Dr. Sarah J. Zielsdorf, MD

04/12/2026

A bit of a repost from 4 years ago with additions and edits…a little insight from me.

Ghost Rider

“Pack up all those phantoms
Shoulder that invisible load
Keep on riding north and west
Haunting that wilderness road
Like a ghost rider

Carry all those phantoms
Through bitter wind and stormy skies
From the desert to the mountain
From the lowest low to the highest high
Like a ghost rider”

This past week as usual I’ve done my best to pour into several dear patients the love and support of a physician who has been where they are now. Hurting, sick, scared, and traumatized.

I’ve used the phrase “you have to put your own oxygen mask on first before you can help anyone else”, sometimes several times in a row with patients.

Neil Peart (1952-2020), percussionist and lyricist for the band Rush, and author, said it best, in his book Ghost Rider: Travels on the Healing Road (and distilled into the song from the 2002 album V***r Trails):

“My little baby soul was not a happy infant, of course, with much to complain about, but as every parent learns, a restless baby often calms down if you take it for a ride. I had learned my squalling spirit could be soothed the same way, by motion, and so I had decided to set off on this journey into the unknown. Take my little baby soul for a ride.”

When he was a baby, our son Jack would not go to sleep. For almost two years my husband had to drive him around. Every. Single. Night. Only then would he relax his body and drift off. My husband would return, dead tired himself, and carry Jack so tenderly up to his crib, our baby finally spent and wrung-out after fighting sleep so hard. I often have this image of my baby soul personified as my strong-willed little boy. So often my soul fights change, kicking and screaming but knowing the need to change, to move, to grow. But nevertheless, ever fighting. Right now I can feel my baby soul once again at this precipice, fighting. Do I jump? Do I change deeply? Do I stay on this path? How do I do this? Why do I have to do this?

In the late 1990s within a 10-month period Neil Peart lost his 19 year old daughter and his wife. He was lost. He had to move. His life depended on it, so he rode his motorcycle over 55,000 miles in 14 months, from Canada to South America. He nourished his baby soul, driving it toward new purpose an an eventual rebirth. When we are struggling, we have to move. Treat yourself like a little baby or your best friend. Use kind words. Be gentle to yourself. Eat good food. Be grateful. Laugh. Sing (it oxygenates the blood!) Get outside. Walk softly. Stretch. Rest. Naps encouraged. Self-compassion is the most difficult lesson. I’m still working on this.

At the end Neil breaks his sticks, not only a common thing for drummers to do but a powerful and intentional statement of emotion. Rest in Peace, NEP.

in Rio (2002)

04/10/2026

The last two days in addition to our clinical duties and mine as medical director, we brought together all of MM’s staff for meetings across all fronts, from the admin team and the clinical team working in breakout sessions, individual one-on-one work with our brand strategist, and all of us together. We are working on our mission statement, practice identity, and cohesiveness. We had a team building session competing in game shows last night (Go Team Dr Z and the Blondes 🤣), who eeked out a victory over a highly capable Team MM Warriors. The result is that you will continue to see big changes from our practice as we work for the patient at the center of everything that we do. Our mission never changes. I finished the day with messages and personalized/precision medicine, having a wonderful conversation with one of our highly skilled local compounding pharmacists, for personalized patient solutions.

*Strong recommendation for Game Show Battle Rooms in Lombard for your next group event - we had a blast 😀.

04/03/2026

I pray that everyone celebrating Good Friday, Easter, and Passover is able to celebrate with family and be at peace during this time!

03/31/2026

Dr. Katie Burns, a pathobiologist and toxicologist from University of Cincinnati, has published an important article on the pathogenesis of

It is well known to be a disease of immune system dysfunction and often associated with but not proven to be an autoimmune process. We now know that there is significant overlap between purely autoinflammatory conditions and autoimmune diseases. Increasingly, we know that the microenvironment is proinflammatory, leading the way for pathogenesis.

To date it takes women on average, a decade to gain a diagosis after years of their pain being ignored or frankly gaslit. Final diagnosis comes with surgery/surgeries, and often subesquent scar tissue laid down causing further pathology. Sometimes more surgery is required for lysis of adhesions.

Did you know as many as 1 in 10 women have endometriosis?!?
Endometriosis symptoms include severe pelvic pain, especially during menstruation (often exceeding typical cramps), painful sexual in*******se (dyspareunia), and chronic, lower abdominal pain and bloating, often with significant microbial dysbiosis ("endo belly"). Other common symptoms include infertility, heavy or irregular periods, fatigue, and bowel/bladder pain during urination or defecation. Symptoms can vary and may occur regardless of activity, throughout the cycle.

We have been pending a point of care lab (DotLab) for nearly a decade. Research such as this is leading to hopes of new, non-invasive home/lab testing and new treatments for this devastating condition.

