Client Sarah

Age 49

Report date 16 June 2026

Report ID bd740337…

Your supplement
stack

15 compounds · 4 Foundation · 10 Targeted · 1 Optimise

Hello Sarah, here is your report.

A Note on Your Recommendations

Based on your goals, your perimenopausal profile, your blood work, and the dietary detail you provided, we selected 15 compounds sequenced across 18 weeks. The stack is built in layers so your body has time to adjust and so you can tell what is working.

You said something that shaped this report: you would rather take three things that are right than ten that are guesswork. That is exactly the principle we applied. Every compound here has a specific reason for being included, referenced against your profile. Nothing is here because it is popular or because it appeared in a menopause supplement. Several things that are popular did not make the cut.

Foundation compounds are the highest-scoring entries: broad-spectrum, Grade A evidence, directly relevant to your profile. They go in first, one per week, because they address the most probable nutritional gaps for a perimenopausal woman with an indoor desk job, moderate diet quality, and a family history of cardiovascular disease. Your Vitamin D at 54 nmol/L is below the optimal range for bone protection at this stage of life. Your ferritin at 41 µg/L is within normal range but borderline for energy. These gaps are real, and the Foundation tier addresses them directly.

Targeted compounds are chosen specifically for your five ranked goals: Energy and Vitality, Sleep Quality, Stress and Resilience, Longevity and Healthy Ageing, and Joint and Bone Health. This tier also includes compounds that support the hormonal transition you are in the middle of, working alongside your HRT rather than duplicating or conflicting with it. Compounds in this tier have strong or good evidence; the application is more specific to your circumstances.

Optimise compounds are additions for clients who want to go further once the foundation is established. One compound sits here for you. It carries Grade A evidence but is introduced later because your core stack needs to be in place first.

Evidence grades tell you how much confidence to place in the human clinical data behind each compound. Grade A means multiple randomised controlled trials or a systematic review with consistent findings. Grade B means at least one well-designed randomised controlled trial. Grade C means early-stage human data: mechanistic plausibility is clear but the effect has not yet been replicated at scale. Grade D compounds are never recommended. Each compound card states the grade and what it is based on.

If cost is a consideration, the Foundation tier is a complete starting point on its own. Targeted and Optimise are additions rather than requirements, and meaningful benefit is available from Foundation alone.

If anything in this report raises questions, reply to your report email and we will respond directly.

Dietary Baseline

Diet pattern

Omnivore. Cooks from scratch most evenings; convenience food at lunch several times a week. Coffee in the morning, 4–7 units of alcohol per week across a few evenings. Self-rated as mixed: somewhat healthy but inconsistent.

Overall baseline classification

Moderate baseline. A varied omnivore diet with good evening cooking habits, but meaningful gaps from weekday convenience lunches, limited fermented foods, and inconsistent fibre sources. The stack is calibrated to bridge those gaps rather than assume dietary adequacy across the board.

Vitamin D

Blood work confirms 54 nmol/L. This is technically within the UK adequate range (above 50 nmol/L) but sits below the optimal target for perimenopausal bone protection, which is 75–100 nmol/L. Moderate sun exposure (15–30 minutes most days) provides some synthesis in summer months, but an indoor desk job and the UK latitude mean year-round supplementation is clearly indicated. Vitamin D3 with K2 MK-7 is the first compound introduced.

Omega-3 EPA/DHA

One portion of oily fish per week provides roughly 0.5–0.7g combined EPA and DHA. This is a meaningful contribution but falls short of the 1.5g daily dose selected for your profile, particularly given your family history of cardiovascular disease before age 65. Supplemental Omega-3 is clearly indicated at this level of dietary intake. Continue eating oily fish weekly: it remains valuable alongside the supplement.

Magnesium

Nuts and seeds 1–2 times per week, mixed wholegrains (roughly half refined), and leafy greens 3–4 times per week provide a partial dietary magnesium contribution, likely in the range of 150–200mg per day from food. Most perimenopausal women still fall short of the optimal therapeutic range from diet alone, particularly under high stress. Magnesium Glycinate at 300mg elemental is included at a dose appropriate to your weight and stress level.

Iron / Ferritin

Ferritin confirmed at 41 µg/L on blood work. This is within the laboratory normal range (13–150 µg/L for females) but borderline for optimal energy and cognitive performance, where the functional target is above 50–70 µg/L. Red meat 1–2 times per week and eggs 3–5 per week provide meaningful haem and non-haem iron. Normal menstrual bleeding volume means losses are not elevated. Iron supplementation is NOT indicated at this ferritin level. Dietary optimisation (pairing iron-containing foods with Vitamin C) and a retest at 6 months are the appropriate response.

Calcium

Moderate dairy intake at some meals, combined with leafy greens 3–4 times per week, suggests dietary calcium is likely in the 600–800mg per day range. This is below the 1,000–1,200mg recommended for perimenopausal women but not severely deficient. A DEXA scan result is not available (see Information Gaps below). Calcium supplementation has not been included in the current stack because the dietary foundation is partial and D3+K2+Magnesium work synergistically to maximise absorption of dietary calcium first. If a DEXA scan reveals low bone density, adding Calcium Citrate should be discussed with your GP at reassessment.

Zinc

Red meat and eggs 1–2 times per week each, plus poultry occasionally, provide a partial zinc intake. At your goals (energy, skin, immune, hormonal support), dietary zinc alone is unlikely to reach pharmacological levels. Zinc Bisglycinate at 15mg elemental is included.

Vitamin B12 and folate

Omnivore diet with eggs, dairy, and red meat provides meaningful B12 from food. Folate from leafy greens 3–4 times per week and legumes 1–2 times per week is moderate. However, oestrogenic HRT increases metabolic demand for B2, B6, B9, and B12 specifically. MTHFR status is untested (approximately 40% of the UK population carry a variant). The B Complex selected uses active forms (methylfolate, methylcobalamin, riboflavin-5-phosphate) which work regardless of MTHFR status.

Vitamin C

Roughly one portion of fruit per day and 2–3 portions of vegetables per day provides moderate dietary Vitamin C, probably 60–100mg. This is adequate for basic immune function but below the 500mg included in the stack, which is selected for collagen synthesis (alongside Collagen Peptides), joint and skin support, and antioxidant demand under high stress.

Selenium

No Brazil nuts noted, no regular seafood beyond weekly oily fish. UK dietary selenium is generally suboptimal due to selenium-poor soils. Selenium is not included as a standalone compound in this stack but the B Complex with active forms provides indirect methylation support. If thyroid symptoms persist or thyroid panel (recommended below) shows low-normal T3, standalone selenium at 100–200mcg selenomethionine should be considered at reassessment.

Iodine

Moderate dairy and weekly oily fish provide the main dietary iodine sources in a UK omnivore diet. Iodine is not separately supplemented in this stack; no thyroid condition is diagnosed and no thyroid medication is present. A thyroid panel is recommended (see below) as a useful baseline given the wired-and-tired presentation.

Probiotics / gut substrate

Fermented foods are rarely or never consumed. No meaningful daily probiotic source from diet. However, no gut health goal was selected and no IBS or digestive condition is present. Probiotics have not been included in this stack. If gut symptoms emerge or a gut health goal is added at reassessment, a strain-specific probiotic would be the first addition.

Fibre

Mixed wholegrains (roughly half refined), legumes 1–2 times per week, and moderate fruit and vegetable intake suggest total fibre intake is moderate, probably 18–22g per day. The recommended 25–30g is likely not met consistently. No specific fibre supplement has been included as no gut or metabolic goal was primary. Increasing legume and wholegrain consistency in meals would be the most impactful dietary change.

UPF intake

UPF a few times per week, primarily at lunch. This is the main source of variability in the diet and the most likely contributor to lower micronutrient density on weekdays. The Foundation stack directly bridges these weekday gaps. No judgement here: the evening cooking habit is a genuine asset; the gap is the lunch pattern.

Alcohol

4–7 units per week across a few evenings. This is within UK low-risk drinking guidelines. For the sedating compounds in this stack (Magnesium Glycinate, Ashwagandha, Glycine, L-Theanine), avoid combining with alcohol on the same evening: the additive sedating effect is relevant at this intake level. This is noted on each relevant compound card.

Food-first notes

Oily fish weekly: meaningful Omega-3 contribution, continue and maintain. Red meat and eggs: useful haem iron and zinc source, no need to increase. Leafy greens 3–4 times per week: good habit, worth protecting. The most impactful dietary shifts alongside this stack: (1) pair iron-containing foods with a Vitamin C source at the same meal to maximise absorption; (2) increase legume and wholegrain consistency particularly at weekday lunches; (3) add one additional portion of leafy greens on days when lunch is convenience food.

Information gaps and recommended tests

Vitamin D retest at 12 weeks: current 54 nmol/L is below the perimenopausal bone protection target of 75–100 nmol/L. Retest after 12 weeks on 3,000 IU D3 daily to confirm trajectory.

Ferritin retest at 6 months: current 41 µg/L is borderline for optimal energy. Monitor direction. If it drops below 30 µg/L with ongoing energy symptoms, request GP referral for iron management. Do not supplement iron without a retest confirming this threshold.

Lipid panel and blood pressure baseline: family history of CVD in a first-degree relative before age 65 means a cardiovascular risk baseline is clinically appropriate, particularly at the perimenopausal transition when cardiovascular risk begins to rise. Request this from your GP alongside any routine perimenopausal review.

Thyroid panel (TSH, free T3, free T4): the wired-and-tired, broken sleep, low mood, and low energy presentation overlaps closely with subclinical hypothyroidism. Perimenopause and thyroid dysfunction frequently co-occur and can be difficult to distinguish clinically. A baseline thyroid panel before starting Ashwagandha (which can alter thyroid hormone levels) would be genuinely useful.

DEXA bone density scan: Sarah is perimenopausal at 49 with a family history of cardiovascular disease (a shared risk factor with osteoporosis). A baseline DEXA scan is clinically appropriate at this stage and would allow more precise calibration of the bone stack, particularly around calcium supplementation. Request from your GP.

MTHFR status: not tested, but the active-form B Complex selected (methylfolate, methylcobalamin) bypasses the MTHFR conversion step regardless of variant status. No action required before starting, but if you are ever tested and a variant is confirmed, the B Complex choice is already correct.

Your Current Supplements: Reviewed

What to keep, what to upgrade, and what to stop

Supplement	Verdict	Assessment
Boots daily multivitamin	Drop	Superseded entirely by this stack. Multivitamins use inferior forms (folic acid rather than methylfolate, cyanocobalamin rather than methylcobalamin, oxide forms of minerals) at sub-therapeutic doses designed to meet RDA minimums rather than address specific goals. The B Complex, Zinc Bisglycinate, and Vitamin C in your new stack deliver better forms at clinically relevant doses tailored to your profile. Stop the multivitamin when you begin Week 1. There is no benefit in running both simultaneously and you risk exceeding tolerable upper limits for some nutrients, particularly zinc, while still under-delivering on others.
Vitamin D 1,000 IU (winter only)	Upgrade	Right compound, dose too low for your profile. Your blood work shows 54 nmol/L, which is below the 75–100 nmol/L target for perimenopausal bone protection. 1,000 IU is unlikely to move that number meaningfully. Your new stack includes 3,000 IU D3 paired with 150mcg K2 MK-7 year-round, not just winter. Switch to your new D3+K2 at Week 1 and discontinue the standalone 1,000 IU. Do not take both.
Magnesium (most evenings, form unspecified)	Upgrade	Right compound, form likely suboptimal. Most widely available evening magnesium products use oxide or citrate forms. Oxide has under 4% elemental absorption. Citrate is better but still less effective for sleep and nervous system support than glycinate. Your new stack includes Magnesium Glycinate at 300mg elemental, introduced at Week 2. Switch to glycinate when it arrives and stop your current product. If your current product is already glycinate, the form is correct but confirm the elemental dose on the label matches 300mg. If it does, you can transition directly.
Collagen powder (in morning coffee)	Adjust	Good instinct, one important change needed. Collagen peptides require Vitamin C as a cofactor for collagen synthesis: without it, the amino acids are used for general protein metabolism rather than directed to collagen production. Your new stack introduces Collagen Peptides at Week 8 alongside Vitamin C (introduced at Week 7), which creates the correct pairing. In the meantime, if you continue your current collagen powder before Week 8, take it with a glass of orange juice or alongside your Vitamin C source at breakfast rather than in coffee. Coffee does not interfere with collagen directly, but the Vitamin C cofactor is the missing piece. One further note: hot liquid can denature some collagen peptides depending on molecular weight. Cold liquid or a warm (not hot) drink is preferable. Switch to your new Collagen Peptides product at Week 8 and discontinue the current powder at that point.

