Nutrition coaching in San Francisco tends to fall into two categories: generic macro targets derived from your height, weight, and activity level, or expensive concierge programs that are heavy on personalization theater and light on actual data.
Custom Fit SF takes a different approach. Nutrition coaching here starts with bloodwork — a comprehensive panel that identifies what's actually happening in your metabolism, where your deficiencies are, and what your body is or isn't responding to. The registered dietitian reviews the results and builds recommendations from that foundation, not from population averages.
What Advanced Bloodwork Reveals That a Standard Panel Doesn't
The annual blood panel most San Francisco residents receive through their primary care physician typically includes a CBC, basic metabolic panel, and lipid panel. This is useful for catching acute problems. It's insufficient for performance and longevity optimization.
The markers that tend to matter most — and are frequently omitted from standard panels — include:
- Apolipoprotein B (ApoB): A more accurate predictor of cardiovascular risk than LDL-C, ApoB measures the number of atherogenic lipoprotein particles directly.
- Fasting insulin and HOMA-IR: Insulin resistance precedes elevated fasting glucose by years. Most standard panels measure glucose but not insulin — missing early metabolic dysfunction entirely.
- hsCRP: High-sensitivity C-reactive protein is a marker of systemic inflammation — a factor in cardiovascular disease, neurodegeneration, and poor recovery from training.
- Homocysteine: Elevated homocysteine is associated with cardiovascular and cognitive risk, and is frequently driven by B-vitamin deficiencies that are correctable with targeted supplementation.
- Vitamin D, B12, ferritin: Deficiencies in these three are common in San Francisco's indoor-heavy professional population and have real downstream effects on energy, recovery, mood, and immune function.
- Hormone panels: Testosterone, DHEA-S, IGF-1, and thyroid markers are rarely included in standard panels and are highly relevant for body composition, recovery capacity, and training response.
What a Registered Dietitian Does With This Data
A registered dietitian reviewing your bloodwork isn't generating a list of supplements to buy. The analysis is about causality: why is your ApoB elevated — is it dietary, genetic, or driven by a specific pattern the data can identify? Why is your ferritin low — is it intake, absorption, or demand from training? Why does your recovery feel compromised even when your training load is managed?
The recommendations that follow from this analysis are specific. Not "eat more leafy greens" but which forms of which nutrients, in what amounts, adjusted against your current intake and your bloodwork trajectory over time.
Bloodwork + DEXA + VO₂ Max: The Full Picture
Bloodwork reviewed in isolation is useful. Bloodwork reviewed alongside DEXA body composition data and VO₂ Max results is a substantially different level of analysis.
For example: elevated inflammation markers alongside low lean mass and a below-average VO₂ Max create a specific picture of risk and intervention priority. High ApoB alongside excess visceral fat (identifiable on DEXA) sharpens the cardiovascular risk conversation considerably. Low ferritin alongside a depressed VO₂ Max score might explain why training isn't producing expected aerobic gains.
Custom Fit SF's registered dietitian consultations are designed to synthesize all of this — not to review bloodwork in a vacuum.
The Longevity Blueprint
For members who want the full diagnostic picture at once, the Longevity Blueprint combines DEXA, VO₂ Max, advanced bloodwork, genetic testing, and a registered dietitian consultation into one structured package. The output is a prioritized action plan — training, nutrition, and supplementation — based on your actual biology, not a protocol designed for a population average.
Who Dietitian Consultations at Custom Fit SF Are For
- People who've been told their bloodwork is "normal" but continue to feel suboptimal
- Anyone managing body composition goals who hasn't seen expected results from training alone
- Athletes and active professionals who want nutrition dialed to their specific physiology
- People on GLP-1 medications who need guidance on preserving lean muscle during rapid weight loss
- Anyone who wants nutrition recommendations derived from data rather than guidelines
Get Started at Custom Fit SF
Advanced bloodwork panels and registered dietitian consultations are available at Custom Fit SF's Hayes Valley studio (1844 Market St) and Downtown SF location. They can be booked as standalone services or as part of the Longevity Blueprint package.