By symptom
Food cravings.
Cravings are biology pulling for what it needs, often dressed up as what it can get easily.
What’s actually going on
How I think about this.
Persistent cravings — for sugar, salt, carbohydrate, alcohol — are almost never about willpower. The cellular biology underneath usually shows the same patterns I read across the rest of HOMe: blood sugar variability driving the next spike-and-crash, neurotransmitter precursors running short and pulling for the fastest dopamine hit, gut microbiome shifted toward species that thrive on what you crave, and nutrient gaps that the body mistakes for energy gaps.
This is part of the same through-line. Cravings, energy crashes, mood symptoms, and weight resistance share substrate. When the substrate gets better, multiple symptoms ease together. When patients are told to push through cravings without addressing the underlying biology, the failure is predictable and the patient blames themselves.
Reading the biology under the craving is the first move.
The physician’s lens
How I read this in practice.
A CGM if blood sugar is plausibly involved, which it almost always is. Metabolomics for the neurotransmitter precursors. Gut microbiome composition for the dysbiosis pattern that feeds the cycle. Standard labs to rule out the obvious — thyroid, iron, B12. The combination almost always tells a coherent story the patient can act on.
The systems behind it
Where this symptom comes from.
Most cases touch more than one. Open each area to read the biology underneath.
Biological pillars
Pillar
Metabolomics.
Urinary organic acids read the upstream patterns of energy production, neurotransmitter balance, detoxification, and recovery.
Read this pillarPillar
Gut-Immune health.
The microbiome runs 70% of your immune system, shapes inflammation, mood, and metabolism. Read the ecosystem directly.
Read this pillarPillar
Chronobiology.
Every hormone, immune function, and metabolic process runs on a circadian schedule. The disruption is measurable, and the consequences are systemic.
Read this pillarWhat I’d test first
The data that explains it.
Cravings respond fast to CGM data because the curve makes the pattern impossible to argue with. I usually start there, then layer in metabolomic and gut testing if the picture warrants it.
Advanced testing
CGM (continuous glucose monitor)
Two weeks of glucose data mapped to meals, sleep, and stress. The single most useful tool for cravings driven by blood sugar variability.
Read the panelAdvanced testing
GI Effects
Reads the microbial composition that often drives cravings for the substrate the microbes prefer. The dysbiosis pattern is more common than most patients expect.
Read the panelWhile you wait
Moves worth making before testing.
These are the levers I’d pull while we set up the workup. Most of them produce real signal inside two weeks.
- Eat 30 grams of protein at breakfast for two weeks. Most carbohydrate cravings drop measurably when morning protein is consistent.
- Walk for 10 minutes after meals. Lowers the post-meal glucose excursion that often drives the next craving.
- Cut ultra-processed snacks for two weeks and see what happens. The flavor system was engineered to override satiety; removing it lets the satiety signal recalibrate.
- Note when cravings hit hardest and what you ate two hours before. The pattern is often obvious once you write it down.
If two weeks of the basics doesn’t move the needle, that is exactly the kind of presentation a Precision Call exists for. Your biology is telling you something the lifestyle layer cannot fix on its own.
More reading
What I’ve written on this system.
Article
The future of precision medicine, and the role metabolomics plays in it.
Precision medicine is where the field is going. Metabolomics is one of the most important reads it brings online. Here is what is real, what is hype, and what I think a practice will look like in ten years.
Read thisArticle
Metabolomics and weight loss: finding the blockers.
When weight loss is not responding to the right inputs, the blocker is usually metabolic. A metabolomics panel surfaces the specific blocker so the intervention can match it.
Read thisArticle
Hormone imbalances, read through a metabolomics lens.
A hormone panel tells me the levels. Metabolomics tells me what the body is doing with those levels. Together they explain symptoms a hormone panel alone misses.
Read thisBrowse other symptoms
Something else on your mind?
Fatigue and low energy
When the tank stays low no matter how much you sleep.
Brain fog
The lights are on but the signal feels weak.
Poor sleep
Either you can't fall asleep, or you can't stay asleep.
Digestive issues
Bloating, irregularity, sensitivities that keep widening.
Mood and stress
Patience runs short, recovery from stress takes longer.
Hormonal imbalance
Energy, sleep, libido, and weight stop responding to the basics.
Perimenopause
The years when the body's hormonal rhythm changes, before the period stops.
Low libido
Desire that used to be reliable is gone or muted. Both sexes, both directions.
Hair loss
Thinning, shedding, or texture changes that didn't used to happen.
Erectile dysfunction
ED is the canary. The body is telling you something about vascular and hormonal health.
Weight loss resistance
You eat well, you train, the scale doesn't move. Something deeper is in the way.
High cholesterol concern
Your last lab flagged it. You want a second opinion before you take a statin.
High blood pressure concern
The reading came back elevated. You want the full picture before you start a prescription.
Insomnia
You can't get to sleep. You can't stay asleep. Or both.
Athletic recovery problems
You train hard. You don't bounce back. Something physiological is in the way.
Headaches and migraines
Recurring headache patterns the standard workup hasn't solved.
Joint pain
Pain in one joint is often a local problem. Pain that travels, or pain in multiple joints, is usually a systemic one.
Anxiety
Some anxiety is psychological. Much of what shows up in clinic is biological with a psychological face.
Acne and skin issues
The skin is rarely the problem. It is the most visible report on what is happening one layer down.
Thyroid symptoms
Cold all the time. Hair shedding. Sluggish mornings. A 'fine' TSH that explains none of it.
PMS and cycle issues
A difficult cycle is often a window into how your body handles hormones across the rest of the month.
Food cravings
Cravings are biology pulling for what it needs, often dressed up as what it can get easily.
Chronic allergies
New or worsening allergies in adulthood usually point to a barrier and an immune tone, not a specific allergen.
Start here
Want me to read your data?
A complimentary 30-minute call by phone or video with me. You tell me what is going on. I tell you how I would approach it. You decide if I am the right physician for you.