David Epstein wrote a book called Range that argues the most creative breakthroughs come from people who've worked across many domains, not from those who specialized early. When I read it, I didn't learn anything new. I just finally had a word for what I'd been doing my entire life.
Selling rocks at six
My first business was selling rocks. I was six years old. I went door to door in my neighborhood and I wouldn't go home until I made twenty dollars. I also sold origami, ran lemonade stands, and did concessions. By the time I was twelve I was selling candy at my school, Lincoln Prep in Kansas City. By thirteen I had gotten myself hired at a grocery store called Milgram's, which was illegal because I was thirteen. I was persistent about it. The FBI eventually investigated Milgram's and shut it down, though not because of me specifically.
The point is not that I was entrepreneurial as a kid. The point is that I never waited for someone to tell me I was allowed to do something.
The operating room
When I was twelve or thirteen, I started spending my weekends in the hospital where my mom worked. She was an RNFA with thirty years in cardiac surgery, cardiothoracic surgery, and neurosurgery. I was there in the capacity of cleaning things up, putting surgical trays together, taking instruments downstairs to decontam. But I was watching everything.
There was a drawing test they gave people who worked in the OR. It was a picture of a sterile field and you had to identify everything wrong with it. I missed one: a small trash can within a foot of the operating table. That one still bothers me. But my mom came back and told me I'd done better than most people who had formal education.
When I was thirteen there was a Take Your Daughter to Work Day. They sent all the kids to Kirmayer Fitness across the street from KU Med to play basketball or whatever. I said, "Fuck that, I don't want to go to Kirmayer Fitness. They're doing surgery across the street." I snuck out, went across to the hospital, found the women's locker room for the operating room, put on a bunny suit, walked into the surgical area, and said I was there for surgery.
That day I lasered my first cancerous polyp off of someone's esophagus.
I was thirteen years old.
There was also a situation around that time where I got someone fired. A woman was carding a live heart on ice and she wasn't wearing a mask. It wasn't that I was angry about it. It was closer to bewilderment. I knew this person had more education than I did. I knew she knew things I didn't know. But I also knew she needed to be wearing a mask. Why wasn't she? I went to my mom and the woman was terminated.
I spent years in and around operating rooms after that. Not because I had credentials but because I was good at it. When I was nineteen, I worked as a circulating nurse and translator in La Paz, Bolivia. I was invited to circulate for specific surgeons. I was asked for over people who had formal education. Not because I was cute. Because I was competent. That distinction matters to me.
I always wanted to get back into a hospital somehow. The microbiome medicine angle turned out to be the way back in.
Color theory, mathematics, and arguing with painters
I had been sensitive to color and design since I was three years old. The inciting incident was a pair of red-gold sandals being paired with a black and yellow-gold Halloween costume. I did not appreciate that combination and I was vocal about it.
By six the sensitivity had become an obsession with color theory. By the time I was working as a color and design consultant in my early twenties, doing work for photographers in Kansas City and consulting on historical home renovations for a man named William Poole who was restoring Italian Renaissance mansions, I had come to believe that the prevailing frameworks for understanding color were wrong. Specifically, I believed color was a function of mathematics, not of the subjective categorizations that dominated the field.
I had been writing a book about this. Carol Jackson, the author of Color Me Beautiful, had agreed to write the foreword. I'd also contacted her to tell her I thought she'd gotten some things wrong.
Through the renovation work with William Poole I ended up meeting some people who turned out to be well-known painters and professors at the Kansas City Art Institute. I didn't know who they were at the time. I drew my theories out on a napkin and it became a bit of an argument, which ended when I broke the whole system down into mathematics and they couldn't counter it. I did a short seminar at the Art Institute after that.
The color theory obsession seems unrelated to microbiome research. It isn't. What it trained was pattern recognition across complex systems where everyone else was relying on subjective interpretation. When I look at a microbiome signature, I'm doing the same thing I was doing with color: seeing the underlying structure that the surface-level categorization obscures.
