Tom Nikkola

Hey Perimenopause

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Low Ferritin Protocol

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This protocol complements the content of my free "Common Sense Guide to Ferritin" found on my website here: https://www.tomnikkola.com/ferritin-guide . You don't use all the supplements, just those that would benefit based on the cause of the low ferritin you're dealing with, which is outlined in the guide.

Stomach Support

Because so many people are low in stomach acid and enzymes, Advanced Digestive Enzymes has been the most "life-changing" supplement across the board for my clients. This unique formulas has a significant impact on increasing the acidity of the stomach, which not only helps break down protein and fat, but a more acidic stomach also kills pathogens before they can reach the gut. If you deal with reflux or heartburn, it's almost always an issue of too little acid in the stomach, not too much. Advanced Digestive Enzymes should not be used concurrent with H2-blocking drugs and proton pump inhibitors because these drugs are intended to block the production of stomach HCl. If you're using acid-lowering medications, you may need to work with your practitioner to put a plan together so you can reduce the use of those meds, which make your stomach less acidic. Advanced Digestive Enzymes is contraindicated in patients with peptic ulcers.  And if you're dealing with other gut issues, such as dysbiosis, addressing the acidity of the stomach is a crucial first step before tackling the gut and the microbiome, or you'll just continue letting bad bacteria populate your gut. That's why I start my clients with this supplement for 4-8 weeks before moving onto gut supporting nutrition or supplement plans. Though individual needs vary, most of my clients start with using 1 capsule with each meal for the first week, and then use 2 per meal thereafter.

Bile / Gallbladder Support

Without a gallbladder, bile drips continuously into the small intestine instead of releasing in a concentrated pulse when fat hits the duodenum. The result is predictable: poor fat emulsification, fat-soluble vitamin malabsorption (A, D, E, K), loose or urgent stools, bloating after meals, and over time, a sluggish enterohepatic circulation that strains detox pathways and estrogen clearance. This trio addresses the three things a missing gallbladder can no longer do well. It supplies bile and digestive enzymes on demand, replenishes the raw material your liver needs to make bile salts, and binds excess bile acids in the colon so they don't irritate the bowel or recirculate. Thorne Advanced Digestive Enzymes, 1 to 2 capsules with each meal containing fat or protein. This formula combines ox bile, pancreatin (amylase, lipase, protease), betaine HCl, and pepsin. The ox bile compensates for the missing concentrated bile release, while the pancreatic enzymes and HCl handle the upstream digestion that often falters alongside gallbladder loss. Skip with very low-fat snacks. Avoid if you have an active peptic ulcer. Pure Encapsulations Taurine, 1 capsule (1000 mg) once or twice daily, away from meals. Taurine conjugates with bile acids in the liver to form taurocholic acid, which is more water-soluble and gentler on the gut than glycine-conjugated bile. After gallbladder removal, taurine-conjugated bile is often better tolerated and supports more efficient fat digestion and cholesterol clearance. NOW Psyllium Husk Powder, 1 teaspoon in 8 to 12 oz of water, once or twice daily, away from medications and supplements by 2 hours. Psyllium binds excess bile acids in the colon, which reduces the bile acid diarrhea many post-cholecystectomy clients experience. It also supports estrogen and toxin elimination through stool, since unbound bile can otherwise be reabsorbed and recirculated. Start with ½ teaspoon and increase as tolerated. Always take with adequate water. BodyBio TUDCA, 2 capsules once per day with food. TUDCA is a bile acid naturally formed in the body that supports the digestion and utilization of fats and oils and demonstrates neuroprotective benefits*. TUDCA supports digestive ability by supporting healthy fat metabolism and breakdown as well as proper nutrient absorption. It is also supportive to cellular and mitochondrial health.  Reassess after 4 to 6 weeks. Most clients notice steadier digestion, less urgency, and better tolerance of fat-containing meals within the first two weeks.

GLP-1 Support Protocol

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GLP-1s slow gastric emptying and decrease appetite. Even at microdoses. The supplements selected fill in micronutrient gaps, optimize the gut environment (your GLP-1 will work better), support muscle preservation, and protect skin, hair, and bone. Every supplement is practitioner-grade. The doses are intentional and the brands are vetted. You have access to all the available brands and products, so if you have a preferred brand you can make a swap.

Wake Up Rested — Fragmented Sleep

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Your quiz results identified sleep architecture disruption as your primary sleep disruptor. You're sleeping but not going deep enough to recover, spending too much time in light sleep stages and not enough in slow-wave and REM. This protocol supports GABA-A activity, core body temperature drop, and arousal threshold reduction so your brain can sustain the deep sleep cycles where physical repair, growth hormone release, and immune consolidation actually occur. Glycine is the anchor of this protocol, the evidence for its effect on slow-wave sleep depth is the strongest of any supplement here. If alcohol is part of your routine, eliminating it for 14 days will do more than any supplement on this list.