One Health Direct Primary Care

09/05/2026

Post 1. September is Perimenopause Awareness Month 💛

And I'm excited about how much the conversation around perimenopause has changed.

We are talking about it. We're asking better questions. We're learning more about HRT, advocating for ourselves, and recognizing symptoms that generations of women were ofter expected to simply live with.

I LOVE that.❤️❤️

But as a primary care physician, I also want to help us make the conversation even bigger.

Because HRT matters. Symptom relief matters. Feeling like yourself again matters.

And there's more.....
Perimenopause and menopause are also an opportunity to take a closer look at the health that will carry us through the next several decades:

✅Our heart and cardiovascular risk
💪Our muscle and strength
🦴Our bones
✅Our metabolism
✅Blood pressure, cholesterol and blood sugar
😴Sleep
🧠Brain and emotional health
✅Sexual and vaginal health
✅Body composition

That's what looking Beyond Hormones means to me.

It means bringing hormones into a bigger conversation about helping women feel better NOW while building strength, protecting health and reducing risk for what comes NEXT.

I'm going to spend this time talking about it.

We'll talk about:
✨What's actually happening in our body during the menopause transition
✨Perimenopause myths that need a little more context
✨Why our health in our 40s can influence health decades later
✨The numbers I want women to know beyond a routine cholesterol panel
✨And why I'm becoming increasingly passionate about MUSCLE as part of women's healthcare

➡️➡️There are also some exciting things coming for women right here in Asheville. 👀💪

So stay with me this month.
Ask questions. Share these posts with your girlfriends, sisters, coworkers and the women you love.

08/05/2026

Hormones are only part of the story. Learn what your body is really trying to tell you.

Women often hear that hormone replacement therapy is the answer- but very few conversations explore everything else happening during perimenopause and menopause.

Join us for an afternoon of education, encouragement, and real conversation as local women’s health experts discuss the physical, emotional, and nervous system changes that occurs during this season of life.

Whether you’re just beginning to notice changes or have been navigating menopause for years, you’ll leave with practical knowledge, trustworthy resources, and a better understanding of your body.

This free community event includes:

-Educational presentations

-Nervous system and musculoskeletal wellness

-Lifestyle strategies behind hormones

-Expert panel discussion

-Audience Q&A

If you are a woman experiencing any of the following, this event is for you!:

-Perimenopause

-Menopause

-Hormonal changes

-Fatigue

-Brain fog

-Sleep issues

-Anxiety

-Joint pain

-Weight changes

-Low libido

-Mood changes

07/28/2026

Your labs are normal.

I hear this story over and over.
This patient had persistent fatigue and hair loss despite:
✅Normal thyroid
✅Normal vitamin B12
✅Normal vitamin D
✅Normal comprehensive metabolic panel
✅CBC without anemia (only mild microcytosis)

Her symptoms were attributed to perimenopause, and she even started hormone replacement therapy.

But she still didn't feel better.

➡️➡️➡️Although many laboratories report ferritin ≥15 ng/ mL as "normal," evidence suggests that depleted iron stores can produce symptoms well before anemia develops. A normal hemoglobin does not rule out iron deficiency.

Ferritin should always be interpreted in the context of the patient's symptoms, CBC indices, inflammatory status, and overall clinical picture.

Educational purposes
PMID: 19795093
PMID: 14555374
PMID: 27262813
PMID: 28625177

07/28/2026

06/30/2026

For most people with normal kidney function, moderate intake is usually well tolerated However, the risk of high potassium is higher if you also have:
* Chronic kidney disease (CKD)
* Diabetes
* Heart failure
* Dehydration

If you're on an ACE inhibitor or ARB, enjoy coconut water in moderation and make sure you're having your potassium and kidney function checked as recommended by your healthcare provider.

✅Save this post for future reference and share it with someone taking lisinopril, losartan, or another blood pressure medication.

