What a real baseline panel actually screens for

Measurement precedes intervention. That is easy to assert and slightly harder to specify, so here is the specification: what a baseline panel for metabolic therapy contains, and what each test is actually for.

The panel

Comprehensive Metabolic Panel. Kidney function (BUN, creatinine), liver enzymes (AST, ALT), fasting glucose and electrolytes. It establishes where kidney, liver and glucose sit before anything is prescribed, which is what makes any later change interpretable.

HbA1c. Average blood glucose across the preceding two to three months. It determines whether undiagnosed diabetes or prediabetes is present, which changes both eligibility framing and what the treatment is aiming at. Per the American Diabetes Association, below 5.7% is normal, 5.7% to 6.4% is prediabetes, and 6.5% or above meets the diagnostic criteria for type 2 diabetes. That does not disqualify anyone, since GLP-1s are approved for that indication, but it does change the monitoring.

Complete Blood Count. Red cells, white cells, platelets. Detects anaemia, which complicates weight loss and is worth knowing about before hair loss becomes a question.

Lipid Panel. Total cholesterol, LDL, HDL, triglycerides. Largely a baseline-capture exercise: without a starting value, any later improvement is unmeasurable.

TSH. Thyroid function, and it earns its place twice over: hypothyroidism is a common cause of weight loss resistance, and thyroid status affects hair loss risk. Note that the GLP-1 boxed warning concerns medullary thyroid carcinoma and MEN 2 history, which is a history question rather than something TSH screens for.

Urinalysis. Protein, glucose and other markers: additional kidney and metabolic screening.

Ferritin, where indicated. Iron storage, relevant to hair health, and low results are actionable through supplementation rather than exclusion.

What actually stops or changes treatment

This section is worth reading carefully, because it is widely got wrong, including in the source this note was adapted from.

The labelled contraindications are narrow: a personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, or known hypersensitivity. The boxed warning concerns thyroid C-cell tumours observed in rodents, whose human relevance has not been determined.

Reduced kidney function is not itself a contraindication. Semaglutide labelling requires no dose adjustment for renal impairment, and FLOW enrolled adults with chronic kidney disease down to an eGFR of 25, roughly a tenth of them below 30, and reported benefit. A low eGFR is a reason for a provider to look harder and monitor more closely. It is not an automatic exclusion, and presenting it as one is both inaccurate and a way of turning away people the evidence supports treating.

Severely elevated liver enzymes or signs of liver disease warrant investigation; mild elevation from fatty liver disease generally does not change the plan. Very high HbA1c or fasting glucose indicates poorly controlled diabetes and may warrant closer monitoring or endocrinology involvement. Elevated TSH and low ferritin are ordinarily managed alongside treatment rather than being grounds to withhold it.

To be explicit about who decides: none of the above is an eligibility rule of ours. Amerigo Health does not practice medicine or prescribe. These are the questions a panel puts in front of an independent, licensed provider, who makes the determination.

Cadence

Baseline before prescribing. CMP and HbA1c at three months. CMP and HbA1c again at six, with lipids repeated if the baseline was abnormal and TSH where clinically indicated. Annually thereafter: CMP, HbA1c, lipids. Individual history moves this, and the schedule is the provider’s to set.

A note on collection

At-home kits do not meet the same standard for clinical decision-making as an in-person draw, which carries chain-of-custody, sample integrity and medical-legal documentation requirements. For screening curiosity this is immaterial. For a result that will gate a prescription, it is not.

What we do with it

None of this is advanced diagnostics. It is six standard tests, run before rather than after, read by someone qualified to act on them. The distinction between this and a conventional annual physical is not the sophistication of the panel. It is that the results are tied to a decision and re-run on a defined schedule, rather than filed and forgotten until next year.

The provider makes the clinical determination. The panel just makes sure they are making it with something in front of them.