Nutritionist for St. George, Utah

St. George has two populations and they want the same thing for different reasons. One is retired or close to it, moved down for the winters, and entirely uninterested in a slow decline. The other is endurance athletes drawn by year-round training and a marathon that half the town seems to run. Both are asking how to keep performing, which makes this the part of Utah where hormone work comes up most often and least apologetically.

The desert changes the physiology. Summer heat pushes hydration and electrolyte needs far past what people carry over from cooler places, and chronic low-level dehydration quietly degrades energy, cognition and recovery long before anyone thinks to test for anything. Plenty of people here treat their thirst as the signal. By then it's late.

The age profile also means more people arriving with existing labs in hand and a sense that something isn't adding up — results inside the normal band, symptoms that clearly aren't. That's the most productive place to start, because there's already a baseline to read against.