Sarah Gates, FNP

04/10/2026

Most supplements aren’t tested the way you think they are 👀

Especially magnesium.

If you’re taking magnesium glycinate for sleep, anxiety, or muscle recovery… here’s what matters:

✔️ Not all “magnesium glycinate” is actually glycinate
✔️ Some are mixed with cheaper forms (like oxide) that don’t absorb well
✔️ Doses on the label aren’t always accurate
✔️ Heavy metal contamination can happen

So how do you know what you’re actually getting?

👉 Look for the USP Verified seal

USP (United States Pharmacopeia) means:
• The supplement contains what the label says
• It’s been tested for contaminants
• It meets quality and purity standards
• It actually breaks down and absorbs in your body

And here’s the kicker…

🟡 Most magnesium glycinate supplements are NOT USP verified

One of the few you can grab easily at places like CVS or Target:
→ Nature Made Magnesium Glycinate

It’s not fancy. It’s not influencer-branded.
But it’s been independently tested—and that matters.

✨ Many local pharmacies and chiropractors also carry pharmaceutical-grade supplements that go through more rigorous third-party testing. These can be great options too—just at a higher price point.

Bottom line:
If you’re going to spend money on supplements, make sure you’re actually getting what you paid for.

Quality > hype. Every time.

04/08/2026

Tell me you love your shoulder replacement without telling me… 😂

This patient is thriving after her reverse total shoulder less than a year later 🙌 At PCI I work side by side with Dr. Eyberg, who fellowship trained in upper extremity surgery under Mark Frankle —one of the nation’s leaders in shoulder replacement —so our patients get expert care every step of the way. 💪🩺

📞 Call us today to learn more or schedule your visit: 319‑398‑1545

04/05/2026

Downshifting❣️

We often think inflammation is mostly about food.

Eat less sugar.
Take the supplement.
Add the anti-inflammatory ingredient.

But when researchers studied the world’s longest-living populations, they found something bigger:

The people aging best were not stress-free.
They just did not stay stressed all day.

That is a major difference.

Because stress is part of life everywhere, including in the Blue Zones. But Blue Zones researchers found that these communities tend to have daily rituals that help bring stress back down, including prayer, napping, ancestor remembrance, and time to gather with others.

Blue Zones describes this pattern as “downshift,” and notes that these rituals help reduce the inflammation linked to chronic stress.

That matters because chronic stress affects the entire body.

Research has linked chronic psychological stress to ongoing low-grade inflammation, and that kind of inflammation is tied to many of the diseases people fear most as they age.

The National Institute on Aging also describes chronic, low-grade inflammation, sometimes called inflammaging, as a feature of aging that contributes to age-related disease.

In other words:

It is not only the stress itself.
It is whether your body ever gets the signal that the stress is over.

That is where modern life goes wrong.

So many women spend the entire day activated.

Rushing.
Scrolling.
Working.
Caretaking.
Worrying.
Pushing through.
Then collapsing at night without ever truly coming down.

That is not resilience.

That is overload.

And over time, overload has a cost.

The Blue Zones pattern offers a different model.

Not a perfect life or a life without stress.
A life with built-in recovery.

What this looks like in the Blue Zones:
A pause.
A prayer.
A nap.
A slow meal.
A walk with someone you love.
A moment at the end of the day when your nervous system is allowed to exhale.

That is one reason this pattern matters so much for healthy aging.

The women who age the slowest do not just avoid inflammatory foods.
They interrupt inflammatory living.

And that is a lesson many modern women desperately need.
Because the goal is not to become a person with zero stress.

The goal is to stop carrying the same stress signal from morning to night, day after day, year after year.

What this can look like in real life:
- 10 quiet minutes before the day starts
- a short walk without your phone
- prayer, meditation, or deep breathing
- sitting outside in the evening
- one meal eaten slowly
- calling a friend instead of staying in your head
- resting before you are completely depleted

It does not have to be dramatic.
It just has to be daily.

