One priority, chosen for your case, with the reasoning that picked it and a four-week plan you can run.
Payment comes first, then the intake form arrives by email. I read it before any work starts.
You have five things you could change tomorrow and every one of them sounds reasonable: magnesium, or sleep timing, or more carbohydrate, or morning light, or getting the seed oils out.
Change several at once and you learn nothing, because when something shifts you will not know which lever moved it. Change them in the wrong order and the good ones fail on you. If your thyroid signal is low, magnesium will not do what it does in someone whose thyroid is fine, and you will file magnesium under things that do not work for you and never go back to it.
That order is the one thing I cannot put in an article, because it depends on you.
Picking blind has a price and it is paid in months.
One complaint, two invented readers
Both readers below are made up. Nobody has received one of these yet, so there is no client here and no outcome.
“My energy just runs out at the same hour every afternoon.”
The sentence is identical and the first move is opposite. No article can tell you which one you are, because an article is written for everyone at once.
The case below is invented: a 34-year-old with an office job, a 40-minute commute at each end of the day, and no cooking on weeknights. She asked whether to push carbohydrate up or fix her gut first. The priority chosen is neither of the two options she offered.
Worked example on an invented case. No client, no patient, no real person.
... and the two constraints you named, which are the 40 minutes of driving at each end of your day and no cooking on weeknights. What I am not accounting for is your training, because you told me it has been the same three sessions a week for two years and you do not want it touched.
Section 3 · Why this priority comes first
For the next 30 days, the thing to change is the form of the carbohydrate you already eat. Leave the amount where it is.
You asked me to choose between pushing the carbohydrate up and fixing the gut first. Neither of those is the first move.
What you told me. You added fruit and oats to fix your energy, you were bloated by evening inside a week, and you have now cut them back twice. Before that you spent four months low carb, your energy fell, and you stopped. Your first food most days is coffee at your desk around 9:40. You drink about 500 ml of milk a day and one large glass of orange juice, usually on its own.
What I judge is sitting furthest upstream. The bloating arrives in the evening from carbohydrate that went in during the day. That delay is the signature of fermentation, which means some of the fuel is not being absorbed high in the small intestine and is reaching bacteria further down instead. Amount is not the variable that decides that. Rate and form are.
Your small intestine is the first gate fruit sugar meets, and its capacity is not a fixed number. It has been measured properly in mice, where low and slow doses were cleared at roughly 90%, where one large dose overran the gate and the sugar carried on to the liver and to the bacteria, and where clearance rose when the sugar arrived with food and rose again with repeated exposure. The gate widens with use. The human work is much smaller and it does not locate that gate at all, so there is no number to stay under. A glass taken on its own and drunk fast is the hard case for it. The same sugar split into smaller servings and taken with food is the easy one. Full grades in Section 8.
Both of the things you tried land on the hard side of that. A big glass of juice on an empty stomach arrives all at once. Oats and unpeeled fruit carry their own fermentable material down the tract regardless of how well you handle the sugar.
Cutting the carbohydrate back is the move sitting in front of you, and it is the move you have already made twice. It takes the fuel out along with whatever else it takes out, and it ends with carbohydrate filed under things that do not work for you. You ran the four-month version of it and your energy fell, which is why the question you sent me is a question at all. The cost of a wrong first move is not the month it takes. It is that the lever gets crossed off and you never go back to it.
Why the other candidates wait.
What would change my mind. If the evening score has not moved by the end of week 2 while your swapped servings are running at 2 or 3 a day, then fermentable load is not the variable and the ordering above is wrong. The next thing I would look at is the 500 ml of milk. Most adults worldwide stop making much lactase after childhood, roughly two thirds of them, and that is the ordinary adult pattern rather than a disorder. Lactase is the enzyme that splits lactose, and lactose that goes unsplit ferments in exactly the way described above. Milk is something you can watch for a week against the same evening score. If the score tracks the milk and not the fruit, the priority changes and all three actions change with it. If milk is a persistent problem for you, that belongs with your clinician rather than with a swap.
