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  4. Well-researched approach abridging conventional medicine, functional medicine has really helped increase confidence. How accurate of a marker is insulin? How are you using insulin in clinical practice? When you run the advanced metabolic workup with insulin C-peptide, etc., as markers, do you have guidelines on how to determine beta cell destruction?

Well-researched approach abridging conventional medicine, functional medicine has really helped increase confidence. How accurate of a marker is insulin? How are you using insulin in clinical practice? When you run the advanced metabolic workup with insulin C-peptide, etc., as markers, do you have guidelines on how to determine beta cell destruction?

Chris Kresser:  Yeah, I mean insulin, like other markers, is not perfect, but it does, it can be used in the context of a more complete panel to get a general sense of what’s happening. Fasting insulin, ideally,  many clinicians believe it should be below seven as an indicator of optimal metabolic function. And then we use the other markers in the beta cell section on the True Health Diagnostics  panel to get a sense of what’s happening. You can argue ultimately if you approach things from a practical perspective and you think about, okay, well, what are the potential treatments that I’m going to do anyways? I’m going to look at diet, I’m going to look at different variations on diet as a way of regulating glucose and insulin, I’m going to look at lifestyle, and then I’m finally going to look at drugs or, you know, then supplements, then drugs.

You’re still going to have to go through those things and see how the patient responds. And ultimately if they don’t respond to some of the things that would regulate glucose and insulin levels if beta cell capacity were intact, then the assumption is that beta cell capacity has declined and they may actually eventually need insulin if they don’t already. So you can arrive at that conclusion even without testing despite tracking how your treatment goes, but the markers can be important as well. And then ultimately if you suspect beta cell failure, depending on your level of experience with that, it may be worth referring out to an endocrinologist for that level of testing and workup.

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