Rung 1 panel
Core Stress and Metabolic
5 tests · 22 biomarkers
Member$57.68
At-vendor lab cost, no markup.
Non-member$154.68
Lab cost plus $97 interpretation and review.
SLEEP PROGRAM
Bad sleep undoes everything else you do.
One bad night pushes your blood sugar toward pre-diabetic ranges, and years of it wreck your brain and hormones. You spend a third of your life asleep, and almost no one measures it. We find what is disrupting yours and correct it through the signals that set your clock: meal timing, exercise, light, and temperature. We add breathwork, meditation, targeted support, and prescription only if needed.
Available to North Carolina residents.
Two ways in
Measure the curve, or reset your sleep.
Sleep work is coaching first: a circadian and behavioral protocol built on the wearable already on your wrist, without reaching for a pill. Testing is added only when the picture calls for it.
When the curve needs measuring.
DUTCH cortisol awakening response
$322 all in
DUTCH CAR $175 at cost + specialty interpretation $147
- Your cortisol rhythm, measured across the first hour of the day
- Physician interpretation by Dr. Tagge
- A written read of what the curve says about your sleep and stress
- HSA / FSA eligible
Ask about the test
Ordered through the practice. A quick call scopes whether the measurement is warranted.
Work it with me
The relationship.
The Precision Partnership
$150 / month
Labs at cost. The behavior-change arc typically runs about three months, built on your Oura or Whoop data.
- A comprehensive video intake, then monthly check-ins
- Direct messaging access throughout
- Testing ordered at cost as your plan evolves, no markup
- Your protocol updated as the data comes in
- However long the work takes. Some seasons run three months, some longer
See the Partnership
The rate rises as the practice grows. You keep the rate you join at. Questions first? Start with a free Precision Call.
Recognition
What this shows up as.
- You can't fall asleep. Your mind is on, your body won't follow.
- You wake at 3 a.m. and can't get back.
- Sleep looks long enough on paper. You wake unrested.
- You're tired all day and wired at night.
- Anxiety has crept into the evenings.
- Hormonal shifts have changed how you sleep.
The stakes
Sleep is not just rest.
Insulin sensitivity drops measurably after a single bad night. Blood pressure climbs. The brain’s glymphatic clearance only happens in deep sleep. Hormones break when sleep does.
Chronic sleep loss is the cascade behind insulin resistance, cardiovascular risk, mood disorders, and accelerated aging. It is rarely a sleep problem in isolation. It is the system saying the timing is wrong.
The outcome
What changes when sleep gets read.
- Falling asleep within 15 to 20 minutes, most nights.
- Staying asleep through the night, or returning quickly when you wake.
- Waking unfueled by caffeine. Energy that holds through the day.
- Mood stabilizes. The afternoon crash fades.
- Downstream markers move. Insulin, blood pressure, recovery.
Timelines vary. Some patterns respond in weeks. Deeper resets (hormonal, circadian, microbiome) take months. The plan tracks toward the targets above. Not a guaranteed result.
The read
Three rungs. Climb only when the last read leaves a question.
Most patients are read on rung one. The deeper rungs earn their place when the standard panel does not answer the question.
1
The read for most
Core Stress and Metabolic Panel.
Cortisol, insulin, glucose, and the metabolic markers that move with them. A focused read on the system most likely driving your sleep pattern.
2
When the curve needs to be measured directly
DUTCH Complete cortisol curve.
Dried urine, 24-hour collection. Reads the cortisol curve across the day and the sex-hormone metabolites alongside it. Reserved for when serum cannot answer the question.
Rung 2 panel
DUTCH Complete
Dried urine. 24-hour cortisol curve + sex-hormone metabolites.
The member workup
Inside the Precision Partnership. Lab at vendor cost, interpretation included. The pricing path most patients use.
Standalone option
Lab cost plus an interpretation fee for non-members. Priced above the standard $97 interpretation fee given the depth of the read.
3
When apnea or a parasomnia is on the table
Sleep study as a directed referral.
A home sleep test or an in-lab study. Ordered to a local sleep medicine center, read by a board-certified sleep physician, integrated into your Plan. Not performed in-house. Reserved for indication.
Rung 3 referral
Ordered to a local sleep center.
- Home sleep test (HST) for apnea screening when the clinical question is straightforward.
- In-lab polysomnography (PSG) when the picture is mixed or parasomnia is on the table.
- Read by a board-certified sleep physician. Integrated into your Plan by Dr. Tagge.
- Paid directly to the sleep center. No markup. No price card.
Not performed in-house. This is a directed referral.
The markers
What gets read, and why.
Most of these markers come from a single metabolomic panel. The upstream read that catches sleep biology before standard labs flag anything.
Cortisol rhythm
The diurnal curve. Sleep-onset trouble lives here.
Glucose stability overnight
Stay-asleep trouble lives here. The 3 a.m. wake.
Sex hormones
Progesterone, estradiol, testosterone. Sleep changes when they shift.
Thyroid (TSH, free T3, free T4)
A subclinical thyroid problem disrupts sleep at every stage.
Magnesium status
Metabolomic read. The calming mineral, often depleted.
Ferritin
Low iron fragments sleep architecture. Often missed.
Inside the Partnership
Sleep is a process, not a prescription.
The Plan moves layer by layer. Light protocol first. Then glucose stability. Then targeted minerals when the panel calls for them. Hormone work when life stage or the panel says so. Behavior patterns refined over weeks.
Most patients see change in the first few weeks. Deeper resets land over months.
Common questions
Common questions.
Where to next
The pillar
Chronobiology
Why the circadian system runs every other system, and what reading it actually means.
Read the pillarThe panel
Blood work for sleep
Cortisol rhythm, insulin, glucose. Read the system disrupting sleep before reaching for a sleep aid.
See the panelsThe writing
Sleep essays
Long-form writing on circadian biology, glucose at 3 a.m., light hygiene, and the mechanics of restoration.
Read the writingRead the signal. Move the levers. Sleep follows.
Start with a Precision Call.
Start with a Precision Call
No charge. No card. No pressure.
The Precision Health Report
The science of optimizing your biology, sourced and translated, with no hype. A weekly report from Dr. Tagge.
Get the weekly report