You have labs, wearable trends, and meds—but no single picture. This guide gives you a repeatable loop to read the numbers and act with confidence.
”Who it’s for: prevention-minded adults, families, athletes, people on chronic meds, and anyone using wearables to stay ahead.
1. Why a system matters
- Reference ranges rule out disease, not optimize performance (fasting insulin is often missing).
- Data silos hide trends: labs, devices, meds, lifestyle.
- Payoff: earlier metabolic warning, better training/nutrition decisions, fewer over/under-treatments.
2. Core metric stack
| Domain | Key metrics | Red flag | Optimal line | Recheck | Source |
|---|---|---|---|---|---|
| Metabolic | Fasting insulin, HOMA-IR, HbA1c, fasting/post-meal glucose | HOMA-IR > 2.0 | HOMA-IR < 1.0 | 3–6 mo | Labs + fingerstick |
| Lipids | TG/HDL ratio, ApoB, non-HDL | TG/HDL > 1.7 | TG/HDL < 0.87 | 6–12 mo | Labs |
| Inflammation | hs-CRP, homocysteine, GGT | hs-CRP > 1.0 | hs-CRP < 0.5 | 6 mo | Labs |
| Hormones | Thyroid panel, sex hormones, cortisol rhythm | TSH > 4.0 | TSH 1–2 | 6–12 mo | Labs |
| Nutrition | Vitamin D, ferritin, B12, magnesium | Vit D < 30 ng/mL | 40–60 | 6 mo | Labs |
| Cardiorespiratory | Resting HR, HRV, VO2 est | HRV < 30 | HRV > 60 | Weekly | Wearables |
| Sleep | TST, deep/REM %, sleep latency | Deep < 15% | 18–23% | Nightly | Wearables |
Relationships: Metabolic ↔ Lipids ↔ Inflammation; Sleep/Stress ↔ Cortisol ↔ Glucose; Meds ↔ Monitoring labs.
3. Collect & normalize
- Labs: same lab, morning, fasting; log meds/cycle/illness.
- Wearables: sync Apple Health/Google Fit/Oura/Huawei to one hub.
- Lifestyle: macros, training load, sleep schedule, stress.
- Views: “annual baseline” + “quarterly trend” to avoid overreacting to one-off spikes.
4. Interpretation playbooks
4.1 Metabolic first: insulin before glucose
- Measure fasting insulin + glucose → compute HOMA-IR → consider OGTT with insulin if borderline.
- HOMA-IR >2: tighten carbs + strength training → recheck 8–12 weeks; >3.5 discuss meds (metformin/GLP-1) with your clinician.
- See: Fasting insulin, HOMA-IR.
4.2 Lipids: TG/HDL then ApoB
- TG/HDL >1.7 suggests small dense LDL → fix carbs/weight first; if ApoB stays high, consider statin/ezetimibe.
- See: Triglycerides guide, ApoB risk.
4.3 Inflammation trio
- hs-CRP 1–3: check sleep, oral health, body fat, recent infection; >3 get medical eval.
- Homocysteine >10: check B vitamins/folate intake and thyroid function.
- GGT high: review alcohol, meds, NAFLD; correlate with lipids and liver enzymes.
- See: CRP, Homocysteine.
4.4 Thyroid
- TSH >4 + symptoms → add FT3/FT4 + antibodies; consider ultrasound.
- On levothyroxine: recheck TSH/FT4 every 6–8 weeks after dose change.
- See: Thyroid panel.
4.5 Sleep & recovery
- Track TST, deep/REM, sleep latency, awakenings, HRV.
- Fix order: consistent wake time → morning light → cut late alcohol/high GI → cooling/stretch.
- Device deep dive: Oura sleep stages.
5. 4-week action loop
- Week0: baseline labs + device sync; pick 1–2 primary metrics (e.g., HOMA-IR, TG/HDL).
- Week1–2: dietary + training + sleep interventions; daily trends.
- Week3: mini-retro; adjust carbs/protein split; progressive overload in lifts.
- Week4: spot-check labs or rely on trend metrics; refresh action card.
Quick nutrition guide
- Carb 30–40% energy, prioritize low GI; protein 1.6–2.0 g/kg; fats mainly mono/poly-unsat.
- Supplements only after labs (Vit D, magnesium, B12, iron/ferritin as needed).
Training mix
- Strength 3–4x/wk (compound lifts), cardio 2–3x/wk (Zone2 + intervals).
- If recovery poor: keep intensity, cut volume first.
Med safety checkpoints
- Metformin/GLP-1: watch GI and hypoglycemia; monitor renal function.
- Statins/ezetimibe: CK, creatinine, liver enzymes; stop and seek care if severe myalgia.
- SGLT2: hydrate; pause during acute illness/surgery per clinician.
- ARB/ACEI: monitor potassium, blood pressure.
6. Tools & templates
- Calculators: HOMA-IR, TG/HDL, BMI, FFMI; embeddable widgets with canonical link.
- Trackers: weekly goals, one-page sleep/HRV/training/food sheet; monthly radar chart.
- Alerts: HRV drop + sleep debt + CRP uptick → prompt rest/medical review.
7. FAQ
Q: Normal labs but constant fatigue—what first?
Check thyroid, ferritin, Vit D, sleep duration, HRV, and stress load.
Q: If post-meal glucose is fine, do I still need insulin?
Yes. Insulin rises before glucose drifts; HOMA-IR catches early resistance.
Q: How often to retest?
Metabolic/lipids every 3–6 months; thyroid/nutrition every 6–12; sooner if meds or symptoms change.
Q: Home glucose vs lab mismatch?
Calibrate, same finger/time, watch trends not single points; confirm with a lab if unsure.
Q: Data scattered across apps?
Use Apple Health/Google Fit as the hub, sync into WellAlly, and manually log key lab values.
8. Do this next
- Enter your latest labs + one week of wearable data to build a baseline radar.
- Pick one primary metric (e.g., HOMA-IR) and run the 4-week loop.
- On meds? Read the matching drug card and set follow-up reminders.