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.

After working in hospice and witnessing roughly 1,000 deaths in a single year, Dr. Charlotte Grinberg changed how she lives — and how she practices medicine. In this episode of The Authentic Physician, she and Dr. Amy (Loden) Tiffany talk about healthspan versus lifespan, why the dying almost never talk about their jobs, and what midlife women most often regret. They get into the direct primary care model and why removing insurance buys back the one thing patients actually need: time. They also cover the hard stuff most doctors won't say out loud — that postpartum bloodwork is often quietly abnormal, that the body's best window for pregnancy is earlier than the culture admits, and that medicine itself pushes women to delay families in ways that carry real cost.This is a conversation about living well so you can age well, told by two physicians who left the traditional system to practice the way they always wanted to.CONNECT WITH DR. CHARLOTTE GRINBERG🌐 To Life Primary Care & Longevity: tolifelongevity.com✍️ Substack — The Bookends of Life💼 LinkedIn: Dr. Charlotte GrinbergCONNECT WITH DR. AMY TIFFANY🌐 Website: vitalitymwc.org📱 Instagram: @dramytiffany💼 LinkedIn: Dr. Amy Loden TiffanySubscribe for honest conversations about women's health, midlife, metabolic health, and rebuilding trust between physicians and the people they serve.CHAPTERS00:00 What does a hospice doctor know about living well?01:37 Who are you without your credentials?02:55 Does marriage actually affect your longevity?04:49 What changed after seeing 1,000 deaths in one year?06:07 Why isn't it only the elderly who die?07:53 Does faith change how people face death?11:06 What's the difference between lifespan and healthspan?14:34 Why don't patients trust the healthcare system anymore?16:55 The one thing this doctor refuses to compromise on19:32 "Too much time with patients" — when caring gets you in trouble23:20 Why women turn to functional medicine after being dismissed25:39 How much of your health is lifestyle vs. supplements?30:32 Is leaving the system selfish during a doctor shortage?33:18 "Why do you love your job more than me?"34:29 The harmful advice women physicians pass down36:44 The truth about fertility timing nobody tells you39:03 What postpartum bloodwork actually reveals39:31 Is medicine pushing women to delay families?43:26 What the dying teach us about how to liveABOUT DR. CHARLOTTE GRINBERGDr. Charlotte Grinberg is an internal medicine and hospice & palliative medicine physician and the founder of To Life Primary Care & Longevity in the Washington, DC and Maryland area. She trained in internal medicine and completed a hospice and palliative care fellowship within the Harvard Health System after earning her MD from Sidney Kimmel Medical College at Thomas Jefferson University. Her writing on the human side of medicine has appeared in JAMA, NEJM, Health Affairs, The Free Press, STAT, and Slate.ABOUT DR. AMY TIFFANYDr. Amy Loden Tiffany is a triple board-certified physician in internal medicine, lifestyle medicine, and obesity medicine, and the founder of Vitality Medical & Wellness Consulting, a concierge practice in St. Louis focused on perimenopause, postpartum recovery, and metabolic health for midlife women. She hosts The Authentic Physician, where she has candid conversations with physicians about medicine, identity, and the health transitions women aren't prepared for.

