23 Lab Tests in Menopause and What They Tell You

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through postmenopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25mg of CBD and 25mg CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over-the-counter solutions, whether for sleep or migraines, can ruin gut health, and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by healthcare providers worldwide and backed by thousands of happy customers, many of whom come from our Flipping 50 community. There is zero THC, so it's non-habit-forming. It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. What's the difference between functional lab tests and lab tests that you might get in the routine visit to that Western-trained doctor that you've been seeing and might love for decades? In this episode, I'm going to share literally behind the scenes 23 lab tests that I just did. Now, if you go in for a regular or infrequent, maybe, lab testing because things are going well and your health is good, it's maybe a while since you've looked at all markers. Thus, 23 different— and yes, that was a significant amount of vials, let me just tell you. But I will let you know, and in on the reasons why to do each of these tests and discuss them and why they're slightly different maybe than what you might expect from your regular quote-unquote doctor. If you're not working with a functional medicine doc, why you might want to look at your alternatives and which of these that I do regularly before I was even working with a functional doc regularly you know, 8 or 9 years ago, because we can order our own self-directed labs. Which of these I would do and can and could do. Now, it's not an all-inclusive list of labs, by the way. This is just literally in real time what I did. So come on with me. I'll show you behind the scenes. I'm Debra Atkinson. You're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you knew to ask them. The goal to help accelerate your results with science and the practical application of proven protocols while living your best life. There's no more powerful health influencer in the world than a midlife woman. And it's not just about you, but the 3 generations that you influence. My unique 40-year career, including being a university senior lecturer in kinesiology, an industry subject matter expert, and an international speaker, to founder of the first and the only exclusively made for menopause and beyond fitness membership in the world. Every week I interview experts behind the scenes and the science of optimal hormone balancing, fitness, and longevity, and share answers to our community's questions so you can have the vitality and the energy that you want, need, and deserve. Buckle your seatbelt. In this episode, I'm going to share my recent 23 lab tests that I've had in menopause. 23 to be exact. I'll share with you why so many and how often, what I'll learn from them. And that's the most important piece. A lot of times somebody will say, well, should I test my hormones? And the question I ask back in response is, do you know what you're going to do with them? Are you interested in HRT? Because if yes, first of all, I wouldn't just order those labs yourself. You want to make sure you're ordering the lab that will be inclusive of everything that your practitioner wants to see. They may prefer to order their labs in the way they want to. That helps them make the educated decisions best on your behalf. So if you don't have the doctor that, you know, you would want to prescribe those hormones, please don't get these offline. Don't order them. Don't get some over-the-counter thing. That's really not a good idea. You wanna be under the care of a physician trained to do this, trained in hormone prescription, trained in helping you with your goals that you've talked to, spoken with, who understands what's your background, what are your goals? I mean, are they really an ambitious athletic endeavor, or are they optimizing your aging and longevity and, and feeling good and energetically? So connecting the dots is not always easy, though I'm— I ran most of these tests as a part of— you still got it, girl— almost a decade ago. I did these self-directed labs, doing the research to interpret them, doing all the heavy lifting, taking actions, or either following up with a physician and/or— and looking at dietary, exercise, and natural solutions that would improve my results. And I recommend you utilize a physician who's willing to and not threatened by your desire to learn more about the what, when, and why for these tests. All right. Hopefully you know how you feel and you know something's not quite right, or I'm not willing to settle for feeling like this. And hopefully you're not thinking this is just a byproduct of menopause or midlife or quote unquote my age. That's flying out the window these days, and hopefully you're letting it. So open your window a little bit more if you need to. But if there are signs you're not doing okay in spite of your efforts, you know, include unexplained weight gain, inability to lose it if you do gain it, feeling lethargic, tired, either on a regular basis or after exercise, you know, add to that insomnia dizziness, brain fog, gut issues. So many more reasons why you'd want to do some of these lab tests. And, and again, this is not an all-inclusive list, but we're going to get started here. So these are the recent lab tests in menopause that I did. Number 1, fasting glucose. And I'm so glad we're starting with this one. So in August, by the way, I am running a continuous glucose monitor challenge. Now, it's not really— the challenge isn't use the monitor. But the challenge is, get the monitor, I'll