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Tanya Borowski Nutrition & Functional Medicine, The Candlemakers, West Street, Lewes (2026)

31/03/2026

Think of serum ferritin like a vault in a bank: holding all your hard earnt £££ (iron) safely inside. When we test for ferritin, most people assume that's exactly what we're measuring: the contents of that vault.

But - we're not measuring the vault at all. We're measuring the shadow it casts.

Because ferritin actually is an intracellular storage protein. It lives inside hepatocytes(liver cells) and macrophages, not in the bloodstream. What a blood test picks up is the tiny amount that leaks out. That leak tells you something about what's happening inside those cells but it is not the iron itself.

Usually……Until inflammation enters the picture.

Because IL-6 (the cytokine at the heart of every chronic inflammatory state) drives ferritin synthesis through a completely separate pathway. Nothing to do with how much iron is actually stored.

Which means a ferritin of 70 in a woman with IBD or RA for example is not the same as a ferritin of 70 in a woman with no inflammation. Same number. Completely different clinical meaning.

Swipe through for the full breakdown and to understand why ferritin is a shadow and not the actual vault in the bank holding all the ££££!

25/03/2026

Yesterday we talked about why the second half of the menstrual cycle creates a window of vulnerability for BV and thrush.

Today we're looking at how different contraceptive methods may be amplifying that vulnerability. Or indeed protecting against it.

This is one of the most under-discussed conversations in women's health, and the research is only just catching up.

Here's what we now know from a landmark 2025 randomised study of 162 women (I know, it’s not huge — but it’s a study on women! ) plus a growing body of evidence across contraceptive methods:

The combined pill? Actually one of the most protective options for your vaginal microbiome — the oestrogen component keeps glycogen up, Lactobacilli fed, and pH low.

The copper IUD? Within just 3 months, the majority of women with a healthy microbiome at baseline had shifted away from it — with measurable increases in pro-inflammatory cytokines.

The LNG implant (Nexplanon)? A genuinely surprising positive story. Women were actively shifting toward protective Lactobacillus-dominant profiles.

👉 The progestin-only pill? Honestly, we don't have enough data yet.

Swipe for the full breakdown (method by method, with references).

If you're a practitioner, this belongs in your intake process. Contraceptive history isn't background noise - it's active biology.

If you're a woman who's been told recurring BV or thrush is just "one of those things" - it frankly isn't. There are patterns here, and there are tools in our kit bag to draw upon.

24/03/2026

If you, a client or loved one regularly suffer with BV or thrush in the second half of your cycle - this is why ⬇️

The vaginal microbiome doesn't remain static across the menstrual cycle . It shifts as our s*x hormone levels naturally fluctuate, thus creating a very specific window of vulnerability.

Here's what's happening...

Oestrogen is your vaginal microbiome's best friend. It stimulates glycogen production in the vaginal lining — and glycogen is the food source that keeps your protective Lactobacilli thriving. More Lactobacilli = more lactic acid = a low, acidic pH that pathogens simply can't tolerate.

But in the luteal phase (approx day 15–28), progesterone takes over. And progesterone suppresses glycogen. Lactobacilli numbers fall, pH creeps up, and the environment shifts — creating a window where BV and thrush can gain a foothold.

There's another piece of this puzzle that most people have never heard of: lactoferrin. It's one of the most powerful antimicrobial proteins in the body, secreted by your cervicovaginal glands in direct response to oestrogen. It works by starving pathogens of iron (which they need to replicate) and physically disrupting bacterial cell walls. As oestrogen dips in the late luteal phase, lactoferrin follows it down, and that protective layer quietly disappears.

This isn't bad luck. It's biology. And once you understand it, you can work with it.

Swipe through for the full breakdown, including the research behind the lactoferrin connection.

📌 Save this if you or someone you know struggles with recurring vaginal infections.

Tomorrow we uncover how different contraceptive methods affect the vaginal microbiome 👀 - some may surprise you!

19/03/2026

We’re now almost three months into Women's Health Mastery 2026 programme and I'm so impressed by the commitment this group is demonstrating.

We're not even at the halfway point and the depth of learning happening is fabulous. Let me give you a glimpse into what we've covered since January:

🧱The Foundation: We kicked off with The Mapping System Blueprint - teaching my exact framework for case evaluation, mindmapping complex cases, and building the clinical toolkit that transforms scattered information into clear, actionable treatment plans.

🩸Module 1 - Mastering Pathology: We’re now in the depths of mastering foundational biochemistry. We've gone deep - and I mean DEEP - into a Comprehensive blood chemistry interpretation across 6 intensive sessions:
➡️ Acid-base balance & electrolytes
➡️ Calcium regulation, parathyroid, and osteoporosis
➡️ Liver, gallbladder & bile acid malabsorption
➡️ Immunology foundations with the incredible Robyn Puglia (a mammoth 3-hour session that was absolute gold)
➡️ Cardiometabolic health - lipids, cardiovascular risk, glucose & metabolics in women's health

PLUS, there has been even more collaboration and learning through:
📖 4 drop-in clinic sessions reviewing real cases and clinic management
🙋‍♀️Our wonderful private Facebook community with over 136 questions answered individually

This week we're diving into Cardiometabolic Health Part 2 - Glucose & Metabolics in Women's Health, and there's SO much more coming.

