A woman in her 40s came to me completely destroyed by stress. Doctor said she was fine. She was not fine. We fixed her cortisol, her gut, her nutrients, her sleep — comprehensively. She got her life back. Then she told me to write it all down. So I did. The Cortisol Fix — available for pre-order now, releasing May 15. 🧵👇

I stayed nearly 20 years in a job I didn't love. Not for lack of skill. Just quiet fear of the unknown. I see the same pattern with food: "I'll start Monday." "What if I'm hungry all day?" The 10 food fears I see most, and the first step for each 👇 alignwellnessai.substack.com…

PCOS has a new name: PMOS. In May 2026, polycystic ovary syndrome was officially renamed polyendocrine metabolic ovarian syndrome after a 14-year global consensus published in The Lancet. As a dietitian for 25+ years, I cheered. The old name made it sound like a cyst problem. The new one puts the real driver front and center: metabolism. Here's what most young women with PMOS are never told 🧵 1/ It's incredibly common, and rising. An estimated 8–13% of women have PMOS, and up to 70% are undiagnosed. Among girls and young women aged 10–24, cases rose about 59% worldwide from 1990 to 2021. Most of the young clients who come to me have it, even when they booked for acne, belly weight, or fatigue. 2/ The pill is a bandage, not a fix. Combined birth control pills work by stopping ovulation. That monthly bleed is a withdrawal bleed, not a true period. It can help symptoms, but it doesn't touch insulin resistance or inflammation. Many women come off it years later to find everything right where they left it. 3/ Lower-carb eating has the strongest evidence. • A 2025 meta-analysis of 7 RCTs (495 women): keto lowered weight, visceral fat, insulin resistance, LH, and testosterone, and raised SHBG. • A low-carb Mediterranean diet beat a low-fat diet for weight, testosterone, insulin, and cycle regularity. • On a low-GI diet, 95% of women had more regular cycles vs. 63% on a conventional healthy diet. 4/ Build your plate around protein and whole-food fats. ⅓ protein (30–40 g), ⅓ vegetables, a generous serving of olive oil, avocado, nuts, or ghee, and a small portion of slow carbs. In a 2025 study, high protein preserved muscle during weight loss: 1.5 kg lost vs. 4.4 kg on standard protein. 5/ Intermittent fasting? It can help, but it isn't magic. A 2026 Nature Medicine trial found a 1–7 p.m. eating window matched calorie counting for weight loss and also lowered the free androgen index and A1c. It didn't fix cycles in six months. 6/ The piece most plans miss: hidden food sensitivities. Even "healthy" foods can keep inflammation and insulin resistance stuck. In my practice, MRT testing with the LEAP protocol often works better than any generic diet. I saw it in my own CGM data. 7/ Supplements can speed things up once the foundation is in place. Myo-inositol, vitamin D, and omega-3s have the strongest evidence. I graded 15 of them in the full guide. Test, not guess. Full evidence-based PMOS diet guide 👇 thehealthyrd.com/pmos-diet/ #PMOS #PCOS #TheHealthyRD

