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10/15/2026

🍷 GLP-1 MEDICATIONS: TURNING DOWN THE VOLUME ON ALCOHOL CRAVINGS?⁣
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What if a medication designed to treat diabetes and obesity could also help reduce alcohol cravings? Emerging research suggests GLP-1 receptor agonists, including semaglutide (Ozempic/Wegovy/Mounjaro/Zepbound), may do exactly that.⁣
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🧠 It’s not just about appetite. It’s about the brain.⁣
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GLP-1 receptors are involved in the brain’s reward and motivation pathways. These medications may reduce the reinforcing effects of alcohol, potentially decreasing cravings and excessive drinking.⁣
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🔬 A 2025 randomized clinical trial published in JAMA Psychiatry found that low-dose semaglutide reduced alcohol craving, drinking quantity, and heavy-drinking outcomes in adults with alcohol use disorder.⁣
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🔬 Additional observational studies suggest GLP-1 medications may be associated with fewer alcohol-related complications. But here’s the important distinction:⁣
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Reducing alcohol cravings is NOT the same as treating alcohol addiction. These medications are promising, but larger clinical trials are needed. GLP-1 agonists are not currently FDA-approved treatments for alcohol use disorder.⁣
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Additionally, CaloCurb, the only GLP-1 supplement that has human studies showing effective appetite suppression and weight loss, WITHOUT the muscle loss seen with GLP-1 medications, has also helped with alcohol cravings! My takeaway:⁣
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We may be discovering that GLP-1 medications do far more than regulate blood sugar and body weight. They may influence the neurological pathways driving cravings, reward, and addictive behaviors. Perhaps the next frontier of metabolic medicine isn’t just what we eat. It’s understanding why we crave.⁣
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Less craving. More control. Better health.⁣
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10/10/2026

Women Are Ignored…..⁣
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And we must do something about it! ⁣
Though it seems more attention to women’s health lately, the actual amount of funding for women’s health is less now than it was in 1990. Less than 10% of NIH’s budget is for women’s health. For half the population!⁣
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Women have different metabolisms, different responses to the same medications, different responses to exercise and diet than men. Yet the healthcare system gives them the same advice and expect the same outcome. ⁣
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Your liver processes drugs and toxins different than men. You burn more calories exercising yet your body retains and stores fat during non-exercise periods. ⁣
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As you enter perimenopause you lose some of the tools that kept your weight off and your mind clear. You deserve a full hormone evaluation and management during that time. Your ability to manage your blood sugar depends heavily on your hormones. Your ability to keep muscle strong also depends on your hormone balance. Your primary doctor was not taught that. So you are told to just exercise more and eat less. Yet you struggle to keep the weight off. ⁣
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Demand better care. Demand more funding for research. Demand more from the health care system. Become a health partner with your physician. Not enemies. Because that is what the health care system does. It sets you and your doctor up as enemies. ⁣
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Comment on your stories of dis sisal in the health care system:

10/06/2026

WE CAN’T FIX WOMEN’S HEALTH IF WE STOP FUNDING THE SCIENCE⁣
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For decades, women were underrepresented in medical research.... and they still are.⁣
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The medical community wants to correct this. But there is a problem: funding.⁣
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A National Academies analysis concluded that NIH spending on women’s health had been essentially flat over the previous decade and decreased as a percentage of overall NIH funding. In 2020–2024, there was real momentum toward changing that, including new federal initiatives specifically targeting women’s health research such as Executive Order 14120 prioritizing federal investment in women’s health projects.⁣
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But recent disruptions to biomedical research funding threaten that progress. NIH terminated large numbers of grants in 2025, and subsequent analyses found that the impact disproportionately affected female scientists and other historically underrepresented investigators. Why does this matter? Because we still have enormous knowledge gaps in:⁣
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• Menopause and perimenopause⁣
•Endometriosis⁣
• PCOS • Cardiovascular disease in women⁣
• Autoimmune disease • Alzheimer’s disease⁣
• Maternal health • Female-specific responses to medications⁣
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You cannot practice evidence-based medicine without evidence. And you cannot build that evidence without funding the research. You cannot make up for a century of dismissal with less research. Women make up roughly half the population.⁣
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Women’s health should never be a research afterthought.⁣
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10/02/2026

I’m excited to be part of A4M Women’s Health Summit - the premier clinical training event focused on transforming care for women from perimenopause to power years! ✨⁣
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Join me October 8-10, 2026 in San Antonio at La Cantera Resort & Spa for this incredible summit educationally partnered with . I will be talking about how gender-bias in the health care system ignores women going through menopause. I will be getting into the details of perimenopausal care. There will be other great discussions by great speakers We’ll explore cutting-edge approaches to metabolic medicine, autoimmunity, gut-brain-hormone connections, and longevity medicine with practical strategies you can apply immediately to help midlife women thrive with sustainable vitality.⁣

