Our expertiseEnergy & metabolism

Energy & metabolism

Energy is not just about how much you sleep or how hard you work. It is the result of hundreds of biological processes working in coordination. When energy production breaks down, the cause is rarely obvious, and rarely just one thing.
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Why Energy &
metabolism matters

Mitochondria, the structures inside cells responsible for producing energy, are affected by nutrient availability, toxin exposure, hormonal balance, gut health and chronic inflammation. When any of these factors are compromised, energy production suffers.

Blood sugar regulation also plays a central role. Unstable glucose patterns create energy crashes, cravings, brain fog and difficulty sustaining focus, all of which are frequently overlooked as metabolic issues.

Concerns where
Energy & metabolism
may play a role

Together with Dr Fiona Forbes and the medical team, we use over 400 biomarkers to understand the underlying factors contributing to symptoms.

Chronic fatigueLow energyAfternoon crashesBrain fogChronic fatigueLow energyAfternoon crashesBrain fog
Weight gainDifficulty losing weightBlood sugar imbalancesInsulin resistanceWeight gainDifficulty losing weightBlood sugar imbalancesInsulin resistance
Type 2 diabetesMetabolic syndromePoor physical recoveryMuscle weaknessType 2 diabetesMetabolic syndromePoor physical recoveryMuscle weakness
Cold hands and feetThyroid concernsLong COVID fatigueME/CFSCold hands and feetThyroid concernsLong COVID fatigueME/CFS

These concerns are not assessed in isolation, but always in the context of the full biological picture.

How energy & metabolism
connects to other systems

Energy production is downstream of almost every other system. When it breaks down, it is usually because something else has gone wrong first.

Thyroid dysfunction directly reduces metabolic rate and cellular energy production
Gut dysbiosis reduces nutrient absorption, depleting the cofactors that mitochondria need
Chronic inflammation impairs mitochondrial function and increases oxidative stress
Adrenal dysregulation and cortisol imbalances disrupt blood sugar and energy regulation
Heavy metal or toxin accumulation can interfere with mitochondrial enzyme function

Our approach

At Forbes.health, we assess energy and metabolism through biomarkers that show how the body is actually producing and regulating energy at a cellular level. That means looking beyond standard thyroid or iron panels to assess mitochondrial function, blood sugar patterns, nutrient cofactors and the systems that support them.

We look for the reasons behind the fatigue, not just the fatigue itself.

Our role is not only to identify what is out of range, but to understand how the body is functioning as a whole, and what may be driving symptoms beneath the surface.

Dr Fiona Forbes

Dr Fiona Forbes,

Chief Medical Officer

How we assess

Relevant testing panels

The most relevant tests depend on the individual, their symptoms and their medical history. For energy & metabolism, the following panels are frequently used:

Organic Acids Test (OAT)

Provides one of the most detailed pictures of mitochondrial function available in routine testing. Includes Krebs cycle markers, B vitamin status, oxidative stress markers and yeast and bacterial patterns that affect energy production.

Thyroid Panel Plus Hormones and PSA

Thyroid function is one of the most common contributors to low energy and metabolic slowdown. We assess TSH, Free T4, Free T3 and TPO antibodies as a minimum for anyone presenting with fatigue alongside hormonal markers.

Oxidative Stress Panel

Assesses DNA damage markers and oxidative stress load. Provides insight into cellular health and the body's antioxidant capacity. Relevant to persistent fatigue, poor recovery and patterns of accelerated cellular ageing.

Toxic Metals

Assesses 21 heavy metals including arsenic, lead and aluminium. Heavy metal accumulation can directly impair mitochondrial function and is a frequently overlooked contributor to chronic fatigue.

From insight to direction

Whether navigating persistent symptoms or taking a proactive approach, the goal is always the same: to understand what your body is doing and why.

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Questions and answers

Frequently asked questions

Because fatigue has many potential causes, and standard panels test a narrow range of them. Mitochondrial function, blood sugar patterns, gut absorption, cortisol rhythm and nutritional cofactors are all commonly missed in routine testing. We look at all of these.

Mitochondria are the structures inside cells that produce ATP, the body's primary energy currency. When mitochondrial function is impaired, cells cannot produce energy efficiently. This shows up as fatigue, poor recovery and reduced physical and cognitive performance.

Yes. What you eat affects blood sugar regulation, gut health, nutrient availability and inflammation, all of which feed into energy production. But dietary changes work best when guided by data. What helps one person may not help another.

Start with a free discovery call. We will go through your symptoms, history and what has already been tried, and tell you honestly whether this is the right area to start.