If this were a disease of men, we'd have drive through diagnostics...effective treatments, and proper pain management!

https://insight.jci.org/articles/view/186133/pdf

As endometriosis is a systemic immunological condition, we must treat it as such. I am the volunteer Education Director of and one of the Medical/Research Advisors to the Low Dose Naltrexone (LDN) Research Trust. We use it to modulate the immune system and reduce inflammation in conditions including endometriosis and adenomyosis.



https://pmc.ncbi.nlm.nih.gov/articles/PMC8708975/

Endometriosis is a chronic gynecological disease that affects 1 in 10 reproductive-aged women. Most studies investigate established disease; however, the initiation and early events in endometriotic lesion development remain poorly understood. Our study used neutrophils from human menstrual effluent...

03/30/2026

With my face full of BAS (Big Ass Salad) my staff surprised me with lovely spring flowers and a beautiful card for National Doctor’s Day. I’m so grateful and appreciative of my hard working and caring staff.

03/29/2026

Personal post. I take meal prep very seriously. It’s the difference between me making poor choices that impact my health negatively or skipping meals completely, especially during the work week. I’m always looking for ways to improve nutrient density and front load my calories to improve the chronobiology of my microbiome - did you know that our gut bugs can tell when it’s light and when it’s dark? And when we eat too late we shift toward a more inflammatory state and become more insulin resistant.

Insulin, like many of our hormones, peaks in the morning. So as a perimenopausal woman, I am front loading my meals, prioritizing as many colorful plants, proteins, and fiber (both soluble and insoluble), and fermented foods with the addition of homemade bone broth, healthy fats including avocado and high quality olive oil, green tea, bitter plants and digestive bitters, total body collagen, and creatine. I’m back to lifting weights. I got my labs done. Woof. It’s a lot. I know. My staff puts up with my BAS prep almost daily (Big Ass Salad). All the glass jars and dishes and my weirdness. 🤣😬

But after being told I could die of liver disease in 2012 (one of my book chapters will be called - “sh*t gets real when you have a liver biopsy” OR “it’s all fun and games until you have a liver biopsy”) due to my severe hypothyroidism and insulin resistance from Hashimoto’s, I changed EVERYTHING. And I healed. My liver went from 27cm (severe hepatomegaly) to normal sized at about 15cm in a year. I was told I would never have children and I was pregnant 18 months later. I found a doctor to change me from synthetic T4 to natural desiccated thyroid. I lost more than 40 pounds. I changed everything about my nutrition and learned everything I could - none of it from medical school.

I gain weight terribly easily. I’m not even 5 feet tall and I have a slow basal metabolic rate. It’s not fair that I can’t eat many calories in a day. But I overate most of my life and, due to trauma, really messed up another hormone signaling pathway - leptin and ghrelin. Like many of my patients, I can’t tell what it’s like to be full. I have had disordered eating like every other woman who was in their teens or 20s in the 90s.

So, I can either meal prep and do the work, or I can get sick. I can’t cheat because if I do, the sugar and processed food addiction takes hold. No, I can’t “just have one bite”. Big Food started with “Dr. Bliss”. A food scientist that found the perfect mix of salt, sugar, and fat. The bliss point. Add in obesogens and all of the other chemicals and it’s lose lose. You eat the whole bag, whole carton, and it isn’t your fault. You binge on fast food. It’s been designed this way. Even most gluten free snacks, unfortunately. Choose as unprocessed stuff as you can. And if you have the willpower and functioning hormones and microbiome that I don’t, congrats! I’m sure someone is going to come on and say that it’s weakness and that they can have one donut just fine. It’s truly amazing to watch. Those people do exist. But it’s increasingly rare.

Fun fact - when I was already a DOCTOR and not yet diagnosed with Hashis or liver disease my very thin perfect endocrinologist told me I had “fork-in-mouth syndrome” at the height of my illness. I’ll never forget her disdain as she read my weight. As my husband says never trust a skinny chef, I say never trust an endocrinologist that never had a hormonal issue. Other fun fact: my reverse T3 was 30 at the time. I subsequently became bed-bound and nearly died the next year. But that lab “isn’t important” and “isn’t used”. Thanks American Thyroid Association!

Two other fun topics to expound on. I’m about to grow my own broccoli sprouts! Tons of kits out there to diy. I bought more while I wait on mine but they are one of the most nutritious foods on the planet! Add them to everything. They are cancer cell fighting, anti-inflammatory powerhouses, and also support estrogen metabolism with their sulforaphane, glucoraphanin, and myrosinase (Nrf 2 activation!)

And finally, resistant starches. Carbs are not the enemy. Meal timing and complex carbs are important. By cooking, cooling, and reheating certain foods such as rice and potatoes, you cause a process called retrogradation.

