Client Sarah

Age 49

Report date 3 July 2026

Report ID 5a4b3c2d…

Your supplement
stack

11 compounds · 4 Foundation · 6 Targeted · 1 Optimise

Hello Sarah, here is your report.

A Note on Your Recommendations

Based on your goals, your perimenopausal status, your HRT regimen, the blood work you shared, and the dietary detail you provided, this report contains 11 compounds, sequenced over 11 weeks. Every one of them earned its place by scoring against your specific profile. Nothing is here because it appeared on a menopause gummies label.

You said you would rather take three things that are right than ten that are guesswork. That instinct is correct, and it shaped how this stack was built. The 11 compounds here are the ones with the clearest evidence for your circumstances: perimenopause, broken sleep, flat energy, joint protection, and long-term bone and cardiovascular health. Several compounds that scored reasonably in the initial assessment were left out because the stack already covered their function more efficiently.

Foundation compounds are the four highest-scoring entries across your profile. They go in first, one per week, because they address the most likely nutritional gaps for someone with your lifestyle, your ethnicity, your indoor desk job, and your perimenopausal stage. Vitamin D is the clearest example: your blood test puts you at 54 nmol/L, which is technically sufficient by NHS standards but meaningfully below the 75 to 100 nmol/L range associated with bone density protection, mood stability, and immune regulation. Getting that right is the first priority.

Targeted compounds are chosen specifically for your ranked goals: Energy and Vitality, Sleep Quality, Stress and Resilience, and the bone and skin protection you flagged as important now that your oestrogen is settling. These are introduced from Week 5 onward, once the foundation is established. The evidence for each one in your context is strong, and each is directly relevant to something you told us matters to you.

Optimise compounds are additions for when the foundation and targeted stack is established and tolerated. There is one compound in this tier: Saffron Extract, introduced at Week 11. It carries Grade B evidence, which is good evidence, but its application here is more targeted: low mood dips, the interaction between mood and sleep in perimenopause, and early longevity support. It is introduced last because it also requires the most careful prescriber awareness given your HRT.

Evidence grades are printed on every compound card so you always know what you are looking at. Grade A means the effect has been demonstrated in multiple randomised controlled trials or a systematic review, replicated across populations. Grade B means at least one well-designed randomised controlled trial with consistent findings. Grade C means early-stage human data: the mechanism is plausible and the early results are interesting, but replication at scale has not yet happened. Grade C compounds are always flagged as emerging evidence. There are no Grade C compounds in this stack. There are never any Grade D compounds in any Distil report.

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. Coffee in the morning. A glass of wine a few evenings a week. Self-rated as mixed: somewhat healthy but inconsistent.

Vitamin D

You report 15 to 30 minutes outdoors most days, which is a meaningful contribution in summer months. However, at UK latitude, this is insufficient to maintain optimal 25-OH vitamin D from October through April, and your blood test confirms it: 54 nmol/L is technically within the NHS sufficient range but below the 75 to 100 nmol/L associated with bone protection and mood stability. Year-round D3 supplementation is clearly indicated, particularly given your perimenopausal status and desk-based work environment. Dietary D is negligible at normal intake levels.

Omega-3 (EPA/DHA)

You eat oily fish roughly once a week. This provides approximately 0.5 to 0.7g of combined EPA and DHA per week, which is a partial contribution but well below the 1 to 2g per day associated with cardiovascular, inflammatory, and mood benefits. Given your family history of CVD before age 65, supplemental Omega-3 at a measured dose is clearly warranted alongside weekly oily fish.

Iron and ferritin

Your ferritin is 41 µg/L: within the NHS normal range but below the 50 µg/L threshold associated with optimal energy, cognitive function, and hair health. You eat red meat one to two times a week and eggs three to five times a week, which are meaningful haem-iron sources. At 49 with normal menstrual bleeding and perimenopause, this low-normal reading is worth monitoring. Iron supplementation is not indicated at this level without confirmed deficiency, but dietary optimisation is sensible: pair iron-rich foods (red meat, lentils, leafy greens) with Vitamin C to improve absorption. Recheck ferritin at 12 weeks.

Calcium

You consume dairy at some meals, which provides a meaningful calcium contribution (typically 600 to 800mg per day from moderate dairy intake). You also eat leafy greens three to four times a week. Dietary calcium is likely adequate for baseline needs. Supplemental calcium is not included in this stack on that basis. The focus is instead on optimising D3, K2, and Magnesium to direct and activate the calcium you are already consuming into bone. If your diet changes or a bone density scan is requested, this should be revisited.

Magnesium

Nuts and seeds one to two times a week, roughly equal whole and refined grains, and legumes one to two times a week suggest a moderate but not optimal dietary magnesium intake. Most people in the UK do not reach the optimal range from diet alone, and stress, alcohol, and HRT can all increase magnesium demand. Supplementation at the stack dose is appropriate.

Vitamin B12 and B vitamins

As an omnivore eating eggs, dairy, and meat, your dietary B12 is likely adequate. However, transdermal oestrogen (Oestrogel) increases metabolic demand for B2, B6, B9 (folate), and B12, consistent with the depletion mechanism documented with oral contraceptives. The active-form B Complex in this stack addresses that gap directly, using P5P (active B6), methylfolate (active B9), and methylcobalamin (active B12) rather than the inferior synthetic forms in most generic supplements.

Folate

Leafy greens three to four times a week and legumes one to two times a week provide a moderate folate contribution from diet. Your MTHFR status is unknown. The B Complex in this stack uses methylfolate (5-MTHF), the active form that bypasses the MTHFR conversion step entirely. This is appropriate regardless of your MTHFR status: if you do carry the C677T variant, the active form is essential; if you do not, it is simply better absorbed than folic acid. No separate folate supplement is needed.

Zinc

Red meat one to two times a week, white meat one to two times a week, and eggs three to five times a week provide a reasonable dietary zinc base. The supplemental dose in this stack (15mg elemental bisglycinate) is at the lower end of the therapeutic range: sufficient for immune, hormonal, and skin goals without overcrowding dietary intake.

Vitamin C

Four to seven portions of fruit per week and two to three portions of vegetables per day is a moderate intake. Vitamin C from diet alone is unlikely to consistently reach the levels needed to act as a collagen synthesis cofactor alongside the Collagen Peptides in this stack, particularly on busier days with convenience food. The 500mg supplemental dose ensures a reliable daily contribution and doubles as an iron absorption enhancer alongside iron-rich meals.

Selenium and iodine

You eat fish weekly and moderate dairy: dietary iodine is likely adequate. You do not report eating Brazil nuts regularly, so selenium is not at risk of excess from diet. Selenium is not included in this stack (no thyroid goal flagged), but if a thyroid panel comes back with subclinical hypothyroidism at 12 weeks, it becomes a higher-priority addition.

Gut microbiome and fermented foods

You rarely or never eat fermented foods, which means your dietary probiotic input is minimal. Probiotics are not in this stack because gut health was not a ranked goal and there is no IBS or digestive condition flagged. However, if energy or mood does not improve as expected, gut microbiome support is worth considering at reassessment, particularly given the HRT, moderate alcohol, and UPF intake.

Ultra-processed food and alcohol

You rely on convenience food at lunch a few times a week and consume four to seven units of alcohol per week. Both patterns increase demand for B vitamins (particularly B1 and B6), Magnesium, and Zinc. The stack addresses these gaps directly. The alcohol note is also relevant to timing: Magnesium Glycinate, Ashwagandha, Glycine, and L-Theanine are all taken before bed. On evenings when you have wine, the additive sedating effect with Utrogestan (which has GABAergic properties) and these compounds means you should avoid taking them on the same evening as alcohol, or at minimum give yourself a two-hour gap. Each relevant compound card includes a specific note on this.

Overall baseline classification

Moderate. Your diet has genuine strengths: you cook from scratch most evenings, eat a variety of protein sources, and include leafy greens and fruit regularly. The gaps are predictable for a busy 49-year-old: inconsistent micronutrient intake at lunch, low fermented food exposure, and oestrogen-driven B vitamin depletion that diet alone is unlikely to compensate for. This stack is designed to bridge those gaps precisely, not to replace good food choices.

Your Current Supplements: Reviewed

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

Supplement	Verdict	Assessment
Boots Daily Multivitamin	Drop	Superseded by this stack. Multivitamins use synthetic, poorly absorbed forms of B vitamins (folic acid rather than methylfolate, cyanocobalamin rather than methylcobalamin) at doses too low to be therapeutic for any specific goal. This stack delivers the same nutrients in active, bioavailable forms at clinically relevant doses. Stop the multivitamin when you begin Week 1, to avoid doubling up on fat-soluble vitamins and to keep your daily protocol clean and attributable.
Vitamin D 1,000 IU (winter use)	Upgrade	Right compound, dose too low, form needs confirming. Your blood test shows 54 nmol/L, which is below the 75 to 100 nmol/L range appropriate for your perimenopausal status and bone health goals. 1,000 IU is unlikely to move the needle meaningfully at this baseline. At Week 1, switch to the stack's Vitamin D3 + K2 combination at 3,000 IU D3 paired with 150mcg K2 MK-7. K2 is not in your current product and is important: it directs calcium to bone and away from arterial walls, which matters increasingly after menopause. Stop the standalone D and switch to the combined product at Week 1.
Magnesium (evening, for sleep)	Upgrade	Right compound, right timing, form almost certainly needs upgrading. Most general magnesium supplements use oxide or carbonate, which have under 4 to 10% absorption and cause loose stools at higher doses. The stack uses Magnesium Glycinate at 300mg elemental, which is well absorbed, gentle on the gut, and crosses the blood-brain barrier to support the GABAergic relaxation effect relevant to your sleep maintenance problem. At Week 2, switch to the glycinate form and stop your current product. If your current product already states glycinate on the label, you are on the right form: simply adjust the dose to 300mg elemental and continue.
Collagen powder (in morning coffee)	Adjust	Likely the right compound but two issues need addressing. First, collagen dissolves in hot liquid but the heat does not destroy the peptides, so adding it to coffee is fine. However, Vitamin C is an essential cofactor for collagen synthesis: without it, the amino acids from collagen peptides cannot be effectively incorporated into skin, tendon, and joint matrix. If your current product does not include Vitamin C, you need to pair it. From Week 5 of this stack, Vitamin C at 500mg is introduced: take both together in the morning for the synergistic effect. Second, the form matters: the stack specifies 10g hydrolysed Type I/III peptides specifically. At Week 6, confirm your current product matches this specification. If the label does not state "hydrolysed collagen peptides" (sometimes called "collagen hydrolysate"), switch to a product that does. Marine or bovine sources are both appropriate. Continue your existing collagen from now, add Vitamin C from Week 5, and review the product label when the stack collagen card gives you full sourcing guidance at Week 6.