Dropping out, coming back, and the professor who said no
I dropped out of high school. Then I came back the last few months of my senior year, made up all my work, and graduated with close to a 4.0. I went to college at UMKC but took a break after one year to go to cosmetology school. Eventually I came back to UMKC's business school and ended up in an independent studies program under a Harvard business professor named Carla Pavone.
In 2009, I told Professor Pavone that I wanted to start the Paleo Foundation and certify foods as Paleo. She discouraged me. She saw no indication that the Paleo diet was going to become popular.
I started the Paleo Foundation anyway. Fifteen years later it's the world's leading certification body for Paleo, Keto, and Grain-Free products, and I'm building the Heavy Metal Tested and Certified program on top of it.
The psychology of certification is interesting to me because it defies some of the rules of economics. It's a psychological product. The consumer isn't buying the food. They're buying the trust that the mark represents. That's closer to the psychology I'd been studying informally since I was a kid than to anything I learned in business school.
The psychology I built from necessity
I was the truth-telling scapegoat child of a covert narcissist. That's a clinical description of an experience that, when you're living through it, just feels like the world doesn't make sense and you're the only one who notices.
I picked up psychological skills from that experience the way a person picks up a language by being dropped in a country. Not formally, not systematically, but out of necessity. I developed frameworks for understanding manipulation, communication, and emotional dynamics that I later named: the up-down framework, the holes-and-ladders framework, and the master sentence framework.
Two separate psychologists, at different times, asked me to write a book about these systems. I said no both times. It wasn't what I wanted to do. But the systems worked. People who used them reported cutting roughly ten years off their therapy timelines. I don't say that to make a claim about therapy. I say it because it's another instance of the same pattern: I build systems for understanding complex, opaque dynamics, and they work, and the fact that I have no formal credentials in the field doesn't change that.
The health crisis that connected everything
In 2008 I was perfectly healthy. By the end of 2009, at twenty-five, I'd been diagnosed with PCOS, PMDD, schizophrenia, grade three anemia, cirrhosis, a kidney mass, reflux, peripheral neuropathy, optic neuritis, bacterial vaginosis, amenorrhea, endometriosis, and finally celiac disease. I gained fifty pounds in three months.
Instead of treating these as separate conditions, I asked what I thought was a simple question: what if these are not separate conditions at all, but symptoms of something bigger? And if so, symptoms of what?
That question led me to the microbiome. In 2010, when the published literature on the human microbiome was still a handful of papers, I started piecing together the overlapping signatures of my conditions. I found patterns. I designed interventions based on those patterns.
By 2012, I had become convinced that a fecal microbiota transplant could address my celiac disease. I went to gastroenterologists and tried to get them to do it. They refused. Every one of them said there wasn't enough evidence. They just wouldn't do it. So I did it myself, DIY.
It worked. I became the first known person to undergo FMT for celiac disease.
When I went public about it on the SCD Podcast with Jordan Reasoner, I was lambasted. People were angry that I had done it, angry that I was talking about it, angry that someone without medical credentials was claiming results from a procedure that no gastroenterologist would perform.
Four years later, in 2016, a published case study appeared: "Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer." It described what happened when another patient underwent the same procedure. It was treated as a breakthrough. The procedure I'd been criticized for doing in 2012 was now the subject of a peer-reviewed paper documenting full recovery.
I consider myself 98 to 99 percent recovered from conditions that conventional medicine treats as permanent.
The Reddit thread that opened metallomics
The discovery of microbial metallomics happened because of something small. I had spent years self-experimenting with diet and I had a list of foods that I'd identified as problematic for me. One day I saw a discussion on Reddit about the low-nickel diet. I noticed that the foods on the low-nickel diet list were almost exactly the same foods I'd already figured out were bad for me through trial and error.
That was the thread I pulled. I started looking into nickel and its role in microbial pathogenesis. What I found was that nickel is an essential cofactor for some of the most important virulence factors in pathogenic bacteria, but it's not required by human host cells. That asymmetry is a therapeutic lever that nobody was paying attention to.
