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In this episode of The Hormone Café, Dr. Sarah Pederson explains how surgery fits into a holistic fertility and women’s health plan. She walks through when surgery is truly helpful, what happens before and during surgery, and how proper recovery—including nutrition and pelvic rehab—can dramatically improve fertility outcomes.
In this episode of The Hormone Café, Dr. Sarah Pederson breaks down the thyroid—why it’s central to metabolism, hormone production, fertility, and energy, and why thyroid testing should always be part of a comprehensive women’s health and fertility workup.
She explains how to properly test the thyroid, interpret results through a fertility-focused lens, recognize autoimmune thyroid disease early, and create a long-term plan that supports both hormone balance and metabolic health.
🦋 Why the Thyroid Is So Important
When thyroid function is off—either too low or too high—it can disrupt the entire endocrine system.
⚠️ Symptoms of Thyroid Dysfunction
High thyroid (hyperthyroidism) may cause:
Any patient with hormone imbalance or irregular cycles should have their thyroid evaluated.
🧪 What a Comprehensive Thyroid Panel Includes
A full thyroid evaluation includes:
🧠 Understanding TSH (and Why “Normal” Isn’t Always Optimal)
While many labs consider TSH up to 4.5 “normal,” in fertility and women’s health:
Values outside this range may still cause symptoms and fertility challenges.
🔁 Why Thyroid Labs Should Be Rechecked
If an abnormal result appears:
🧬 Why Thyroid Antibodies Matter
You can have:
If untreated, antibodies can:
🦴 Hypothyroidism & Subclinical Hypothyroidism
Subclinical hypothyroidism:
First-line support includes:
🥗 Nutrients Essential for Thyroid Function
If deficient, restoring these nutrients alone may normalize thyroid function.
💊 When Thyroid Medication Is Needed
Important considerations:
Sometimes changing the brand (Synthroid, Tirosint) works better than changing the dose.
🔄 Thyroid Medication Is Not Always Permanent
The goal is lowest effective dose for the shortest necessary time.
🔥 Hyperthyroidism & Why Imaging Matters
Evaluation includes:
Dr. Sarah shares a case where hyperthyroidism and nodules revealed thyroid cancer—highlighting why imaging can be critical.
🧬 Hashimoto’s Thyroiditis: A Long-Term Strategy
Goals of care:
Antibody levels can range from mild to very high (hundreds).
🌿 Nutrition for Hashimoto’s
Key food sources:
🚫 Gluten & Dairy: Individualized, Not Universal
Highly processed gluten-free foods can worsen inflammation and blood sugar.
If antibodies don’t improve, restriction is unnecessary.
💊 Other Tools to Lower Antibodies
Progress is always monitored with repeat labs.
🧠 Preventing Hashimoto’s Flares
Long-term success comes from:
🌸 T3 vs. T4 in Fertility
Low T3 is best addressed by:
T3 may be appropriate later in life when fertility is no longer a goal.
If you’re struggling with fatigue, brain fog, irregular cycles, or unexplained fertility challenges, a comprehensive thyroid evaluation can be transformative.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson breaks down supplements for women’s health—how to use them strategically for hormone balance, fertility, vaginal health, and metabolism, and why more supplements is almost never better.
She walks through her testing-first, nutrition-forward philosophy, explains why random supplement stacking can backfire, and outlines how to create a personalized supplement plan that actually works—and eventually allows you to come off supplements altogether.
🌱 Dr. Sarah’s Core Supplement Philosophy
Taking 20–30 supplements because of TikTok, Instagram, or generic advice often overwhelms digestion, metabolism, and absorption—and can worsen symptoms.
🧪 Why Testing Comes First
You should never take supplements that work against your hormone profile.
⚠️ When Supplements Can Make Things Worse
Without testing, supplements can actively harm progress.
💊 Targeted Supplementation: Less Is More
If levels don’t improve, the issue may be absorption or gut health, not dosage.
🧠 Fat-Soluble vs. Water-Soluble Vitamins
Fat-soluble (A, D, E, K):
Taking fat-soluble vitamins long-term without testing can impair metabolism and organ function.
🦠 Absorption, Gut Health & Fillers Matter
Some patients react to:
The issue is often the form, not the supplement itself.
🌿 Why One Supplement at a Time Is Important
Dr. Sarah recommends introducing supplements one at a time—especially for sensitive patients.
🚫 Never Power Through a Bad Reaction
Stop it.