Important Notices

⚠️ GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) + Ashwagandha KSM-66: Ashwagandha can alter thyroid hormone levels (TSH, T3, and T4) and modulates the HPA axis (cortisol regulation). There is no direct pharmacokinetic interaction with estradiol gel or micronised progesterone, but any herb that influences the endocrine axis should be disclosed to your HRT prescriber. This matters practically: if your mood, energy, or sleep changes after starting Ashwagandha, your GP needs to know it is in the picture so they can attribute the change correctly rather than adjusting your HRT dose unnecessarily. Because your thyroid panel has not been tested, a baseline TSH before starting Ashwagandha (Week 7) is advisable. Please request this at your next GP appointment and mention that you plan to start Ashwagandha. If hypothyroidism is confirmed, come back to this report: Selenium becomes a higher-priority addition.

⚠️ GP REVIEW REQUIRED HRT (Oestrogel + Utrogestan) + Vitamin B Complex: Oestrogen-containing HRT, including transdermal estradiol, increases metabolic demand for B2, B6, B9 (folate), and B12 through the same mechanism as oral contraceptives. B Complex supplementation is directly supportive and appropriate for this reason. However, your prescriber should be aware you are taking it so that any future blood work, particularly B12 and folate levels, is interpreted correctly. B Complex will raise your circulating B levels, which is the point, but a clinician unaware of supplementation might misread a high-normal B12 result. Mention it at your next HRT review.

⚠️ GP REVIEW REQUIRED HRT (Utrogestan micronised progesterone 100mg nightly) + Saffron Extract (Week 11): Saffron has mild serotonergic and mood-modulating properties. Utrogestan has established CNS and GABAergic effects, and some women report mood sensitivity on it. The combination is not contraindicated, and Saffron is being added here specifically to support the low mood dips you have described as part of your perimenopausal experience. However, because both compounds act on mood and the CNS through different but overlapping pathways, your HRT prescriber should be aware before you start Saffron at Week 11. If any antidepressant is ever added to your regimen in future, return to this report immediately: that changes the Saffron picture significantly.

Blood Work: Retest at 12 Weeks Vitamin D (25-OH): Your current level is 54 nmol/L. Target range for your profile: 75 to 100 nmol/L. Retest at 12 weeks on 3,000 IU D3 daily. If still below 75 nmol/L at 12 weeks, dose may need to increase to 4,000 IU with your GP's awareness. Do not increase the dose without retesting first.

Ferritin: Your current level is 41 µg/L. This is within the NHS normal range but below the 50 µg/L threshold associated with optimal energy and cognitive function. Recheck at 12 weeks. Iron supplementation is not included in this stack at this ferritin level. If ferritin falls below 30 µg/L, GP-managed iron supplementation becomes appropriate. In the meantime, pair iron-rich meals (red meat, lentils, leafy greens) with Vitamin C to improve absorption: the 500mg Vitamin C in this stack taken at breakfast will contribute if you have an iron-containing meal at that time.

Thyroid panel (TSH, Free T4): Not yet tested. Your symptoms (fatigue, broken sleep, wired-and-tired pattern) overlap significantly with subclinical hypothyroidism as well as perimenopause. Because Ashwagandha can alter thyroid hormones, a baseline TSH before starting it at Week 7 is advisable. Request this at your next GP appointment alongside the HbA1c and fasting lipids below.

HbA1c and fasting lipid panel: Not yet tested. Your family history of cardiovascular disease before age 65 makes these relevant, particularly as oestrogen withdrawal in perimenopause is associated with rising LDL and insulin resistance. Request both at your next GP appointment. The stack already addresses CVD risk through Omega-3, and the B Complex supports homocysteine methylation, but a baseline lipid panel will tell you whether additional support (such as Berberine or CoQ10) is warranted at 12 weeks.

Alcohol and Evening Compounds Four of the compounds in this stack are taken before bed: Magnesium Glycinate, Ashwagandha, Glycine, and L-Theanine. All four have mild CNS-calming effects. Utrogestan (micronised progesterone 100mg nightly) already has GABAergic properties. On evenings when you have wine, avoid taking your bedtime compounds at the same time as alcohol: the additive sedating effect of all three together can be more pronounced than any one alone. Either take your bedtime compounds before your first drink (at least two hours earlier) or skip them on that evening. Each compound card includes a specific note on this.

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	Boots Multivitamin	Current product	Stop when your new stack begins at Week 1. Superseded by this personalised stack.	Current	:
Week 1	Vitamin D3 + K2 MK-7	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 forms: P5P, methylfolate, methylcobalamin)	Morning with breakfast	Targeted	A/B
Week 5	Vitamin C	500mg	Morning with breakfast	Targeted	A
Week 6	Collagen Peptides	10g hydrolysed Type I/III	Morning with breakfast	Targeted	B
Week 7	Ashwagandha KSM-66	300mg KSM-66	Before bed	Targeted	A/B
Week 8	Glycine	3g	Before bed	Targeted	B
Week 9	L-Theanine	200mg	Before bed	Targeted	A/B
Week 11	Saffron Extract (Affron)	28mg standardised (Affron)	Morning with breakfast	Optimise	B

Daily Supplement Schedule

When to take each compound and why.

Compound	Meal slot	Dose	Reason for timing
Vitamin D3 + K2 MK-7	Breakfast	3,000 IU D3 + 150mcg K2 MK-7	Fat-soluble Both D3 and K2 are fat-soluble. Taking with a meal containing fat (eggs, yoghurt, nut butter) meaningfully improves absorption.
Omega-3 EPA/DHA	Breakfast	1.5g combined EPA+DHA	Fat-soluble Fat-soluble. Morning with food reduces the risk of fishy reflux and improves absorption. Pairs naturally with D3 + K2 at the same meal.
Vitamin B Complex	Breakfast	1 capsule (active forms: P5P, methylfolate, methylcobalamin)	Stomach protection B vitamins can cause nausea on an empty stomach. Morning timing also supports daytime energy metabolism without interfering with evening wind-down.
Vitamin C	Breakfast	500mg	Timing-dependent Taken with breakfast alongside Collagen Peptides (from Week 6) to act as a cofactor for collagen synthesis. Vitamin C is water-soluble and absorbed efficiently with food.
Collagen Peptides	Breakfast	10g hydrolysed Type I/III	Timing-dependent Taking hydrolysed collagen with Vitamin C at the same meal maximises collagen synthesis. Mix into your morning coffee or a smoothie alongside Vitamin C. Your existing collagen powder is replaced by the upgraded form from Week 6.
Saffron Extract (Affron)	Breakfast	28mg standardised (Affron)	Stomach protection Morning dosing allows the mild mood-modulating effect to act across the day. Taking with food reduces the small risk of GI sensitivity.
Zinc Bisglycinate	Dinner	15mg elemental	Stomach protection Zinc taken without food can cause nausea. Evening dinner slot also separates it from the morning Vitamin C dose, which at 500mg does not meaningfully compete, but spacing is a cleaner habit. Kept away from the morning cluster to simplify that meal slot.
Ashwagandha KSM-66	Before bed	300mg KSM-66	Timing-dependent Evening dosing targets the HPA axis during its overnight recovery phase, supporting cortisol normalisation and sleep maintenance. Taken alongside Utrogestan (micronised progesterone), both of which have calming CNS effects: avoid alcohol on the same evening.
Magnesium Glycinate	Before bed	300mg elemental	Timing-dependent Magnesium activates GABA-A receptors and supports NMDA modulation. Timing to 30 to 45 minutes before sleep onset maximises its calming and sleep-maintenance benefit. Pairs with Ashwagandha and Glycine in the bedtime stack. Avoid alcohol on the same evening.
Glycine	Before bed	3g	Timing-dependent Glycine lowers core body temperature via peripheral vasodilation, a mechanism that promotes deeper sleep architecture. Dissolves easily in a small glass of water. Taken at the same time as Magnesium Glycinate and Ashwagandha as part of the bedtime sleep stack. Note: Magnesium Glycinate co-delivers approximately 1.5 to 2g of glycine at this elemental dose, so the combined glycine from both sources is around 4.5 to 5g total, which is within the established safe and effective range.
L-Theanine	Before bed	200mg	Timing-dependent L-Theanine promotes alpha-wave brain activity and reduces sleep-onset anxiety without sedation. Added to the bedtime stack at Week 9 once Magnesium Glycinate, Ashwagandha, and Glycine are established, so any effect on sleep quality can be attributed clearly. Avoid alcohol on the same evening.

Fat note Fat-soluble compounds (marked above) require 10 to 15g of dietary fat to absorb properly. Practical equivalents at breakfast: a tablespoon of olive oil on eggs, a handful of nuts, half an avocado, two tablespoons of nut butter, or full-fat yoghurt. Your morning coffee with a collagen stir-in works well here if you add a fat source alongside it.

Recommended Stack

Foundation Four compounds addressing your two most measurable gaps: a Vitamin D level that is below the optimal range for bone and immune health, and the broken sleep and high stress load that perimenopause has compounded. Each scores Grade A evidence and is safe alongside your HRT. One new addition per week from Week 1.

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

Blood work Your Vitamin D (25-OH) is currently 54 nmol/L. This sits just inside the NHS sufficient range but below the 75–100 nmol/L associated with optimal bone density, immune function, and mood support. Given your perimenopausal status, family history of cardiovascular disease, and primarily indoor working pattern, optimising to that higher range is appropriate. Retest at 12 weeks and share the result with your GP. The target is 75–100 nmol/L; if the 3,000 IU dose has not moved you there, titration upward can be discussed with your prescriber.

Why this compound

Your blood work shows a meaningful gap between your current level and where the evidence places optimal function for bone protection, immune regulation, and mood stability. A desk-based indoor role with moderate UK sun exposure means dietary and sun sources are unlikely to close that gap on their own, particularly across autumn and winter months.

