A free training from Remedy Functional Medicine
Your labs are normal. You're not fine.
Why midlife fatigue, brain fog and stubborn weight often don't show up on a standard panel — and what a root-cause work-up actually looks for.
Stacy Marie Ronquillo, NP
FNP-BC · AGACNP-BC · IFMCP · MSCP
Two in the morning
02
"I'm lying here wide awake and exhausted at the same time, and tomorrow I'll drag through another day, and everyone keeps telling me I'm fine."
Who this is for
03
You've done everything right, and your body isn't cooperating.
You don't need to have all of these. Most women watching have four or five.
- Your labs came back normal and you feel anything but
- The two or three o'clock crash you'd lie down on the office floor for
- Waking at 3am wired-but-tired, then dragging all day
- Weight settling around the middle while you eat clean and move
- Brain fog — losing words mid-sentence, forgetting why you walked in
- A drawer of half-used supplements that never made a difference
- Being told you're "borderline" with no plan attached
- Re-explaining your entire history to a new provider every single time
What you'll leave with
04
Three things, whether or not we ever speak again.
Why "normal" wasn't an answer
What a standard panel is actually designed to detect, and the question it was never built to answer.
What a thorough work-up looks for
The five areas a root-cause work-up covers, and why the first changes usually come from the least glamorous of them.
Better questions for any provider
The specific things to ask for at your next appointment — with us, or with the doctor you already have.
Who's talking
05
Stacy Marie Ronquillo, NP
I came to root-cause medicine from the opposite end of it.
- Double board-certified nurse practitioner — Family (FNP-BC) and Adult-Gerontology Acute Care (AGACNP-BC)
- Master's of Nursing, UCLA
- Institute for Functional Medicine Certified Practitioner (IFMCP)
- Menopause Society Certified Practitioner (MSCP)
- 18+ years in healthcare, including more than a decade in Level 1 trauma emergency rooms
Before we start
06
This is education, not medical advice.
Nothing here diagnoses you or replaces care from someone who knows your history. I don't know your labs, your medications or your risk factors, and I'm not going to pretend otherwise from a slide deck. Individual results vary. Supplements and hormone therapy are tools that help some people in some situations — they are not guaranteed fixes and I won't talk about them that way.
Belief one · the labs
07
"Everything looks normal."
Three words that end the appointment. Here's the thing — they were probably true. And they still weren't an answer to the question you came in with.
The question that got asked
08
A standard panel is built to catch disease. It was never built to tell you you're thriving.
Reference ranges are population ranges. They're drawn so that a result outside them is unusual enough to warrant action. That's a screening tool, and it's a good one. It just answers "is there a diagnosable problem here?" — not "is this body running well?"
What the panel asks
Is there a diagnosable problem here?
Measured against a population range. A result outside it is unusual enough to act on.
Answered well
What you asked
Is this body running well?
Needs the results read together, against what optimal looks like, with the history beside them.
Not what the test is for
Both are reasonable questions. Only one of them got asked.
In range vs. optimal
09
"In range" and "optimal" are not the same number.
A population range is wide by design. Sitting just inside the edge of it is technically normal and can still be a long way from where you feel like yourself. This is the gap that produces a clean lab report and an exhausted woman — and it's exactly the gap a functional read is looking at.
One result
Technically in range, so it prints as normal and nothing gets flagged — and still a long way from the middle of the range.
Now several at once
- Thyroidnormal
- Iron storesnormal
- Vitamin Dnormal
- Blood sugarnormal
Every line is normal on its own. Together they describe a woman who feels terrible — and nothing on the report is flagged.
Schematic. Illustrates how ranges are read — not anyone's results.
The other half of the gap
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And then there's what a routine panel usually doesn't order at all.
Not because anyone is careless — because a screening visit orders screening tests. If it was never run, "normal" never covered it.