Your body should feel better, not worse. A reaction signals:
🧬 Egg Quality Supplements: Keep It Simple
Common options include:
These work best alongside nutrition and gut optimization—not in isolation.
🌸 Using Supplements to Support Hormone Production
If a supplement doesn’t change lab values or symptoms, it’s discontinued.
🦠 Probiotics Are Not One-Size-Fits-All
Taking the wrong probiotic can worsen overgrowth and symptoms.
🌿 Estrogen Metabolism & Gut Support
Dietary changes are often more powerful than pills.
🔄 Supplements Should Be Temporary Whenever Possible
Supplements are a bridge, not a permanent crutch.
🩺 Short-Term Supplement Use After Surgery
Used for ~3 months to reduce inflammation and recurrence—then discontinued.
☕ Alternative Ways to Get Antioxidants
A 360° approach minimizes daily capsule overload.
📊 Measuring Effectiveness Matters
If it’s not working, it’s stopped.
🧾 Why Everyone Needs a Supplement Audit
The goal is the lowest supplement load possible while maintaining optimal health.
If you’re overwhelmed by supplements, unsure what you actually need, or want a data-driven plan for fertility, hormones, or gut health, a comprehensive supplement audit can make all the difference.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson explains Primary Ovarian Insufficiency (POI)—also known as premature menopause—what it is, how it’s diagnosed, why it happens, and how to support your body hormonally, metabolically, and emotionally if your ovaries stop functioning earlier than expected.
Dr. Sarah walks through real patient examples, the long-term health implications of early estrogen loss, and why hormone support is often essential—not optional—in these cases.
🌱 What Primary Ovarian Insufficiency Is
It may also be called:
🔥 How POI Is Diagnosed
Hormones must be tested more than once to identify patterns, not just a single snapshot.
🧠 Why Brain Hormones Are So High
Replacing estrogen helps calm this feedback loop.
🩺 Why POI Is Different From Natural Menopause
This creates opportunities—but also unique medical needs.
🦴 Why Estrogen Replacement Is Critical
Without estrogen, women with POI:
💊 Hormone Therapy: Not Optional in POI
This is long-term physiologic replacement, not short-term symptom control.
🌸 How Hormones Are Replaced
Doses are:
📊 Ongoing Monitoring Is Key
Some days may require more hormone support (stress, workouts, illness).
🔄 Hormone Needs Are Dynamic
🧬 What Causes POI?
Sometimes, no clear cause is found.
🧪 What Else Needs to Be Evaluated
🌸 Vaginal Health & Estrogen
Support includes:
👶 Fertility With POI: Is Pregnancy Possible?
Each cycle must be closely monitored and adjusted.
❤️ Supporting Blood Flow & Inflammation
🧠 The Emotional Side of POI
Dr. Sarah emphasizes:
With the right plan, patients can feel excellent, energized, and empowered.
If you’ve gone long stretches without a period, are experiencing menopausal symptoms in your 30s–40s, or have been diagnosed with POI, comprehensive hormone evaluation is critical.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson breaks down menopause from start to finish—what it is, when it happens, common symptoms, and how to support your body so you can feel strong, clear-headed, and energized during this transition.
Dr. Sarah explains the difference between perimenopause and menopause, why symptoms happen, and why menopause is a natural life stage—not something to fear or “power through.” Most importantly, she emphasizes that just because menopause is natural does not mean you have to feel miserable.
🌸 What Menopause Actually Is
Perimenopause is the transition phase, where communication between the brain and ovaries becomes erratic before cycles stop completely.
📅 When Menopause Happens
Every woman’s timeline is different—and that’s normal.
🔄 Why Symptoms Occur
The body is shifting from cyclical hormone production to very low baseline hormone levels.
🔥 Common Menopause Symptoms
Some women have many symptoms; others have very few.
✨ Menopause Is Natural — Suffering Is Not Required
Do not dismiss symptoms as “just menopause.”
😴 Insomnia & Night Sweats: The Big Drivers
Good sleep should happen 5–6 nights per week. Anything less needs support.
🩸 Blood Sugar & Metabolism Matter More Than Ever
Dr. Sarah often uses continuous glucose monitoring (CGM) to personalize nutrition.
🥩 Protein First in Menopause
Carbohydrate spikes can worsen:
⚡ Cortisol, Anxiety & the “Tired but Wired” Feeling
Support includes:
🌡️ Thyroid & Thermoregulation
Optimizing thyroid function is essential for symptom control.
