Lara Briden

Lara explains that a normal blood glucose, even a normal HbA1c, cannot rule out insulin resistance because it is a condition of chronically elevated insulin. She says there are other ways to test for it.

Lara explains that chronically high insulin makes it much harder for the body to access body fat for energy, so it is harder to burn fat and harder to fuel yourself between meals. She describes it as being trapped in carb burning, which can show up as fatigue and carb snacking to get through the afternoon or night.

In Lara's view, the later stages of perimenopause push everyone toward insulin resistance as progesterone and then estradiol drop and testosterone shines through more. She says this promotes visceral belly fat and can increase intestinal permeability, with how far it goes depending on other risk factors.

Lara names magnesium, taurine, choline, inositol and glycine. She says they support mitochondria, metabolic health and sleep, and that many were traditionally found in organ meats and animal foods.

Lara says pill bleeds are not menstrual cycles, so stopping the pill lets you see what your real cycle is like, which may mean missing or irregular periods at first. She asks patients what their periods were like before the pill and how many years they cycled beforehand, since even two or three years of cycling often makes the road easier.

Lara is a little nervous about fasting through the morning because protein in the morning helps signal your circadian rhythm. She eats leftover meat for breakfast and suggests protein powder if you cannot face meat.