Perimenopause isn’t a syndrome to treat. It’s a complex, shifting transition that most women in their 40s are already navigating, whether they realize it or not. For practitioners working in functional medicine, failing to recognize and address the nuances of this phase can mean missing the real root of your clients’ symptoms.

In this episode, Tracy Harrison lays out five critical practitioner blind spots that lead to frustration and subpar outcomes. She challenges the idea that a fixed protocol can support women through perimenopause, reminding us that the only constant in this life stage is change. Hormones don’t decline in a straight line. Progesterone drops early and steadily, while estrogen tends to spike and swing before it ever goes down. This hormonal chaos can trigger anxiety, insomnia, mood swings, migraines, and even histamine-related issues that are too often misdiagnosed or ignored.

Tracy explains how common symptoms such as poor sleep, bloating, mood instability, hot flashes are often driven by overlooked mechanisms like GABA depletion, serotonin fluctuations, or impaired histamine clearance. She breaks down why alcohol can sabotage sleep and worsen hot flashes, why estrogen dominance is more common than we think, and how mindset and chronic stress directly influence hormone symptoms through the nervous system.

This episode is a call to meet women where they are, not with a standard protocol, but with a dynamic, personalized approach that accounts for the biochemical, emotional, and environmental complexity of perimenopause. If you want to truly support midlife women, you need more than hormone labs and supplements. You need to understand the full picture, and be prepared to shift with it.

Episode Breakdown:

00:00 Understanding Perimenopause: A Natural Transition

05:02 Why Protocols Fail in Perimenopause Care

08:06 How Progesterone Drop Triggers Mood and Sleep Issues

11:22 Alcohol’s Hidden Role in Anxiety, Insomnia, and Hormone Disruption

12:29 The Overlooked Link Between Histamine and Perimenopause Symptoms

16:21 Estrogen Dominance in Early Perimenopause: What Practitioners Miss

21:48 The Estrogen-Serotonin Connection and Its Impact on Mood

26:10 What Really Causes Hot Flashes and Night Sweats

30:00 How Stress Hormones Worsen Perimenopause Symptoms

32:09 Why Mindset and Thought Patterns Matter in Symptom Management

33:45 Partnering with Patients Through Perimenopause

Links

Take SAFM’s 10 CME course - the Essential Gut Deep Dive: https://schoolafm.com/gut-course

Get weekly Clinical Tips in your inbox: https://schoolafm.com/clinical-tips

Learn more about SAFM’s practitioner training: https://schoolafm.com/our-program

Subscribe to our Youtube channel: https://www.youtube.com/@safmchannel

Access daily quick tips on Facebook: http://www.facebook.com/AppliedFunctionalMedicine/

Podcast production and show notes provided by HiveCast.fm

What happens in the gut doesn’t stay there. It can quietly ignite inflammation, disrupt immune balance, impair cognition, and set off chronic conditions that leave practitioners chasing symptoms instead of causes.

In this episode, Tracy Harrison delivers a call to action for practitioners to look beyond surface-level symptoms and trace chronic dysfunction back to the digestive system. She breaks down the often-missed connections between low stomach acid, impaired enzyme activity, compromised bile flow, and damaged intestinal lining, and how each of these can block nutrient absorption, trigger systemic inflammation, and create a breeding ground for disease. From medication-induced gut damage to the misunderstood role of histamine overload, Tracy illustrates how even everyday interventions like NSAIDs and antibiotics can have far-reaching consequences for the brain, hormones, immune system, and more.

Through vivid metaphors and practitioner-tested insights, Tracy exposes the pitfalls of removing “problem” body parts without resolving the upstream dysfunctions that caused them. She urges practitioners to shift from managing symptoms to restoring core physiological balance, using functional medicine to address root causes and rebuild long-term resilience. This episode challenges conventional thinking and invites a deeper, more strategic approach to healing, one that begins in the gut and ripples outward into every system of the body.

Episode Breakdown:

00:00 The Gut as the Root of Systemic Disease

01:42 Why “You Are What You Eat” Is Misleading

04:46 How Low Stomach Acid and Enzyme Deficiency Fuel Disease

07:09 Bile Flow, Estrogen, and Gallbladder Dysfunction

11:48 NSAIDs, Ibuprofen, and the Hidden Cost to Gut Health

14:05 Histamine Overload and the Brush Border Breakdown

18:30 Leaky Gut and Immune System Overexposure

23:15 Lipopolysaccharides and the Gut-Brain Axis

28:03 How Medications Disrupt Gut Integrity

32:50 The Rise of Food Sensitivities and Systemic Inflammation

38:28 Oral Health as the Starting Point of Gut Dysfunction

43:08 The Critical Role of Bile in Digestion and Immune Defense

47:45 Don’t Treat the Victim, Address the Root Cause

Links

Take SAFM’s 10 CME course - the Essential Gut Deep Dive: https://schoolafm.com/gut-course

Get weekly Clinical Tips in your inbox: https://schoolafm.com/clinical-tips

Learn more about SAFM’s practitioner training: https://schoolafm.com/our-program

Subscribe to our Youtube channel: https://www.youtube.com/@safmchannel

Access daily quick tips on Facebook: http://www.facebook.com/AppliedFunctionalMedicine/

Podcast production and show notes provided by HiveCast.fm

More exercise. Extra supplements. Cleaner eating. Sometimes the advice we rely on most can quietly work against the people we’re trying to help.

In this episode, Tracy Harrison discusses why functional medicine demands more than just protocols and good intentions. She shares real clinical scenarios where common strategies like high-intensity workouts or high-dose vitamin D can actually worsen symptoms when underlying issues like adrenal fatigue or oxidative stress are at play.

Tracy also challenges how we interpret lab markers. Is a high HDL level always a good sign? What do low liver enzymes really tell us? She connects the dots between nutrient status, metabolic patterns, and the subtle red flags that can get lost in standard lab reviews.

This episode moves through supplements, lab work, diet trends, and minerals with one constant thread: context matters. This is a practical, case-based reminder to pause, ask better questions, and treat the person, not the lab result or the trend.

Episode Breakdown:

00:00 When “Healthy” Advice Makes Patients Worse

01:04 The Hidden Risks of Over-Exercising

10:10 Vitamin D, Magnesium, and Supplement Missteps

14:08 How to Read Lab Markers with More Precision

24:00 Metabolic Dysfunction Beyond Blood Sugar

29:02 Green Smoothies, Oxalates, and Gut Health

36:26 Recognizing Histamine Intolerance in Your Patients

41:06 Why More Iron Isn’t Always the Answer

45:34 Understanding Magnesium Forms and Deficiency

Links

Take SAFM’s 10 CME course - the Essential Gut Deep Dive: https://schoolafm.com/gut-course

Get weekly Clinical Tips in your inbox: https://schoolafm.com/clinical-tips

Learn more about SAFM’s practitioner training: https://schoolafm.com/our-program

Subscribe to our Youtube channel: https://www.youtube.com/@safmchannel

Access daily quick tips on Facebook: http://www.facebook.com/AppliedFunctionalMedicine/

Podcast production and show notes provided by HiveCast.fm