🔗 Learn more: https://vitalitymwc.orgWhat if the symptoms you've been told are "just perimenopause" are actually something else entirely?Dr. Amy Tiffany sits down with Dr. Rachael Clark, a board-certified family medicine physician who spent eight years in academic medicine before a post-COVID health collapse forced her to rebuild her own health — and rethink how she practices medicine. Today she runs Village Health and Healing, a functional and integrative medicine practice outside Philadelphia, where she helps women uncover the root causes behind chronic fatigue, gut issues, and the symptoms too often dismissed as "just getting older."In this conversation, you'll learn why burnout has four layers (physical, mental, emotional, and spiritual), what reactivated Epstein-Barr virus is and why Dr. Clark believes it's an overlooked driver of chronic mystery symptoms, how to think about adrenal and liver health before blaming your hormones, and why the question "is this really perimenopause?" deserves to be asked before you accept your symptoms as inevitable.⏱️ Chapters00:00 — Who is Dr. Rachael Clark?02:29 — Have high-achieving women been sold a dream?05:52 — What is burnout, really? The four layers11:06 — What did a COVID infection trigger in her body?15:11 — When is weight gain actually inflammation?19:27 — What is reactivated Epstein-Barr virus?22:01 — How do you test for reactivated EBV?23:49 — Can diet, herbs, and lifestyle calm a reactivated virus?26:17 — Why did part of her have to "die" to leave academic medicine?30:02 — When did physicians stop being scientists?31:07 — Did COVID cause the distrust in medicine?34:29 — Are your symptoms really perimenopause?38:12 — Is adrenal fatigue real? Two physicians disagree42:04 — What is energetic healing?45:25 — How to work with Dr. Rachael ClarkKey Takeaways:Epstein-Barr virus is the virus that causes mono, and after the initial infection it remains dormant in the body's immune cells for life. Reactivation of Epstein-Barr virus can be triggered by other infections, prolonged stress, and environmental exposures like mold. The EBV early antigen antibody is the lab marker most specific for viral reactivation. Burnout affects physicians on four levels: physical exhaustion, mental depletion, emotional emptiness, and spiritual disconnection. Many midlife symptoms attributed to perimenopause may have other contributing causes, which is why a thorough workup matters before accepting "it's just your age" as an answer. This episode is educational and is not medical advice — always work with a physician who knows your health history.🩺 About Dr. Amy TiffanyDr. Amy Loden Tiffany, MD, MBA, FACP is a triple board-certified physician (Internal Medicine, Lifestyle Medicine, Obesity Medicine) and the founder of Vitality Medical and Wellness Consulting, a concierge primary care practice in St. Louis serving women navigating perimenopause, postpartum recovery, and metabolic health.👩‍⚕️ About Dr. Rachael ClarkDr. Rachael Clark, MD is a board-certified family medicine physician practicing functional and integrative medicine at Village Health and Healing in West Chester, PA, seeing patients virtually across Pennsylvania and Delaware. She also leads Village Healing Circle, an educational program open to women everywhere.🔗 Practice: https://villagehealthandhealing.com🔗 Course: https://www.villagehealingcircle.com📸 Instagram: @villagehealthandhealing#Perimenopause #ChronicFatigue #EpsteinBarrVirus #FunctionalMedicine #WomensHealth #BurnoutRecovery #TheAuthenticPhysician

Dr. Amy Loden Tiffany sits down with St. Louis OB-GYN and menopause expert Dr. Becky Lynn to explain the perimenopause symptoms women are never warned about, and how to feel like yourself again.Perimenopause is the transition leading up to menopause, and it can begin years before your periods stop. Its symptoms go far beyond hot flashes and night sweats — they include anxiety, depression, disrupted sleep, weight gain, and joint aches. Many women are told their labs are "normal" and sent home, but feeling unwell during this transition is real and treatable.Dr. Lynn explains why so many clinicians were never trained to manage perimenopause: when the Women's Health Initiative results were released in 2002, a generation of physicians stopped prescribing hormone therapy and stopped learning about it. She also breaks down why a rushed 15-minute appointment can't address hormones, sleep, libido, and weight in one visit, and what a direct-care concierge practice does differently — the visit is paid out of pocket, while labs, imaging, and prescriptions still go through your insurance.She and Dr. Tiffany also tackle health misinformation, including the dangerous claim that women should replace mammograms with thermography. Thermography is not a substitute for a mammogram, and the FDA warns against using it for breast cancer screening.If you've felt dismissed, rushed, or told that what you're experiencing is "just aging," this conversation is for you.Chapters00:00 — Who is Dr. Becky Lynn?02:00 — Who is she outside of medicine?05:30 — How did she find her way into women's health?08:00 — How did she end up specializing in sexual health?09:00 — What are her three specialties, and how are they connected?10:00 — Why don't more doctors talk about perimenopause?13:00 — Why is the 15-minute doctor visit failing women?13:45 — Why did she leave traditional medicine?16:30 — What is a direct-care concierge practice?17:15 — Is a no-insurance model actually worth it?19:45 — Why does team-based care matter for women?22:40 — What do women most misunderstand about perimenopause?24:00 — How do you spot health misinformation online?24:45 — Why is thermography dangerous as a mammogram alternative?27:00 — Final thoughtsWork with Dr. Amy Tiffany / book a consult: https://vitalitymwc.org/?utm_source=youtube&utm_medium=social&utm_campaign=becky_lynn_perimenopauseConnect with Dr. Becky Lynn:Website: evorawomen.comInstagram: [verify — see note below]LinkedIn: linkedin.com/in/beckyklynnYouTube: @BeckyLynnMD#Perimenopause #Menopause #WomensHealth #MidlifeWomen #HormoneTherapy #MenopauseSupport

