OvationLab and Fullscript have partnered to create positive change in the world of healthcare—making personalized, integrative medicine more accessible and effective than ever before. This protocol is one of the many ways in which OvationLab and Fullscript are helping healthcare providers prescribe evidence-based, high-quality integrative care.

weight management protocol table

Labs and supplements for metabolic health

Comprehensive metabolic health assessment and management are crucial in modern healthcare and serve as cornerstones for overall well-being. This approach utilizes a range of diagnostic tools—including tests for glucose metabolism, inflammation markers, nutrient status, and hormonal function—to provide a whole-person view of an individual’s health. 

By enabling early detection of potential issues and facilitating personalized patient plans, this strategy allows for timely interventions. The benefits extend beyond physical health, empowering individuals to make informed lifestyle choices and reducing healthcare costs. By addressing multiple aspects of metabolic health simultaneously, healthcare providers can effectively address a wide range of metabolic concerns. This comprehensive approach may not only improve patient outcomes but also contribute to fostering a healthier society and promoting longevity.


Labs

Foundational lab tests

Fasting blood glucose

Fasting glucose levels provide valuable insights into the body’s ability to regulate blood sugar. They’re a crucial indicator of metabolic health and an essential tool for the early detection of metabolic disorders. A fasting blood glucose test result between 70–99 mg/dL is considered normal, levels between 100–125 mg/dL relate to prediabetes, and levels of 126 mg/dL or higher on two separate tests usually relate to diabetes. (Mathew 2023)(Nakrani 2023)


Insulin resistance panel

Insulin resistance panels can provide a comprehensive evaluation of insulin resistance by combining measurements of fasting insulin and C-peptide using advanced LC/MS/MS technology. Insulin resistance panels can offer a more accurate assessment of metabolic health than traditional glucose tests alone, as they can detect early signs of insulin resistance before glucose levels become elevated. (Cho 2022)(Nolan 2019)


Hemoglobin A1C 

Hemoglobin A1C (HbA1c) provides insights into the average blood glucose levels over the previous 2–3 months, making it a crucial biomarker for assessing long-term glycemic control and metabolic health. Beyond its role in diagnosing and monitoring diabetes, HbA1c has been shown to correlate with insulin resistance, cardiovascular risk, and other components of metabolic syndrome (MetS), making it an important tool for evaluating overall metabolic health even in non-diabetic individuals. (Osei 2003)(Sherwan 2016)


High-sensitivity C-reactive protein

High-sensitivity C-reactive protein (hs-CRP) is a crucial biomarker for assessing low-grade systemic inflammation, which is closely linked to MetS, insulin resistance, and cardiovascular risk. Elevated hs-CRP levels have been shown to strongly correlate with various components of MetS, including central obesity, insulin resistance, and dyslipidemia, making hs-CRP testing a valuable tool for evaluating overall metabolic health and predicting the risk of developing type 2 diabetes and cardiovascular disease. (den Engelsen 2012)(Devaraj 2009)(Wang 2009)


Homocysteine

Homocysteine is a valuable biomarker for comprehensively assessing metabolic health, as elevated levels (hyperhomocysteinemia) have been independently associated with MetS and various cardiovascular risks. High homocysteine levels can indicate vitamin B deficiencies and are linked to increased risks of cardiovascular disease, stroke, and other age-related pathologies. (Shih 2023)(Kumar 2017)


Serum uric acid

Elevated serum uric acid (SUA) has been consistently associated with an increased risk of MetS and its components, including hypertension, dyslipidemia, and insulin resistance. Higher baseline SUA and larger temporal increases in SUA independently predict the risk of developing MetS, highlighting the importance of monitoring SUA levels for early detection of metabolic disorders. (Ali 2020)(Bowden 2022)(Feng 2022)(Płaczkowska  2021)


Creatine kinase

Creatine kinase (CK) plays a crucial role in cellular energy metabolism. It catalyzes the reversible transfer of phosphate between ATP and creatine to maintain energy homeostasis. in high energy demand tissues. As a key regulator of energy balance and a sensitive marker of muscle damage, CK levels in blood tests provide valuable insights into overall metabolic and muscular health, muscle function, and potential tissue damage. (Aujla 2024)(Bonilla 2021)(Hargreaves 2020)(Kongas 2007)


Vitamin D 25-OH

Beyond its well-known functions in bone metabolism, vitamin D plays a crucial role in metabolic health, with deficiency being linked to various metabolic disorders including obesity, insulin resistance, diabetes, and cardiovascular diseases. Adequate vitamin D levels have been associated with improved insulin sensitivity, glucose metabolism, and lipid profiles, as well as reduced inflammation, making it an important biomarker to assess in metabolic health evaluations. (Eun Park 2018)(Melguizo-Rodríguez 2021)


Omega-3 index

The omega-3 index test measures key fatty acid markers, including the omega-3 index and the EPA/AA ratio, to provide insights into overall metabolic health, inflammation levels, and potential risks for chronic conditions such as cardiovascular disease and diabetes. (Albracht-Schulte, 2020)(Poudyal 2011)


