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Peptide and GLP Pep Talk

“I Just Ate. Why Am I Thinking About Food Again?”

A message from Dr. Maki

Have you ever finished lunch and immediately started looking for something sweet? Or found yourself standing in front of the pantry after dinner, even though you weren’t really hungry?

Maybe you tell yourself, “I’ll be better tomorrow.” Then tomorrow comes, and you’re having the same conversation.

There’s a term for this: food noise. It’s when thoughts about food keep coming up throughout your day. What can I eat? Should I have a snack? Why do I want something sweet again?

That gets tiring, especially when you’re trying to lose weight.

This is one area where GLP-1 medications may help. For some people, the cravings ease up, and they spend less time thinking about food. They can eat a meal, feel satisfied, and get on with their day.

But how much medication do you need?

That’s something we figure out based on your response. If your appetite is more manageable and you’re making progress, we don’t automatically need to increase your dose.

I still want you eating. I want you getting enough protein, keeping up your strength, and having the energy to do the things you enjoy. If you barely eat all day because you have no appetite, that is going to backfire in the long run.

If food noise is something you struggle with and you’ve been wondering about GLP-1 medication, respond to this email. We can answer your questions and discuss whether it makes sense for you.

We are licensed to prescribe in WA, CA, UT, AZ, and HI.

Progesterone Sensitivity

Why Some Women Struggle With Oral Progesterone...
and What to Do Instead
Dr. Valorie Davidson

The Many Faces of Oral Micronized Progesterone:

• I sleep like a baby
• My mood is amazing
• I’m not mean anymore
• My periods are on time
• My periods are not heavy anymore
• I’m no longer anemic
• My anxiety is so much better
• My anxiety is so much worse
• I’m bloated
• I’m munchy
• I can’t seem to get going in the morning
• My mood is low
• I feel like I was drugged

Progesterone Sensitivity

Being sensitive or having negative symptoms from oral progesterone is not unheard of. For some women, they just cannot tolerate oral progesterone. And those who are sensitive can have a range of symptoms.

Symptoms of Oral Micronized Progesterone Sensitivity:

• anxiety
• depression
• brain fog
• fatigue
• dizziness
• panic attacks
• Bloating
• Increased appetite

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Why? Why do these symptoms occur from oral progesterone?

GABA GABA… GABA Gone Wrong:

When you take progesterone orally, it is absorbed through the digestive tract and travels to the liver (first-pass metabolism). During this first pass through the liver, much of the progesterone is metabolized into other compounds, including the neuroactive metabolite allopregnanolone.

Allopregnanolone:

Allopregnanolone can cross the blood-brain barrier, where it enhances GABA’s effect. Or, more succinctly, it increases the sensitivity of GABA receptors to GABA.

Allopregnanolone doesn't make more GABA; it makes the receptors more responsive.

Ideally, by increasing GABA responsiveness, it can cause relaxation, better sleep, and even improved mood (less irritability).
​

But in some, that increased GABA sensitivity can cause:

• Too much sedation: groggy the next morning and even throughout the day.
• Low mood: sad, apathetic, not finding joy in what you once found joy in.
• Brain fog from feeling overly sedated.
• Dizziness from the sedation, and some women report feeling woozy or ‘drunk-like.’

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​But where does the anxiety come from?

• In some women, an increase in GABA sensitivity can be paradoxical and result in panic and anxiety.
• Progesterone is also a precursor in the pathway that can eventually produce cortisol. It is not proven, but in my clinical experience, some, not all, get anxious when taking oral progesterone, and I think it is more than the paradoxical effect of allopregnanolone. I suspect that some could be converting to cortisol.

What About Bloating and Oral Progesterone?

Progesterone can slow gastrointestinal motility by relaxing smooth muscle in the digestive tract. For some women, slower transit can mean more constipation, gas, abdominal fullness, and bloating. In my clinical experience, I have seen women who had regular digestion and bowel movements and still become bloated on progesterone. And it is no fun to feel puffy, bloated, and full. So it is important to address this and find alternatives or remedies for the bloating.
​

Weight Gain From Oral Progesterone?

Progesterone doesn't directly cause weight gain. But there are some theories.

• It can affect appetite-regulating centers in the hypothalamus, which in turn can increase appetite/cravings.

Coupled with feeling tired, groggy, skipping your walk/gym, and eating a little more can make you gain weight.

Don’t Want To Take Progesterone? Don’t Neglect Your Uterus!

Perhaps you have some or all of these symptoms from taking oral progesterone, but you are taking estradiol HRT, and you have a uterus.

You need progesterone to help protect your uterus.

Estrogen stimulates the uterine endometrial lining to grow. Progesterone helps balance that effect by keeping the lining from becoming too thick

Without adequate progesterone, unopposed estrogen can increase the risk of endometrial hyperplasia and, over time, increase risk of endometrial cancer.

Even if progesterone makes you feel terrible, stopping it is not the answer. The goal is to find the ‘right’ progesterone for you to feel good and protect your uterus.
​

Can’t Tolerate Oral Progesterone? Now What?

If you have any of these symptoms from oral progesterone, don’t assume progesterone is simply not for you.

There are other options:

• Dose
• Formulation
• Administration

In the full article, let’s go over your options for your progesterone sensitivity.

​Continue reading to learn your progesterone options and what may work better for you.

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Upgrade to the paid article

HRT can be healthy for your brain. We know that there are many estrogen receptors found in the brain. And that estrogen can influence cerebral brain flow, glucose metabolism, inflammation, and neuronal function (newsletter #35: The Overloaded Menopause Brain: Estrogen Edition)
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But I found two studies looking at HRT and brain health in women.
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And the results are really encouraging!
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​Study: Menopausal hormone therapy and risk of dementia: A population-based cohort study using UK Biobank data
​Published in Alzheimer’s & Dementia, 2026.​

This study had more than 183,000 postmenopausal women and found HRT was associated with a lower risk of dementia. The other interesting aspect of this particular study found that lower Alzheimer risk was associated with women that started HRT between the ages of 46 and 56.

Study: Menopausal hormone therapy and Alzheimer’s disease neuropathology
​Published in Neurology, 2026.​
This study has a different approach from the previous study. They studied brain tissues at autopsy and found that women that used estrogen-only HRT had few Alzheimer-related changes in the brain.

This study does not suggest that progesterone is harmful or should be stopped. There were not enough women using combined estrogen and progesterone therapy to determine how progesterone may have affected the results.

I know we don’t need a study to tell us what we already know. And we all know not all studies are the same and might have their own agenda. But I really do love reading research and this felt really congruent with you, me, and our focus on hormonal health for longevity.

Disclaimer

All content found in this newsletter, including text, images, audio, video, or other formats, was created for informational purposes only. The purpose of this website and blog is to promote consumer/public understanding and general knowledge of various health topics. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concern regarding this topic, then it is time to find a new doctor.