Healthy aging is about the signals you give your body over and over again:

You are safe.
You can slow down.
You can recover now.

In Blue Zones, that recovery is not treated like a luxury.
It is part of how life is lived.

And that may be one of the most anti-inflammatory habits of all.

For more on the best natural ways to reduce stress, see the full guide here: https://bit.ly/402gcFp

Follow along for more practical, natural steps to slow biological aging and live a longer, fuller life.

04/02/2026

Magnesium might be one of the most underrated tools in your health toolbox 🧰

It’s not flashy—but it touches everything:

✔️ Supports bone health + structure
✔️ Keeps bowels moving (without harsh laxatives)
✔️ Helps regulate muscle function (hello fewer cramps)
✔️ Can support sleep + a calmer nervous system
✔️ Plays a role in pain modulation

Here’s the kicker: it’s involved in 300+ enzyme reactions in the body 😳

And yet, many people don’t meet recommended intake. We just don't eat enough magnesium rich foods such as dark leafy greens, nuts and seeds, legumes and whole grains.

To supplement, I usually recommend patients start with magnesium glycinate—it’s gentle, well-absorbed, and the form I take myself. It's also readily available and inexpensive.

I use magnesium strategically depending on goals:
→ Bowels? Different form
→ Sleep + stress? Different form
→ Muscle recovery or pain? Yep—different form

It’s not one-size-fits-all.

Simple. Foundational. Effective.

Sometimes the basics are the real flex 💁‍♀️

Disclaimer: Always check with your primary care provider before starting supplements, especially if you have kidney issues or take other medications.

03/30/2026

Big milestone today 🎉

I completed A4M Module I: Advanced Endocrinology —advanced training focused on hormone health, metabolism, and the connections between stress, thyroid, and s*x hormones.

This is part of a bigger personal goal I set for 2026 to go all-in on continuing education—just crossed 80 CME hours and counting 💪

While orthopedic surgery will always be a core part of my work, I’m passionate about expanding how I support patients beyond the OR—especially those dealing with fatigue, weight changes, and hormone-related symptoms that don’t always show up clearly on standard labs.

Excited to keep building this and bringing a more complete approach to patient care.

More to come 💫.

03/26/2026

Trying to eat clean without blowing your grocery budget? 🛒✨

Here’s the deal with the Dirty Dozen & Clean Fifteen (2026 edition) 👇

🍓 Buy organic (Dirty Dozen)
These tend to have the highest pesticide residue:
Strawberries, spinach, kale, grapes, peaches, cherries, nectarines, pears, apples, blackberries, blueberries, potatoes

🥑 Save your money (Clean Fifteen)
These are typically low in pesticides — ok to buy conventional:
Avocados, sweet corn, pineapple, onions, papaya, peas, asparagus, cabbage, watermelon, cauliflower, bananas, mangoes, carrots, mushrooms, kiwi

💡 Real-life tip:
You don’t have to buy everything organic to be healthy.
If you focus on just switching the Dirty Dozen, you’re already making a meaningful impact ✔️

And remember — eating fruits and veggies (organic or not) will always be better than avoiding them altogether 🙌

03/20/2026

Bone health isn’t just about calcium… it’s about inflammation, too 🦴🔥

Chronic, low-grade inflammation quietly accelerates bone breakdown. When inflammatory cytokines are elevated, they stimulate osteoclast activity (the cells that break down bone) and suppress osteoblasts (the cells that build it). Over time, that imbalance can tip you toward bone loss.

So where do omega-3s come in? 🐟✨

Omega-3 fatty acids (especially EPA and DHA) are powerful anti-inflammatory nutrients. They help:
• Reduce inflammatory signaling
• Support a healthier balance between bone breakdown and formation
• Potentially improve bone density over time

Think of omega-3s as part of your “bone protection team,” not just your heart health plan ❤️

(Spoiler alert: decreasing inflammation can also impact weight loss 👀⚖️)

Here’s the kicker 👇
The average American only gets about ~100 mg/day of these anti-inflammatory omega-3s…
but we likely need closer to 500+ mg/day for optimal health.