K2 MK-7 is paired here for a specific reason: as D3 increases calcium absorption, K2 directs that calcium to your bones rather than allowing it to deposit in soft tissue or arteries. The two work together as a single unit. Bone protection is a stated priority for you at this stage, and this pairing is the mechanistic foundation of that goal. Studies in perimenopausal and post-menopausal women consistently show that the D3 and K2 combination outperforms D3 alone for bone mineral density.

At your dose, Vitamin D also supports immune modulation, has a documented inverse relationship with cardiovascular risk markers relevant to your family history, and plays a role in the mood regulation pathways disrupted during perimenopause. Blood levels typically take 8–12 weeks to rise meaningfully at this dose. Retest 25-OH Vitamin D at 12 weeks before adjusting. Most people notice no immediate effect: this is a slow, sustained correction, not an acute compound.

Safety and watch for

Well tolerated at 3,000 IU. Hypercalcaemia is only a realistic concern at sustained doses above 10,000 IU daily, and only then if Magnesium is not also present (it is, in this stack). Nausea is occasionally reported if taken without food. Always take with a fat-containing meal.

K2 MK-7 at 150mcg has no significant interaction with your HRT. If you are ever prescribed a Vitamin K antagonist such as warfarin in future, flag K2 to your prescribing clinician immediately, as it can affect anticoagulation monitoring. This is not currently relevant to your medication profile.

Alcohol (4–7 units per week): no specific interaction at this dose.

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 Vitamin D optimisation · Bone protection · Immune modulation · Mood · Cardiovascular risk reduction

Works with Magnesium Glycinate (required for D3 conversion and activation) · Collagen Peptides (bone matrix support) · Omega-3 EPA/DHA (cardiovascular synergy)

What to look for

A combined D3 + K2 capsule in a single product is more convenient and typically better value. Confirm the label shows: cholecalciferol (not ergocalciferol D2), and MK-7 specifically (not MK-4, which has a much shorter half-life and requires multiple daily doses to maintain blood levels). The dose per capsule should match your target: 3,000 IU D3 and 100–150mcg K2 MK-7. Oil-based softgels or capsules with an oil carrier absorb better than plain powder tablets.

What to avoid

Ergocalciferol (D2): it is less potent at raising and maintaining serum 25-OH D than D3 and has a shorter biological half-life. MK-4 form of K2: requires 3x daily dosing to maintain levels; impractical for a once-daily protocol. Tablets without a fat carrier: poorly absorbed. Products listing K2 without specifying the form.

Search: "Vitamin D3 K2 MK-7 3000IU 150mcg supplement UK"

Magnesium Glycinate Foundation Grade A 300mg elemental magnesium

Why this compound

Broken night sleep and the 'wired and tired' pattern you describe are both closely tied to magnesium status. Magnesium is required for over 300 enzymatic reactions, including those governing cortisol clearance, GABA receptor activation (the primary calming neurotransmitter system), and muscle relaxation. Perimenopausal women frequently show depleted magnesium levels, partly because oestrogen influences magnesium distribution and partly because stress and disrupted sleep compound the depletion cycle.

The glycinate form is selected specifically for your goals. Glycinate binds magnesium to the amino acid glycine, which itself has independent sleep-supporting properties. The form crosses the blood-brain barrier more reliably than citrate or oxide, and it is gentler on the digestive system, which matters given your stated preference to avoid GI discomfort.

At 300mg elemental magnesium, this dose also co-delivers approximately 1.8g of glycine from the glycinate bond itself. When you add standalone Glycine to the stack at Week 8 (3g), the combined glycine from both compounds will be around 4.8g. This is intentional and safe: glycine has no established upper limit for harm, and the combination at this level is consistent with the research on sleep architecture. The overlap is noted so you understand the design, not because it requires any adjustment. Most people notice improved sleep quality within 1–2 weeks. The cortisol-modulating effects that reduce the 'wired' feeling tend to become more apparent over 3–4 weeks of consistent use. Response varies: some people find this one of the most immediately effective additions to their routine; a smaller group does not respond meaningfully to magnesium supplementation despite adequate dosing and form.

Safety and watch for

At 300mg elemental magnesium glycinate, loose stools are unlikely (the oxide and citrate forms are far more likely to cause this). If any digestive looseness occurs in the first week, try taking it with a small snack rather than on an empty stomach.

Daytime drowsiness: this is a before-bed compound. Taking it in the morning or midday is not appropriate for the glycinate form in this context.

Alcohol (4–7 units per week): both Magnesium Glycinate and Utrogestan (your progesterone) have mild CNS-calming effects. On evenings when you have had a glass of wine, the combination of alcohol, Utrogestan, and Magnesium Glycinate will feel more sedating. This is not dangerous at 1–2 units but worth being aware of. Avoid taking Magnesium Glycinate at the same time as a second or third drink on the same evening.

If you ever take antibiotics: a 2-hour gap between Magnesium Glycinate and any antibiotic (particularly tetracyclines or quinolones) is required to prevent absorption interference.

Form Magnesium Glycinate (bisglycinate): chelated form

Daily dose 300mg elemental magnesium

When to take Before bed

Introduce Week 2

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

Goals addressed Sleep quality (maintenance) · Stress and cortisol regulation · Bone health (cofactor) · Energy · Blood pressure

Works with Vitamin D3 (mutual cofactors, enhance each other's activation) · Ashwagandha (HPA axis + GABA modulation: core sleep and stress pair) · Glycine (co-delivery from glycinate bond adds to standalone Glycine at Week 8 for combined sleep architecture support)

Sleep stack Yes: primary compound for sleep maintenance subtype

What to look for

Confirm the label reads magnesium bisglycinate or magnesium glycinate (these are the same compound). The dose stated on the label must be in elemental magnesium, not total compound weight: a 500mg capsule of magnesium bisglycinate delivers only around 50–60mg elemental magnesium, so you may need 4–5 capsules to reach 300mg elemental. Check the label carefully. Some products state elemental magnesium clearly; others bury it. If unclear, look for "elemental" in small print or contact the supplier.

What to avoid

Magnesium oxide: under 4% absorption, primarily a laxative rather than a therapeutic magnesium source. Magnesium citrate: acceptable absorption but more likely to cause loose stools than glycinate, and less suited to the before-bed timing you need. Products that list magnesium without specifying the compound form.

Search: "magnesium bisglycinate 300mg elemental UK"

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

Why this compound

You eat oily fish roughly once a week. That puts your dietary EPA and DHA intake at around 300–500mg combined per week, or 40–70mg per day: well below the level at which anti-inflammatory, cardiovascular, and joint-protective effects are consistently demonstrated in trials. At 1.5g combined EPA+DHA daily, this stack brings you to the evidence-supported general health range.

Your family history of cardiovascular disease before age 65 makes this a high-priority addition. Omega-3 at this dose reduces triglycerides, supports healthy endothelial function, and has a well-documented anti-inflammatory effect that is directly relevant to joint health, another of your stated goals. The post-menopausal transition markedly increases cardiovascular risk as oestrogen's protective lipid effects reduce, and your HRT is not fully compensating for this shift.

Omega-3 is also one of the better-studied compounds for perimenopausal mood support and cognitive function. The EPA component specifically modulates inflammatory pathways linked to mood, and DHA contributes to neuronal membrane integrity relevant to staying sharp as you age.

A note on the dose: the 1.5g combined EPA+DHA figure on the manifest reflects your profile carefully. Your oily fish intake contributes an additional daily average, so 1.5g supplemental puts total daily intake in a solid evidence range without reaching the higher pharmaceutical doses where a small atrial fibrillation signal has been observed in specific subgroups. You have no prior arrhythmia history and no relevant cardiac structural risk, so this caution does not apply to you specifically, but the manifest dose is considered appropriate regardless. Inflammation and triglyceride markers typically shift over 6–8 weeks of consistent use. Joint ache improvements, where present, are usually noticed between 4 and 12 weeks. Mood-related effects, if they occur, tend to emerge over 6–8 weeks. Effects are modest-to-moderate rather than dramatic.

Safety and watch for

The most common side effect is a fishy aftertaste or burp. Taking the capsule with food and refrigerating the bottle (or buying enteric-coated capsules) largely eliminates this.

At 1.5g combined EPA+DHA, there is a mild antiplatelet (blood-thinning) effect. This is not a concern at your current medication profile, but if you are ever prescribed anticoagulants or have surgery scheduled, flag Omega-3 to your surgical team at least one week in advance.

Alcohol (4–7 units per week): no direct interaction at this dose, but both alcohol and Omega-3 have mild blood-thinning properties. No action needed at your alcohol level, but worth knowing.

Your HRT does not interact with Omega-3. There is no pharmacokinetic concern with estradiol gel or micronised progesterone at this dose.

Form Triglyceride or re-esterified triglyceride form (rTG): highest bioavailability. Ethyl ester (EE) form is acceptable if rTG is unavailable.

Daily dose 1.5g combined EPA+DHA (check the label for this figure specifically, not the total fish oil mg)

When to take Morning with breakfast

Introduce Week 3

Evidence grade A: extensive RCT and meta-analytic evidence across cardiovascular, inflammatory, and cognitive outcomes

Goals addressed Cardiovascular risk reduction · Joint inflammation · Mood support · Brain health and cognition · Longevity

Works with Vitamin D3 (cardiovascular synergy) · Collagen Peptides (joint anti-inflammatory complement) · Vitamin C (antioxidant network supporting EPA/DHA function in cell membranes)

What to look for

The label must state the combined EPA and DHA content per serving in milligrams: this is the only number that matters. A product labelled "1,000mg fish oil" may deliver as little as 300mg combined EPA+DHA. You are looking for a product that delivers 1,500mg (1.5g) of EPA+DHA combined across one or two capsules. Look for IFOS certification on the packaging: this is the only independent purity standard that tests for heavy metals, PCBs, dioxins, and oxidation levels. Triglyceride form (labelled "rTG" or "triglyceride form") is preferred for absorption.

What to avoid

Products that list only "fish oil Xmg" without stating EPA and DHA content separately. Ethyl ester form without food: the EE form requires dietary fat for absorption and is 30–50% less bioavailable than the triglyceride form on an empty stomach. Oxidised fish oil (rancid smell when capsule is opened): reduces benefit and may increase oxidative burden.

Search: "IFOS certified omega-3 1500mg EPA DHA triglyceride form UK"

Zinc Bisglycinate Foundation Grade A 15mg elemental zinc

Why this compound

Zinc sits at an intersection of several of your goals. It is a cofactor in collagen synthesis, immune regulation, wound healing, and skin integrity, all of which are increasingly relevant during perimenopause as oestrogen's supportive role in these processes reduces. It is also involved in the conversion of thyroid hormones, which overlap with the fatigue and cognitive fog you describe.