Not covered here. Your thyroid numbers are a separate question and this review does not settle them. They are used above for timing, and for nothing else. Section 8 names what would settle them, and where the full analysis takes that up. Nothing in this review is a reason to start, stop or change anything a clinician has told you to do.
Section 4 · The 30-day plan
Action 1 of 3. Change the form of the carbohydrate you already eat, and hold the amount ...
Worked example on an invented case. No client, no patient, no real person.
Section 4 · The 30-day plan, Action 1 of 3
Action 1. Change the form of the carbohydrate you already eat. Hold the amount where it is.
What to do. Keep roughly the carbohydrate you are eating now and move it into forms that are absorbed high up, split across the day. Orange juice strained and split, the same daily glass taken as three servings of about a third each, with food rather than on its own. Ripe fruit peeled, or cooked, instead of raw fruit with the skin. White rice or a peeled potato instead of oats and beans on weeknights. Nothing here is added and nothing here is a supplement. The total does not go up this month.
Why this, for you. Every item on that list is either absorbed higher up the tract or arrives alongside something that raised clearance in the mouse work, so less of it carries on to where the bacteria are. Fruit sugar taken on its own barely reached stored glycogen in a tracer study, and the same sugar taken alongside glucose did. Three people were in the arm that matters there, so I am using the direction of it and not the size. Orange juice already carries the two sugars together, so what is left to change with it is the size of each serving and whether food arrives with it. The whole list also survives your week. Not one item on it needs you home before seven or standing over a stove.
The minimum version. On the days you are not up to any of it, do two things. Split the juice into three and swap the oats. Neither one needs cooking or a decision.
What to watch. The evening score, 0 to 3, at the same time every night. That is line 1 of the tracking card in Section 6. One good evening is noise, so read it by the week.
Do not add yet. No probiotics, no digestive enzymes, no antimicrobial herbs, no charcoal, and no change to your magnesium in either direction, unless a clinician has told you otherwise, in which case do what they said. Every one of those would land inside the same window as this change, and you would lose the ability to say which of them moved anything. Actions 2 and 3 have start dates on them in Section 5 for the same reason.
Action 2. Moving your first food to inside 30 minutes of waking, before the drive, with sugar and protein in it ...
Page 7 of 9 · Section 5 · Four-week map
Worked example. Invented case. No client.
Days 1 to 3, set up. Change nothing. Write down what you actually eat and score the evening, so week 4 has a baseline to read against.
Week 1, Action 1 only. The forms change. The amount does not. Actions 2 and 3 stay off.
Weeks 2 to 3, one at a time. Add Action 2 on the first day of week 2, which is moving your first real food to inside 30 minutes of waking and before the drive, with sugar and protein in it, taken out of what you already eat later in the day. Add Action 3 on the first day of week 3, which is moving the larger carbohydrate load of your day into daylight and letting the evening meal be the smaller one. They go in a week apart, so that anything that moves has a name.
Week 4, review. No new changes in this week. Read the four weekly lines together and take the day 30 decision from Section 8.
Page 8 of 9 · Section 6 · Tracking card
Worked example. Invented case. No client.
Three lines a day, and it takes under a minute. Print it or keep it in your phone.
The weekly review takes five minutes, on the same day each week. Average the seven evening scores. Count the yes days. Write one line about the week.
How to read it. A single good evening tells you nothing. What counts as a change is the weekly average falling by a full point or more across two weeks in a row while line 3 holds at 2 or 3. If line 1 falls while line 3 sits at 0, something else moved it, and that is worth knowing too.
Page 9 of 9 · Section 8 · Evidence, and where it stops
Worked example. Invented case. No client.
1. The intestinal gate. In mice, low and slow doses of fruit sugar were roughly 90% cleared by the small intestine, a large single dose overwhelmed it, and clearance rose with feeding and with prior exposure. Jang 2018, Cell Metab, PMID 29414685. Isotope tracing in mice. The gram-per-kilogram figure is a mouse dose and it does not carry across to you as a number to count against.
