Progress Report: Metabolic Coaching for Neurodivergent Perimenopausal Women

V important data to share with you all

Dear reader

I didn’t publish last week. I took an impromptu holiday. I’d already written this piece, and was looking forward to sharing it but I gifted myself some free time instead. I’m telling you this to remind us all that it’s perfectly okay not to do what we said we’d do if our intuition is telling us otherwise and that we need a break.

Six months ago I reached out to let you know I’d retrained as a metabolic health coach, specifically for our overlooked community: neurodivergent, perimenopausal women. I told you to get in touch if you wanted to know more.

This came after my own healing from CFS and burnout, and my new understanding of how I’d healed — the Cell Danger Response. I wasn’t keen to retrain. I already have so many unused qualifications sitting on a shelf. And I knew exactly how much hassle going in a new direction is. It takes time and it takes metabolic energy, and I wasn’t sure I had either to spare. But I couldn’t deny the call. Years of research led me here.

Back when I was sick, the Cell Danger Response, before I had a name for it, felt like heavy unmoveable concrete stuck inside my body. What I know now is that it is moveable, with the right tools.

I’ve been a coach for nearly a decade, so I was confident I could build something with good structure and strong ethical boundaries that could genuinely help although I wasn’t sure exactly what it would look like. I opened up applications to spend one month with me figuring out symptoms and trying small lifestyle changes, something I now call The Forensic Energy Detective Assessment.

I didn’t expect the volume of applications I received. That says something about how needed this type of intervention is, and how underserved our community is.

Since then, I now also have a three month container running for the 30% of women who needed and wanted more than one month’s support (more on that soon) after their assessment.

Separate from the one-to-one work, I’ve opened applications for the world’s first metabolic health retreat for perimenopausal neurodivergent women, here in Cambodia to take place in Jan and Feb 2027. It was extremely challenging to build, and I’m immensely proud of it. You can read more about that here.

Additionally, a client came to stay near me here in Cambodia so I could support her through deep burnout in person. She’s a longstanding client and we already knew each other well. She was too exhausted to move much at the beginning and it was a good reminder of how physically disabling burnout can be. But her stay here worked. I’d do it again and you can read the case study here.

Let’s dig into what actually happened with clients so we can see the useful, bigger picture.

Firstly, every woman who came to me with problematic symptoms had what I’d call a ‘sterling’ approach to her health. Healthy lifestyle, rarely drank alcohol, and valued nature and exercise. Women who were in or have been in talking therapy, eat organic, do Pilates when they can. Some have spent thousands, tens of thousands even, trying to heal, with some working with the world’s leading doctors.

What was missing for these women? The neurodivergent piece.

They were doing all the right things, yes. For a healthy neurotypical person.

And look, everything is ‘so fucking confusing’. This is what a client said to me verbatim last week when discussing mainstream health content. And yes, yes it is.

We have big pharma and big food pushing their agenda, we have conspiracy health influencers, doctors with no time to explain (if you can even get an appt), we have the gaslighting of women’s health experiences generally but certainly with anything to do with hormones. We are bombarded with SO much conflicting information. It is confusing anyway.

So even if you could make sense of any of it (these highly-capable women did) there was still a layer missing. The neurodivergent piece.

What I now know is that your unique neurodivergence MUST come first in relation to your health, not as an afterthought. (I’ll write a separate essay about this). Your symptoms are unlikely to resolve until this is what you lead with.

Unless you’re in excellent health with reliable, stable energy, presume you have insulin resistance. Presume you have dysfunctional mitochondria. Presume you are in or are teetering towards the cell danger response. Why? Because this is the toxic effect living in the modern world has on neurodivergent women. We cannot escape it.

The good news is that it often only takes simple lifestyle changes to see huge gains and real symptom relief. People think I’m spinning a sales line when I say this and I want to assure you I’m not.

This has been as surprising to me as anyone, watching how quickly change can happen, because it took me four long and desperate years to get fully better. But that’s because I wasn’t aware of the science and was following neurotypical advice.

Each woman has her own unique story, but broadly, my clients fall into two categories.

The first are still working (70%). Life is held together, but by a string and it’s about to fall apart. Exhaustion is high. There’s an inability to function properly at work, and time away from work is spent exhausted, unable to get on top of things like housework. Social life has diminished because there’s no energy left to participate. These women have no plans for the future, because there’s no energy to think about one. Nothing to look forward to. Just getting by. Interrupted sleep, aching joints on waking, severe afternoon crashes with accompanying brain fog. One client told me she was too exhausted to do a regular grocery shop, so she’d order takeaway (admittedly healthy) most nights or snack on whatever was in the cupboard - not much.

You might read this and think, poor women, what hope do they have? But these are actually the women who needed only one month of energy detecting and support. A couple of lifestyle changes and they were back, getting on with their lives. The crashes were gone. The pain was gone. Sleep was better. There was hope again. New plans, holidays booked, new jobs applied for. One client’s first sign she was through the worst of it was booking a weekend away with her sister, something she hadn’t had the energy to imagine in over a year.