Your diet provides zinc through red meat, eggs, and dairy, which are all present. This is not a correction of likely severe deficiency but rather an insurance against the mild-to-moderate insufficiency that is common in women at this life stage, particularly given the additional demands of perimenopause on micronutrient status. At 15mg elemental zinc, this is a moderate, well-tolerated dose rather than a high-loading protocol.

The bisglycinate form is selected for bioavailability and digestive tolerability. Standard zinc gluconate and sulfate forms are considerably more likely to cause the nausea that you have flagged as a side-effect priority to avoid. Taking it with your evening meal further reduces any GI risk.

To be direct about the evidence: zinc does not independently boost immune function or skin quality in people who are already replete. The benefit here is maintaining normal function in a physiological context where demand is elevated. If your zinc status is already adequate, you are unlikely to notice a dramatic change; if it is running low (which is plausible given your life stage), effects on skin, hair quality, and energy are typically the first things people notice. Effects, where present, tend to become noticeable over 6–10 weeks. Hair and skin changes are among the slower-to-appear benefits; immune and wound-healing support is more immediate but harder to measure subjectively.

Safety and watch for

Always take with food: zinc on an empty stomach is a reliable cause of nausea, even at modest doses. Your evening-with-dinner timing handles this.

At 15mg elemental zinc daily, copper depletion is not a concern. Copper competition becomes relevant only at sustained doses above 40mg per day. No copper supplementation is needed alongside this dose.

If you ever take antibiotics: take Zinc Bisglycinate at least 2 hours away from the antibiotic dose. This applies especially to tetracyclines and quinolones, where zinc can significantly reduce antibiotic absorption.

Your HRT does not interact with zinc at this dose.

Alcohol (4–7 units per week): alcohol mildly reduces zinc absorption over time. No specific action needed at your intake level, but it is part of the rationale for including zinc in the first place.

Form Zinc Bisglycinate (chelated): superior absorption and GI tolerability vs oxide, sulfate, or gluconate

Daily dose 15mg elemental zinc

When to take Evening with dinner

Introduce Week 4

Evidence grade A: well-established across immune, skin, and reproductive outcome trials

Goals addressed Skin, hair, and nail integrity · Immune resilience · Collagen synthesis cofactor · Bone health (cofactor) · Thyroid hormone conversion

Works with Collagen Peptides (cofactor for collagen synthesis) · Vitamin C (antioxidant network complement) · Vitamin B Complex (B6 P5P in the complex works synergistically with zinc in dopamine and hormone synthesis pathways)

What to look for

Confirm the label reads zinc bisglycinate or zinc glycinate (same compound). As with magnesium, check the elemental zinc figure, not the total compound weight: a 30mg zinc bisglycinate capsule may deliver only 6–7mg elemental zinc. You are looking for products that clearly state elemental zinc at or close to 15mg per serving. Some quality manufacturers state both figures: "zinc bisglycinate 100mg (providing 15mg elemental zinc)."

What to avoid

Zinc oxide: poorly absorbed and hard on the stomach. Zinc sulfate: the most common cheap form; effective but the most likely to cause nausea. Products that state only "zinc Xmg" without specifying the compound form. High-dose products above 25mg elemental: unnecessary at your goals and increases the risk of copper competition over time.

Search: "zinc bisglycinate 15mg elemental UK"

Targeted Six compounds selected for your energy, sleep, stress, joint, and skin goals, calibrated for perimenopause and your family cardiovascular history. These build on the Foundation tier once you have four weeks of consistent use established, and include the collagen and B vitamin support your current routine is missing in effective form.

Vitamin B Complex (Active Forms) Targeted Grade A/B 1 capsule daily (P5P, methylfolate, methylcobalamin)

⚠️ GP REVIEW REQUIRED HRT + Vitamin B Complex: Oestrogen-containing HRT, including transdermal estradiol (Oestrogel), can deplete B vitamins, particularly B2, B6, B9 (folate), and B12, through increased metabolic demand and altered absorption. This depletion mechanism is the same as that documented with oral contraceptives. B Complex supplementation is directly supportive for this reason, but please let your prescribing clinician know you are taking it so that any follow-up blood work, especially B12 and folate levels, can be interpreted in the correct context.

Why this compound

Your HRT is actively increasing demand for several B vitamins, particularly B2, B6, B9, and B12. This is not a side effect of HRT going wrong; it is a well-documented physiological consequence of oestrogen raising B-vitamin turnover. Without replenishing these, the downstream effects compound your existing symptoms: flat energy, low mood, and disrupted sleep.

Beyond correcting HRT-driven depletion, each B vitamin in this stack earns its place individually. B5 (pantothenic acid) is the rate-limiting cofactor in cortisol synthesis. Under sustained high stress, your adrenal glands burn through B5 faster than diet alone can replace it, which is part of why the "wired and tired" pattern persists. B6 in its active P5P form is required for both dopamine and serotonin synthesis, directly relevant to your mood dips. Methylfolate and methylcobalamin support the methylation cycle, which governs homocysteine clearance, a meaningful consideration given your family history of cardiovascular disease before age 65.

The biotin (B7) component also supports the skin and hair quality changes that accompany perimenopause, without requiring a separate high-dose biotin supplement. Most people notice improved energy and mood stability within 3 to 6 weeks of consistent use, though the full effect on homocysteine and methylation markers takes closer to 12 weeks.

Safety and watch for

Take with food. B-complex on an empty stomach is a common cause of nausea in sensitive individuals, and you have flagged GI discomfort as something you want to avoid.

Riboflavin (B2) turns urine a bright yellow. This is harmless and expected; it is simply the colour of excess riboflavin leaving the body.

Alcohol on the same evening: Avoid combining with alcohol on evenings when you also take Ashwagandha, Magnesium Glycinate, or L-Theanine later, as the combined CNS-depressant load is additive. An occasional glass of wine with dinner is not a concern, but avoid it on the same evening as your full sleep stack.

B6 cumulative dose note: This B-complex typically delivers 10 to 25mg of B6 as P5P. No standalone B6 has been added to this stack specifically because the cumulative daily total must remain under 50mg; prolonged excess above that level is associated with peripheral sensory neuropathy, which is reversible on stopping but best avoided. Do not add a separate standalone B6 or P5P supplement without checking the combined total.

High-dose standalone biotin supplements (above 5,000mcg) can interfere with thyroid and cardiac troponin blood tests, producing false readings. The biotin content in a balanced B-complex is well below this threshold, so no interference risk applies here.

Form Active forms only: P5P (B6), methylfolate (B9), methylcobalamin (B12), pantothenic acid (B5)

Daily dose 1 capsule (active forms: P5P, methylfolate, methylcobalamin)

When to take Morning with breakfast

Introduce Week 5

Evidence grade A/B: Grade A for B-vitamin deficiency correction and energy metabolism; Grade B for stress resilience and mood

Goals addressed Energy + Vitality · Stress + Resilience · Longevity (homocysteine/methylation) · Skin, Hair

What to look for

Confirm the label shows active forms. The three most important: P5P (not pyridoxine HCl) for B6, 5-MTHF or methylfolate (not folic acid) for B9, and methylcobalamin (not cyanocobalamin) for B12. These are the forms your body can use directly, without requiring a conversion step that is impaired in a significant proportion of the population (particularly those with MTHFR variants, which you have not yet been tested for).

What to avoid

Generic B-complexes using folic acid, cyanocobalamin, and pyridoxine HCl. These are the cheapest input forms and are common in supermarket and pharmacy own-brand products. They are not interchangeable with active forms for all individuals. Given your MTHFR status is unknown, active forms are the appropriate default.

Search: "Vitamin B Complex active forms methylfolate methylcobalamin P5P UK"

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

Why this compound

Oestrogen plays a central role in collagen synthesis: it upregulates the fibroblasts that produce collagen in skin, joints, and bone. As oestrogen levels fall through perimenopause, collagen production drops measurably, and HRT partially but not fully compensates. The joint aches you are noticing are consistent with this mechanism, as is any change in skin texture or elasticity over the past two years.

Hydrolysed collagen peptides (Type I/III) provide the specific amino acid sequences, particularly hydroxyproline-containing dipeptides, that act as signalling molecules to stimulate your own collagen synthesis rather than simply adding amino acids to your diet. This is the mechanistic difference between eating protein generally and taking collagen peptides specifically.

For bone density, collagen peptides address the organic matrix component of bone that D3, K2, and Magnesium support mineralisation of. All four work on the same structure from different angles.

A note on your existing collagen powder: You are already taking a collagen powder in your morning coffee. If your current product is hydrolysed Type I/III peptides at 10g, the compound card review section confirms what to check. Hot coffee is unlikely to fully denature hydrolysed peptides, but dissolution in a cooler liquid (warm rather than boiling) or a smoothie preserves the peptides more reliably. Skin elasticity improvements are typically reported at 8 to 12 weeks. Joint comfort may improve from 12 weeks onward with consistent daily use. Response to collagen varies more than response to mineral or vitamin compounds.

Safety and watch for

Well tolerated in the vast majority of people. Occasional mild GI fullness at doses above 15g, which is above the dose in this stack.

Glycine overlap note: Collagen is approximately 33% glycine by amino acid composition. At 10g of hydrolysed peptides, you are already receiving approximately 3 to 3.3g of glycine from your collagen dose. This is why your standalone Glycine is set at 3g (the lower end of its range) rather than 5g. The combined glycine from collagen plus the glycinate chelate in Magnesium Glycinate plus your standalone Glycine dose is well within safe limits, but the lower standalone dose is intentional and correct.

Vitamin C cofactor: Always take collagen alongside your Vitamin C dose. Vitamin C is required for the hydroxylation step in collagen synthesis. Both are scheduled at morning breakfast, so this timing is already handled in your stack.

No interaction with your HRT. No allergens flagged given your omnivore diet and no known allergies.

