Tess Strom Nutrition & Functional Medicine

17/06/2026

A lot of women in perimenopause are told their bloods are normal, while feeling very far from normal themselves.

This usually isn't a case of anything being missed. Standard testing wasn't really designed to capture what's happening during this stage.

Three hormones are doing most of the work behind the scenes.
Oestrogen doesn't decline in a straight line. It fluctuates, sometimes sharply, in the years before periods stop.
Progesterone tends to drop earlier and more consistently, and plays a big role in sleep quality and a sense of calm.
Testosterone, often overlooked in women's health entirely, contributes to energy, motivation, and muscle maintenance.

The knock-on effects show up across several systems. Sleep becomes lighter or more fragmented. Gut function can change, bloating or altered bowel habits becoming more noticeable. Energy fluctuates in ways that don't always match sleep or stress levels. Mood can shift more quickly, sometimes with no obvious trigger. And joints, especially ones that have taken load through years of training, can feel stiffer or more reactive.

A standard hormone panel, taken on one day, often can't capture fluctuating levels in a way that reflects what's actually happening month to month. Which is part of why results can come back normal even when the symptoms are very real.
None of this means something has gone wrong. It reflects a real shift in the body's internal environment, and understanding it tends to make the whole experience feel a lot less confusing.

I know this disconnect well myself, and it's part of why I think it deserves more attention than it often gets.

Does this match what people are noticing day to day, the sleep, the energy, the joints? I'd be interested to hear what's felt most noticeable.

Educational only. Please seek professional advice for personal health concerns.

16/06/2026

Perimenopause is often talked about in terms of hot flushes and mood changes. For women who train consistently, the first signs often show up somewhere else entirely.

Recovery starts taking longer. Sleep becomes lighter. Sessions that used to feel routine suddenly feel harder, with no obvious explanation.

This stage is marked by oestrogen and progesterone levels that fluctuate, sometimes unpredictably, often years before periods become irregular. Both hormones are closely tied to sleep, recovery, mood, and how the body responds to training load.

One change that often goes unrecognised is a rise in tendon injuries, such as Achilles, shoulder, or hip tendinopathies during this stage. Oestrogen plays a role in tendon health, and as levels shift, tendons can become more vulnerable, even to training loads that were previously fine.

A familiar picture in clinic is a woman who has trained consistently for years, who knows her body well, finding that her usual approach is not producing what it used to. It is often mistaken for overtraining or simply doing something wrong.
Training does not need to stop during this stage. But it may need to adapt. Paying closer attention to recovery, sleep, and fuelling becomes more important, not less.

Does any of this sound familiar? Genuinely curious to hear from anyone navigating this alongside training.

Educational only. Please seek professional advice for personal health concerns.

12/06/2026

Women who train consistently often ask me how much they should actually be eating.

The honest answer is usually more than you think, and more strategically than you might currently be managing.
A few areas where intake tends to fall short consistently.

Eating before training matters more than many women are told. Fasted or low-carb training may feel fine short-term, but it drives up stress hormones and adds to the cumulative energy gap. Even a small carbohydrate-containing snack 30 to 60 minutes before a session can shift how the body responds.

Post-training is the area I see the most consistent gaps. Appetite is often suppressed after a session, or there is a tendency to eat lightly because the effort feels like it should create a deficit. But protein synthesis is elevated after training and glycogen replenishment is most efficient in this window. Missing it repeatedly has a cost.

Across the day, many women who train eat a high volume of food that looks good on paper but is relatively low in calories. Lots of vegetables, lean proteins, salads. Nutrient-dense, but not always energy-sufficient for a demanding training week.
A bowl of porridge or overnight oats with protein powder, berries, nuts or seeds, and a little cinnamon is a good example of what adequate post-training fuelling can look like. Simple, genuinely satisfying, and easy to put together the night before if time is tight.

None of this requires dramatic changes. It usually starts with looking at timing and composition around training, before anything else.

Does any of this resonate? I'd genuinely love to know what women who train are finding hardest to get right around fuelling.

Educational only. Please seek professional advice for personal health concerns.

10/06/2026

Training consistently, eating carefully, and still not recovering properly. Still fatigued. Still not seeing the results the effort should produce.

This is one of the most common patterns I see in women who train, and one of the most frequently misattributed.
Low energy availability, LEA, happens when the energy you consume doesn't cover both your training demands and what your body needs to function day to day. It doesn't have to look like restriction. It often develops gradually as training increases without intake keeping pace, or during busy periods when consistent fuelling slips.

In women the consequences are particularly significant. When energy availability drops, the body starts making choices. Reproductive function gets deprioritised. Oestrogen and progesterone can decline. Menstrual cycles become irregular or stop. Cortisol rises. Thyroid function may be suppressed. Bone density can be affected over time. Gut function, immune resilience, mood, and recovery all take a hit.

This is now recognised under the broader framework of RED-S, Relative Energy Deficiency in Sport, which documents the systemic impact of LEA across multiple body systems.

The tricky part is that it often goes unrecognised because the athlete looks like they are doing everything right. The mismatch between intake and demand can be subtle and cumulative. Fatigue, poor recovery, recurrent injury, menstrual disruption, and a performance plateau that doesn't respond to more training are the signs most often attributed to overtraining, when the real driver is under-fuelling.

