Women's Essentials

Adds estrogen, testosterone, iron stores and a thyroid screen to the blood count, body chemistry and cholesterol of a yearly physical.

Tiredness, shedding hair, irregular or heavy periods, weight that will not move. Most of what sends a woman looking for bloodwork comes down to a short list of causes, and this panel covers the ones a first draw should rule in or out. Ferritin is the big one. Iron stores run down long before hemoglobin drops, so a normal blood count does not clear you, and low ferritin on its own is enough to explain fatigue and hair loss in a woman who still has periods. TSH catches the thyroid, which produces the same symptoms and is far more common in women. Estradiol is included for cycle and perimenopause questions, with the caveat that it moves through the month, so note your cycle day when you draw. Testosterone matters in women for acne, unwanted hair and libido, and it is run by mass spectrometry here because the levels women carry are low enough that the standard immunoassay is unreliable at them. The blood count, metabolic panel and lipids are the baseline any clinician will want alongside. Estradiol is the standard immunoassay. The LC/MS version holds its precision at low levels and is an upgrade before checkout, as is the testosterone profile that adds free testosterone.

Blood is drawn at a Quest Diagnostics, Labcorp or BioReference patient service center. Price by laboratory: Quest Diagnostics $89, Labcorp $136 or BioReference $155. Your price depends on your state and the laboratories near you. Enter your ZIP code to see them.

What’s included

• Estradiol (standard): Estradiol, a form of estrogen, measured by a standard immunoassay.
• Testosterone, total (LC/MS): Total testosterone, a hormone made by the testes, ovaries and adrenal glands, measured by mass spectrometry.
• TSH: Thyroid-stimulating hormone, the pituitary hormone that signals the thyroid.
• Ferritin: Ferritin, the body's iron-storage protein.
• 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.

Optional upgrades

• Estradiol, sensitive (LC/MS) (in place of Estradiol (standard)): Estradiol measured by liquid chromatography with mass spectrometry (LC/MS), a method designed for low levels.
• Testosterone, total and free (LC/MS) (in place of Testosterone, total (LC/MS)): Total testosterone measured by mass spectrometry, and free (unbound) testosterone measured by equilibrium dialysis.

Tests you can add

• Progesterone: Progesterone, a hormone made mainly by the ovaries, with smaller amounts from the adrenal glands.
• Vitamin D (25-hydroxy): 25-hydroxyvitamin D, the main form of vitamin D circulating in the blood.
• DHEA sulfate: DHEA sulfate, a hormone made mainly by the adrenal glands.

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 have periods, record the first day of your last period. 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.