Key Blood Tests & Biomarkers Worth Discussing With Your Doctor

Friendly reminder: This article is for general education only. Always follow your doctor’s individual advice—lab ranges and health priorities can vary by age, ethnicity, medications, and personal goals.

Why Blood Work Matters in Mid-Life

Shifting estrogen and progesterone levels during perimenopause and menopause can unmask (or worsen) issues such as thyroid disease, insulin resistance, and bone loss. A simple panel of labs offers a data-driven snapshot, helping you and your clinician decide whether lifestyle tweaks, supplements, or prescriptions make sense. Below are the tests most commonly discussed in menopause visits.

1. Sex-Hormone Snapshot

Typical Labs	Why It’s Helpful
• Follicle-Stimulating Hormone (FSH)
• Luteinizing Hormone (LH)
• Estradiol (E2)	• FSH > 30 mIU/mL plus low estradiol usually signals menopause.
• Confirms whether irregular periods are due to menopause vs. other causes (e.g., pituitary issues).

Caveat: Hormone levels can bounce around wildly in perimenopause. One test is just a moment in time; trends + symptoms matter more (Endocrine Society).

2. Thyroid Function

Thyroid-Stimulating Hormone (TSH)
Free T4 (FT4); sometimes Free T3 and Thyroid Antibodies

Why? Hypothyroidism mimics hot flashes, fatigue, and weight gain. Mid-life women have a 5–8× higher risk than men (American Thyroid Association).

3. Metabolic & Cardiovascular Health

Fasting Glucose & Hemoglobin A1c
• Screens for insulin resistance and type 2 diabetes.
Lipid Panel (Total Cholesterol, LDL, HDL, Triglycerides)
• Estrogen’s cardio-protective effect wanes after menopause, so numbers often drift upward.

Consider adding:

High-Sensitivity C-Reactive Protein (hs-CRP) – marker of vascular inflammation.
Apolipoprotein B (ApoB) – newer predictor of atherosclerotic risk (Journal of the American College of Cardiology).

4. Bone & Muscle Support

25-Hydroxy Vitamin D
Serum Calcium & Parathyroid Hormone (PTH)
Magnesium (serum or RBC)

Adequate D + calcium helps slow post-menopausal bone loss. Low magnesium can worsen cramps, sleep, and mood (National Institutes of Health Fact Sheets).

5. Iron Status & Fatigue Check

Ferritin
Serum Iron, TIBC (optional)
Low ferritin (< 30 ng/mL) can amplify tiredness and hair shedding—symptoms many women assume are “just menopause.”

6. Complete Blood Count (CBC) & Basic Metabolic Panel (BMP)

Quick screen for anemia, infection, kidney function, and electrolyte balance. Handy baseline before starting hormone therapy or new supplements.

7. Liver Enzymes

ALT, AST, ALP, GGT
The liver metabolizes both endogenous and prescribed hormones. Abnormal values may alter HRT choices or dosing (Mayo Clinic).

How to Bring This Up With Your Clinician

List your top 3 symptoms (e.g., night sweats, brain fog, joint pain).
Note family history—early heart disease, osteoporosis, thyroid disease, diabetes.
Ask: “Which of these labs could help pinpoint causes and track progress?”
Discuss insurance coverage or local cash pricing (labs can differ by >10×).

Interpreting Results: A Few Nuances

“Normal” ranges come from broad populations; you may feel best at your personal optimal.
Timing matters: test fasting AM for glucose, lipids, and often thyroid; hormone panels are usually done on day 3 of a cycle if you’re still menstruating.
Supplements (biotin, high-dose biotics, iron) can distort lab values—tell the phlebotomist what you take.

Bottom Line

Strategic blood work turns the guessing game of menopause into a measurable plan. Share your symptoms, ask about the tests above, and revisit numbers yearly (or sooner if you start hormone therapy). In 10 mL of blood you’ll gain insights that can protect your heart, bones, metabolism, and day-to-day mojo for decades to come.

Last reviewed: 2023-10-20