Build Muscle, Balance Insulin & Lose Weight To Heal PCOS

JJ Virgin, CNS, BCHN, EP-C

It is funny, it feels like multiple directions, but then it all goes together as this perfect path. Most people do not know. I started. I have always been obsessed with health, but I was obsessed with health and fitness because I wanted to be a Broadway performer. I was in San Francisco going through high school, going to the American Conservatory Theater, and I went up to UCLA on a theater scholarship. Then I got there. Everything that I was being taught at UCLA, they said, You are going to become a waitress at CHIPS. It was this little restaurant, this terrible little restaurant in L.A. with these. Yes, with the toasters. I was, I do not, and I am not going to UCLA to become a waitress at Chips.

I dropped out of the theater department. I started teaching aerobics at the local little health club. I did not know what to do. I was, What? What am I going to take at school? Some English professor insulted me about my writing, and I thought, Well, I will be an English major. It is so funny. and then I ran out of units, and I could not take any more of the exercise or nutrition classes I wanted. the day after I graduated, started in grad school in exercise skills, and then I went all the way up into grad school, doctoral school, and that then I say, Once I say nutrition, I am a perennial student. 

But what is so interesting is that I catered my way through high school and college. I was an English major. I did all of this acting and all of this fitness stuff, and someone would do it. Then I studied all this exercise and nutrition, so I was wondering, What is she going to do with all this? then you look and you go, Oh, she can write, she could speak, she could do TV. It worked perfectly, but it certainly looked like a big mess at the time. My mom was like, What are you doing? Could you just decide on something? Could you get a job, honey? Just get a job.

Felice Gersh, MD

Wow. Did you get a job?

JJ Virgin, CNS, BCHN, EP-C

No, but I had. I did. I got a job. I have had one job in my adult life. I got hired to work at a physical therapy office to bring in exercise and nutrition. I got fired in three months because I had too many ideas. That was my one adult job. No, I am not employable. Therefore, I have my own business. It is way more fun. It keeps you up at night, but it is way more fun. I am more obsessed with health, nutrition, and fitness now than I was in my twenties. I am still so excited about things, and it is even better now because there is so much more research and so many more tools. It is incredible. What is crazy about all of this, Felice? As you look at it now, okay, we have the Internet. I used to have to go to the library and UCLA and go into the stacks to find things. Now we have the Internet. We have way more fitness stuff than we used to have. We have all these different foods, and we are sicker than ever. What the heck?

Felice Gersh, MD

Oh, absolutely.  I know that you are one of the most powerful advocates for the power and healing of nutrition. We could talk all day about that. But there is an area involving health that is so critical, that is so under-discussed and underappreciated, and that is the importance of the musculoskeletal system. Most people talk about bones, but they completely forget about muscles. Maybe you could share with our audience a little bit about what muscles do in the body and why we should care about them.

JJ Virgin, CNS, BCHN, EP-C

It is so much more than what people realize. Now, when I was in graduate school, all the research was being done on aerobics. I was the rogue person because I did mine on building strength, and that was that they wanted you to do the aerobics stuff because they were funded by Precor. Back then, the prevailing thought was that you should never go and lift weights until you lose weight. Do all the cardio to lose weight first, and then lift weights. I go, That is the dumbest thing ever because if you build muscle, it will help you lose fat. But it is still the prevailing wisdom: do all that cardio to lose weight. Even though the research is clear, if you want to be able to burn fat better and lose weight, resistance training is the way to go on the exercise scale. 

We can talk about the diet side too, but when most people think of muscles, I think they think that it can make you look good. I think of muscles as metabolic Spanx. They hold everything tighter, and they support your metabolism because muscle protein turnover is a very expensive process, but they do not realize that muscle is also what I call a sugar sponge. It is all an induction organ, and as such, your muscles store carbohydrates in them as glycogen. Water and carbohydrates get together as glycogen in your muscles because, when you are doing hard exercise, your body has to use that stored glycogen for fuel and deplete it. This is great because if you’re looking for a way to have better blood sugar balance, the fastest way to do that is to get some muscle on. Besides, facts can also make you look better. But as a way to improve insulin sensitivity quickly, the way to do that is by building quality muscle. Now that we think of muscle, we think of bones. But when you have great muscles, you will have great bones, We are all worried about bone. Think of just building your muscles; that will make you have strong bones.

