Essential Bloodwork to Request from your Healthcare Practitioner

As part of my email series on Menopause for Menopause Awareness Month, I dove into what bloodwork you should be requesting from your healthcare practitioner. Either your PCP, Gyno or if you work with Functional Medical Dr., they should all have access to these labs to request. (you may need to check with your insurance on coverage options)

Let's take a look at each one, why they are important key markers during this transition and their optimal ranges. *(Keep in mind that "optimal ranges" can vary slightly depending on lab standards and individual health conditions, so it's always best to consult with your healthcare provider.)

1. FSH (Follicle Stimulating Hormone)

• Purpose: FSH helps regulate the menstrual cycle and the production of eggs by the ovaries. During menopause, FSH levels rise because the ovaries become less responsive, so more FSH is produced to stimulate them.

• Optimal Range:

  • Premenopausal: 4.7 to 21.5 mIU/mL (this varies with the menstrual cycle).

  • Perimenopausal/Menopausal: FSH levels typically rise to over 30 mIU/mL. In full menopause, it can reach 40 to 250 mIU/mL.

2. Estradiol (E2)

• Purpose: Estradiol is a form of estrogen and is the most active estrogen in a woman’s body. Estradiol levels decline significantly during menopause, leading to common symptoms like hot flashes and bone loss.

• Optimal Range:

  • Premenopausal: 30 to 400 pg/mL (varies throughout the menstrual cycle).

  • Perimenopausal: Levels often fluctuate, ranging between 10 to 100 pg/mL.

  • Menopausal: Usually below 10 to 30 pg/mL.

3. Progesterone

• Purpose: Progesterone plays a key role in regulating the menstrual cycle and preparing the body for pregnancy. In menopause, progesterone levels drop because ovulation no longer occurs regularly.

• Optimal Range:

  • Premenopausal (mid-luteal phase): 5 to 20 ng/mL.

  • Perimenopausal: Levels can drop significantly and fluctuate, typically under 10 ng/mL.

  • Postmenopausal: Below 0.5 ng/mL.

4. Thyroid Panel (TSH, Free T3, Free T4)

Since thyroid dysfunction is common in midlife, it’s important to assess these hormones to rule out hypothyroidism or hyperthyroidism, both of which can mimic menopause symptoms.

• TSH (Thyroid Stimulating Hormone):

  • Purpose: TSH stimulates the thyroid to produce thyroid hormones.

  • Optimal Range: 0.5 to 4.5 mIU/L (some experts recommend an optimal range of 1.0 to 2.5 mIU/L for middle-aged women).

• Free T3 (Triiodothyronine):

  • Purpose: Free T3 is the active form of thyroid hormone that influences energy metabolism.

  • Optimal Range: 2.0 to 4.4 pg/mL.

• Free T4 (Thyroxine):

  • Purpose: Free T4 is the hormone produced by the thyroid and converted to T3.

  • Optimal Range: 0.8 to 1.8 ng/dL.

5. Vitamin D

• Purpose: Vitamin D is crucial for bone health and immunity, and deficiency is common during menopause, which increases the risk of osteoporosis.

• Optimal Range:

  • Sufficient: 30 to 100 ng/mL.

  • Optimal for bone health: 40 to 60 ng/mL.

  • Deficient: Less than 20 ng/mL.

6. Lipid Profile (Cholesterol Test)

During menopause, cholesterol levels can rise, increasing the risk of heart disease.

• Total Cholesterol:

  • Optimal Range: Less than 200 mg/dL.

• LDL (Low-Density Lipoprotein): "Bad" cholesterol.

  • Optimal Range: Less than 100 mg/dL.

• HDL (High-Density Lipoprotein): "Good" cholesterol.

  • Optimal Range: More than 60 mg/dL.

• Triglycerides:

  • Optimal Range: Less than 150 mg/dL.

7. Glucose and A1c (Blood Sugar Levels)

Hormonal changes during menopause can increase insulin resistance, leading to higher blood sugar levels. Monitoring fasting glucose and A1c can help detect pre-diabetes or diabetes early.

• Fasting Glucose:

  • Optimal Range: 70 to 99 mg/dL (normal).

  • Pre-diabetes: 100 to 125 mg/dL.

  • Diabetes: 126 mg/dL or higher.

• A1c (Hemoglobin A1c): Reflects average blood sugar levels over the past 2-3 months.

  • Optimal Range: Less than 5.7% (normal).

  • Pre-diabetes: 5.7% to 6.4%.

  • Diabetes: 6.5% or higher.

These tests give you a comprehensive view of hormonal and metabolic health during menopause, allowing women to take proactive steps to support their well-being. If any values are outside the optimal range, it may be beneficial to explore lifestyle changes, supplementation, or treatment under the guidance of a healthcare provider.

Of course you can always set up a FREE Health Coaching Call with me to go over next steps on your menopause journey through my holistic health coaching services.