03/21/2026
Your annual physical usually checks the basics—cholesterol, blood sugar, maybe thyroid (TSH only). You’re told everything looks “normal,” and you move on.
But there’s a big part of the metabolic picture that often gets missed.
Fasting insulin is one of the most important markers in preventive medicine, yet it’s rarely included on standard lab panels. Your blood sugar can look completely normal while your insulin is working overtime behind the scenes to keep it there. By the time glucose starts to rise, insulin resistance has typically been developing for years.
And that matters—because insulin resistance sits upstream of nearly every chronic condition we see today: heart disease, type 2 diabetes, fatty liver, cognitive decline including Alzheimer’s, even certain cancers.
To really understand what’s going on, you need a more complete picture. That includes hemoglobin A1c (your 3-month blood sugar average), a full lipid panel—especially your triglyceride-to-HDL ratio—and inflammatory markers like hs-CRP and homocysteine.
These markers don’t just predict future disease—they show you what’s happening in your body right now.
I’ve seen plenty of patients with “perfect” standard labs who were still on a clear path toward metabolic dysfunction.
Sometimes the difference between catching it early and catching it late comes down to one simple test that was never ordered.
Ask for it. You deserve to see the full picture.
