Women's Midlife

For women in midlife: hormones alongside heart, thyroid and metabolism.

A lipid panel, apolipoprotein B, hemoglobin A1c, TSH, free T4, 25-hydroxy vitamin D, a complete blood count and a comprehensive metabolic panel, with estradiol, total and free testosterone, SHBG and DHEA sulfate. No blood test on its own confirms perimenopause or menopause; your clinician looks at your symptoms and history. Estradiol is measured by a standard immunoassay, which is less precise at low levels; where offered, you can switch to the sensitive LC/MS method, which is designed for low levels. FSH and progesterone are available as add-ons.

Blood is drawn at a Quest Diagnostics patient service center. Prices depend on the laboratory and state. Enter your ZIP code to see the laboratories near you and your price.

Ordering opens soon.

What’s included

• Complete blood count (CBC): Red cells, white cells with a breakdown by type, and platelets, plus hemoglobin, hematocrit and red-cell size.
• Comprehensive metabolic panel (CMP): Glucose, sodium, potassium, chloride, carbon dioxide, calcium, the kidney tests BUN, creatinine and eGFR, total protein, albumin, bilirubin and the liver enzymes ALP, ALT and AST.
• Lipid panel: Total cholesterol, HDL cholesterol and triglycerides, with calculated LDL cholesterol, non-HDL cholesterol and the cholesterol-to-HDL ratio.
• Hemoglobin A1c: The percentage of hemoglobin with glucose attached, which reflects average blood sugar over about the past three months.
• ApoB: Apolipoprotein B, the main protein on LDL and other cholesterol-carrying particles.
• TSH: Thyroid-stimulating hormone, the pituitary hormone that signals the thyroid.
• Free T4: Free (unbound) thyroxine, the main hormone the thyroid releases.
• Estradiol (standard): Estradiol, a form of estrogen, measured by a standard immunoassay.
• Testosterone, total and free: Total testosterone measured by mass spectrometry, and free (unbound) testosterone measured by equilibrium dialysis.
• SHBG: Sex hormone-binding globulin, the protein that carries testosterone and estradiol in the blood.
• DHEA sulfate: DHEA sulfate, a hormone made mainly by the adrenal glands.
• Vitamin D (25-hydroxy): 25-hydroxyvitamin D, the main form of vitamin D circulating in the blood.

Tests you can add

• FSH: Follicle-stimulating hormone, a pituitary hormone that signals the ovaries or testes.
• Progesterone: Progesterone, a hormone made mainly by the ovaries, with smaller amounts from the adrenal glands.
• TPO antibodies: Antibodies to thyroid peroxidase, an enzyme in the thyroid gland.
• Free T3: Free (unbound) triiodothyronine, the active form of thyroid hormone.
• Lipoprotein(a): Lipoprotein(a), an LDL-like cholesterol-carrying particle that a standard lipid panel does not report.

Before your draw

Fasting required.

Fast for 9 to 12 hours before your draw; water is fine. Book a morning appointment, ideally before 10 a.m., for the testosterone test. If you still have periods, record the first day of your last period. If your cycles are irregular, ask your clinician which day to test. Note any hormonal birth control or hormone therapy and when you last took it. If you take insulin or other diabetes medicine, ask your clinician how to take it while you fast. Don't stop your usual medicines unless your clinician tells you to. If you take biotin (vitamin B7), including in hair, skin and nail supplements or multivitamins, have your blood drawn at least 8 hours after a usual dose, or at least 72 hours after a high dose. If biotin was prescribed, ask your clinician before stopping it.