Albumin/creatinine ratio (urine)

The albumin/creatinine ratio (urine) (uAUR) is a crucial biomarker for assessing early kidney dysfunction and metabolic health, even at levels below the traditional threshold for microalbuminuria. Elevated uACR, even within the normal range (<30 mg/g), has been associated with increased risks of hypertension, cardiovascular disease, and all-cause mortality. (Friedman 2008)(Mahemuti 2023)


Lactate dehydrogenase

Elevated lactate dehydrogenase (LDH) levels can indicate various pathological conditions including cancer, liver disease, muscle damage, and cardiovascular disorders. Beyond its diagnostic value, LDH plays a vital role in cellular energy metabolism by catalyzing the interconversion of lactate and pyruvate, making it an important indicator of glycolytic activity and metabolic adaptations in both normal and disease states. (Chen 2021)(Farhana 2023)(Klein 2020)


B vitamins

B vitamins are crucial in maintaining fundamental cellular functions and various essential metabolic pathways, acting as cofactors in energy metabolism processes and influencing key aspects of metabolic health such as glucose tolerance, insulin sensitivity, and lipid profiles. Adequate intake of B vitamins, particularly folate, vitamin B6, and vitamin B12, has been associated with a reduced risk of metabolic syndrome and its components. (Lee 2023)(Zhu 2023)


Iron

Iron plays a crucial role in metabolic health assessment due to its complex interactions with glucose and fat metabolism, insulin sensitivity, and inflammation. Abnormal iron levels, whether deficiency or overload, can contribute to metabolic disorders such as obesity, type 2 diabetes, and non-alcoholic fatty liver disease. (Abbaspour 2014)(Hilton 2023)(Qiu 2022)


Comprehensive metabolic panel

A comprehensive metabolic panel (CMP) provides a broad assessment of metabolic health by measuring 14 substances, including electrolytes, proteins, and liver enzymes. CMP offers insights into kidney and liver function, electrolyte balance, and overall metabolic status, making it an essential tool for evaluating general health and helping diagnose metabolic disorders. (Messier 2010)(Nuri Erçin 2016)(Panwar 2015)


Complete blood count

A complete blood count (CBC) assesses metabolic health by providing insights into various cell components in the blood, including white blood cells, red blood cells, and platelets. Beyond its traditional use in diagnosing acute conditions, CBC components, such as white blood cell count, neutrophil-to-lymphocyte ratio, hemoglobin, and platelet indices, are useful markers for predicting and assessing cardiovascular disease, type 2 diabetes, and other metabolic disorders. (Marra 2024)(Seo 2022)

Comprehensive lab tests

Advanced lipid panel with inflammation

Advanced lipid testing provides a more comprehensive assessment of cardiovascular and metabolic health risks than standard lipid panels. It measures additional parameters such as low-density lipoprotein (LDL) particle size and number, apolipoprotein B, and lipoprotein(a). These advanced markers offer greater insight into atherogenic particle concentrations, insulin resistance, and genetic risk factors, allowing for more accurate prediction of cardiovascular disease risk, especially in cases where traditional lipid panels may misclassify risk or fail to capture the full metabolic picture. (Chandra 2015)(Feingold 2023)


F2-isoprostane/creatinine ratio

The F2-isoprostane/creatinine ratio is considered the gold standard for measuring oxidative stress, providing valuable insights into metabolic health and cardiovascular risk, particularly in individuals with lifestyle risks such as poor diet, smoking, or hyperlipidemia. Elevated levels of F2-isoprostanes are associated with an increased risk of coronary heart disease and atherosclerosis. (Il’yasova 2015)(Ma 2017)


Thyroid function tests

Thyroid function tests, particularly thyroid-stimulating hormone (TSH), free thyroxine (T4), and free triiodothyronine (T3), provide insights into thyroid hormone levels, which regulate metabolism, energy expenditure, and various bodily functions. Abnormal thyroid function, even subclinical, has been associated with metabolic syndrome components such as insulin resistance, dyslipidemia, and obesity. (Chugh 2012)(Dunlap 1990)

TSH

Abnormal TSH levels can indicate thyroid disorders that significantly impact metabolic processes, making TSH testing essential for diagnosing and monitoring conditions that affect metabolic health.

Free T4

Free T4 is the primary hormone produced by the thyroid gland. It serves as a crucial precursor to T3 and plays a vital role in regulating metabolism throughout the body. Free T4 levels can identify thyroid disorders that may significantly impact metabolic processes, energy production, and overall physiological function.

