https://linktr.ee/saragottfriedmd

Sara Gottfried, MD, Moraga, CA (2026)

01/30/2026

Your thyroid labs came back normal, according to your conventionally-trained physician.

So why do you still feel exhausted, foggy, and colder than most everyone else?

Because thyroid stimulating hormone (TSH) alone doesn’t always tell the whole story.

TSH is a pituitary hormone. It’s a message about your thyroid, not a thyroid hormone itself.

You can have a normal-range TSH and still have:
→ Low Free T3 (the hormone your cells actually use)
→ Poor T4 to T3 conversion
→ Early autoimmune thyroid disease brewing

This is one of the most common patterns I see in high-performing women.

Especially when chronic stress, undereating, overtraining, low iron, or perimenopause are in the picture.

These are conversion blockers, that disrupt the body’s ability to make active T3 hormone. In 30 years of practice, I see poor conversion most commonly in postpartum, perimenopause, and menopause.

The standard lab panel often misses this entirely.

Most doctors check TSH. Maybe Free T4. Almost never Free T3. Rarely antibodies.

As a result, women walk around for years feeling hypothyroid while being told everything is fine.

It’s not fine. It’s undertested.

What to ask for:
• TSH
• Free T4
• Free T3
• Thyroid antibodies (TPO ± Tg)

And know this: lab normal and optimal are not the same thing.

A TSH of 4.0 is technically normal. But many women feel best between 0.3 and 2.0, and research supports this. It’s the range we use if you’re trying to get pregnant. Many hypothyroid people are undiagnosed and part of the so-called normal reference range.

Your symptoms are data. They matter.
If your body is telling you something is off, it probably is.
Medicine just hasn’t caught up to measuring it correctly yet.

Comment LABS1 and I’ll send you my optimal thyroid lab ranges.

Save this for your next appointment. Share it with someone who needs to hear it.
—

01/29/2026

Longevity doesn’t happen in isolation.

We tried. We had all the books, hosted and listened to the podcasts, followed the protocols. Still felt fragmented.

The missing piece wasn’t more information, it was space, context, conversation, connection. Truly, a different container.

Your nervous system cannot rewire inside the same environment that created the problem. When you change your environment, your nervous system shifts. When your nervous system shifts, your metabolism, hormones, inflammation follow.

This is why most health interventions fail, not because you lack discipline but because you’re trying to implement precision medicine protocols inside outdated medical structures.

Longevity requires integration, not isolation. A place where learning, rest, movement, metabolic optimization aren’t rushed. Where you understand your data in context of your body’s trajectory. Where two physician perspectives converge to challenge what you’ve been told is normal.

That’s what we built in Baja. It’s not a wellness retreat but instead a precision medicine immersion for exhausted achievers ready to stop performing health and start embodying it. You will learn all about “hormone therapy plus” (the best hormone protocols, peptides, and when needed, biologics) built on the unsexy basics that need to be done daily, and how they all differ for men versus women.

Comment BAJA to learn if this retreat is right for you.

01/28/2026

Estrogen is a key driver of brain chemistry, metabolism, and resilience as we age.

When levels drop, brain fog, insulin resistance, and mental slowing often follow.

Find TREATED WITH DR SARA on your favorite podcast platform.

I'm in pre-production mode for season two of my podcast.

What topics would you love to learn more about?

Share your suggestions below 💫

01/27/2026

Walking builds health. Walking with load builds resilience.

We add weight to the movement our patients already do. Not as punishment, but as precision medicine that builds muscle, balance, and improves mitochondria and body composition.

Load changes the equation: more energy demand, more mechanical work, stronger cardiovascular signal. Same route. Different adaptation.

The research shows load carriage increases cardiorespiratory stress, improves functional capacity, and delivers the mechanical stimulus bone tissue requires. Impact plus load. That combination matters for skeletal health, particularly in women losing bone density after 35 in perimenopause and beyond. We lack good data on how it affects bone density in younger women, so maybe we should start a research study?

Note that breathing mechanics change under load. Chest wall mobility matters. Fit and dose determine whether carrying load becomes therapeutic or counterproductive.

I started with 10 lbs in a vest, added a 10 lb ruck after six weeks of adaptation. uses 40 lb or more. Different bodies, different baselines, same principle: progressive load matched to individual capacity.

We start patients at 5 to 10 lbs, worn at home first. Higher in men. Notice how your ribcage feels. Adjust fit before adding distance or weight. If posture degrades or joints protest, especially around the ribs, the dose is wrong.

This is load as medicine. Calibrated, progressive, intentional.

If you can walk, you can train for longevity. The question is whether your load is dosed correctly.

Comment HEALTHSPAN for our rucking protocol.

PMID 10995045, 24198268, 36324291, 15086665, 9467434, 10733058, 40442671

01/26/2026

He’s man who can explain your cortisol dysregulation and then immediately teach you how to do a pelvic roll mid-conversation. Or explain why you don’t need a statin and then teach you how to do a clean Kung Fu whip roundhouse.

