The Functional Pharmacist

Do you chew ice all day and have no idea why?

That can actually show up with iron deficiency, even before you are technically anemic.

A lot of women only hear about iron when hemoglobin drops. But your stored iron can run low first. That is where ferritin comes in. Ferritin gives us a better idea of how much iron you have in reserve.

This gets especially relevant when periods are heavy. You can lose a little too much blood month after month and slowly burn through those stores without one dramatic moment where something suddenly feels wrong.

Sometimes it is not just fatigue either. Restless legs at night, workouts feeling harder, more hair shedding, trouble concentrating, or that oddly persistent need to chew ice can all be clues worth mentioning.

If your CBC looked normal but you still feel off, ferritin is a lab name worth knowing.

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Prednisone can raise your blood sugar within the same day, even if diabetes has never been part of your history.

The sneaky part is when it happens. Morning prednisone often leaves the fasting number looking fairly normal, then blood sugar climbs after breakfast and stays higher through the afternoon and evening. Current ADA guidance specifically warns that checking only in the morning can miss it.

That matters if you start steroids and suddenly feel much thirstier, more tired, are peeing more often, or notice blurry vision. Those symptoms can show up when blood sugar gets high.

Prednisone is not a bad medication. Sometimes it is exactly what you need. I just think people should know this can happen before they are surprised by a high reading later.

And the higher the dose or the longer you are taking it, the more relevant blood sugar becomes.

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If you hit your 40s and suddenly feel like you are not handling life the way you used to, I would not automatically write that off as stress.

The 40% number in this video does not mean 40% of women develop depression. It means women in perimenopause had about 40% higher odds of depressive symptoms or a depression diagnosis than women who had not entered the transition yet.

And newer data are not making this look like a small issue. A 2026 review covering more than 1.1 million women estimated that about 32% of women in perimenopause had depressive symptoms at a given point in time.

What I would pay attention to in real life is when the change started. Maybe your periods became unpredictable around the same time your sleep fell apart. Maybe you became much more tearful, flat, irritable, or stopped enjoying things you normally care about.

Write that timeline down. It is much more useful at an appointment than trying to summarize the last six months as just feeling off.

Perimenopause may not explain everything, but mood absolutely belongs in the conversation.

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Ten minutes is not a lot of time, but the timing may be doing more work than people realize.

In a small randomized trial, peak blood sugar after a glucose drink was about 18 mg/dL lower when participants walked for 10 minutes right away compared with sitting. And a larger review of exercise studies found that moving after eating lowered the blood sugar rise more effectively than exercising before the meal, with earlier movement generally working better.

So if blood sugar is something you are working on, I would not only look at what is on the plate. Look at what usually happens once the plate is empty.

A walk is great, but it can also be ten minutes of cleaning up, taking the dog out, or anything that gets your muscles moving instead of going straight to the couch.

It is a small habit, which is probably part of why it is actually doable.

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The name on the box makes these home menopause tests sound much more definite than they really are.

Most are checking FSH. That hormone often rises as menopause gets closer, but during perimenopause it can be high one day and lower again later.

You can still ovulate during that time.

And if you are taking hormonal birth control, the result can be even harder to make sense of because the medication can affect both your bleeding and your hormone levels.

A positive strip does not tell you that pregnancy is no longer possible.

If you bought the test because you are wondering whether you still need birth control, I would ask your clinician before changing anything. The home test cannot answer that question for you.

I think a lot of women assume that if hot flashes have been going on for years, something must be off.

The SWAN study followed women through the menopause transition and found frequent hot flashes and night sweats lasted a median 7.4 years.

For women whose symptoms started before or early in perimenopause, it was more than 11 years.

And even after the final period, they often kept going for years.

That is a very different timeline from what most women expect when this starts.

If you are losing sleep night after night or planning your day around hot flashes, I would bring it up instead of assuming you just have to outlast them. There are hormone and nonhormone treatment options, and how much these symptoms are affecting your life matters.

I’m curious how many women were actually given a realistic timeline when their hot flashes first started.