Healthy Living Blog: 95% of Women Are Nutritionally Depleted – No Wonder Women in Midlife Feel Terrible with Julie Sawaya
I want to ask you something honest: do you feel like you’re doing everything right, but your body still isn’t cooperating?
You’re eating well. You’re taking supplements. Maybe you’ve even had some labs done and your doctor told you everything looks “normal.” And yet you’re exhausted. You can’t think clearly. The weight won’t budge. You feel like you’re running on fumes, and nobody seems to have a real answer for why.
Here’s what I’ve come to believe after years of working in the health and wellness space and talking to some of the most brilliant practitioners and researchers in women’s health: most of us are not broken. We are depleted. And those are two very different things.
That distinction is exactly why I knew I had to bring today’s guest on. Julie Sawaya is the co-founder of Needed, a women’s health supplement company now backed by over 15,000 practitioners. But the reason I trust her isn’t the resume (although a Stanford MBA and a background in nutrition are nothing to dismiss). It’s the founding story. Julie was doing everything right, shopping farmers markets, trained in nutrition, incredibly intentional about what she was putting into her body. And when she tested her own nutrient levels? Almost every single one came back in the red zone.
If it’s happening to someone like her, it’s happening to most of us. And today, I want to walk you through what we talked about because this conversation genuinely changed the way I’m thinking about my own health.
The Nutritional Standard We’re All Being Measured Against Is From 1941
Let’s start with something that honestly made my jaw drop. The RDA, the Recommended Daily Allowance that appears on every supplement label, every nutrition guideline, every doctor recommendation, was created in 1941. It was a wartime measure designed to establish the bare minimum nutrition needed to keep a population from developing serious disease. Not thriving. Not optimal health. Survival level.
And here’s the deeper problem: when researchers went back to examine the specific RDA for pregnant and breastfeeding women, a study population of over a million participants was used as the basis. Less than 5% of those participants were actually pregnant or breastfeeding.
Let that sink in.
The nutritional standard designed specifically for pregnant and breastfeeding women was built on research that barely included them. And the standard for perimenopausal women? It doesn’t meaningfully exist. There’s an RDA for women 18 to 50 (a wildly broad range), and then one for women over 50, but neither is grounded in research focused on what women actually need during these hormonally demanding periods of life.
Julie described it simply: the nutrition standards for women’s health are broken. And until we understand that, we’re going to keep chasing optimal health using a broken map.
Why Depletion Is a Continuum, Not a One-Time Event
One of the most important frameworks Julie shared is the idea that nutritional depletion isn’t something that happens at one stage of life. It’s a continuum that runs through a woman’s entire hormonal journey.
It often starts with hormonal birth control. Many of us (myself included, I was on the pill from around 15 years old for nearly 20 years) have learned more recently that synthetic hormones can interfere with the body’s ability to absorb certain nutrients, particularly B vitamins and minerals. That depletion doesn’t announce itself. It builds quietly.
Then comes the depletion of pregnancy and breastfeeding, where the body masterfully prioritizes the baby at the expense of the mother, literally pulling choline from the maternal brain and calcium from bones and teeth. Most women are told that prenatal vitamins are for the baby. But Julie made a point I won’t forget: a prenatal vitamin is as much for the mother’s health as it is for the baby’s.
Then, when pregnancy and breastfeeding are over, most women stop supplementing. Life moves on. And the depletion that was present before pregnancy, worsened during it, and was never fully replenished quietly carries forward.
Here’s what’s striking: the most nutritionally demanding time in a woman’s life is pregnancy. The second most demanding? Perimenopause.
So most women arrive at perimenopause already running low, and the intensity of symptoms they experience is, in part, a consequence of that unaddressed depletion.
What Women in Perimenopause Are Actually Missing
When Julie and I got into the specific nutrients, this is where the conversation really opened up for me, and I think it will for you too.
Choline is the one I want to lead with because I think it’s the most underappreciated nutrient in women’s health right now. Ninety-five percent of women in the US are deficient in it. It’s critical for brain health and cognitive function, including memory, mood, attention, and focus. It’s found primarily in egg yolks (not egg whites, something to remember if you’ve been a longtime yolk-tosser, and a lot of us were told to avoid them for decades). As estrogen drops in perimenopause, choline needs actually increase. And here’s what hit me: so much of what we attribute to hormonal brain fog could actually be a choline problem. That’s not a complicated fix. It’s not scary. It’s a nutrient.