This is the level of commitment it takes to truly master women's health. Going beyond surface-level CPD and weekend courses. It’s trusting deep, transformative education that fundamentally changes how you practice. It’s not easy but I’m so proud of how well this cohort is leaning into the experience.

Tanya x

18/03/2026

Following the ISGE Congress a few weeks ago, one message came through loud and clear: bisphosphonates should not be the first tool we reach for in bone protection (even though they very much still are!) And understanding HOW they work explains exactly why 🦴

When taken orally or by injection, bisphosphonates embed themselves into the bone mineral matrix with extraordinary affinity. When osteoclasts resorb that bone, they internalise the drug — and that's when it gets to work.

Once inside the cell, nitrogen-containing bisphosphonates inhibit an enzyme called FPPS — a key step in the mevalonate pathway. This cuts off production of FPP and GGPP — the lipid anchors osteoclast signalling proteins literally need to function. No anchors = no ruffled border, no resorption activity. The osteoclast falls apart from the inside.

Powerfully effective at preventing the breakdown of bone…. But here's the clinical reality.
These drugs have a half-life in bone of up to a decade! This sustained suppression of remodelling compromises bone quality - most critically the trabecular bone that gives bone its tensile structure - even as DEXA scores look reassuring. DEXA measures density. It tells us nothing about architecture. This is why long-term users can develop atypical femoral fractures and osteonecrosis of the jaw - the bone looks dense but has lost its flexible, adaptive capacity.

In the perimenopausal and early postmenopausal years, we have infinitely better options. Drugs that work with bone biology, not around it.

The image adapted from ISGE presentations - shows the sequencing beautifully >>>

Bisphosphonates have their place. That place is just not at the beginning of the conversation.

Save this if you work with perimenopausal or postmenopausal women: this is the clinical context that changes how you support them

16/03/2026

The way we treat endometriosis is changing. And it's long overdue.

For too long, surgery has been positioned as the answer — the more, the better. But the evidence tells a different story. Not all pain comes from lesions. More laparoscopies don't equal less suffering. And women deserve more than a revolving door of procedures.

This Tuesday, I'm hosting a free live Q&A with two extraordinary clinicians — Dr Peta Wright and Dr Thea Bowler — for an open, honest conversation about another way forward.

We'll be talking about the shift toward holistic, multidisciplinary care. About chronic pain, and why it's so much more complex than a scan can show. About what compassionate, evidence-based care actually looks like for women living with endo.

📅 Tuesday 17 March · 7:30pm · Free online
🔗 Register via link in bio

Come with your questions, an open mind and heart ❣️

This one matters

12/03/2026

This year, the conversation around Endometriosis Awareness Month has taken a deeply uncomfortable turn, as a result of Australian ABC documentary "Scarred", a 7-month investigation into Melbourne gynaecologist Dr Simon Gordon, revealing a pattern of surgery experts described as going far beyond accepted practice. Laparoscopies, o***y removals & hysterectomies performed on young women - despite post-operative pathology showing little / no evidence of endometriosis.

100’s of former patients are now coming forward 😡 It is essential viewing. But please watch with care. It contains deeply distressing content - this case ripples in multiple directions.

Years of diagnostic delay leave women desperate & trusting. When a confident specialist finally tells you that you have severe disease - after a decade of being dismissed - of course you believe them. Vulnerability allegedly exploited in the most harmful way imaginable.

The tragedy is that excision surgery, performed well & with proper indication, can be life-changing. The problem was never surgery itself - it's without clinical justification to support it. As other interviewed Gynaes explain >> Swipe

This is why the model has to change. Pelvic pain isn't JUST about tissue damage. It's about nervous system dysregulation, unprocessed trauma, aberrant inflammatory responses from other systems causing hormone dysregulation & the body's sometimes misdirected protective responses.

Women bouncing between specialists with no answers. Surgical interventions that offer temporary relief at best. Medications that mask rather than address root causes. There is another way...

In 2024 I visited Vera Wellness Clinic in Australia and spent time with Dr Peta Wright and Dr Thea Bowler - two of the most evidence-informed, genuinely progressive clinicians I've met in women's health. What they've built is extraordinary & the way they approach pelvic pain & endometriosis care is exactly the kind of model this conversation needs right now.

Tue 17th March at 7.30pm I'm hosting a free live online Q&A (🔗 in bio) with these outstanding women - an open, honest conversation about another way forward. Come with your questions ❣️

11/03/2026

It's Endometriosis Awareness Month - and we are experiencing a massive paradigm shift in medical thinking. FINALLY, we are moving away from the brutal diagnostic approach long delivered by gynecology.

For too long, women have been told the devastating news that "Endometriosis is a chronic incurable condition with cyclical pelvic pain, heavy bleeding, infertility, and reduced quality of life as its main manifestations."

