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Cyclospora. It's a quick way to lose weight, but not what I'd recommend. I keep getting asked about the "explosive diarrhea" parasite that's been all over the news this week. Since I know a lot of you are living out of coolers and gas station food at shows right now, I wanted to break down what's actually going on. The parasite is called Cyclospora cayetanensis. It causes an illness called cyclosporiasis, and while we see a handful of cases every summer, 2026 is turning i

Every horse person I know already understands a piece of nutrition science that most physicians never mention to their human patients. Feed hay before grain. Never turn a hungry horse loose on a full grain bucket with an empty stomach. Get some forage into that gut first, then let the concentrate follow. You do this because it works, and it turns out researchers have actually measured why. A 2020 study out of the Journal of Equine Veterinary Science tested exactly this...

Sweat patches, WHOOP bands, Oura Rings, and performance vests are showing up on elite World Cup athletes, and the teams deploying them have a specific goal: catch fatigue before it becomes a problem, personalize recovery, and find every possible edge. England's team has been tracking jet lag through heart rate variability. Brazil's squad wore sweat patches to dial in hydration in real time. You may even have one for your last ride, counting strides and turns and transitions.

Wondering if you might be in perimenopause? Our symptom checker can help answer this question! https://www.presencemd.net/menopausecalc The official medical definition of menopause is twelve consecutive months without a period. It is tidy. It is also completely useless if you have an IUD, a hysterectomy, an endometrial ablation, or years of hormonal birth control behind you. A significant number of women fall into exactly this category. They spend years wondering what is ha

A study published last month in Annals of Oncology followed over 160,000 adults with obesity and no diabetes. One group took GLP-1 medications like semaglutide or tirzepatide. The other group received diet and exercise counseling only. Researchers tracked who developed obesity-associated cancers over two years. People on GLP-1 medications had a 41% lower incidence of obesity-related cancers. Forty-one percent. Take a breath and let that number register, because it is a big o

Lulu's T post incident. We updated her tetanus shot. You can ride a 1,200-pound animal at full speed through a sliding stop. You wrap your horse's legs before your own. You tape your fingers, ice your knees, and push through things that would send most people home. The last time you got a tetanus booster, though? You probably cannot remember. Neither can most of my patients. Tetanus cases are rising. The people getting sick are almost entirely those who were never vaccinat

Stress management techniques Here is a truth that most weight loss programs do not want to tell you. Weight is not just about willpower. It is not just about what you eat or how much you move. It is a system. A complicated, layered, deeply personal system. If you have ever felt like you were doing everything right and still not getting the results you expected, it is probably because you were only pulling one or two of the levers available to you. At PresenceMD, we look at

It's Not Over One of the biggest hesitations I hear from people considering GLP-1 medications is the worry that you might have to take them for the rest of your life. I immediately agree with people when they share that worry. Why wouldn't we want to continue a medication that decreases your risk of heart disease, kidney disease, strokes, and many types of cancer? Of course we want to continue this medication! I think part of this worry is rooted in weight stigma. The last

Annie drunk at the vet You are standing in a barn at 6am, wrapping legs, hauling hay, running on coffee and sheer determination, and somewhere between classes you found a reel that told you to get your cortisol checked, your DUTCH test done, your vitamin D optimized, your hormones mapped, and your adrenal function evaluated. The reel had 400,000 likes and a very pretty graphic. The woman in it had a medical title that sounded official. Here is what she did not tell you: mos

My cell phone has this little widget that likes to pull old photos from my camera roll and show them to me. I love seeing pictures of my kids from years ago, a quick shot of my horse, and or a photo that makes me question what in the world I was doing and why is that still on my camera roll?? My phone served me a photo from a few years ago (before I went on a GLP1) when I was at Disney World with my family. My first thought was, "Wow. I looked a lot heavier then." My seco

Abby the cat embracing napping as her preferred wellness strategy I remember that saying from my days at the Air Force Academy. It's an homage to not working harder than you have to, and there are tons of wellness influencers out there on every social media platform telling you what you have to do to live longer. Here's a great study that actually answers the question, and it's a lot easier than you think. BLUF: An extra 5 minutes of sleep, 2 minutes of at least moderate

You swapped the sugar. You read the labels. You picked the diet soda, the sugar-free yogurt, the protein bar sweetened with erythritol. You did everything right. Except maybe you didn't. A new article in Medscape is making the rounds in the medical world, and it is one I want every single one of my patients to read. The headline says it all: "The Sweetener Trap: Are Sugar Alternatives Backfiring?" Spoiler alert -- the answer is looking more and more like yes. Here is what y

Feeding Time Let me guess. You are trying to lose weight, you are eating less than you used to, and somewhere around 2pm every day, you feel like you have been hit by a slow-moving truck. Your workouts feel harder than they should. You are losing weight, which is great, but you are not sure if what you are losing is actually fat or if your body is quietly cannibalizing the muscle you spent years building. This is where creatine comes in. Creatine is one of the most studied

Horse people are meticulous. We read labels on feed, we research farriers, we debate supplements like it's a doctoral thesis. We would never buy a generic wormer and call it good. And yet, somewhere between the tack room and the trailer, a lot of us are slapping on whatever SPF was on sale at the gas station and calling it a day. That ends now. PresenceMD is officially carrying EltaMD and PCA Skin, and we are bringing their best sellers directly to the horse shows. No dermato

Tough enough to rope with pink Wegovy and Zepbound are all the rage in the media right now because they work for weight loss. We prescribe Ozempic and Mounjaro because they work for diabetes. But a study just dropped in JAMA Network Open that made me sit up straight in my chair — and I want every woman who takes one of these medications to know about it. Breast cancer is the most common cancer in women in the United States, and if you have obesity or type 2 diabetes when yo

The prescription is the easy part There is a decent chance you have seen the ads. Hers. Ro. Found. Noom. Some version of a clean website, a smiling woman, a promise of GLP-1 medications delivered to your door in a few days after a quick online questionnaire. Maybe you have clicked on one. Maybe you have wondered if it was too good to be true. Maybe you signed up. I am not here to shame anyone for that. The healthcare system has failed a lot of people for a long time, and wh

When I was in medical school, we were told that weight loss was easy. Take in fewer calories than you expend. Eat less, move more. You just need to work harder, and weight loss is easy. What we now understand is that model is just... wrong. We have evolved over millions of years to not starve to death, and we are REALLY good at it. Our ancestors had to tolerate weeks to months of little food but still be able to walk for long distances and not die. If they couldn't do t

Some fancy fruity drink. With a flower. My kids did two years of school at home during COVID. My husband's immunosuppressed, and we really weren't sure how he would tolerate a COVID infection during those early days. Our family closed ranks, and I added yet another job to my list at the time: doctor, military commander, farmer wife, elementary/middle school teacher. One of those jobs was not my strength, and shout out to all the people who educate our children because th

If you've ever been told you don't have PCOS because your ultrasound looked fine — keep reading. After eleven years, 22,000 survey responses, and a landmark paper in The Lancet, polycystic ovary syndrome has officially been renamed polyendocrine metabolic ovarian syndrome — PMOS. More than 50 medical organizations worldwide, including the Endocrine Society, signed on. This isn't a rebranding. It's a correction. The Old Name Was Getting Women Missed PCOS was named for one fe