Hone Optimization: Neurophysiologist Louisa Nicola
Biomarker testing, supplements, and training tweaks restored the Neuro Athletics founder’s energy and sharpened her recovery.
Louisa Nicola is a clinical neuroscientist and founder of Neuro Athletics, a consulting firm that works with elite athletes to optimize brain and body performance. She hosts The Neuro Experience podcast and has coached Olympic and professional sports teams.
“I’ve always been focused on performance; it’s my world. But I hit a point where I could feel I wasn’t fully optimized. I was doing the same amount of exercise I had been for years—5-6 high-output sessions per week, mostly running plus strength training and conditioning—but my energy, sleep, and recovery felt just a little off.
I knew I needed to take a more proactive approach to my health, get proper data, and course-correct before it became a bigger issue. I was also interested in learning more about my hormone levels, especially testosterone, as it plays such a big role in mood, muscle mass, and energy.”
Initial Labs and Clinical Assessment
While often overlooked in women, testosterone supports muscle strength, energy, mood, and more.1 Just like men, women’s testosterone declines with age; by the time a woman turns 40, her total testosterone is about 50 percent of what it was at 21. 2 For women, a total testosterone level of 40–60 ng/dL is ideal.
This “active” form of testosterone plays a role in muscle mass, energy, metabolic function, libido, and mood. Low levels correlate with reduced fitness performance and recovery and increased the chance of injury. 3 An optimal level for women is 0.5-0.7 nd/dL.
Sex hormone binding globulin is a protein that binds to circulating sex hormones and reduces their bioavailability. Elevated SHBG can result from excess estrogen, thyroid hormone, or even high protein intake. In Louisa’s case, stress, diet, and training load could be contributing. High SHBG reduces free testosterone, which could be happening here. An ideal SHBG range is between 30-100 nmol/L.
T3 is the active form of thyroid hormone that regulates metabolism and energy. When T3 is low, metabolism slows down, energy drops, and fatigue sets in. 4 Louisa’s level was on the lower end of normal; an ideal range is 3.0 – 5.0 pg/ml.
Clinical Notes
Louisa’s labs weren’t ‘alarming,’ but they were suboptimal. Her testosterone was low, but there’s no universally accepted lower threshold for women, and symptoms often appear within the standard reference range.
– James Staheli, D.O., Medical Director, Hone Health
Louisa’s Optimization Protocol
Supplements
- DHEA (25 mg daily): Supplemental DHEA can support the production of sex hormones, including testosterone and estrogen. 5
- Vitamin D3 (5,000 IU): Vitamin D deficiency is widespread and can contribute to fatigue, mood changes, and poor recovery. Some research suggests it also supports hormone production, including testosterone. 6, 7
Lifestyle changes
- Stress reduction: Chronic stress elevates cortisol and disrupts the hypothalamic–pituitary–gonadal (HPG) axis, suppressing hormone production. Grounding techniques like meditation and breathwork can lower sympathetic nervous system activity and help restore hormonal balance.
- Exercise: Louisa was training intensely but wasn’t giving herself enough time to recover. Overtraining can lead to chronically elevated cortisol and overtraining symptoms. High cortisol levels create a negative feedback effect on the hypothalamus and pituitary gland, inhibiting GnRH production, which lowers lutenizing hormone (LH) and follicle stimulating hormone (FSH), ultimately decreasing testosterone. Elevated cortisol can also increase aromatase activity, converting testosterone into estrogen and further reducing levels. To strike a better balance, we revised her program to include:
- 2 high-intensity sessions per week (zone 4+ and heavy lifts)
- 2 zone 2 aerobic sessions for base-building
- 1–2 active recovery or mobility-focused days
- 1 full rest day per week
- Diet: Louisa followed a mostly Mediterranean-style diet but wasn’t consistently meeting protein needs. Protein provides amino acids essential for hormone synthesis, including testosterone precursors. Aiming for 1.6–2.0 grams of protein per kilogram of body weight supports lean mass, recovery, and hormone health—especially when paired with strength training.
3-Month Follow-up and Assessment
Clinical Notes
Louisa’s follow-up labs showed that her FT3 is now within the optimal range, supporting better energy and metabolic function. Her total and free testosterone levels have improved, though they remain below the optimal range. Interestingly, her SHBG increased slightly, which may be binding more of the available testosterone. We’ll want to continue to bring her SHBG down and increase testosterone.
– James Staheli, D.O., Medical Director, Hone Health
“I wanted a sustainable, data-driven approach, and that’s exactly what I got. The best part was going through my labs with a physician who really listened to my concerns and goals. I wanted to start by supporting my body through supplements and lifestyle changes, and avoid pharmaceuticals unless absolutely necessary.”
– Louisa Nicola
“I really had to be intentional about tracking how I was feeling and making time for recovery, not just output. It was a little hard to stay on track when things got busy, but the biggest challenge was mentally giving myself permission to slow down and prioritize recovery. Once I did, I saw big improvements.”
Scott A, Newson L. (2020) Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care.
↑Zumoff B, Strain GW, Miller LK, Rosner W. (1995) Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women.
↑Chung KJ, Kim KH. (2015) Forbidden fruit for athletes, but possible divine blessing for rehabilitation: testosterone.
↑Maria M. Fariduddin; Nowreen Haq; Nidhi Bansal. (Updated June 2024). Hypothyroid Myopathy
↑Wierman ME, Kiseljak-Vassiliades K. (2022) Should Dehydroepiandrosterone Be Administered to Women?
↑Chen C, et al. (2019) Causal Link Between Vitamin D and Total Testosterone in Men: A Mendelian Randomization Analysis.
↑Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B. (2008) Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women.
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About the author
Tracy Middleton is the Senior Editorial Director at Hone and an award-winning health journalist and editor with more than 20 years’ experience. She is the former Editor in Chief and Brand Director of Yoga Journal and former Health Director of Women’s Health, and a member of the Association of Health Care Journalists.
