The Panel
Eleven tests. Every one has a decision attached.
A standard panel rules out disease. This one reads function. If a result can’t change what you do next, it isn’t on this panel. We cover heart, metabolism, hormones, and energy: the four systems that decide how you feel at 45 and whether you’re still performing at 65.
I select the panel and interpret every marker. I am not licensed to order or draw blood: the requisition goes through your physician, or through a direct-access lab if you would rather skip the appointment. Either way you own the results.
Why these eleven?
A standard panel is built to rule out disease. This one is built to read function. These eleven markers meet three criteria:
- Actionable — lifestyle intervention moves them meaningfully.
- Revealing — they expose dysfunction you cannot feel until it is severe.
- Predictive — they forecast decline years before diagnosis.
I don’t test everything. I test what changes performance.
Some of these markers are routine in an annual physical. Others usually need a specific request, and insurers don’t always cover them without a diagnosis. Each marker below is labeled so you know which is which. The requisition explains every one in a physician’s language.
Most doctors won’t order the non-standard markers without prompting. That is not a criticism of physicians—it is a recognition that their incentive structure (insurance reimbursement, 15-minute appointments, disease-focused training) doesn’t align with performance optimization. Direct-access labs exist for this reason.
Cardiovascular
4 markersApoB (Apolipoprotein B)
The best single measure of your cardiovascular risk.
Standard lipid panels measure the cholesterol inside LDL particles; ApoB counts the particles themselves. Particle number is what drives plaque. When LDL and ApoB disagree, ApoB is the better guide. Moves within 4–8 weeks of change.
If it’s off: Nutrition, body composition, and training changes, plus physician referral to discuss medication where appropriate.
Lp(a) (Lipoprotein(a))
A genetic cardiovascular risk factor invisible on standard panels.
Roughly 1 in 5 people have elevated Lp(a). It is set largely by genetics and barely changes with lifestyle, so it is tested once, at intake, and never again. Requested in nmol/L.
If it’s off: Your ApoB target gets stricter, and you’re referred to your physician to bring cardiovascular prevention forward.
Lipid panel (Triglycerides, HDL, LDL)
One order, three numbers. The triglyceride-to-HDL ratio is the useful one.
Triglycerides respond quickly to alcohol, carbohydrate intake, and visceral fat. The triglyceride-to-HDL ratio is a strong proxy for metabolic health. LDL is reported; ApoB is the number we steer by.
If it’s off: Alcohol, carbohydrate strategy, and body-fat reduction.
hs-CRP (High-Sensitivity C-Reactive Protein)
Low-grade inflammation, read in context.
Adds cardiovascular risk information beyond ApoB and is needed to correctly interpret ferritin, which rises with inflammation. Easily raised by illness or hard training, so it’s always read in context.
If it’s off: Sleep, training load, body composition review; values above 10 usually mean acute illness and are rechecked in two weeks.
Metabolic
2 markersFasting Insulin
The marker most GPs never order.
Reveals insulin resistance years before fasting glucose or HbA1c rise. Read with fasting glucose (from the CMP) as HOMA-IR. Assays vary between labs, which is one reason we use the same lab every time.
If it’s off: Carbohydrate strategy, training, sleep, and possibly a two-week continuous glucose monitor.
HbA1c (Hemoglobin A1c)
A roughly three-month average of blood sugar.
Captures trends a single fasting glucose misses. Read alongside the CBC and iron markers, since iron deficiency and red-cell turnover can distort it.
If it’s off: Same levers as insulin; confirms whether changes are holding.
Hormonal
1 markerTotal Testosterone + SHBG (free testosterone calculated)
Total, bound, and the free fraction that actually reaches your tissues.
Total testosterone read alone can mislead. SHBG binds testosterone and makes it unavailable; high SHBG with “normal” total T is a commonly missed finding. Free testosterone is calculated from total T, SHBG, and albumin, more reliable than cheap direct assays.
