Specialties
Metabolic health.
Insulin sensitivity, body composition, cardiorespiratory fitness. The whole-organism metabolic system, read against optimal, not disease.
Why it matters
Most chronic disease in modern adults starts as metabolic dysfunction. Insulin resistance, sarcopenia, deconditioning, fatty liver — these begin years before any diagnosis and reverse cleanly when caught early. Conventional care does not measure the right markers until it is too late. The window where this is most fixable is exactly the window where standard panels look normal.
What it is
Metabolic health is how your body partitions fuel, maintains glucose control, builds and protects muscle, and generates aerobic capacity. It lives at the intersection of mitochondria, hormones, gut, sleep, and movement. The right read tells you whether you are aging in line with the calendar or ahead of it.
What I read for
Fasting insulin first — it moves years before HbA1c. HOMA-IR. Body composition with a DEXA scan when warranted, not just BMI. Cardiorespiratory fitness via VO2 max. Triglyceride-to-HDL ratio. Visceral fat. The pattern across all of them, not any single number.
Signs it isn't working
What this shows up as.
Most cases touch more than one of these. Recognize what you feel.
- Weight that has crept up over years without an obvious change in diet or activity.
- Energy crashes between meals or after carbohydrate-heavy meals.
- A waistline expanding faster than the rest of the body.
- Brain fog after lunch or in the late afternoon.
- Family history of type 2 diabetes, even when you are not diabetic yet.
- A sense that your body has lost the resilience it had a decade ago.
Levers
Things you can do.
Practical, ordered roughly by impact. The plan that fits you depends on what your biology shows.
01
Strength train, twice a week minimum
Sarcopenia is one of the strongest drivers of metabolic decline. The intervention is heavy resistance work, not cardio.
02
Zone-2 aerobic
Two to four hours per week at conversational pace builds mitochondrial density and metabolic flexibility.
03
Time-restricted eating
A 10 to 12 hour daily window. Most of the benefit is in the consistency, not the length.
04
Sleep, non-negotiable
Insulin sensitivity drops measurably after a single bad night. Most metabolic resilience is built overnight.
05
Reduce ultra-processed food
Not perfection. Just shifting the ratio. Whole-food meals more often than not.
06
Two weeks with a CGM
A continuous glucose monitor for 14 days surfaces the personal patterns no textbook can predict. The data is yours after.
Work with me
This area inside the Partnership.
The panels that read this system run as part of a Precision Partnership membership. I interpret your data into a written Plan that traces every recommendation back to a finding.
Connected systems
Read alongside.
No system stands alone. These are the areas that interact most with this one.
Questions
About Metabolic health.
Why test fasting insulin if my glucose is normal?
Insulin moves first. Years before glucose or HbA1c rises, your body compensates by producing more insulin to keep glucose in range. A fasting insulin above the optimal range is the earliest reliable signal that the system is straining.
Do I need a DEXA scan?
Not always, but it is the best single read on body composition. It tells you muscle mass, visceral fat, and bone density in one pass. Worth doing as a baseline, then every two to three years if you are working on metabolic health intentionally.
What is a meaningful VO2 max number?
Context matters. The right target depends on your age, sex, and goals. The actionable question is whether your VO2 max is improving, holding, or declining. That trajectory predicts more about your decade ahead than the absolute number.
Where do GLP-1 medications fit?
They are real tools when the data supports them. I prescribe them as part of a Plan, not in isolation. The point is sustained improvement in metabolic markers and body composition, not just weight loss.