- A full thyroid panel rather than TSH on its own
- Fasting insulin alongside glucose and A1C
- Ferritin and full iron studies, not just haemoglobin
- B12, folate and vitamin D
- Sex hormones read in the context of where you are in your cycle
- Markers of inflammation
- Gut and nutrient status, which a blood panel doesn't describe at all
Belief two · the self-blame
11
You didn't fail the diet. The diet had no diagnosis behind it.
Keto, Whole30, fasting, the macros app, the trainer, the drawer of supplements. Every one of them was a generic protocol applied to a body nobody had actually investigated. That's not a discipline problem. That's a sequencing problem.
Reframe
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Fatigue, fog and a stalling metabolism are signals. Not a character flaw, and not a life sentence.
A symptom is your body reporting something. The useful response to a report is to read it — not to argue with it, and not to apologise for it.
The three o'clock wall
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The afternoon crash isn't a coffee problem.
A day that starts on fumes, holds together on caffeine and something quick at lunch, and then falls off a cliff mid-afternoon is describing a pattern in how your body is handling fuel. Coffee treats the symptom at three. It doesn't touch the shape of the curve.
A day, as it gets described
More coffee is a treatment for three o'clock. It doesn't change the shape of the curve.
Illustrative of a commonly described pattern. Not measured data.
The sentence that stops the conversation
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"That's just perimenopause" is not a plan.
Perimenopause is real, and it may well be part of what's happening. But naming a life stage is a description, not a treatment plan. And this is precisely the window where a careful, targeted look tends to be worth the most — not the window to white-knuckle.
The real obstacle
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This is a structural problem, not a personal one.
Most practices carry panels of two thousand-plus patients per provider. Nobody inside that arithmetic can take a full history, connect sleep to cycle to gut to blood sugar, and build a plan — however good they are. A different result needs a different structure, which is why Remedy keeps panels small and visits 30 to 90 minutes.
The conventional format
2,000+ patients per provider
Rule out the dangerous thing. Address the loudest symptom.
How Remedy is built
Intentionally small panels
Take the whole history, put it beside the labs, and build a plan.
Bars are drawn to the stated visit lengths. Panel sizes are Remedy's description of the two models.
Belief three · the mechanism
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Filling in the Gaps
The root-cause work-up conventional care tends to skip — hormones, metabolism, thyroid, gut and nutrient status — read against optimal patterns rather than disease thresholds, and delivered with enough time in the room to actually connect them.
The five gaps
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Five places the answer usually turns out to be hiding.
They are not independent. Blood sugar affects sleep, sleep affects hormones, hormones affect the gut, the gut affects what you absorb, and what you absorb affects your energy. Looking at one in isolation is how a picture gets missed.
- 01
Hormones
Read in the context of your cycle, not one number on a random Tuesday.
- 02
Metabolism
Fasting insulin beside glucose — insulin often moves years earlier.
- 03
Thyroid
The full panel. TSH alone is one number standing in for a system.
- 04
Gut
Absorption and digestion. An immaculate diet you don't absorb is not nutrition.
- 05
Nutrient status
Iron, B12, folate, vitamin D — the raw materials for making energy.
- And they feed each other
Blood sugar affects sleep. Sleep affects hormones. Hormones affect the gut. The gut affects what you absorb. What you absorb affects your energy — which affects your blood sugar.
You cannot see a loop one box at a time, six weeks apart.
What usually moves first
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The first changes tend to come from the boring end.
Not hormones. Metabolism, gut and nutrient status — the unexciting three. They're often the most addressable, and steadying them frequently makes everything downstream easier to read. It is also the opposite of what you'd be sold by anyone leading with hormones.
Said plainly
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Hormone therapy is a tool. It is not the plan.
It helps some women a great deal in some situations, and it is not right for everyone. You will not be pushed onto it here, and you will not be refused a conversation about it either. It gets considered on the evidence, in your context, once we can actually see the picture — and if we use it, you'll understand why.
What ninety minutes buys
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What actually happens in a first visit.