That rabbit hole became the field of microbial metallomics. It connected naturally to my decade of experience in food certification: the same metals I was studying in the microbiome were the same metals contaminating the food supply. HMTc certification wasn't a pivot. It was an inevitability.
Calling the trend, betting everything
I have a pattern of calling trends before they arrive and moving on by the time they peak. The Paleo diet. The ketogenic diet. Tiny houses. The microbiome-everything wave. Prebiotics. In 2009, I told a Harvard business professor the Paleo diet was going to become huge. She saw no evidence of that. I had almost no evidence either. I bet my entire life on it anyway, leaving Kansas City for Los Angeles with my mom, Kimberly Eyer, to start the Paleo Foundation and begin certifying foods.
That bet paid off. The Paleo Foundation became the world's leading certification body for Paleo, Keto, and Grain-Free products.
In 2020, I told Fred Hart, the founder of Interact (one of the most respected brand and packaging design agencies in the CPG space), that one day we'd see Pepsi putting prebiotics in their cans and listing it on the front of the label. He thought I was nuts. In 2026, Pepsi did exactly that. When I messaged Fred about it, his response was: "Well if it isn't the oracle herself! Hope you're well. Too bad we don't have a recording of that call. And now you need to put out a 2030 trends prediction piece."
I'm usually right about these things, not because I'm psychic but because I follow the mechanistic logic of where consumer awareness and science are converging and I project forward.
My next calls: human-grade pet food is going to become mainstream. And heavy metal contamination is going to become a much bigger consumer issue than anyone currently appreciates, because once the microbial metallomics framework starts to land with researchers and regulators, people will realize that heavy metals aren't just toxicants. They're ecological selection pressures that shape which microbes thrive in your gut. That realization changes everything about how we think about food safety.
In 2012, while running the Foundation, I wrote a book called Eat Paleo, Save the World: An Omnivore's Perspective on Sustainability. I later retitled it The Sustainability Diet. I had gotten deeply interested in rewilding through Paul S. Martin's Twilight of the Mammoths and I was building what I thought was an airtight case against monoculture agriculture.
Then I read The Rational Optimist by Matt Ridley and it made things go sideways for me. For the first time, I had a genuinely compelling argument in favor of monocultures. That mattered to me because I have a rule: I don't consider myself knowledgeable on a topic unless I can argue the opposing side better than its proponents can. Ridley gave me the argument I'd been missing, and it forced me to rethink some of what I'd written.
One chapter of that book was a scathing takedown of organic agriculture and farming. The people who read it said it was the best chapter I'd written, but that if the book got out it would be the end of organic agriculture as we know it.
I said, "If little old Karen Pendergrass can take down organic agriculture, then it deserves to be taken down. And it would need to be rebuilt with a new set of principles and a new framework focused on actual closed-loop systems instead of greenwashing agricultural practices that were still reliant on the very non-organic monocultures they so purport to hate."
Others in the industry felt like I was being too exposing. I felt like I was someone on the inside trying to push us toward something better. The book never got published. But then Joel Salatin said something to me that gave me a change of heart. He said anything worth doing was worth doing poorly at first. He also said he never claimed he was sustainable. There was a lot of merit in that. Maybe it was a good thing the book never came out. But that chapter still lives on my computer.
The cat who proved the method
My cat Flip lived to be twenty-four years old. When I brought her to Cyprus and she developed kidney issues, I took her to Markos Ktori at the Limassol Veterinary Clinic. He looked at her labs and said there was nothing to do except palliative care.
I said, "Want a bet?"
