The Metabolic Rebuild
A lab result you can't ignore. A diagnosis you didn't expect to hear at 45. A provider who named the problem, handed you a pamphlet, and sent you on your way. These are the moments that bring individuals in perimenopause to structured medical care — a medical reality that has outpaced what a 15-minute visit can address.
A prescription and a follow-up in three months is not a plan. Neither is piecing this together on your own while your body is changing in ways that carry real long-term consequences.
The Metabolic Rebuild is structured medical care for exactly this moment — care that evaluates the full picture, addresses what is driving the changes in your body, and stays with you long enough for the changes to hold.
Built on the Adaptive Defense Model — a clinical framework that sequences every intervention to your individual physiology.
Five months. Ten clinical visits. One dedicated provider. Telehealth in Oregon and Idaho.
The clinical architecture
The Metabolic Rebuild comprises six core components — each one prescribed, monitored, and adjusted based on what your individual physiology requires. The clinical relationship itself, and the monitoring architecture that informs every decision, are explored in more depth below.
Clinical Partnership & Access
Biweekly visits with one dedicated provider, plus secure messaging and twice-weekly office hours. The clinical relationship is the infrastructure — every other component flows through it.
Read more below →Clinical Monitoring Kit
Clinical-grade devices for measuring body composition, blood pressure, overnight recovery, and glucose response — shipped to you at enrollment, yours to keep.
Read more below →Nutrition Prescription
Individualized protein, carbohydrate, fat, and fiber targets based on your labs and body composition — recalibrated at every visit as your physiology changes. Not a meal plan. A clinical prescription.
Exercise, Movement & Recovery
Prescribed exercise, daily movement targets, and intensity guidance informed by heart rate variability (HRV) — all calibrated to protect lean mass and match your recovery capacity.
Medication Management
GLP-1, bioidentical hormone replacement therapy, and metabolic medications when indicated — all prescribed within a structured clinical framework and sourced through a quality-certified compounding pharmacy.
Read more below →Health Literacy
Twelve short educational modules — delivered weekly alongside your care — teach you to read your own metabolic signals and make informed decisions independently. The skill that makes results durable long after the program ends.
Clinical Validation
Comprehensive laboratory reassessment at week 12 confirms that your internal physiology is changing the way your external progress suggests — and informs what happens next.
Clinical partnership & access
Your care begins with two onboarding sessions that establish your nutrition, movement, recovery, and medication plan. From there, biweekly follow-ups are built around two weeks of objective data — so every decision reflects what your physiology is showing, not guesswork.
Between visits, your provider reviews your biometrics, tracking data, symptoms, and medication response through your secure portal. When something shifts — a plateau, disrupted sleep, a change in recovery — your plan adjusts before your next appointment, not after.
This is not more contact for its own sake. It is robust clinical continuity to ensure your care stays responsive and precise as your body changes. This is the work of structured metabolic medicine that fragmented care simply cannot do.
Clinical monitoring kit
Every clinical decision — nutrition targets, medication, training intensity, phase readiness — is informed by objective data, not self-report alone. The monitoring kit is the infrastructure that makes this possible.
Data from your devices flows automatically to your patient portal, where your provider reviews it during scheduled twice-weekly chart reviews and at every visit. That review is what turns each biweekly appointment into a data-informed decision point rather than a conversation about what you remember.
You will also learn to read this data yourself — your morning HRV, your body composition trends, your glucose patterns. That skill is part of what makes results durable after the program ends. But the primary purpose is clinical: it gives your provider the objective picture that precise care requires.
Medication management
GLP-1 medication is scaffolding — a powerful tool introduced when your foundation supports it, with defined entry criteria and a plan for taper when your goals are met. Bioidentical hormone replacement therapy is different: durable, ongoing care managed by the same provider overseeing your metabolic health.
The clinical arc: how structured care unfolds across five months
Your care follows a defined clinical progression. The Metabolic Evaluation is the diagnostic prelude that determines how your Metabolic Rebuild unfolds: which systems are addressed first, when medication enters the plan, and how each phase is sequenced based on what your physiology shows.
