Chapters
This is Part 3 of the Vively Practitioner Masterclass, recorded on 29 October 2026, and the final session in the series. Dr Michelle Woolhouse, integrative GP and Vively's Founding Medical Director, takes Sarah's case from Part 1 and Part 2 into the Vively practitioner platform, and shows how she reviews a client's results there: blood tests, continuous glucose monitoring, meals, sleep and activity, read together.
What you will take from this session
- One client record brings blood results, CGM, meals, sleep and activity together, so you can read results against how the client actually lives.
- Read the Baseline as a pattern and a trend. Sarah's HbA1c, fasting glucose, fasting insulin and HOMA-IR all sit inside the laboratory range, and all of them are creeping up.
- A progesterone drawn 7 days before the next period shows whether she ovulated. Below about 30 nmol/L suggests a missed ovulation, which can bring heavier periods and falling iron.
- A CGM shows how glucose responds to real meals, day to day, which a blood test can't. Clients also find it motivating.
- Read hs-CRP and other inflammation markers in clinical context and over time. One result out of line shouldn't cause a client anxiety.
- Perimenopause is a window for prevention, before type 2 diabetes or fatty liver take hold.
Sarah's record in the platform
Sarah is an example client, not a real person. She is 44, tired by mid-afternoon, foggy and gaining weight around the middle, and her cycles have shortened.
Michelle starts with the layout. The left-hand navigation holds the client list, guides, the marker library and the referral tab. Sarah's profile snapshot shows her priorities and life stage, vitals such as blood pressure, height, weight and waist circumference, and her allergies, medications, supplements and lifestyle notes. When a client connects Apple Health, you can also see heart rate variability and exercise.
Sarah's Baseline and Perimenopause Test
Sarah's Baseline showed low iron, borderline vitamin D and metabolic markers drifting the wrong way. Each result sat inside the laboratory range. Read together and over three years, they tell a clearer story.
| Marker | 2024 | 2025 | 2026 |
|---|---|---|---|
| HbA1c (%) | 5.2 | 5.4 | 5.6 |
| Fasting glucose (mmol/L) | 5.0 | 5.1 | 5.2 |
| Fasting insulin (mIU/L) | 6.8 | 8.1 | 9.6 |
| HOMA-IR | 1.5 | 1.8 | 2.2 |
| Ferritin (µg/L) | 41 | 30 | 22 |
Michelle also pointed to the calculated ratios the platform adds, such as the uric acid to HDL ratio and the triglyceride-glucose index, which moved in the same direction.
The Perimenopause Test uses two draws in one cycle: Day 2 to 5 for FSH, LH and oestradiol, and progesterone 7 days before the next period. Sarah's second draw fell on Day 18 of a 25-day cycle, and her progesterone came back well below 30 nmol/L. That suggests she didn't ovulate that cycle. Cycles without ovulation can bring heavier periods, which fits her falling ferritin. The timing for every hormone is in the hormone test timing guide.
Continuous glucose monitoring and lifestyle tracking
Sarah's 14-day CGM showed an average glucose of 5.2 mmol/L, glucose variability of 8.3 (in the optimal range), 88% of the time in her target range, and an estimated HbA1c of 4.9%. That is better than her blood tests suggested, which Michelle put down to the lifestyle coaching that followed her Baseline.
In the same record, meals logged as photos carry a Vively score out of 10 and a macronutrient breakdown. Sarah's included scrambled eggs on sourdough, a salmon and avocado bowl, and a chicken stir-fry with brown rice. Sleep and recovery trends sit alongside, with activity averaging about 8,500 steps a day and 2.8 workouts a week.
Michelle's point: a CGM complements blood tests rather than replacing them. It shows the effect of each meal in real time, which motivates clients in a way a test every few months can't. More on using one is in CGM for clients without diabetes.
Biological age, inflammation and clinical context
Sarah's phenotypic age, calculated from her blood results, was 42 against a calendar age of 44, with a pace of ageing close to one year per year.
Her hs-CRP was 2.6 mg/L, against a Vively optimal of below 1. hs-CRP measures low-grade, chronic inflammation, and it fits the metabolic picture. Asked what to do when two inflammation markers seem to disagree, such as CRP and an albumin-based ratio, Michelle said clinical context, recent illness or meals, and the trend over time matter more than any single result. Interpret carefully, so a client isn't left anxious about one number.
Her closing message: perimenopause is a preventative window. Acting on Sarah's trends now, while every result is still inside the range, is how you head off type 2 diabetes and fatty liver later.
Try it with your own clients
Every Vively practitioner can claim one complimentary Medicare Baseline Health Check, for themselves or a client, which is the quickest way to see a real report in the platform. Verified practitioners can refer Baselines, hormone tests and CGMs from a client's record under Refer something.
Request practitioner access, or email Jaimee to book a one to one walkthrough of the platform.
The full series
- Part 1: Normal does not mean optimal, on reading blood results beyond the reference range.
- Part 2: Beyond the Baseline, on which thyroid and hormone tests to add, and when to draw them.
- Part 3: this case clinic.
Can twice-monthly hormone tests track the cycle for women following a fasting protocol?
A practitioner asked about clients following a cycle-based fasting approach such as Fast Like a Girl. Michelle explained that after menopause, hormone levels flatten out with little change across the month, so energy dips while fasting are more likely to come from over-exercising or stress than from the cycle. In perimenopause, the two-draw Perimenopause Test still shows whether a client is ovulating.
What does the Perimenopause Test include?
Two draws in one cycle, with progesterone timed 7 days before the next period, plus a full thyroid panel, LH, DHEA-S and testosterone. Michelle recommends the full panel over progesterone alone, because DHEA-S and testosterone add to the picture of a client's energy and vitality. Progesterone can also be added on its own.
What if two inflammation markers disagree?
Read them in clinical context: recent illness, recent meals and the trend across several tests. A single result out of line with the rest is a reason to look again, not a diagnosis, and it shouldn't leave a client anxious.
Can I try the platform before I refer clients?
Yes. Every Vively practitioner can claim one complimentary Medicare Baseline Health Check, for themselves or a client. Email Jaimee to book a one to one walkthrough of the platform and your first referral.
- Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603.
- Levine ME, Lu AT, Quach A, et al. An epigenetic biomarker of aging for lifespan and healthspan. Aging. 2018;10(4):573-591.
- Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice. Circulation. 2003;107(3):499-511.
- Australasian Menopause Society. Perimenopause and diagnosis of menopause.