Cardiometabolic Health
Borderline lab results your doctor said to "keep an eye on." Cholesterol that's crept up over the years. Blood sugar that runs a little high but not high enough for a diagnosis yet. Blood pressure numbers that are trending the wrong direction. Weight that's shifted around your midsection despite no real change in habits. These are often treated as background noise until they become a diagnosis.
Cardiometabolic health covers how your body manages blood sugar, blood pressure, cholesterol, and weight, systems that are deeply interconnected and often start showing subtle signs of strain years before a formal diagnosis like type 2 diabetes or cardiovascular disease appears. My approach here is about catching and addressing that early pattern, not waiting for it to become a crisis. If a diagnosis already exists, nutrition, lifestyle, and nutraceuticals can play a meaningful role in supporting overall health, longevity, and how effectively medications work.
Patterns I look at
Insulin resistance and prediabetes. Insulin resistance develops gradually and often flies under the radar on standard bloodwork until fasting glucose is already elevated. Fatigue after meals, sugar cravings, difficulty losing weight around the midsection, and brain fog can all be early signals. I look at markers beyond fasting glucose alone, including fasting insulin and HbA1c, to catch this pattern earlier.
Type 2 diabetes. For patients managing an existing diagnosis, I work alongside your GP or endocrinologist to support blood sugar regulation through nutrition, movement, and lifestyle strategies that complement your medical management, rather than replace it.
Cholesterol and triglycerides. Elevated LDL cholesterol and triglycerides are commonly flagged on routine bloodwork, and they're influenced by a wide mix of factors, diet, genetics, thyroid function, inflammation, and insulin sensitivity among them. I look at your full lipid picture in that broader context rather than focusing on a single number. Where appropriate, this may include evidence-based nutraceuticals which have research behind their association with total cholesterol, triglycerides, and LDL-C specifically.
Blood pressure. Hypertension is often symptomless until it's well established, which is part of why it's sometimes called a silent condition. Stress, chronic pain, electrolyte balance, magnesium status, nutrition, and vascular inflammation can all play a role, and addressing these alongside any prescribed medication is something I discuss with patients rather than positioning as a replacement for it.
Metabolic syndrome. This describes a cluster of markers, elevated blood pressure, blood sugar, waist circumference, and abnormal cholesterol, which tend to occur together and raise long-term cardiometabolic risk. Because these markers interact, I look at the pattern as a whole rather than treating each number in isolation.
Non-alcoholic fatty liver disease (NAFLD). NAFLD involves fat accumulation in the liver that isn't related to alcohol use, and it's closely tied to insulin resistance, elevated triglycerides, and weight distribution around the midsection, which is part of why it often shows up alongside the other patterns on this page rather than in isolation. It's frequently picked up incidentally on imaging or through mildly elevated liver enzymes, with few obvious symptoms in earlier stages. My approach typically looks at insulin sensitivity, dietary pattern, and liver-supportive nutrients and herbs, such as milk thistle, alongside monitoring markers over time with your GP.
Weight and body composition changes. Shifts in weight, particularly around the midsection, are often tied to the same underlying drivers as the markers above, insulin sensitivity, cortisol, thyroid function, and inflammation. Rather than focusing on weight as an isolated goal, I look at what may be driving the change.
The gut-metabolic connection
Gut health and metabolic health are more connected than most people realize. Microbiome composition and bile acids has been linked to how the body regulates blood sugar, processes fats, and manages systemic inflammation, all of which feed into cardiometabolic risk over time. This is part of why a fatigued, bloated patient with borderline labs isn't necessarily dealing with two separate issues; the gut is often part of the same picture.
Testing I may use
Depending on your presentation, this can include:
Fasting insulin and HbA1c, alongside fasting glucose
Full lipid panel, including particle-level markers where relevant
Inflammatory markers (such as hs-CRP)
Cardiovascular Lipoprotein Particle Profile (LPP) Test
Thyroid panel, given its influence on metabolic rate and cholesterol
Gut microbiome testing where digestive symptoms are also present
My approach
Every cardiometabolic case starts with an in-depth look at your history, current labs, diet, activity, stress, and sleep. From there, I build a plan that may include targeted nutrition, evidence-based nutraceuticals, herbal medicine, and lifestyle strategies, always working alongside your GP or specialist, particularly where medication is already part of your care.