A first visit at Remedy runs ninety minutes. Here's where that time goes.
- Your full health history — properly, going back years, in one sitting, written down
- Every symptom mapped together rather than triaged one at a time
- Labs you already have, re-read against optimal patterns rather than only disease thresholds
- Agreement on what still needs running, and why each one is worth doing
- The beginnings of a plan built for your physiology — not a protocol handed to everyone
If you want to go further
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The Remedy Program — a six-month root-cause reset.
A ninety-minute first visit, then a personalised six-month program built around what we find. Same provider throughout. It's by application, because the model only works at a size where we can actually do the work.
What's in it
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Built against the specific things that went wrong last time.
A 90-minute first visit
Your whole history, in one sitting, with time to connect it — the thing an eleven-minute appointment structurally cannot do.
The same provider, every visit
No revolving door and no re-explaining your story from the beginning to somebody new.
30 to 90-minute visits
Follow-ups long enough to actually review what changed and adjust, rather than to check a box.
Direct-message access
Message your provider between visits instead of holding a question for six weeks or guessing.
Telehealth or in-clinic
In-clinic in Portland, or telehealth across Oregon and Washington.
Optional membership after
If you want ongoing partnership once the six months are done, it's there. Optional — continue only if it's serving you.
The commitment
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Health-driven, not profit-driven.
Small panels. Transparent pricing. No upsells on pills or tests you don't need. If a test won't change what we do next, we won't order it — and if a supplement isn't doing anything for you, the right advice is to stop taking it.
In their words
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What patients and colleagues say.
“Stacy was kind, caring, compassionate and informative. She made me feel heard, respected, and that my concerns were valid. She was open to going at my pace and comfort level. I feel like I have a great partner in my health now — a feeling that had been lacking with my previous provider.”
“As the owner of a pediatric functional medicine clinic, I've referred countless moms to Stacy Marie, NP — many stuck for years, if not decades, without answers. Time and again her collaborative approach has given them breakthroughs that finally move the needle. What sets her apart is not just her expertise, but the way she teaches. A resource I wholeheartedly recommend.”
“I'm blown away by the personal attention tailored to my specific background and needs. I'm excited to get to the root of health problems rather than just masking symptoms with drugs. The access to shoot off a quick text and actually get a timely, helpful reply is amazing.”
Asked and answered
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The questions you're already thinking.
- "My labs were normal — what would you even find?"
- Possibly things that were never ordered, and possibly things that were ordered and read only against disease thresholds. Sometimes the most useful hour is re-reading what you already have.
- "How is this different from what I've already tried?"
- What you tried were generic protocols with no diagnosis behind them. The difference isn't effort or willpower — it's sequence. Investigate first, then act on what's actually there.
- "Isn't this just perimenopause I have to accept?"
- Perimenopause is real and may well be part of it. It's also exactly when a targeted look tends to be worth the most. A life stage is a description, not a plan.
- "Functional medicine feels expensive and a little out there."
- Fair. This is evidence-based and transparently priced, and it won't sell you pills or tests you don't need. Ask me hard questions on the consult — that's what it's for.
- "Are you going to push me onto hormones or sell me supplements?"
- No. Both are tools used when they help, in your context, with the reasoning explained. Neither is the plan and neither is the business model.
- "I don't have time for another program that won't work."
- That's why it's six months with the same provider and messaging between visits, rather than a protocol handed over at one appointment. I can't promise you an outcome. I can tell you the structure is built for follow-through.
One next step
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If you're done being tired, start with a conversation.
Apply for a first visit with Remedy Functional Medicine. In-clinic in Portland, or telehealth across Oregon and Washington. If it isn't a fit, we'll tell you — and you'll still leave with the questions from tonight.
In-clinic in Portland, or telehealth across Oregon and Washington.
Educational and marketing content only. No diagnosis, treatment or cure claims. Individual results vary; nothing here replaces personalized medical care. Supplements and hormone therapy are tools, not guaranteed fixes.