This is what people don’t understand about Brad. He’s Stanford-trained. He’s building a transformational men’s community. He’s rewriting the rules of precision medicine. He has multiple black belts, surfs triple overhead, and heli skis. And he’s also the most fun human you’ll ever meet.

While other people are doing pull-ups with perfect form and zero personality, is over here loosening his joints, moving like his body is having the time of its life, reminding everyone that optimization without joy is just another cage.

You can count on him for the fun factor.
Always.
The dance breaks.
The guitar solos.
The spontaneous adventures.
The way he turns a random Tuesday into something magical.

This is what regulated masculinity actually looks like. Not rigid, performative. Not taking himself so seriously that he forgets to be alive in his body.

He’s proof that you can be in your genius zone and playful, deep and light, a physician and a shaman who knows that healing happens just as much through laughter as it does through protocol.

TRIBE: We are SO CLOSE to getting him to 10,000 followers for his birthday today. Help us spread the word about what masculinity can be when men are actually alive in their bodies.

Tag a guy who needs to follow Brad because he’s interested in skiing, surfing, regulation, and longevity. If your men need a reminder that strength includes softness, discipline includes spontaneity, and wisdom includes silliness, send them here.

Because the future of masculinity isn’t more control or domination like we see all over the current news. It’s more aliveness.

And this man is fully, unapologetically alive.

Thank you for being part of the challenge.

01/26/2026

Happy birthday to the man whose nervous system is so regulated, his presence alone makes everyone around him settle.

It’s magnetic. Everyone who meets you feels it. That rare quality of being both brilliant and safe, and you use it for good.

Brad, you’re redefining what masculinity looks like in medicine and beyond. Watching you lead your men’s groups and create space for vulnerability, depth, and real connection has been beautiful to witness. You’re not just talking about what’s possible for men, you’re building it.

You make me swoon with your safety, your heart-centeredness, and the way you take great care of everyone in your orbit. From strangers on the street to every patient interaction to the wide circle of people who love you, you show up fully. Generous, curious, present, real, strong, kind. Hilarious, creative, adventurous.

Everyone who meets you feels your magnetism. That rare combination of brilliance and warmth. The way you think, the way you see problems no one else sees, the way you turn ideas into reality.

The best physicians don’t just practice medicine, they reimagine what’s possible. You do this every day with remarkable humility and care.

So to my tribe, I need a favor in honor of Brad’s birthday. I’m asking for your help with a birthday challenge: let’s get Brad to 10,000 followers today. He’s humble and would never ask, but his Stanford-educated content and shaman-level wisdom need to reach more people. Get the men in your life to follow him. Help us deliver this gift of connection.

- my king. My collaborator. My person.

The world is better because you’re in it. I’m better because you’re in my life.

Here’s to another year of loving you, challenging standards, creating culture, and being exactly who you are.

I love you.

01/25/2026

Two physicians. About 90,000 hours of clinical practice between us. We want to say what the medical establishment won’t.

Loneliness hurts your brain.

Rigorously research shows 23-59% increased dementia risk across every subtype: Alzheimer’s, vascular, frontotemporal. Over 600,000 individuals tracked.

We recommend genetic testing for ApoE4 while treating loneliness like a personality flaw, not a toxin.

Here’s what makes loneliness different from isolation or lack of social support: loneliness is the subjective experience of disconnection. You can be surrounded by people and still be severed from the web of belonging that keeps humans neurologically intact.

Your body registers this disconnection as a threat. Your nervous system responds with fight/flight/freeze/fawn, and your brain pays the price.

The association persists after adjusting for depression, isolation, support systems, and every other modifiable risk factor we measure. Loneliness is a distinct pathological state with distinct neurobiological consequences.

We’ve built a culture that manufactures loneliness at industrial scale, then pathologizes the individuals who experience it. We call it a personal problem when it’s a structural crisis with measurable neurodegenerative outcomes.

This isn’t about resilience, it’s about recognizing that connection is not optional for brain health. It is foundational. It’s neurobiology. It’s survival architecture. It’s the substrate your brain requires to stay intact.

The research exists. The interventions are well documented in peer-reviewed journals. What’s missing is the cultural courage to name loneliness as the public health emergency it actually is.

We’re not looking for likes, we’re looking for people willing to rebuild the social substrate of health. If that’s you, signal below 💕

01/25/2026

These are real replies I receive to my weekly newsletter, and I’m sharing them because they reflect why I keep writing it.

So many women reach a point where they’re told their labs are “normal,” their symptoms are vague, or that this is simply what aging looks like.

What’s often missing is context — an explanation of what’s actually changing in the body, and reassurance that you’re not imagining any of it.

The newsletter is where I have the space to slow things down to share a perspective that comes from decades of clinical work and living through these transitions myself.

It’s where I write things I don’t share on social, and where ideas have room to breathe.

If you’re on my list, you’ll also be the first to receive news of the latest blog posts and free resources.

Plus, as we move closer to the launch date for book #7, there will be some sneak peeks of the new book that won’t live anywhere else.

