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Women are told their thyroid labs are normal far more often than men, yet they are also far more likely to have thyroid disease. This is not coincidence, it is biology. Thyroid disorders are among the most sexually dimorphic conditions in medicine, meaning that we see major differences between men and women. Autoimmune thyroid disease, hypothyroidism,…

We’ve built a world that is incompatible with our biology. The average person spends 93% of their life indoors, which represents one of the most dramatic environmental shifts in human evolutionary history, compressed into roughly three generations. Meanwhile, your nervous system is paying the price. I’m talking about heart rate variability, or HRV. For those…

Your doctor has 12 minutes for your appointment. Your perimenopause and menopause will last, on average, 42 years. The math has never worked, and women are paying the price with their health, their careers, and their quality of life. A 2025 study published in Mayo Clinic Proceedings revealed what millions of women already know from…

If testosterone were a party guest, women would be the hosts. Androgens are the most abundant hormone in women. Yet this class of hormones (that includes DHEA and testosterone) still gets introduced like it wandered in from the men’s side of the room. Women make testosterone every day, from the ovaries and adrenal glands, plus…

We’re both physicians. We both had ‘acceptable’ Vitamin D levels. We were both insufficient. I’m Sara Szal, an OB/GYN with 30 years of experience. My Vitamin D was 32 ng/mL. My doctor said, “You’re fine. Above 30 is sufficient.” But I was struggling with recurrent infections, seasonal mood issues every winter, rising anti-nuclear antibodies, and…

You achieved everything on the checklist. The education, the career, the carefully constructed life. So why does your body feel like it’s breaking down? This isn’t a personal failing. It’s a physiological inevitability when we ignore how female bodies actually work. The Biology of Achievement at All Costs Female physiology operates on multiple overlapping rhythms:…

We’re both physicians. We both had normal labs. We both had prediabetes. If it happened to us with medical degrees, access to testing, and decades of clinical experience, it’s happening to you. The Setup I’m Sara Szal, an OB/GYN with three decades in women’s health. My fasting glucose was 110 mg/dL. Standard labs flagged it…

Total plasma exchange (TPE)—also known as therapeutic plasma exchange or plasmapheresis—is an advanced medical procedure that replaces a person’s plasma to remove harmful substances from their blood. Once largely confined to critical care units and autoimmune disease treatment, TPE is gaining renewed attention in areas like neurology, transplant medicine, and more recently, aging and longevity…