Your supplement
stack.

You reported a vitamin D level of 54 nmol/L, just above the UK sufficiency threshold of 50 nmol/L (20 ng/mL) and at the lower end of the sufficient range. Fifteen to thirty minutes of daylight most days helps, but it tends not to hold levels there through a UK autumn and winter, particularly from a primarily indoor, desk-based routine.

Vitamin D contributes to the maintenance of normal bones, which matters more now that your oestrogen is changing, and to the normal function of the immune system. K2 (MK-7) is paired with it for a specific reason: it directs the calcium that vitamin D helps you absorb toward your bones rather than your artery walls, which becomes more relevant as you consider calcium support later in this stack.

Well tolerated at this dose for the vast majority of people. Take with a meal containing some fat (breakfast is ideal) since both D3 and K2 are fat-soluble and absorb poorly on an empty stomach.

Hypercalcaemia (nausea, fatigue, confusion) is only a realistic concern at much higher doses taken long-term, or in combination with thiazide diuretics, which you are not taking. Retest your vitamin D at 12 weeks to confirm you are holding comfortably above the sufficiency threshold rather than guessing.

Falling asleep easily but waking overnight and struggling to get back to sleep points to a maintenance-type sleep issue rather than an onset one. Glycinate is the specific form worth confirming here: it is the gentlest form on the gut, and magnesium itself supports the GABA signalling that helps you stay asleep once you are there.

Magnesium also plays into your stress load through the HPA axis, the same cortisol-regulating pathway that gets stretched thin by the "wired but tired" feeling you described, and it supports over 300 enzymatic reactions relevant to energy and bone health as your oestrogen shifts.

Glycinate is the gentlest form on the gut of the common options, with far less of the loose-stool effect seen with citrate or oxide. You mentioned wanting to avoid digestive discomfort, which is a further reason to confirm this specific form rather than a generic "magnesium" product.

You reported 4-7 units of alcohol most weeks: avoid taking magnesium on an evening you have been drinking, as the sedating effects are additive. Keep magnesium at least 2 hours away from any future antibiotic or bisphosphonate course.

You have a family history of cardiovascular disease before age 65, and you eat oily fish only once a week, well short of the twice-weekly intake associated with cardiovascular benefit. A daily combined EPA+DHA dose closes that gap directly, supporting healthy triglycerides and reducing background inflammation.

This also supports joint comfort, which you mentioned alongside your other perimenopausal symptoms, and it complements the CoQ10 in your stack through a separate but related cardiovascular pathway.

Take with your breakfast to avoid the "fishy burp" some people get on an empty stomach, and keep capsules refrigerated once opened. Loose stools can occur at higher doses but are uncommon at this level.

You are not on any blood-thinning medication, so the mild effect omega-3 has on platelet function is not a concern for you day to day. It is worth mentioning to any surgical team if you ever have planned surgery. Choose an IFOS-certified product: this is the meaningful purity marker for heavy metals and oxidation, not the headline mg figure on the front of the bottle.

You have not had B12 tested, so this is added as a sensible precaution rather than a confirmed correction. B12 is central to energy metabolism, nerve function, and red blood cell production, and low levels can compound the flat, fatigued feeling you described alongside your broken sleep.

Methylcobalamin is used here rather than the cheaper cyanocobalamin found in most multivitamins, as it is the neurologically active form and requires no conversion step in the body.

Extremely well tolerated. B12 is water-soluble, so any excess beyond what your body needs is simply excreted in urine rather than accumulating.

Our curated interaction database records no interaction between Vitamin B12 and either Oestrogel or Utrogestan. Your Interactions Summary raises a separate consideration we have not assessed as an interaction: HRT may modestly lower circulating B6, B12 and folate, which is part of why B12 is in this stack. If you are ever prescribed metformin or a long-term acid-reducing medication (a PPI), flag this supplement to your GP, as both can reduce B12 absorption over time.

You described significant daily stress alongside feeling "wired but tired," and B5 (pantothenic acid) sits directly in the adrenal pathway that governs how well your body manages that load. B6, in its active P5P form, supports the dopamine and serotonin synthesis relevant to the mood dips you mentioned.

This active-form complex also carries methylfolate rather than folic acid, a sensible default given you have not been tested for the MTHFR variant that affects how well some people convert folic acid to its usable form.

Bright yellow urine from the riboflavin (B2) content is harmless and expected. Take with food to avoid mild nausea some people notice on an empty stomach.

This complex delivers B6 at roughly 15mg, comfortably under the 50mg/day threshold associated with nerve-related side effects on prolonged use, so there is no cumulative concern at this dose. Our curated interaction database records no interaction between a B complex and either Oestrogel or Utrogestan. The Monitor note in your Interactions Summary is a separate consideration we have not assessed as an interaction, and it is part of why this complex is here.

Vitamin C is a required cofactor for collagen synthesis, so it is added directly alongside the collagen peptides you already take each morning, rather than as a separate, unrelated addition. Without adequate vitamin C, collagen supplementation does less than it could.

It also supports the skin goal you mentioned as your oestrogen changes, alongside general immune function and antioxidant protection.

500mg is well below the level associated with GI discomfort or loose stools, which tends to appear above 1g. You have no kidney disease, so there is no need for the dose caution that would otherwise apply.

If digestive comfort is a priority for you, a buffered form (sometimes labelled non-acidic or "gentle") is worth choosing over plain ascorbic acid, given your preference for avoiding GI upset.

You describe falling asleep easily but waking in the night and struggling to settle again, alongside a high stress load and that "wired but tired" pattern that often runs through perimenopause. L-theanine increases alpha-wave activity and calming brain chemistry without acting as a sedative, which makes it well suited to a mind that is overstimulated rather than simply tired.