💊 Bioidentical Hormones — Used Correctly
But must be:
Hormones alone are not enough without addressing nutrition, gut, thyroid, and metabolism.
🥦 Nutrition Still Comes First
Dr. Sarah recommends a primal-style diet during menopause.
⏰ Intermittent Fasting — Use Carefully
Fasting windows should support metabolism, not stress it.
🏋️ Exercise for Hormone Support & Bone Health
Overtraining can worsen:
🧠 Brain Fog & Estrogen Metabolism
Daily bowel movements, hydration, and detox pathways matter.
💧 Hydration & Hormone Clearance
📊 A Whole-Body Approach
Everything must work together.
🔁 Lifestyle Changes Are Required — And Worth It
With the right plan, many women feel better in their 50s and 60s than ever before.
If you’re in perimenopause or menopause and struggling with symptoms, a personalized, whole-body approach can make all the difference.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson dives into nutritional status and nutrition testing—why it’s foundational for hormone production, fertility, and overall health, what nutrients are most important to test, and how to turn results into a personalized action plan.
Dr. Sarah explains why even “healthy eaters” can be nutrient deficient, how deficiencies impact ovulation, egg quality, energy, and metabolism, and why targeted testing allows for precise nutrition and supplement support instead of guesswork.
🥗 Why Nutrition Is the Foundation of Hormone Health
Feeling good, ovulating regularly, and having stable energy all start with nutrition.
🧪 Why We Test Nutrients Instead of Guessing
Testing provides clarity, direction, and measurable progress.
🧬 The NutrEval: A Comprehensive Nutrition Panel
This gives a full picture of cellular health and hormone-building capacity.
✨ Antioxidants & Egg Quality
Key antioxidants evaluated include:
Low antioxidants = increased cellular stress and reduced fertility potential.
⚡ Mitochondrial Health = Energy & Hormones
Nutrition testing helps identify where mitochondrial support is needed.
🔥 Omega-3, Omega-6 & Inflammation Balance
Even “healthy” diets can have excess omega-6 due to salad dressings and packaged foods. Testing ensures proper ratios, not just good intentions.
🐟 Why Omega-3s Are Hard to Get from Diet Alone
☣️ Toxins & Heavy Metals That Impact Hormones
These toxins can interfere with estrogen production and overall endocrine function, sometimes requiring detox support or increased antioxidant intake.
🧠 Methylation Support: Are You Using the Right Vitamins?
Without proper methylation, vitamins can build up without being utilized—testing identifies what form your body needs.
🥦 Food First, Supplements Second
Brightly colored fruits and vegetables provide plant-based antioxidants, while supplements fill only true gaps.
💊 Why Supplements Sometimes “Don’t Work”
Switching forms (liquid, powder, different capsule) can dramatically improve absorption.
🧂 Minerals Matter More Than You Think
Deficiencies may reflect absorption issues, mineral imbalances, or endocrine dysfunction.
📊 Personalized Plans, Not Supplement Overload
Targeted plans focus only on deficiencies—and are re-tested to ensure improvement.
💉 When IV Nutrition Is Helpful
IVs may include vitamin C, B vitamins, glutathione, and alpha-lipoic acid.
If you’re struggling with hormone imbalance, fatigue, poor ovulation, or fertility challenges, nutrition testing can provide clarity and direction.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson breaks down bioidentical hormones—what they actually are, how they differ from synthetic hormones, and how they’re used safely and effectively in clinical practice. She walks through testosterone, progesterone, estrogen, and DHEA, explaining how each hormone functions in the body, the best delivery methods, and why dosing, timing, and personalization matter so much.
Rather than using hormones as a “band-aid,” Dr. Sarah emphasizes a root-cause, physiology-first approach—supporting the body while working toward long-term balance and eventual weaning when appropriate.
🌱 What “Bioidentical” Really Means
These hormones are used to support—not override—natural physiology.
🔥 Testosterone in Women: Why It Matters
Dr. Sarah explains why daily, low-dose testosterone is preferred over pellets or injections, how it supports fertility, and why the goal is always eventual weaning—not lifelong use.
💊 Best Absorption Methods for Testosterone
Oral testosterone is avoided to protect gut and liver health and ensure steady absorption.
🌸 Progesterone: Timing Is Everything
Progesterone should always support the natural cycle—not disrupt it.