If it’s off: Sleep, fat loss, alcohol, and training load. A low result is always rechecked before it is treated as a finding, and confirmed low results are referred to your physician.
Energy & Micronutrients
3 markersVitamin D (25-Hydroxyvitamin D)
Commonly low in people who work indoors.
Deficiency is common, especially in winter and with indoor work, and cheap to correct. Correcting a deficiency is worthwhile; supplementing beyond sufficiency hasn’t shown clear benefit, so we aim for adequate, not maximal.
If it’s off: Supplementation and retest.
Ferritin + Iron Panel (with transferrin saturation)
Iron stores, read both directions.
Low iron causes fatigue and brain fog even when hemoglobin looks normal. In men, high iron is the more common problem and can quietly affect the liver and heart. Ferritin also rises with inflammation, so it’s read alongside hs-CRP and transferrin saturation. Running them together avoids a second draw.
If it’s off: Low ferritin in a man is always referred to his physician. High ferritin with high transferrin saturation is referred for workup.
TSH with reflex Free T4
Screens for an underactive or overactive thyroid.
TSH is the pituitary signal to the thyroid. If it’s abnormal, the lab automatically runs Free T4 from the same sample, with no extra draw. Thyroid problems cause fatigue, weight change, and low mood that are easy to mistake for burnout.
If it’s off: Physician referral.
11 line items. 3 calculated ratios. One blood draw.
Safety panels
Run with every draw, for every client.
CMP (includes glucose, albumin, kidney and liver markers)
CBC (includes hemoglobin and hematocrit)
What we calculate
Derived from the markers above—no extra draw needed.
HOMA-IR (fasting insulin + glucose)
Triglyceride-to-HDL ratio
Free testosterone (total T, SHBG, albumin)
When you test
Intake
Full panel plus CMP and CBC, for everyone. Includes Lp(a), tested once only.
Day 45
Intensive only. A targeted recheck of any fast-moving marker flagged at intake (triglycerides, fasting insulin and glucose, ApoB). If nothing was flagged, there is no day-45 draw.
Day 90
Everything expected to move: ApoB, lipid panel, fasting insulin, HbA1c, testosterone + SHBG, hs-CRP, CMP and CBC. Vitamin D and iron are added if they were off at intake.
Continuation
Moving markers every 3 months (Intensive) or 6 months (Structured). Thyroid and iron once a year if normal. Lp(a) never again.
We don’t re-run slow markers that were normal. Your day-90 draw is smaller, cheaper, and every number on it is one we expect to move.
Labs about $[PRICE] per draw, paid directly to the lab.
Before your draw
Draw between 7 and 9 a.m., fasted 10 to 12 hours (water is fine; hydrate normally).
No hard training for 48 hours before.
No alcohol for 48 hours before.
No biotin supplements for 72 hours before (it distorts hormone and thyroid results).
If you're on testosterone therapy, draw at the same point in your injection or dosing cycle every time.
Reschedule if you are sick.
Same lab every time.
When a number means see your doctor
Low ferritin in a man is always referred to his physician.
High ferritin with high transferrin saturation is referred for workup.
Elevated Lp(a) is referred to your physician for cardiovascular prevention planning.
hs-CRP above 10 usually means acute illness and is rechecked in two weeks.
A low testosterone result is always rechecked before it is treated as a finding.
An abnormal TSH is referred to your physician.
For clients on testosterone therapy, elevated hematocrit is referred to the prescribing physician.
Any value outside clinical range is referred to your physician.
Direct-access labs are not billed to insurance and do not enter your medical record unless you choose to share them.
Already on medication?
Many men in their 40s and 50s are already on testosterone therapy, GLP-1 medications, statins, or finasteride. Intake asks about all of them, because they change how the panel is read. For men on testosterone therapy, hematocrit becomes a key safety marker, estradiol is added routinely, and draw timing is standardized. Your prescribing physician stays in charge of your medication; I adjust how results are interpreted and coached.