That gap matters—especially when we’re talking about inflammation and bone loss.

Where to find them:
• Fatty fish (salmon, sardines, mackerel)
• High-quality fish oil supplements
• Algae-based omega-3s (great plant-based option)

And let’s be honest—no one wants fishy burps 🤢
That usually comes down to quality. A well-sourced, purified omega-3 from a trusted company should not leave you tasting it all day. Look for third-party testing, proper storage, and brands that prioritize freshness.

If you’re considering an omega-3 supplement and want help choosing a high-quality option (without the fishy aftertaste), I do have a professional-grade dispensary I trust—happy to share the link 💬

Bone health is a long game—and inflammation is often the missing piece 🧩

02/26/2026

I’ve watched someone close to me commit to The Wahls Protocol for almost a year — and the results have been incredible. 52 pounds down. No medications. No crazy calorie restriction.

Just focusing on lowering inflammation and fueling the body with real, nutrient-dense food.

It’s not about perfection. It’s about consistency.

If you’re looking for a starting point to support your metabolism, hormones, or overall health — reducing inflammation through food is powerful.

Your body wants to heal. Sometimes it just needs the right environment. 🌱

For the past 15 years, clinical professor and researcher Terry Wahls (82MD, 86R) has been exploring how the foods we eat affect the gut microbiome. Wahls and other University of Iowa nutrition experts have published findings about the gut microbiome in patients with cancer, multiple sclerosis, and other diseases.

Follow the link in the comments to learn what’s happening at Iowa.

02/20/2026

A first for me today: a telephone encounter (patient message) titled “Fall/beautician name.”

Detailed medical concerns… followed by a specific request for my beautician 😂🤣

Grateful to help people heal — and thankful for the glam squad that keeps me clinic-ready 💇🏻‍♀️🫶🏼💖

01/18/2026

Gentle January reminder 🌱 | Bone care basics

Vitamin C supports collagen formation — a foundational component of bone and soft tissue healing.

Adequate intake has been shown to support:
• Fracture healing
• Post-operative recovery
• Tendon and ligament repair

Small supports add up, especially during recovery.

— Sarah Gates, FNP

01/10/2026

Vitamin D who?! 🥶

With less sunlight in the winter months, vitamin D levels often dip — and vitamin D plays an important role in:
• Bone strength
• Muscle function
• Balance and fall prevention
• Recovery after injury or surgery

In Iowa, limited winter sun exposure makes low vitamin D especially common this time of year — even in otherwise healthy adults.

Before adding more to your plate this year, it’s worth making sure the basics are covered 🦴

This time of year, our bodies need a bit more support.

— Sarah Gates, FNP

11/12/2025

If you know me personally, you’ve probably endured at least one of my “soapbox moments” about how the Women’s Health Initiative (WHI) findings were misunderstood and misrepresented. Not all hormones are created equal.

The fear that “HRT causes cancer” came largely from studies using synthetic, non–bioidentical hormones (some derived from horse urine!!!), which are chemically different from the plant-derived, bioidentical hormones many clinicians use today.

It breaks my heart to meet women terrified to replace hormones their bodies are no longer producing—women who are suffering needlessly with poor quality of life because they were never told there’s a difference.

So yes—this FDA decision is really big news (and honestly, long overdue). My hope is that it marks the beginning of a new era where women can pursue healthier, happier lives with evidence-based therapy—and without fear of judgment or repercussions from clinicians who simply weren’t taught the whole story.

Here’s to informed choices, empowered women, and better health. 💛✨

“Tragically, tens of millions of women have been denied the life-changing and long-term health benefits of hormone replacement therapy because of a medical dogma rooted in a distortion of risk. For too long, issues of women’s health have been underrecognized. Women and their physicians should make decisions based on data, not fear.” — U.S. Food and Drug Administration Commissioner Dr. Makary