👀Looking for a primary care office that actually has time to listen? Schedule a free Meet & Greet with us and see if One
Health Direct Primary Care is the right fit for you. We'd love to meet you and answer your questions.📍Asheville, NC

Schedule your Meet & Greet today!
LINK IN BIO

05/30/2026

Cardiovascular risk isn't one number.

The deeper workup showed:
→ Elevated Lipoprotein(a) [Lp (a)] — a genetic risk factor linked to increased risk of heart disease and stroke
→ High ApoB — reflecting a higher burden of atherogenic particles
→ Strong family history
→ Untreated hypertension

➡️This changed the entire risk conversation.

Some patients with "normal" cholesterol may still carry significant cardiovascular risk that standard screening doesn't fully capture.

❓Questions worth asking:
* Do you have a family history of early heart disease or stroke?
* Has your Lp(a) ever been checked?
* Do you know your ApoB?
* How are sleep, blood pressure, insulin resistance, and metabolic health affecting risk?

Heart disease develops over years. Earlier identification means more opportunities for prevention.

Follow for more information

05/22/2026

🙄It’s getting harder and harder to find certain doses of estradiol patches..😳

Meanwhile I’m over here wondering…When demand for testosterone replacement keeps rising in men — aging population, more diagnoses, direct-to-consumer clinics, lifestyle shifts…

Will we see the same thing happen? 👀

Hormone shortages don’t usually happen because people suddenly “want hormones.”

They happen because of:
→ Manufacturing complexity
→ Limited manufacturers
→ Supply chain disruptions
→ Increased demand outpacing production
→ Regulatory or quality control issues

Estradiol patches have had recurrent shortages partly because transdermal systems are harder to manufacture and fewer companies produce them.

As hormone optimization discussions grow for BOTH men and women… it’s a fair question:❓Are testosterone therapies immune to the same pressures?

Food for thought. 🙃

PMID: 37660750 — Drug shortages: trends, causes, and solutions.
PMID: 24603674 — Drug shortages: a complex health care crisis.

05/22/2026

🗣️Common concerns in midlife…Weight gain, fatigue, poor sleep, and feeling like your body has changed overnight.

Many women are told:
• Eat less
• Exercise more
• It’s stress
• It’s aging
• Your labs look “fine”

But symptoms deserve context.
In some patients, contributors may include:
✓ Sleep apnea
✓ Insulin resistance before diabetes develops
✓ Changes in body composition and visceral fat
✓ Perimenopause and hormonal shifts
✓ Chronic stress and poor sleep
✓ Cardiometabolic risk factors
✓ Loss of muscle mass over time

✅The workup matters. ✅Questions matter.
✅History matters.

AND…Evaluation should go beyond the scale and beyond standard screening labs when symptoms persist.

❓❓What symptom do you wish more healthcare professionals took seriously in women over 40?

➡️➡️Follow for more case-based education on perimenopause, metabolic health, heart disease prevention, and understanding the “why” behind symptoms!

PMID: 11874812, 16227462, 39076340.

05/20/2026

GLP-1 medications work. I love them! But losing weight TOO fast isn’t always the goal.

Rapid weight loss may increase risk for muscle loss, fatigue, and declining strength — especially if protein intake and resistance training are ignored.

I want my patients losing fat while preserving muscle.

If you’re on a GLP-1, ask:
✔️ Am I eating enough protein?
✔️ Am I maintaining strength?
✔️ Am I monitoring body composition instead of just scale weight?

Because long-term health > rapid weight loss.

PMID: 40151468 | 40471104 | 33485495

05/18/2026

Final update on our patient… 🩺

For treatment:
✅Rosuvastatin (Crestor) 40 mg ✅Ezetimibe (Zetia) 10 mg

PLUS:
✔️ nutrition changes
✔️ stress management
✔️ sleep optimization
✔️ blood pressure control
✔️ lifestyle changes

➡️➡️➡️Results:
LDL: 186 → 65
ApoB: elevated → 70s

❤️The biggest win was changing overall cardiovascular risk trajectory.

PMID for case series videos: 28444290; 33257928; 18997196; 30307554; 30586766; 28444290

Education only — not individual medical advice.