The System is Broken: Preventive Tests Your Doctor Won’t Order
Doctors say, “Your labs look normal”, while metabolic disease silently builds for 10-20 years. I believed those reassurances, and the medical system failed me.
I’m writing this series so it doesn’t fail you.
These are the five tests that revealed what was actually happening in my body. These are tests any doctor can order, and your insurance will cover them during a standard annual physical.
You don’t need special access. You need to know what to ask for.
The Hidden Truth
Only 12% of American adults are metabolically healthy. (UNC Chapel Hill)
Insulin resistance typically progresses for 12–20 years before glucose becomes abnormal. (Centers for Disease Control)
One in four normal-weight adults is metabolically unhealthy. (National Institute of Health)
Print This for Your Next Appointment
Before your next annual physical, remember to request these five tests:
A1C
Fasting Glucose
Triglyceride-to-HDL Ratio
Fasting Insulin
LP-IR Score (Lipoprotein Insulin Resistance)
These tests cost nothing extra when ordered with annual labs.
If your doctor says, “We don’t need those”, say, “I want them ordered for preventative metabolic screening.”
A Note on Privacy: I’m sharing parts of my results because it’s the only way to show how normal labs can hide early metabolic dysfunction. My labs are now “optimal”. As part of this series, I will explain how I healed my body at the earliest warning signals.
1 — Glucose & A1C (The Illusion of “Normal”)
What they are: the two most common blood sugar tests your doctor orders annually.
The problem: These tests detect insulin resistance only after it has progressed to prediabetes. That means early dysfunction is completely missed.
A1C
“Normal”: ≤ 5.6
“Prediabetes”: 5.7–6.4
Optimal metabolic range: 4.8–5.2
Fasting Glucose
“Normal”: under 100
Metabolic sweet spot: 80-85
My results (when I first started investigating)
A1C: Normal (but not optimal)
Fasting Glucose: Normal (but not optimal)
Glucose is late to the party. Insulin is working overtime long before blood sugar changes.
These “quiet early signs” are dismissed as “fine”. They are not fine.
2 — Triglyceride-to-HDL Ratio (The Metabolic Clue Doctors Ignore)
What it tells you: This simple calculation from your basic lipid panel predicts insulin resistance more accurately than total cholesterol or LDL.
The Ranges:
Under 1.0 - Ideal
1-2 - Early insulin resistance
Over 2 - Likely insulin resistance
My ratio
Triglycerides: 128
HDL: 71
Triglycerides (128) ÷ HDL (71) = 1.8 (early insulin resistance)
“My cholesterol was ‘normal,’ but my ratio told the real story.”
This is one of the easiest, most overlooked metabolic signals on your entire blood panel.
3 — Fasting Insulin (The Hidden Red Flag)
Doctors rarely order this test. They wait until glucose levels are elevated, which can take years.
What it measures: How hard your body is working to keep blood sugar stable behind the scenes.
Optimal Ranges
2–6 µIU/mL — Optimal
7–9 µIU/mL — Early Insulin Resistance
10+ µIU/mL — Insulin Resistant
My result
Fasting Insulin: 8.2 µIU/mL = Early Insulin Resistance
No one had ever tested insulin before. Now I finally understood what my body had been trying to tell me.
4 — HOMA-IR (The Insulin Resistance Score)
Once you have fasting glucose and fasting insulin, you can calculate HOMA-IR (Homeostatic Model Assessment of Insulin Resistance).
It demonstrates how well your body regulates blood glucose using insulin.
HOMA-IR: (Glucose × Insulin) ÷ 405
Ranges:
Under 1.0 - Excellent
1.3 - 1.8 - Early insulin resistance
1.8 - 2.9 - Significant insulin resistance
My score
(91 × 8.2) ÷ 405 ≈ 1.84 (Significant insulin resistance)
This number confirmed what the ratio and fasting insulin suggested. Now I had a pattern, not just a single data point.
5 — LP-IR (The Smoking Gun)
When everything pointed toward insulin resistance, I asked for what cardiologists call the gold standard.
LP-IR = Lipoprotein Insulin Resistance Score
It measures how insulin is affecting lipoproteins (fat particles) in your blood.
Scale
Under 25 - Low insulin resistance
25-44 - Moderate insulin resistance
45+ - High insulin resistance
My Score
LP-IR Score: 50 (High Insulin Resistance)
This was the test that made everything undeniable.
LP-IR doesn’t care if your glucose is normal. It reveals what insulin is doing behind the scenes.
Key Lipoprotein Indicators
Large VLDL-P (High): liver fat export
Small LDL-P (High): inflammatory, sticky particles.
Large HDL-P (Low-normal)” protective particles, but struggling
VLDL Size: (High): carbohydrate-driven
LDL Size: (Small)” early fatty liver
This was early liver stress hidden behind “normal” cholesterol numbers.
What I Learned (and what I want you to know)
The standard medical system tells you:
“Everything looks normal.”
“Your labs are fine.”
“We’ll keep watching.”
But the truth is:
The system isn’t watching insulin. And insulin changes first.
Your Move
Print the five tests before your next annual physical.
Ask your doctor for these five tests.
Don’t take “you don’t need these” as an answer.
Record your results.
Calculate your scores.
You’re not being difficult. You’re being proactive. You deserve answers.
Coming Up Next: Part III
Metabolic symptoms no one connects to insulin resistance (especially cravings, anxiety, belly weight, alcohol sensitivity, and magnesium/potassium depletion.) They are all connected.