Form Hydrolysed Type I/III peptides (bovine or marine: both appropriate for skin and joint goals)

Daily dose 10g hydrolysed Type I/III peptides

When to take Morning with breakfast (alongside Vitamin C, 30 to 60 minutes before any strength training session)

Introduce Week 6

Evidence grade B: multiple RCTs in joint pain and skin elasticity; evidence for bone matrix is mechanistically sound but less replicated independently

Goals addressed Joint + Bone Health · Skin, Hair + Nails · Longevity + Healthy Ageing

What to look for

Hydrolysed collagen peptides, also labelled as collagen hydrolysate. Confirm the label states Type I and/or Type III (not Type II, which is for osteoarthritis via a different mechanism). Marine collagen has slightly superior bioavailability for skin applications; bovine is more widely available and appropriate for joint and bone goals. Either works well here. Confirm 10g per serving or close to it. Unflavoured powder dissolves easily and adds nothing to the taste of a smoothie or warm drink.

What to avoid

Products labelled "vegan collagen" or "collagen booster" without actual collagen peptides. These contain precursor amino acids and plant extracts but no collagen, and are not equivalent. Also avoid products combined with very high-dose added vitamin A (retinol) or proprietary herbal blends where the collagen content is unclear per serving.

Search: "hydrolysed collagen peptides Type I III powder 10g UK" or "marine collagen peptides unflavoured UK"

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

⚠️ GP REVIEW REQUIRED Ashwagandha and thyroid hormone levels: Ashwagandha can alter thyroid hormone levels, specifically TSH, T3, and T4, in either direction depending on starting thyroid status. Any client who has thyroid blood tests should inform their prescriber they are taking it so that results can be interpreted correctly. This applies to you even though no thyroid condition has been diagnosed: your fatigue and "wired and tired" symptom pattern overlap with both perimenopause and subclinical hypothyroidism, and a baseline TSH before starting Ashwagandha is advisable.

HRT + Ashwagandha: There is no direct pharmacokinetic interaction with estradiol (Oestrogel) or micronised progesterone (Utrogestan). However, Ashwagandha modulates the HPA axis and has cortisol-lowering effects that may influence the broader endocrine context in which your HRT is working. Please inform your HRT prescriber that you are adding this so that any changes in how you feel, particularly energy, mood, or sleep, can be attributed correctly rather than assumed to be an HRT adjustment effect.

Hepatotoxicity caution: Rare but documented cases of idiosyncratic liver injury have been reported with Ashwagandha. Stop taking it immediately and contact your GP if you notice yellowing of the skin or eyes (jaundice), dark urine, persistent nausea, marked fatigue, upper-right abdominal pain, or itching. Use KSM-66 or Sensoril standardised extract only; do not stack with other herbal products that carry a liver burden.

Why this compound

The "wired and tired" pattern you describe is a very specific presentation: elevated cortisol maintaining alertness and anxiety during the day, combined with dysregulated HPA axis output disrupting sleep architecture at night. It is common in perimenopause because oestrogen withdrawal removes its buffering effect on cortisol. HRT addresses the oestrogen side; Ashwagandha addresses the cortisol side directly.

KSM-66 is the most studied standardised extract, with multiple RCTs demonstrating meaningful reductions in serum cortisol (approximately 15 to 30% in high-stress populations), improvements in sleep quality particularly in the maintenance subtype (waking in the night rather than difficulty falling asleep), and statistically significant reductions in self-reported stress and anxiety.

Your sleep subtype, waking in the night and being unable to return to sleep, is the maintenance pattern. This is the subtype where Ashwagandha has the strongest evidence. It works by regulating the cortisol awakening response that drives early-morning arousal before it is appropriate, which is exactly what wakes you up at 2 or 3am.

The 300mg KSM-66 dose is the lower end of the evidence range (trials use 300 to 600mg). Starting here is appropriate given your sensitivity to overstimulation and the fact that evening timing with Utrogestan adds a degree of CNS overlap. If you tolerate it well and want to assess for more pronounced effect, you could consider moving to 600mg at your 12-week review, discussed with your GP. Most people notice improved sleep continuity within 2 to 4 weeks and a perceptible shift in stress reactivity within 4 to 8 weeks. Response varies: some people notice a clear effect within 2 weeks; others take the full 8 weeks. A small proportion do not respond meaningfully to Ashwagandha.

Safety and watch for

Vivid dreams are the most commonly reported side effect, especially in the first 2 to 3 weeks. They tend to settle. If they are disruptive, this is worth flagging at your GP review.

Utrogestan (micronised progesterone) timing: Utrogestan has established GABAergic and mild CNS-sedating effects. Ashwagandha is also calming. Both are scheduled at bedtime. At 300mg KSM-66, the additive sedation is mild and is actually beneficial for sleep continuity. This is by design, not a concern, but note that adding alcohol on the same evening as both compounds is inadvisable: the triple CNS-depressant load (progesterone, Ashwagandha, alcohol) is worth avoiding.

Reassessment note: Ashwagandha is appropriate for up to 12 months of continuous use based on current safety data. Reassess annually. Do not stop abruptly after 8 or more weeks of use: taper over 1 to 2 weeks to avoid a cortisol rebound effect.

Avoid in pregnancy. You have confirmed this does not apply.

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

Daily dose 300mg KSM-66

When to take Before bed (alongside Magnesium Glycinate, 30 to 45 minutes before sleep)

Introduce Week 7

Evidence grade A/B: Grade A for cortisol and stress; Grade B for sleep quality and HPA axis regulation

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

What to look for

The label must state KSM-66 or Sensoril. These are the two proprietary standardised extracts used in all clinical trials. KSM-66 is a root-only extract with the strongest evidence base for stress, cortisol reduction, and sleep. Confirm the dose per capsule is 300mg of KSM-66 extract (not 300mg of generic ashwagandha root powder, which is not equivalent).

What to avoid

Generic ashwagandha root powder without standardisation to withanolide content. These products vary widely in potency and have no direct clinical trial backing. Also avoid blends that combine ashwagandha with other adaptogens (Rhodiola, Panax Ginseng, Eleuthero) in a single capsule: you cannot control individual doses or attribute any effect or side effect accurately.

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

Vitamin C (Ascorbic Acid) Targeted Grade A 500mg

Why this compound

Vitamin C is in this stack primarily as a non-negotiable cofactor for collagen synthesis. It is required for the hydroxylation of proline and lysine residues during collagen cross-linking: without adequate Vitamin C, collagen peptides cannot be assembled correctly into functional structural protein regardless of how much collagen you consume. The two must be taken together, which is why both are scheduled at morning breakfast.

Beyond the collagen role, Vitamin C contributes to immune resilience, supports iron absorption from plant sources (relevant given your ferritin is at the lower end of normal), and serves as a key antioxidant in skin tissue, where oestrogen withdrawal increases oxidative stress load.

500mg is a well-evidenced, well-tolerated daily dose. Your omnivore diet with regular fruit and vegetables provides an estimated 80 to 120mg daily from food, so 500mg supplemental brings your total to approximately 580 to 620mg, within the range associated with optimal tissue saturation without the GI effects that can appear above 1g. Effects on collagen synthesis occur continuously from the first dose rather than accumulating over weeks in the way that some compounds do. Immune and antioxidant benefits are similarly immediate. The visible benefits for skin and joints develop over 8 to 12 weeks as collagen turnover allows newly synthesised collagen to replace degraded tissue.

Safety and watch for

Well tolerated at 500mg. GI discomfort and loose stools are the most commonly reported side effects and typically appear only at doses above 1g. You have flagged GI sensitivity as a priority, so 500mg is the appropriate dose rather than splitting a higher amount.

No interactions with your HRT. No interactions with other compounds in this stack at this dose.

Iron absorption note: Taking Vitamin C at breakfast alongside iron-containing foods (eggs, meat, leafy greens) modestly improves non-haem iron absorption. Your ferritin is at 41 µg/L, which is low-normal. This is a useful passive benefit from the timing.

Form Ascorbic acid (standard form: well absorbed, appropriate here)

Daily dose 500mg

When to take Morning with breakfast (alongside Collagen Peptides)

Introduce Week 5 (alongside Vitamin B Complex; introduce both in the same week)

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

Goals addressed Joint + Bone Health · Skin, Hair + Nails · Immune Resilience · Collagen synthesis cofactor

Sourcing

Vitamin C at 500mg is one of the most standardised and reliable supplements available. Quality variation is minimal at this dose and form. Confirm the label shows ascorbic acid and 500mg per tablet or capsule. No special form is required at this dose: buffered ascorbate (calcium ascorbate or sodium ascorbate) is an option if you find plain ascorbic acid causes any gastric discomfort, but this is unusual at 500mg.

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

Glycine Targeted Grade B 3g

Why this compound

Glycine is an inhibitory neurotransmitter in the brainstem and spinal cord, and it acts on NMDA receptors in ways that promote sleep onset, improve sleep architecture, and reduce core body temperature, which is a physiological prerequisite for entering and maintaining deep sleep. In the context of perimenopausal broken sleep, where HPA dysregulation and thermoregulatory instability both contribute, glycine targets the temperature regulation mechanism directly.

The 3g dose is set intentionally at the lower end of the evidence range (3 to 5g) for two specific reasons: first, your Magnesium Glycinate provides an additional 1.5 to 2.4g of glycine from the glycinate chelate; second, your Collagen Peptides at 10g supply approximately 3 to 3.3g of glycine from their amino acid composition. Your total daily glycine from all three sources is approximately 7.5 to 8.7g, which is well within safe limits and meaningfully above the threshold for sleep effects. A 5g standalone dose would be redundant and would not add benefit.

Glycine also supports overnight collagen synthesis: the resynthesis of connective tissue that occurs during deep sleep depends partly on glycine availability, making the timing before bed doubly appropriate. Most people notice improved sleep depth and fewer night wakings within 1 to 2 weeks. The evidence base for glycine and sleep is smaller than for Grade A compounds (the primary RCT by Bannai et al. 2012 is a well-designed but relatively small trial), which is why the Grade B classification is honest. That said, the mechanism is well understood and the safety profile is excellent.

Safety and watch for

Glycine is extremely well tolerated. Mild sedation is expected and is the point. Take before sleep, not earlier in the day.

Alcohol on the same evening: Avoid combining with alcohol on evenings when you are taking your full sleep stack (Magnesium Glycinate, Ashwagandha, Glycine, L-Theanine). With Utrogestan also present at bedtime, the combined CNS-depressant effect is meaningful. One or two glasses of wine on an evening when you skip the sleep stack is a different calculation to taking all four sleep compounds alongside alcohol.

Glycine is a naturally occurring amino acid found in animal protein. No allergy or interaction risk in your profile.

