Normal bloodwork doesn't always mean your iron is fine. In perimenopause, heavy periods are often why you're still exhausted.

The internet is full of warnings about muscle loss on GLP-1s, and most of them get the clinical picture only half right. A patient who loses 15 pounds of fat and 2 pounds of muscle has a better body composition outcome than they started with, even though their absolute muscle dropped.

Many women in their forties and early fifties walk into the clinic with the same story. Their weight has only shifted by a few pounds, but their body feels unfamiliar. The shape is different. Pants fit differently. Strength feels different. Sleep is different. They have not changed how they eat or how they move, and yet something has clearly changed.