Weight and metabolic check
Insulin resistance, thyroid and metabolic risk, measured rather than assumed. Nine markers, one fasting collection, explained by a doctor.
The weight and metabolic check is a nine-marker fasting blood panel for women whose weight has changed in a way that diet and activity do not explain. It looks at glucose handling, long-term blood sugar, cholesterol, liver function, thyroid, androgens and cortisol together. It costs $199 with your own doctor's request, or $279 with a KnowLuna doctor who requests it and explains the results in a 20-minute video consult. Collect at an accredited Australian centre after an overnight fast, or choose a home kit or a nurse visit at checkout (options below).
What it measures
- Fasting glucose: blood sugar after an overnight fast, the standard screen for impaired fasting glucose and diabetes, and one of the two glycaemic markers in this panel.
- HbA1c: average blood sugar over the past two to three months, unaffected by this morning's meal.
- Lipid profile: total cholesterol, LDL, HDL and triglycerides. Insulin resistance often shows here first as high triglycerides and low HDL.
- Liver function: enzymes that can rise when fat accumulates in the liver, a common companion of metabolic change.
- TSH: the first-line thyroid check. An underactive thyroid slows metabolism and is a checkable cause of weight gain.
- Testosterone and SHBG: read together to estimate free androgen activity. A raised index with weight change and irregular cycles points towards PCOS.
- Cortisol: a morning stress-hormone level, included as a rough baseline only. A single morning cortisol cannot rule cortisol excess in or out; where that is a real question, your doctor arranges a specific screening test, such as a late-night salivary cortisol or an overnight suppression test. Combined hormonal contraception and the stress of the blood draw itself both lift a morning reading.
- Uric acid: often raised alongside insulin resistance and fatty liver, and read in that context.
Who it's for
Women whose weight will not shift despite genuine effort, who get cravings or energy crashes after meals, who carry new weight around the middle, or who have a family history of type 2 diabetes. It suits women with irregular cycles who wonder about PCOS, women in their forties whose body composition has changed, and anyone who wants a proper metabolic baseline. It is for adults aged 18 and over.
What you'll learn, and what you won't
You'll learn whether insulin resistance, blood sugar, thyroid, androgens or cortisol are contributing to how your body is behaving, with each marker explained against your laboratory's range and read as a pattern rather than in isolation. That pattern turns "I don't know why" into a specific conversation with your doctor.
What it cannot do: it does not measure your metabolic rate, it cannot say why weight changed if every result is within range, and it is not a weight-loss plan. It is an explanation, not a programme. A blood test is one input to a doctor's assessment, not a diagnosis on its own.
Why weight changes in women have hormonal and metabolic causes
Several checkable processes shift the intake-and-output equation in women. PCOS commonly involves insulin resistance, which drives fat storage and hunger. An underactive thyroid slows energy use. In perimenopause, falling oestrogen moves fat towards the abdomen even when the scales barely change, and disrupted sleep raises cortisol and appetite.
Insulin resistance runs through most of these. When cells respond less to insulin, the pancreas makes more, and high insulin promotes fat storage and blocks fat release. Glucose can stay normal for years, which is why this panel reads fasting glucose and HbA1c alongside triglycerides and HDL rather than relying on one number. Fasting insulin and HOMA-IR are sometimes discussed, but the assay is not standardised and guidelines advise against them for assessing an individual, so they are not in this panel. Read more in insulin resistance in women.
Reference ranges and what they mean
| Marker | Typical adult range | What it usually means |
|---|---|---|
| Fasting glucose | Below 5.5 mmol/L makes diabetes unlikely; 5.5 to 6.9 is an uncertain band usually followed by a glucose tolerance test (6.1 to 6.9 is formally impaired fasting glucose); 7.0 or above, confirmed on repeat, is in the diabetes range | Within range does not exclude insulin resistance. The uncertain band prompts further testing, usually a 75 g oral glucose tolerance test arranged by your doctor. |
| HbA1c | Below 6.0 percent (42 mmol/mol) is typical; 6.0 to 6.4 suggests raised risk; 6.5 percent (48 mmol/mol) or above is in the diabetes range | Average glucose over two to three months, read with fasting glucose. |
| Lipid profile | Total cholesterol above about 5.5 mmol/L is commonly flagged by Australian laboratories, with LDL above about 3.5, HDL below 1.0 and fasting triglycerides above about 2.0. Cholesterol is read as part of overall cardiovascular risk (Australian cardiovascular disease risk guideline 2023) rather than against a single cut-off | High triglycerides with low HDL is the classic insulin-resistance pattern; LDL matters most for heart risk. |
| Liver function | Enzymes within the laboratory range | Mildly raised enzymes with other metabolic markers can point to fat in the liver. |
| TSH | About 0.4 to 4.0 mIU/L | Above range suggests an underactive thyroid and leads to a fuller thyroid panel. |
| Testosterone, SHBG, free androgen index | Laboratory-specific female ranges; SHBG tends to be low when insulin is high | A raised index with irregular cycles is one feature doctors assess for PCOS. |
| Morning cortisol and uric acid | Laboratory-specific ranges | A single morning cortisol cannot rule cortisol excess in or out, so an unusual result is repeated or followed by a specific screening test rather than acted on alone; uric acid is often mildly raised with insulin resistance. |
Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.
