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.
Coming soon
Sleep
Sleep is fixable. Most plans don’t read the signal.
Cortisol rhythm, glucose stability, sex hormones, thyroid, light. Read together, not in isolation.
Start with a Precision Call
No charge. No card. No pressure.
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.
DUTCH lab cost and standalone interpretation fee placeholder. Pending Dr. Tagge sign-off.
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.
Marker list provisional. Pending Dr. Tagge’s clinical sign-off.
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.
Pending Dr. Tagge sign-off: melatonin protocol, z-drug, and trazodone prescribing language pending approved scope.
Common questions
Questions that come up a lot.
Why do I wake up at 3 a.m.?
Stay-asleep trouble is almost always a blood-sugar problem first and a stress-rhythm problem second. Glucose drops in the second half of the night, the adrenal system fires cortisol to pull it back up, and you wake. Alcohol in the evening makes both of these worse. Late eating, magnesium gaps, and light exposure after sunset all contribute. The pattern is readable. The fix is upstream.
Should I take melatonin?
Used correctly, yes. Most people use it at the wrong time and at doses ten times higher than the dose that actually works. The right protocol is small (often 0.3 to 0.5 mg), early evening, and time-bounded. Daily long-term high-dose melatonin is a different conversation.
Do I need a sleep study?
If apnea or a parasomnia is on the table, yes. A home sleep test or an in-lab study answers what blood work cannot. If the picture looks like primary insomnia driven by stress, hormones, or glucose, the panel reads first and the sleep study is reserved for when the panel does not answer the question.
Magnesium glycinate or another form?
Glycinate for sleep. The glycine itself calms. Magnesium L-threonate for cognitive support. Citrate for bowel motility. Oxide is poorly absorbed. The form matters more than people think.
What about wearables?
Useful as a trend tool, not a diagnostic. Sleep stages from a wrist tracker are an estimate, not a measurement. The most reliable signal from a wearable is the night-to-night trend in heart rate variability and resting heart rate. Both move with your circadian and metabolic health long before symptoms do.
Read the signal. Move the levers. Sleep follows.
Start with a Precision Call.
Start with a Precision Call
No charge. No card. No pressure.