Dr. Sara Szal: Stop Ignoring What Your Body’s Trying to Tell You! (THESE Are the Hormone Signals You Can’t Afford to Miss!

What if your tired mornings were a biological signal, not a character flaw?

That idea hit me hard while listening to a candid conversation between a curious interviewer and Dr. Sarah Sal, a clinician who mixes Harvard-trained medicine with a palpable human warmth. She argues that fatigue, anxiety, stubborn weight, and even relationship friction often have a hormonal fingerprint.

Stress as the common thread

Dr. Sal frames cortisol not as an abstract lab number but as the conductor of an orchestra. Too much and everything else plays off-key; too little and the system is exhausted. She calls it a Goldilocks zone — not too high, not too low — and gives concrete ranges: morning cortisol around 10–15, afternoon levels nearer 5–10. That specificity felt refreshing. Measurement, she insists, is the first act of self-care.

Honest and blunt, she shares that her own cortisol once ran three times optimal. That personal admission made her clinical recommendations feel earned, not theoretical.

Metabolism and the insulin story

Insulin got star billing. Picture insulin as the bouncer deciding whether glucose gets into the cell-club. When cells grow numb — insulin resistance — glucose piles up in the bloodstream. The consequence for women can show up earlier: pre-diabetes–range fasting glucose (100–125) already raises cardiovascular risk. The hopeful note? Insulin is remarkably responsive: diet and movement can shift it within days.

Sex hormones, thyroid, and the decades that matter

She maps hormonal life like a travel guide: puberty’s volatility, the steadiness of your twenties, the subtle decline that can start in your late twenties and the more obvious perimenopausal changes after forty. Thyroid problems, she says, often signal autoimmune roots and show up far more in women. Her bedside manner with facts — short, practical, and sometimes discomfiting — makes it easier to imagine testing rather than guessing.

Birth control: a complicated trade-off

This segment made my jaw drop. Birth control pills are effective contraception, yes — but they also change sex hormone–binding globulin (SHBG), which lowers free testosterone. For roughly a quarter of women, libido or lubrication drops. Pills can raise markers of inflammation, deplete micronutrients like magnesium and B vitamins, and in some cases leave SHBG elevated even a year after stopping. She doesn’t condemn contraception. She argues for informed consent and personalized transitions off hormonal methods, often recommending a copper IUD as a hormone-free, high-satisfaction alternative.

Small rituals, big hormonal effects

The practical takeaways are disarmingly simple: measure what matters, sleep well, and design evening rituals to decompress. A ten-minute post-meal walk improves glucose handling. Meditation, breathwork, and short social rituals regulate cortisol. She also urges people to use heart rate variability as a real-time stress dashboard.

• Measure first: start with cortisol and metabolic markers.
• Move purposefully: a 10-minute walk after dinner helps insulin.
• Ritualize evenings: replace automatic wine or TV with brief regulation practices.
• Bridge off birth control: plan contraception alternatives and address micronutrients.

What really caught my attention was the way Dr. Sal wove spirit into science. She described medicine as both data and devotion: testing and metrics plus empathy and presence. That combination reframed care from cold diagnosis to partnership.

Where measurement meets meaning

The conversation repeatedly circles back to one radical notion: you are your best clinician. Doctors see you a fraction of your life. Most of your health is written in daily sleep, stress, food, movement, and relationships. The remedies she prescribes aren’t exotic. They are measurable and doable. That gives the subject a surprising optimism.

So if you’ve been blaming willpower for exhaustion, or treating symptoms without checking the underlying biology, consider a different story: hormones are talking to you. Are you listening?

There’s a mellow urgency to that thought — science gives you tools, and the small rituals you build make them work. The most interesting question left floating with me is how much of our identity could shift if we treated biology as a partner rather than an enemy.