Why do I feel off but my tests are normal? - Ep. 69 - I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.In this episode, Dr. Alvarez addresses one of the most common and frustrating experiences women face during perimenopause: feeling “off” even when their labs come back normal. If you’ve ever been told “everything looks fine,” “it’s just stress,” or “this is just aging” — while still feeling tired, anxious, foggy, wired, or not like yourself — this episode reframes those symptoms as signals worth taking seriously.Dr. Alvarez explains why normal lab results do not always tell the full story, especially during perimenopause, when estrogen levels can fluctuate dramatically from one day to the next. These hormonal shifts can affect the brain, blood vessels, metabolism, nervous system, inflammation, cholesterol, sleep, and cardiovascular risk.With clarity and urgency, she breaks down:Why estrogen is more than a reproductive hormone — and how it affects the brain, blood vessels, metabolism, and heartWhy perimenopause can make women feel anxious, foggy, tired, wired, and unlike themselvesWhy “normal labs” may miss hormonal fluctuation and early physiologic changesWhy perimenopause can begin in the late 30s and 40sWhat women should consider evaluating beyond basic labs, including:Hormonal patterns, including estradiol, progesterone, testosterone, free testosterone, thyroid markers, and cortisolCardiometabolic markers such as fasting glucose, hemoglobin A1c, fasting insulin, and insulin resistanceAdvanced lipid markers including LDL, HDL, triglycerides, non-HDL cholesterol, ApoB, and lipoprotein(a)Blood pressure and vascular health, including ambulatory blood pressure monitoring when appropriateBody composition, including waist circumference, visceral fat, body fat percentage, and lean muscle massInflammation markers such as high-sensitivity C-reactive protein, homocysteine, and ferritinDr. Alvarez also shares why these symptoms matter from a prevention standpoint. Perimenopause is not just about symptoms — it can be a critical window to detect early cardiovascular risk before it becomes disease.This episode is a direct call-to-action for women who have been dismissed, minimized, or told to ignore what their body is signaling. Becoming the CEO of your own health starts with asking better questions, understanding what should be evaluated, and taking symptoms seriously before they become something more.Visit NitzaMD.com Follow @NitzaMD on Instagram and Facebook