A study from April 2026 found that choline can improve brain function in postmenopausal women within three hours of taking it. If you’ve been struggling with brain fog and haven’t looked at choline, this is your sign to start.
Vitamin D deficiency affects more than half of perimenopausal women, and some research suggests the number could be as high as 85 to 90 percent. This is true even for women who live in sunny climates and spend time outdoors. The reference ranges used in conventional lab work are often oriented around “not deficient” rather than optimal, so many women are told they’re in the normal range when they’re actually far from where they need to be for hormone health, immunity, and mood.
Magnesium is critical for hundreds of processes in the body, and the form matters enormously. Most supplements use magnesium oxide, which is cheap, poorly absorbed, and more likely to cause digestive disruption than any real benefit. Magnesium glycinate is a much better-absorbed form with a calming effect on the nervous system.
Potassium is one almost nobody talks about, and this stat surprised me: only 8% of perimenopausal women meet the dietary reference value for potassium. It’s a critical electrolyte, and the banana fear of recent years hasn’t helped.
Omega-3 fatty acids (specifically DHA and EPA) are critically important for heart health, brain function, mood, immune function, and inflammation. The average American consumes about 50 milligrams of DHA per day and 18 milligrams of EPA. The optimal intake is around 500 milligrams combined. That is a significant gap. And our brains are 60% fat, so the most important fat for brain function is the one most of us are chronically low in.
The Leaky Bucket Problem with Supplements
One of the analogies Julie used that I keep coming back to is the leaky bucket. If you’re depleted at the nutrient level and you start adding in symptom-specific support, whether that’s adaptogens, stress support, or even hormone replacement therapy, you’re essentially pouring water into a leaky bucket. Some benefit gets through, but not nearly what it could if the foundational gaps were addressed first.
This is something I see constantly in the wellness space. Women jump straight to HRT, to peptides, to biohacking tools, without first establishing what their nutritional baseline actually looks like. And when those things don’t work as well as expected, they assume the approach is wrong. But it may just be that the foundation wasn’t there first.
Julie put it beautifully: vitamin and mineral deficiencies are like missing letters from the alphabet. You simply cannot spell all the words. Your body cannot perform all of its functions when the building blocks aren’t there.
How to Read a Supplement Label Without Getting Fooled
This part of our conversation is practical and I think every woman needs to hear it.
The first thing to look for is ingredient form, not just ingredient name. The most common form of folate in supplements is folic acid, a synthetic version that many women (especially those with an MTHFR gene variation) cannot properly absorb. Methylfolate is a more bioavailable form that works better for most women.
For magnesium, avoid magnesium oxide. Look for glycinate or citrate instead. For B12, cyanocobalamin is the most common form, and it’s literally B12 attached to a cyanide molecule. Methylcobalamin or adenosylcobalamin are far more usable by the body.
One important nuance worth adding: if you have a slow COMT gene variation, highly methylated forms of vitamins can actually feel overstimulating for some women. The right approach is always to introduce one thing at a time, pay attention to how you feel, and not assume that what works for most will automatically work for you.
The second thing to watch for is proprietary blends, what Julie calls “pixie dusting.” This is when a brand lists an impressive-sounding ingredient but doesn’t disclose the actual dosage. They can put it on the label for marketing purposes without actually including a therapeutic amount. B12 is a common example: the most frequent dosing is around 2.8 micrograms, which is roughly 70 times lower than what’s considered optimal.
Third, look for third-party testing certifications. Clean Label Project, NSF Certified for Sport, and Friend of the Sea (for omega-3 products) are markers that a brand is serious about purity, heavy metal testing, and potency verification.
On omega-3 specifically: most fish oil on the market is rancid. Mixing omega-3 with vitamins and minerals, which many multivitamins do, is one of the easiest ways to oxidize it. Rancid omega-3 doesn’t reduce inflammation. It increases it, the exact opposite of why you’re taking it. Look for a triglyceride form, third-party tested, and stored separately from your other supplements.
The Unsexy Basics First
I want to close with something Julie said that I think cuts to the heart of why so many women feel stuck despite doing so much: we are a culture that doesn’t like the nuanced multi-step approach. We want the solution. We want the hack. We want the one thing that fixes it.
But the most effective path to feeling better in midlife isn’t the most exciting one. It’s fixing the leaky bucket first. It’s addressing the boring foundational nutrient gaps before layering on the more sophisticated support. It’s the unsexy basics, done consistently, that create the conditions for everything else to actually work.
Fnd Needed’s full line at thisisneeded.com and use code NATALIEJILL for 20% off your first order.
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
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