teach you how to use it, teach you what you're learning by making individual changes one at a time, not 5 at a time, so we know it's working. Fasting levels above 125 are indicative of diabetes. Now, most of the women that I'll have come in don't have numbers like that, but they may have numbers regularly that are 105, 108. I mean, and that is cause for concern. When your fasting glucose numbers are up, your inflammation is up. We're causing damage that is going to rob you of healthy years. So you would never do that for somebody else, so don't do that for yourself. The numbers between 100 and 125, that's an indication of prediabetes. So knowing this is really helpful for, I would say, monitoring your habits. But I think the real word there is for doing the habits. And you and I, not always, I will say this, that some of the things that you might be doing are unintentionally opposite of what we would have you do now. We've learned a lot, you know, since 40 years ago when I first began this. There are a lot of things that I used to recommend because it was the best science we had at the time that we no longer do. And yet some of the things that you're still going to read about in mainstream recommendations, especially if it's led by the government or a large agency, take a long time to change. You may have heard me say before, it takes almost two decades, the average of 17 years, to take a science that was peer-reviewed journal, that was a double-blinded longevity study that's so worth its salt to get into mainstream and be adopted in practical application, working with patients or clients, depending on who we're talking about, in programming, published so that articles are getting it out to us. Even with social media being like instantaneous, we still see this delay in people adopting things. We keep things lodged in here that we heard years ago. In fact, you know, the largest study on female nurses talking about breast cancer. That was recounted, it was withdrawn, and yet so many people still think, oh, estrogen causes breast cancer. Not true, you know. So that's just an example. But knowing this, what is your blood sugar in real time? So you actually have a monitor on the back of your arm, you have the app on your phone. I was reaching for my phone, I don't have it right now. And you can see an hour after breakfast, how was I impacted by that breakfast? What's happening? And you could see tomorrow if I have the same breakfast but a better night's sleep, how am I affected then? If I have a good night's sleep, I have the same breakfast, and I go for a walk 30 minutes after that meal, how am I affected then? If I have the same breakfast, have a good night's sleep, go for a walk after breakfast and have apple cider vinegar and water within half an hour before the breakfast, how do I do then? So we can test all kinds of things. Now I just also gave you the quick fix. You don't even have to have a continuous blood glucose monitor on, but if you did all those things, your blood sugar levels would be better. And if your blood sugar level is better, your insulin level is lower and you're not in fat storage quite so long. So if you want to join us on this blood sugar monitoring event, you need to get started right away. But you can do so at flipping50.com/myglucose. That's the glucose monitor that I recommend. It's one that will allow you to share your results with me so that you can be a part of this group. And if we're going through things and you have something strange spiking happening, we can reach out and figure out problem solving why, because I can actually look at your account if you enable that. All right, so we just led into fasting glucose is a pretty common test. What's not so common is fasting insulin levels. So I'm looking at mine because I want to know— last 5 pounds, and actually I've just shaken it, by the way. So I am, you know, at fighting weight and body composition, which is where I wanted to be, but I lost some inflammation. But I was struggling to do that for a little bit. So I, I want to look at fasting insulin levels, and that's not a common test. Metabolism issues or weight loss resistance are good reasons to check your fasting insulin. So beyond just fasting glucose, insulin resistance can promote additional weight gain and/or prevent you from losing it. So if you think you're doing everything you can, it may be inflammation. That was my issue. And/or your insulin— fasting insulin can tell you, is this part of the problem, right? So next up is A1C. That should sound pretty familiar. It's interesting that I would say 20 years ago, if I said that as somebody would say, what is that? I don't know what that is. Today I think we all know about it, which is just an eye-opener and how aware that we all are now. And I don't think that's just an age. I believe that if I said to my son and daughter-in-law-to-be, you know, what is A1C? They're 30, 29, 30. I think they would both be able to define it. So this number can indicate how well controlled your sugar levels have been over the last 3 months. So again, this is an inflammatory marker and it's tied to the first 2 tests that I just mentioned. So it's all of these are helping us look at pieces of the puzzle. How are they related? Can indicate a pre-diabetic or diabetic condition. This is an important one. So realize over the last 3 months So it's really kind of taking a picture of what just happened while you're fasting. Glucose levels and your fasting insulin are telling you what happened on that morning that you went in. It's a right now kind of thing. And if you're wearing the continuous blood glucose monitor, you're looking at like what's happening in real time