IBS is often called “just functional.” A 2020 study suggests the gut tissue tells a different story. 🧵 Researchers took biopsies from three sites in the gut (terminal ileum, cecum, and rectum) in three groups: People with IBS People with inflammatory bowel disease (Crohn’s and ulcerative colitis) Healthy controls They measured three inflammatory signaling molecules: TNF-α, IL-6, and IL-1β. What they found: → TNF-α was HIGHER in IBS gut tissue than in both IBD and healthy controls. → Within IBS, TNF-α was highest in constipation-predominant IBS (IBS-C) and lower in diarrhea-predominant IBS (IBS-D). → IBD had a different pattern. IL-6 was the dominant inflammatory signal there. → IL-6 and IL-1β in IBS looked similar to healthy controls. What this means: IBS and IBD are not the same disease. IBD causes visible, destructive inflammation. IBS doesn’t. But “not IBD” doesn’t mean “no inflammation.” IBS appears to have its own inflammatory fingerprint, and TNF-α may play a meaningful role in how it develops. That fingerprint is easy to miss. A standard colonoscopy can look normal, and so can routine bloodwork. Then patients hear “everything looks fine” while they’re still bloated, in pain, and running to the bathroom (or not going at all). Why it matters for treatment: If low-grade inflammation is part of the picture, it’s worth asking what’s driving it: Food sensitivities and reactive foods Microbiome imbalances Gut barrier (“leaky gut”) issues Chronic stress and cortisol dysregulation Post-infectious changes Those are things you can actually work on. A few honest caveats: This was a small study, and it measured cytokines in tissue samples using staining, not blood levels. It doesn’t prove TNF-α causes IBS. But it adds to a growing body of research showing IBS is a real, biological condition, not something that’s “all in your head.” But it's not an isolated study either. There are many other showing that IBS is inflammatory. If you’ve been told your gut is fine but you don’t feel fine, your symptoms are real, and they deserve a deeper look. 📚 Mitselou A, et al. Proinflammatory cytokines in irritable bowel syndrome: a comparison with inflammatory bowel disease. Intest Res. 2020;18(1):115-120. doi.org/10.5217/ir.2019.0012… #IBS #GutHealth #Inflammation #FunctionalNutrition

Not all liver herbs are created equal. Milk thistle, artichoke, dandelion, and burdock show up in nearly every “liver cleanse” on the shelf. But when you look at what happens when they’re tested in people, the gap is huge. Here’s how they rank by human evidence: 🥇 Milk thistle: 26 randomized trials found lower liver enzymes and less fatty liver. In a 48-week trial in NASH, it reduced liver scarring in 22% of people vs. 6% on placebo. 🥈 Artichoke leaf: lowered ALT and AST across 8 trials, and it’s my go-to for sluggish bile and bloating after fatty meals. 🥉 Turmeric: lowered liver enzymes in 15 trials, but high-dose extracts with black pepper have been linked to rare liver injury. 4️⃣ Berberine: 10 trials and 811 people showed lower liver enzymes, triglycerides, and insulin resistance. Then the drop-off: Schisandra: promising animal data, but serious drug interactions Dandelion: great as food; almost no human liver research Burdock: a root vegetable first; some teas have been contaminated One I’d skip for the liver: skullcap. Supplements have been found contaminated with germander, a plant that damages the liver. Two more things nobody puts on the label: → Milk thistle tea barely works. Its active compound doesn’t dissolve well in water, so choose a standardized extract. → Many of these are in the daisy family. Ragweed allergy? Be careful. I made a one-page chart with the evidence, best forms, and cautions for each 👇 Full research: thehealthyrd.com/herbs-for-l… Test, don’t guess. #TheHealthyRD #LiverHealth

So is smiling-give everyone a big smile always and a big hug when you can ⬇️

Most “liver detoxes” get it backwards. Juice cleanses, detox teas, 3-day flushes. Here’s what actually happens when your liver detoxes. It works in three steps: 1️⃣ Break it down. Liver enzymes start taking harmful substances apart. The catch: partway through, some briefly become MORE harmful, so you need antioxidants from colorful plants. 2️⃣ Make it harmless. Your liver attaches protective molecules like glutathione. This step runs on protein. A juice cleanse starves it. 3️⃣ Remove it. Waste leaves through bile, stool, and urine. If you’re not having a daily bowel movement, some of it gets absorbed back into your body. That’s why my 14-day protocol is food-first: ➡️Protein at every meal ➡️Cruciferous veggies + broccoli sprouts daily ➡️Bitter greens for bile ➡️30+ g fiber and plenty of water ➡️Fermented foods for the gut-liver connection ➡️Sleep, sweat, and fewer chemical exposures One standout: in a 12-week trial of 291 adults, a daily broccoli sprout drink helped people clear 61% more benzene, a common air pollutant. And here’s the part most programs miss: apart from short-term tools like activated charcoal, almost all of this should become your everyday life, not a 2-week event. Test, don’t guess. Get a liver panel before and after. Full protocol 👇 thehealthyrd.com/liver-detox… #TheHealthyRD #LiverHealth #Detox

Lion’s mane mushrooms for the win yet again. I always notice that they improve my focus and clarity!