3. The human version. Nine healthy adults drank 30 g of fructose with 30 g of glucose, and about 14% got past first-pass extraction. Francey 2019, PMID 30661675. That 14% assumed the intestine absorbed all of the drink, so it cannot tell you an intestinal gate exists or where yours sits.
6. Where this runs out. In a randomised trial, 21 g a day of a fermentable fibre for 12 weeks lowered plasma endotoxin by about 40% while it rose 48% on placebo. Parnell 2017, PMID 28229548. That was 37 participants and a secondary analysis of stored samples. It is still what the human trial record has, and it runs against the lever you have been given. Lowering fermentable load is a conditional lever for the pattern you described, not a rule for people at large.
Entries 2, 4, 5, 7 and 8 continue, each with its species, its sample size and what it does not cover.
Worked example, written on a case I made up. Nobody has received one of these yet, so there is no client here, no patient and no outcome. The template is the one every real review will use.
What changes is your priority and the reasoning that picked it.
Labs are optional. If you have them, up to five markers from one collection date, read as part of the picture rather than as a diagnosis.
$450, paid once. One PDF of 8 to 10 pages, five working days from the day I accept your intake, and nothing recurring. The Comprehensive Metabolic Analysis, where I read every system in your case rather than the one priority you declare, is $1,500. If you move up to it later, the full $450 comes off that price, so starting here costs you nothing at the higher tier.
The roadmap, the protocol, the templates, the reading list and the DOCX live in the Comprehensive Metabolic Analysis, which reads every system in your case and runs $1,500. There are no calls at either price. What the analysis adds after the document is one check-in once the plan has been running.
There is no follow-up and no messaging, and the price reflects that. The document carries a minimum version of each action for the days you are not up to it, the two likeliest ways the plan falls over with a response to each, and three things to track so day 30 gives you something you can read rather than a feeling. If anything you are doing feels wrong, stop and speak to your clinician rather than waiting on me.
This is not written by a clinician.
This works alongside your medical care. The intake asks what you already take. If something in what you send me needs a clinician, I say so in the review. I do not tell you to start, stop or change medication, and checking anything I suggest against what you already take is your clinician's call or your pharmacist's, not mine.
You pay once. There is nothing recurring.
Payment comes first, and I read your intake before I take the work.
I read every intake before I accept it, and I only accept the ones I can answer properly. Nothing is settled at the moment you pay. It is settled after I have read what you sent. If what you send me is not a single-priority case, I refund you in full before I start any work and point you at the full analysis or at a clinician, rather than hand you something thin. The refund covers fit, not the result of following the plan.
If you are buying from inside the EEA or the UK you have the statutory right to withdraw within fourteen days. If you want me to start before that runs out, you tell me so in writing, and that is what gives it up.
The intake asks you for a question, not an answer.
You name the area you most want to decide or improve over the next 30 days, pick one of six categories, and describe how the week actually runs. If you could already name the priority with confidence you would not need anyone to read it. I do the sorting.
Several tangled problems, a full lab review, and wanting someone in the loop after the document lands are what the $1,500 analysis is for. A medication question belongs with your clinician, and I will say so rather than write around it.
You are the least neutral reader of your own body.
You were there for every day that produced the week you are living in now, so every line of your routine arrives attached to a decision you already made and you cannot read it as written. The bad sleep was the late email. The cold hands are just how you are. It is the same reason you cannot proofread your own writing. The eye supplies what it meant to say. I wrote all nineteen chapters of the book and I am still not neutral about my own week.
What you are paying for is the ordering, made by someone who is not living inside the case.
$450, paid once. One PDF of 8 to 10 pages, five working days from an accepted intake, and nothing recurring. The Comprehensive Metabolic Analysis is $1,500, and the full $450 comes off it if you move up later.
I will not promise you a health outcome. Nobody reading your case on paper is in a position to. What you get is one decision, the reasoning under it, and a way to tell at day 30 whether it moved.
Get your priority readI read every intake before I accept it. If yours is not a single-priority case, I refund you in full before I start any work.
There is no countdown on this and there is no discount coming.
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