Felice Gersh, MD

In terms of how we can go about maintaining and developing better bones, we want to do resistance training. Is this something that people can do on their own, or should everybody go out and hire a personal trainer? What would you suggest?

JJ Virgin, CNS, BCHN, EP-C

Muscle building has two sides. There is the diet part of it, and there is the exercise. There are three sides because there is diet, there is exercise, and there is recovery. You build your muscles when you are recovering, not when you are doing the work. You have to do the work to break it down, and then you need the amino acids from the protein to rebuild, and then you need to recover and rest for that process. On the exercise part of it, if I said, Hey, everyone has to work with a trainer, well, now we have just canceled out a lot of people that are going to go. We cannot afford that. 

In a perfect world, we would be learning all of this stuff in elementary school. We would be learning how to do all of these things—pushups, squats, and pull-ups—correctly. That would set us up for life. But it is not happening. Here we are now. What is most important when you are doing resistance training is that you are doing it in great form. The form is always going to be your limiter. so you want to make sure that your form looks good. A mirror can be super helpful here; YouTube videos. We have access to free training all over the Internet. There are some basic things to think about with resistance training. I have divided the body into four parts, and there are three that I focus on because one of them will happen naturally. 

If you do everything correctly, you have the upper body pushing. Those are things like shoulder presses, chest presses, push-ups, dips, and upper-body pulling. Those are things like pull-ups pull-downs, and rows. You have hips and thighs, hip and thigh hinging, things like squats, lunges, and step-ups, and then you have your core. But the reality is, if you are doing squats correctly, if you are doing pushups correctly, and if you are doing pull ups correctly, you have to engage your core through all of those things. When I look at doing this, I think of doing very metabolically costly compound movements that use a lot of stuff. I know you commented about my arms. I do not do bicep curls or tricep extensions; I do pushups and pullups because that is going to work my biceps and triceps along with my chest and my shoulders, so I do not have to mess with them. 

We do bigger movements, and if you are injured, if you are concerned about form, then you can go to a gym and use some of the different machines that the gyms will have. You start with the trainer as a complimentary first session, which is great because you learn how to do things. But the big thing here is that you should never push past what your form will allow you to do. Technique is always the most important, and then to build muscle, the best range to work in It has been extended since I was in school; we have been taught something different. Now the research has been expanded to show that you can build muscle anywhere from six repetitions to 30 repetitions by doing multiple sets of an exercise. 

Let us say you are doing pushups, and you can do 30 pushups on your toes. You could do three sets of those. Let us say you can only do ten. You do three sets of those. It is the sets. It is the reps, and then it is the rest taking the least. Usually, I do this every other day, even every third day, because your body has to do that repair. You do some micro damage to your muscles when you work out. Your body is going to use amino acids to help trigger something called mTOR to do muscle protein synthesis to give you the building blocks and give you the building blocks you need to build your muscles. Then your body is repairing while you are recovering. Those are the three elements. I think we probably should hit nutritional because it can get confusing, too.

Felice Gersh, MD

Absolutely. I want to touch on nutrition and recovery, but let me ask you: you are talking about doing things like pull-ups and push-ups? Those are using your body weight. You’re not using any equipment. You mentioned that. Do you recommend that people, if they want to do these things at home, buy some free weights or buy bands? Is there a place for that, or do we not even need them?

JJ Virgin, CNS, BCHN, EP-C

Well, no. Body weight can work for a while, but as you get stronger, exercise is progressive, and pretty soon you are like, It is too easy. I will tell you one of the things that I love I think I wish I had been out more in the pandemic for everybody because it could have solved a lot of people’s home gym problems. I think the TRX trainer, which is this thing that you can put into a doorjamb, I travel with this so that wherever I am, we went to Bali this summer and we got to one of the hotels, and I am. They had a couple of dumbbells and a bench, and that was it. But I had my TRX trainer, so it allowed me to do one-legged squats and rows and all sorts of different exercises by having. You can do a set of bands, you can do a TRX trainer, you can do dumbbells, especially the adjustable dumbbells, and you can do a lot of things at home. 