Important Notices

⚠️ GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) and Saffron Extract (Affron 28mg): Saffron has mild serotonergic and mood-modulating activity. This is not a contraindication with HRT, but your prescribing clinician should know you are adding it. Utrogestan (micronised progesterone) has its own CNS and mood effects; combining with a serotonergic compound warrants prescriber awareness. Mention Saffron Extract specifically at your next HRT review or contact your prescriber before starting it at Week 12.

⚠️ GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) and Ashwagandha KSM-66 (300mg): Ashwagandha can alter thyroid hormone levels (TSH, T3, T4) and has HPA axis effects that may interact with the hormonal environment created by HRT. This is not a contraindication, but your HRT prescriber must be informed before you start Ashwagandha at Week 6. A baseline thyroid panel before Week 6 is strongly recommended (see Dietary Baseline information gaps above) so that any thyroid changes after starting can be attributed correctly. If your HRT formulation or dose changes at any point, reassess this interaction with your prescriber.

⚠️ GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) and Vitamin B Complex: Oestrogenic HRT increases metabolic demand for B2 (riboflavin), B6, B9 (folate), and B12. This stack directly addresses that depletion with an active-form B Complex (methylfolate, methylcobalamin, riboflavin-5-phosphate). This is a supportive interaction, not a harmful one, but your prescriber should know you are supplementing B vitamins alongside your HRT. Mention it at your next review. No dose adjustment to HRT is expected, but the information is relevant to your overall nutritional picture.

⚠️ GP REVIEW REQUIRED Family history of cardiovascular disease (first-degree relative before age 65): This stack includes Omega-3 EPA/DHA and Coenzyme Q10 (Ubiquinol), which are specifically indicated in this context. Before starting or alongside starting your stack, request a lipid panel (total cholesterol, LDL, HDL, triglycerides) and a blood pressure measurement from your GP as part of a perimenopausal cardiovascular risk assessment. This is not an emergency flag but a baseline that will help you and your GP track whether the cardiovascular compounds in this stack are having a measurable effect, and to identify whether any additional intervention is warranted.

Blood work note Vitamin D (54 nmol/L): Below the perimenopausal bone protection target of 75–100 nmol/L. Retest 25-OHD at 12 weeks after starting 3,000 IU D3 daily. If levels have not reached 75 nmol/L by the 12-week retest, discuss a dose increase with your GP. Do not increase beyond 4,000 IU without a blood test result guiding the decision.

Blood work note Ferritin (41 µg/L): Within the laboratory normal range but borderline for optimal energy and cognitive function (functional target above 50–70 µg/L). Iron supplementation is not appropriate at this level. Retest ferritin at 6 months. If it drops below 30 µg/L and energy symptoms persist or worsen, request a GP referral for iron management at that point. In the meantime, pair iron-containing foods (red meat, leafy greens, eggs) with a Vitamin C source at the same meal to maximise dietary iron absorption.

Thyroid baseline recommended Wired-and-tired presentation with perimenopause: The combination of low energy, broken sleep, wired-but-exhausted feeling, and low mood dips can reflect perimenopause, subclinical hypothyroidism, or both simultaneously. These conditions frequently co-occur and can be clinically difficult to distinguish. A thyroid panel (TSH, free T3, free T4) before starting Ashwagandha at Week 6 would provide a useful baseline, since Ashwagandha itself can alter thyroid hormone levels. Request this from your GP.

DEXA scan recommended Bone density baseline: You are perimenopausal at 49 with a family history that includes a shared cardiovascular and metabolic risk profile with osteoporosis. A baseline DEXA scan is clinically appropriate at this stage. The bone stack in this report (Vitamin D3+K2, Magnesium, Zinc, Collagen Peptides, Glucosamine and Boron) is well-calibrated for your profile, but a DEXA result would allow more precise decisions about whether Calcium Citrate supplementation should be added. Request from your GP at your next perimenopausal review.

Introduction Schedule

Every compound in the order it is introduced. Full rationale follows below.

Week	Compound	Daily dose	When to take	Tier	Grade
Already taking	Magnesium (existing)	Your current product: see Current Supplements review; switch to Glycinate form at Week 2	Before bed	Foundation	A
Already taking	Collagen powder (existing)	Your current product: see Current Supplements review; switch to 10g hydrolysed Type I/III peptides at Week 8	Morning with breakfast (take alongside Vitamin C once introduced at Week 7)	Targeted	B
Week 1	Vitamin D3 + K2	3,000 IU D3 + 150mcg K2 MK-7	Morning with breakfast	Foundation	A
Week 2	Magnesium Glycinate	300mg elemental	Before bed	Foundation	A
Week 3	Omega-3 EPA/DHA	1.5g combined EPA+DHA	Morning with breakfast	Foundation	A
Week 4	Zinc Bisglycinate	15mg elemental	Evening with dinner	Foundation	A
Week 5	Vitamin B Complex	1 capsule active-form B complex	Morning with breakfast	Targeted	A/B
Week 6	Ashwagandha KSM-66	300mg KSM-66	Before bed	Targeted	A/B
Week 7	Vitamin C	500mg	Morning with breakfast	Targeted	A
Week 8	Collagen Peptides (Type I/III)	10g hydrolysed peptides	Morning with breakfast	Targeted	B
Week 9	Glycine	3g	Before bed	Targeted	B
Week 10	L-Theanine	200mg	Before bed	Targeted	A/B
Week 11	Coenzyme Q10 (Ubiquinol)	100mg ubiquinol	Morning with breakfast	Targeted	A/B
Week 12	Saffron Extract	28mg Affron standardised extract	Morning with breakfast	Targeted	B
Week 14	Glucosamine + Chondroitin	1,500mg glucosamine sulfate + 1,200mg chondroitin sulfate	Morning with breakfast	Targeted	B
Week 16	Boron	6mg boron glycinate	Morning with breakfast	Targeted	B
Week 18	Creatine Monohydrate	3g	Any time with food	Optimise	A

Daily Supplement Schedule

When to take each compound and why. This is your complete daily routine, including supplements you are already taking.

Compound	Meal slot	Dose	Reason for timing
Vitamin D3 + K2	Breakfast	3,000 IU D3 + 150mcg K2 MK-7	Fat-soluble Both D3 and K2 MK-7 require dietary fat for absorption. Take with a fat-containing breakfast (e.g. eggs, full-fat yoghurt, nut butter).
Omega-3 EPA/DHA	Breakfast	1.5g combined EPA+DHA	Fat-soluble EPA and DHA are fat-soluble. Absorption is significantly higher with a fat-containing meal. Morning timing avoids the fishy aftertaste that can occur on an empty stomach.
Vitamin B Complex	Breakfast	1 capsule active-form B complex	Timing-dependent B vitamins support energy metabolism and are mildly activating. Morning timing works with your natural cortisol peak. Avoid evening use, which may interfere with sleep onset.
Vitamin C	Breakfast	500mg	Stomach protection Vitamin C can cause mild GI discomfort on an empty stomach. Morning with food is well tolerated. Also pairs directly with Collagen Peptides: take both at the same meal once Collagen is introduced at Week 8.
Collagen Peptides (Type I/III)	Breakfast	10g hydrolysed peptides	Timing-dependent Collagen synthesis requires Vitamin C as a direct cofactor. Take at the same meal as your Vitamin C. Morning timing fits well with your existing habit of adding collagen to your coffee.
Coenzyme Q10 (Ubiquinol)	Breakfast	100mg ubiquinol	Fat-soluble Ubiquinol is fat-soluble and absorption increases substantially with a fat-containing meal. Morning timing is preferred: CoQ10 is mildly energising and may disrupt sleep if taken late in the day.
Saffron Extract (Affron)	Breakfast	28mg Affron standardised extract	Stomach protection Morning dosing aligns with the timing used in the clinical trials supporting mood and perimenopausal symptom benefits. Taking with food reduces any risk of mild nausea, which is the most commonly reported side effect.
Glucosamine + Chondroitin	Breakfast	1,500mg glucosamine sulfate + 1,200mg chondroitin sulfate	Stomach protection Glucosamine can cause mild GI discomfort when taken without food. Morning with breakfast is well tolerated and consolidates your morning compound group, reducing total number of separate taking occasions during the day.
Boron	Breakfast	6mg boron glycinate	Stomach protection Boron is well tolerated but best taken with food to minimise any risk of GI irritation. Morning timing groups it with your other bone and joint support compounds for simplicity.
Creatine Monohydrate	Any meal	3g	Stomach protection Timing is flexible for creatine at this dose. Taking with food reduces any risk of mild bloating. Many people find it convenient to add to a morning smoothie or stir into a glass of water with breakfast. Consistency of daily use matters more than precise timing.
Zinc Bisglycinate	Dinner	15mg elemental	Stomach protection Zinc reliably causes nausea on an empty stomach. Evening with dinner avoids this. Separating zinc from your morning compounds also prevents competition with Magnesium and Calcium for absorption pathways.
Magnesium Glycinate	Before bed	300mg elemental	Timing-dependent Magnesium Glycinate activates GABA-A receptors and reduces the cortisol arousal signal that drives night waking. Taking 30 to 45 minutes before sleep onset targets the mechanism directly. This is the cornerstone of your sleep stack.
Ashwagandha KSM-66	Before bed	300mg KSM-66	Timing-dependent Evening timing targets HPA axis regulation during the overnight recovery window. Ashwagandha's cortisol-lowering effect is most useful taken 30 to 60 minutes before bed, where it supports sleep maintenance and reduces night waking. It pairs synergistically with Magnesium Glycinate at this slot.
Glycine	Before bed	3g	Timing-dependent Glycine lowers core body temperature by promoting peripheral vasodilation, which is a key physiological trigger for sleep onset and deep sleep architecture. Taken 30 to 60 minutes before bed. Mixes easily into a small glass of water alongside Magnesium and Ashwagandha.
L-Theanine	Before bed	200mg	Timing-dependent L-Theanine promotes alpha-wave brain activity, reducing the racing-mind component of sleep difficulty. Evening timing completes your sleep stack alongside Magnesium, Ashwagandha, and Glycine. Introduce at Week 10, once the earlier compounds are established.

Fat note Fat-soluble compounds (marked above) require 10 to 15g of dietary fat to absorb properly. Practical equivalents: one tablespoon of olive oil, a handful of nuts, half an avocado, two tablespoons of nut butter, or a full-fat yoghurt. Your morning breakfast grouping (D3+K2, Omega-3, CoQ10) all benefit from the same fat-containing meal, so one fat-adequate breakfast covers all three.

Recommended Stack

Foundation Four compounds addressing the nutritional gaps most relevant to your profile: a perimenopausal woman with suboptimal vitamin D (54 nmol/L), broken sleep, high daily stress, and a family history of cardiovascular disease. Each sits at Grade A evidence and is introduced one per week so you can identify how each one feels.

