Welcome back.
Three things I've learned over the last three weeks of writing this newsletter:
One. Information in this space is moving so fast that even clinicians and prescribers can't keep up.
Two. Prices are falling faster than most people realize, and they're falling differently depending on the drug, the dose, and where you buy it.
Three. Regulations are shifting under everyone's feet with a lot of unknowns. Meanwhile, every wellness influencer is trying to sell you a GLP-1 booster supplement, and every CVS endcap is promising "GLP-1 Support" on the box. Everyone is moving in to capitalize on the confusion.
More and more, women are taking our health into our own hands. Honestly, who else is better suited to take care of your health than you?
My goal is for this newsletter to be a navigation tool. Let's go!
📝 This week's read. I just published a Substack about cutting through the protein noise and to understand if we should be this obsessed with protein. I dug into macronutrient heroism (yes, not all macros wear capes), protein goggles, and the surprising amount of agreement underneath all the noise. The very short version of what's inside:
I am the friend who yells "eat the chicken" at every Italian dinner. I have been told I can be bossy. I have also been thanked. I went looking to see if I had gone too far. (Spoiler: somewhat.)
The history of how protein became a hero makes sense, and is the first and only macronutrient to be celebrated vs. villainized. The trends are fascinating and make sense as to why we also over-consumed SnackWells in the 90s.
The credible middle, where most of the experts actually agree, is roughly 0.55 to 0.8 grams of protein per pound of body weight per day. For a 150-pound woman, that's about 80 to 120 grams. For a 180-pound woman, about 100 to 145. The "200 grams a day" you keep hearing is an outlier number, not the consensus.
On a GLP-1, every gram you eat matters more than it did before. Protein is the lever that protects muscle (and bone) when you're eating less.
Yes, it's important, but we don't need to go crazy. Real food first. Supplements when you genuinely need them.
And if you haven't taken the survey yet, it's anonymous and right here →. The answers shape what I write next.
🚫 Two things to ignore
What's real, what's fear-mongering, what's someone trying to sell you something.
1. The hair loss panic, and what it's selling you. Hair shedding on GLP-1s is real. It happened to me. It was the worst side effect by a landslide for me. Here's what every dermatologist who has actually studied it says: the drug itself isn't directly causing it. The condition is called telogen effluvium, and it's a stress response your body has when you lose weight too fast or you're not eating enough. It typically shows up two to three months in on GLP-1s because with decreased calories, your body decides hair isn't an essential function and pulls the resources elsewhere.
Worth flagging, because it's an underrated argument for going slow on this journey: clinical literature consistently points to losing more than 1 to 2 pounds per week as the threshold above which telogen effluvium becomes likely. Below that pace, it's much less common. Think about it this way: people on Weight Watchers have been losing significant weight for decades at exactly that 1 to 2 pound per week pace, and you don't see widespread reports of weight loss induced hair loss in that population. The pace of loss matters more than the total. (Beverly Hills Hair Group, Nashville Dermatology Physicians)
The fix is sufficient protein, nutrients, and slower weight loss. FWIW, my hair thickness mostly came back when I started eating enough.
Nutrafol and other supplements seem to work for some people. I tried it. But look at the actual ingredient list and what you're paying about $88 a month for is, mostly, a multivitamin plus marine collagen plus a couple of adaptogens. Worth knowing what it actually is and make sure that's the actual solution.
That said, if you are genuinely struggling to eat enough food right now, a supplement may make sense for a short window while you work on the bigger problem.
There is no magic pill for hair regrowth on a GLP-1. There's protein, there's the rest of your macronutrients, and there's awareness of what you're giving your body to build.
2. The CVS endcap "GLP-1 boosters." Force Factor just launched a line called Super GLP-1 Support at Walmart and CVS. The hero ingredient is something called Eriomin, a citrus bioflavonoid that, in a 12-week clinical study cited on the bottle, raised the body's own endogenous GLP-1 by about 15.6% versus placebo.
Two things to know. First, every one of those trials was run on prediabetic patients with elevated blood sugar, not on those curious about or on GLP-1s. Second, a 17% nudge to your body's own GLP-1 is not in the same universe as a GLP-1 medication, which activates the receptor at roughly 100x what your body produces naturally. The marketing isn't lying. It's just renting credibility from a category it doesn't belong to.
So, not snake oil. Also not a baby GLP-1.
✊ One thing to do: confront the brutal facts
There's a concept from one of my favorite business books, Good to Great, called the Stockdale Paradox: confront the brutal facts of your current reality, while never losing faith that you will prevail in the end. Jim Collins wrote that paradox about companies, but it applies cleanly to your health.