You compound the benefits with colorful potatoes, especially purple fleshed potatoes and sweet potatoes, which have been shown to inhibit colon cancer cells!!!

Frozen purple sweet potato undergoes starch retrogradation, a process where gelatinized starch reorganizes into a crystalline structure upon cooling and freezing, which increases its resistant starch (RS) content - Type 3 Resistant Starch. This transformation makes the starch less digestible, converting it into a prebiotic that acts as fiber, beneficial for gut health and increases our healthy probiotic levels including Akkermansia muciniphila.

So I batch baked 6 huge purple organic Stokes’ sweet potatoes, cooled, cut and froze them.
Steaming may have preserved even more of the anthocyanins (antioxidants) in the purple flesh, but I’m still figuring it all out.

Eat the BAS (Big Ass Salad), eat what’s in season and on sale, get early morning light, find something to be grateful for even in all of this happening *gestures at world*, hug family and/or a pet. It’s messy, no one is perfect, but the goal is to be better than yesterday. This is my today. And I am grateful.

03/28/2026

On Friday the clinical staff had our team meeting to update clinical protocols, to share wins of the week and discuss what we are seeing work and what is not working. Because medicine is always changing. We are growing. Personally, professionally, and as a team. Where are we now? Where do we want to be? As medical director of Motivated Medicine, my intention is cohesion and consistency among all clinicians without ambiguity. We meet daily to discuss patient cases. We must always strive for not only practicing above the standard of care of medicine, but above that of other practices.

Especially to those of you who have known me for close to 12 (!?!?) years as your physician, I am eternally grateful for your help, in the maturation process that comes with seeing thousands of patients and the wisdom of daily work. In advocating for my patients in the ways that I needed when I was sick and didn’t have. In validating your experiences and your symptoms.

In reflecting this week, it is hard to believe that I have been teaching clinicians professionally for 20 years, since I was a graduate student teaching Infectious Disease fellows at The George Washington University Hospital.

Here I am, having graduated with my MS in Public Health, Microbiology, and Emerging Infectious Diseases, ready to start medical school at Loyola and move back to the Midwest. I was less than 2 months away from my next autoimmune flare, though it would take years before I put the pieces together and nearly a decade before I was validated.

Medicine keeps me humble and grateful. Always.

03/26/2026

My past life as an infectious disease clinician/microbiologist and current practice of medicine collided this week with a new patient. She came in with international labs from January that showed a urinalysis that looked like she could have had an infection but it wasn't cultured. With her underlying history and previous hospitalization I was concerned. I re-ran her urine test, which now clearly showed true infection (which she has now had for at least 3 months)...of course she is weak and feels unwell. Her UA was cultured, and came back positive for ESBL E.coli. That's Extended Spectrum Beta-Lactamase producing E.coli bacteria and that's bad news.

These bugs are often multi-drug resistant, acquired in hospitals and from previous antibiotic use and can be hard to treat. Luckily there are two oral antibiotics she is sensitive to, of which we started one, and also are addressing the underlying biofilms surrounding the bladder walls and urethral neck that enrich the bacteria, promote the resistance, and propagate chronic recurrent urinary tract infections (rUTIs).

I have to ask. How many "Functional Medicine" doctors do this? I treat the whole person, and yes, sometimes it starts with the chronic UTI.

03/15/2026

Hope everyone is having a great weekend!

Yesterday I went to the park with my son - it was freezing but clear. We had the whole place to ourselves, and it was a rare moment of peace in recent memory. I have been focused on meal prepping as the key to practice what I preach: nutrient density is my goal. I have so much prepped from the week that I could make a fantastic meal that our 7 year old loved in record time today - roast chicken with half an avocado, side of mixed lettuce with microgreens, sprouts, parsley, dandelion, purple carrot, purple sweet potatoes roasted with ghee, onion and thyme, splash of balsamic and olive oil, and some blueberries. I had my big anti-inflammatory salad of all of the above with leftover snap peas, extra red cabbage and a cup of homemade bone broth with some of the chicken, purple sweet potatoes, the salad dressed with more herbs, olive oil, and apple cider vinegar. Make it as colorful as possible! Shop one day, prep one day!

03/11/2026

I am hoping and praying that all of my patients in the Kankakee/Pontiac areas are ok following the tornadoes and large hail yesterday. I know power is still down for many. Appreciate updates if you have them.

02/26/2026

Posting for a researcher about a women's health study. If you can help, please consider completing! Thank you!

12/23/2025

End of another year, hard to believe. Our Motivated Medicine team is grateful and thankful to all of our patients for making our practice so wonderful.

Motivated Medicine closes annually December 24th - January 1st to provide our team with protected time to rest, reset, and return refreshed for the new year.

We will answer only emergent messages during this time.

Wishing our patients and friends a joyous Christmas, peaceful holidays, and a happy New Year.

~Dr. Z