More on Friday on what the research says and what addressing it involves.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns.

05/06/2026

Most people I speak to are not asking for anything extraordinary.

To get through a training session and actually recover from it. To wake up feeling ready rather than already depleted. To fuel consistently and feel the benefit of it. To feel like their body is working with them rather than against them.

These are not unrealistic things to want. They are what the body is capable of when the underlying systems are functioning as they should. The difficulty is that when things have been off for a long time, the symptoms start to feel normal. Fatigue between sessions becomes expected. Disrupted sleep becomes something you just manage around. Gut issues on training days become something you plan for rather than address.

There is usually a clear underlying pattern behind all of this. It is rarely one thing. More often it is a combination of factors, cortisol load, sleep quality, gut function, hormonal balance, that have developed gradually and respond well when they are properly understood and addressed.

If any of this week’s content has resonated, a discovery call is a free, no obligation conversation about what is going on and whether working together makes sense.

Find out more at tessstrom.co.uk.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns.

04/06/2026

04/06/2026

More training. More discipline. More restriction. And still not getting the results you used to.

This is one of the most common patterns I see, and it almost never comes down to effort.

At a certain point, pushing harder stops working. Not because you’re doing something wrong, but because the body has been under sustained pressure for too long and the systems that support recovery, energy, and performance are depleted.

Cortisol dysregulation, poor sleep, gut issues, hormonal imbalance: these don’t resolve with more effort. They tend to get worse. And they develop so gradually that by the time people notice something is off, they’ve often been running on empty for months.

The athletes I work with who make the most meaningful progress are rarely the ones who needed to do more. They are the ones who needed a different approach.

More on this on Friday.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns.

02/06/2026

Chronic stress doesn't just affect how you feel. It changes how your body functions.

Most athletes are familiar with the idea of training stress. What's less often talked about is the cumulative load of everything else: work pressure, poor sleep, under-eating, relationship demands, financial strain. All of it registers in the body as stress. All of it affects cortisol. And cortisol affects everything.

When the stress response stays activated over time, the natural cortisol curve shifts. Instead of peaking in the morning and declining through the day, it becomes dysregulated. The pattern that follows is one I see regularly in clinic, wired but unable to wind down, poor sleep, sluggish mornings, energy that doesn't recover between sessions, training that feels harder than it should for the effort you're putting in.

This is the under-recovery problem that doesn't always show up as overtraining in the classic sense. It shows up as a gradual flattening of performance, mood, and resilience. The body is trying to tell you something. It's rarely about pushing harder.
Research highlights work intensification and chronic stress as among the most significant health challenges of this decade. In clinic, what I see most often is someone who has been carrying a high load for a long time and has started to mistake depletion for their new normal.

More on hormones and stress this week.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns.

29/05/2026

Not all constipation is the same. Which is why what works for one person does nothing for another.
There are three distinct patterns. Slow transit, where things aren’t moving through quickly enough and stool dries out and hardens. Normal transit, where speed is fine but diet, hydration, stress, or hormones are affecting stool quality. And obstructed defecation, a physical outlet issue that diet alone won’t resolve and that often goes unrecognised for years.

If constipation has come on suddenly and is persistent, or is accompanied by blood in the stool, unexplained weight loss, or significant abdominal pain, please consult your GP promptly.

For slow or normal transit, these are good evidence-based starting points:
Kiwi fruit, two to three a day. If organic, keep the skin on as it adds to the effect. Wash well first and blend into a smoothie if you find the texture difficult.

Rye bread. I grew up eating this in Sweden and recommend it regularly in clinic. Look for dense wholegrain rye, Scandinavian-style loaves, pumpernickel, or rye crispbreads. Many lighter mixed loaves in UK supermarkets contain very little rye and won’t have the same effect.

Psyllium husk, particularly useful for improving stool consistency.

Water, especially important if you’re training and increasing fibre at the same time.

If symptoms persist after eight weeks, or you’re experiencing significant straining, incomplete emptying, or a sense of blockage, it’s worth looking further rather than continuing to manage it alone.

Understanding which pattern you have changes everything.

If you’d like to explore that further, a discovery call is a good place to start. Find out more at tessstrom.co.uk.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns

27/05/2026

Your gut needs a proper meal to move properly. A snack won’t trigger it.

The colon has powerful contractions that create the urge to go and drive transit. They fire only around six times a day and need a calorie-dense meal to activate, roughly 600 calories. For athletes eating light before training, grazing throughout the day, or skipping breakfast, this is directly relevant to how well your gut functions around training.

The urge to go is also worth paying attention to. Suppress it and the window closes. The next urge may not come for up to 24 hours. Over time this makes the gut progressively less responsive. It’s one of the most underappreciated drivers of sluggish digestion.

The morning window matters most. Breakfast within an hour of waking, a short walk outside, and time to respond to the urge after eating are simple but genuinely effective habits for gut motility.

I attended a clinical seminar on gut motility and the microbiome recently. These foundations came up repeatedly as highly effective and consistently underused.

More on Friday on what happens in the gut when transit slows, and what the latest research says about supporting it.

Tess Strom, Nutritional Therapist, Functional Medicine Practitioner and Head of Nutrition at Unbroken Triathlon Club.

Educational only. Please seek professional advice for personal health concerns.