Field Notes.
Thoughts, stories and ideas.
Low Testosterone After a TBI: Why Nobody Checked, and What to Ask For
Current as of September 28, 2026. General information, not medical advice. Short answer: A head injury can damage the pituitary, and about a third of people have some pituitary hormone deficiency in the years after a TBI. Nobody screens for it routinely, because the VA and DoD guideline for mild
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Regenerative Post-Surgical Wound Care for Active Patients
Regenerative Approaches to Post-Surgical Wound Care: Supporting Recovery in Active Patients Recovery from surgery has a rhythm most active patients find frustrating. You feel ready to move at week three, but the tissue underneath is still knitting itself together at its own pace. In our practice, we spend a lot
Cortisol, Testosterone & Estrogen: Energy & Focus
Cortisol, Testosterone, and Estrogen: How Hormonal Imbalances May Be Undermining Your Energy and Focus Most of the fatigue I see in my exam room is not a sleep problem. It looks like one on the surface. You get seven hours, maybe eight, and still drag through your afternoon. You blame
GLP-1 Weight Management Guide for Professionals
GLP-1 Protocols and Weight Management: What High-Performing Adults Should Know Before Starting If you're a busy professional considering semaglutide or tirzepatide, the calculus is different than it is for the average patient. You're not trying to hit a number on a scale before a wedding. You&
7 Subtle Signs Your Hormones Hurt Performance
Beyond Fatigue: 7 Subtle Signs Your Hormones May Be Working Against Your Performance Goals Most patients who come to us suspecting a hormone issue lead with the same complaint: they're tired. Fatigue is the headline symptom, the one that finally pushes a busy executive or a competitive masters
Peptide Therapy: A High-Performer's Guide
What Is Peptide Therapy? A High-Performer's Guide to Today's Most Talked-About Protocols Peptides are short chains of amino acids, typically fewer than 50, that act as biological signaling molecules. Your body already makes thousands of them. Insulin is a peptide. So is oxytocin. What we call
Hormone Optimization for Men Over 40: Lab Testing
Hormone Optimization for Men Over 40: What Comprehensive Lab Testing Can Reveal Most men who come to see me in their 40s and 50s don't lead with the word "hormones." They lead with fatigue that coffee no longer touches, a midsection that won't respond
Cortisol Imbalance: Energy, Sleep & Focus Effects
How Cortisol Imbalance May Be Undermining Your Energy, Sleep, and Focus Cortisol gets a bad reputation it doesn't fully deserve. The hormone your adrenal glands release in response to stress is also what pulls you out of bed in the morning, sharpens your thinking before a difficult meeting,
Why the Scale Lies About Your Weight
Why the Scale Lies: How Hormone Optimization Supports Sustainable Weight Management Beyond Calorie Counting The scale is a blunt instrument. It measures your gravitational pull toward the earth, nothing more. It cannot distinguish muscle from fat, water from bone, or a stressful Tuesday from a well-slept Sunday. And yet patients
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