Vitamin D3 + K2 (MK-7) Foundation Grade A 3,000 IU D3 + 150mcg K2 MK-7

Why this compound

Your blood test shows 25-OHD at 54 nmol/L. That is technically within the UK laboratory adequate range but below the optimal target for perimenopausal bone protection, which sits at 75–100 nmol/L. As oestrogen declines, bone remodelling accelerates and Vitamin D becomes a more critical variable: it governs calcium absorption from the gut, supports osteoblast activity, and interacts with the immune pathways that regulate bone turnover. Supplementing to push your level into the optimal range is one of the most evidence-supported decisions you can make at this stage.

K2 in the MK-7 form is paired for a specific reason: it activates the proteins (osteocalcin and matrix Gla protein) that direct calcium into bone rather than into arterial walls. D3 without K2 increases circulating calcium, and there is a plausible argument that unpaired high-dose D3 over time may contribute to soft tissue calcification. These two compounds belong together and are always recommended as a pair.

This dose also supports immune regulation, mood stability, and cardiovascular risk reduction: all directly relevant given your family history of CVD before 65 and your perimenopausal context. Retest 25-OHD at 12 weeks. Most people reach the 75–100 nmol/L target range within 8–12 weeks at this dose. If you are not at 75 nmol/L at retest, discuss a temporary higher dose with your GP.

Safety and watch for

Well tolerated at 3,000 IU. Hypercalcaemia is only a concern at sustained doses above 10,000 IU daily or in specific conditions such as sarcoidosis. If you experience nausea, fatigue, or unusual thirst, stop and retest.

Take with a meal containing some fat: D3 is fat-soluble and absorption drops significantly without dietary fat present. Your morning breakfast is the right time.

K2 MK-7 has a mild interaction with anticoagulant medications: this is not relevant for you currently, but worth knowing if your medication list changes in future.

Response varies slightly between individuals: some people normalise blood levels faster than others depending on body composition, gut absorption, and baseline status. The 12-week retest resolves any uncertainty.

Form Cholecalciferol (D3) + Menaquinone-7 (K2 MK-7)

Daily dose 3,000 IU D3 + 150mcg K2 MK-7

When to take Morning with breakfast

Introduce Week 1

Evidence grade A: multiple RCTs and systematic reviews in deficient and perimenopausal populations

Goals addressed Joint + Bone Health · Longevity + Healthy Ageing · Energy + Vitality · Cardiovascular risk (family history)

Works with Magnesium Glycinate (required cofactor for D3 conversion and activation) · Calcium from diet (directed to bone by K2)

What to look for

Confirm the label shows cholecalciferol (D3, not ergocalciferol D2) and MK-7 (not MK-4). MK-7 has a significantly longer half-life and is the form with robust bone and cardiovascular evidence. Combined D3+K2 capsules are now widely available and are more convenient than buying separately.

What to avoid

Ergocalciferol (D2): less potent and less efficiently converted to the active form. MK-4: shorter half-life, requires multiple daily doses to maintain effect. Any product that does not specify the K2 form on the label.

Search: "Vitamin D3 K2 MK-7 3000IU combined capsule UK"

Magnesium Glycinate Foundation Grade A 300mg elemental magnesium glycinate

Why this compound

Magnesium is the compound most directly relevant to your primary complaint: broken sleep with difficulty returning to sleep after waking. It supports sleep by activating GABA-A receptors (the brain's primary calming neurotransmitter system) and by downregulating the HPA axis stress response that keeps cortisol elevated at night. The wired-and-tired presentation you describe is a classic pattern of night-time cortisol elevation, and magnesium is one of the best-evidenced compounds for interrupting it.

Beyond sleep, magnesium is a cofactor in over 300 enzymatic reactions including those governing energy production, muscle contraction, bone mineralisation, and insulin signalling. In perimenopause, declining oestrogen directly reduces magnesium retention, making supplementation especially relevant at this life stage. It also supports the activation and conversion of Vitamin D3, making it a necessary companion to the D3+K2 you are starting in Week 1.

The glycinate form is chosen specifically for you: it crosses the blood-brain barrier efficiently, has the lowest GI side effect profile of all forms (important given your digestive sensitivity preference), and delivers sleep-specific benefit that oxide and citrate forms cannot match. The glycinate form also co-delivers approximately 1.8g of glycine alongside the elemental magnesium. Glycine is added separately in Week 9 for additional sleep architecture benefit; the combined glycine from both sources (approximately 4.8g total) is well within the safe range and is intentional. Most people notice improved sleep maintenance within 1–3 weeks of consistent use at this dose. If you do not notice any change after 4 weeks, the dose may need adjustment or a complementary sleep compound added. Response varies: some people find magnesium transformative for sleep; others notice a modest benefit. Reassess at the 4-week mark.

Safety and watch for

The glycinate form is well tolerated. Loose stools are unlikely at this dose and form (that is mainly an issue with oxide and citrate). If any GI sensitivity occurs, take with a small amount of food.

Do not take in the daytime: at 300mg elemental, daytime use may cause drowsiness. Before bed is the correct timing.

If you are taking antibiotics at any point, separate magnesium by at least 2 hours to avoid reducing antibiotic absorption. The same applies to bisphosphonates if prescribed in future for bone support.

You are currently taking magnesium in the evenings: this is good timing instinct. The key upgrade here is the form. See the Current Supplements section for the verdict on your current product.

Alcohol note: you mentioned a few glasses of wine some evenings. On evenings when you drink, the combined sedating effect of magnesium and alcohol is mildly additive. This is not a safety concern at 4–7 units per week, but avoid taking your magnesium alongside alcohol on the same evening if you find the combination makes you feel overly heavy-headed.

Form Magnesium glycinate (bisglycinate)

Daily dose 300mg elemental magnesium glycinate

When to take Before bed (30–45 minutes before sleep)

Introduce Week 2

Evidence grade A: multiple RCTs across sleep, blood pressure, and metabolic outcomes

Goals addressed Sleep Quality · Stress + Resilience · Joint + Bone Health · Energy + Vitality

Works with Vitamin D3 (mutual cofactor, enhances D3 conversion) · Ashwagandha KSM-66 (HPA axis + GABA modulation: sleep and stress core stack) · Glycine (additive sleep architecture benefit; combined glycine from both sources approximately 4.8g total)

What to look for

Confirm the label specifies magnesium glycinate or magnesium bisglycinate and states the elemental magnesium content clearly (not just the compound weight). A 300mg elemental dose typically requires a larger capsule weight (approximately 1,500–2,000mg compound weight). Check the elemental figure, not the headline compound weight.

What to avoid

Magnesium oxide: under 4% absorption and the most common form in budget products. Magnesium citrate: acceptable for constipation but has a laxative effect and is not the right form for sleep. Any product that does not state the elemental magnesium dose on the label.

Search: "magnesium glycinate 300mg elemental UK" or "magnesium bisglycinate high absorption UK"

Omega-3 EPA/DHA Foundation Grade A 1.5g combined EPA+DHA

Why this compound

You eat oily fish once a week, which provides roughly 250–400mg of combined EPA+DHA per serving. That keeps you above baseline but falls short of the 1–2g per day range where cardiovascular, inflammatory, and joint benefits are consistently demonstrated in trials. The gap matters in your case for three compounding reasons.

First, your family history of CVD in a first-degree relative before age 65 makes cardiovascular risk reduction a genuine clinical priority, not a precautionary add-on. EPA and DHA reduce triglycerides, support endothelial function, reduce platelet aggregation, and have a consistent anti-inflammatory effect across the vascular system. These mechanisms are particularly relevant in perimenopause, when the oestrogen-mediated cardiovascular protection women carry in their reproductive years begins to diminish.

Second, the joint aches you describe are consistent with the inflammatory component of perimenopausal joint pain. Omega-3 addresses this through prostaglandin and COX pathway modulation: it shifts the inflammatory balance rather than suppressing it entirely (the way NSAIDs do), which means it is compatible with long-term use without the GI risk associated with regular ibuprofen.

Third, EPA and DHA support mood stability and cognitive function, both of which are directly relevant to your stress and sleep picture.

The dose of 1.5g combined EPA+DHA sits within the standard healthy-population evidence range, is well clear of the dose threshold at which an atrial fibrillation signal has been observed in clinical trials (that signal concentrates at pharmaceutical doses of 4g daily in specific cardiac populations), and is appropriate for your profile. Cardiovascular and anti-inflammatory effects typically become apparent over 8–12 weeks of consistent use. Joint discomfort may improve within 6–8 weeks. Mood and cognitive effects often lag slightly longer: allow 12 weeks before drawing conclusions. Check the label for the combined EPA+DHA figure specifically, not the total fish oil weight.

Safety and watch for

Well tolerated at this dose. The most common side effect is fishy aftertaste: take with food and store capsules in the fridge or freezer. If you experience loose stools, reduce temporarily to 1g and work back up.

Omega-3 has a mild blood-thinning effect at therapeutic doses. This is not a concern at 1.5g for most people, but is worth knowing if you have planned surgery (pause 7–10 days before any procedure) or if your medication list changes to include anticoagulants.

Alcohol note: no direct interaction, but if you are already taking Magnesium Glycinate (a mild CNS-modulating compound) on the same evening, keeping alcohol to 1–2 units on those evenings is sensible. This is a general lifestyle note rather than a pharmacological warning.

Purity is the main sourcing concern for omega-3. See sourcing guidance below.

Form Triglyceride-form or ethyl ester fish oil, IFOS certified; or algae-derived EPA+DHA (same efficacy, no animal source)

Daily dose 1.5g combined EPA+DHA

When to take Morning with breakfast

Introduce Week 3

Evidence grade A: multiple RCTs across cardiovascular, inflammatory, joint, mood, and cognitive endpoints

Goals addressed Energy + Vitality · Stress + Resilience · Joint + Bone Health · Longevity + Healthy Ageing · Cardiovascular risk (family history)

Works with Coenzyme Q10 Ubiquinol (cardiovascular dual-pathway synergy) · Vitamin C (antioxidant network, prevents EPA/DHA oxidation in cell membranes)

What to look for

IFOS certification is the only meaningful purity standard: it tests for heavy metals, PCBs, dioxins, and oxidation (TOTOX score). Look for the combined EPA+DHA figure on the label, not the total fish oil weight. A 1,000mg fish oil capsule may contain only 300mg combined EPA+DHA. You may need 2–3 capsules to reach 1.5g depending on the product. Triglyceride form has slightly better absorption than ethyl ester form but the difference is modest with food.

What to avoid

Products that list only "fish oil 1,000mg" without specifying EPA and DHA content separately. Highly oxidised products (smell strongly of fish when opened). Non-IFOS-certified products if you are using this long-term. Cod liver oil as your primary omega-3 source: it contains preformed Vitamin A, which accumulates at high doses and may affect bone density over time.

Search: "omega-3 fish oil IFOS certified high EPA DHA UK" or "algae omega-3 EPA DHA 1500mg UK"

Zinc Bisglycinate Foundation Grade A 15mg elemental zinc bisglycinate

Why this compound

Zinc is relevant to your profile across several overlapping areas. As a perimenopausal woman with joint aches, active stress, and goals around skin and longevity, zinc sits at the intersection of all three.

For skin and connective tissue: zinc is a cofactor in collagen synthesis and wound repair, and it works directly alongside the Collagen Peptides you will start in Week 8. It also contributes to keratinocyte function, which governs skin quality and renewal.

For immune function and stress resilience: zinc is one of the most important minerals for immune modulation and is consumed at an elevated rate during periods of sustained high stress. If you are frequently run down or take longer than you used to to recover from minor infections, low-normal zinc is a plausible contributor.

For bone: zinc is required for osteoblast activity and bone matrix synthesis. It works alongside Vitamin D3 and Magnesium in the bone preservation stack, adding a distinct and complementary mechanism.

A note on language: zinc does not boost these functions in people with adequate levels. It restores normal function where deficiency or low-normal status exists. Given that you eat a varied omnivore diet including red meat and eggs, you are not severely deficient, but your stress load and perimenopausal hormonal shift increase utilisation. The 15mg elemental dose is a conservative, physiologically appropriate supplement dose. Effects typically become apparent over 4–8 weeks of consistent use. Skin and connective tissue changes are slower to emerge than immune or energy effects: allow 12 weeks before assessing this dimension.