For me, I am looking at what you are most likely to do. If you are one of those people who loves to go to a gym because of the socialization of it, or if you just want to be able to do different things, go to the gym. If you hate going to the gym, then do it at home. It is most important to find the thing that you will do consistently because if you look at what makes the difference with exercise, you are not getting fit one time. It is the consistency over time that makes all the difference. If that is a home gym for you, you can do a home gym with a TRX and a couple of dumbbells for a couple hundred dollars. It is pretty cost-effective.

Felice Gersh, MD

Now that everybody can manage that, In terms of the different parts of the body, you mentioned different muscle groups. Do you recommend that you split up the different muscle groups for different days of the week or try to do it all in one day and then rest for three days? Is there any best way, or is there a good way?

JJ Virgin, CNS, BCHN, EP-C

I will tell you, that I think that our current exercise recommendations are abysmal. People are, but I do not have time. I go, Make time. I had a great nutrition mentor early on. If you do not have time, make time, because this is that important. If exercise were a drug, every doctor would be prescribing it. It is amazing all of the different things that it does. I know here we are looking at blood sugar control, insulin sensitivity, and the ability to burn fat. It is one of the most amazing tools out there. What I love is that you’ve got to hit each body part twice a week. You could do four days a week of resistance training and flip it, say, you do hips and thighs one day, push the next, and then take a break and then do that again. Or you can do it three days a week and do all of it depending on what fits your schedule the best because, on the other days, I like to have people do some cardio that involves some high-intensity interval training because that is another thing that is good for helping burn off that visceral adipose tissue. It works great, creating a big oxygen debt that is good for your metabolism so that you’ve got things to do. 

The other thing that I love now is that when I think of exercise police, I think of hard things, that you get hot are sweaty, and that might hurt a bit. I do not think of walking as exercise, but when we think of metabolism overall, we have our basic metabolic rate, our basal metabolic rate, which is going to be dictated by our age or sex, our thyroid, and how much muscle mass we have in our body. Those are things that dictate it. Then we have the thermic effect of food, of which we know protein is going to be the highest driver. Just taking some of your carbs and fat and replacing them with protein will give you better metabolic effects. Then you have your activity divided into exercise and non-exercise activity thermogenesis. The exercise does not do that much during the exercise, but if you are doing hit or resistance training, you will get bigger effects afterward. One is because you have depleted glycogen stores. Now you have a place for sugar to go, rather than being stored as fat. Two, because your body has to recover. You have had some oxygen recovery your body has to do after the exercise. 

But the underrated one that people do not think about is something called non-exercise activity thermogenesis. This is for things like walking, taking the stairs, and parking farther away. But there is a way therapeutically you can use walking that is so important here because if you just put into your plan that I am going to walk after your biggest meal of the day, or even better, twice a day, but especially, let us say, after dinner, I am going to go for a 20-minute walk that is going to help lower the blood sugar response to that meal. It is super effective for doing that. That is another thing that I believe is one of the reasons we had so many issues during the pandemic: people just weren’t moving as much. They did not leave the house. They did not have to park the car and walk somewhere; they were just home. All of that neat that non-activity that non-exercise activity thermogenesis took a plummet.

Felice Gersh, MD

I am so glad you brought up the thermogenesis issue because, as many people have heard, sitting is the new smoking. That this sedentary lifestyle—even fidgeting, I heard—is better than nothing?

JJ Virgin, CNS, BCHN, EP-C

Yes. There was a study they just did where they showed they did this little crazy thing. What they found is that people who did this walking—I was—who on earth would do this all day long? But literally, they could have. I have this little apple box under me that I could do this with so close. But if I just did catchphrases all day long on my little apple box, you are going to trigger me, and you better control your blood sugar. I am sitting at a standing desk, and I have a treadmill next to me underneath the standing desk. I do a lot of my meetings standing or on the treadmill. I do not do my interviews on the treadmill. I saw someone else doing that. I am. Well, that is a little weird. But, it is so critical to look at, whenever you cannot sit and stand instead better, whenever you can walk instead of stand better, all of that. We lived in a two-story house, and when we did it, our offices were upstairs. I thought, Oh, I should bring a coffeemaker upstairs and put a refrigerator upstairs. I thought, No, I should not do that. I should make myself have to walk downstairs to go get all those things. up and down, up and down all day long, because I do not let myself have all the things I wanted to have up here.

