Wellness Prescriptions at Twisted Tree Wellness:

GLP‑1 medications are injectable or oral drugs that mimic a natural gut hormone to improve blood sugar, reduce appetite, support weight loss, and protect multiple organ systems in people with type 2 diabetes and/or obesity. They have been in clinical use since 2005 and now have an extensive safety and outcomes track record when used as prescribed. Studies continue to show profound health benefits extending far beyond weight management. Cardiovascular and brain health are dramatically improved and all cause mortality decreases for patients on GLP1s: this means that people statistically live longer on GLP1s.

GLP‑1 medications help protect the heart and kidneys in people with type 2 diabetes by lowering the risk of heart attack, stroke, and cardiovascular death, and by slowing kidney damage in appropriate patients. They do this partly by improving blood vessel health and reducing harmful inflammation and oxidative stress in the cardiovascular and renal systems.​

They also affect the liver, brain, and other organs by calming inflammatory and immune pathways and supporting healthier cell function, which may improve fatty liver and arterial disease. Early research suggests possible benefits in conditions like sleep apnea, some liver diseases, certain brain and mood disorders, and obesity‑related cancers, but these uses are still being studied and are not yet routine standards of care.

• Many patients report improved energy, mobility, sleep quality, and health‑related quality of life as weight, glycemia, blood pressure, and inflammatory markers improve.​
• These medicines often enable reduction in doses or number of other cardiometabolic medications, which can simplify regimens and improve perceived wellbeing in appropriate patients.

• Current evidence suggests no major increase in overall serious adverse events or pancreatitis compared with placebo in weight‑loss trials in non‑diabetic adults, although pancreatitis and gallbladder disease remain labeled risks requiring monitoring.​
• GLP1s carry boxed or prominent warnings about medullary thyroid carcinoma risk based on rodent data; they are contraindicated in patients with personal/family history of MTC or MEN2 and should be used cautiously in those with unexplained thyroid nodules.​
• Rare events such as bowel obstruction, severe gastroparesis, biliary disease, and mood changes have been reported, so individualized risk assessment and ongoing clinical follow‑up are essential.

• GLP‑1 medications are among the more expensive chronic therapies, with annual costs for branded agents commonly in the multiple‑thousand‑dollar range before insurance, and incremental pharmacy costs (including managing side effects) several thousand dollars higher over 1–3 years vs non‑users.​
• Insurance coverage varies widely by indication and plan; diabetes indications are often covered, while weight management prescriptions frequently face denials. 
• Twisted Tree Wellness offers GLP1s only through a customized treatment plan that bypasses insurance for these reasons. 

Life coaching is for people who are ready to invest in themselves so they can move from feeling stuck and overextended to feeling clear, confident, and aligned. It is especially powerful for high-capacity caregivers, busy professionals, leaders, and parents who are used to taking care of everyone else but now want support, perspective, and accountability for their own growth. It also serves anyone who wants help setting boundaries, clarifying goals, and actively transforming their life, relationships, and work into something more intentional and fulfilling.

Expect life coaching at Twisted Tree to feel focused, collaborative, and surprisingly efficient in how quickly it shifts your inner landscape. You’ll choose the coach who best fits your personality and goals—Tanya or Hannah—then meet virtually once a week for a dedicated, confidential session tailored to what you most want to change.

Between sessions, you’ll receive brief but highly impactful “homework” that might take only a few minutes a day but creates outsized shifts in awareness and behavior. During sessions, you’ll complete transformative exercises with your coach and begin to notice dramatic changes in your thinking, self-talk, motivation, and emotional state, along with a growing sense of momentum and a clearer trajectory toward the life you actually want to be living.

Life coaching results build quickly and then deepen over time. In as little as 2 sessions, many people experience immediate relief, a clear sense of what’s really going on, and one or two practical shifts that bring noticeable change. In 6 weeks, clients typically see marked changes in self-talk, boundaries, and daily choices, with more consistent follow-through and a sense of renewed motivation. Within 12 weeks, it is common to feel like a different and more authentic version of yourself—clearer, calmer, and more intentional—with new thought patterns, habits, and relationship dynamics that support a fundamentally different trajectory.

Hormone therapy is a treatment that gently replaces some of the hormones your body makes less of during perimenopause and menopause, mainly estrogen and often progesterone. By bringing these hormone levels back into a healthier range for you, it can ease symptoms like hot flashes, night sweats, vaginal dryness, sleep problems, mood changes, and brain fog, and can also help protect bone health in many women. The exact type, dose, and form (such as pills, patches, or creams) are personalized after a careful review of your health history so that benefits and risks are balanced for your specific situation.

Hormone replacement therapy (HRT) is mainly for women in perimenopause or menopause who are bothered by symptoms like hot flashes, night sweats, sleep problems, mood changes, vaginal dryness, or brain fog. It is especially considered for women with moderate to severe symptoms, or those at higher risk of bone loss and fractures, after a careful review of their age, health history, family history, and personal risk factors. In general, HRT is most often recommended for women who are under 60 or within about 10 years of their final period, and who do not have contraindications such as a history of certain cancers, blood clots, stroke, or significant liver disease.

Empower Pharmacy is a specialized compounding pharmacy that prepares customized hormone replacement medications—such as estrogen, progesterone, testosterone, thyroid, and other hormones—tailored to each patient’s prescription and needs. They work in both 503A and 503B settings, meaning they can create patient‑specific formulations (like creams, capsules, troches, pellets, and gels) as well as larger‑batch office‑use products, all under strict quality and sterility standards. For women in perimenopause and menopause, this allows highly individualized dosing, combinations, and delivery routes that can better match symptom patterns and tolerability, supporting a more precise and flexible approach to hormone therapy than standard, one‑size‑fits‑all prescriptions.

For menopause, the most commonly used HRT medications are forms of estrogen (such as estradiol tablets, skin patches, gels, or sprays, and conjugated estrogens) often paired with a progestin or micronized progesterone for women who still have a uterus. Many clinicians use a combination of estradiol plus progesterone in various doses and delivery methods to match a woman’s symptoms and risk profile, and local vaginal estrogen (as creams, tablets, or rings) is also widely used when the main issues are vaginal dryness or pain with intercourse.

In this practice, hormone therapy is offered entirely outside of insurance so care can stay truly personalized, transparent, and under your control. The compounding pharmacy used for HRT also does not bill insurance, which allows them to create customized formulations and doses based on your specific needs rather than on what a plan will cover.​

Working outside of insurance means there are no surprise bills, prior authorizations, or coverage denials shaping your treatment; you know the cost up front, and that fee includes both your medication and all direct interactions with Dr. Parrish related to your hormone care. This model supports a higher‑touch, longer‑visit approach, where decisions are driven by your symptoms, goals, and safety—not by time limits or insurance rules.