Prologue

You can be doing everything “right” and still feel like your body has turned on you. We meet Lorraine, a strong, stylish mum who trains hard, keeps the household running, and yet feels flat, puffy, and deeply tired. Her GP tells her the blood tests are within normal range, but she’s not sleeping, she’s gaining weight she’s never had to fight before, and she’s quietly embarrassed in her own skin. That gap between what the lab report says and what your life feels like is where this conversation begins.

We walk through the clinical clues that show up in perimenopause, including the classic apple-shaped belly that often signals a deeper hormonal imbalance. We unpack why oestrogen dominance and progesterone deficiency can drive anxiety, overwhelm, broken sleep, and stubborn weight, and why “eat less, train more” can backfire when your body is under hormonal and metabolic strain. We also explain why foundational blood testing and full blood panels can reveal deficiencies and patterns that standard GP testing may miss, helping us treat for optimal results rather than merely “within range”.

From there, the story widens into metabolic health: non-alcoholic fatty liver disease (NAFLD), insulin resistance, and a sluggish thyroid can sit underneath midlife weight gain and fatigue, even when alcohol isn’t the cause and results look acceptable on paper. The core takeaway is hopeful and practical: when we heal the gut, support liver function, rebalance hormones, and restore metabolism, you can move from fat-storing mode to fat-burning mode and reclaim real vitality through the transition to menopause. If this resonates, follow the podcast, share it with a friend who needs it, and leave a review so more women can find the help they’ve been missing.

Transcript

A Letter To You, Beautiful

SPEAKER_00 0:00

Prologue A Letter to You, Beautiful Before we begin, I want to paint a picture of what I often see when a woman walks into my clinic. After nearly three decades, I've learned that every woman is unique and gorgeous in their own way, and as unique as their biochemistry and perimenopausal symptoms, but tenants of their stories are always similar. As I walk you through this healing story, pause and ask yourself Do I see myself at all in this lovely woman? Her name is Lorraine. I first met Lorraine when she came to see me for her initial consultation. She's a stunning woman whose energy is a bit feisty. She's petite in stature with legs any woman would die for. I could see that she smashes it at the gym because she has incredible muscle definition in her calves and forearms. She had a funky, cool style, and was wearing cute white shorts. Then I noticed that for her top she wore an oversized shirt, a very stylish one, but it hung almost to the bottom of her shorts. And underneath that shirt I could see there was a big, fluffy, round apple abdomen, so common for certain women in perimenopause. With my many years of study in Chinese medicine, my eyes are trained to observe certain medical issues, often without needing any data. Lorraine's abdomen already provided quite a bit of information, indicating I would need to do more testing. But before I said a word about this, I first listened.

Lorraine’s Hidden Struggle Behind The Smile

SPEAKER_00 1:35

Lorraine began. Okay, I've heard you're incredible, and if anyone can help me, I know it's you. I get the holistic approach to perimenopause and menopause, so here's the blood work my general practitioner, GP, has done. She passed her results to me and continued. You can see by the numbers, I'm not really that unwell. I just want to feel amazing. I thought, okay, but why are you here then? I listened more. Lorraine continued. My doctor said according to my numbers everything is fine. Everything is within normal range. As I looked over Lorraine's results I immediately saw big gaps in her blood work. She followed by saying What I really want is for you to help me reduce my weight a bit. I've put on some kilos recently, but my doctor says everything else looks normal. She paused, her eyes cast down, and said So why is this happening? And then the tears came. I have two small children at home, two dogs and my husband is gone most of the week, due to a major project off site. Lorraine looked at me and asked, So if everything's so great with my health, why do I constantly feel exhausted? I'm not sleeping. Then she said something that caught my attention. I'm just so tired of being exhausted. She took a moment, and I looked at this beautiful woman and recognized what I see in many of my patients. Constant exhaustion becomes their default state. For many, to the point that women will feel it defines their entire experience. It's not just physical exhaustion these women face, but it's also emotional and mental exhaustion. Then, timidly, Lorraine asked, And maybe if you could just help me lose a little weight, everything would be good again. More tears. She went on to describe how embarrassed she was by her body in front of her husband. She's never struggled with her weight before, and could always get the results she wanted at the gym, but nothing she tried worked anymore. I said, Lorraine, I'm so glad you're here because we can make you feel amazing. We can get your weight to where you want it to be and help you get your life back to feeling manageable. You see, your current blood work provides some data about what's going on in your body, but not all of the information we need to properly treat you.

When “Normal Range” Still Feels Wrong

SPEAKER_00 4:00

Let me stop for a moment. Do you see yourself at all in Lorraine? Do you feel mentally and emotionally exhausted? Do you sleep deeply and feel restored when you wake? Do you feel comfortable in your own body? Lorraine was like so many women I see who have been told they're fine because according to their bloods, they're within normal range. In one sense, they want to believe their doctor when he says everything is fine, but then they feel conflicted because they know something isn't right in their body. The blood work your GP typically orders provides some information, but it often doesn't include some of the critical data that you need to see what's going on in your body at a deeper level. The bloods I order are the full blood panels within the foundational blood testing, so I can determine where your deficiencies are. We will discuss this foundational testing and its crucial role more in chapter 5.

Oestrogen Dominance And Progesterone Deficiency

SPEAKER_00 4:55

Let's go back to Lorraine's story. Her apple-like abdomen was not a result of calories in too many and calories out not enough. I could tell in her presentation that most likely she was estrogen dominant and severely progesterone deficient. I will speak in great depth about what this hormonal imbalance means in the next few chapters. But for now, I was able to tell Lorraine that once we rebalanced her hormones, her weight would take care of itself. With the imbalance between her estrogen and progesterone levels corrected, her feelings of anxiety and overwhelm would also disappear and she could sleep. Lorraine

Fatty Liver, Insulin Resistance And Thyroid Clues

SPEAKER_00 5:33

also presented as a textbook case of non-alcoholic fatty liver disease, NAFLD. Without getting too into the weeds, as we will talk about it again in chapter 5, NAFLD is a condition where excess fat builds up in the liver. But in this case, it's not due to significant alcohol use. It can potentially lead to inflammation and liver damage. Most often, NAFLD is caused by insulin resistance, a precursor condition to type 2 diabetes, which can also affect the thyroid. Lorraine's testing told me that her thyroid was a bit sluggish. Even though Lorraine tested within normal range, in functional medicine, in my clinic, I want to treat women for optimal results. I wanted her thyroid to be functioning better than just within range. All of these issues I identified in Lorraine can be resolved when we heal her gastrointestinal tract and metabolism and get her plumbing straightened out, so Lorraine would no longer be in a fat-storing mode, but a fat-burning mode.

Foundational Testing And The Root Cause Plan

SPEAKER_00 6:37

The lesson to take away from Lorraine's story is that when I do the foundational blood testing to identify the potential deficiencies in your foundational health, we are then able to customize your treatment to resolve the root causes of your symptoms once and for all. When your gut is healed, when your hormones are in balance, then you're able to reclaim your metabolic health and vitality for good. But it begins with proper data, through proper testing.

Why This Book Exists And Next Steps

SPEAKER_00 7:05

Lorraine and every woman like her is the reason why I've written this book. The information in these pages is for every woman who wants to feel better, who wants to feel amazing once again, even though she's been told you're within normal range. Also you can make the beautiful transition from perimenopause to menopause, feeling vital and vibrant. I am so glad you're here, beautiful. Let's begin your journey. Fondly Dr. Kirsty Holland.