I came back a month later. We redrew her labs. Everything was back within normal range. No pharmaceutical intervention. The answer was gum arabic, a high-molecular-weight prebiotic fiber that I knew from my research could modify the microbiome in site-specific ways. I had written a research paper in 2019, "Beyond 'Just Eat Real Food': The Case for Prebiotic Fiber and Hydrocolloid Fortification in Modern Diets," documenting the nephroprotective, anti-diabetic, bifidogenic, and anti-obesigenic properties of gum arabic backed by twelve citations. Flip wasn't an experiment. She was a clinical application of research I'd already done.
Markos looked at the labs. He looked at me. He said, "How did you do that?"
He was one of the first people who ever asked me how instead of waving it off. He's still my vet eight years later.
Flip wasn't the only case. Since then I've applied the same site-specific prebiotic fiber approach and the Microbiome Signature Triangulation Method across conditions that most people would consider unrelated. I've worked with clinicians on drug repurposing for metastasized bone cancer, pancreatic cancer, basal cell carcinoma, and melanoma. I've put patients with NAFLD and chronic kidney disease into remission using site-specific prebiotic fibers. I like cancer, which is a strange thing to say, but I find the mechanistic puzzles genuinely compelling. The conditions that are harder for me so far are end-stage renal failure and autism, where I haven't yet found the same level of clarity I've found elsewhere. But the method is the same in every case: find the upstream pressure, identify the ecological dynamics, and intervene at the level of the system rather than the symptom.
The certification I refused to build
In 2020, I started down the path of developing a microbiome-approved food certification. It seemed like the logical next step: I'd been certifying foods for a decade and I was now deep in microbiome research.
But I couldn't do it. Not because it was technically impossible, but because I couldn't figure out how to do it with intellectual honesty. There is no such thing as a universally good anything for the microbiome. What helps one condition can harm another. The field was not ready for a general-purpose "microbiome approved" mark, and launching one would have been irresponsible.
That refusal is why the Microbiome Signatures Database exists. I realized that the path to an honest microbiome certification ran through condition-specific pattern curation. If we could formalize which taxa are elevated and reduced in each condition, and which interventions shift those patterns in the right direction, then eventually, maybe, we'd have enough information to build that program. The database is the prerequisite to the certification. It exists because I said no to the shortcut.
150 PhDs and one non-PhD
In November 2025, I presented at the 11th Beneficial Microbes Conference in Amsterdam. I was the only person in the room without a PhD. There were a hundred and fifty of them and one of me.
I was an invited guest. I was nervous. I was also completely at home, because nobody else in that room had put together what I had put together. Nobody else had presented microbial metallomics to them. Nobody else had walked them through a microbiome signature and shown how a low-nickel diet works for endometriosis through nickel-dependent glyoxalase. Nobody else had ended a presentation with a STOP analysis that made the entire room question whether they should be recommending iron and zinc supplementation for endometriosis patients.
I know how that sounds. I know what it looks like when someone without formal credentials stands in front of a room full of people who have them and says "I see something you don't." I've watched the movies about people who do that. Catch Me If You Can. Something the Lord Made. Hidden Figures. The Imitation Game. I resonate with all of them for a very specific reason.
The field of microbial metallomics is nascent. If I wanted to go to school to learn it, I couldn't. It doesn't exist yet as a formalized field. That's been held against me. But it also means that the work I'm doing is the work that will eventually be taught, and I'd rather be the one doing it than the one waiting for someone with the right letters after their name to get around to it.
The through-line
Every job I've ever had, every obsession I've ever followed, every system I've ever built has been an instance of the same thing: seeing a complex system that other people treat as opaque or siloed, finding the underlying structure, and acting on it regardless of whether anyone gave me permission.
Rocks at six. Sterile fields at thirteen. Color as mathematics. The microbiome as an ecosystem, not a list of taxa. Heavy metals as selective pressures, not just toxicants. Certification as psychology, not economics.
David Epstein calls this range. I just call it how I think. And it's the reason I can do what I do: run five organizations, publish a journal, build software, design certification standards, and present original research to a room full of scientists who've been studying the microbiome longer than I have. None of those things would be possible if I'd specialized early. All of them are possible because I didn't.
