These are the lab tests you need to do if you're over 40
Hot flashes? Fatigue? Mood swings? Achy joints? Crappy sleep?
You've done the “routine bloodwork.”
Your doctor says everything looks fine.
But you don't feel fine.
If this sounds familiar, you're not alone — I hear this all the time from the women I work with.
And what might surprise you is this:
The most helpful tests to figure out what's going on in perimenopause or menopause aren't the hormone tests.
Yes, hormone bloodwork can confirm menopause. But it can't tell us how you're feeling or why you're feeling off.
Instead, what helps me the most is listening closely to your symptoms — and combining that with the right tests that often get overlooked.
If you're over 40 and want answers, these are the lab tests I recommend most often:
1. Nutrient Deficiencies
Ferritin (iron stores), Vitamin B12, and Vitamin D are the big three.
• Ferritin (iron stores): Low levels are incredibly common and can lead to fatigue, cold hands/feet, poor exercise tolerance, and more — even if your “iron” looks okay.
• Vitamin B12: Also frequently low, and linked to tiredness, numbness/tingling, brain fog, and poor concentration.
• Vitamin D: A potent anti-inflammatory that supports mood and immune health. Many women test below optimal, even when they have been taking a supplement. Testing your blood level allows me to calculate how much vitamin D you need to get into the optimal range.
2. Inflammatory Markers
CRP and ESR don't pinpoint where inflammation is coming from, but they do give us a picture of how much inflammation is in the body — something that becomes more common as hormones shift. Reducing that number, if it is elevated, is important for helping to improve long-term health risk.
3. Fasting Insulin (not just glucose)
Glucose alone doesn't tell the full story. With both fasting insulin and glucose, I can calculate your insulin resistance ratio — a key indicator of how well your body handles carbs.
As estrogen declines, insulin resistance often increases — and this can affect everything from energy to weight to cholesterol. The good news? It's something we can improve with the right nutrition, movement, and targeted support.
4. Cholesterol Panel
Cholesterol often increases in perimenopause and menopause. Even if it's still “normal,” understanding your baseline and catching early changes can help you be proactive — especially since high cholesterol can be a sign of inflammation.
So when someone says “everything came back normal,” that doesn't always mean everything is optimal.
When I review lab results, I'm looking with a much finer lens — not just for disease, but for early signs of imbalance and areas we can support to help you feel better and function better.
Hormone therapy can be incredibly helpful — but it works best when the foundational pieces (like nutrient status, blood sugar balance, and inflammation) are in a good place. That's when women really start to see and feel lasting change.
Feeling like something's still off — even when your labs are “normal”?
I can order these tests for you and take the guesswork out of the process.
We'll review the results together and take a deep look at what's really going on and build a plan to help you feel strong, energized, and clear-headed.