The diagnostic foundation that precedes every Metabolic Rebuild.
Comprehensive intake, full metabolic and hormonal lab panel, and a 45-minute review of findings. Your evaluation results determine the sequence of every intervention in the Metabolic Rebuild — which lever moves first, and when.
Foundation
Build the metabolic foundation before introducing deficit or medication.
Sleep, stress, protein, and movement are addressed first — because when these systems are unstable, restriction produces muscle loss, not fat loss. Monitoring devices are deployed and baseline patterns established. The scale may be quiet. That is by design.
Acceleration
Introduce targeted deficit and medication when the foundation supports it.
Biweekly visits are now guided by four weeks of objective trends — body composition, glucose patterns, and recovery signals. Your provider adjusts the plan based on what the data shows. Fat loss becomes visible in your measurements and your labs.
Integration
Pressure-test durability before you graduate into Continued Care.
Lean mass preservation is verified, medication taper is evaluated, and a second CGM window confirms that the metabolic skills you built are holding. The goal is not solely more weight loss — it is ensuring that what you built will last.
Structured clinical care is the work of months, not visits. It is a defined investment — in your physiology, in your long-term trajectory, in the work that gets you to durability. The price reflects five months of that partnership: from your Metabolic Evaluation through your graduation into Continued Care.
The Metabolic Rebuild
Five months of clinical care. Ten clinical visits. One dedicated provider.
- Your $595 Metabolic Evaluation fee, credited in full toward this enrollment
- Ten clinical visits with one dedicated provider — two Metabolic Evaluation visits plus eight biweekly Metabolic Rebuild visits
- Provider review of your biometric and symptom data at every visit and between visits
- GLP-1, BHRT, and metabolic medication management when indicated
- Individualized nutrition, movement, and recovery prescriptions
- A clinical monitoring kit and two CGM windows
- Week-16 laboratory reassessment and treatment refinement
- Access to an asynchronous, modular course that accompanies the Metabolic Rebuild
Medication costs, lab reassessment costs ($140–$250 depending on panels), and supplement recommendations are separate from program fees. A 15% dispensary discount is included.
Ready to start?
The Metabolic Rebuild begins with a Metabolic Evaluation — a comprehensive diagnostic assessment that maps your metabolic and hormonal picture before any treatment begins.
You do not need to decide today whether the Metabolic Rebuild is right for you. The Metabolic Evaluation determines what your body needs, what should happen first, and whether this level of care is the right next step.
If the program is appropriate, your Metabolic Evaluation findings become the blueprint for your care. If it is not, you leave with a clear understanding of your physiology and specific clinical recommendations you can act on.
The Metabolic Evaluation
This is how the Metabolic Rebuild begins. Map your full metabolic and hormonal picture and receive the clinical blueprint that determines how your care unfolds.
Schedule a Metabolic EvaluationThe Discovery Visit
Want to talk through your situation first? Start with a no-obligation 15-minute conversation to discuss your goals and determine clinical fit.
Schedule a Discovery VisitA clinical relationship designed to evolve
The Metabolic Rebuild is a defined season of care — but your physiology does not simply reset at month five. Your body's weight-defense response remains active for up to two years after meaningful weight loss. Hormonal shifts continue through perimenopause and beyond.
Graduating into Continued Care is how what you’ve built gets protected.
Active Care
$425/moThe phase where progress is protected. When your metabolic picture is still evolving — continued weight loss, medication titration, hormonal transition — Active Care maintains the clinical depth that kept the work moving. You keep the visit cadence, provider access, and monitoring infrastructure because your physiology still requires them.
Steady Care
$250/moThe long-term metabolic and hormonal medical home. When your clinical picture has stabilized — weight at or near goal, medications stable, labs trending well — care shifts to lighter-touch stewardship. This is where hormonal care becomes durable, ongoing support through perimenopause, menopause, and beyond. The same provider who knows your full history continues managing your metabolic and hormonal health as your needs evolve.
Same provider. Same clinical relationship. The metabolic and hormonal medical home that carries you forward.