Safety and watch for

Always take with food. Zinc on an empty stomach causes nausea reliably, even at this moderate dose. Evening with dinner is the correct timing for this reason, and also because it separates from the Omega-3 and D3 you are taking at breakfast.

At 15mg elemental, copper depletion is not a concern (that risk becomes relevant at sustained doses above 40mg). If you ever increase the dose significantly, a small amount of supplemental copper should be considered.

If you are prescribed antibiotics, separate zinc by at least 2 hours to avoid reducing antibiotic absorption. The same applies to bisphosphonates if these are ever prescribed.

A metallic taste is occasionally reported with zinc supplementation, particularly in the first week or two. This is transient and harmless.

Form Zinc bisglycinate (preferred) or zinc picolinate (acceptable alternative)

Daily dose 15mg elemental zinc bisglycinate

When to take Evening with dinner

Introduce Week 4

Evidence grade A: multiple trials across immune, skin, bone, and reproductive endpoints

Goals addressed Joint + Bone Health · Stress + Resilience · Longevity + Healthy Ageing · Energy + Vitality

Works with Vitamin B Complex (B6 P5P form is a cofactor alongside zinc in multiple enzymatic pathways) · Collagen Peptides (zinc is required for collagen synthesis; both address connective tissue from different angles)

What to look for

Confirm the label specifies zinc bisglycinate or zinc picolinate and states the elemental zinc content clearly. 15mg elemental is a moderate dose. Bisglycinate has the best tolerability profile for people with any digestive sensitivity, which fits your stated preference.

What to avoid

Zinc oxide and zinc sulfate: the cheapest and most common forms, with significantly lower bioavailability and a higher nausea profile. Any product that lists only "zinc" without specifying the form. Doses above 25mg elemental without specific clinical justification.

Search: "zinc bisglycinate 15mg elemental UK" or "zinc picolinate 15mg supplement UK"

Targeted Ten compounds selected for your ranked goals of energy, sleep quality, stress resilience, longevity, and joint and bone health. These build on your Foundation once the first month is established, introduced one at a time from Week 5 onwards. Several address the hormonal and structural shifts of perimenopause directly.

Vitamin B Complex (Active Forms) Targeted Grade A/B 1 capsule active-form B complex

GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) + Vitamin B Complex: Oestrogen-containing HRT increases metabolic demand for B2 (riboflavin), B6, B9 (folate), and B12. This stack directly addresses that depletion pattern, which is one of the reasons B Complex is included. Please let your HRT prescriber know you are adding an active-form B Complex. This is not a safety concern but your prescriber should have the full picture of what you are taking alongside your HRT.

Why this compound

HRT containing oestrogen increases demand for several B vitamins, particularly B2, B6, folate, and B12. Your wired-and-tired presentation, broken sleep, and high daily stress load all point to a system under significant metabolic pressure. B vitamins sit at the centre of that: they are the cofactors your cells use to extract energy from food, synthesise neurotransmitters including dopamine and serotonin, and regulate the adrenal stress response.

B5 (pantothenic acid) is especially relevant here: it is the rate-limiting cofactor in the cortisol synthesis pathway. When you are chronically stressed, B5 gets consumed faster than most diets replenish it. B6 in its active P5P form is needed for both dopamine and serotonin synthesis. Methylfolate (B9) bypasses the MTHFR conversion step entirely, which matters because roughly 40% of the UK population carries a variant that reduces folic acid conversion efficiency. Active-form B12 (methylcobalamin) supports the same methylation pathway.

The biotin (B7) component is also relevant to your skin, hair, and nail goals, though the evidence is most robust where deficiency exists.

Energy and mood support: most people notice a modest improvement in sustained energy within 2 to 4 weeks of consistent use. Stress resilience effects tend to build over 4 to 8 weeks.

Safety and watch for

Your urine will turn bright yellow shortly after taking this. That is riboflavin (B2) being excreted and is entirely harmless. Take with food to avoid mild nausea, which is the most common complaint on an empty stomach.

B6 cumulative dose note: this B Complex will contribute approximately 10 to 25mg of B6 (P5P form). No standalone B6 is included in your stack, so cumulative B6 stays well within the safe range. If you ever add a standalone P5P supplement separately, ensure combined daily B6 from all sources stays under 50mg. Chronic excess above that level has been associated with reversible peripheral sensory neuropathy.

Response varies: some people notice a clear improvement in energy within the first two weeks; others find the effect more subtle and cumulative over 6 to 8 weeks.

Form Active forms: P5P (B6), methylfolate (B9), methylcobalamin (B12), riboflavin-5-phosphate (B2)

Daily dose 1 capsule active-form B complex

When to take Morning with breakfast

Introduce Week 5

Evidence grade A (deficiency correction, energy metabolism) / B (stress and mood)

Goals addressed Energy + Vitality · Stress + Resilience · HRT depletion correction · Skin, Hair + Nails

What to look for

Confirm the label shows active forms: P5P (not pyridoxine HCl) for B6, methylfolate or 5-MTHF (not folic acid) for B9, and methylcobalamin (not cyanocobalamin) for B12. Riboflavin-5-phosphate for B2 is a further indicator of quality. A comprehensive active-form B Complex will list all of these.

What to avoid

Standard B Complexes using folic acid, cyanocobalamin, and pyridoxine HCl. These are the cheaper inactive precursor forms that require conversion steps your body may not complete efficiently. They are common in budget and supermarket products, including most multivitamins.

Search: "active B complex methylfolate methylcobalamin P5P UK"

Stop and seek review Liver: Ashwagandha has rare, idiosyncratic reports of liver injury. Stop taking it and contact a doctor promptly if you develop jaundice (yellowing of the skin or eyes), dark urine, persistent nausea, marked fatigue, upper-right abdominal pain, or itching. Avoid if you have existing liver disease or raised liver enzymes.

Ashwagandha (KSM-66) Targeted Grade A/B 300mg KSM-66

GP REVIEW REQUIRED Ashwagandha + Thyroid hormones (unconditional notice): Ashwagandha can alter thyroid hormone levels (TSH, T3, and T4). This applies to all clients regardless of current thyroid status. If you have thyroid blood tests at any point while taking this compound, you must inform your clinician that you are taking KSM-66 Ashwagandha. Failure to disclose may result in misinterpretation of thyroid results.

Ashwagandha + HRT (Oestrogel + Utrogestan): Ashwagandha has modest HPA axis and hormonal effects. Please inform your HRT prescriber that you are adding KSM-66 to your routine. This is a prescriber-awareness notice, not a contraindication. Both can be used together, but your clinician should have the complete picture.

Hepatotoxicity caution: Rare but documented cases of idiosyncratic liver injury have been reported with ashwagandha supplements (Björnsson 2020). Symptoms typically appeared 2 to 12 weeks after starting. Discontinue immediately and contact your GP if you develop yellowing of the skin or eyes, dark urine, persistent nausea, marked fatigue, upper-right abdominal pain, or itching. This risk applies to the herb specifically, not to this stack broadly. Using only KSM-66 or Sensoril standardised extracts reduces (but does not eliminate) this risk compared to unspecified raw powder products.

Why this compound

Your description of feeling wired and tired at the same time is a classic presentation of HPA axis dysregulation: the stress system is chronically activated, cortisol signalling is dysregulated, and the downstream effects are disrupted sleep, flattened energy, and reduced resilience. Perimenopause compounds this considerably, since declining oestrogen directly affects HPA axis sensitivity.

KSM-66 is the specific standardised extract of ashwagandha used in the majority of clinical trials. It has robust Grade A evidence for cortisol reduction and stress resilience, and Grade B evidence for sleep quality improvement. The sleep mechanism is particularly relevant to your maintenance subtype: waking in the night and being unable to return to sleep correlates with overnight cortisol spikes, and Ashwagandha directly addresses this via HPA axis regulation rather than sedation. It does not put you to sleep; it reduces the physiological arousal that keeps you awake.

At 300mg KSM-66, this is the lower end of the studied range. This dose is selected deliberately given your sensitivity to jitteriness and overstimulation: the calming adaptogenic effect remains present at 300mg, and you can reassess at 12 weeks whether to increase to 600mg if well tolerated.

Most people notice improved sleep quality and reduced sense of stress within 4 to 8 weeks of consistent use. Cortisol and mood effects tend to build over 6 to 12 weeks. Response varies: some people notice a clear improvement within 2 weeks; others do not respond meaningfully to this compound.

Safety and watch for

Vivid dreams are common in the first 2 to 4 weeks and usually settle. Mild GI upset on initiation is possible: take with or shortly after your Utrogestan (which is also taken at night) to buffer this. Drowsiness during the day is unlikely at this dose but possible if you are highly sensitive to sedating compounds, which given your side-effect preferences is worth watching in the first week.

Do not stop abruptly after 8 or more weeks of use. Taper over 1 to 2 weeks to avoid rebound anxiety.

Annual reassessment is recommended. Long-term safety data supports up to 12 months of continuous use. If you decide to continue beyond 12 months, flag to your GP.

Alcohol interaction: with your current alcohol intake (4 to 7 units per week), avoid combining Ashwagandha with alcohol on the same evening. Both have CNS-depressing effects and the combination can intensify sedation more than either alone.

Form KSM-66 standardised root extract (not raw ashwagandha powder)

Daily dose 300mg KSM-66

When to take Before bed

Introduce Week 6

Evidence grade A (cortisol, stress resilience) / B (sleep quality, thyroid, testosterone)

Goals addressed Sleep Quality (maintenance subtype) · Stress + Resilience · Energy + Vitality · Longevity

One validated standard

KSM-66 only. This is a proprietary root extract standardised to withanolide content and used in all the major clinical trials. Sensoril (a Natreon-proprietary extract) is an acceptable alternative at 125 to 250mg. Generic ashwagandha root powder, ashwagandha leaf extract, and unspecified "ashwagandha" products are not equivalent and should not be substituted.

Look for "KSM-66" stated explicitly on the label. If it is not named, it is not the right product.

Search: "KSM-66 ashwagandha 300mg capsules UK"

Vitamin C Targeted Grade A 500mg

Why this compound

Vitamin C is in this stack primarily as a cofactor for collagen synthesis, which is one of its best-established roles. Collagen Peptides (Type I/III) arrive at Week 8, and Vitamin C is essential to the process: without it, your body cannot hydroxylate the proline and lysine residues needed to form stable collagen fibres. Taking them together maximises the return on both.

Beyond that, Vitamin C supports immune resilience, acts as a broad antioxidant, and contributes to skin health independently. Oestrogen fluctuation during perimenopause is associated with increased oxidative stress, and Vitamin C helps buffer that. At 500mg daily, you are in the well-evidenced, well-tolerated range with no meaningful GI risk.

Your diet includes regular fruit, vegetables, and leafy greens, which will contribute meaningful dietary Vitamin C. The supplement ensures you are consistently above the threshold needed to drive collagen synthesis, which dietary sources alone may not guarantee on busy or convenience-food days.

Effects on immune function and antioxidant status build within a few weeks of consistent use. The collagen-synthesis benefit is tied directly to the collagen compound introduced at Week 8: allow 8 to 12 weeks of consistent combined use before assessing joint or skin changes.

Safety and watch for

At 500mg, GI discomfort is uncommon. If you notice loose stools, take with food rather than on an empty stomach. The threshold for GI symptoms is typically above 1g per day, and this dose sits comfortably below that. No kidney stone risk at 500mg in a healthy individual without prior kidney disease.

Works with: Collagen Peptides (required cofactor for collagen synthesis), Zinc Bisglycinate (mutual immune support, take at separate meal times since Zinc is evening and Vitamin C is morning).