Felice Gersh, MD

I thought the same thing when they first came out with remote control televisions. Is it hard to get up and go to the television? It is people who are that lazy, but it is so funny. They do not make things too convenient.  Park further away. Every little bit helps.

JJ Virgin, CNS, BCHN, EP-C

Well, just even when they took that vacuum cleaner thing and made it self-propelled, do not do that, and they gave you the lawnmowers you could sit on. I am like, No, no.

Felice Gersh, MD

You mentioned another word when you were talking a bit ago: adipose tissue. Well, women with PCOS need to build muscle, and many of them want to lose a lot of adipose tissue because about 80% are overweight or obese. Now, there is always concern that if you lose weight, you may simultaneously lose fat and muscle. That brings in nutrition, timing of eating, and how to lose weight. You are such an expert in this area. Talk about if you can, first of all, exercise after eating. Is it better to exercise fast, then refeeding, and then lose weight without losing your vital muscle?

JJ Virgin, CNS, BCHN, EP-C

I feel the weight loss drugs have shed light on this because there is so much talk about, if you use the weight loss drugs semaglutide or Tirzepatide, you are going to lose muscle. The reality is, if you ever go on a caloric restriction diet and you do not do the things, you are going to lose muscle. It is not just those; that is not it; it is just that was a good thing to shine a light on this. I believe that we have to be careful unless someone’s morbidly obese. If you are, let us say, 50 to 60 pounds, or more, then you are going to lose a little bit of lean tissue, too, because you realize you have skeletal muscle and you have lean body mass. Skeletal muscle is a component of lean body mass. Everything else is fat mass. You do have about 3% of that lean body mass, which supports the fat mass. You are going to lose a little. But my benchmark is that when you are losing fat and the leaner you are, the less fat you weigh, the less muscle you have to spare at all.  But my goal is that you lose no more than 5% of your fat-free mass. That is super key. Now, if you had more to lose, you could go up to 10%. But how do you offset that? 

A lot of it has to do with both your diet and doing resistance training while you are losing weight and then making sure that you are monitoring your weight correctly. In a perfect world, we would not have scales anymore. I cannot stand the fact that we still use a scale instead of a bioimpedance scale, an InBody, or a DEXA scan so that we know what that weight is made up of. You’ve got to be able to monitor, and you can do this at home with an inexpensive bioimpedance scale. They are not perfect, but they are going to at least give you the percentage differences. If you combine that with a waist measurement, then you will know, because if you are losing weight without losing your waist, you are making yourself worse, not better. We have to make sure that as you are losing weight, you are losing fat and holding on to your building muscle. That is why the goal here is to restore your metabolic health because you have to be metabolically healthy to do that. We do not lose weight to get healthy. We become metabolically healthy so that our body can build muscle and burn fat. If you are not metabolically healthy, if you are insulin resistant, it is hard to burn fat. That is why resistance training is so important. But the other side of that, too, is diet. 

Now, it is interesting with women because there is all this talk about fasted workouts, but when you look at all the research, there might be a little bit more of an indicator of losing fat during a fasted workout, but then it evens out over the day, so it does not make any impact. The issue is that unless you’re doing more long-distance cardio where you are using fat for fuel when you are doing high-intensity interval training or resistance training, you are using carbohydrates as your primary fuel source. Whenever you are doing intense exercise, the fuel sources are carbs, not fat. that is coming from your muscle glycogen stores. Why would fast workouts matter there? It does not. What I find with all of this is that women tend to not do as well with fast workouts. I always say, See how you feel if doing a fasted workout means that you are working out, not that you cannot work out as hard; you are doing yourself a disservice now that you do not want to eat and then immediately go work out because you only have so much blood. If the blood is going to your stomach, not your muscles, that is a problem too. 

