I know my ob/gyn said I'm not peri-menopausal, but my friend brought up the logic that it is only a hormonal moment in time that the blood test captures, not the full picture. For the full picture it's taking into account:

1. Random hot flashes followed by horrible fatigue that are not blood sugar related. Protein helps, but doesn't offset it

2. Hair loss. I managed to reverse it by taking biotin supplements, but something was shifting to cause that, even after the liver symptoms reversed.

3. Sleep disturbances. I wrote this off to re-setting my schedule in the hospital where I had to be up by 7-8 am for breakfast and doctor rounds, but after a few months I still wake up at odd times, can't sleep in and have to take naps to try and address the lingering fatigue. I still don't have a total handle on this and am using my "lunch break" as "crash out on the loveseat and sleep for an hour" breaks.

The IUD keeps my period away permanently, so that's not a reliable gauge, but considering all of these other symptoms, and having my thyroid tested as well (it's fine), the only thing left is peri-menopause. 

So for now I'll try to figure out how to address the sleep problems, and find what can work for me since my doctor isn't going to help me out on it. Billions of women have made it through menopause without any assistance, so I guess it's time for me to join their ranks. Portable fan, check. Quick-dry towel to wrap around my neck when flashing, check. The rest will follow.