Form Free-form glycine powder or capsules (powder dissolves easily in water)

Daily dose 3g (lower end of range: intentional given glycine contribution from Collagen Peptides and Magnesium Glycinate)

When to take Before bed (30 to 45 minutes before sleep, alongside Magnesium Glycinate and L-Theanine)

Introduce Week 8

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

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

Sourcing

Glycine is straightforward to source. Powder form is the most practical: it has a naturally sweet taste and dissolves completely in a small glass of water. Capsules are available if preferred but require 6 to 8 capsules to reach 3g, which is less convenient. No special form or brand is required: glycine is glycine. Confirm the product contains no added fillers, sweeteners, or herbal blends.

Search term: "Glycine powder 500g unflavoured supplement UK"

L-Theanine Targeted Grade A/B 200mg

Why this compound

L-Theanine is an amino acid found in green tea that crosses the blood-brain barrier and promotes alpha-wave activity, the neural state associated with relaxed alertness. At 200mg before bed it shifts the nervous system from sympathetic arousal (the wired component of your "wired and tired" pattern) toward a parasympathetic state that supports sleep onset and continuity without causing sedation in the way that sleep medications do.

It is particularly well suited to your sleep pattern for two reasons. First, you report falling asleep easily but waking in the night, which suggests your sleep onset mechanism is largely intact but your arousal threshold during the night is lowered, meaning your nervous system is too easily brought back to alert. L-Theanine dampens this hypersensitivity to arousal signals. Second, you have flagged jitteriness and overstimulation as side effects you specifically want to avoid: L-Theanine is one of the few compounds that reduces anxious arousal without causing drowsiness during the day, which means if you find it useful at night you could also consider 100mg in the morning to buffer the cortisol peak without impacting your alertness. That is not in this stack; the current dose is evening-only.

L-Theanine also pairs synergistically with Magnesium Glycinate (both present in your bedtime stack), with complementary mechanisms: Magnesium via GABA-A receptor activity, L-Theanine via alpha-wave induction and glutamate modulation. The combination is meaningfully more effective than either alone. Most people notice reduced time lying awake after night waking within 1 to 2 weeks. Response varies: some people find a clear calming effect within days; a minority do not respond meaningfully. If you notice no change after 4 weeks, this is a compound worth reconsidering at reassessment.

Safety and watch for

Extremely well tolerated. One of the safest compounds in the database at standard doses. No known serious adverse effects.

Mild additional drowsiness is possible when combined with Magnesium Glycinate, Ashwagandha, and Glycine simultaneously. The full sleep stack (all four compounds together) is designed for this: the additive effect is appropriate at bedtime and is not a concern. Taking any of these compounds during the day would be inadvisable.

Alcohol on the same evening: Combining L-Theanine, Magnesium Glycinate, Ashwagandha, and Glycine with alcohol on the same evening amplifies CNS depression. With Utrogestan (micronised progesterone) also taken at night, this is a meaningful stacking consideration. An occasional glass of wine with dinner is low risk; a full evening of drinking alongside the complete sleep stack is not recommended.

No interactions with your HRT. No interactions with any other compound in this stack.

Form L-Theanine (Suntheanine is a well-validated branded form; generic L-Theanine from reputable suppliers is also appropriate)

Daily dose 200mg

When to take Before bed (30 to 45 minutes before sleep, alongside Magnesium Glycinate, Glycine, and Ashwagandha)

Introduce Week 9

Evidence grade A/B: Grade A for anxiety reduction and alpha-wave induction; Grade B for sleep quality specifically

Goals addressed Sleep Quality (maintenance subtype) · Stress + Resilience · Energy + Vitality (via improved sleep continuity)

Better option

Suntheanine is a patented fermentation-derived L-Theanine that is used in the majority of clinical trials and is the form against which purity standards are most consistently validated. It is worth seeking out, especially given that you are stacking this with several other compounds and product quality matters.

What the gap is

Generic L-Theanine from reputable supplement brands is likely adequate at 200mg, but purity and consistent dosing are harder to verify. The gap between Suntheanine and a quality generic is modest rather than clinically significant. Confirm the label states "L-Theanine" (not "green tea extract" as the sole source, which is not equivalent at this dose).

Search: "L-Theanine 200mg Suntheanine capsules UK" or "L-Theanine 200mg supplement UK"

Optimise One refinement: a standardised saffron extract with specific trial evidence in perimenopausal mood and hot flush support. Introduced from Week 11 once your Foundation and Targeted compounds are settled. Optional: the earlier tiers stand well on their own.

Saffron Extract (Affron) Optimise Grade B 28mg standardised Affron

⚠️ GP REVIEW REQUIRED HRT (Utrogestan) + Saffron Extract: Saffron has mild serotonergic and mood-modulating properties. Utrogestan (micronised progesterone 100mg nightly) has established CNS and GABAergic effects, and some women notice mood changes on it. The combination is not contraindicated, but the additive CNS and mood modulation warrants prescriber awareness, particularly because Saffron is included here partly for mood support. Inform your prescribing clinician that you are taking Saffron Extract so that any mood-related symptoms can be attributed correctly and your HRT review can proceed with full information.

Why this compound

Perimenopause frequently brings low mood dips alongside the physical symptoms, and you named this in your goals context alongside the flat energy and broken sleep. Saffron Extract, specifically in the Affron-standardised form, has been trialled directly in menopausal mood, showing clinically meaningful reductions in depressive symptoms and anxiety in RCT settings. The 28mg Affron dose is the exact dose used in clinical trials: this is not a rounded approximation.

The mechanism is partly serotonergic modulation and partly through safranal and crocin, the active compounds standardised in Affron, which influence dopamine reuptake and HPA axis tone. It sits in a different lane from Ashwagandha: Ashwagandha addresses the wired-and-tired cortisol dysregulation; Saffron addresses the low mood and emotional flatness that often persists once the cortisol picture settles.

It is introduced at Week 11, after your Foundation and Targeted compounds are established, because its value is as a mood-specific layer on an already-functioning stack. Evidence at 28mg is comparable in effect size to low-dose antidepressant treatment in non-clinical depression, though with a different mechanism and a gentler side-effect profile. Most people notice a shift in mood and emotional stability within 4 to 6 weeks of consistent use. Response varies: some women notice a clear lift in the first two weeks; others take six to eight weeks to register a meaningful change. If you notice no effect by Week 18 of the full stack, this is the first candidate for reassessment.

Safety and watch for

At 28mg Affron, the side-effect profile is mild. Reported effects in trials include occasional GI discomfort, dry mouth, and mild headache in the first week. Take with food to reduce any GI sensitivity, which is directly relevant given your stated preference to avoid digestive discomfort.

Do not exceed the 28mg Affron dose without clinical guidance. Higher doses (above 100mg) carry a risk of uterine stimulation, which is not relevant at this dose but worth noting as a reason not to double up.

Alcohol on the same evening: Saffron's mild CNS and mood-modulating effects, combined with Utrogestan (GABAergic) and an evening glass of wine, represent three overlapping CNS pathways. Saffron is a morning compound, so direct same-evening stacking is less of a concern, but note that the cumulative sedating and CNS-modulating load across the day is already meaningful. Keep alcohol to one unit or fewer on evenings when Utrogestan is taken.

If any antidepressant is added to your medication list in future, return to this card immediately. Saffron's serotonergic activity means it would require prescriber review in that context.

Form Affron standardised saffron extract (Crocus sativus L., standardised to 3.5% Lepticrosalide)

Daily dose 28mg standardised Affron

When to take Morning with breakfast

Introduce Week 11

Evidence grade B: at least one well-designed RCT. Affron-specific evidence in mood and menopausal depression. Generic saffron powder is not equivalent.

Goals addressed Stress + Resilience · Energy + Vitality (mood component) · Perimenopause symptom support

Cycling No cycling required. Reassess at 6 months.

One validated standard

Affron (Pharmactive Biotech Products) is the only clinically validated form for mood and menopausal indications. The clinical trials that support this recommendation used Affron standardised to 3.5% Lepticrosalide. Satiereal is a second validated standardised extract (used in appetite research); either is acceptable. Generic saffron capsules, powders, or culinary-grade saffron threads are not equivalent and have no clinical evidence at this indication.

Look for: "Affron" or "Satiereal" explicitly named on the label, with 28mg per serving. The word "standardised" alone is insufficient: the specific extract name must be present.

Search term: "Affron saffron extract 28mg supplement UK"

Considered, Not Included

Everything we assessed for you and left out, and why. We do not hide the rest.

The stack above is what we recommend for you. It is not everything that exists for your goals. Below is what we also assessed and chose to leave out, with the reason for each. We would rather show you the full picture than leave you wondering what we left off.

Left out because your stack already covers it

These are good compounds. For your profile they overlap with something already in your stack, so adding them would cost you more without adding much.

Compound	Why it's not in your stack
Folate / 5-MTHF	Your Vitamin B Complex already supplies methylfolate (5-MTHF) in active form alongside the full B-vitamin family; adding a standalone methylfolate capsule on top delivers no meaningful extra methylation benefit for you, you have no confirmed MTHFR variant, no fertility goal, and no pregnancy context that would justify the additional cost and pill.
Coenzyme Q10	CoQ10's strongest evidence is for statin users and established cardiovascular disease, neither applies to you. Your family history of CVD is addressed by Omega-3 and Vitamin D3+K2, which carry Grade A cardiovascular evidence directly relevant to your profile. Adding CoQ10 here would be speculative rather than targeted, and does not match any of your ranked goals closely enough to justify the cost at this stage.
Magnesium L-Threonate	Magnesium L-Threonate's specific benefit is brain-penetrant magnesium delivery for cognitive ageing, a goal you have not ranked. Your sleep and stress goals are already covered by Magnesium Glycinate (Grade A, which you are already taking and is the preferred form for both), L-Theanine, Glycine, and Ashwagandha. Running a second magnesium form alongside Magnesium Glycinate adds meaningful cost and pill burden for a brain-specific mechanism that is not a priority for you right now.
Probiotics (Multi-strain: Strain Specificity Required)	You have no diagnosed gut condition, no IBS, no recent antibiotic use, and gut health is not among your five ranked goals. Probiotics' Grade A evidence is strain-specific for IBS and post-antibiotic recovery, neither applies to you. The general wellness benefit is Grade B and overlaps partially with what a good diet and the rest of your stack provide. Given your preference for a lean, evidence-led stack, this does not clear the bar for inclusion at this time.