Inflammation is one of the most misunderstood drivers of chronic symptoms, because it rarely looks the same in two people. After 25+ years as a dietitian, here’s what I see. The most common pattern: puffiness A swollen face. A bloated belly that won’t budge no matter how clean you eat. In some clients, a buffalo hump on the upper back, a sign that inflammation and cortisol are working together. But inflammation can also show up as: → Migraines → Asthma and seasonal allergies → Vestibular problems and dizziness → POTS → Joint and muscle pain → Skin rashes → Gut issues → Fatigue → Poor sleep → A slow metabolism That last one matters. Chronic inflammation hijacks your hormones: cortisol, thyroid, insulin, sex hormones. When that happens, your metabolism slows down and weight loss feels impossible. Why generic advice fails Most people are handed a standard “anti-inflammatory diet.” But inflammation is personal. A food that’s healing for one person can be a trigger for another. My own reactive foods? Olive oil, halibut, egg yolks, sunflower, and mustard. Olive oil and halibut sit at the top of nearly every anti-inflammatory food list. For my body, they were doing the opposite. I never would have guessed it. Food sensitivity reactions are sneaky They can be delayed by hours or even days. Today’s migraine may come from yesterday’s lunch. That’s why food journals and guesswork so often come up empty. What I use instead: MRT + LEAP MRT (Mediator Release Test) measures how your white blood cells respond to foods and food chemicals. From there, the LEAP protocol builds your eating plan around your least reactive foods. The focus is on what you can eat, not just what to cut. The results In my clients, fixing their foods has near completely resolved every symptom on that list: the puffiness, migraines, asthma and allergies, dizziness, POTS symptoms, aches, rashes, gut issues, fatigue, poor sleep, and sluggish metabolism. No drugs. Just nutritious, personalized food. Read more: Why MRT changes everything: thehealthyrd.com/the-best-fo… My personal MRT case study: thehealthyrd.com/how-mrt-tes… Food sensitivities + blood sugar, with my CGM data: thehealthyrd.com/food-sensit… Your symptoms are information. Your plan should be as unique as you are.

For almost all of human history, medicine came from plants, foods, and minerals. In about one century, that changed. Here’s how 👇 In 1910, Abraham Flexner published a report on American medical education for the Carnegie Foundation. He wasn’t a physician. He was a schoolteacher and education reformer. To be fair, the report did some good. It raised lab and science standards at schools that badly needed it. But it also dismissed schools rooted in herbal, eclectic, and homeopathic medicine. Between 1910 and 1922, U.S. medical schools dropped from 131 to 81. Most natural medicine colleges closed in the decades that followed. Five of the seven Black medical schools and the women’s medical colleges closed in that same window too. Fast forward to today. Follow the money: → NIH budget: ~$47 billion → NIH center for complementary & integrative health: ~$170 million → That’s about 0.36% Plants and nutrients usually can’t be patented, so few companies will fund large trials of them. Here’s the irony. Drug companies never stopped mining nature: 🌳 Willow bark → aspirin 🌸 Foxglove → digoxin 🌲 Pacific yew → paclitaxel 🌿 Goat’s rue → inspired metformin 🍃 Sweet wormwood → artemisinin (2015 Nobel Prize) About half of approved small-molecule cancer drugs come from natural products. So the question isn’t whether plants work. It’s why we only respect them once they’re patented. And no, supplements aren’t “unregulated.” The FDA regulates them as a category of food under DSHEA (1994). They just don’t need pre-market approval like drugs. Quality is the real issue, so choose third-party tested brands. The tide is turning. In May 2025, the World Health Assembly adopted the WHO Global Traditional Medicine Strategy 2025–2034, which aims to strengthen the evidence base and integrate traditional and complementary medicine into health systems. I was trained in the most conventional way possible. I’ve also been the primary author of an RCT on vitamin D3 in heart failure. Nutrients deserve the same rigor, and the same respect, as any drug. Hold every medicine, natural or synthetic, to the same honest standard. Full article: thehealthyrd.com/why-are-nat…