The Metabolic Medicine Programme

Understanding your metabolic blood panel

Every number tells a story. Here's what your results actually mean โ€” in plain language.

Before we begin your programme, we look at your baseline metabolic health through a focused blood panel. These aren't just routine checks โ€” they're a window into how your body is managing energy, hormones, and inflammation right now. Use this guide to read your results with confidence.

Range key
Optimal range
Worth monitoring / flagged
Low / below range
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Blood Sugar & Insulin
How your body handles glucose and energy
Fasting Blood Glucose
FBG
Core

This measures sugar circulating in your blood after an overnight fast. It's the foundational snapshot of how well your body regulates glucose when you haven't eaten.

Optimal: 70โ€“99 mg/dL
Pre-diabetic: 100โ€“125 mg/dL
Diabetic: โ‰ฅ126 mg/dL
Even within the "normal" range, lower is generally better for metabolic health and long-term energy stability.
HbA1c
Glycated Hemoglobin
Core

Think of HbA1c as your blood sugar average over the past 2โ€“3 months. It's like a long-term report card โ€” one meal won't change it. It shows whether glucose has been consistently elevated.

Optimal: below 5.7%
Pre-diabetic: 5.7โ€“6.4%
Diabetic: โ‰ฅ6.5%
Our programme targets bringing HbA1c below 5.5% โ€” the sweet spot for metabolic resilience and weight regulation.
Fasting Insulin
โ€“
Core

Insulin is the key that unlocks your cells to absorb glucose. When it's chronically high (even with "normal" blood sugar), it signals that your body is working harder than it should โ€” a hallmark of insulin resistance.

Optimal: 3โ€“8 ยตIU/mL
Elevated: above 10 ยตIU/mL
High fasting insulin often precedes weight gain, PCOS, and type 2 diabetes โ€” sometimes by years.
HOMA-IR
Insulin Resistance Score
Core

HOMA-IR is calculated from your fasting glucose and insulin together. It gives a single number that reflects how resistant your cells are to insulin's signal.

Optimal: below 1.5
Borderline: 1.5โ€“2.5
Insulin resistant: above 2.5
Reducing HOMA-IR is one of the most meaningful outcomes of our 12-week programme.
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Lipid Profile
Fats in your blood and cardiovascular risk
Triglycerides
TG
Core

Triglycerides are the main form of fat stored and transported in your blood. They spike after eating carbohydrates and sugar, and chronically elevated levels are a strong metabolic warning sign.

Optimal: below 100 mg/dL
Borderline: 100โ€“149 mg/dL
High: 150 mg/dL or above
High triglycerides + low HDL is one of the clearest patterns of insulin resistance on a lipid panel.
HDL Cholesterol
Good Cholesterol
Core

HDL acts like a clean-up crew โ€” it carries cholesterol away from arteries back to the liver. Higher HDL is protective. Low HDL is a red flag for metabolic and heart health.

Optimal (women): above 50 mg/dL
Optimal (men): above 40 mg/dL
Low: below these values
Exercise and reducing refined carbohydrates are the most reliable ways to raise HDL.
LDL Cholesterol
Bad Cholesterol
Core

LDL carries cholesterol to your tissues. When elevated, particularly the smaller, denser particles, it can contribute to arterial plaque over time. Context matters โ€” LDL alone doesn't tell the whole story.

Optimal: below 100 mg/dL
Borderline: 100โ€“129 mg/dL
High: 130 mg/dL or above
We always interpret LDL alongside TG and HDL โ€” a high LDL with great TG/HDL ratio tells a very different story.
TG : HDL Ratio
Atherogenic Index
Core

This ratio is one of the best simple indicators of insulin resistance and cardiovascular risk. It tells us about the quality of your cholesterol landscape, not just the individual numbers.

Optimal: below 2.0
Raised risk: 2.0โ€“3.5
High risk: above 3.5
Calculate yours: divide your TG by your HDL (in mg/dL). This number often improves dramatically within 8โ€“12 weeks on our programme.
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Liver Health
Your body's metabolic powerhouse
ALT
Alanine Aminotransferase
Core

ALT is the most liver-specific enzyme. When liver cells are under stress โ€” often from fat accumulation (fatty liver) or inflammation โ€” ALT leaks into the bloodstream. It's a sensitive early warning.

Optimal (women): below 25 U/L
Optimal (men): below 35 U/L
Elevated: above these values
Non-alcoholic fatty liver (NAFLD) is closely linked to insulin resistance and is reversible with lifestyle change.
GGT
Gamma-Glutamyl Transferase
Core

GGT is sensitive to alcohol, fatty liver, and oxidative stress. Even within "normal" labs, a trending rise in GGT is worth noting as a metabolic signal.

