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PHYSICIAN ADVOCACY: OUR PATIENTS DESERVE OUR VOICES! 🩺⁣A wonderful evening at the Montgomery County Medical Society (MCM...
10/23/2026

PHYSICIAN ADVOCACY: OUR PATIENTS DESERVE OUR VOICES! 🩺⁣
A wonderful evening at the Montgomery County Medical Society (MCMS) Annual Fall Advocacy Leadership Meeting!⁣
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Featured speaker Dr. Bobby Mukkamala, outgoing president of the American Medical Association (AMA), delivered a passionate and personal message about something I believe is fundamental to medicine: physicians must advocate for our patients, our colleagues, and the health of our communities.⁣
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What made his message particularly meaningful was hearing about his personal journey through medicine and cancer. Dr. Mukkamala and I share similar experiences with cancer giving us both a perspective that medical training alone cannot teach: what it feels like to be the patient navigating an unfriendly healthcare system.⁣
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We discussed the growing frustrations physicians face in a system where administrative demands and professional pressures compete with what matters most: caring for patients. SEE 3rd Photo!⁣
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A highlight of my evening was unexpectedly reconnecting with Dr. Pallavi Gowda, a former resident I had the privilege of helping train at Walter Reed Army Medical Center! Seeing her now thriving in private practice at Premier Health Concierge Medicine was a wonderful reminder of one of the greatest rewards of teaching medicine: watching the next generation succeed.⁣
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Another highlight was the opportunity to speak personally with Dr. Mukkamala about an issue close to my heart: women’s health advocacy. We discussed the persistent gender bias in medicine, inadequate research funding, and my frustration that, despite increasing awareness, meaningful progress remains painfully slow.⁣
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I also had the opportunity to share news of my upcoming book, The Athena Factor, which addresses the need to fundamentally rethink how we approach women’s healthcare. Advocacy must lead to action.⁣
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To my fellow physicians: What is the ONE issue in healthcare you believe we should be advocating for most urgently?⁣
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To All: What is your most pressing issue concerning the health care system?⁣
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10/18/2026

THYROID RELATED TO CHOLESTEROL?!⁣
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When cholesterol levels rise, we often talk about diet, exercise, genetics, and medications.But what about your THYROID? Thyroid hormones do much more than regulate energy and metabolism. They play a critical role in how your liver processes and clears cholesterol from the bloodstream. Here’s the science:⁣
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Your thyroid hormones, chiefly T3, help regulate LDL receptors in the liver. These receptors remove LDL cholesterol from circulation. When thyroid function declines, LDL receptor activity decreases, allowing LDL cholesterol to accumulate in the bloodstream.⁣
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The result? • Increased LDL cholesterol • Increased total cholesterol • Sometimes elevated triglycerides • Potentially increased apoB-containing particles • Greater cardiovascular risk when these abnormalities persist. ⁣
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And the research is compelling! A 2020 systematic review and meta-analysis found that treating overt hypothyroidism with levothyroxine reduced:⁣
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LDL cholesterol by 41 mg/dL and Total cholesterol by approximately 58 mg/dL⁣
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That’s a substantial improvement from correcting an underlying hormonal deficiency! Even subclinical hypothyroidism can contribute to unfavorable cholesterol levels. And this is what gets missed the most. Why? Because the system waits until your thyroid overtly fails before treating and cholesterol medications are given before recognizing thyroid issues.⁣
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Here’s the important clinical takeaway: If your cholesterol is elevated, particularly without an obvious explanation, your thyroid deserves attention. ⁣
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A TSH test, with free T4 AND free T3 along with thyroid antibodies, can help identify hypothyroidism. ApoB and Lp(a) can provide additional cardiovascular risk information in appropriate patients.⁣
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Sometimes, understanding your cholesterol begins with understanding how your hormones work together to balance your entire metabolism..⁣
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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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I’m excited to be part of A4M Women’s Health Summit - the premier clinical training event focused on transforming care f...
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

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