Diagnostic testing
Metabolic Health Assessment (MHA)
Weight loss resistance is often a metabolic story, and most of it is visible years before a standard result turns abnormal.
The Metabolic Health Assessment is a fasting blood panel covering blood sugar regulation, insulin sensitivity, lipids, thyroid, iron and inflammation. It is the panel to run when weight has stopped responding, energy is unreliable, or you want a clear baseline before starting a weight management programme.
It exists because of a gap in ordinary testing. Fasting glucose is usually the last marker to move. Insulin rises to compensate and can stay elevated for years while glucose still reads normal, so the standard result comes back fine while the underlying problem builds. Measuring insulin alongside glucose is what makes that visible early.
PhotographyMetabolic Health Assessment collection kit, laid out on a clean surface.
What it measures
Inside the MHA
Fasting glucose and fasting insulin
Measured together and combined into HOMA-IR, an index of insulin resistance that neither marker shows alone.
HbA1c
Average blood sugar over roughly three months, which smooths out day to day noise.
Full lipid panel with ApoB
Total, LDL, HDL and triglycerides, plus ApoB, which counts the particles rather than the cholesterol inside them.
Triglyceride to HDL ratio
A practical marker of insulin resistance that often shifts before anything else.
Thyroid panel
TSH with free T4 and free T3, because thyroid function sets the floor for metabolic rate.
hs-CRP, liver markers and ferritin
Low grade inflammation, ALT and GGT as early signals of fat in the liver, and iron status.
Insulin and ApoB are the two that most standard panels leave out, and they are frequently the two that explain what the rest of the results are doing.
Who this test is for
It may be a fit if you are experiencing
- Weight that will not move despite consistent effort with food and training
- Energy crashes, afternoon slumps, or hunger returning an hour after eating
- Weight carried mainly around the middle
- A family history of type 2 diabetes, PCOS or heart disease
- Anyone considering, starting, or coming off a GLP-1 medication
- Perimenopause, when insulin sensitivity commonly shifts
- A wish to establish a baseline before making changes worth measuring against
It pairs well with the Adrenal Stress Index. Cortisol and insulin act on each other, and seeing only one of them explains only half of what is happening.
Why blood
Why this is the one panel not collected at home
Insulin, HbA1c and ApoB are measured in serum and need a proper venous draw with the right tubes and handling. There is no at-home equivalent that gives numbers worth acting on, so this panel is the exception to our usual approach.
You receive a requisition and attend a collection site at your convenience, fasted. Nothing else changes: the results come back to the same practitioner review, and are read alongside your intake and any other panels rather than on their own.
Fasting matters here more than on most panels. Insulin and triglycerides respond quickly to a recent meal, and a non-fasted sample makes the two most informative markers unreadable.
How results are used at LivBTR
Your results are never read in isolation
They are interpreted alongside your intake, symptoms, lifestyle, nutrition, movement, and any other findings. From there we build a personalized support plan.
- Nutrition built around blood sugar stability rather than calorie restriction alone
- Protein and fibre targets set against your own insulin picture
- Strength training guidance, since muscle is where glucose is disposed of
- Realistic sequencing when weight loss resistance has a metabolic cause
- A clear baseline to measure a GLP-1 or lifestyle change against
- Referral to your primary care provider where results warrant medical assessment
Most people find the insulin result the useful one. It reframes weight loss resistance as a physiological problem with a plan attached, rather than a question of effort.
Metabolic Health Assessment questions
Why is this not collected at home like the other panels?
Insulin, HbA1c and ApoB need a venous draw and specific sample handling to be reliable. We would rather send you for a proper draw than offer an at-home version that produces numbers you cannot act on.
How long do I need to fast?
Twelve hours, water only. Book a morning appointment and fast overnight, which is the least disruptive way to do it. Continue any regular medication unless told otherwise.
Is this a diagnosis of diabetes or heart disease?
No. It is a functional wellness assessment interpreted within an integrative framework and does not diagnose disease. Results in a range that warrants medical assessment are flagged, and you are encouraged to take them to your primary care provider.
My doctor already checked my blood sugar and it was normal.
That is common and it is the reason this panel measures insulin as well. Glucose is typically the last marker to move, and insulin can be raised for years before it does. Normal glucose with high insulin is a specific, actionable finding.
Is this useful if I am already on a GLP-1?
Yes. It shows what the medication is doing to insulin sensitivity and lipids rather than only to the scale, and it gives you a baseline for the conversation about eventually coming off it.
If weight has stopped responding and nobody has measured your insulin, that is the gap worth closing first.
A fasting insulin result changes the plan more often than any other single number on this panel.