based on my stress level, my sleep, the exercise I've done, the food I've eaten or not eaten. Next test is serum ferritin. So for any of you who are feeling low on energy, one of the first things, or one of a few first things that come to mind for me, are your iron level, your B12 level, your vitamin D level. Those are pretty closely related, all of them, to energy level. So anybody who's struggling with you know, inability to exercise, can't quite get going, you know, adrenals may be something. But adrenals are going to definitely be something if you're not getting sufficient micronutrients. And those of us that have been chronic dieters, maybe don't eat a lot of red meat, you're probably at risk for this. So serum ferritin— and realize I'm postmenopausal, so a lot of women think Well, there's no reason for me to look at that because I'm not losing iron because I'm not having a cycle anymore. Still a good idea to look at this. When I was in reproductive years, regularly cycling, I was always the low end of healthy, and that was okay. It got me through, except when I moved to altitude and lived in Boulder, Colorado, and I lived in the mountains. At altitude, really. So at about 8,800 feet, and there's less oxygen in the air, right? So are we following? And I didn't have that ferritin level that I needed, so I had to do some extra boosting to my iron levels. And really, my energy level went up in about a week, and ferritin levels improved by doing that regularly. Now here's the deal. I'm a meat eater. I eat plenty of meat, plenty of bison and elk and venison, as well as fish and seafood. But when you were looking at where can we get the best, you know, we're looking at beef or meat has the most amount of ferritin in it. So realize that if somebody like me can do that, who has that 2 or 3 times a day, that's, you know, probably room for you if you don't eat much red meat and you still believe, like 1980 said, you know, that red meat causes heart disease. It no longer— we no longer believe that, by the way. But there you have it. So serum ferritin is— I'm looking at it just to look at where my levels are. I've had periods of time where I've bumped it up. I've even done IV therapies to bump it up and, and then look to see, am I maintaining it now, you know, with my diet only? Next is vitamin D. So this is important for energy— I mentioned it earlier as well— and for gaining muscle. Vitamin D is very related to gaining muscle, particularly fast-twitch muscle fiber, which you hear me talk so much about, as well as energy. So falling into norms though for this one is really dangerous. And then walking away feeling like, oh, okay, I'm good, my fatigue must be due to something else. Norms versus optimal levels are something you really have to understand. There's a big distinction. So this one can be important for women in midlife and beyond to know that, you know, you may be in the norm and your numbers may be something like 40, which is going to be in a norm value. But optimal level is where you want to be, which is somewhere between about 60 and 80. And here's how you might feel, you know, you're feeling like you don't have much energy, you can't gain much lean muscle, feel wiped out after your exercise or your workouts, or don't want to start it in the first place. So knowing this, that norms compare you to a lot of people who test is like an average. A lot of people who test don't feel very good, and with some tests, depending on the lab, it's really very regional. So if I'm here in Phoenix and I'm testing at the lab 6 minutes from my house, very convenient, but a lot of people here in Phoenix also maybe testing who don't feel very good. And I get those results and it's like, here's where you are according to norms if I just went by that. So I kind of want to be in the norms with those people who don't feel very good, right? So please take into account that you might not have known what you didn't know. The next test that my physician offered to run was uric acid. So optimal levels may support antioxidant activity, but too high can be linked to oxidative stress. So uric acid is one of these that we want in the sweet spot, you know. And sometimes even with functional medicine, it's, you know, in the higher value of norm levels is what they will say. This is optimal. So it's not that every single test indication By the way, is different as far as where's norms versus optimal levels. So uric acid can be really important. Vitamin A concentrations of uric acid and vitamin A are closely associated. And so this test might be used to indicate a reason why uric acid levels are high, if they are. So these are like sister tests. You know, generally if you're doing one, the other one is probably also going to appear. CRP. So again, this is another inflammatory marker that many of us are very aware of now and, and understand, but didn't, you know, again, 20 years ago. So it's a major marker of inflammation. Risk of disease increases significantly with CRP. So we want to know, you know, where that one is, and then if it is high and elevated You would want to be working with a physician to help you get to the bottom line, and probably we're going to first dive into lifestyle habits. So what's going on? How's your diet? How's your sleep? How's your exercise? How are you coping with stress? Because those are things that help decrease inflammation and You know, also intake potentially of anti-inflammatory foods and/or supplements. A fasting lipid panel. So that's looking at cholesterol. This is probably one of the most common things, right? You know this one, cholesterol, your LDL, your HDL, that's your bad and your good cholesterol, and the total ratio of