Hey y’all!
Can I tell you the thing that still makes me want to flip a table?
It’s the phrase “your labs are normal.”
Because for a lot of women… especially women with PCOS, perimenopause knocking, and years of “borderline” results that nobody ever actually addressed… “normal” doesn’t mean fine. It means nobody looked deep enough.
Here’s what most routine bloodwork checks when it comes to blood sugar: fasting glucose and A1C. That’s it.
And here’s what those tests miss: how hard your body is working to keep those numbers where they are.
Your fasting glucose could be sitting at a perfect 94 mg/dL.
Your A1C could be a beautiful 5.4%.
And your pancreas could be GRINDING out insulin behind the scenes just to hold those numbers in place.
You wouldn’t know. Because nobody ordered the test that shows it.
That test is called fasting insulin. And when you pair it with your fasting glucose, you can calculate something called your HOMA-IR score… which basically tells you how insulin resistant your body is right now.
Not how your blood sugar looks on paper. How your body is actually functioning.
The CDC says over 115 million American adults have prediabetes. 8 in 10 don’t know it. That’s not because they’re ignoring their health. It’s because the standard tests aren’t catching it early enough.
And research published in Diabetes Care found that using A1C alone to screen for prediabetes missed about 75% of at-risk people.
If that doesn’t make you want to flip the table too… I don’t know what will.
Here’s what I want you to do:
Next time you have bloodwork, ask your doctor to add a fasting insulin level. It’s drawn from the same blood, at the same time. You may need to specifically request it because it’s not included in standard panels.
Once you have it, here’s the math: (fasting glucose x fasting insulin) / 405 = your HOMA-IR score.
Under 1.0 = optimal.
Over 2.5 = insulin resistance may be present.
Over 3.0 = significant.
That one number could explain more about why you feel the way you feel than every “normal” result you’ve ever gotten combined.
I wrote a full deep dive on this on the blog… why standard panels miss it, what it means if you have PCOS, and the exact labs I’d tell my best friend to ask for. If you want the whole picture, it’s there for you.
You deserve better than “normal.”
XOXO,
NIKI, RN
PCOS. Perimenopause. Metabolic health. The real stuff. Not just “eat less, move more.”
Not sure where to start? Take my free quiz and I’ll send you a custom plan.
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I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
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