The perfect world to be in. You get up in the morning, you eat about 90 minutes later, you break your fast, and you make sure you break your fast with a good bolus of protein so that you now start to trigger muscle protein synthesis because you’ve got enough leucine to trigger mTOR, which is going to trigger muscle protein synthesis. That is 30 grams or more of animal protein. Then you have another 2 hours, then you go work out. That would be a perfect world if that could work for people. to do that, and then, it is very interesting in all of that: when should you eat, the refeeding, and all of that? It is very nuanced. It becomes important for the more sedentary people, as they are first starting, and then for the very elite. The reality is that it is not as important for most of us as people seem to think it is. I think sometimes we tend to major in the minors when we need to major in the majors. 

What are the majors? Get that resistance training in for each of your body parts at least twice a week. Push yourself so you get as close to not being able to do another one as possible. Make sure that you are eating protein to support your body’s ability to build muscle. What does that look like? It is somewhere between 0.7 and 1 gram per target body weight. I have dug through all the research by Dr. Stu Phillips and Dr. Donald Layman defined these things. It is double the RDA. The RDA was based on 18-year-old guys and nitrogen excretion. It is such outdated garbage data and then making sure that you get that good first morning break is the fast thing. Now, I am not depending on age because diets are tools, and so we have to use the tools. I do think time-restricted feeding is important. I think that it is how we used to eat and that we need to get back to it. We should be eating in a 10 to 12-hour window, maybe an 8 to 12-hour window every day. That is what we used to do. 

When I grew up, I did not wake up immediately, eat, then have a snack, then have lunch, then have another snack, another snack dinner, and then a snack before bed. Because God forbid you get hungry. When did we start this continuous feed? Well, we started that during the 80s when they took the fat out of the food because that was bad. That’s when all of this obesity thing started to go sideways. We went super plant-based. We took the fat out of ultra-processed food and just created a mess. We created an obesogenic diet, which is low in protein, high in fat, and high in carbs. That is a recipe for obesity, so the first thing is, if you think about eating quality protein, let us say if you are a 100 and 120 pounds person and let us say 130, that is probably somewhere between 100 and 130 grams of protein a day, getting 30 to 40 grams in that morning, focusing on your bumper meals of morning and evening, making sure you are getting enough, and then getting some in at lunch. But again, the evening will set you up to not go into muscle protein breakdowns quickly and the morning will set you up to break that overnight fast and the muscle protein breakdown getting that in and then getting in quality carbs. 

I wrote a book called Sugar Impact Diet to help people understand that all carbohydrates turn to sugar. You just want to make sure you are making that slowly from the food you eat, not mainlining it. There is a big difference between eating lentils and blueberries and eating French fries, which is obvious. Make sure that you eat, and I hope people eat protein first because, as it turns out, if you eat protein first, you make better food choices and you will make sure you get your protein. It is so much more satisfying. It is an interesting protein; the thermic effect of protein is about 25%. That means that you’re going to expend somewhere in the neighborhood of 25% of those calories on the digestion and stimulation of those calories. a lot of that in that muscle protein synthesis, expensive fats, negligible 3% or less, carbohydrates, 5 to 10%. 

If all you did was look at your diet and go, I am going to eat protein first, which is more satiating and has better blood sugar control. That is going to make me eat less next time I put in my non-starchy vegetables, a little bit of fruit, but things that are low-sugar impact berries. Then look at how much fat I got in my animal protein. Maybe add a little bit of olive oil or something in my cooking or on my salad, and then see where you are at; you will be full. That is the thing, that’s fantastic. If all you did was eat the same amount of calories as you are now, but you pushed out a little bit of your fat or carbs in favor of protein, you will lose weight.

Felice Gersh, MD

Well, that is fantastic advice. In terms of animal versus plant protein, is there a significant difference in building muscle? For example, say someone wants to eat beans as their protein versus a chicken.