When to do this test
Fast for 8 to 12 hours before collection. Water is fine; no food, coffee, tea, juice or gum. Book a morning appointment so the fast is overnight and cortisol is read in its morning window (ideally before 10am). Take usual medicines unless your doctor says otherwise, and tell us what you take. If you have cycles, day 2 to 5 is ideal for the androgen readings but any day is acceptable. Combined (oestrogen-containing) contraception raises SHBG, lowers free testosterone and lifts total cortisol, so tell us if you use it; progestogen-only methods have a smaller and less predictable effect. Avoid testing while unwell.
What the result can lead to
A result showing insulin resistance, an impaired glucose band, a thyroid outside range or a PCOS pattern gives you and your doctor something specific to discuss; that discussion is where decisions are made. KnowLuna does not offer weight-loss programmes or medicines and this page does not recommend any. Results all within range are also information: they rule out several common drivers. Abnormal results are always followed up by a doctor, and a repeat panel in six to twelve months is a common way to track change.
How it works
- Order online. Either upload the request your own doctor has signed, or a KnowLuna women's health doctor reviews your short questionnaire and requests the panel.
- Collect at an accredited centre near you in the morning after an 8 to 12 hour fast, or choose a home kit or a nurse visit (options below).
- Results are usually ready within a few business days, explained in plain English in your account, with a 20-minute doctor consult if you chose that option.
Choose how you collect
Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.
A quick draw at an accredited pathology collection centre near you. Usually under ten minutes. Included.
Lancet kit posted to you with an Express return satchel. If the lab cannot test your sample we send a replacement kit at no charge.
A near-painless device draws a small sample from the upper arm, with far fewer failed samples than a finger-prick. Express return satchel included.
A registered nurse comes to your home or workplace for a standard blood draw. Metro areas of capital cities; other locations on request.
Common questions
What are the signs of insulin resistance?
Common clues include weight gained around the middle, strong cravings for sweet or starchy food, tiredness after meals, dark velvety skin at the neck or armpits, skin tags, irregular cycles and a family history of type 2 diabetes. None is proof on its own. Fasting glucose, HbA1c and lipids together are how it is checked, with an oral glucose tolerance test through your doctor where a closer look is needed.
What blood tests check for weight gain causes in women?
Doctors usually look at thyroid function (TSH), blood sugar handling (fasting glucose and HbA1c), lipids and liver function, and in women with cycle changes the androgens testosterone and SHBG. A morning cortisol is included as a rough baseline; where cortisol excess is a real question, a doctor arranges a specific screening test instead. This panel includes all of them in one fasting collection.
What is a normal HbA1c in Australia?
An HbA1c below 6.0 percent (42 mmol/mol) is generally considered typical. Results from 6.0 to 6.4 percent indicate a raised risk of developing diabetes, and 6.5 percent (48 mmol/mol) or above, confirmed on repeat, is in the diabetes range. Your doctor interprets it with your fasting glucose and your lab's range.
Do I need to fast for this test?
Yes. Fast for 8 to 12 hours before collection, with water only. Fasting glucose and triglycerides are both affected by a recent meal, so an overnight fast with a morning appointment gives the most reliable result. HbA1c and TSH do not need fasting but are collected at the same time.
Can hormones cause weight gain in perimenopause?
Yes. Falling oestrogen shifts fat storage towards the abdomen, sleep disruption raises cortisol and appetite, and insulin sensitivity often declines in the mid-forties. This panel checks the measurable pieces; the perimenopause and menopause panel looks at the reproductive hormones themselves.
Is this the same as a PCOS test?
They overlap but differ. The PCOS panel is built around the hormonal features of PCOS, adding LH, FSH, prolactin and DHEA-S. This check is weighted towards metabolism: fasting glucose, HbA1c, lipids, liver, uric acid and cortisol, with testosterone and SHBG for the androgen picture.
Sources and further reading
- Pathology Tests Explained (RCPA): HbA1c
- Pathology Tests Explained (RCPA): glucose
- Pathology Tests Explained (RCPA): lipid profile
- Pathology Tests Explained (RCPA): cortisol
- RACGP: Management of type 2 diabetes, a handbook for general practice
- Better Health Channel: pre-diabetes
General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.
Related
Then a real conversation.