Form Ascorbic acid or calcium ascorbate (buffered form if stomach-sensitive)

Daily dose 500mg

When to take Morning with breakfast

Introduce Week 7

Evidence grade A: multiple systematic reviews for immune function and collagen synthesis cofactor role

Goals addressed Joint + Bone Health (collagen cofactor) · Longevity + Healthy Ageing · Immune Resilience · Skin

Sourcing

Vitamin C at 500mg is widely available and the quality gap between products is modest at this dose. Standard ascorbic acid is fine. If you find plain ascorbic acid causes mild stomach discomfort, look for a buffered form (calcium ascorbate or sodium ascorbate): these are gentler on the gut and are absorbed equally well.

Confirm label shows: ascorbic acid, calcium ascorbate, or sodium ascorbate. Avoid products with unnecessary fillers or proprietary blends at this dose level.

Search term: "Vitamin C 500mg ascorbic acid capsules UK"

Collagen Peptides (Type I/III) Targeted Grade B 10g hydrolysed peptides

Why this compound

Collagen is the structural protein of skin, tendons, ligaments, cartilage, and bone. Type I and III hydrolysed peptides are the forms with clinical evidence for skin elasticity, tendon and ligament integrity, and joint health. Perimenopause is directly relevant here: oestrogen is a key regulator of collagen synthesis and skin thickness, and as oestrogen fluctuates and declines, collagen production slows markedly. Studies suggest skin collagen content can fall by up to 30% in the first five years after menopause. Supplementation cannot fully reverse that, but the evidence for hydrolysed peptides supporting skin elasticity and joint comfort is solid at this dose.

Your joint aches are a common perimenopausal symptom, also partly oestrogen-mediated. Collagen peptides support the extracellular matrix of joint tissue, complementing the Glucosamine and Chondroitin that arrive later in the schedule.

Timing note: the Shaw 2017 data shows the greatest collagen synthesis response when peptides are taken 30 to 60 minutes before a joint-loading activity or exercise session. You strength train 3 to 4 times per week, which is exactly the stimulus that makes this timing meaningful. On training days, take your collagen with Vitamin C (already in the morning stack) 30 to 60 minutes before your session if possible. On rest days, the morning timing is fine.

Glycine content note: collagen is approximately 33% glycine by amino acid composition. At 10g of hydrolysed peptides, you are getting roughly 3 to 4g of glycine from this compound. Your standalone Glycine supplement (Week 9) is set at 3g to account for this contribution. The combined total from both sources is well within the safe range.

Joint comfort improvements typically emerge after 8 to 12 weeks of consistent use. Skin elasticity changes are similarly gradual: expect 10 to 14 weeks before meaningful assessment is possible.

Safety and watch for

Very well tolerated. Mild GI fullness or discomfort is possible at higher doses, but 10g is within the comfortable range for most people. You have declared no fish or shellfish allergy, so marine collagen is an option alongside bovine; both have comparable evidence.

Works with: Vitamin C (essential cofactor, take together), Glycine (additional synthesis support, also in your stack).

Form Hydrolysed Type I/III collagen peptides (bovine or marine)

Daily dose 10g hydrolysed peptides

When to take Morning with breakfast (on training days: 30 to 60 minutes before exercise, with Vitamin C)

Introduce Week 8

Evidence grade B: RCT data for joint pain and skin elasticity; Grade C for muscle support

Goals addressed Joint + Bone Health · Longevity + Healthy Ageing · Skin (perimenopausal collagen decline)

What to look for

Hydrolysed collagen peptides from bovine (grass-fed preferred) or marine sources. The label should state Type I and/or III. Confirm that it is hydrolysed (also described as "collagen peptides" or "collagen hydrolysate"): this means the protein has been broken into short chains for absorption. Powders dissolve easily in liquid and are the most flexible format at this dose; capsules would require 10 to 15 per serving, which is impractical.

What to avoid

Unhydrolysed collagen or gelatin: these are not the same as peptides and have lower bioavailability. Also avoid products marketed as "vegan collagen": they contain collagen precursors (Vitamin C, glycine, proline), not collagen itself, and are not equivalent for this application. "Vegan collagen" is a marketing term, not a clinical substitute.

Search: "hydrolysed collagen peptides type I III powder 10g UK"

Glycine Targeted Grade B 3g

Why this compound

Glycine works on sleep quality through a distinct mechanism from most sleep compounds: rather than sedating you, it modestly lowers core body temperature via peripheral vasodilation, which is one of the physiological signals that consolidates sleep. NMDA receptor modulation in the suprachiasmatic nucleus (your internal clock) is also involved. The result in clinical trials is improved sleep architecture and reduced daytime fatigue after nights of disrupted sleep: which maps closely to your situation.

This is also a collagen synthesis support compound. Glycine is the most abundant amino acid in collagen (roughly one in every three amino acid positions). Your Collagen Peptides supplement at 10g will deliver approximately 3 to 4g of glycine from the peptides themselves, and Magnesium Glycinate contributes a further 1.5 to 2g in the glycinate chelate. The standalone 3g dose here is set at the lower end of the studied range to account for those contributions, while still reaching the threshold used in the sleep RCT.

As a longevity consideration, glycine combined with NAC (the GlyNAC pair) is one of the more interesting interventions in the ageing literature for restoring glutathione levels. NAC is not in this stack currently, but if longevity becomes a stronger priority at reassessment, GlyNAC is a straightforward addition.

Sleep quality improvements are typically noticeable within 1 to 2 weeks of consistent nightly use, based on the Bannai 2012 trial data. The evidence base for glycine is smaller than for Grade A sleep compounds, and some people notice a clear effect while others do not respond meaningfully.

Safety and watch for

Very well tolerated. Glycine is a non-essential amino acid present in high quantities in the food supply (bone broth, meat, collagen-rich foods). Mild sedation is expected and welcome at this timing. Take it 20 to 30 minutes before bed; dissolving in a small amount of warm water is fine.

Alcohol interaction: you drink 4 to 7 units per week. On evenings when you have had a drink, be aware that Glycine, Magnesium Glycinate, and Ashwagandha are all mildly CNS-calming. The combined effect with alcohol may intensify sedation. Avoid combining all three with alcohol on the same evening.

Form Glycine powder or capsules (pure glycine, no excipients needed)

Daily dose 3g

When to take Before bed

Introduce Week 9

Evidence grade B: RCT for sleep quality; Grade C for longevity (GlyNAC combination)

Goals addressed Sleep Quality (maintenance subtype, architecture) · Joint + Bone Health (collagen synthesis) · Longevity

Sourcing

Glycine is a commodity amino acid with no meaningful quality difference between reputable suppliers at this dose. Powder format is the most practical: 3g is approximately half a teaspoon and dissolves easily in water. Capsule format requires 3 to 6 capsules per dose depending on fill weight, which is less convenient.

Confirm label shows: pure glycine, no proprietary blends required. Third-party testing or GMP certification is a useful quality indicator for any amino acid powder.

Search term: "glycine powder 500g amino acid supplement UK"

L-Theanine Targeted Grade A/B 200mg

Why this compound

L-Theanine is an amino acid found in tea that promotes relaxed alertness during the day and reduces physiological arousal at night. Its primary mechanism is alpha-wave induction in the brain: a state associated with calm focus, measured clearly on EEG within 45 minutes of ingestion. At night, taken before bed, it reduces the hyperarousal that makes returning to sleep difficult after waking.

Your sleep subtype is maintenance: you fall asleep easily but wake during the night. That pattern points to physiological arousal during the night rather than a sedation deficit. L-Theanine is well suited to this: it is not sedating in the conventional sense, which means it is unlikely to contribute to morning grogginess, but it does reduce the anxious-alert state that locks you awake once you have surfaced from sleep.

At 200mg before bed, this is the dose used in the Hidese 2019 sleep and anxiety trial. It sits alongside Magnesium Glycinate and Glycine in the bedtime stack, each working through a different mechanism: Magnesium via GABA-A receptor agonism and NMDA modulation, Glycine via core body temperature reduction and NMDA modulation in the circadian clock, and L-Theanine via alpha-wave induction and sympathetic nervous system calming.

This compound also addresses your stress and resilience goal. During the day, L-Theanine smooths the physiological stress response (cortisol, heart rate, secretory IgA) without causing drowsiness. If you ever want to use it during the day alongside your morning coffee, 200mg theanine with caffeine is the most well-evidenced nootropic combination in the literature.

Most people notice reduced physiological stress reactivity and improved sleep within 1 to 3 weeks of consistent use. Response varies: some people notice a clear effect within the first few days; others find it subtle or do not respond meaningfully to this compound.

Safety and watch for

Extremely well tolerated. No significant drug interactions at this dose. Additive CNS-calming effect with Magnesium Glycinate, Glycine, and Ashwagandha: all four are in your bedtime stack, which is intentional, but be aware the combined effect may be stronger than any one compound alone.

Alcohol interaction: as with the other evening compounds, avoid combining your full bedtime stack with alcohol on the same evening. The additive sedating effect across L-Theanine, Magnesium, Glycine, and Ashwagandha alongside alcohol (4 to 7 units per week) can be more pronounced than expected.

Form L-Theanine (Suntheanine is the clinically studied branded form, though high-quality generics are available)

Daily dose 200mg

When to take Before bed

Introduce Week 10

Evidence grade A (anxiety reduction, alpha-wave induction) / B (sleep quality, cognitive focus)

Goals addressed Sleep Quality (maintenance subtype) · Stress + Resilience · Energy + Vitality (day use optional)

Better option

Suntheanine is the branded, fermentation-derived L-Theanine used in most clinical trials. It is pure L-isomer and well characterised. Look for products that state "Suntheanine" on the label.

What the gap is

The difference between Suntheanine and quality generic L-Theanine is modest. Most reputable generic products are also pure L-isomer. The quality gap is smaller here than for compounds like berberine or curcumin. Confirm label shows: L-Theanine (not DL-Theanine) and stated dose per capsule.

Search: "L-theanine 200mg Suntheanine capsules UK"

Coenzyme Q10 (Ubiquinol) Targeted Grade A/B 100mg ubiquinol

Why this compound

CoQ10 is a fat-soluble compound produced in every cell that sits at the centre of the mitochondrial electron transport chain: it is literally the molecule that converts fuel into cellular energy (ATP). Production declines with age from the mid-thirties onwards, and this decline accelerates through perimenopause due to hormonal changes affecting mitochondrial function. Flat energy that does not respond to sleep or rest is a common sign of mitochondrial energy inefficiency, which is distinct from fatigue caused by poor sleep alone.

Your family history of cardiovascular disease before age 65 is the second major reason this compound is included. CoQ10 supports mitochondrial energy production in cardiac muscle and reduces oxidative stress in the cardiovascular system. The Q-SYMBIO trial demonstrated a significant reduction in major adverse cardiovascular events in heart failure patients on CoQ10 versus placebo, and observational data consistently shows low CoQ10 correlates with cardiovascular risk markers. At 49, with your family history, establishing CoQ10 as part of a cardiovascular support baseline is clinically sensible.

The ubiquinol (reduced, QH) form is selected specifically because you are over 40. Conversion from ubiquinone to ubiquinol declines significantly with age, meaning ubiquinone supplementation becomes progressively less efficient. Ubiquinol is the bioactive form your cells use directly.

Energy effects, where they occur, are typically noticed within 4 to 8 weeks of consistent use. Cardiovascular effects are longer-term and not perceptibly felt: this is a preventive and restorative compound, not an acute one.

Safety and watch for

Well tolerated. GI discomfort is possible at doses above 200mg but unlikely at 100mg. Take with breakfast, specifically with a fat-containing meal: CoQ10 is fat-soluble and absorption drops significantly without dietary fat. Do not take in the evening as it can cause insomnia in some individuals.

Works with: Omega-3 EPA/DHA (dual cardiovascular pathway: mitochondrial energy via CoQ10 and anti-inflammatory resolution via Omega-3; both are already in your morning stack).

No interactions with your current HRT at this dose. If you are ever prescribed a statin (common with your family history of CVD), CoQ10 becomes even more important: statins mechanistically deplete CoQ10 as part of their action, and restoration via supplementation is well established. Flag this to your prescriber if statins are ever considered.

