@SaraSzalMD

Precision medicine doctor. 4X NYT bestselling author. Director of Precision Medicine & Longevity, Thomas Jefferson University.

[@SaraSzalMD @DrGottfried]

Lately I’ve been wondering whether women inherit more than our mother’s mitochondria or our grandmother’s recipes.

Maybe we also inherit invisible agreements.

Things like:

Keep the peace.
Don’t be too much.
Take care of everyone else first.
Don’t disappoint.
Be easy to love.

https://t.co/miazigIiuP

[@SaraSzalMD @DrGottfried]

Most relationship fights aren’t really about the dishes, the text, the sex, or who’s late.

Sue Johnson’s research suggests they’re often about one deeper question:

“When I need you most… will you be there for me?”

The content of the fight matters less than the attachment need underneath it.

Curious: Have you ever realized a recurring argument was really about wanting reassurance, closeness, or emotional safety?

Asking for a friend. ❤️

[@SaraSzalMD @DrGottfried]

@femalelongevity @drgabriellelyon How do you regulate your nervous system when there’s a lot happening in a full life?

[@SaraSzalMD @DrGottfried]

My favorite relationship ritual that’s 10X better than couples therapy and it’s FREE! https://t.co/gosXGscDxf

[@SaraSzalMD @DrGottfried]

You need a ferritin at least above 40 for new hair growth. Optimal 70-80

[Kayla Barnes-Lentz @femalelongevity]

Nutrient status

Vitamin D: 60-80 ng/mL
Ferritin: 50-150 ng/mL
B12: 500-1000 pg/mL
RBC magnesium: 5.0-6.5 mg/dL
Omega-3 index: 8-12+%

Ferritin drops every month with menstruation. Low iron stores can cause fatigue, brain fog, and hair loss even when iron looks "normal."

[@SaraSzalMD @DrGottfried]

I commonly see +ANA in women with breast implants #breastimplantillness

[Kayla Barnes-Lentz @femalelongevity]

Autoimmune markers

ANA: negative
TPO antibodies: under 9 IU/mL
TgAb: under 1 IU/mL

Autoimmune conditions affect women at roughly twice the rate of men and can build silently for years. Thyroid antibodies can be elevated long before TSH ever looks abnormal.

[@SaraSzalMD @DrGottfried]

@AdriPeralM Good question! What are you curious about? Maybe I’ll write one!

[@SaraSzalMD @DrGottfried]

Excessive thinking can become a defense against transformation. I am in recovery from overthinking.
How about you?

[@SaraSzalMD @DrGottfried]

Depends on ovarian age and whether you’re on hormone therapy or herbs like Chastetree

[Kayla Barnes-Lentz @femalelongevity]

Female hormones

Estradiol: 60-400 pg/mL (varies by cycle phase) Progesterone (day 19-21): 10-25 ng/mL
Total testosterone: 40-70 ng/dL
DHEA-S: ~200-350 µg/dL under 40
AMH, FSH & LH: age and cycle dependent

These aren't just "fertility hormones." They shape brain, bone, muscle, and sleep.

[Kayla Barnes-Lentz @femalelongevity]

Liver & detox

AST: 10-25 U/L ALT: under 20 U/L (women 20+ may signal fatty liver)
GGT: under 20 U/L

Your liver processes every hormone, toxin, and medication in your body. GGT is often overlooked but can be an early signal of oxidative stress.

[Kayla Barnes-Lentz @femalelongevity]

Thyroid

TSH: 1.0-2.0 mIU/L
Free T3: 3.0-4.0 pg/mL
Free T4: 1.0-1.5 ng/dL
Reverse T3: under 15 ng/dL
TPO & TgAb: as low as possible

Most doctors only run TSH. Women are far more likely than men to have thyroid dysfunction, and a single marker can miss it.

[@SaraSzalMD @DrGottfried]

How are your insulin and glucose? I reversed prediabetes and you can too.

[Kayla Barnes-Lentz @femalelongevity]

Metabolic health

Fasting insulin: 2-5 uIU/mL
Fasting glucose: 72-85 mg/dL
HbA1c: 4.8-5.2% HOMA-IR: under 1.0

Your glucose can read "normal" while your insulin is working overtime. Fasting insulin is the one most doctors skip, but it can flag dysfunction years before glucose ever moves.

[@SaraSzalMD @DrGottfried]

Childhood trauma increases both Alzheimer’s disease and dementia. Women experience more adverse childhood experiences than men. It may explain part of why Alzheimer’s is twice as common in women.

[@SaraSzalMD @DrGottfried]

Female lab panel! Love my collaborations with @femalelongevity

[Kayla Barnes-Lentz @femalelongevity]

Most doctors run the bare minimum and tell you your labs are "fine." Here's the expanded female lab panel to test, and the optimal ranges across every system that affects energy, mood, brain, hormones, and how you age. In collaboration with @DrGottfried MD.

[@SaraSzalMD @DrGottfried]

@CandiceND Yes! This!!!

[@SaraSzalMD @DrGottfried]

The female body was not designed to be a smaller, more compliant version of a male body. It was designed to cycle, adapt, sense, protect, and create life.

Yet modern culture keeps asking women to override hunger, sleep, hormones, grief, desire, and intuition in order to stay productive.

When women burn out, we call it a personal problem but often it is a design problem.

https://t.co/Wmua71ic4C

[@SaraSzalMD @DrGottfried]

The clitoris was not correctly mapped in a peer-reviewed medical journal until 1998. The nerve map was published in March 2026.

Every gynecologist who graduated before 2000 trained on an incomplete anatomy and passed their lack of knowledge onto you.

Most of their patients never knew. It led to not just a knowledge gap but also an orgasm gap.

The full clitoral structure is 9–11 cm.
Contains 10,000 nerve endings. Wraps around the vaginal canal on both sides.

Yet the part most people can identify is about 1 cm.

We can do better.

[@SaraSzalMD @DrGottfried]

@DrKristieLeong Yes! Exercise snacks are so yummy!

[@SaraSzalMD @DrGottfried]

I dreamed I had to make brunch for a house full of people. There wasn’t enough food, so I ran to buy more, got home, and it still wasn’t enough.

Then I woke up.

How many women are still living this dream?

When there’s not enough time, energy, or love, we’re taught to become more resourceful, not to question why we became responsible for feeding everyone in the first place.

Women’s burnout isn’t just biology.

It’s culture.

[@SaraSzalMD @DrGottfried]

@bryan_johnson Interesting. This may be the most profound thing I’ve seen you post @bryan_johnson