In business, you can't win without knowing your numbers. Your fixed costs. Your variable costs. Your revenue. Your liabilities. This is the foundation on which everything is built.
Health is the same. Before you decide whether a supplement is the right answer, find out if you actually need it. Before you panic about a side effect, find out what's actually causing it. Before you change your dose or your protocol based on something you saw or read online, look at what you're actually putting in your body, how you're actually moving it, and what your numbers actually look like. Then go look at the Instagram post with your own lens.
We are all unique snowflakes, and now we can finally have unique snowflake coaching tools to match.
I built mine for myself because I found it was a really easy way to understand what was going on. It's a personalized AI health coach that calculates your protein and macro range, holds your daily intake in one place, and keeps the conversation going as you adjust. It works for anyone, GLP-1 or not, and I'd love for you to copy my homework:
Find it here →. Use it. Don't use it. Build your own. The point isn't the tool. The point is that you are the person best suited to take care of your health, and the tools to do it well are sitting right in your pocket.
If you want help figuring out what works for you, hit reply. I'm always happy to share what I'm doing.
🏢 Industry Watch
Three numbers from this week worth knowing.
1. The CEO of Eli Lilly thinks 30 million people will be on GLP-1s globally by the end of this year. That's up from 20 million at the end of 2025. The industry's own modeling, just months ago, had us hitting 30 million in 2028 to 2030. Lilly just pulled that timeline forward by two to four years. Translation: this category is growing way faster than even pharma was modeling. (Lilly Q1 2026 earnings call)
2. Lilly's Q1 revenue grew 56%, while their average drug prices fell. Volume was up 65%. Realized prices were down 13%. Net revenue: +56%. More people are taking these drugs at lower prices, and the unit economics still work for pharma at scale. (Lilly Q1 8-K)
3. Out-of-pocket pricing snapshot, by drug and dose, current as of this week:
Sources: NovoCare, LillyDirect, Foundayo. If you have commercial insurance that covers obesity meds, you'll pay much less. If you're on Medicare or Medicaid, this isn't your chart, and separate programs apply. On a compound and you’re on a different journey.
📖 One thing to read this week
This Medscape piece on midlife women, menopause, and GLP-1s in the real world is one of the best things I've read on this topic in a long time. The clinician at the center of it, Dr. Younglove, counsels her patients that GLP-1s "don't magically cause the body to release stored fat" and pulls the medication if patients aren't doing the lifestyle work. Brutal, but probably also exactly the kind of care more people should be getting.
It also lands at exactly the right moment for what's becoming the most important cohort in this category: women in midlife navigating perimenopause, menopause, hormone therapy, and a GLP-1 all at once. Every macro theme I've been writing about (the fast-moving information, the lifestyle work nobody is enforcing, the gap between what providers can offer and what women actually need) shows up in this one piece.
If you read one thing this week, read this one.
👀 One thing to watch
The FDA is closing the door on compounded GLP-1s. In plain English:
Big bulk compounding pharmacies (called 503B facilities) used to be allowed to produce semaglutide and tirzepatide because the FDA had declared an official shortage. The FDA ended that shortage last year. Last week, the agency proposed a rule that would permanently bar these big facilities from making these drugs again, even if a future shortage is declared.
Smaller compounding pharmacies (503A facilities) are still operating for now. Most telehealth companies use 503A, not 503B, so the immediate impact on access is smaller than the headlines suggest. But the trend line is clear, and there is one frame I want you to walk away with.
This is not a safety story dressed in policy clothes. This is pharma asking the government to keep cracking down on cheaper versions of their drugs so they can keep their revenue. The cheaper versions are not unsafe for the people taking them. The consumer is the one who pays more.
A lot of people have already been affected by earlier rounds of this crackdown. If you're on a compound and haven't been affected yet, it might be worth reaching out to your provider now and starting to think through a Plan B. You're not alone in this, and hopefully it doesn't become an issue. But it's worth being ready.
One question this week: what's something your prescriber didn't tell you that you wish they had? Hit reply. I'm collecting these for a future piece, and the answers I've gotten so far have been gold.
See you next Tuesday.
Helaine
Helaine Knapp is the founder of CityRow, a fitness company she built and scaled for a decade before selling in 2024. She is also the author of Making Waves, host of the Step Into Next podcast, and an executive advisor and coach working with founders and leadership teams navigating growth and transition. She has been on her own GLP-1 journey for nearly two years and is building something for everyone navigating this one.