The science
How the medicines we use actually work.
Plain-English explainers for the mechanisms behind our protocols. If your clinician recommends something, you should understand why — and what the evidence does and doesn't say.
How peptides work
Tiny peptides. Big cascades.
Peptides are precision signaling molecules. Your body makes them naturally — we help your cells make more of the ones you need. Each peptide triggers powerful outcomes downstream: faster recovery, calmer gut, sharper mind, and more.
How GLP-1 medications work
The hormone you make. Just more of it, longer.
GLP-1 (glucagon-like peptide-1) is a hormone your gut releases when you eat. It tells your pancreas to release insulin, tells your stomach to empty more slowly, and tells your brain you've had enough. Patients who respond to GLP-1 medication often describe a quieter relationship to food — what the community calls “food noise” getting turned down.
Compounded semaglutide, tirzepatide, and retatrutide are longer-acting analogs of that same hormone. They're given once a week (injectable) or daily (oral versions), and they extend the body's natural appetite-regulation signal from a few minutes to several days.
The escalation ladder matters — too high too fast and you get nausea or GI side effects; too low for too long and you don't reach the effective dose. Your clinician adjusts your dose monthly based on your symptoms, side effects, and labs.
How hormone therapy works
Replacing what the body stops making — at the right dose, by the right route.
In perimenopause and menopause, ovarian estrogen and progesterone production falls. The symptoms you feel — hot flashes, sleep changes, mood shifts, vaginal symptoms, brain fog — track that hormonal change. Replacing what's missing, at the right dose and via the right route, restores the signal.
The route matters: transdermal estradiol (patch or cream) bypasses first-pass liver metabolism and has a lower VTE risk than oral estradiol. Progesterone is added when a uterus is present to protect the endometrial lining. In some patients, a small amount of testosterone improves libido, energy, and mood — but dose targets stay in the upper half of the premenopausal range, never supraphysiologic.
For men, the same principle applies to testosterone replacement: identify the deficiency biochemically (two morning fasting draws), pick the right route (weekly subcutaneous, daily gel, or daily oral), monitor hematocrit and PSA, and adjust quarterly. Fertility-preserving alternatives (enclomiphene, hCG) exist for men who want to keep family-building on the table.
How thyroid therapy works
Most thyroid problems aren't solved by looking at TSH alone.
Your thyroid releases T4 (largely inactive), which your body converts to T3 (the active form) in peripheral tissues. Standard primary-care often tests only TSH and sometimes free T4 — missing the conversion step entirely.
The full thyropause panel checks TSH, free T4, free T3, reverse T3 (a marker of conversion stress), and thyroid antibodies (TPO, Tg). If your free T3 sits in the bottom of the reference range despite a “normal” TSH, you're not making enough active hormone — and a clinician who understands the picture may add T3 or natural desiccated thyroid to the regimen.
Functional-medicine targets are tighter than the standard ATA reference ranges. Your patient education should explain this clearly: New Tides uses an optimal-range framework, not a disease-or-not framework. We retest every six to eight weeks during titration so your dose tracks your body, not a textbook.