I do get resistance from clients. Particularly around fuel and movement. We’re hard wired with false information and it feels risky to try something new, especially something which sounds simple or too easy. And, because we’re all neurodivergent it can also feel unsafe to step out of our long established routines, even if they’re not working for us.

My approach is client centred, and the program of work is co-created, so we bounce around ideas until we find something the client feels comfortable trying, just for a week. Clients absolutely do say: No, Hannah, I don’t want to try that—such as changing what they eat for breakfast, the time they eat, or their exercise routine—and I welcome this. Safety always comes first and there are numerous ways to heal.

For one client simply changing meal timings and moving less intensely resolved all problematic symptoms within two weeks.

This is not magic. This is biology. And this is how fast these interventions can work.

Before I give you the GOLD of what all my clients had in common, so we can make general assumptions about what most ND Peri women (probably) need, let me tell you about my second group of clients.

The second type of client (30%) has been absent from work (and much of her life) for more than six months. She has been diagnosed with one or more chronic conditions such as CFS, fibromyalgia, or PMDD etc.

A month of guidance and support does bring genuine gains. Sleeping better through the night, less intense afternoon crashes, less pain. But the small changes aren’t quite enough to bring someone out of a well established Cell Danger Response. We need to go deeper and that’s why I created my three-month program: The Cellular Rebuild: A 12 week Neuro-Metabolic Container. This is led by me but also includes work with a specialist TRE (Trauma Release Exercise) practitioner.

Now onto the GOLD.

Please hear this. There were two key interventions that all of my clients benefited from (presume you could too?)

1. Stabilisation of blood sugar

2. Regular full sensory rest

These are key drivers affecting your cells. Sure, there may be other stuff too, but, fundamentally, if you sort these pieces out I expect that your your daily life will improve - I’ve seen the evidence with all of my clients.

And just to clarify something, because I know there’s been a lot of confusion around this - overstimulation CAN cause insulin resistance. The nervous system work isn’t separate from the metabolic work with food and movement, the nervous system piece IS also metabolic in nature. For example, a client can stabilise her blood sugar via food but her mitochondria can still be dysfunctional if she’s regularly overstimulated with no respite. The Cell Danger Response will activate and cells will lock down.

The exhaustion, the crashes, the doing everything right and still not getting symptom relief, this is no longer a mystery. It’s your specific biology, your specific nervous system, and it looks different for ND women. If this sounds like you and you want support, book a free chat here. We’ll talk through what’s actually going on in your biology, and figure out together if this is the right next step. (The assessment itself is £525, with payment plans available via Klarna if that's helpful.)

Here’s what’s extremely hopeful. That 70% group, the ones who feel wrecked and burned out and have lost most of the joy in their life when they first come to me, their Cell Danger Response often hasn’t had time to become deeply entrenched yet. That’s why change can happen so quickly for them.

For the other 30%, those with long established health conditions, once blood sugar is stabilised and sensory rest is incorporated and some energetic gains are seen, the next layer of work is a heavily tailored mind/body approach (yes, this is metabolic work too). We are only half-way through my first 12-week metabolic container so I can’t offer any insights yet. This work is deep and complex and each client responds slightly differently to each intervention. I’m looking forward to gathering the data and providing you with any patterns I identify when it’s finished.

And lastly, I now insist on a pre-assessment call to see if clients are a good fit because I’ve realised this work isn’t for everyone who thinks they want it. Maybe the client isn’t in the right place to make changes, our values around health don’t align, or she wants to be healed by me (not humanly possible!).

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Now let’s talk about my own coaching capacity. I share this with you so when you’re thinking about your own capacity you allow it to be gentle. It was hard to work out but here’s what I know now. The ideal balance is two assessments a month, and just two women at a time in my three month container.

These are tiny numbers. But the work is highly bespoke. It involves a huge amount of processing and pattern recognition. It involves holding sensitive information, statistics, and emotional space, often, on screen. And, to hold someone else’s health data, someone else’s deeply personal story, is an incredibly tender, incredibly humbling thing. It’s also metabolically costly.

I also have a pro bono commitment, coaching local Khmer women who wouldn’t otherwise have access to this kind of support, which matters to me and I have to factor this in.

The work is metabolically costly in other ways. I started talking about my approach on LinkedIn. I got a fair amount of shit from other health coaches. This knowledge just isn’t out there in the mainstream, although the science is there if anyone bothered to look. I do struggle with RSD so there was that to contend with but overall there was a feeling of outrage. What the implications of this knowledge gap are for the long-term health of our community. I felt a bit defeated. I got upset. Then I decided it’s not my job to educate the masses. It’s not my job to educate anyone, really, apart from my fellow neurodivergent women, right here, in this little space we’ve built.

Thank you for your continued support and faith in me.

I am currently working behind the scenes to create a group offering so I can serve more of you, while also honouring my own capacity.

I hope you have a gentle week,

Love Hannah xoxo

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P.S. Next Sunday, instead of my usual essay, I’m doing something different. Twenty minutes coaching with me via pre-recorded video, guiding you through what your real energetic capacity looks like right now, so you can understand when you’re about to breach it.