Conventional labs to assess:

1. Comprehensive Metabolic Panel (CMP) (14 biomarkers) 
2. Fasting insulin 
3. Fasting glucose
4. A1C

Functional labs to assess:

1. Dutch testing
2. GI-MAP stool testing

Full Panel for Thyroid Health:

1. Thyroid Stimulating Hormone (TSH)
2. Free T4
3. Total T4
4. Free T3
5. Total T3
6. Reverse T3 (inactive ‘thyroid hormone’, r/t chronic stress)
7. Thyroid antibodies: Thyroglobulin Antibodies (TG) & Thyroid Peroxidase (TPO Ab)

1. Fasting Glucose and Fasting Insulin:
Both fasting glucose and fasting insulin need to be done together. These values are then plugged into a HOMA-IR calculator to determine whether there is insulin resistance, which is a huge contributor to stubborn weight loss!

Looking at fasting glucose alone or fasting insulin alone or even HbA1c alone is not enough to determine whether you have insulin resistance. *Chronic stress can cause blood sugar dysregulation, which can eventually develop into insulin resistance.

HOMA-IR score:
Optimal: 1.5-1.4
Early IR: >1.9
Severe IR: >2.9

2. 4-point cortisol testing (offered in DUTCH testing): I offer this test which is signed off by a physician): testing serum cortisol at diff points of the day can help determine if there is imbalanced cortisol production and/or adrenal dysfunction, which can all contribute to stubborn weight loss. Saliva/urine testing is the more preferred method of cortisol testing. At a minimum, AM cortisol (between 7-9am) and PM cortisol (4-6pm) should be done.

3. Sex Hormones (offered in DUTCH testing): I offer this test which is signed off by a physician): sex hormone imbalances can lead to weight gain. Testing sex hormones like estradiol, progesterone, and testosterone at specific days of the cycle can give us a good overall snapshot of the status of your hormones. The best days to test your sex hormones are on Day 3 of your cycle and 7 days after ovulation.

4. Vitamin D: Vitamin D deficiency has been correlated with an increased risk of wt gain. Correcting Vit D deficiency thro optimal supplementation has been shown to help with facilitating weight loss and improving thyroid function overall. Vitamin D should be tested 1-2x year esp in the winter months when sunlight exposure is minimal. Standard ranges: 30-50 or 30-100 versus Optimal ranges: 50-70. (serum 25-OH Vitamin D)

5. ESR and HS-CRP: elevated levels of these 2 inflammatory markers can indicate that there is a lot of inflammation in the body, which is a major contributor to weight gain and stubborn weight loss. Oftentimes, making changes to your diet are not enough to bring down these inflammatory markers and can indicate that there is another major source of inflammation in the body.