Dr Cobi

It's so easy to look sideways.

Someone else is further ahead. Their family looks different. Their career happened faster. Their prayer was answered first. They seem to have figured out something you're still struggling with.

But comparison will steal the joy from the life God actually gave you.

Your life doesn't need to unfold according to someone else's timeline to be meaningful.

There are chapters of your story that haven't even been written yet.

“For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.” — Jeremiah 29:11

Keep going. God isn't finished. 🤍

Before you change a single food, look at how often you are eating. Insulin cannot come back down while you are feeding it every ninety minutes, and that is happening in kitchens full of healthy food.

And the food is usually fine. She is eating well and grazing while she does it.

So here is what I ask for. If I do not have actual genetic testing, I say three meals a day, four to six hours apart. That is my default without your data, not a rule for everybody.

Two very good reasons. One, your insulin gets to reset between meals. Two, your migrating motor complex gets to sweep your gut. Almost nobody has heard of that one.

Even a hard-boiled egg gives you an insulin response for a couple of hours. So do the almonds.

Nothing on your plate has to change. Count your gaps for one day.

'My heart just races out of nowhere.' I hear that in the same appointment where someone tells me their doctor called it anxiety. Thyroid output sets your heart rate, so it belongs in that workup too.

Anxiety is a real answer. Sometimes it is the answer, and I am not telling you a racing heart is nothing to have checked.

What I am saying is that the list was short. Thyroid output sets your heart rate, so thyroid belongs in the same look. And it rarely arrives on its own. It is the cold, the hair loss, the weight gain, the brain fog, the fatigue.

If a TSH is all that was run, I would just say that is very incomplete testing. None of this rules anything out. It adds.

If your heart races and nobody has looked at your thyroid, that is worth adding to the list.

She had been cold for years and had stopped mentioning it, because it never sounded like a symptom.

And on its own it is not much. That is the honest version. What makes me look is that it rarely arrives on its own. I often feel like it is a compilation of symptoms. It is the cold, it is the hair loss, it is the weight gain, it is the brain fog, it is the fatigue.

Her TSH was normal. It had been normal for years, and every time she was told her thyroid was fine.

Antibodies can be elevated while the TSH still reads in range. A TSH on its own is very incomplete testing, and that gap is the part of the picture that moves first.

This is not a diagnosis. It means the panel was not finished.

Save this if the cold is on your list and nobody has run your antibodies.

It's easy to notice what's missing.

The thing that hasn't happened yet. The prayer that hasn't been answered. The problem that still isn't resolved.

But when we intentionally look around, there is so much goodness tucked into ordinary life.

A person we love. A safe place to sleep. A beautiful morning. Laughter. A meal around the table. A healthy body that carried us through another day. Another chance to begin again.

Not every season is easy. Gratitude doesn't require pretending that it is.

It simply reminds us not to let what's difficult make us blind to what's still good.

“Give thanks to the Lord, for he is good; his love endures forever.” — Psalm 107:1

Happy Sunday. 🤍

She tells me her libido is gone, then adds, almost apologetically, that she thinks it is really her marriage. Desire runs on physiology and on connection and on how much you are carrying, which is why a hormone-only plan keeps not working.

And she might be partly right about the marriage. That is worth taking seriously rather than waving away.

But she is also carrying a full load, sleeping badly, and running on hormones that have genuinely shifted. The hormone-only version and the relationship-only version fail for the same reason. Each is trying to explain a three-input problem with one input.

Foreplay is in the kitchen. It is physiology, but it is also connection, and it is also the dishwasher getting unloaded.

So I do not pick a side, and I do not let her pick one either. Save this if you have been quietly deciding it is your marriage.

If I could run one test on every woman before she started a hormone plan, it would not be her hormone levels. It would be which route her body sends estrogen down after it has done its job, because that is what decides whether hormone therapy lands well for her or badly.

And I am not talking about getting rid of your estrogen. That is really confusing to women thinking, wait, am I not missing estrogen? You are. That is not the question.

The question is what form it is in, and how well you are methylating it. If you are converting more into 4-OH and 16-OH, those are the things we work on. I love talking about 2-OH, 4-OH, 16-OH and methylation. People are always surprised any of it exists.

There is protection in knowing what your estrogen is doing, and more confidence in the decision. Link in bio.

Rounds of probiotics and a food sensitivity panel, and nothing changed. That is not a failure of effort.

Both of those tell you something. Neither of them tells you whether the process is working.

GI-MAP is honestly my favourite test to do. I love it. And what I am reading is not a list of bugs. I am reading whether you are actually digesting, whether your bile is moving, and what is overgrown in there.

So I look at dysbiosis. Overgrowth, so SIBO or SIFO. Parasites and candida. Whether you have lost pancreatic elastase, or your steatocrit has climbed, which is fat digestion. Sluggish bile flow. An anti-gliadin IgA that has gone suddenly positive out of nowhere. Elevated zonulin. H. pylori. But also calprotectin, which does something none of the others do, because it tells me whether this is actually inflammatory bowel disease rather than IBS. That one is super valuable.

The finding that changes my plan is rarely the one the patient expects.

If you have been treating your gut without ever mapping it, that is the gap. Discovery call link in my bio.

Some seasons are just heavy.

Family. Work. Relationships. Health. Decisions. People we love who are struggling. Things happening in the world that we cannot fix.

We can become so accustomed to carrying everything that we forget we're allowed to put some of it down.

God never asked us to be strong enough to carry everything ourselves.

“Come to me, all you who are weary and burdened, and I will give you rest.” — Matthew 11:28

Whatever feels heavy today, give some of it back to Him. 🤍