Uncharted: The Science Behind Women's Health

Fatigue, brain fog, disrupted sleep, unexpected weight changes—when these symptoms show up during perimenopause, how do you know what's actually driving them? Is it shifting reproductive hormones, thyroid function, stress, or some combination of all three?In this episode of Uncharted, host Dr. Lara Zakaria sits down with Dr. Carrie Jones, a naturopathic physician and women's health educator, to unpack the complex hormonal changes of perimenopause and why symptoms don't always have a straightforward explanation.From the often-overlooked roles of progesterone and testosterone to the intersection of reproductive hormones, stress physiology, and thyroid health, Dr. Jones explores why looking at a single hormone or lab result rarely tells the whole story. She also shares how clinicians can connect the dots between symptoms, menstrual history, age, and lab work to better understand what may be happening beneath the surface.In this episode:Why perimenopause is about more than declining estrogenThe roles progesterone and testosterone play in symptoms like poor sleep, fatigue, and brain fogHow reproductive hormones, stress physiology, and thyroid function intersectWhy weight can change even when diet and exercise habits haven'tWhat TSH alone may miss—and when additional thyroid testing makes senseHow clinicians distinguish perimenopause from thyroid conditions and other potential causes of overlapping symptomsRelevant resources:It’s Probably Perimenopause — Dr. Carrie Jones’s forthcoming bookIs It Menopause, Thyroid Function, or Both? Understand the OverlapMenopause and Thyroid Function: What’s the Connection?Phases of Life and Thyroid Energy PatternsChapter markers:(01:54) - How hormone patterns change during perimenopause (05:12) - Why progesterone and testosterone matter alongside estrogen (07:55) - How hormonal changes may affect stress resilience (10:42) - Why weight can fluctuate during perimenopause (13:41) - What an expanded thyroid panel can reveal (18:14) - Hormonal transitions and thyroid autoimmunity (19:36) - How clinicians assess perimenopause and menopause (21:49) - Why symptoms may reflect perimenopause and a thyroid condition (25:46) - Advocating for individualized care

How can stress physiology influence thyroid health, and what can cortisol testing tell us? Part 2 of Dr. Lara Zakaria’s conversation with Dr. Jaclyn Smeaton, naturopathic physician and Chief Medical Officer at Precision Analytical, explores the relationship between the two.They discuss what free and metabolized cortisol may reveal about cortisol clearance, why “adrenal fatigue” can oversimplify complex symptoms, and how other hormone systems contribute to the broader clinical picture.Missed Part 1? Listen here.In this episode:How thyroid function and cortisol metabolism affect each otherHow the brain, adrenal glands, and tissues shape stress physiologyWhat free and metabolized cortisol can reveal about cortisol clearanceHow stress and metabolic health affect estrogen and progesteroneWhy “adrenal fatigue” can oversimplify stress-related symptomsHow sleep and circadian rhythms fit into a broader clinical pictureChapter markers: (01:17) - What cortisol testing can reveal about thyroid function (06:16) - How stress affects thyroid hormones and activity (07:51) - How clinicians can assess stress alongside thyroid function (11:12) - Why “adrenal fatigue” can be a misleading term

A thyroid test can fall within the reference range even when someone continues to experience fatigue, brain fog, changes in mood or energy, or other persistent symptoms. That can leave patients and clinicians wondering what the results do and don’t show, as well as what to explore next.In Part 1 of this two-part conversation, host Dr. Lara Zakaria talks with Dr. Jaclyn Smeaton, a naturopathic physician and Chief Medical Officer at Precision Analytical. They discuss what TSH measures, what other thyroid markers can show, how stress physiology may affect thyroid signaling and hormone conversion, and what the cortisol awakening response can tell clinicians about the body’s response to stress.Part 2 continues the discussion with a closer look at cortisol assessment and the relationship between stress physiology and thyroid health.In this episode:What TSH measures and how to interpret it alongside a person’s symptomsWhat free T4, free T3, reverse T3, and thyroid antibodies measureHow stress physiology may affect thyroid signaling and hormone conversionWhat the cortisol awakening response is and how Jaclyn uses it in her clinical workChapter markers:(01:16) - Dr. Jaclyn’s path to women’s health (03:36) - What TSH alone can miss about thyroid function (06:24) - What a broader thyroid panel can include (09:03) - How stress and the HPA axis affect thyroid function (11:14) - What cortisol testing can reveal alongside thyroid labs (12:55) - What the cortisol awakening response measures

