8 Crucial Biomarkers Missed on Bloodwork From Your PCP
I think one of the hardest things about midlife, perimenopause and trying to figure out what you need is sifting through the WILD WEST of information online. There is just so. so. much.
And let’s be real…
You’re tired. Your body composition is changing. Your hair is thinning.
Your digestion feels off. And the habits that used to help you feel good aren’t doing the job anymore!
The last thing you need is having to discern what to even believe!
Your symptoms deserve attention. And sometimes, the next step is asking whether the tests you’ve had actually answer the questions your symptoms are raising! Because the truth is - standard bloodwork can provide valuable information. BUT - functional testing, selected more specifically around your symptoms and history, will add way more context to your metabolic health, thyroid, iron status, hormone health, cardiovascular risk and more!
That’s why I want to share some of the key functional health markers that get missed in standard blood draws. Because these eight markers are worth understanding and discussing with your medical provider. And if they won’t test these - I will inside my program (which you can learn about HERE anytime!)
1. Fasting insulin: More context behind your blood sugar!
Fasting glucose tells you how much glucose is in your blood after an overnight fast. Insulin helps your body regulate that glucose. When your cells become less responsive to insulin, your pancreas may compensate by producing more. That extra insulin can keep blood glucose within range for a while.
So normal glucose doesn’t automatically rule out insulin resistance. Elevated insulin alongside normal glucose can be a clue that warrants further evaluation.
2. GGT: A closer look at liver and bile duct health
Gamma-glutamyl transferase, or GGT, is an enzyme found mainly in the liver. Elevated levels can occur with liver or bile duct problems, alcohol use, and certain medications. An elevated result raises a question: Why is it elevated?
This should be interpreted alongside other liver markers, including ALT, AST, alkaline phosphatase and bilirubin, as well as any medications, alcohol intake and medical history.
3. Thyroid testing: When it makes sense to go beyond TSH
TSH is a signal from your pituitary gland that helps regulate thyroid hormone production. It is a useful first test for most people, but additional testing may be appropriate depending on the result, your symptoms, and your history.
Free T4 can help clarify thyroid function. Thyroid antibodies, such as TPO and thyroglobulin antibodies, may help investigate an autoimmune thyroid condition when clinically indicated. T3 testing is more useful in certain situations, particularly suspected hyperthyroidism.
If you’re persistently tired, cold, constipated, or noticing hair changes, bring those symptoms into the conversation.
4. Ferritin and an iron panel: Understanding iron stores
A complete blood count, or CBC, helps evaluate your red blood cells and identify anemia. But iron stores can become depleted before anemia develops. Ferritin provides information about stored iron. Serum iron, transferrin or total iron-binding capacity, and transferrin saturation add context about circulating iron and how it is transported.
Ferritin also needs careful interpretation because inflammation can raise it. A higher result does not automatically mean your iron stores are abundant. For a woman with heavy periods, fatigue, or unexplained hair shedding, iron status may deserve a closer look.
5. ApoB: Another way to assess cardiovascular risk
A standard cholesterol panel measures how much cholesterol is carried in your blood. Apolipoprotein B, or ApoB, helps estimate the number of circulating particles capable of contributing to plaque buildup in arteries.
That distinction matters because cholesterol concentration and particle number don’t always tell the same story. ApoB can provide additional cardiovascular risk information beyond LDL cholesterol.
6. SED rate: A clue about inflammation
Erythrocyte sedimentation rate, often called ESR or “sed rate,” measures how quickly red blood cells settle in a test tube. An elevated result can suggest inflammation, but it does not identify where that inflammation is happening or what caused it. Infection, autoimmune conditions, anemia, and other factors can influence the result.
7. hs-CRP: Inflammation and cardiovascular risk
High-sensitivity C-reactive protein, or hs-CRP, detects low concentrations of CRP, a protein associated with inflammation. It can add information to cardiovascular risk assessment, particularly when interpreted alongside other risk factors.
The goal is to understand whether the result reflects a persistent pattern and whether it changes your care plan.
8. Homocysteine: A possible clue about B-vitamin status
Homocysteine is an amino acid your body processes using nutrients including Folate and Vitamin B12. Elevated levels can occur with certain vitamin deficiencies and other health conditions. Higher levels are also associated with cardiovascular risk.
If it is elevated, the useful question is: What might be contributing to this result?
You don’t need every test on this list simply because you’re over 35.
But, you do deserve a thoughtful conversation about what you’re experiencing, what has already been checked and what would meaningfully guide your next steps!
Understand that ONE biomarker never explains the whole person.
In my work, I help women understand their results, recognize questions worth asking and build sustainable habits alongside appropriate medical care. Because PROACTIVE health means paying attention early, following up when symptoms persist and using testing with a clear purpose.
If you’re not getting the direction, answers and support you need - time to find a new practitioner!