JJ Virgin, CNS, BCHN, EP-C

Here is the challenge with that, you assume that 100 grams is the bare minimum total protein you need throughout the day. 30 grams at a meal is assuming animal protein, and you are not going to get the same essential amino acid. We eat protein for the amino acids. There are 20 amino acids; nine are essential, and we must get them from our food. The challenge with plant versus animal is that plants are not in the same balance you get with animals, and they tend to be low in something, like soy, and methionine, and so they tend to be lower in different things. You can build muscle with those. You are going to need to add a higher amount of protein, and you are going to have to be very careful to make sure that you are getting what you need. You have to be a little bit of a food scientist as you are putting this together. Now, the challenge is: let us say that you want to get your protein from beans. To be able to do that without overloading carbs is pretty much impossible. I will do one I know off the top of my head, which is four ounces of chicken breast. To get the same amount of essential amino acids and protein, I will need six cups of quinoa. Well, you overload your day’s worth of carbs doing that. That is the challenge when you are doing plant-based. When you are doing plant-based, if you want to do that, if you can do soy, you do not have food and harm it. It is not interacting with your thyroid function. That would be a better choice. 

Protein powders are going to be a way to do this, but you are going to have to supplement to do it without overloading your carbs. Because the reality is, I have people start with about 100 grams of carbs a day. More than that, they need to earn through exercise. But that is where I find women tend to do well in 100 grams, maybe 130 if they are exercising a little bit more than that. I start with fat at around 60 grams, and then we will play around with that as well. That is my foundation, and I see where you do best. We are either going to bring up the carbs or we are going to bring up the fat, but we do not bring the carbs and fat together because that is a recipe for weight gain. That is my concern with a plant-based diet, is that I do not know how to get you the protein you need without supplements.

Felice Gersh, MD

Yes. I have quite a few patients who are vegans, so it is challenging to get everything balanced out with them in terms of the supplements, the shakes, and the supplemental shakes. If someone wants to use a shake for protein after a workout, Do you recommend using a protein shake in the half hour after a workout? If they did and they were open to not having just a vegan like, rice or a pea protein or something, do you recommend whey protein or do you do shakes, or is that a last resort? What do you think?

JJ Virgin, CNS, BCHN, EP-C

I take a shake every day. I love shakes. Here are some of the options now that there is an anabolic window. There is just still so much controversy around that whole thing. But after you exercise, your carbohydrates will go into your muscles without the need for insulin. That is super cool. I love some carbs and protein post-exercise; a little bit of fat can also help, and bile acid also helps with protein digestion. That is cool if you do more of a pea-soy blend for protein. There was a study that came out; I cannot say that the satellite was in front of me, but it showed that it would be fine for building muscle. Depending on which type, there are peas, there is soy, there is chia, and there is hemp. You find yours. 

But I think in Plant Kingdom, you are better off doing a blend. I then have people cover their bases by adding a hit of essential amino acids. That is how I cover it. I love shakes. If you are not dairy intolerant, whey is the gold standard. I do a lot of food sensitivity work. That was the Virgin diet. Looking at all this food sensitivity testing and seeing so many people reacting to dairy and eggs that was my challenge: if you’ve got a leaky gut, this is probably not going to be a good one because the last thing you want to do is eat something every single day that is launching an inflammatory response because inflammation shuts down muscle protein synthesis. That would be a bummer. But if you can handle whey, it can be amazing. It is just, does that work for you or not? You could do a food sensitivity test. You could do a virgin diet, do food testing, take it out for three weeks, and see how you feel. But if you can tolerate it, it is amazing. That is amazing. 

I use a bone broth and protein shake. I have two shakes that I make. One’s a pea-based shake for plant-based shakes, and one is a bone broth shake. The thing with bone broth is that it is 80% collagen. This is not a complete protein. That is what people need to understand: that when you do that, that is not a complete protein. If you’re doing that, you are doing an essential amino acid blend on the side. Or use it as part of something all stirred into a coconut with pea yogurt. I will use blends to get there. That is, if you are doing more plant-based work, you are just going to have to be a bit of a food scientist. That is the dedication, and to also look at and go, why am I doing this? Is this for health, or is this a spiritual reason or what? Because if it is for health, I will show the research that shows that clean, clean animal protein. That is the challenge. You cannot take McDonald’s burgers and compare them to grass-fed beef. But show me this research, because it is not there to say that this is bad for you. There is some great research that Trudy Scott shared with me about how important grass-fed beef is for depression and anxiety.

