Dr. Amy Tiffany sits down with board-certified endocrinologist Dr. Neeli Singh to unpack why your labs can be normal while you feel completely off, what actually happens when you microdose a GLP-1, and why the weight you lose on these medications isn't all fat.

Dr. Singh is board-certified in Endocrinology, Internal Medicine, Lifestyle Medicine, and Obesity Medicine, a Menopause Society Certified Practitioner, and the founder of EndoHarmony — a direct-care endocrinology practice offering 90-minute visits, in person in Westborough, Massachusetts and virtually across MA, NH, NY, ME, MD, and AR.

After 20+ years with Mass General Brigham, she left the 20-minute-appointment system to build a practice around root causes instead of rushed protocols.

This conversation is for women 35 to 55 who are doing everything right and still gaining weight, anyone on or considering a GLP-1 medication, and every woman who's been told her thyroid is "fine" while she feels anything but.

After watching, you'll understand why thyroid doses shift during perimenopause and how oral estrogen changes your medication needs, how GLP-1s actually work in the body and how to protect your muscle while taking them, why binge eating disorder is a brain condition rather than a willpower failure, and how to eat with your cycle instead of fighting it.

Timestamps:

0:00 – Who is Dr. Neeli Singh, and what does an endocrinologist treat?

3:18 – Why did a Mass General Brigham endocrinologist build her own practice?

4:17 – What is lifestyle medicine, and how is it different from functional medicine?

6:42 – Why lifestyle medicine is really "the medicine of your habits"

7:03 – Did functional medicine find the thyroid problem your endocrinologist missed?

9:29 – Why did patients stop trusting doctors — and did COVID cause it?

11:59 – Who is Dr. Singh without the credentials?

13:43 – Why she left Mass General Brigham after 20 years

15:25 – 20-minute appointments vs. 90-minute visits: what direct care changes

17:26 – Why does your thyroid dose keep changing in perimenopause?

19:27 – How do GLP-1 medications like Ozempic actually work?

21:19 – Are you losing muscle on your GLP-1? How to protect it

22:31 – GLP-1s, PCOS, and pregnancy: what women need to know

24:13 – Does microdosing Ozempic actually work? An endocrinologist answers

26:06 – Are compounded GLP-1s safe?

27:08 – The eating disorder 99% of people don't know they have

30:14 – How your menstrual cycle changes cravings and blood sugar

33:20 – How to eat with your cycle (luteal phase strategy)

36:46 – Does an IUD or ablation stop your cycle? What's really happening

38:33 – Gestational diabetes: the warning most women never get

43:30 – How to work with Dr. Singh at EndoHarmonyConnect with

Dr. Neeli Singh:

🔗 Website: https://endo-harmony.com

📋 Find a certified menopause practitioner: https://menopause.org

Connect with Dr. Amy Tiffany:

🌐 Website: vitalitymwc.org

📱 Instagram: @dramytiffany

💼 LinkedIn: Dr. Amy Loden Tiffany

Subscribe for honest conversations about medicine, hormones, midlife, and restoring trust — between physicians and the people they serve.

Microdosing a GLP-1 medication means staying on the lowest effective dose to maintain weight loss, and it works when supervised by a physician.

Weight lost on GLP-1 medications includes muscle, so adults on these drugs need 30 to 40 grams of protein per meal and strength training three to four times per week.

Binge eating disorder is the most common eating disorder in the United States, and most people who have it are never diagnosed.

About one in three women who have gestational diabetes will develop type 2 diabetes, which is why screening should continue for life.

Your doctor telling you bone density screening starts at 65 isn't wrong — but it might not be right for you.

In this episode, Dr. Amy sits down with Dr. Roshni Patel, a board-certified OB-GYN and Menopause Society Certified Practitioner, to talk about the guidelines built for populations instead of the woman actually in the room.

They get into why hot flashes are a documented heart disease risk factor most women have never heard connected to their symptoms, why women routinely get zero pain management for procedures their male counterparts would receive anesthesia for, and why Dr. Patel walked away from insurance-based medicine to build a direct care practice from scratch.

Chapters:

00:00 Who Is Dr. Roshni Patel Outside the White Coat?

02:18 What Made Her Leave the Traditional Medical System?

05:10 How an Unconventional Path Led to OB-GYN

07:23 Why Aren't OB-GYNs Trained in Menopause Care?

11:44 What Is a Direct Care (Micro) Practice?

13:24 How Direct Care Actually Works for Patients

16:15 The Bone Density Guideline Doctors Are Quietly Rethinking

18:19 Is Hormone Therapy as Risky as We've Been Told?