🩸 When Progesterone Is Helpful
Dr. Sarah outlines how cyclic progesterone can help retrain the body to ovulate and cycle regularly.
🌙 How Progesterone Is Given
If progesterone makes you feel worse, the dose or delivery method needs adjusting—there’s no “powering through.”
🧠 Estrogen: Not Too High, Not Too Low
Dr. Sarah explains why estrogen must be tested before and after ovulation and how low estrogen is often misdiagnosed as PCOS.
📈 When & How Bioidentical Estrogen Is Used
The goal is always physiologic balance—never excess.
🌊 Perimenopause, Menopause & Hormone Smoothing
Dr. Sarah emphasizes that hormone therapy should always have a plan—support, stabilize, then wean.
🧬 DHEA: The Precursor Hormone
It can be used orally or vaginally depending on goals and symptoms.
📊 Root Cause Always Comes First
Hormones support healing—they don’t replace it.
If you’re struggling with hormone symptoms, fertility challenges, or perimenopause and want a personalized, physiology-based approach, support is available.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson breaks down perimenopause—what it is, how to know if you’re in it, and what you can do to feel better during this major hormonal transition. She explains why symptoms can feel extreme and unpredictable, how hormone testing actually works in perimenopause, and why a whole-body, root-cause approach is essential for long-term relief.
Rather than accepting “this is just part of aging,” Dr. Sarah outlines how targeted nutrition, lifestyle support, lab testing, supplements, and — when appropriate — low-dose bioidentical hormone therapy can dramatically improve quality of life.
🌿 What Perimenopause Actually Is
🔥 Common Symptoms of Perimenopause
🧪 How to Test for Perimenopause (and Why One Lab Isn’t Enough)
🩸 When Irregular Bleeding Is a Red Flag
🥗 Why Nutrition Is Always the Foundation
🧠 Supporting the Entire Endocrine System
📈 Why Blood Sugar Matters More Than You Think
🌱 Gut Health, Absorption & Hormone Balance
💊 Supplements: When to Support vs. When to Avoid
🧠 Mental Health & Nervous System Support
🌸 Hormone Therapy: When It’s Helpful
📊 Discovery, Stabilization & Weaning Phases
If you think you may be in perimenopause or you’re experiencing symptoms that are affecting your quality of life, you don’t have to navigate it alone.
📍 Westminster, Colorado
In this episode of The Hormone Café, Dr. Sarah Pederson explains how IV nutrient therapy can support fertility when diet and supplements aren’t enough. She breaks down why nutrient deficiencies persist despite “doing everything right,” how IVs bypass absorption barriers, and how targeted IV formulations can improve egg quality, sperm quality, implantation, and surgical recovery.
💉 Why IV Therapy Matters in Fertility Care
🧪 Key Nutrients Commonly Low in Fertility Patients
🥚 Egg Quality IV
🌱 Implantation & Uterine Blood Flow IV
🩺 Pre- & Post-Surgical Recovery IVs
👨 Sperm Quality IV
🧠 IV Therapy as an Adjunct—Not a Replacement
If you feel like you’re doing “all the right things” but still struggling with egg quality, implantation, recovery, or sperm parameters, IV therapy may be a supportive next step.
📍 Westminster, Colorado
In this episode, Dr. Sarah Pederson breaks down the three most common female hormone profiles—low estrogen & progesterone, estrogen dominant, and progesterone dominant/low estrogen—and explains how each one affects mood, energy, cycles, fertility, and overall health. This episode empowers women to understand their symptoms, test hormones properly, and align nutrition, exercise, supplements, and treatment with their unique hormone profile.
🧪 The Three Core Hormone Profiles
Each profile presents differently and requires a different approach to treatment, lifestyle, and supplementation.
🩺 Why Proper Hormone Testing Matters
🌱 Low Estrogen & Low Progesterone (Low–Low Profile)
Root causes may include:
Support strategies:
⚖️ Estrogen Dominance
Key contributors:
Support strategies:
🌡️ Progesterone Dominant / Low Estrogen
Key focus areas:
🧠 Why Hormone Ratios Matter
If you suspect hormone imbalance or feel stuck with persistent symptoms, proper hormone testing and individualized care are essential.
📍 Westminster, Colorado
From the publisher's feed
The Hormone Café is your cozy corner for honest conversations about women’s health, fertility, and hormones. Hosted by Dr. Sarah Pederson, holistic OB-GYN and founder of Vera Health and Fertility,…
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