Dr. Amy Tiffany sits down with hair restoration physician Dr. Nancy Echefu to unpack why women's hair loss has over 200 causes and what actually works when one-size-fits-all treatments fail.

Dr. Echefu is a board-certified physician and the founder of Havilah Hair Restoration in Peachtree City, Georgia. As one of the few female hair transplant surgeons recognized by the International Society of Hair Restoration Surgery (ISHRS) — where she serves as a Patient Advocate — she sees what most dermatologists and primary care doctors miss: the difference between hair loss, hair shedding, and the dozens of overlapping triggers that show up in high-functioning women navigating stress, hormones, postpartum recovery, and perimenopause.

After watching, you'll understand why a single supplement like Nutrafol isn't the answer for most women, why scalp micro-pigmentation can be dangerous without underlying medical treatment, what actually happens during a hair transplant (and why women are good candidates too), and how to find a qualified hair restoration surgeon in your area no matter where you live.

Chapters:00:00 — Why are women's hair loss cases so much harder to diagnose?02:13 — What happens when dermatology and hair transplant clinics don't talk to each other?04:17 — What questions should a hair restoration consultation actually answer?06:14 — Is scalp micro-pigmentation safe? The risk most clinics don't tell you about09:27 — Does Nutrafol work? An honest answer from a hair restoration doctor10:24 — Why women's hair loss has more than 200 possible causes13:00 — The stigma around hair transplants for women15:45 — What hair transplant aftercare actually requires17:26 — How follicular unit extraction (FUE) works, step by step21:11 — How to find a qualified hair transplant surgeon anywhere in the world23:05 — How hormones, perimenopause, and GLP-1s affect hair loss24:40 — "Lazy family syndrome" — why GLP-1 shedding isn't the same as hair loss25:43 — Where to find Dr. Nancy and how to book a free virtual consult

Connect with Dr. Nancy Echefu:🌐 Havilah Hair Restoration: hh-restorations.com📱 Instagram: @havilahhairrestoration📺 YouTube: Havilah Hair Restoration📅 Free virtual consultations available 7 days a week

Connect with Dr. Amy Tiffany:🌐 Website: vitalitymwc.org📱 Instagram: @dramytiffany💼 LinkedIn: Dr. Amy Loden Tiffany

Subscribe for honest conversations about medicine, midlife, identity, and the health transitions high-achieving women are rarely prepared for.

Female hair loss has more than 200 possible causes, which is why a single supplement or one-size-fits-all treatment rarely addresses the root issue. Scalp micro-pigmentation can create the visible appearance of density, but without ongoing medical treatment for the underlying hair loss, the pigmented area becomes exposed as the hair continues to thin. Hair transplants for women are safe, use the patient's own follicles from the back of the scalp, and do not require immunosuppressive medication. The International Society of Hair Restoration Surgery (ISHRS) maintains a global directory of qualified hair transplant surgeons searchable by city, state, and country at ISHRS.org.

