Vancouver, British Columbia
The Assessment Pathway
Measurement happens in sequence. Each stage informs the next, and the sequence ends in interpretation rather than in a folder of results.
Stage 0 · Before arrival
Pre-visit laboratory work
Blood and urine are drawn locally, so the results are already in hand when the assessment days begin.
- Complete blood count with differential
- Comprehensive metabolic panel
- Cystatin C
- Urine albumin-to-creatinine ratio
- Urinalysis
- HbA1c
- Fasting glucose and insulin
- Full lipid panel with ApoB
- Lipoprotein(a) — measured once in a lifetime
- High-sensitivity CRP
- Ferritin and iron studies
- Thyroid panel — TSH, free T4, free T3
- 25-hydroxy vitamin D
- Vitamin B12 with methylmalonic acid
- Homocysteine
- Magnesium
- Uric acid
- GGT
- NT-proBNP
- Omega-3 index
- Sex steroids by mass spectrometry
- IGF-1
- DHEA-S
- Liver fibrosis index (derived, no additional draw)
- PSA where appropriate
Stage 1 · Day one, morning
Physiology
Measured performance rather than reported performance. These are the values that move fastest, and the ones worth repeating.
- Cardiopulmonary exercise testing with VO₂max
- Resting metabolic rate
- DXA body composition
- Grip strength
- Gait speed
- Chair-stand
- Balance
- Pulse wave velocity
- Carotid intima-media thickness
- Central blood pressure
- Spirometry with diffusing capacity
- Postural analysis
Stage 2 · Day one, afternoon
Sensory, cognitive and sleep
Hearing, vision, smell, cognition and sleep are measured directly. Change in these domains is often the earliest signal available.
- Audiometry
- Speech-in-noise testing
- Visual acuity and contrast sensitivity
- Olfactory testing
- Computerised cognitive battery
- Home sleep apnoea test
- Fourteen-day continuous glucose monitor — fitted here, reviewed later
Stage 3 · Where clinically indicated
Selective testing
Nothing in this stage is routine. Each item is ordered only when the earlier stages, your history, or your family history give a specific reason.
- Coronary artery calcium scorewhere clinically indicated
- CT coronary angiography with fractional flow reservewhere clinically indicated
- Liver elastographywhere clinically indicated
- Targeted ultrasoundwhere clinically indicated
- Oral glucose tolerance test with insulinwhere clinically indicated
- ApoE testing, with counselling before and afterwhere clinically indicated
- Pharmacogenomic testingwhere clinically indicated
- Hereditary panels where family history warrantswhere clinically indicated
Stage 4 · The product
Interpretation
Everything before this stage produces numbers. This stage produces the decision.
A ninety-minute interpretation consultation with a physician, working through every measured value in context rather than in isolation.
A complete written report: each value, your percentile position, and the reasoning behind what matters and what does not.
A twelve-month plan built from your own measured thresholds, not from population averages.
Correspondence to your family physician, because this programme sits alongside your existing care rather than replacing it.
Stage 5 · At three, six and twelve months
Re-assessment
The inexpensive physiology repeats on a defined schedule, alongside a narrow laboratory subset. Repeated under the same conditions, these measures are comparable — which is what makes them worth repeating.
- Grip strength
- Gait speed
- VO₂max
- Pulse wave velocity
- Body composition
- A narrow laboratory subset selected from Stage 0
Every marker referenced above appears once, by body system, on What We Measure. Each service is available and priced individually; the full schedule is on the Pricing page.
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Choose the clinic and the dates that suit you. Every course begins with an assessment, and we will tell you plainly if this is not the right intervention for you.
Interventions restricted under Canadian regulation are delivered at our Costa Rica clinic, under the same physicians and the same protocol.