Optimal: below 25 U/L
Raised: 25โ€“50 U/L
High: above 50 U/L
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Hormonal Balance
Thyroid, cortisol & sex hormones
TSH
Thyroid Stimulating Hormone
Hormone

TSH tells us how hard your pituitary gland is working to stimulate your thyroid. A high TSH often means your thyroid is underperforming โ€” which can significantly slow metabolism, cause weight gain, and fatigue.

Optimal: 1.0โ€“2.0 mIU/L
Hypothyroid risk: above 2.5 mIU/L
Low (hyperthyroid risk): below 0.5 mIU/L
Even a TSH in the "normal" range (up to 4.5) but above 2.5 can cause symptoms in sensitive individuals.
Free T3 & Free T4
Active Thyroid Hormones
Hormone

T4 is the storage form; T3 is the active thyroid hormone your cells actually use. Checking both reveals whether your body is efficiently converting T4 โ†’ T3, which TSH alone can miss.

Free T3: 2.3โ€“4.2 pg/mL
Free T4: 0.8โ€“1.8 ng/dL
Low T3 despite normal TSH is called "low T3 syndrome" โ€” common under chronic stress and calorie restriction.
Cortisol (morning)
Stress Hormone
Hormone

Cortisol should be highest in the morning and taper through the day. Chronically elevated cortisol promotes fat storage (especially abdominal), increases blood sugar, and disrupts sleep and other hormones.

Morning optimal: 10โ€“20 ยตg/dL
High: above 20 ยตg/dL
Low: below 7 ยตg/dL
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Inflammation Markers
The hidden driver of metabolic disease
hsCRP
High-Sensitivity C-Reactive Protein
Inflammation

CRP is produced by the liver in response to inflammation anywhere in the body. The high-sensitivity version detects low-grade chronic inflammation โ€” the kind that silently drives weight resistance, fatigue, and heart risk.

Optimal: below 1.0 mg/L
Moderate risk: 1.0โ€“3.0 mg/L
High: above 3.0 mg/L
Chronic low-grade inflammation is now understood to be central to obesity, insulin resistance, and metabolic syndrome.
Uric Acid
โ€“
Inflammation

Elevated uric acid isn't just about gout. It is increasingly recognised as a metabolic marker โ€” linked to insulin resistance, fructose overconsumption, and inflammation.

Optimal (women): below 6.0 mg/dL
Optimal (men): below 7.0 mg/dL
High uric acid often improves significantly with reduced sugar (especially fructose) and better hydration.
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Key Vitamins & Minerals
Nutritional foundations of metabolism
Vitamin D
25-OH Vitamin D
Vitamin

Vitamin D acts more like a hormone than a vitamin. It influences insulin sensitivity, immune function, mood, bone density, and muscle performance. Deficiency is extremely common and often overlooked.

Optimal: 40โ€“60 ng/mL
Insufficient: 20โ€“39 ng/mL
Deficient: below 20 ng/mL
Deficiency is very common, particularly in northern states and winter months. Low vitamin D is associated with difficulty losing weight.
Vitamin B12
Cobalamin
Vitamin

B12 is essential for nerve function, red blood cell formation, and energy production. Those on metformin, plant-based diets, or with digestive issues are at higher risk of deficiency.

Optimal: above 400 pg/mL
Low-normal: 200โ€“400 pg/mL
Deficient: below 200 pg/mL
Ferritin
Iron Storage
Vitamin

Ferritin measures your body's iron stores, not just circulating iron. Low ferritin causes fatigue, hair loss, and poor exercise capacity โ€” all of which can derail a lifestyle programme. Very high ferritin can indicate inflammation.

Optimal (women): 50โ€“150 ng/mL
Optimal (men): 100โ€“200 ng/mL
We often see low ferritin in women who are tired despite "normal" hemoglobin โ€” ferritin tells a more complete story.
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Kidney Function
Filtration, fluids & electrolytes
eGFR
Estimated Glomerular Filtration Rate
Core

eGFR measures how efficiently your kidneys are filtering waste from the blood. It's a key safety check, especially if you're changing diet significantly or considering certain medications.

Normal: above 90 mL/min/1.73mยฒ
Mildly reduced: 60โ€“89
Reduced: below 60
Creatinine
โ€“
Core

A waste product from muscle metabolism, creatinine is filtered by the kidneys. Elevated levels suggest the kidneys aren't clearing waste effectively. Note: it can be mildly raised in very muscular individuals โ€” context matters.

Optimal (women): 0.5โ€“1.1 mg/dL
Optimal (men): 0.7โ€“1.3 mg/dL