Metabolic Health and Insulin Resistance

Comprehensive testing, and treatment that matches it.

Most people arrive here after being told their labs look fine. Fasting glucose normal, cholesterol acceptable, come back next year. Meanwhile they are gaining weight around the middle, crashing at three in the afternoon and sleeping badly.

Standard panels are built to catch disease that has already arrived. They are not built to catch the decade of drift that precedes it.

What I test

Fasting insulin and HOMA-IR, not just glucose. Hemoglobin A1c read alongside them rather than alone. ApoB and Lp(a) rather than total cholesterol. hs-CRP and other inflammatory markers. A full thyroid panel including free T3 and reverse T3, not just TSH. Sex hormones, because metabolic and hormonal drift travel together, particularly through perimenopause. Continuous glucose monitoring where it would change what we do.

That panel usually explains what the standard one missed.

Why this sits inside an oncology practice

Insulin resistance is not only a cardiovascular problem. It shapes the environment cancer grows in, and it worsens through treatment. Steroids, reduced activity, disrupted sleep and hormonal suppression push most patients metabolically backward over a course of therapy. Survivorship care that ignores this leaves people at higher cardiometabolic risk than the cancer they just finished treating.

What I prescribe

Metformin. GLP-1 agonists, including semaglutide and tirzepatide, with muscle mass and protein intake monitored while you are on one, which is the part that usually gets skipped. Targeted nutrients where testing supports them. Thyroid support where the full panel warrants it.

Diet strategy built around your actual eating pattern rather than a protocol, and resistance training, which does more for insulin sensitivity than any supplement I could give you.

Who I see

Insulin resistance and prediabetes. Weight gain during or after cancer treatment. Perimenopausal metabolic change. Hashimoto's and hypothyroidism. Fatty liver. People with a family history of diabetes or cardiovascular disease who want to know where they actually stand.

Cost

Initial consultation is $350 for 60 minutes. Follow-ups start at $120. Visits are self-pay and I do not bill insurance. A full metabolic panel through my discounted physician-ordered pricing typically runs $70 to $150 total.

Washington and Oregon

Prescribing is limited to patients in Washington and Oregon. Outside those states I can review your case and provide guidance.

Book a free 15-minute consult.