Felice Gersh, MD

Yes, I think there is even a little data showing that a little bit of saturated fat can make you happier. You do not want to have zero. That is why I just wish all my vegans out there, everyone out there who is a vegan, would listen to that because a little bit of animal or a moderate amount can help. Well, sometimes people are not very moderate, and they get very enthusiastic. Then they have a lot of muscle pain. I was wondering, what do you recommend when, they call it Weekend Warrior sometimes, the over enthusiastic one who just does way too many wraps or whatever, and then, wow, they pay the price the next day? Do you have any suggestions for that crowd other than to not do it again?

JJ Virgin, CNS, BCHN, EP-C

Yes, knock it off. Well, this is your body’s email system. I always say if you are sore of a joint site, that is a bad one or sore to touch, and it lasts more than a day or two. This is a problem. Your body is there; what are you doing now? There are a couple of reasons this could be happening. It was interesting, Felice. The way I knew that I was starting to go into menopause was that I could not recover from my workouts for a minute, and my estrogen dropped. I was, It can tell you that something’s wrong hormonally, either with thyroid or estrogen. But a lot of times it is just that you are doing too much; you are overtraining. You are either not giving yourself enough recovery. 

There are a couple of things I love. Number one, I think all women should be taking creatine. Women have only 70 to 80% of the tissue stores and creatine that men do. Creatine helps us do that intense exercise because it is part of the fossil creatine system, you can make ATP, so creatine is hugely important. I think all women should eat 3 to 5 grams a day, which is important for their skin, brain, and bones. creatine for the win. I also love electrolytes. I think that we should be doing some electrolytes. Take a lot of electrolytes and water when you go to the gym. Not with sugar; no sugar. That is important. 

But then also do those things that help with recovery. A couple of things that can be helpful. I have at home a cold plunge. Yes, this is it. I have a love-hate relationship. This is a great thing. You do not do it immediately after exercise because it can limit your results. After all, it is so potent as an anti-inflammatory that it can then stop the inflammatory process that happens after you work out that you need to have happen. You do not do it for at least 6 to 8 hours after working out. But a cold plunge or a cold shower can help reduce inflammation. I love foam rolling to help just get the blood flow going by doing light versions of the same movement. If I am sore, I will go and do the same movement, but without any resistance. Just get the blood flow going. Then Epsom salt baths are another big, amazing, and incredible one too. That can help a lot.

Felice Gersh, MD

What an amazing array of advice you have given during this interview. I cannot thank you enough. I always talk about the importance of muscle, and I love that you explained it. There is so much detail about how to make stores replenish and just do everything to nurture our vital muscles and the whole area of fitness that you have explored and explained. I cannot wait to see when your book comes out because you shared that you’re writing a whole book on this topic. That will be fantastic. Now you have already written so many amazing books, and I know so many of the viewers out there want to access them, listen to your podcast, and see all the other amazing things that you have produced. How can they follow you? How can they access some of this?

JJ Virgin, CNS, BCHN, EP-C

All of that is at JJVirgin.com. I have got well beyond 40 that you were a huge hit on, by the way. Yes, I am very active on YouTube and Instagram as well. Then we have a lot of recipes on the website, so that is super fun. If you want to cook or if you want to be what I call a lazy cook, I make simple recipes. You will love our recipes. They are fabulous.

Felice Gersh, MD

Well, I love to eat. I am going to give them to my husband to make.

JJ Virgin, CNS, BCHN, EP-C

But my husband cooks too.

Felice Gersh, MD

Well, this is wonderful that you have been able to find this time because I know how incredibly busy you are to share your incredible knowledge with all of our viewers out there. I hope you will take this all to heart and listen to this interview a few times because there is so much information packed into it. Thank you again. It is always a pleasure to have the opportunity to speak with you.

JJ Virgin, CNS, BCHN, EP-C

Thank you.