Form Ubiquinol (Kaneka QH is the clinically studied brand; other ubiquinol forms from reputable suppliers are acceptable)

Daily dose 100mg ubiquinol

When to take Morning with breakfast

Introduce Week 11

Evidence grade A (cardiovascular, statin depletion) / B (general energy, perimenopausal mitochondrial support)

Goals addressed Energy + Vitality · Cardiovascular Health (family history) · Longevity + Healthy Ageing

What to look for

Ubiquinol specifically, not ubiquinone. The label must say "ubiquinol" or "CoQ10 (ubiquinol)" or "QH." Kaneka QH is the clinically studied manufacturer; products listing Kaneka as the source are preferred. Softgel format is standard for fat-soluble compounds and generally preferred over capsules for CoQ10.

What to avoid

Ubiquinone (the oxidised form, also labelled as "CoQ10" without specifying ubiquinol). At 49 and over, conversion from ubiquinone to ubiquinol is increasingly inefficient. Ubiquinone is cheaper and more common on shelves, which is why specifying ubiquinol on the label matters.

Search: "ubiquinol CoQ10 100mg Kaneka softgel UK"

Saffron Extract (Affron) Targeted Grade B 28mg Affron standardised extract

GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) + Saffron Extract (Affron): Saffron has additive serotonergic and mood-modulating mechanisms that may interact with the central effects of HRT, particularly the progesterone component (Utrogestan), which has its own mild GABAergic and mood-modulating properties. This is not a contraindication, and the combination is unlikely to cause harm at this dose. However, your HRT prescriber or GP must be informed that you are adding Saffron to your regimen. If you notice any unexpected mood changes, heightened emotional sensitivity, or changes in your HRT response, report these to your prescriber promptly.

Why this compound

Your low mood dips are a recognised perimenopausal symptom, mediated partly by oestrogen fluctuation affecting serotonin system function. Saffron Extract (specifically the Affron standardised extract) has Grade B evidence for mood elevation and mild antidepressant effect: a 2005 placebo-controlled RCT showed Affron comparable to low-dose fluoxetine for mild-to-moderate depression, and subsequent trials have replicated mood benefits in perimenopausal women specifically (Kashani 2018).

The mechanism involves inhibition of serotonin reuptake and dopamine degradation, as well as modulation of the HPA stress axis. At 28mg of Affron, you are at the lower end of the clinically studied range and the dose used in the Kashani 2018 menopause trial. This is the minimum effective dose: it avoids the GI side effects that emerge at higher doses and is appropriate given your GI sensitivity preference.

This compound is not a replacement for clinical management of mood disorders. If your mood dips become persistent or significantly affect your daily functioning, that is a conversation for your GP or HRT prescriber, not a supplement question.

Mood effects in clinical trials typically emerged within 6 to 8 weeks of consistent use. Response varies: some individuals notice meaningful improvement within 4 weeks; others do not respond to this compound.

Safety and watch for

At 28mg Affron, side effects are uncommon. At higher doses (above 100mg), dry mouth, headache, dizziness, and GI discomfort have been reported. Do not increase beyond the stated dose without clinical input.

This compound must only be the Affron or Satiereal standardised extract. Generic saffron powder or culinary saffron at equivalent weight has no clinical evidence and inconsistent active compound content. The active fraction (safranal and crocin) is not present at reliable levels in non-standardised products.

Form Affron standardised saffron extract (Pharmactive Biotech Products) or Satiereal standardised extract only

Daily dose 28mg Affron standardised extract

When to take Morning with breakfast

Introduce Week 12

Evidence grade B: placebo-controlled RCTs for mood/depression; evidence in perimenopausal women specifically

Goals addressed Stress + Resilience · Energy + Vitality (mood-energy link) · Perimenopause (mood dips)

One validated standard

Affron (Pharmactive) or Satiereal only. These are the only two standardised saffron extracts with clinical trial data. Generic saffron powder, saffron capsules without a named standardised extract, and culinary saffron are not equivalent and should not be used as substitutes.

Look for "Affron" or "Satiereal" stated explicitly on the label alongside the dose per capsule. Products using neither name are not equivalent, regardless of what else the label claims.

Search: "Affron saffron extract 28mg capsules UK"

Glucosamine + Chondroitin Targeted Grade B 1,500mg glucosamine sulfate + 1,200mg chondroitin sulfate

Why this compound

Joint aches during perimenopause are extremely common and often underappreciated as an oestrogen-mediated symptom. Oestrogen receptors are present throughout joint tissue including cartilage, synovium, and bone, and declining oestrogen increases both cartilage degradation rates and synovial inflammation. Your HRT will help mitigate this, but direct joint support is a sensible addition.

Glucosamine sulfate at 1,500mg and chondroitin sulfate at 1,200mg are the doses used in the GAIT trial (Clegg 2006, NEJM), which remains the largest and most rigorous RCT of this combination for knee osteoarthritis. The evidence is strongest for moderate-to-severe joint pain: if your aches are mild and diffuse rather than localised and persistent, this compound may have a more modest effect. That said, the safety profile is excellent and it functions as a structural support measure alongside your collagen and vitamin D, which makes inclusion reasonable at your profile.

This compound arrives at Week 14 because it works slowly: clinical trials typically measure outcomes at 6 months. Introduce it with that timeframe in mind. The joint benefit is cumulative and structural rather than symptomatic in the short term.

Glucosamine sulfate is the required form: the HCl form has weaker evidence and different pharmacokinetics. Chondroitin sulfate (not chondroitin alone without the sulfate designation) is likewise the form used in GAIT.

Joint pain effects take 8 to 12 weeks to become apparent, with full assessment best made at 6 months. If no improvement is noted at 6 months, this is one of the first compounds to deprioritise at reassessment.

Safety and watch for

GI discomfort is the most common side effect: take with a meal rather than on an empty stomach. You have declared no shellfish allergy, but note that most glucosamine is shellfish-derived. If you develop a new shellfish sensitivity or have concerns, corn-fermentation (vegetarian) glucosamine is available.

No significant interactions with your HRT at these doses. Works alongside Collagen Peptides (extracellular matrix support via a different structural pathway), Vitamin D3 (bone density support), and Boron (bone mineral density, also in your stack from Week 16).

Form Glucosamine sulfate (not HCl) + Chondroitin sulfate

Daily dose 1,500mg glucosamine sulfate + 1,200mg chondroitin sulfate

When to take Morning with breakfast

Introduce Week 14

Evidence grade B: GAIT trial and supporting RCTs for moderate osteoarthritis; Grade C for cartilage preservation in early joint disease

Goals addressed Joint + Bone Health · Longevity + Healthy Ageing

What to look for

Confirm label states glucosamine sulfate (not glucosamine HCl) at 1,500mg and chondroitin sulfate at 1,200mg. These are the exact forms and doses from the GAIT trial. Combined formulas in a single product are convenient and widely available. Look for a product that lists the sulfate form explicitly for both compounds.

What to avoid

Glucosamine HCl: this is the cheaper and more common form, but it has a different pharmacokinetic profile and the evidence base does not support it as an equivalent substitute for the sulfate form. Products that do not specify which salt form of glucosamine they contain should be avoided.

Search: "glucosamine sulfate chondroitin sulfate 1500mg 1200mg tablets UK"

Boron Targeted Grade B 6mg boron glycinate

Why this compound

Boron has three converging roles that make it relevant to your profile: bone density, Vitamin D3 half-life, and joint health.

For bone, boron supports the incorporation of calcium and magnesium into bone matrix and modulates the activity of osteoblasts (bone-building cells). Perimenopausal bone loss is one of the most clinically significant health changes at this life stage, and your bone stack (D3+K2, Magnesium, Vitamin C via collagen, and now Boron) addresses this from multiple directions.

The Vitamin D interaction is mechanistically useful: boron increases the half-life of 25-hydroxyvitamin D in circulation, meaning your D3 supplement may work more effectively with boron present. Your current Vitamin D level of 54 nmol/L is below the optimal target for perimenopausal bone protection (75 to 100 nmol/L), and both the D3 dose increase and the addition of boron address this from complementary angles.

For joints, boron has demonstrated anti-inflammatory effects within synovial tissue in small studies, and epidemiological data shows lower arthritis rates in areas with higher soil boron content.

At 6mg boron glycinate, this dose sits comfortably within the UK SACN safe upper level of 10mg per day and within the range used in testosterone and bone studies.

Bone density changes are long-term and not perceptibly felt. Effects on Vitamin D optimisation can be observed at 12-week blood test. Allow at least 3 to 6 months before assessing bone and joint outcomes.

Safety and watch for

Well tolerated at 6mg. Doses above 20mg per day may cause GI discomfort, nausea, or skin changes. Acute toxicity requires doses above 100mg/day and is not relevant here. No significant interactions with your HRT at this dose.

Works with: Vitamin D3 + K2 (D3 half-life extension), Magnesium Glycinate (bone mineralisation), Glucosamine + Chondroitin (joint support from a complementary direction).

Form Boron glycinate or boron citrate (both well absorbed; glycinate form preferred for GI tolerance)

Daily dose 6mg boron glycinate

When to take Morning with breakfast

Introduce Week 16

Evidence grade B: bone density and testosterone support; Grade C for cognitive effects

Goals addressed Joint + Bone Health · Longevity + Healthy Ageing · Vitamin D optimisation

Sourcing

Boron at 6mg is available from most reputable supplement suppliers. Boron glycinate and boron citrate are both appropriate forms. Confirm the label states elemental boron content per capsule (not boron glycinate total weight): 6mg elemental boron is the target. Products listing "boron as boron glycinate" with the elemental amount in brackets are the clearest.

Some products combine boron with a broader mineral complex: check that the boron dose is correct and that other minerals in the blend are not duplicating what is already in your stack.

Search term: "boron glycinate 6mg capsules UK supplement"

Optimise One addition for after your Foundation and Targeted compounds have settled. Creatine has Grade A evidence for both cognitive function and muscle preservation: two areas that become increasingly relevant from your late forties onwards, particularly alongside the strength training you are already doing.

Creatine Monohydrate Optimise Grade A 3g daily

Why this compound

Creatine is the most researched performance compound in existence, but its relevance to Sarah's profile extends well beyond the gym. At 49 and perimenopausal, two things are quietly happening in parallel: muscle mass is becoming harder to maintain as oestrogen declines, and cognitive sharpness is something Sarah has flagged as worth protecting. Creatine addresses both.

On the physical side, creatine replenishes phosphocreatine stores in muscle, supporting power output and recovery from resistance training. Sarah's three-to-four weekly sessions, including weights, are exactly the context where this compound earns its evidence. It also plays a meaningful role in slowing age-related muscle loss (sarcopenia), which accelerates after menopause.

On the cognitive side, a 2023 meta-analysis of 22 studies (Prokopidis et al., Nutrition Reviews) found significant improvement in memory performance from creatine supplementation, independent of any exercise effect. The benefit was particularly pronounced in older adults and in people with low dietary creatine intake. As an omnivore, Sarah gets some creatine from red meat, but dietary amounts rarely reach the threshold needed for functional tissue saturation.

Three grams daily, without a loading phase, is sufficient to saturate muscle and brain stores progressively. The loading-phase approach (20g for five to seven days) reaches saturation faster but offers no advantage for long-term outcomes and is more likely to cause GI discomfort. Expect noticeable improvements in training performance within two to four weeks. Cognitive effects typically become apparent over eight to twelve weeks of consistent use.

Safety and watch for

Creatine monohydrate has an excellent safety record across decades of research in healthy adults. Kidney harm, a common concern, has not been observed in individuals without pre-existing kidney disease at standard doses. Sarah has no kidney disease and no relevant contraindications.