If any of the words from my newsletter readers resonate with you, it's probably a sign you need to be on my list, too.

Comment NEWSLETTER for the link to join my list.

01/24/2026

Your birth certificate is a legal document. Your biological age is a physiological one.

Most wellness metrics measure one thing. Cholesterol. Complete blood count. Glucose. Blood pressure. They’re usually snapshots of isolated systems that miss the forest for the trees.

Biological age is different. It integrates your genetics with your biomarkers into a quantifiable metric for how you are aging. It accounts for what you inherited AND what you’ve done with it. It tells you: based on how your cells are actually performing, how old is your body?

and I both have patients who are 45 chronologically and 55 biologically. Or you can be 45 and test at 35. The difference isn’t vanity, it’s prediction and provides a map for where to get to work. Biological age correlates with disease risk, mortality, cognitive decline, and functional capacity better than any single biomarker we have (PMID: 33568819). We test biological age on every patient.

Biological age is the metric that sees stress, sleep deprivation, alcohol, movement, nutrition, loneliness, inflammation, and recovery as cumulative forces acting on your cells and DNA. It doesn’t care what you say you do. It measures what your body shows.

We test biological age in our longevity programs because it’s one of the few metrics honest enough to integrate the whole picture. Your liver function and your lifting schedule. Your ApoB and your sleep debt. Your genetics and your last five years of choices.

It’s also one of the only metrics you can improve. You can lower your biological age through targeted interventions. You can watch it respond to what you change.

Most people don’t know their number. They’re guessing about whether what they’re doing is working.

Comment NEWSLETTER if you want to learn more from us about what your doctor should know and track.

Have you measured your biological age? If yes, what did you learn? ⬇️

PMIDs: 34888528, 36986232, 37329949, 37689318, 40650062

01/24/2026

Prediabetes: The Quiet Coup

If you wait until your doctor says “pre-diabetes,” you’re already late.

Here’s what mainstream medicine rarely tells you:
You can look healthy.
Your labs can be normal.
And your blood sugar can still be spiking like a pinball machine 🎯

In a landmark Stanford study from Michael Snyder’s lab, Hall et al. put continuous glucose monitors (CGMs) on people without diabetes. What they found was uncomfortable and clarifying:

So-called healthy people were having pre-diabetic and diabetic-range glucose spikes after everyday meals.

No diagnosis.
No warning.
No intervention.

Comment TRACKER to get my board-certified guide to tracking your blood sugar at home.

That afternoon crash?
It may have a lab value.

That “I’m just tired / moody / unfocused” feeling?
You may be riding a glucose roller coaster and calling it a personality.

This is the quiet coup of prediabetes:
• It starts years before diagnosis
• It hides behind “normal” fasting glucose
• It shows up first as energy crashes, cravings, brain fog, irritability

The home test that exposes it?
A CGM.

Not to obsess.
To see.
To stop outsourcing your power.
To catch dysregulation before it becomes disease.

Because prevention doesn’t start with a prescription.
It starts with tracking the data you can feel.

PMID: 30040822

01/24/2026

For decades, medicine trained us to hand over our power.

Now patients have access to their own data...and everything is changing.

This is how disease care becomes true healthcare.

Are you enchanted with your own chemistry and biology like I am?

🎙️ Comment HUBERMAN for the podcast link

Thank you

01/23/2026

When rage hits, your body doesn’t need talk therapy. It needs metabolic clearance.

This is what cortisol does: it mobilizes glucose, suppresses digestion, redirects blood flow to big muscle groups, and prepares you to MOVE.

But modern life asks you to sit still with it, to take a breath, to journal through it. That doesn’t always work.

Your physiology doesn’t care about your Calm app subscription.

High-intensity interval training clears stress hormones through the exact pathway they were designed for. Muscular contraction and cardiovascular demand.

Studies show HIIT improves mood markers and subjective well-being in both men and women (PMID: 31394213). It reduces anxiety and depression scores more effectively than moderate exercise (PMID: 29796577). It enhances sleep quality by increasing slow-wave sleep duration and reducing how long it takes you to fall asleep (PMID: 30374942).

Translation: when you move hard and fast, your body completes the stress cycle instead of storing it in your neck, jaw, traps, and gut.

A few months ago, we went to Los Angeles, where was born and raised. We stopped at the Mulholland Tennis Club where Brad had been a member back in the 1970s. He pointed to the courts where he learned to hit, to compete, to channel everything into movement. Even then, he understood what his body needed when the world felt too big or too small.

Battle ropes. Sprints. Heavy carries. Surf burpees. Tennis. Boxing. Whatever gets your heart rate above 85% max and forces your muscles to burn through what anger put there.

This isn’t about “fitness.” It’s about completing what your body started.

Tell us: what helps you move the toxicity through your body when you feel rage? ⬇️

Sara Gottfried, MD

01/30/2026

01/29/2026

01/28/2026

01/27/2026

01/26/2026

01/26/2026

01/25/2026

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01/23/2026

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