Interactions Summary

Checked against your current medications, health profile, and stack

Compounds / Factor	Verdict	Notes
HRT (Oestrogel + Utrogestan) + Vitamin B Complex	GP Review	Transdermal estradiol and micronised progesterone can increase your metabolic demand for B vitamins, particularly B2, B6, folate, and B12, through mechanisms consistent with how oral contraceptives deplete these nutrients. Supplementing with B Complex is directly supportive of this and is appropriate here. Let your prescribing clinician know you are taking a B Complex so that any future B12 or folate blood work can be interpreted correctly against your HRT background.
HRT (Oestrogel + Utrogestan) + Ashwagandha	GP Review	Ashwagandha modulates the HPA axis and can alter thyroid hormone levels (TSH, T3, T4). There is no direct pharmacokinetic interaction with estradiol gel or micronised progesterone, but any herb that influences the endocrine axis should be disclosed to your prescribing clinician. This matters practically: if you notice a change in energy, mood, or sleep pattern after starting Ashwagandha, your clinician needs to know it is in your stack to attribute any effect correctly. A baseline thyroid panel (TSH, Free T4) before starting Ashwagandha at Week 7 is advisable.
Utrogestan (micronised progesterone 100mg nightly) + Saffron Extract	GP Review	Utrogestan has established CNS and GABAergic effects; some women notice mood changes on it, particularly in the first months of use. Saffron Extract (Affron, 28mg) has mild serotonergic and mood-modulating properties and is included here partly for mood support. The combination is not contraindicated, but the additive influence on mood and CNS warrants prescriber awareness. Mention Saffron to your HRT prescriber at your next review. If any antidepressant is introduced in future, the Saffron card must be revisited immediately.
Utrogestan (nightly) + Magnesium Glycinate + L-Theanine + Ashwagandha + Glycine (all taken before bed)	Monitor	Utrogestan is taken at night partly because of its sedative, GABAergic properties. Magnesium Glycinate, L-Theanine, Ashwagandha, and Glycine all support relaxation and sleep through related but distinct pathways. These are introduced gradually across Weeks 2, 7, 8, and 9 precisely to allow you to observe each compound's individual effect. The combination is appropriate for your maintenance-type sleep disruption, but introduce each one at the scheduled week rather than all at once, and note how you feel each time a new compound is added. If daytime sedation occurs, bring it up with your prescriber.
Alcohol (4–7 units per week) + before-bed compounds (Magnesium Glycinate, Ashwagandha, L-Theanine, Glycine)	Monitor	All four before-bed compounds support relaxation or sleep, and Utrogestan (your nightly progesterone) adds a further sedating layer. On evenings when you drink, avoid taking these compounds in close proximity to alcohol. The additive CNS-depressant effect is unlikely to be dangerous at 1–2 units, but it may leave you feeling groggier the following morning and reduces the quality signal you need to assess whether each compound is working.
Omega-3 EPA/DHA (1.5g combined)	Note	At 1.5g combined EPA+DHA daily, Omega-3 has a mild, reversible antiplatelet effect. This is well below the dose range associated with clinical bleeding risk. No medication in your current list interacts with it at this dose. Mention it to your GP at your next routine review as part of a complete supplement disclosure.
Vitamin D 25-OH (54 nmol/L) + D3 supplementation at 3,000 IU	Blood Work	Your current level of 54 nmol/L sits within the NHS sufficient range but below the functional optimum of 75–100 nmol/L associated with bone density preservation, immune function, and mood. Given your perimenopausal status, family history of cardiovascular disease, and indoor desk-based work, optimising to the 75–100 nmol/L range is appropriate. Retest 25-OH Vitamin D at 12 weeks and share the result with your prescriber. The 3,000 IU D3 dose in this stack should move your level into the target range within that window.
Ferritin (41 µg/L)	Blood Work	Your ferritin sits within the NHS normal range but below the 50 µg/L threshold associated with optimal energy, cognitive sharpness, and hair health. Iron supplementation is not indicated here: there is no confirmed deficiency and adding iron without a clear clinical case is unnecessary. Instead, prioritise dietary iron sources at meals that also contain Vitamin C: red meat with leafy greens, or legumes alongside the Vitamin C (500mg) already in your morning stack. Recheck ferritin at 12 weeks. If it falls below 30 µg/L, GP-managed iron supplementation would then be appropriate.
Family history: cardiovascular disease before age 65	Note	Your stack addresses cardiovascular risk meaningfully through Omega-3 (anti-inflammatory, triglyceride-lowering), Vitamin D (vascular endothelial support), Zinc (antioxidant cofactor), and the methylfolate and methylcobalamin in your B Complex (homocysteine clearance). HbA1c and a fasting lipid panel are not yet available. Given the family history and the lipid changes that commonly accompany perimenopause, requesting both tests at your next GP appointment is strongly advisable. If the lipid panel shows dyslipidaemia, Berberine and CoQ10 become higher-priority additions at the 12-week reassessment.
Thyroid status (not assessed)	Blood Work	Fatigue, broken sleep, and the 'wired and tired' pattern you describe overlap significantly with both perimenopause and subclinical hypothyroidism. A baseline thyroid panel (TSH, Free T4) before you begin Ashwagandha at Week 7 is recommended. Ashwagandha can modulate thyroid hormones, which means any change in your thyroid function after starting it needs a baseline for comparison. If subclinical hypothyroidism is confirmed, Selenium becomes a high-priority addition at the 12-week reassessment.
Collagen Peptides + Vitamin C (co-timing)	Synergy	Vitamin C is a required cofactor for collagen synthesis: it supports the hydroxylation of proline and lysine, the structural cross-links that give collagen its tensile strength. Taking both at the same meal (both timed to morning with breakfast in this stack) is intentional and maximises the benefit from the collagen you are already consuming. No interaction concern.
Vitamin D3 + K2 (MK-7 150mcg)	Synergy	K2 MK-7 directs calcium mobilised by Vitamin D to bone rather than arterial walls. The pairing is particularly important at perimenopausal age when bone remodelling accelerates. No interaction concern at 150mcg MK-7.
Magnesium Glycinate + Ashwagandha + L-Theanine + Glycine (sleep stack)	Synergy	These four compounds address your maintenance-type sleep disruption through complementary mechanisms: Magnesium activates GABA-A receptors and supports cortisol clearance overnight; Ashwagandha regulates the HPA axis and reduces the cortisol rebound pattern that drives night waking; L-Theanine promotes alpha-wave activity and calm arousal; Glycine reduces core body temperature and supports sleep architecture depth. Introduced sequentially from Weeks 2, 7, 8, and 9 as scheduled.

⚠️ GP REVIEW REQUIRED: Ashwagandha + HRT Before starting Ashwagandha at Week 7, request a baseline thyroid panel (TSH, Free T4) from your GP and inform your prescribing clinician that you are adding an adaptogenic herb to your routine. Ashwagandha can shift thyroid hormone levels. This does not mean it is unsafe alongside HRT, but your clinician needs this information to interpret any future thyroid or hormone-related blood work correctly, and to attribute any changes in energy, mood, or sleep to the right cause. If your thyroid panel comes back abnormal, contact us before starting Ashwagandha.

⚠️ GP REVIEW REQUIRED: Saffron Extract + Utrogestan Mention Saffron Extract (Affron, 28mg daily) to your HRT prescriber at your next review. Both Saffron and Utrogestan have CNS and mood-modulating properties. The combination is not contraindicated, but your prescriber should know it is part of your stack so that any mood-related observations at review appointments can be contextualised accurately.

⚠️ GP REVIEW REQUIRED: Vitamin B Complex + HRT Inform your prescribing clinician that you are taking a B Complex (active forms including P5P, methylfolate, and methylcobalamin). Estradiol-containing HRT increases demand for B2, B6, folate, and B12. The B Complex in this stack directly supports this, but your prescriber should know so that any future B12 or folate results can be read against your HRT and supplementation background rather than standard reference ranges alone.

Sleep Stack Guidance

Personalised to your sleep pattern: maintenance disruption (waking during the night)

Your sleep pattern is the maintenance subtype: you fall asleep without difficulty but wake during the night and struggle to return to sleep. This is the most common pattern in perimenopause and is driven primarily by cortisol dysregulation, HPA axis instability, and the loss of progesterone's sedative effect during the night. Your stack targets this directly.

Magnesium Glycinate is already in your stack from Week 2. Ashwagandha, Glycine, and L-Theanine are introduced at Weeks 7, 8, and 9 respectively, once your Foundation tier is established. Each is added one at a time so you can observe its individual contribution before the next is added.

Compound	Dose	When	Mechanism
Magnesium Glycinate	300mg elemental	30–45 minutes before bed (Week 2 onwards)	GABA-A receptor agonism; reduces overnight cortisol arousal signal; supports neuromuscular relaxation. The glycinate form crosses the blood-brain barrier more readily than oxide or citrate.
Ashwagandha KSM-66	300mg KSM-66	Before bed (introduce Week 7)	HPA axis regulation: reduces cortisol rebound that causes the 2–4 am wake pattern. Also has mild GABAergic activity synergistic with your nightly Utrogestan. The primary compound for maintenance-type sleep disruption in perimenopausal women.
Glycine	3g	Before bed (introduce Week 8)	Reduces core body temperature by redirecting blood flow to the extremities, which is a key physiological trigger for sleep onset and maintenance. Also supports slow-wave (deep) sleep architecture. Mild inhibitory neurotransmitter at the spinal cord level.
L-Theanine	200mg	Before bed (introduce Week 9)	Promotes alpha-wave brain activity: a calm, alert state that is associated with easier return to sleep after waking. Does not cause sedation directly but reduces hyperarousal. Pairs well with Magnesium Glycinate and Ashwagandha for the wired-at-night presentation.

Important note on Utrogestan timing: You already take Utrogestan 100mg at night, which has its own sedative and GABAergic properties. These four compounds work alongside that rather than duplicating it. Because of this layering, introduce each new sleep compound at its scheduled week and pay attention to how you feel the morning after. If you feel notably groggy on waking after adding a new compound, reduce the dose of that compound by half for two weeks before returning to the full dose. On evenings when you drink alcohol, avoid taking the before-bed compounds in close proximity: the additive CNS effect with Utrogestan and alcohol combined is worth being aware of.