What does it really mean to “heal your gut,” and how is gut health connected to thyroid function?In this episode of Uncharted, host Dr. Lara Zakaria talks with registered dietitian and functional medicine practitioner Alisha Knicely about the two-way relationship between gut and thyroid health. Drawing from both her clinical work and her personal experience with Hashimoto’s disease and hypothyroidism, Alisha explains how thyroid function can affect digestion, motility, stomach acid, and nutrient absorption, and how digestive health may influence thyroid health in return.In this episode:The difference between Hashimoto’s disease and hypothyroidismHow low thyroid function may affect digestion, motility, stomach acid, and nutrient absorptionWhy thyroid medication may improve lab results without resolving every symptomHow under-eating may work against healingPractical ways to support digestion through healthy meal habits and nutrient-dense foodsWhen targeted supplements may be considered as part of an individualized planRelevant resources:Understanding Thyroid AutoimmunityThe Thyroid Plateau: Why Symptoms Linger Despite Medication and “Normal” LabsChapter markers:(01:15) - Alisha’s Hashimoto’s and hypothyroidism diagnosis (04:24) - Hashimoto’s vs. hypothyroidism (07:00) - How first-hand experience changed Alisha’s patient approach (08:17) - Explanation of the gut-thyroid connection (12:00) - Lifestyle changes that can help with thyroid and gut health (14:14) - Dietary patterns to try and avoid (15:46) - Approach to targeted supplementation

Why do so many women with “normal” thyroid labs still feel exhausted, foggy, and unlike themselves?In the first episode of Uncharted, host Dr. Lara Zakaria talks with Corey Schuler, PhD, FNP-C, APHN-BC, CNS, about the Energy Allocation System (EAS): an emerging framework for understanding how the body produces, distributes, and prioritizes energy over time.Together, they explore why symptoms such as fatigue, brain fog, disrupted sleep, and weight changes may persist even when standard thyroid labs fall within conventional reference ranges—and how clinicians and patients can use this perspective to ask better questions and look more closely at the full picture.This conversation introduces the thinking behind EAS and lays the foundation for Uncharted’s first season on women’s thyroid health.In this episode:What the Energy Allocation System is—and why it was developedHow the body’s stress-response, thyroid, and reproductive systems may interact over timeWhy persistent symptoms can occur even when thyroid labs are within conventional rangesWhy TSH is important, but may not always tell the whole clinical storyHow clinicians and patients can begin applying EAS and its questions Relevant resources:Energy Allocation System Chapter markers:(02:15) - Dr. Corey’s background and journey (03:04) - The Energy Allocation System (EAS) in simple terms (04:41) - Why the EAS was created (06:51) - Why the EAS has resonated (07:45) - Hypothetical situation using the EAS lens (12:10) - How EAS changes our understanding of thyroid health (15:59) - How to implement EAS in practice today

Uncharted is a new podcast from Allergy Research Group (ARG) for practitioners and anyone curious about the science of women’s health. In each episode, host Dr. Lara Zakaria sits down with a clinician, researcher or women’s health expert to unpack one question, connect the dots and make the conversation useful in practice and everyday life. The focus for Season 1 is women’s thyroid health. We hope you join us.Disclaimer: The information shared in this podcast is for educational purposes only and is not intended to replace individualized medical advice, diagnosis, or treatment.