Keep your candle. Bring your labs.
I’m a naturopathic doctor who believes in ritual—but I do not believe your salvation lives in a $300 detox kit, a hero supplement stack, or a shirtless savior on a podcast telling you to distrust every doctor and eat only beige animal parts. I love a candle. I love a spell. I will also order your DEXA, put you on estrogen, prescribe IV iron, and recommend a statin if your heart risk says so.
Call it witchcraft with receipts.
This is not where I started. My grandpa was a chiropractor; body literacy is family heirloom. I taught cycle charting and supported unmedicated births (when safe). I high-fived moon charts—and I still do. I also used to make more room for default “natural first” plans, including delayed vaccine schedules for certain mom/kid pairs. Over years in practice, the moon charts met the lab charts; the birth tub stood alongside epidurals and, when needed, IVF. The more I tracked outcomes, the more my plans shifted: fewer supplements, tighter indications; more sleep, strength, and protein; more data, less dogma. My work now is both candle and clinic: ritual for meaning, evidence for decision-making, continuity for real change.
If you’ve been burned by medicine, your distrust is a form of self-protection. I honor that. We’ll keep your questions—and the shots—on the table.
🧭 The Compass
When I’m deciding what to recommend, I check three points:
- Ritual (meaning): What grounds you—and what you’ll actually do when the day goes sideways.
- Evidence (receipts): Clear indication, measurable outcome, stop date, follow-up.
- Relationship (continuity): A home team, fewer handoffs, scheduled check-ins. Care that remembers you.
Keep · Add · Resize
This isn’t a dunk on wellness. It’s a re-size.
Keep (because they help): body literacy, ritual, cycle charting, physiologic birth support when safe, nutrition, movement, sleep, trauma-sensitive care.
Add (because outcomes improve): DEXA, IV iron, menopause hormone therapy (HRT), statins when indicated, vaccines, GLP-1s for the right patient, CBT-I for insomnia, and pelvic floor PT.
Resize/Toss (because the ROI is poor): default delayed vax schedules, “hero” supplement stacks, detox challenges, ideology-first protocols.
Supplement sanity rules
- Start with a lab or diagnosis, not a vibe.
- One hypothesis → one product → one outcome window.
- Name the sunset date up front.
- Keep the stack under five unless you’re in short-term specialty care.
- Re-check the lab—or stop.
Three Patients, Three Receipts
(composites; details changed)
1) The Fog That Wasn’t “Just Stress”
Ferritin 7 ng/mL; dizziness, anxiety, “not in the room.” Oral iron had failed for years. We did IV iron. Eight weeks later: ferritin 95; insomnia index 16→7; light returns to the eyes. Plan: treat bleeding, re-check at 12 weeks, set a maintenance floor.
MI micro-script (iron): “On a scale from 0–10, how ready are you to try an infusion so we can see if your brain comes back online? What would move you one point?”
2) The Sleepless Switch
Hot flash and night sweat flares, 2 a.m. wake, mood edges. Under 60, within 10 years of final period. We started transdermal estradiol + micronized progesterone and CBT-I. Ten weeks: sleep efficiency 68%→87%, PHQ-9 11→4, night sweats → rare. Plan: 3-month touchpoint; goals-based taper only if asked.
MI micro-script (HRT): “What matters most—sleep, mood, sex, bones, flashes? Let’s aim there for 12 weeks, then reassess with you in the driver’s seat.”
3) The Quiet Cardio Coup
LDL and apoB climbing; postpartum BP history; late perimenopause. We layered fiber, Mediterranean pattern, resistance training, alcohol audit, transdermal estrogen (timing window appropriate), and a low-dose statin after shared decision. Three months: apoB 120→74; BP 138/86→122/78; treadmill no longer brutal.
MI micro-script (statin): “If your 10-year risk is a 7/10 problem, how open are you to a 2/10-risk medication that cuts that problem nearly in half? We can start low, monitor, and stop if it’s not you.”
Vaccines: The Public-Health Love Language
You can keep your crystals—and add your shots. Midlife immune wins are not a culture war; they’re community care.