19:00 Why Hot Flashes Are a Heart Disease Warning Sign

20:05 What Insurance Is Actually Incentivized to Do

24:08 Have Physicians Given Away Their Power?

28:22 The $1,200 Lab Bill Nobody Warned Her About

33:43 Why Women Don't Get Anesthesia for Painful Procedures

36:50 What We Forget When We Put on the "Doctor" Hat

38:16 Where to Find Dr. Patel

Hot flashes and night sweats — vasomotor symptoms, medically speaking — are a documented risk factor for heart disease in women.

Direct care (or concierge) gynecology removes insurance billing from the visit, which allows for longer appointments and continuous access to the same physician.

Current bone density screening guidelines recommend starting at age 65, though individual risk factors can change that timeline.

Dr. Roshni Patel, DO, FACOG, MSCP is a board-certified OB-GYN and Menopause Society Certified Practitioner. She's the founder of Luminate Gynecology, a direct care practice in Mountainside, NJ, built around longer appointments and real access to her — not a 15-minute visit squeezed between insurance codes.

Dr. Amy Loden Tiffany, MD, MBA, FACP is a triple board-certified physician (internal medicine, lifestyle medicine, obesity medicine) and founder of Vitality Medical and Wellness Consulting in St. Louis, MO. She hosts The Authentic Physician — honest conversations about the health transitions women aren't always prepared for.

If your body suddenly isn't responding the way it used to — your joints ache, your shoulder froze up out of nowhere, or the workouts that used to work just don't anymore — this episode is for you. Dr. Amy sits down with sports medicine physician Dr. Sarah "Sassy" Weinstein to unpack what's actually happening to women's muscles, joints, and tendons in their 30s, 40s, and 50s, and why so much of it traces back to hormones nobody connected for you.They get into the injuries that quietly show up in postpartum and perimenopause, why estrogen loss makes your joints and tendons more vulnerable, and why "just rest it" is often the wrong call. Dr. Weinstein breaks down the regenerative treatments everyone's asking about — PRP, shockwave, and where the evidence really stands on stem cells — plus the supplements actually worth your money, why lifting heavier protects your bones without bulking you up, and how to start strength training if you've never touched a weight. It's a real, practical conversation about staying strong and active through midlife, from two physicians building medicine the way it should be.Chapters00:00 – Intro & welcome01:32 – Who she is without the credentials03:17 – How her own injuries shaped her path06:08 – Leaving the system to build her own practice11:05 – Why imposter syndrome shows up in every career13:24 – What is primary care sports medicine — and should you rest or get seen?16:39 – The postpartum & perimenopause injuries no one connects to hormones19:16 – PRP, shockwave & stem cells: what does the evidence say?22:47 – Why would a doctor want you MORE inflamed?26:31 – Do collagen, glucosamine & turmeric actually work?28:27 – The supplements she actually recommends31:17 – What are women getting wrong about their bodies?34:05 – Why grip strength is a warning sign for your 80s34:47 – Where should a beginner start with strength training?38:43 – PT vs. a sports medicine physician: what's the difference?42:16 – Can the food you eat reduce joint pain?47:44 – How do you get enough protein on a plant-predominant diet?50:18 – What advice is actually harmful to your body?52:22 – Why stress might be behind your physical pain54:06 – Where to find Dr. Sassy WeinsteinDr. Sarah "Sassy" Weinstein, DO, is a primary care sports medicine physician, fellowship-trained in sports medicine and dual board-certified in Family Medicine and Lifestyle Medicine. She completed her fellowship at the University of Colorado, serving as a team physician for NCAA Division I football, women's volleyball, and women's lacrosse at CU Boulder, along with the NHL's Colorado Avalanche and the NBA's Denver Nuggets. After her tenure at Rothman Orthopaedics, she founded CORE Sports Medicine & Lifestyle Medicine in New Jersey, where she uses non-surgical, evidence-based care — including ultrasound-guided diagnosis, PRP, and shockwave therapy — alongside nutrition and lifestyle medicine to treat and prevent injury. A New Jersey native and lifelong athlete, she lives locally with her husband and two children.Instagram: @drsassyweinstein Website: coresportsmedicine.comDr. Amy Loden Tiffany, MD, MBA, FACP, is triple board-certified in Internal Medicine, Lifestyle Medicine, and Obesity Medicine, and the founder of Vitality Medical and Wellness Consulting in St. Louis. On The Authentic Physician, she has honest conversations with women about hormones, metabolism, perimenopause, postpartum recovery, and reclaiming their health in midlife.