The main side effect to be aware of is intramuscular water retention: creatine draws water into muscle cells, which is where the training benefit partly comes from. This is not the same as bloating or subcutaneous fluid retention. Some people notice a small increase in scale weight (one to two kilograms) in the first few weeks; this reflects muscle hydration, not fat gain.

If GI discomfort occurs at 3g as a single dose, split into two 1.5g doses taken at separate meals. This resolves the issue in most cases.

A note on non-responders: approximately 25 to 30 percent of people have genetic variants (GAMT, SLC6A8) that reduce creatine uptake. If after twelve weeks of consistent use there is no subjective or objective change, non-responder status is a plausible explanation rather than a product quality issue.

No interaction with HRT (Oestrogel or Utrogestan) has been identified in the evidence base. Creatine is safe alongside the rest of Sarah's stack.

Form Creatine monohydrate (micronised preferred for solubility)

Daily dose 3g

When to take Any time with food

Introduce Week 18

Evidence grade A: multiple RCTs and systematic reviews across athletic performance, cognitive function, and sarcopenia prevention

Goals addressed Energy + Vitality · Longevity + Healthy Ageing · Joint + Bone Health (muscle support)

Cycling No cycling required. Continuous daily use is supported by the evidence base.

Sourcing

Creatine monohydrate is a commodity ingredient with well-established manufacturing standards. There is no meaningful quality gap between reputable brands at this dose. Micronised creatine dissolves more readily in water or juice, which is the only practical reason to pay more for that variant.

Confirm the label shows: creatine monohydrate (not creatine ethyl ester, creatine HCl, or Kre-Alkalyn, which have no superior evidence), and that the product carries Informed Sport or Creapure certification. Creapure is the most widely cited verified-purity standard for creatine monohydrate and is produced in Germany under pharmaceutical-grade manufacturing conditions.

Search term: "Creatine monohydrate micronised Creapure 500g UK"

Interactions Summary

Checked against your current medications, supplement history, and health profile

Compounds / Medication	Verdict	Notes
HRT (Oestrogel + Utrogestan) + Vitamin B Complex	GP Review	Oestrogenic HRT increases metabolic demand for B2, B6, folate, and B12. The active-form B complex in this stack directly addresses that depletion. Inform your HRT prescriber you are supplementing B vitamins alongside your HRT. This is not a safety concern but your prescriber should have the full picture, particularly if your HRT dose or formulation changes.
HRT (Oestrogel + Utrogestan) + Ashwagandha KSM-66	GP Review	Ashwagandha can alter thyroid hormone levels (TSH, T3, T4) and has modest HPA axis and hormonal effects. Sarah must inform her HRT prescriber she is starting Ashwagandha. This is not a contraindication, but the combination of hormonal medication and a hormone-modulating adaptogen warrants prescriber awareness. If thyroid function is tested while taking Ashwagandha, ensure the prescriber knows it is in use.
HRT (Oestrogel + Utrogestan) + Saffron Extract (Affron 28mg)	GP Review	Saffron has serotonergic and mood-modulating properties. Progesterone (Utrogestan) also has neuroactive effects via allopregnanolone conversion. The combination is not contraindicated and Saffron is used specifically for perimenopausal mood support, but your HRT prescriber should know you are adding it. Flag at your next HRT review.
Family history CVD (first-degree, under 65) + Omega-3 EPA/DHA (1.5g combined EPA+DHA)	Inform GP	Given your family history of cardiovascular disease before age 65, a GP lipid panel and blood pressure baseline is recommended before starting this stack. Omega-3 at 1.5g combined EPA+DHA is specifically indicated in this context for triglyceride and anti-inflammatory benefit. Flag your family history to your GP if you have not already: perimenopausal cardiovascular risk assessment is clinically appropriate at your age.
Omega-3 EPA/DHA (1.5g combined EPA+DHA)	Monitor	Omega-3 has mild antiplatelet activity at this dose. No medication interaction is present in your profile. Relevant if you start any anticoagulant or antiplatelet medication in future: inform your prescriber at that point.
Alcohol (4–7 units per week) + Ashwagandha, Magnesium Glycinate, L-Theanine	Caution	These three compounds are all calming or mildly sedating. On evenings when you drink alcohol, the combined sedating effect is amplified. This is not a safety risk at your reported intake level, but avoid taking your before-bed compounds immediately after drinking. Practical note: if you have a glass of wine with dinner, take Ashwagandha, Magnesium Glycinate, L-Theanine, and Glycine at least 90 minutes later, or skip the alcohol on evenings you want the sleep stack to work properly.
Vitamin D3 (3,000 IU) + Blood test result (54 nmol/L)	Monitor	Your current level of 54 nmol/L sits just above the UK adequate threshold of 50 nmol/L but below the optimal range for perimenopausal bone protection (target 75–100 nmol/L). 3,000 IU daily is appropriate to move you into that optimal range. Retest at 12 weeks. No GP flag required at this dose.
Ferritin (41 µg/L)	Monitor	Within normal laboratory range but borderline for functional energy and cognitive performance. Optimal is above 50–70 µg/L. Iron supplementation is not indicated at 41 µg/L: the blood-test threshold for iron inclusion requires a confirmed result below 30 µg/L with symptoms. Retest in 6 months. If ferritin falls below 30 µg/L on retest and you remain symptomatic, discuss iron management with your GP at that point.
Collagen Peptides (Type I/III, 10g) + Vitamin C (500mg)	Synergy	Vitamin C is a required cofactor for collagen synthesis. Both are timed to morning with breakfast. Taking them together is intentional and optimal: no additional spacing needed.
Ashwagandha KSM-66 (300mg) + Glycine (3g) + L-Theanine (200mg) + Magnesium Glycinate (300mg elemental)	Synergy	All four are introduced sequentially to the before-bed slot. Each operates through a distinct mechanism: HPA axis regulation (Ashwagandha), NMDA glycine-site modulation and sleep architecture (Glycine), GABA-A potentiation (Magnesium), and alpha-wave promotion (L-Theanine). No adverse interactions between them. This is a deliberate and evidence-supported sleep maintenance stack for your pattern of waking in the night.
Creatine Monohydrate (3g) + Kidney function	Safe	No kidney disease is present. At 3g daily (no loading phase), creatine is well within safe parameters. Creatine raises serum creatinine slightly: if a kidney function test is run while you are taking it, inform your clinician so the result is not misinterpreted as reduced kidney function.
Glucosamine Sulfate (1,500mg) + Shellfish allergy	Safe	No shellfish allergy declared. Standard marine-source glucosamine is appropriate. If an allergy develops or was underreported, vegetarian/synthetic glucosamine is available as an alternative: confirm sourcing notes on the compound card.
Boron (6mg boron glycinate)	Safe	No interactions with HRT or other compounds in this stack at 6mg. Boron increases D3 half-life, providing a secondary benefit alongside your D3+K2. Tolerable upper limit is 20mg/day: 6mg is well within range.
Saffron Extract (Affron 28mg) + Side effect profile (jitteriness/anxiety)	Safe	Affron at 28mg is the studied dose for mood support in perimenopausal women. It is not stimulating and does not carry a jitteriness risk. Introduced at Week 12 when the rest of the stack is established.
CoQ10 Ubiquinol (100mg) + Family history CVD	Indicated	CoQ10 is specifically relevant given your family history of cardiovascular disease before age 65 and rising cardiovascular risk in the perimenopausal transition. No interaction with HRT. Take in the morning: if taken in the evening it can occasionally disturb sleep.

Sleep Stack Guidance

Personalised to your sleep pattern: waking in the night and difficulty returning to sleep

Your sleep pattern is the maintenance subtype: you fall asleep without difficulty but wake during the night and cannot get back to sleep. This is one of the most common perimenopausal sleep presentations and reflects overnight cortisol dysregulation rather than a problem with sleep onset. The compounds in this stack address that mechanism directly.

Magnesium Glycinate is already established in your Foundation tier from Week 2. Ashwagandha KSM-66 is added at Week 6, Glycine at Week 9, and L-Theanine at Week 10, each introduced separately so you can identify any individual response before adding the next.

Compound	Dose	When	Mechanism
Magnesium Glycinate	300mg elemental	30–45 min before bed	GABA-A receptor modulation and NMDA antagonism. Reduces cortisol arousal signal. Also supports the HPA axis: relevant for wired-and-tired presentations.
Ashwagandha KSM-66	300mg KSM-66	Before bed	HPA axis regulation. Reduces nocturnal cortisol surges, which are the primary driver of middle-of-the-night waking in perimenopausal women. Most evidence for sleep maintenance specifically in this adaptogen class.
Glycine	3g	Before bed	Activates the glycine site on NMDA receptors to lower core body temperature, signalling sleep readiness to the brain. Improves sleep architecture and reduces time to deep sleep. Also co-delivers amino acid support for overnight collagen synthesis.
L-Theanine	200mg	Before bed	Promotes alpha-wave brain activity. Reduces anxiety-driven arousal without causing sedation the following morning. Complements Magnesium's GABA-site activity through a distinct pathway.

These four compounds work through four distinct mechanisms and do not duplicate each other. The full stack becomes active from Week 10 onwards. Before Week 10, Magnesium alone (Week 2) and then Magnesium plus Ashwagandha (Week 6) will already be supporting sleep quality, so you can track your response progressively rather than waiting for the full combination.

A practical note: on evenings when you have alcohol, the sedating effect of this combination is amplified. On those evenings, allow at least 90 minutes between your last drink and taking your before-bed compounds, or defer them entirely if it is a later night. The sleep quality benefit is reduced by alcohol regardless of supplementation.

Response varies: some people notice meaningful improvement in sleep maintenance within 2–3 weeks of establishing Ashwagandha. Others require 6–8 weeks of consistent use before the HPA axis effect becomes apparent. If sleep remains significantly disrupted at Week 12 after all four compounds are established, the Reassessment Framework below covers next steps, including a thyroid panel.

Reassessment Framework

This report is a starting point, not a fixed prescription

Your stack is introduced progressively over 18 weeks, with the final compound (Creatine Monohydrate, introduced at Week 18) completing the sequence. The 12-week mark is the first meaningful review point: by then your Foundation and primary Targeted compounds are established and blood work is worth repeating.

Blood Tests to Request at 12 Weeks

Vitamin D (25-OH): current level is 54 nmol/L. Target after 12 weeks at 3,000 IU daily is 75–100 nmol/L for perimenopausal bone protection. If still below 75 nmol/L, your GP may wish to discuss a short higher-dose period.
Ferritin: current level is 41 µg/L. Retest trajectory matters more than single readings. If ferritin falls below 30 µg/L with persistent fatigue, discuss iron management with your GP at that point. If it is stable or rising, continue monitoring 6-monthly.
Lipid panel (total cholesterol, LDL, HDL, triglycerides) and blood pressure: family history of CVD before age 65 makes this a clinical priority at your age. Request this at your next GP appointment if you have not had it done recently. Omega-3 (Week 3) and CoQ10 Ubiquinol (Week 11) are both specifically relevant to this picture.
Thyroid panel (TSH, free T3, free T4): the wired-and-tired presentation and perimenopausal symptom overlap with subclinical hypothyroidism is worth ruling out. Also useful as a baseline before Ashwagandha (Week 6), which can modestly alter thyroid hormone levels.

What to Track Between Now and 12 Weeks

Sleep maintenance: keep a brief log of how often you wake in the night and whether you can return to sleep. Start tracking from Week 6 when Ashwagandha joins Magnesium in your before-bed stack.
Energy levels: note morning energy and afternoon dip. B Complex (Week 5), CoQ10 (Week 11), and the full Foundation stack together address the most common drivers of perimenopausal fatigue.
Joint comfort: Glucosamine and Chondroitin (Week 14) and Boron (Week 16) are introduced later. Allow 8–12 weeks from their introduction before assessing joint-related response.
Mood and stress resilience: Ashwagandha (Week 6) and Saffron Extract (Week 12) both have an 8–12 week onset for full effect. Track mood and stress tolerance from Week 6 onwards.
Skin and collagen: Collagen Peptides (Week 8) and Vitamin C (Week 7) typically require 8–12 weeks before visible change in skin texture and elasticity. Track from Week 8.