It pairs naturally with the magnesium glycinate you already take before bed: magnesium supports the GABA and NMDA pathways involved in settling the nervous system, while L-theanine works through a different, complementary calming mechanism. Taken together they tend to make the night wake less abrupt and easier to recover from.

L-theanine is one of the best-tolerated compounds in this stack. It does not cause jitteriness, which fits your stated preference to avoid overstimulating supplements, and there is no meaningful GI burden at this dose.

Response varies: most people feel a clear calming effect, but a minority notice little difference and that is a normal, documented response pattern, not a sign anything is wrong. With your 4 to 7 units of alcohol a week, avoid taking this on an evening you have been drinking: the calming effect is mild but additive with alcohol's sedating effect.

The combination you describe, high daily stress, waking in the night and struggling to get back to sleep, and a wired-but-tired feeling, points fairly directly at HPA-axis dysregulation. KSM-66 ashwagandha has the strongest evidence in this database for lowering cortisol and supporting this axis, and this is specifically the profile it tends to help most.

Our curated interaction database records no interaction between KSM-66 ashwagandha and either Oestrogel or Utrogestan, so nothing we hold argues against taking it alongside them. Ashwagandha carries interactions elsewhere in that database, mostly with thyroid medication and with sedatives, which is why the note below asks you to flag it if your thyroid is ever checked. A checked result is not the same as a clearance. Taken in the evening, it tends to work well alongside the magnesium and L-theanine already in your stack as part of a layered before-bed routine.

Vivid dreams are common and usually settle after the first few weeks. Mild GI upset can occur when starting; if this is a concern for you, take it with food rather than on an empty stomach.

Rare, idiosyncratic liver irritation has been reported with ashwagandha extracts, appearing as yellowing of the skin or eyes, dark urine, persistent nausea, or upper right-sided abdominal pain, usually within the first few weeks. This is uncommon and self-limiting once stopped, but stop immediately and seek medical advice if any of these appear.

Response varies: some people notice a clear reduction in stress reactivity within 2 to 3 weeks, others do not respond meaningfully to this compound. Do not stop abruptly after 8 or more weeks of use: taper the dose down over 1 to 2 weeks instead. With your 4 to 7 units of alcohol a week, avoid taking this on an evening you have been drinking, as the calming effect is additive. Reassess this compound annually; long-term data supports continuous use for up to 12 months at a time.

CoQ10 is a core part of how your cells generate usable energy, and the body's ability to convert the standard ubiquinone form into the active ubiquinol form declines with age, which is why ubiquinol is the more reliable choice for you at 49. This mechanism is relevant to the flat, low energy you describe alongside your broken sleep.

Your family history of cardiovascular disease before age 65 is a second reason this compound earns a place: CoQ10 supports mitochondrial function in cardiac muscle and has antioxidant activity relevant to cardiovascular tissue, and it pairs well with the omega-3 already in your stack for a dual anti-inflammatory and mitochondrial approach.

Well tolerated at 100mg. Mild GI discomfort is possible at higher doses but is uncommon at this level. Take it in the morning, as it can be mildly stimulating for some people and may disturb sleep if taken late in the day.

Our curated interaction database records no interaction between ubiquinol and either Oestrogel or Utrogestan. If you are ever prescribed warfarin in future, flag CoQ10 to your prescriber, as it can reduce the anticoagulant effect and INR would need monitoring.

You already take a collagen powder in your morning coffee, which is a good habit to continue rather than restart. Declining oestrogen during perimenopause is directly linked to reduced skin collagen content and slower bone matrix turnover, which lines up with your stated interest in protecting your bones and looking after your skin as your hormones settle.

Hydrolysed Type I/III collagen peptides at 10g/day is the form and dose with the best evidence for skin elasticity and connective tissue support. The one change worth making is pairing it consistently with vitamin C, which you are now also taking at breakfast: vitamin C is a required cofactor for your body to actually build new collagen from the peptides you are supplying, so taking them together in the morning matters more than the collagen dose itself.

Very well tolerated at 10g/day. Mild fullness or GI discomfort can occur at higher doses but is unlikely at this level, which is relevant given your preference to avoid digestive upset.

Collagen is animal-derived; there is no true vegan equivalent, only precursor nutrients, so if you were ever to move away from an animal source this would need reframing rather than a like-for-like swap. You have no declared allergies relevant to bovine or marine sources, so either is a reasonable choice.

Perimenopause and the years around it bring a sharper drop in bone density as oestrogen declines, which is exactly the phase you are in now. Calcium citrate is the form to look for rather than calcium carbonate, since it is absorbed reliably regardless of stomach acid levels and tends to sit more comfortably with sensitive digestion.

This is introduced last and deliberately so. Calcium only belongs in a stack once Vitamin D3, K2 and Magnesium are already established, which they are by week 11 in your schedule. K2 directs the calcium towards bone rather than soft tissue, and Vitamin D governs how well it is absorbed in the first place. Taking calcium without those in place is the scenario worth avoiding, not the compound itself.

At 500mg, this is a modest, deficiency-filling dose rather than a maximal one, which suits someone getting a reasonable amount of dietary calcium already. Mild constipation is the most common side effect at this dose, more so with carbonate than citrate, so if you notice this, spreading fluid intake through the day tends to help.

Take this at least two hours away from any iron, zinc or magnesium supplement, as they compete for absorption. Since your Magnesium Glycinate is taken before bed and this is at lunch, the timing already separates them appropriately. Very high doses of calcium over long periods have been associated with kidney stone risk, but this is not a concern at 500mg alongside the K2 already in your stack.