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🔗 Register now: https://www.a4m.com/the-womens-health-summit-2026.html

09/28/2026

PERIMENOPAUSE Ignored?⁣
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Treating a woman in perimenopause is not simply “replacing hormones.” Ovarian function is fluctuating, not absent. Estradiol and progesterone can swing dramatically from week to week. Symptoms may include disrupted sleep, hot flashes, mood changes, brain fog, declining s*xual desire, altered body composition, and fatigue.Then comes testosterone.⁣
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Women produce testosterone too. Yet in the United States, there is currently no FDA-approved testosterone product specifically formulated for women. That leaves clinicians in an uncomfortable position.⁣
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The strongest evidence supports transdermal testosterone for postmenopausal women with hypoactive s*xual desire disorder (HSDD). Seems rather limiting, and one-sided. The Global Consensus Position Statement concluded that evidence is insufficient to make recommendations for premenopausal women. Why? BECAUSE WOMEN HAVE BEEN IGNORED IN STUDIES!! ⁣
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And therein lies the problem:The biology is ahead of the regulatory system.⁣
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Clinicians may have to adapt testosterone products designed for men to doses appropriate for women. Treatment requires off-label prescribing AND basing it on s*x drive rather than true physiologic need. This is the larger issue in women’s health:⁣
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A lack of evidence is not always evidence of no effect. Sometimes it means we have not adequately studied the woman sitting in front of us.⁣
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Perimenopausal women deserve better research, better formulations, and clinicians educated enough to understand both what the evidence supports and where the evidence ends.⁣
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References: doi:10.1210/jc.2019-01603. doi:10.1016/j.jsxm.2020.10.009.⁣
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American College of Obstetricians and Gynecologists. 2023. “Compounded Bioidentical Menopausal Hormone Therapy.” ACOG Clinical Consensus.

09/01/2026

PEPTIDE vs. HORMONE: WHAT’S THE DIFFERENCE?⁣
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🧬 A peptide is a short chain of amino acids that can act as a biological signal. Peptides may tell cells to repair tissue, regulate inflammation, release other hormones, alter metabolism, or change cellular behavior.⁣
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⚡ A hormone is defined by its job, not its molecular structure. Hormones are chemical messengers produced in one tissue, released into circulation, and used to communicate with cells elsewhere in the body.⁣
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They’re related, but they’re not the same thing.⁣
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Some hormones ARE peptides. But not all peptides are hormones, and not all hormones are peptides. Insulin, growth hormone, and GLP-1 are peptide hormones.⁣
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Estradiol, progesterone, testosterone, and cortisol are steroid hormones, made from cholesterol, not amino acids. Even if they have the same number of amino acids like the examples I spoke of: GHK-CU and Thyrotropin Releasing Hormone (TRH) both ate 3 amino acids in size but different mechanisms of release and function.⁣
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Think of it this way: Peptide = what it’s made of and Hormone = what it does.⁣
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And biology rarely respects the neat little categories we try to put it in.

08/30/2026

GLP-1s CAUSE MUSCLE WASTING? NOT SO FAST.⁣
⁣This is a room full of metabolic health experts, physicians, and scientists. Believe us when we say: #
One of the biggest misconceptions about GLP-1 therapy is that weight loss automatically means muscle wasting. The problem starts with confusing lean mass with muscle mass.⁣
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Lean mass ≠ muscle.⁣
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Lean mass includes muscle, but also water, glycogen, organs, connective tissue, and other non-fat tissues. During significant weight loss, reductions in water and glycogen can therefore appear as “lean mass loss” without representing equivalent loss of skeletal muscle.⁣
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In the STEP-1 semaglutide trial, lean mass decreased—but fat mass decreased substantially more, resulting in improved body composition.⁣
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MRI data with tirzepatide similarly demonstrate substantial reductions in visceral and ectopic fat while providing a much more sophisticated picture of what happens to muscle during weight loss. This is why I don’t treat the scale.⁣
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I treat body composition.⁣
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In clinical practice, serial BIA (bioelectrical impedance analysis) can help track:⁣
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• Skeletal muscle mass • Body fat • Visceral fat estimates⁣
• Total body water • Changes over time⁣
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BIA isn’t MRI and hydration affects the results, but when measurements are standardized and followed longitudinally, it can be an invaluable clinical tool.⁣
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GLP-1 therapy shouldn’t simply produce a smaller patient.⁣
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The goal is a metabolically healthier patient with less fat and preserved muscle. Protein. Resistance training. Body composition monitoring.⁣
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Protect the muscle. Target the fat.

