By Dr. Bryn Hyndman, MD

Proactive bloodwork for women reveals early imbalances, empowers informed health decisions, and supports long-term wellbeing before symptoms or disease take hold.

Why bloodwork matters

A new year is a natural time to gently check in with your health, not from fear or pressure, but from curiosity and care.

A health check in you may not have considered is optional bloodwork. Bloodwork can offer meaningful insight into how your body is functioning beneath the surface, often showing early imbalances before symptoms become known.

These tests can reveal patterns like inflammation, nutrient deficiencies, or changes in blood sugar regulation, shifts that often develop quietly over time.

When we notice these signals early, we have the opportunity to support the body before small imbalances become bigger concerns.

Most routine bloodwork covered by the healthcare system is designed to detect or monitor disease.

It’s an important safety net, but it doesn’t always reflect the nuances of day-to-day health. Until a diagnosis is reached, care often remains general, focused on eating well, moving more, and managing stress.

A more proactive approach looks a little deeper. By exploring specific biomarkers, we can better understand how lifestyle, stress, nutrition, and physiology interact long before disease develops.

While these tests are typically not covered by provincial health plans and are paid privately, they can be a valuable investment, offering clarity, reassurance, and confidence as you make thoughtful choices in support of your health.

Understanding lab results

Know that an “abnormal” result does not automatically mean a diagnosis. It’s simply information, data about what your body may need more support with.

Blood markers can help your provider identify things like:

•  inflammation
• low iron stores (ferritin)
• vitamin deficiencies
• hormone patterns
• signs that further testing is needed

The goal is to connect your results and your symptoms to make a smart, personalized plan.

What tests should I get?

Start with a symptoms journal

This is one of the most powerful tools you can bring to your appointment.

Use your journal to track things like:

• fatigue, insomnia, mood changes
• hair thinning or hair loss
• inability to burn fat and lose weight
• dizziness between meals
• bruises that don’t heal well
• low libido or breast tenderness

Patterns matter. Symptoms help your provider decide which tests to add beyond the basics.

Core bloodwork to consider requesting

CBC (Complete Blood Count)

A CBC checks major components of your blood and can help detect:

• infection (white blood cells)
• anemia (red blood cells, hemoglobin)
• clotting issues (platelets)
• how you may be responding to medications or illness

Iron notes for women:

• Ferritin = iron stored (your “iron savings account”)
• Hemoglobin = iron being used right now in the bloodstream

Ferritin matters for energy, immunity, oxygen delivery, and temperature regulation.

CMP (Comprehensive Metabolic Panel)

A CMP gives a broad look at how your body is functioning, including:

• electrolytes (hydration balance and more)
• liver enzymes
• kidney function

Sample: Kidney Function Markers

• Creatinine: higher may suggest kidney strain
• GFR: lower may suggest decreased kidney filtration
• BUN: higher can reflect dehydration or kidney stress
• Electrolytes: help assess hydration and find underlying diseases

 Blood sugar testing (metabolic health)

If you get dizzy, shaky, faint, headachy, or “hangry” when you go too long without food, blood sugar regulation may be part of the picture. Metabolic flexibility is the ability to switch from burning glucose to burning fats or ketones.

Useful tests:

• fasting glucose
• fasting Insulin (not part of your annual check up)
• HbA1C (an overview of blood sugar patterns over 3 months)
• HOMA: can be calculated with these results, and show signs of insulin sensitivity (good) and resistance (not good)

Blood sugar imbalance can also increase cortisol (stress hormone) and cravings, so finding issues early can be a huge win.

Lipid panel

This checks your cholesterol profile:

• HDL = “helpful” cholesterol (we want enough of this)
• LDL = can increase risk of cardiovascular disease if too high

General guideline:

• total cholesterol under 200 mg/dL for adults
• Note that your full risk picture depends on multiple markers, not just one number.
• Advanced markers such as particle size and count, ApoB, ApoE, LDL particle number, homocysteine and lipoprotein(a) provide deeper insight into cardiovascular risk and should be tested at least once over the age of 40.
• Family doctors are not usually trained in testing and understanding these advanced markers. I do see cardiologists testing Apo(B) and Lp(a) in adults with risk factors for cardiovascular disease.

