive approach to care. Her book, Beyond the Pink, is one of the most thoughtful books I’ve read on breast cancer and survivorship, and a beautiful testament to the quality of care she provides.

IN THIS EPISODE, YOU WILL LEARN:

Common misconceptions about breast cancer risk

The future of personalized breast cancer screening

How genetic testing can help clarify breast cancer risk and inform screening decisions

What may be contributing to the increase in breast cancer among younger women

How Dr. Teplinsky approaches a new breast cancer diagnosis and treatment planning

How Dr. Teplinsky helps patients navigate body image, grief, and surgery

How Dr. Teplinsky approaches fertility preservation and treatment for younger women

Which options are available, and which remain debated, when navigating menopause after breast cancer

How cancer treatment side effects can make it difficult to start or maintain an exercise program

How patients can advocate for themselves and how loved ones can provide support

Bio:

Dr. Eleonora Teplinsky is a board-certified medical oncologist specializing in breast and gynecologic cancers. Through her clinical work, media presence, and digital platforms, she has built a reputation for translating complex medical information into clear, compassionate, and actionable insights—empowering women to navigate cancer, survivorship, and long-term health with confidence.

Her forthcoming book, Beyond the Pink, represents a critical shift in how breast cancer is understood, discussed, and lived through—moving beyond diagnosis and treatment to address the full scope of survivorship and long-term health. The book fills a significant gap in patient education by focusing on what happens after cancer care ends. Blending clinical expertise with patient-centered guidance, Beyond the Pink offers a comprehensive, actionable roadmap for navigating menopause, fertility, cardiovascular health, sexual health, mental well-being, and life after cancer.

** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab.

Connect with Cynthia Thurlow

Cynthia’s website.

Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Dr. Eleonora Teplinsky

On all social media: @drteplinsky

Beyond the Pink: Navigating Life, Health, and Breast Cancer is HERE.