08/19/2026

❤️ YOUR ANNUAL CHOLESTEROL CHECK IS “NORMAL.”IS YOUR HEART RISK?⁣
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Most people get a cholesterol panel and are told: “Everything is Normal.”⁣
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But the regular cholesterol panel tells us how much cholesterol is being carried. It does not always tell us how many artery-clogging particles are carrying it. And that distinction matters.⁣
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Every major plaque-forming particle, LDL, triglyceride-rich remnants, and Lp(a), carries one apolipoprotein B (apoB) molecule. One particle = one apoB.⁣
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That makes apoB essentially a headcount of atherogenic particles circulating in your blood. When LDL-C and apoB disagree, cardiovascular risk tends to follow apoB, the particle burden, not simply the amount of cholesterol being carried.⁣
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This discordance is particularly important in people with insulin resistance, diabetes, metabolic syndrome, or elevated triglycerides. You can have a seemingly reassuring LDL-C while carrying an increased number of cholesterol-depleted, plaque-forming particles.⁣
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And then there is Lp(a).⁣
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Lp(a) is an LDL-like particle with an additional apolipoprotein(a). It promotes atherosclerosis and is associated with inflammation, thrombosis, and calcific aortic valve disease. Approximately 20% of people have elevated Lp(a) levels, which are largely genetically determined.⁣
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You cannot look at someone and know their Lp(a). You have to measure it. Current expert guidance recommends measuring Lp(a) at least once in every adult’s lifetime.⁣
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Then there are triglyceride-rich remnant particles, another source of cardiovascular risk that LDL-C alone may underestimate. These particles can enter the arterial wall and become retained, depositing cholesterol and promoting inflammation.⁣
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🩸 A Better Cardiovascular Conversation⁣
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A standard lipid panel remains important. But for a more complete assessment, ask whether you should also know your: ApoB • Lp(a) • non-HDL-C • triglycerides/remnant cholesterol⁣
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And in selected patients, additional lipoprotein particle analysis can further characterize risk.⁣
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Cholesterol is the cargo. Particles are the vehicles delivering it to the arter

08/04/2026

I'm a metabolism and hormone doctor, and these are the signs I look for long before a lab result confirms anything. None of them involve a scale, and none of them get celebrated, but they tell me a woman's metabolism is genuinely repairing.

When cortisol follows its proper rhythm, blood sugar stays steady overnight, and inflammation comes down, the changes show up in oddly specific places first.

Seven green flags worth watching for:
➡️ Waking a few minutes before the alarm, not jolted
➡️ Being genuinely hungry for breakfast again
➡️ Going four hours without thinking about food
➡️ No 3pm crash and no reach for coffee
➡️ Warm hands and feet at night
➡️ Sleeping straight through the 3am window
➡️ A waistband that fits the same at 9pm as at 9am

💡 If none of these sound like you yet, that is not failure. It is just a starting point, and every one of them is reversible.

Want the full breakdown? Comment ATHENA and I'll send my PDF over ⬇️

This content is for educational purposes only and is not a substitute for individual medical advice.

08/03/2026

One glass, that's all it takes now and you are lying awake at 3am wondering what happened to you.

I'm a metabolism and hormone doctor. This is not you becoming a lightweight and it is not you getting old. Your body is processing alcohol through a completely different hormonal environment than it was five years ago.

Here is what changed:
1️⃣ Falling estrogen slows how quickly your liver clears alcohol, so the same drink stays in your system longer
2️⃣ Your body composition shifted, which changes how alcohol distributes and concentrates
3️⃣ Alcohol triggers hot flashes directly by widening blood vessels, on top of everything else already doing that
4️⃣ It spikes then crashes your blood sugar, which your body is already struggling to keep steady
5️⃣ As it metabolizes, it pulls you out of deep sleep and spikes cortisol, and that is your 3am wake up
6️⃣ Your sleep was already fragmented, so it lands on top of a deficit instead of a full tank
7️⃣ The next day fog gets blamed on the w**e, when the w**e only amplified what was already happening

💡 The drink did not change. Your physiology did. That is worth understanding rather than just feeling bad about.

Comment ATHENA and I'll send you my PDF where I break down what is really shifting for women in this phase ⬇️

This content is for educational purposes only and is not a substitute for personalized medical advice.

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