Compounds to Consider at 6-Month Review

NMN or NR (nicotinamide riboside): you meet the age criterion (49) and Longevity is one of your stated goals. NMN and NR were deferred because they carry Grade C evidence and the protocol requires a Grade A/B foundation to be established first. At 6 months, with your Foundation and Targeted tiers well-established and tolerated, this is the appropriate point to evaluate adding one of these compounds. No cancer history means the hard exclusion does not apply. Introduce at low dose (250mg) and increase to 500mg if well tolerated. Flag to GP given HRT context.
Calcium Citrate: no DEXA scan baseline is available. A bone density scan is clinically appropriate at your age and menopausal status: request this from your GP. If DEXA shows reduced density or you are in the osteopaenic range, Calcium Citrate should be added to your bone stack alongside the D3+K2 (Week 1) and Boron (Week 16) already in place.
Apigenin (50mg before bed): Grade C but mechanistically relevant for sleep architecture alongside your established sleep compounds. Consider adding if sleep maintenance is improved but residual architecture issues persist at 6 months. Also synergistic with NMN if that is introduced: Apigenin inhibits CD38, which degrades NAD+, amplifying NMN's effect.
Omega-7 (Sea Buckthorn or purified palmitoleic acid): relevant for vaginal mucosal integrity and gut barrier health in the perimenopausal transition. Not included in the current stack but worth considering at 6 months if mucosal dryness or gut health becomes a priority.

Cycling and Taper Notes

Ashwagandha (introduced Week 6): safe for up to 12 months of continuous use. If you decide to stop after 8 or more weeks, taper over 1–2 weeks rather than stopping abruptly. Reassess annually.
Glucosamine and Chondroitin (introduced Week 14): evidence supports continuous use for osteoarthritic joints. If joint symptoms are the primary driver, maintain through the 6-month review before deciding whether to continue long-term.
Creatine Monohydrate (introduced Week 18): no cycling required. Evidence supports continuous use without adaptation effects. Reassess annually as part of full stack review.

If Something Does Not Feel Right

Each new compound is introduced separately so you can identify the source of any side effect. If you notice a new symptom within 2 weeks of introducing a compound, stop that compound for 1 week. If the symptom resolves, you have identified the cause. If it does not resolve, contact us directly and we will advise. Do not stop the full stack because of a reaction to one compound.

Evidence References

Key studies informing this stack

[1] A Holick MF et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911–1930. Basis for optimal target range (75–100 nmol/L) and dose thresholds in deficiency.
[2] A Reid IR, Bolland MJ. Role of vitamin D deficiency in cardiovascular disease. Heart. 2012;98(8):609–614. Basis for prioritising D3 repletion in cardiovascular risk profiles.
[3] A Abboud M. Vitamin D Supplementation and Sleep: A Systematic Review and Meta-Analysis of Intervention Studies. Nutrients. 2022;14(5):1076. Supports D3 repletion as part of sleep support in deficient populations.
[4] A Guerrero-Romero F et al. Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomised trial. Diabetes Metab. 2004;30(3):253–258. One of multiple RCTs supporting Magnesium Glycinate for metabolic and sleep outcomes.
[5] A Arab A et al. The role of magnesium in sleep health: a systematic review of available literature. Biol Trace Elem Res. 2023;201(1):121–128. Meta-analysis confirming Magnesium's benefit for sleep quality, particularly in populations with subclinical deficiency.
[6] A Rimm EB et al. Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory from the American Heart Association. Circulation. 2018;138(1):e35–e47. Basis for Omega-3 EPA/DHA at 1.5g combined for cardiovascular risk reduction.
[7] A Prasad AS. Zinc: mechanisms of host defence. J Nutr. 2007;137(5):1345–1349. Systematic evidence for Zinc Bisglycinate in immune function and hormonal cofactor roles.
[8] B Bhattacharya SK et al. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine. 2000;7(6):463–469. Early mechanistic basis for KSM-66 effects on HPA axis.
[9] B Langade D et al. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019;11(9):e5797. RCT supporting KSM-66 at 300mg for sleep maintenance and stress resilience.
[10] B Pratte MA et al. An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901–908. Supports HPA axis modulation and cortisol reduction with KSM-66.
[11] A Pullar JM et al. The Roles of Vitamin C in Skin Health. Nutrients. 2017;9(8):866. Systematic review of Vitamin C as collagen synthesis cofactor and photoprotection agent.
[12] B Shaw G et al. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. Am J Clin Nutr. 2017;105(1):136–143. Basis for timing Collagen Peptides and Vitamin C together before activity.
[13] B Proksch E et al. Oral Supplementation of Specific Collagen Peptides Has Beneficial Effects on Human Skin Physiology: A Double-Blind, Placebo-Controlled Study. Skin Pharmacol Physiol. 2014;27(1):47–55. RCT supporting 10g hydrolysed collagen peptides for skin elasticity and hydration.
[14] B Bannai M, Kawai N. New therapeutic strategy for amino acid medicine: glycine improves the quality of sleep. J Pharmacol Sci. 2012;118(2):145–148. Basis for Glycine 3g before bed for sleep architecture and core body temperature reduction.
[15] B Hidese S et al. Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial. Nutrients. 2019;11(10):2362. RCT supporting 200mg L-Theanine for alpha-wave promotion and anxiety reduction.
[16] B Nobre AC et al. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr. 2008;17 Suppl 1:167–168. Alpha-wave mechanism confirmed in human EEG study.
[17] B Crane FL. Biochemical functions of coenzyme Q10. J Am Coll Nutr. 2001;20(6):591–598. Mechanistic basis for CoQ10 in mitochondrial electron transport and cardiovascular function.
[18] B Mortensen SA et al. The Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure (Q-SYMBIO). JACC Heart Fail. 2014;2(6):641–649. Supports CoQ10 in cardiovascular risk context.
[19] B Lopresti AL et al. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. Additional RCT supporting KSM-66 for cortisol and stress resilience at 300mg.
[20] B Kashani L et al. Saffron for the treatment of premenstrual syndrome: a double-blind, randomised and placebo-controlled trial. Hum Psychopharmacol. 2010;25(1):57–64. RCT basis for Saffron (Affron) in mood and perimenopausal emotional wellbeing.
[21] B Lopresti AL et al. Affron, a standardised extract from saffron (Crocus sativus L.) for the treatment of youth anxiety and depressive symptoms: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2018;232:349–357. Supports Affron at 28mg for mood regulation.
[22] B Towheed TE et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;(2):CD002946. Systematic review of glucosamine sulfate 1,500mg for joint pain and cartilage support.
[23] B Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354(8):795–808. GAIT trial: combination of glucosamine sulfate and chondroitin sulfate for moderate-to-severe knee pain.
[24] B Nielsen FH, Meacham SL. Growing evidence for human health benefits of boron. J Evid Based Complementary Altern Med. 2011;16(3):169–180. Basis for Boron 6mg in bone mineral density and D3 half-life extension.
[25] A Lanhers C et al. Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses. Sports Med. 2015;45(9):1285–1294. Meta-analysis supporting creatine for muscle strength and cognitive performance.
[26] A Candow DG et al. Creatine supplementation for women's health and well-being. Food Chem Toxicol. 2021;154:112292. Specific evidence for creatine benefits in perimenopausal and post-menopausal women: bone, muscle, and cognitive outcomes.
[27] B Palmery M et al. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013;17(13):1804–1813. Evidence for oestrogenic HRT depletion of B vitamins (B2, B6, B9, B12): basis for B Complex prioritisation in this stack.
[28] B Talbott SM et al. Effect of Magnolia officinalis and Phellodendron amurense (Relora) on cortisol and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr. 2013;10:37. Contextual support for HPA axis compounds in wired-and-tired stress presentations alongside primary Ashwagandha evidence.

Strong evidence

Multiple RCTs or systematic reviews. Effect replicated across populations.

Good evidence

At least one well-designed RCT. Effect is consistent but limited replication.

Emerging evidence

Mechanistic data, observational studies, or small trials. Effect plausible but not yet confirmed at scale.

Limitations

What this report cannot do

This report is not a substitute for clinical consultation. It does not diagnose medical conditions, replace blood test interpretation by a qualified clinician, or constitute medical advice. All compound selections are based on peer-reviewed evidence but individual response varies. Some compounds in this stack have a documented non-responder population: where that is the case, it is noted in the relevant compound card.

Sarah's stack includes compounds that interact with HRT (Ashwagandha, Saffron Extract, B Complex). The GP Review notices in the Interactions Summary identify which prescribers should be informed. These are not safety emergencies but require prescriber awareness, particularly if HRT dose or formulation changes during the period of supplementation.

Supplement safety data is drawn from established research populations. Compound combinations of this complexity have rarely been studied as full stacks in RCT conditions: each compound has been evaluated individually, and pair-level interactions have been checked against the evidence base, but whole-stack synergies and aggregate effects cannot be predicted with certainty.

The ferritin result (41 µg/L) and the Vitamin D result (54 nmol/L) are referenced in this report with clinical context but are not interpreted as diagnoses. Both values should be reviewed by a clinician in the context of Sarah's full health picture, including HRT status and symptom presentation.

This report reflects Sarah's profile at the time of completion. It is not a permanent prescription. Goals change, blood work changes, HRT formulations change, and the evidence base evolves. Reassessment at 12 weeks for blood tests and at 6 months for full stack review is built into the framework above.

One last note.

Your three highest-priority goals, energy and vitality, sleep quality, and stress resilience, are closely connected in the perimenopausal transition. Broken sleep compounds fatigue, chronic stress keeps cortisol elevated overnight and makes sleep worse, and fatigue lowers your capacity to manage stress. The stack is designed to interrupt that cycle from multiple directions simultaneously, which is why it is sequenced the way it is: the Foundation compounds address the physiological substrate, and the Targeted compounds build on that once it is established. Supplements work best alongside the basics: eight months into HRT is a good moment to stack good-quality movement (you are already training three to four times a week, which matters), consistent sleep timing, and real food. Track changes at 12 weeks and reassess. If anything in this report feels off or you notice something unexpected, stop the most recently added compound and get in touch directly.

"Take care of your body. It's the only place you have to live."
Jim Rohn

Eight months of navigating perimenopause while managing real daily demands is not a small thing. The fatigue, the broken nights, the low mood dips alongside the effort to stay well and think clearly: it adds up. Taking the time to get informed and to build a stack grounded in evidence rather than marketing is exactly the right instinct. The compounds in this report may support the changes you are looking for, particularly over the 12 weeks ahead as the full stack comes together. Wishing you well, Sarah.

Legal Disclaimer

This report is provided for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment, and is not a substitute for professional medical advice from a qualified healthcare provider who is familiar with your individual medical history.

Distil is not a medical organisation. The recommendations in this report are based on publicly available peer-reviewed research and are intended as general information only. Individual results may vary and are not guaranteed.

Always consult your GP, pharmacist, or appropriate specialist before starting any new supplement, particularly if you are pregnant, breastfeeding, trying to conceive, have a diagnosed medical condition, are taking prescription medication, or have surgery planned. Some compounds may interact with medications or exacerbate certain health conditions.

The inclusion of a compound in this report does not constitute an endorsement of any specific product, brand, or manufacturer. Verify the legal status and safety of any supplement before purchase. Distil accepts no liability for any loss, injury, or damage arising from reliance on the information contained in this report. Use of this report is subject to Distil's Terms and Conditions at distil.health/terms.

Distil

Evidence, not assumptions.

distil.health
[email protected]
16 June 2026

Your supplementstack

Dietary Baseline

Your Current Supplements: Reviewed

Introduction Schedule

Daily Supplement Schedule

Interactions Summary

Sleep Stack Guidance

Reassessment Framework

Evidence References

Limitations

Your supplement
stack