Conditional add-ons
Ordered only when intake, history, or core results indicate them.
Estradiol, LH, FSH, and prolactin: if low testosterone is confirmed on recheck (run together in the recheck draw), or routinely for clients on testosterone therapy.
GGT: for clients who drink regularly. A sensitive, fast-moving readout of alcohol's effect on the liver.
PSA screening is a decision for you and your physician, so it's not part of this panel.
Three ways to get tested
I select and interpret the panel; I don’t order or draw it. Here are the three ways clients get the panel run. Any of them works.
Through your physician
What to do
Download the requisition above and bring it to your next appointment, or send it to your doctor ahead of time.
What to expect
Several markers are routine and ordered without friction. Others, including ApoB, Lp(a), fasting insulin, SHBG, hs-CRP, vitamin D, and the iron panel, may need a direct request. The requisition explains each one in a physician’s language.
If your doctor declines
Some won’t order optimization markers outside a diagnosis. That is common and not a dead end — use a direct-access lab instead.
Cost
Often covered by insurance when tied to symptoms. Out of pocket, [VERIFY].
Direct-access lab testing
What to do
Order the panel yourself online, then walk into a partner lab for the draw. No doctor visit, no referral.
US direct-access labs
Quest Direct, Ulta Lab Tests, Walk-In Lab, and LabCorp OnDemand all let you order individual markers or a full panel directly.
Outside the US
Outside the US, we match the panel to a local lab. Costs vary by country.
When to use it
The fastest path, and the one that guarantees you get every marker on the list. I can help you match the panel above to the right order.
Cost
Labs about $[PRICE] per draw, paid directly to the lab. Direct-access labs are not billed to insurance and do not enter your medical record unless you choose to share them.
Functional or sports-medicine physician
What to do
Book with a functional-medicine or sports-medicine doctor who already works in the optimization space.
What to expect
They order every marker on this list without hesitation and often suggest useful additions. The closest match to how this system reads results.
When to use it
Ideal if you already see one, or want a local physician partner alongside the coaching engagement.
Cost
Visit fee plus lab work; varies by practice. Rarely covered by insurance.
Marker list for your physician
Print or download this list for your physician or direct-access lab. Each marker is numbered and named in clinical terms.
1. Apolipoprotein B (ApoB)
2. Lipoprotein(a), reported in nmol/L (intake only)
3. Lipid panel (total cholesterol, triglycerides, HDL, LDL)
4. hs-CRP
5. Fasting insulin
6. Hemoglobin A1c
7. Testosterone, total
8. SHBG (free testosterone calculated)
9. 25-Hydroxyvitamin D
10. Ferritin + iron panel with transferrin saturation
11. TSH with reflex to Free T4
Plus safety panels
CMP (includes glucose, albumin, kidney and liver markers)
CBC with differential
Fasting and timing instructions
Draw between 7 and 9 a.m., fasted 10 to 12 hours (water is fine; hydrate normally).
No hard training for 48 hours before.
No alcohol for 48 hours before.
No biotin supplements for 72 hours before (it distorts hormone and thyroid results).
If you're on testosterone therapy, draw at the same point in your injection or dosing cycle every time.
Reschedule if you are sick.
Same lab every time.
Common questions about testing
Free testosterone is most reliable when calculated from total testosterone, SHBG, and albumin. Total alone can look normal while free is suppressed, so the panel reads them together.
Several markers are routine and ordered without friction. Others, including ApoB, Lp(a), fasting insulin, SHBG, hs-CRP, vitamin D, and the iron panel, may need a direct request. The downloadable requisition explains each in clinical terms. If your physician won’t order the optimization markers, a direct-access lab will.
Insurance often covers markers tied to a symptom or diagnosis and rarely covers pure optimization testing. Direct-access labs let you pay out of pocket with no appointment or referral.