Common midlife needs (confirm with your clinician): Flu annually; COVID-19 per current guidance; Tdap once then Td q10y; Shingrix at 50+ (two doses); pneumococcal at 65+ or earlier with risks; Hep B catch-up if not immune; MMR/Varicella if non-immune.
Why it fits the Compass:
- Ritual: Protect your circle (grandparents, babies, the friend in chemo).
- Evidence: Fewer hospitalizations and deaths; strong real-world effectiveness.
- Relationship: Shots today prevent catastrophic detours that break continuity later.
Empathy bridge: If you’re vaccine-hesitant, you’re still welcome here. Bring your questions. Informed consent is a conversation, not an eye roll.
Continuity of Care (Relationship as Medicine)
Healing loves a home team. Continuity isn’t an app; it’s a practice.
The Continuity Cadence (90-day sprint):
- Choose a home clinician/team; keep portal & pharmacy info in one place.
- Baseline: symptoms, vitals, key labs (CBC/ferritin, lipid + apoB, A1c/fasting insulin, TSH contextually, vitamin D).
- Plan: 1–3 moves (not 13). Book the follow-up now for 6–12 weeks.
- Co-care: loop in pelvic floor PT, CBT-I, dietitian, or specialist without losing the home base.
- Review: Did it help? Keep, tweak, or stop. Iterate.
How We Choose (The Six Questions)
- Efficacy: Does it work for this problem?
- Safety: What are the meaningful risks—and to whom?
- Fit: Can your life carry it?
- Access: Cost, availability, time.
- Values: What matters most right now (sleep, sex, bones, mood, longevity)?
- Follow-up metric: How will we know it helped—and when do we stop?
Sketches (not prescriptions):
- HRT: Often best <60 years or <10 years since menopause; transdermal routes favored if clot risk is a concern.
- Statins: If apoB/LDL stay high or 10-year ASCVD risk is elevated, low dose + lifestyle can reduce events.
- GLP-1s: For obesity/T2D or high-risk phenotypes after other tools; screen for personal/family history of medullary thyroid carcinoma or MEN2; watch GI effects; pair with protein + resistance training to protect muscle.
- Supplements: Iron with ferritin targets; D with levels; omega-3s for high TGs; creatine for strength/cognition (individualize). No endless stacks.
Spotting Woo Without Losing Wonder
You don’t have to surrender wonder to avoid the cult.
Red flags: miracle stacks; “no one else knows this” vibes; giant lab panels no one interprets; moving goalposts; purity politics and shame sales; detox Mondays forever; no endpoints.
Green flags: clear indication and stop date; measurable outcomes you can track; deprescribing is on the table; humility (“Let’s see if this works,” not “This will cure you”).
Keep the ritual—candles, playlists, moon-tracking—for meaning. Keep the evidence for medicine. Keep both if both help.
Micro-FAQ
Do I have to take meds to belong here?
No. We right-size everything. Sometimes the best move is sleep and strength. Sometimes it’s sleep, strength, and a statin. We decide together.
I’m vaccine-hesitant. Can we talk?
Always. Bring your questions. We’ll review your risks, your community, and decide with clarity—not shame.
Can I keep my supplements?
Mostly—if they have a job, a timeline, and a lab we’re aiming to change. If not, we’ll Marie Kondo your shelf.
Is HRT dangerous?
Risk depends on timing, route, history, and goals. For many midlife women in the “window,” benefits often outweigh risks. We individualize.
I can’t afford concierge care.
You don’t need it to do continuity. Use community clinics, pharmacists, and simple follow-ups to create a home-team map that fits your life.
Closing: The Middle Path, On Purpose
I’m not asking you to trade your candle for a copay—or your data for a detox. I’m asking you to let both parts of you sit at the same table: the woman who loves ritual and the woman who loves results.
We’ll use the Compass. We’ll keep what helps, add what matters, and resize the rest. We’ll choose continuity over chaos, outcomes over optics, and consent over charisma. Less purity, more progress. Less performance, more care.
Keep your candle. Bring your labs. That’s wellness—without the cult.
*****General info only; not medical advice. Talk with your clinician about your specific care.
