The Hormone Cafe

In this episode of The Hormone Café, Dr. Sarah Pederson breaks down supplements for women’s health—how to use them strategically for hormone balance, fertility, vaginal health, and metabolism, and why more supplements is almost never better.

She walks through her testing-first, nutrition-forward philosophy, explains why random supplement stacking can backfire, and outlines how to create a personalized supplement plan that actually works—and eventually allows you to come off supplements altogether.

In This Episode, You’ll Learn:

🌱 Dr. Sarah’s Core Supplement Philosophy
Supplements should:

• Support nutrition, not replace it
• Be measured and intentional, not random
• Be used in the lowest effective dose
• Always have a goal and an exit plan

Taking 20–30 supplements because of TikTok, Instagram, or generic advice often overwhelms digestion, metabolism, and absorption—and can worsen symptoms.

🧪 Why Testing Comes First
Before recommending supplements, Dr. Sarah emphasizes testing:

• Nutrient status (antioxidants, vitamins, omegas)
• Egg quality
• Hormone production (estrogen, progesterone, testosterone)
• Metabolism and absorption

You should never take supplements that work against your hormone profile.

⚠️ When Supplements Can Make Things Worse
Dr. Sarah shares examples of supplements that can backfire:

• DIM lowering estrogen in someone already estrogen-deficient
• Probiotics worsening symptoms when taken blindly
• Egg quality supplements used unnecessarily when egg quality is already strong

Without testing, supplements can actively harm progress.

💊 Targeted Supplementation: Less Is More
Examples of precision-based supplementation:

• Low B12 → supplement only B12, not a full B-complex
• Low omega-3s → supplement omega-3, then recheck
• High omega-6s → adjust diet + omega-3 dose

If levels don’t improve, the issue may be absorption or gut health, not dosage.

🧠 Fat-Soluble vs. Water-Soluble Vitamins
Water-soluble (B vitamins, vitamin C):

• Excess is usually excreted in urine

Fat-soluble (A, D, E, K):

• Stored in the body
• Can accumulate to harmful levels
• Must be monitored regularly

Taking fat-soluble vitamins long-term without testing can impair metabolism and organ function.

🦠 Absorption, Gut Health & Fillers Matter
If supplements aren’t raising blood levels:

• Gut inflammation may be blocking absorption
• Microbiome imbalances may interfere
• Fillers or capsule materials may cause reactions

Some patients react to:

• Microcrystalline cellulose
• Silica
• Capsule binders

The issue is often the form, not the supplement itself.

🌿 Why One Supplement at a Time Is Important
Starting multiple supplements simultaneously makes it impossible to identify:

• GI reactions
• Sensitivities
• What’s actually helping

Dr. Sarah recommends introducing supplements one at a time—especially for sensitive patients.

🚫 Never Power Through a Bad Reaction
If a supplement causes:

• Stomach pain
• Nausea
• Fatigue
• Feeling “off”

Stop it.

Your body should feel better, not worse. A reaction signals:

• Incorrect dose
• Poor tolerance
• Wrong form
• Inappropriate supplement for your physiology

🧬 Egg Quality Supplements: Keep It Simple
For low egg quality, Dr. Sarah typically recommends:

• ~3 targeted supplements, not 10

Common options include:

• CoQ10 / Ubiquinol
• NAC (N-acetylcysteine)
• Glutathione
• Resveratrol
• Alpha-lipoic acid

These work best alongside nutrition and gut optimization—not in isolation.

🌸 Using Supplements to Support Hormone Production
Supplements should address why hormones are low, not just push levels:

• Omega-3s for hormone building blocks
• Protein and B vitamins
• DHEA for adrenal support (when appropriate)
• Vitex or maca in select cases

If a supplement doesn’t change lab values or symptoms, it’s discontinued.

🦠 Probiotics Are Not One-Size-Fits-All
Different guts need different species:

• Lactobacillus
• Bifidobacteria
• Saccharomyces boulardii
• Akkermansia

Taking the wrong probiotic can worsen overgrowth and symptoms.

🌿 Estrogen Metabolism & Gut Support
For estrogen dominance:

• Address beta-glucuronidase
• Increase fiber intake
• Use targeted supplements (e.g., calcium D-glucarate when indicated)

Dietary changes are often more powerful than pills.

🔄 Supplements Should Be Temporary Whenever Possible
The long-term goal:

• Restore natural production
• Optimize gut health
• Improve nutrient absorption
• Transition back to food-based support

Supplements are a bridge, not a permanent crutch.

🩺 Short-Term Supplement Use After Surgery
Example: Post-endometriosis surgery:

• Omega-3
• NAC
• Curcumin

Used for ~3 months to reduce inflammation and recurrence—then discontinued.

☕ Alternative Ways to Get Antioxidants
To reduce pill burden:

• Food (greens, berries, protein)
• Teas (green tea)
• Spices (turmeric)
• Powders and tinctures
• IV nutrients (vitamin C, glutathione, ALA)

A 360° approach minimizes daily capsule overload.

📊 Measuring Effectiveness Matters
Supplements should produce measurable change:

• Improved labs
• Better symptoms
• Objective data (e.g., CGM for blood sugar)

If it’s not working, it’s stopped.

🧾 Why Everyone Needs a Supplement Audit
Dr. Sarah recommends regularly:

• Reviewing all supplements
• Measuring what’s actually needed
• Eliminating what’s unnecessary
• Creating seasonal or short-term plans

The goal is the lowest supplement load possible while maintaining optimal health.

Key Takeaways:

• Supplements should be personalized and tested
• More is not better
• Nutrition comes first
• Supplements should improve labs and symptoms
• Bad reactions are not normal
• Every supplement plan needs a goal and an end point