Full panel plus CMP and CBC, for everyone. Includes Lp(a), tested once only. Intensive only. A targeted recheck of any fast-moving marker flagged at intake (triglycerides, fasting insulin and glucose, ApoB). If nothing was flagged, there is no day-45 draw. Everything expected to move: ApoB, lipid panel, fasting insulin, HbA1c, testosterone + SHBG, hs-CRP, CMP and CBC. Vitamin D and iron are added if they were off at intake. Moving markers every 3 months (Intensive) or 6 months (Structured). Thyroid and iron once a year if normal. Lp(a) never again.
Draw between 7 and 9 a.m., fasted 10 to 12 hours (water is fine; hydrate normally). No hard training for 48 hours before. No alcohol for 48 hours before. No biotin supplements for 72 hours before (it distorts hormone and thyroid results). If you're on testosterone therapy, draw at the same point in your injection or dosing cycle every time. Reschedule if you are sick. Same lab every time.
A standard physical is built to rule out disease against wide reference ranges. This panel reads function against tighter, performance-oriented ranges, and it includes markers — Fasting Insulin, SHBG, ApoB, Lp(a) — that a routine physical usually skips.
Sometimes. If a recent panel already includes these exact markers, we can use it as your baseline. Most physicals miss several of the eleven, so a targeted draw is usually needed to fill the gaps.
More tests mean more noise, more false alarms, and more cost without better decisions. Every marker here has a clear action attached. Tests that look impressive but don’t change what you’d do next were deliberately left out.
It’s largely set by your genetics and barely changes over your life. One result tells you what you need to know.
It naturally drops with dieting, hard training, and illness, the exact conditions of an active protocol, which makes it noisy. TSH with reflex Free T4 catches real thyroid problems more reliably.
That’s a finding, not a dead end. Bloodwork is one of four foundations. If your labs are clean and you still feel flat, the answer lives in your sleep, decision latency, environment, or the partner report — and those are measured too.
No. I am not licensed to order tests or draw blood. I select the panel, hand you the requisition, and interpret every marker. The draw happens through your physician or a direct-access lab, and you own the results.
Recommended assessments beyond bloodwork
Some of the most important numbers aren’t in your blood. None is billed by me; you book them locally and results are built into your protocol.
Sleep apnea screening
Completed at intake with a short questionnaire (STOP-BANG). If it flags you, a home sleep test through your physician is recommended. Undiagnosed sleep apnea is common in men in this age range and can drive fatigue, low testosterone, high blood pressure, and poor focus. Treating it can shift everything else on your panel.
Home blood pressure
A 7-day home average at intake and day 90 using a validated upper-arm cuff. One of the most important cardiovascular numbers, and one of the fastest to respond to change.
Waist circumference
Measured at intake and monthly. Free, and tracks visceral fat between scans.
Body composition (DEXA scan)
Recommended at intake and day 90. Lean mass and body fat percentage give the Conditioning and Fuel domains an objective baseline that bloodwork alone cannot provide. Typically $50–$150 per scan through a mobile DEXA service or imaging center.
VO2 max
Recommended at intake if available. One of the strongest predictors of long-term health and lifespan. A formal lab test is ideal; a submaximal estimate from your wearable or a gym protocol is accepted. Your client portal already tracks this metric.
Continuous glucose monitor
Recommended for clients whose fasting insulin or HbA1c suggests early metabolic dysfunction. A two-week CGM worn during your normal routine reveals how your body responds to the meals and training in your actual protocol, not averages. Typically $75–$150 for a two-week sensor.
What bloodwork cannot tell you
Your panel covers one of four foundations. Decision latency, calendar re-acceptance rate, environmental readings, and a six-item partner report measure the other three.
If your panel comes back clean and you still feel exactly the way you feel now, that is not a dead end. It is a finding.
The panel is where we start. The value is in how the protocol shifts as the numbers move.