These tests can reveal actions you can take to optimize your health during such a complex time.
Since there is not a great one-time blood, urine, or saliva test to confirm you’re in the menopause transition (only for post-menopause), we rely on symptoms to help diagnose the condition. That being said, many blood tests can identify changes in our bodies that are more common due to aging and/or the menopause transition, and many of the symptoms have “overlapping” causes like hypothyroidism, anemia, autoimmune disease etc., so it’s important to rule these out.
These tests can also reveal actions you can take to optimize your health during such a fragile time. If you’re looking for some confirmation you’re in perimenopause and/or clarification on questionable symptoms, there are key tests to request that any doctor can order and will most likely be covered by your insurance.
1. The “Standard Tests”: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), and Lipid Panel
These three are basic tests that are often included as part of an annual checkup — but do not forget to ask for them. They’re essential screening tests and do not require symptoms for insurance to cover them during an annual exam.
The CBC measures different features of your blood, including red blood cells, white blood cells, platelets, hemoglobin, and hematocrit. It’s important for the diagnosis of anemia, and it’s also a screening test for immune system issues and different types of cancer.
The CMP reveals information about your overall metabolism, including kidney and liver function and type 2 diabetes risk. It also looks at electrolytes like sodium, calcium, and potassium, which can indicate whether you’re dehydrated, and it’s a screening test for your liver and kidney function. This panel measures the blood levels of albumin, blood urea nitrogen, calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, total bilirubin and protein, and liver enzymes.
The lipid panel, usually drawn while fasting, is a broad picture of heart health, which is a measure of your HDL (“good”) cholesterol, LDL (“bad”) cholesterol, and triglycerides. One of the strongest predictors for preventing heart disease is having a good HDL-to-triglycerides ratio. Your HDL should be higher than or equal to triglycerides.
2. The Diabetes Screen: Hemoglobin A1C (HbA1C)
This test is a more powerful indicator of blood sugar dysregulation than a single fasting glucose level. The HbA1c test measures the percentage of red blood cells saturated with glucose. The higher your A1C, the higher the estimated average blood glucose over the past six weeks. A high HbA1C marker may also increase your risk of Alzheimer’s disease and cancer —
potentially making the test a good predictor of overall longevity.
3. The Thyroid Panel
Thyroid disorders are incredibly common, affecting one in 10 women, and about 60 percent of people with a thyroid problem are unaware of their condition — and thus, unable to manage it appropriately. The TSH is a great screening test, but a more comprehensive thyroid panel is needed for women experiencing unexplainable weight gain or loss, chronic fatigue, cold intolerance, hair loss, forgetfulness, constipation, and feeling generally depressed. Ask for a TSH, free T4, free T3, reverse T3, and two types of thyroid antibody levels called anti-TPO and anti-thyroglobulin. A more comprehensive panel can spot issues early while they can still be addressed with lifestyle changes.
4. Nutritional Deficiencies: Vitamin D, Zinc, and Magnesium
Forty-two percent of patients, on average, have low Vitamin D, and this number gets worse with age and menopause. This deficiency can be due to geography limiting sun exposure, darker skin limiting absorption, a genetic issue, absorption issue, or kidney disease. Vitamin D has multiple responsibilities in the body: It’s a hormone precursor that plays a key role in immune function and mood. Deficiencies in vitamin D can also be a factor in autoimmune diseases and certain cancers. Be sure to ask for it if you have mood disorders or fatigue.
Zinc is used by your body in cell production and immune functions. When you’re zinc deficient, your body can’t produce healthy, new cells. This deficiency leads to symptoms such as unexplained weight loss, wounds that won’t heal, lack of alertness, and decreased sense of smell and taste.
Magnesium deficiency is linked to poor sleep, nerve problems, mood disorders, fatigue, muscle cramping, headaches, and brittle hair and nails. It’s also important for heart health, blood pressure, and keeping your thyroid balanced.
5. Anemia Panel: Iron, Ferritin, Folate, and Vitamin B12
Anemia is a major cause of chronic fatigue. Low vitamin B12 is common among vegetarians and vegans but can also exist among omnivores due to nutrient malabsorption issues caused by antibiotic overuse or celiac or Crohn’s disease. Folate plays a crucial role in healthy pregnancy and preventing birth defects but often is not screened. Low iron can present as anemia or even hypothyroidism. Even if you’re not anemic (which can be tested for with a CBC), you can still be iron deficient — which is why testing for iron and ferritin separately is important.
6. Chronic Inflammation Testing: High Sensitivity C-Reactive Protein (HsCRP), Erythrocyte Sedimentation Rate
These tests are great ways to see if you’re inflamed and then to use as a marker after nutrition/lifestyle changes to track progress. However, these markers are nonspecific, meaning abnormal levels can show that something’s wrong but not what’s wrong. Since nutrition and lifestyle changes fight many causes of chronic inflammation, it’s worth testing.
HSC-Reactive Protein (CRP) is naturally produced in the liver in response to inflammation. A high level of CRP in your blood can occur due to several inflammatory conditions.
The Erythrocyte Sedimentation Rate (ESR) test is rarely performed alone, as it doesn’t help pinpoint specific causes of inflammation. Instead, it can help your doctor identify that inflammation is occurring. It can also help them monitor your condition.
These tests can help you get the most out of your health care and your annual exam. There is nothing more important than understanding what is going on in your body to make the best nutritional choices for your future. And now that you have read through the different tests available, it’s my hope that you feel more confident and empowered to ask for what you need.
