Your Body Is an Engine

No. Metabolic and VO₂ max testing is available to both patients of the practice and non-members.

I have a calcium score of zero but elevated cholesterol. Why would testing help? A zero calcium score is reassuring, but it does not measure functional cardiovascular performance. VO₂ max testing evaluates your actual cardiopulmonary capacity and aerobic fitness relative to age and sex. If VO₂ max is lower than expected, it may suggest higher long-term risk despite a zero calcium score. RMR testing adds insight into metabolic efficiency and substrate utilization (fat vs. carbohydrate use), helping guide lifestyle optimization and, when appropriate, re-evaluation of overall treatment strategy. My blood pressure, HbA1c, or cholesterol are “controlled” on medication. Do I still need testing? Normal lab numbers do not necessarily mean optimal cardiovascular conditioning. VO₂ max testing determines whether your aerobic fitness level is sufficient to support blood pressure control, insulin sensitivity, and long-term metabolic health. It provides precise heart rate training zones so exercise can be targeted rather than generalized. RMR testing evaluates resting metabolism and fuel utilization, helping optimize nutrition to support cardiometabolic health. I am on a GLP-1 medication and losing weight. Why would I need metabolic testing? Weight loss alone does not guarantee improved fitness or preserved muscle mass. RMR testing measures resting calorie expenditure and metabolic balance, helping assess whether weight loss is affecting lean mass or contributing to fatigue. VO₂ max (AMR) testing evaluates cardiovascular capacity and exercise efficiency. This helps ensure that weight loss is accompanied by improved fitness and appropriate conditioning. Repeat testing may be useful during GLP-1 therapy, especially after significant weight change. I exercise regularly but feel plateaued. Can testing help? Many individuals train in inefficient heart rate zones without realizing it. VO₂ max testing identifies ventilatory thresholds and personalized training zones, allowing you to improve endurance, fat oxidation, and performance more effectively. RMR testing ensures that calorie intake and macronutrient balance align with training demands. Why combine VO₂ Max (AMR) and RMR testing? Together, these tests evaluate 23 cardiopulmonary and metabolic biomarkers, providing a comprehensive view of: Aerobic capacity Cardiovascular efficiency Fat and carbohydrate utilization Resting energy expenditure Metabolic flexibility Training zone precision This combination removes guesswork from both exercise and nutrition planning and supports both performance and long-term cardiovascular health.

Your reports are comprehensive, physician-reviewed metabolic analyses generated by the PNOĒ system. Together, the RMR and AMR tests evaluate 23 key cardiopulmonary and metabolic biomarkers, providing an in-depth picture of how your body produces energy, burns fuel, and performs under stress. RMR (Resting Metabolic Rate) measures resting calorie expenditure, fat and carbohydrate utilization, respiratory efficiency, and metabolic balance, giving you precise guidance for nutrition, recovery, and body composition planning. Click for AMR Sample Report AMR / VO₂ Max (Active Metabolic Rate) measures VO₂ max, ventilatory thresholds, heart rate training zones, substrate utilization during exercise, cardiovascular efficiency, and performance capacity, allowing you to train with data-driven precision. Click for RMR/VO2 Max Sample Report Together, these tests remove guesswork and provide objective data to optimize performance, longevity, and metabolic health.

RMR testing typically takes about 15 minutes (plus a 10-15 minute review of results). AMR / VO₂ max testing takes approximately 20 minutes, including warm-up and cool-down (plus a 10-15 minute review of results). The resting Metabolic rate (RMR) test is performed while you are seated or lying comfortably on a padded exam table, breathing normally through a mask while your resting energy expenditure is measured. The VO₂ max test is performed on a stationary air-resistance bike (Rogue Echo Bike). You pedal with your legs while gently pushing and pulling the moving handles with your arms. The resistance increases naturally based on your effort, and the test progresses in stages while your breathing and heart rate are measured.

No. This is a non-diagnostic metabolic performance assessment. While it measures many similar physiologic metrics, it is not intended to diagnose heart or lung disease.

RMR testing is non-invasive and safe for most individuals. AMR / VO₂ max testing involves exercise and may require screening or medical clearance depending on health history.

No. Wearables estimate metrics using algorithms. Metabolic testing directly measures oxygen consumption and carbon dioxide production, providing more precise individualized data.

Testing is not billed through insurance. HSA funds or out-of-network reimbursement may be applicable depending on your plan.

AMR / VO₂ max testing is commonly repeated every 8–12 weeks when actively training. RMR testing may be repeated every 3–6 months or after significant lifestyle or weight changes.

Testing includes a physician’s interpretation of metabolic data. For ongoing nutrition or fitness coaching, referrals may be provided when appropriate.

Teens may be eligible depending on maturity, physical ability, and goals. Parent or guardian consent is required.

VO₂ max naturally declines with age and differs between men and women, so what is considered “good” depends on your demographic group. In general: Being in the “Good” or “Excellent” category for your age and sex indicates strong cardiovascular fitness. Scores in the “Superior” range are typically seen in highly trained individuals. Even moving from “Fair” to “Good” significantly improves long-term cardiovascular risk and longevity outcomes. Below are general reference ranges by age and gender: Important Note on Testing Method VO₂ max values can vary slightly depending on the testing modality used (treadmill, cycle ergometer, rower, or Echo bike). Treadmill testing often produces the highest values. Cycling and air bikes may yield values that are approximately 5–10% lower, depending on familiarity, muscle recruitment, and conditioning. The most important factor is consistency; repeating testing on the same modality allows for accurate tracking over time. Your score should be interpreted in the context of how it was measured and how it trends longitudinally.

VO2 Max measures how effectively your body delivers and uses oxygen during exercise. Higher values generally reflect stronger cardiovascular fitness. VT1 (Aerobic Threshold) is the point where your body begins shifting from fat use more toward carbohydrate use. VT2 (Anaerobic Threshold) is where lactate builds faster than it can be cleared. Most training should occur below VT2, with targeted higher-intensity sessions to improve performance. Click on the link below for a summary table showing fitness zones, heart rate and their relation to VO2 max. Click for Summary Table