CRP / hs-CRP (inflammation + heart risk)

• hs-CRP can help assess inflammation and cardiovascular risk.
• Consider asking for this with a family history of heart disease and after age 45.     
• Beware that many things can cause a temporary elevation of hs-CRP – illness, infection, stress on the body. Retest to check your level if it is elevated.  

Thyroid panel

Thyroid issues can look like:

• fatigue, insomnia
• anxiety or low mood
• hair loss/thinning
• weight gain without clear cause
• cold intolerance

Common thyroid labs include TSH and sometimes free T3 and free T4 depending on symptoms and provider preference. The reference range for TSH goes up to 5.5.

For fertility and longevity, we like to see TSH equal to or below 2.5. Free T3 and free T4 can be tested (private pay) if you have symptoms of hypothyroid. Add in reverse T3 to complete your thyroid health and calculate the ratio of free T3/T4.

Sex hormones (when appropriate)

If you have symptoms of perimenopause, menopause, or hormone imbalance, a provider may consider markers like:

• estrogen, progesterone, testosterone
• FSH/LH
• DHEA
• prolactin

However, your symptoms are the best guide for understanding if you’re experiencing hormonal changes. If you wonder what to treat, you can start with those that are most bothersome for you.

Blood work can help guide us, but we never treat a number or prescribe HRT to reach a certain number.

The most important thing is that you feel your symptoms shifting and improvement happening.

Your blood test results along with your symptom inventory can guide next steps and, if needed, prompt more specialized testing, such as urine or saliva testing.

If a case is complicated and we need more information, I’ll suggest one of three tests, if it’s affordable for the patient. But they’re not essential for starting HRT.

Important note: There’s no single “perfect” hormone path.

Foundations still matter most:

• food
• movement
• sleep
• stress management

Sometimes supplements or targeted hormone support are the missing piece.

Vitamin D3 (especially in Canada and northern latitudes)

In Canada, Vitamin D deficiency is common and can affect:

• bone density (especially with age)
• immune function
• mood and energy

Many people aim for above 50 ng/mL as an “optimal” range (your provider will guide you). In B.C., it may not be covered by MSP unless certain criteria are met.

 Needle fear and waiting for results (you’re not alone)

If bloodwork makes you anxious, try one small step that improves the experience:

Before your appointment

If you have small or collapsible veins, hydration is essential. But drinking 1–1.5 litres of water alone may not be enough. A simple strategy can make the first needle attempt far more successful:

·         Add unsweetened electrolytes to at least 1 litre of water during the hour before your blood draw. If you don’t have electrolytes, add 1 tsp salt to your water. Minerals help your body retain the fluid you drink, making veins easier to access. This trick has been a game‑changer for many women and significantly improves the experience of getting bloodwork.

Note: Fasting means no food or liquid calories after midnight.

During the blood draw

• ask to lie down if you feel faint, or put your head between your legs
• take slow deep belly breathes or use a grounding technique
• look away, listen to music, or visualize your happy place as a pleasant distraction
• have a juice box on you just in case, it can prevent fainting from hypoglycemia

After the blood draw

• bring a reward (coffee, walk, massage, anything)
• remember: this is prevention and self- care in action

Results may lead to changes like diet support, supplements, or follow-up labs, but it’s all information that helps you move forward.

Annual bloodwork builds health-esteem: taking care of yourself so that you can continue to show up for your loved ones and contribute to your community with pep and vitality. It’s a proactive thing to do!

Dr. Bryn Hyndman, MD  (with contributing editor Nancy Hyndman). Dr. Bryn is creating a virtual educational platform for women to transform their #healthesteem. You can follow her @drbrynMD.