Dr. Amy (Loden) Tiffany sits down with internist and geriatrician Dr. Amna Shabbir to unpack why perfectionism isn't a personal flaw — it's a societal trap, and what to do instead.

Dr. Shabbir is dual board-certified in Internal Medicine and Geriatrics, a TEDx speaker ("Perfectionism Has a Solution — It's Not What You Think"), founder of the Early Career Physicians Institute® and Success Curated, and host of the Success Reimagined podcast. She trained at Aga Khan University, Cleveland Clinic, and Duke.

This conversation is for any woman who has been told she's just stressed, who has been the polished one falling apart on the inside, or who has wondered if there's a way to stay ambitious without burning out.

After watching, you'll understand the difference between perfectionism and excellence, why moral injury is not the same as burnout and why that distinction matters for healthcare workers, what the three types of perfectionism actually mean according to the Hewitt and Flett Multidimensional Perfectionism Scale, and how Dr. Shabbir's Courage Bridge framework gives high-achieving women a way through the trap without giving up their ambition.

0:00 – Who is Dr. Amna Shabbir outside her credentials?

1:21 – Why "what do you do for fun" is the question that breaks high achievers

3:25 – What high-achieving women fundamentally misunderstand about perfectionism

4:31 – Why the worse she felt, the better she looked on the outside

6:19 – How self-criticism becomes the default voice for women in medicine

8:34 – From primary care to geriatrics to clinical sabbatical

11:06 – What older women regret about how they treated themselves in their 30s and 40s

13:20 – Why ten specialists couldn't figure out what was happening to her body

14:06 – When male colleagues dismiss women's symptoms as "just stress"

16:50 – The moment her daughter said "Mommy, I know I was stupid" about a 99% test score1

8:32 – What moral injury actually is and why it's not burnout

19:13 – The three types of perfectionism: self-oriented, other-oriented, socially prescribed

26:25 – Why we dehumanize physicians and then expect humanity from them

28:12 – Did she want her daughter's surgeon to be a perfectionist? Her answer might surprise you

29:32 – Excellence vs. perfectionism: the reframe high achievers need to hear

32:01 – The paradox of perfectionism: why perfectionists are a bad hire

33:08 – Introducing the Courage Bridge framework

35:43 – Step 1: Have the courage to examine your intentions

37:33 – Step 2: Have the courage to fail with self-compassion

40:21 – Step 3: Have the courage to model your humanity

42:41 – Why this show exists and why image culture is killing women

43:50 – What she tells her two daughters every morning

45:17 – Rebelling against "fake it til you make it"

47:28 – Nothing has gone wrong: Dr. Tiffany on surrender as anchoring, not giving up

48:35 – The expectation gap of perfectionism

50:23 – How to find Dr. Amna Shabbir and watch her TEDx talk

Perfectionism is not a personal problem — it is a societal phenomenon that punishes humans for being human. The Hewitt and Flett Multidimensional Perfectionism Scale identifies three types: self-oriented, other-oriented, and socially prescribed perfectionism. Moral injury, originally studied in Vietnam War veterans, is the wound of being unable to give the care your patient deserves, and it is distinct from burnout. The Courage Bridge framework offers three steps for high-achieving women: examine your intentions, fail with self-compassion, and model your humanity.

🎙️ Find Dr. Amna Shabbir:Website: https://dramnashabbir.com

Podcast: Success Reimagined with Amna Shabbir, MDTEDx Talk: "Perfectionism Has a Solution — It's Not What You Think" (TEDxRaleigh)LinkedIn: https://www.linkedin.com/in/amna-shabbir-md/Instagram: @dr.amnashabbir

🩺 Work with Dr. Amy Tiffany at Vitality Medical and Wellness Consulting:https://vitalitymwc.org