What your blood tests don’t show and what metabolic health can tell you instead.
What is this ‘metabolic health’ that keeps popping up? And should we care?
One of my patients asked me recently whether ‘metabolic health’ was just a rebrand on being healthy. In a nutshell – yes. But excitingly it allows us to understanding our health, with data. This can give us a window to what is happening inside our body – ideally before things go wrong.
And that may be that moment, before serious illness takes hold, that can make the insight transformative for our current and future health and vitality.
It starts with a beautiful word
The word metabolism comes from the Greek metabolē, meaning “change” or “transformation.” I love this. It fills me with a sense of potential; the idea that nothing is fixed, that the body is always capable of shifting.
In biology, metabolism refers to all the chemical reactions that keep us alive: converting food into energy, building tissues, regulating hormones, repairing cells, detoxifying. It is, quite literally, the process of being alive.
When we talk about metabolic health, we’re asking: how well are all those actions and reactions working?
The five markers
Clinicians mostly assess metabolic health by looking at five key measurements. When all five sit within healthy ranges, without the need for medication – this is considered good metabolic health:
- Blood sugar (fasting glucose and insulin sensitivity)
- Blood pressure
- Triglycerides (blood fats)
- HDL cholesterol (the “good” kind)
- Waist circumference (a proxy for visceral fat)
When all five are optimal, cells respond well to insulin, energy is stored and released efficiently, and inflammation is kept low. When they’re not, those systems start to misfire, creating often low grade symptoms, long before a diagnosis appears.
Research from the United States, where the largest studies have been done, suggests that as few as 1 in 8 adults is fully metabolically healthy. Not people who are visibly unwell but the likes of you and me, going about our lives, feeling vaguely off but can’t quite put their finger on why.
The moment your doctor says “there’s nothing wrong”.
This is where metabolic health becomes, for me, one of the most important concepts in modern healthcare.
There is a stage, referred to as subclinical, where the body is struggling but formal disease hasn’t yet declared itself. Symptoms are below the line where a clinical disease diagnosis can be made, sometimes even thought of or detected. You go to your GP feeling exhausted, brain fog, bloated, low. The tests come back. Everything is “normal”, your GP says ‘there is nothing wrong’.
Then why do you still feel like crap?
Because the tests most commonly run in standard care are designed to detect established disease, not early dysfunction. They will catch diabetes once it’s diabetes. They won’t catch the years of creeping insulin resistance that preceded it.
This is the dis-ease state. I use that hyphen deliberately. Not disease, but a lack of ease within the body. This is a signal and an opportunity to start looking more closely. We don’t wake up one morning with a disease. We will have been gradually building up to this over months and years. Sometimes decades.
Understanding your metabolic markers can catch this early. It can be the difference between a targeted lifestyle intervention and a lifetime of medication. And is the time when mum’s saying of ‘a stitch in time saves nine’ comes into its own.
Going deeper
There is a growing range of tools available: full blood panels, stool analysis, hormone testing, continuous glucose monitors, diagnostic wearables and other data-gathering options that can help build a detailed map of what’s happening metabolically.
They can start to be costly but for anyone who has been told “your results are fine” while continuing to feel rubbish they can be a revelation and revolution, helping you take back control of your health, vitality and wellbeing. The expensive tests however, are not essential.
Five things that move the needle
You don’t need a clinic full of tests to start improving your metabolic health. These five things have the most evidence behind them:
1. Eat real food, regularly Cut out snacking where you can and aim for three proper meals a day built around fresh, whole ingredients. Reducing processed food is one of the single most powerful steps you can take — for your gut, your blood sugar, and your energy levels.
2. Move your body, in a way that is enjoyable for you. Exercise keeps blood sugar balanced, supports cardiovascular and immune health, and does remarkable things for mental clarity. If you can get outside while you do it, even better. Try and find the thing that works for you.
3. Prioritise sleep Aiming to be in bed by 10pm is ideal, though for many people, genuinely impossible. If you work standard hours, try to be asleep by midnight at the latest, and reduce screen time in the hour before bed. Poor sleep is one of the most underestimated drivers of metabolic dysfunction.
4. Be aware and beware of your stress Chronic stress raises cortisol, which raises blood sugar, which over time drives insulin resistance. It is a direct, physiological pathway to poor metabolic health, not just a feeling. If you struggle with the relentless pressure of a never-ending to-do list, I recommend Oliver Burkeman’s Four Thousand Weeks. It reframes our relationship with time and busyness in a way that I absolutely love and can relate to.
5. Know your numbers If you are feeling off ask your GP to get some bloods done, and/or a fasting glucose, a lipid panel, and a blood pressure reading. These are basic, accessible, and give you a starting point. You can’t improve what you can’t see.
The body is always capable of change. One of the underlying tenets of Osteopathy is ‘given the correct environment the body will always strive to heal itself.’ Let’s give it the correct environment.
Working towards our best Metabolic health, our best vitality and life, is in the small, consistent steps we take each day. The same systems that tip towards dysfunction can, with the right conditions, tip back. Small, consistent changes are sometimes all it takes.
Metabolē = transformation.
The body is changing every second of every day. So the question is not whether change is happening, but in which direction?
What is the small change you will make to start tipping the change in the right direction?