This limited perspective is now being challenged . As reported in an opinion piece in the BMJ, "Reclassifying endometriosis as a syndrome would benefit patient care.”

Recognising endometriosis as a syndrome would shift the treatment focus away from the narrow goal of surgical eradication of ALL lesions, irrespective if “superficial “ or “Deep Infiltrating” as a Fait accompli (more on this tomorrow).

Rather it embraces a holistic approach through multidisciplinary care addressing the complex constellation of symptoms, particularly chronic pain. This new framework acknowledges the intricate interplay of biological, psychological, and social factors that shape each woman's unique experience with endometriosis and that not all pain is as a result of lesions.

This evolution in thinking promises more compassionate, comprehensive care that treats women as whole persons rather than collections of problematic tissues. It opens doors to innovative treatment approaches that may finally bring relief to millions of women who have suffered under the limitations of outdated medical paradigms.

I’ve been re-mapping the syndrome of endo for my mentoring teaching, to help and highlight to practitioners the multiple intervention options that can facilitate reduction of pain….. Geek out on this my friends! 🤓

10/03/2026

The conversation around Demi Moore's appearance last week has been hard to miss. While it has centred on speculation about surgery or weight loss drugs, I want to talk about something more clinically important - bone health.

At 63, after decades of documented restrictive eating, extreme exercise regimes & the unavoidable fact she is well and truly a menopause graduate, Demi Moore is in a demographic with a significantly elevated osteoporosis risk. And yet that's not featuring in the conversation. Here's what should be.

Osteoporosis isn't just a menopausal story. It's a lifelong bone account, & the deposits and withdrawals start much earlier than many realise.

The hormone most people forget 🦴 We're conditioned to think oestrogen = optimal bone health. BUT progesterone is equally critical - & here's the part that changes everything:
Progesterone only rises meaningfully in a regular ovulatory cycle. After ovulation, progesterone actively stimulates the building of new bone — acting as nature's back-up plan when oestrogen dips post-ovulation.

No ovulation = no progesterone = net bone loss.

In women with a history of disrupted ovulation, from food restriction, chronic emotional or physical (i.e excessive exercising) stress, the contraceptive pill, or disordered eating: research shows approximately 1% of spinal bone density is lost per year.
Over years, or decades, that accumulates into something significant.

And in perimenopause, as oestrogen becomes erratic, progesterone is largely absent, leaving women even more exposed.
The bone account that wasn't topped up through regular ovulatory cycles in the reproductive years? That's the deficit that shows up on a DEXA scan later. This isn't about Demi Moore specifically but the broader conversation we're not having, as a culture, is this: chronic underfuelling & cycle disruption across a woman's lifespan have consequences that don't announce themselves until midlife or beyond.

That's the conversation worth having. My friends and colleagues & I will be share the stage again at discussing the importance of adolescence health and ovulation ….. Come and see us :)

08/03/2026

International Women’s Day 2026 🌸
This year’s theme is Give To Gain.
And honestly? We don’t even have to think about it. We just do.
This year — more than any other — I’ve watched women show up for each other in the most profound ways. Through devastating bereavement. Through relationship breakdown. Through diagnoses that changed everything overnight. No fanfare. No hesitation. Just there. Unwavering. Present.
There’s a song Helen Reddy wrote back in the 1970s, when the world looked very different for women. And yet the words hit differently today than ever before:
“Oh yes, I am wise — but it’s wisdom born of pain. Yes, I’ve paid the price — but look how much I gained.”
That wisdom? It lives in us. It gets passed down — not through lectures, but through presence. Through kitchen tables( minus the wine these days 😩😉) and late-night texts and turning up.
And then I look at our young women — I see them through my daughter Milli and her incredible friendship group. They pop in, they hang out in the kitchen, sometimes I hear a key in the lock — they all know our door. And I watch them and I think... it’s already in them. That knowing. That instinct to hold each other.

To every woman who has shown up this year for someone else whilst carrying her own quiet weight — I see you. You are the embodiment of this day.
When we give, we gain. We always have.We always will.ROAR ladies …. I hear you.
Happy International Women’s Day 💛

05/03/2026

Let’s dive into a particular supplement marketing email & their “evidence” to suit a narrative or jump on the menopause bandwagon…

This is exactly the kind of marketing that erodes trust in legitimate nutritional science. The industry needs to do better than this!!!

04/03/2026

2026 conference season kicks off today!

I'm in Rome for the ISGE Biannual Congress - three full days of back-to-back gynaecological endocrinology lectures swipe>> to see some I’m attending, I feel like a kid in a sweetie shop!

Clinical pearls, lightbulb moments, and the kind of evidence that shifts our thinking — it's all coming. And to my Affiliate mentees… you’ll be the first to hear my ah ha & 🎤 drop moments 😘

Right … off the lectures I go🤓🏃

Tanya Borowski Nutrition & Functional Medicine

31/03/2026

25/03/2026

24/03/2026

19/03/2026

18/03/2026

16/03/2026

12/03/2026

11/03/2026

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