What to expect: Most people with maintenance-type sleep disruption notice some improvement in the depth or continuity of sleep within two to three weeks of establishing Magnesium Glycinate. Ashwagandha's effect on the cortisol rebound pattern typically takes four to eight weeks to become consistent. Response varies: some people notice a clear shift in sleep quality relatively quickly; others require the full stack (all four compounds at Weeks 7, 8, and 9) before a meaningful difference is apparent. Track your sleep subjectively each week using a simple 1–5 rating so you have a record to bring to your 12-week reassessment.

Reassessment Framework

This report is a starting point, not a fixed prescription

Your profile is actively changing: you are eight months into HRT, perimenopausal symptoms are partially controlled but not resolved, and your Vitamin D and ferritin are both in the low-normal range. A structured reassessment at 12 weeks gives you meaningful data to adjust the stack rather than guessing.

Blood work to request at 12 weeks

Vitamin D (25-OH): target 75–100 nmol/L. Currently 54 nmol/L; 3,000 IU D3 daily from Week 1 should move this into range. If not, dose may need to increase with GP oversight.
Ferritin: currently 41 µg/L. Recheck to confirm it is stable or rising with dietary optimisation. If it falls below 30 µg/L, discuss iron supplementation with your GP. Do not add iron without this result.
Thyroid panel (TSH, Free T4): request this before starting Ashwagandha at Week 7 to establish a baseline. If subclinical hypothyroidism is confirmed, Selenium (100–200mcg selenomethionine) becomes a high-priority addition at the 12-week reassessment.
HbA1c and fasting lipid panel: not yet available. Given your family history of CVD before age 65 and the lipid changes common in perimenopause, request these at your next GP appointment. If the lipid panel shows elevated LDL or triglycerides, Berberine (phytosome form) and CoQ10 Ubiquinol become strong additions at reassessment.

What to track week by week

Sleep continuity: rate each morning on a simple 1–5 scale. Note the week each new compound was added so you can identify which had the clearest effect.
Energy across the day: note any pattern (morning flat, afternoon dip, evening wired). This helps distinguish perimenopausal HPA dysregulation from a nutritional gap.
Joint ache and skin: changes are slow. Do not assess collagen or Vitamin D benefit before Week 12 at the earliest.
Mood: track against your Utrogestan cycle. Saffron Extract (introduced at Week 11) may support mood stability. Note any change in the week after adding it.
GI tolerance: you flagged GI sensitivity. Note any digestive change when each compound is introduced, particularly Collagen Peptides at Week 6 (some people find 10g in one go initially causes mild bloating; split into 5g morning and 5g later if needed).

Additions to consider at 12-week reassessment

Selenium (100mcg selenomethionine): becomes a priority if thyroid panel returns abnormal, or as a supportive addition for immune and thyroid function in perimenopause generally. Low risk, low cost.
CoQ10 Ubiquinol (100–200mg): relevant for your cardiovascular family history, energy production, and the mitochondrial decline associated with perimenopause. If lipid panel shows elevated LDL or triglycerides, elevate this to high priority.
Berberine (phytosome form, 500mg with meals): if HbA1c or lipid panel show early metabolic or cardiovascular risk, Berberine addresses both through AMPK activation. Introduce with GP awareness given its potency. Not appropriate without blood work data first.
Calcium Citrate: if your diet review at 12 weeks shows persistent gaps in calcium intake and your Vitamin D is now optimised, Calcium Citrate (taken alongside the D3+K2 already in your stack) becomes relevant for bone preservation. Assess dietary calcium first before adding this.
Omega-7 (Sea Buckthorn oil): if vaginal dryness or mucosal symptoms are present despite HRT, Omega-7 targets mucosal tissue specifically. Not included in this stack now but noted for future consideration.

Ashwagandha: annual review note

Ashwagandha is safe for up to 12 months of continuous use based on current trial data. At your annual review, reassess whether it remains necessary or whether HPA axis regulation has improved enough to taper off. If stopping after eight or more weeks of use, taper over one to two weeks rather than stopping abruptly.

Saffron Extract: ongoing monitoring

Saffron Extract (Affron, 28mg) is introduced at Week 11. If any antidepressant or serotonergic medication is added to your prescription in future, review the Saffron card with your prescriber immediately before continuing. At your 12-week check, assess whether you have noticed a mood stabilising effect: response to Saffron varies, and if there is no perceptible benefit at 16 weeks, it is a reasonable compound to pause and evaluate.

Full stack review at 6 months

Complete an updated questionnaire at six months. Your perimenopausal status, HRT dose, and symptom profile may all have shifted by then, and the stack may need rebalancing accordingly. If you move into confirmed postmenopause, bone preservation becomes even higher priority and the Calcium Citrate addition should be revisited.

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 25-OH target ranges and supplementation thresholds.
[2] A Booth SL et al. Vitamin K and bone health: a review of the evidence. Food Nutr Res. 2012;56:5505. Basis for K2 MK-7 pairing with D3 for bone calcium direction in perimenopausal women.
[3] A Abbasi B et al. The effect of magnesium supplementation on primary insomnia in elderly: a double-blind placebo-controlled clinical trial. J Res Med Sci. 2012;17(12):1161–1169. Magnesium Glycinate and sleep quality in adults with maintenance disruption.
[4] A Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes. 2015;6(10):1152–1157. Secondary rationale for Magnesium Glycinate in the context of cardiovascular family history and perimenopausal metabolic risk.
[5] A Mozaffarian D. Fish oil and cardiovascular disease: a systematic review. JAMA. 2006;296(15):1885–1899. Meta-analysis basis for Omega-3 EPA/DHA and cardiovascular outcomes at standard supplemental doses.
[6] A Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans. 2017;45(5):1105–1115. Omega-3 anti-inflammatory mechanism relevant to joint ache and cardiovascular risk.
[7] A Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med. 2008;14(5–6):353–357. Basis for Zinc Bisglycinate inclusion for immune function and cofactor roles in collagen and hormone metabolism.
[8] B Palmery M et al. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013;17(13):1804–1813. Documents B vitamin depletion by oestrogen-containing medications including HRT; basis for B Complex GP flag.
[9] A Clarke R et al. Homocysteine and the risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002;288(16):2015–2022. Basis for methylfolate and methylcobalamin in B Complex for homocysteine clearance and CVD family history risk reduction.
[10] A Pullar JM et al. The Roles of Vitamin C in Skin Health. Nutrients. 2017;9(8):866. Basis for Vitamin C as collagen cofactor and skin support in the context of perimenopausal skin changes.
[11] 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. Collagen + Vitamin C co-timing for connective tissue synthesis; basis for morning co-administration in this stack.
[12] 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. Collagen peptides and skin elasticity, hydration, and density.
[13] B Chandrasekhar K et al. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255–262. KSM-66 efficacy for stress and cortisol modulation; basis for sleep maintenance application.
[14] 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. Ashwagandha KSM-66 and sleep quality including sleep onset latency and maintenance.
[15] 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. Glycine 3g before bed and core body temperature reduction; slow-wave sleep architecture improvement.
[16] B Rao TP et al. In Search of a Safe Natural Sleep Aid. J Am Coll Nutr. 2015;34(5):436–447. L-Theanine and sleep quality including reduction of nighttime awakenings; alpha-wave mechanism.
[17] B Kashani L et al. Saffron for the treatment of premenstrual syndrome: a double-blind, randomised and placebo-controlled trial. BJOG. 2007;114(12):1577. Saffron (Crocus sativus, Affron) and mood regulation in perimenopausal and PMS contexts.
[18] B Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol. 2014;29(6):517–527. Saffron extract and mild-to-moderate mood symptoms; basis for Affron 28mg selection.
[19] A Bischoff-Ferrari HA et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293(18):2257–2264. Basis for D3 in perimenopausal bone preservation, particularly when serum level is below optimal.
[20] B Witte AV et al. Effects of Resveratrol on Memory Performance, Hippocampal Functional Connectivity, and Glucose Metabolism in Healthy Older Adults. J Neurosci. 2014: cited as background context only. Primary basis for the Longevity goal framing in this stack is Omega-3, D3, and B Complex methylation support rather than single longevity compounds; included for completeness of goal coverage discussion.

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 and the evidence base continues to evolve.

You are on HRT. Hormonal status affects how your body responds to several compounds in this stack, including Ashwagandha, Saffron Extract, and the B vitamins. The GP Review notices in this report are not precautionary boilerplate: they identify specific points where your prescribing clinician needs information to manage your care accurately. Please act on them before starting the relevant compounds.

This report is based on your profile at the time of completion. Perimenopausal status, HRT dose, and symptom profile all change. Some compounds that are appropriate now may need adjustment or replacement within six to twelve months. Reassessment at 12 weeks and again at six months is built into the framework above for this reason.

Supplement safety data is drawn from peer-reviewed human research populations. The compounds in this stack have established safety profiles at the doses recommended. That said, supplements are not inert: they interact with medications, with each other, and with the physiology of an individual in ways that no report can fully anticipate. If anything feels wrong after introducing a new compound, stop that compound and contact us.

Two blood test values are missing (HbA1c and thyroid panel) that are directly relevant to your goals and to safe use of one compound (Ashwagandha). The Reassessment Framework details what to request and when. Acting on those requests will make the six-month stack review substantially more precise.

One last note.

The goals that matter most to you right now are energy, sleep, and building a foundation that protects your bones, your heart, and your future self. This stack is designed to address all three in a measured, evidence-based sequence rather than throwing everything at the problem at once. Supplements do meaningful work, but they work alongside the basics: the strength training you are already doing is one of the most powerful tools available for bone density and metabolic health in perimenopause, and no capsule replaces that. Track your sleep and energy each week, note what changes when each new compound is added, and bring that record to your 12-week reassessment. If anything feels off at any point, stop and get in touch.

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

The past two years have asked a lot of you: symptoms that came without warning, a body that felt unfamiliar, energy that has not been reliable, nights that do not restore. Starting HRT was one step. Taking the time to get the nutritional picture right, with real evidence rather than another tub of gummies, is another. Both matter. Many women in your position find that the combination of well-managed HRT and a targeted, evidence-based supplement stack gives them back a sense of agency over how they feel. That is what this is built for.

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
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3 July 2026

Your supplementstack

Dietary Baseline

Your Current Supplements: Reviewed

Introduction Schedule

Daily Supplement Schedule

Considered, Not Included

Left out because your stack already covers it

Interactions Summary

Sleep Stack Guidance

Reassessment Framework

Evidence References

Limitations

Your supplement
stack