Free T3

Free T3, the active form of thyroid hormone, directly influences energy expenditure, body composition, and various metabolic processes, making its measurement essential for diagnosing thyroid disorders and evaluating overall metabolic status

Adrenal function profile

An adrenal salivary test assesses hypothalamic-pituitary-adrenal (HPA) axis function by measuring cortisol levels at multiple times throughout the day, offering a comprehensive view of the circadian cortisol rhythm. Detailed assessment of adrenal function is vital for evaluating metabolic health, as cortisol plays a key role in regulating metabolism, blood sugar levels, and inflammation, with imbalances potentially contributing to various metabolic disorders including insulin resistance, obesity, and cardiovascular disease. (Aschbacher 2014)(Garbellotto 2018)

Dietary supplements

Foundational supplementation

Protein powder

Start with a general dose of 10–20 g daily of plant-based or whey protein (although dosages are typically in the 20–40 g range)

  • Various forms of protein—from whole proteins to peptides and amino acids—may support GLP-1 secretion, each interacting with unique or unknown cellular mechanisms based on their structure. (Hira 2021)(Miguéns-Gómez 2021)(Meek 2016)(Volpi 2001)

Glutamine

15–30 g daily

  • A 15–30 g dose of L-glutamine is required to support GLP-1 secretion. (Meek 2016)


Multivitamin, multimineral

Dosing may vary depending on the specific product and should be tailored to the individual’s nutritional needs and goals, such as nutrient repletion or metabolic support. Healthcare providers should consult product-specific guidelines and adjust the dosage based on the patient’s unique requirements and response. 

  • Multivitamin and multimineral supplements can provide essential nutrients that may be deficient in individuals with MetS. (Blumberg 2018)


Omega-3 fatty acids

2 g of combined EPA/DHA daily (adjust dose based on testing)  

  • Omega-3 fatty acids have the potential to support healthy inflammatory balance, insulin function, and cardiovascular function, which collectively support metabolic processes. (Jimenez-Gutierrez 2022)(Smith 2012)


Soluble fiber

5–10 g daily

  • Soluble fibers can help address metabolic health by supporting energy intake, postprandial blood glucose levels, and satiety. These ingredients are resistant to digestion and promote beneficial gastrointestinal (GI) microflora and short-chain fatty acid (SCFA) production, supporting a healthy gut environment that favors comprehensive metabolic health. (den Besten 2015)(Dion 2016)(Kim 2002)(Wu 2023)


Vitamin D3+K2

5,000 IUs (adjust dose based on testing) plus 25–95 mcg daily (depending on the dose of vitamin D)

  • Vitamin D+K supplementation supports metabolic health, GLP-1 levels, insulin function, healthy glucose levels, and bone health. (Kuang 2020)(Pazarci 2020)(Zhang 2021)

Specialty supplements

Amarasate® 

125 mg once daily to start, gradually increasing to 500 mg daily

  • Amarasate®, an extract of New Zealand hops, has been shown to support the body’s natural GLP-1 production and cholecystokinin (CCK) hormone levels.
  • Amarasate® can support satiety during fasting. (Walker 2019)(Walker 2022)(Walker 2024)

Creatine monohydrate

5 g daily 

  • Creatine can support metabolic health by helping address muscle recovery within the first 96 hours following exercise, promoting a faster and more effective recovery. (Harmon 2021)(Kreider 2021)(Smith-Ryan 2021)(Wu 2022)(Kreider 2017)


Strength combination

Beta‐hydroxy‐beta‐methylbutyrate (HMB)

2,000 mg daily

  • HMB, a metabolite of the essential amino acid leucine, has shown promise in combating normal age-related muscle loss and supporting strength and function in older adults. Research suggests that combining HMB with vitamin D3 supplementation may enhance these benefits, potentially offering a synergistic approach to maintaining muscle health and functionality in aging populations. (Flakoll 2004)(Rathmacher 2020)(Wilson 2008)


Calcium

240 mg daily


Epicatechin (green tea leaf extract)

400 mg daily

  • This flavonoid in dark chocolate, green tea, and certain fruits may support muscle growth and exercise performance by helping inhibit myostatin and promoting nitric oxide production. These mechanisms can contribute to muscle mass development and athletic performance. (Mafi 2017)(McDonald 2015)(Ramirez-Sanchez)


PurpleForce® purple tea (Camellia sinensis) leaf extract

100 mg daily

  • PurpleForce® contains anthocyanins, catechins, flavonoids, and other polyphenols that may support antioxidant activity, supporting muscle recovery. (Shimoda 2015)


AstraGin® (Astragalus membranaceus and Panax notoginseng)

50 mg daily

  • Containing extracts of Astragalus membranaceus and Panax notoginseng, AstraGin® supports improved absorption of amino acids, vitamins, and minerals, while also supporting the integrity of the intestinal barrier. (Chang 2022) 


Senactiv® (Panax notoginseng and Rosa roxburghii extracts, Astragalus membranaceus and Panax notoginseng root extracts)

50 mg daily

  • Senactiv® supports muscle growth and recovery by enhancing mitochondrial function and reducing oxidative stress. (Wu 2019)(Wu 2019)

Reviewed by

Natacha Montpellier, ND

Medical Science Liaison

Dr. Natacha Montpellier is a registered naturopathic doctor in Ontario, Canada. She currently maintains a private clinical practice focused on hormonal and reproductive health. Dr. Natacha, ND, also serves as a Medical Science Liaison on Fullscript’s Medical Advisory team.

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