total to HDL. So remember that just your HDL, if it's really high, that's your good cholesterol, and your total number is also high, the ratio may save you, you know. And they generally will say, you know, we're not going to worry about it because although the total is high, the HDL is good. And this is something that you as a female in midlife should realize, right? So if your HDL is good and it was good going into menopause, probably even if your total begins to creep up pretty quickly. If your HDL ratio is still good, you know, keep an eye on it. But no, cholesterol does increase, and, and it's not uncommon for that to occur because your hormones are trying to generate more cortisol so that they can make more hormones. That's where it happens. Okay, free testosterone. So free and total testosterone. So two tests here are done related to testosterone. This is the testosterone that's immediately available, free, is like circulating free, be free in your body, and it can support weight loss and improve memory and strength. All of them. Testosterone, elevated testosterone levels, if it's too much, can lead to hair growth, acne, moodiness. So we're talking hair growth not where you want it, by the way. Just to clarify. So we're talking hair growth on your face, you know, places where all of a sudden is like, where'd that sucker come from? But too low can lead to difficulty gaining muscle and bone density. So realize this: testosterone is the most abundant hormone in the female body. Most of us associate females with estrogen, and of course we need that too. But we need testosterone to gain muscle. And by the way, we need sleep in order to release the testosterone. Our body may be able to produce it, but if we're not sleeping, that actually doesn't get on the assembly line for us. So we have to make sure it's there. So we need that, and we also need vitamin D for bone density. I didn't mention that earlier, but we need testosterone for bone density. We need testosterone for bone density as well as for muscle. Both of them. Also, you want it for libido, right? So it is great for mood, and yet mood, memory— these are great, but libido, by the way, if you're struggling with that, that's something else to look at. So DHEA, and we can say DHEA-S, which is kind of just a sulfur division, but if we'd say DHEA, your precursor to the sex hormones— this is like you have to take algebra before you take geometry. It's also an indicator of adrenal function, and it's very related to high or low cortisol levels. Can wreak havoc on your immune system, but so too can DHEA. So they are similar yet different. So it— they serve different functions, of course. So your DHEA, you have to have that to kind of light the fire for estrogen, progesterone, testosterone. So we need that there, and we also want to pay attention to it. If you're getting more colds, more flu, you're not sleeping really well, that can be DHEA. Not just your cortisol levels. Next up, so two estrogen levels— there are three types, but we're going to test two of them right now. Estradiol, check for optimal levels. For some women, confirming that they're in menopause, and for other women like me who's doing hormone replacement and that hormone levels are optimized, so we're looking at my estradiol numbers to say is it where it should be, or if my number's a little bit low or a little bit high, you know, we can either add more or decrease the amount that I'm taking. Estrone is the estrogen that's produced after menopause. It's kind of like this would be a marker to look at, am I in postmenopause yet? And it's not that you wouldn't know if it's been 12 months since your last period, you probably, probably know, right? It's like something's missing here. And although many of us would be like, yeah, I don't miss that thing at all. If it's something, but it's a good way again, to check, just to look at levels and confirm progesterone. It can lower post-menopause and makes sleep and relaxing harder. So progesterone is in a balanced relationship with estrogen. Generally, if somebody is giving you progesterone or they're giving you estrogen, they're also giving you some level of progesterone to make sure that, you know, if you take more of one, you have to take more of the other. So if my estrogen prescription increased, and I don't know if it was 6 months, 9 months ago, I think we did increase it. So my progesterone also had to go up. So if they're in a balanced relationship and then one of them— your need changes for one reason or another, you've got to look at the both of them. Very rarely I have worked with clients, and whether in a group in our program or privately, who were taking only one and not the other. I said, what about your, you know, progesterone level? What about taking that? Really? Right, because that didn't make sense to me. I said, yeah, I would go and ask about that. And here's the relationship between the two of them. Educated her a little bit, and she went back. And, you know, it was, it was really an oversight by her practitioner. So please realize we We still have to advocate. We can't just turn it all over and let them put it on automatic and assume we don't need to pay attention. So important stuff. So next, thyroid tests. So, and just so that you all know, I am on thyroid medication. I have been on for, gosh, probably 5 or 6 years now and really would like not to be, you know. I mean, I would rather kick it into gear, make sure I'm paying attention to my adrenals, my cortisol, and not have to take it if that's a possibility. You know, better diet if I, if I could do that, or more optimal exercise, sleep, and doing anything that I could to optimize it naturally. But for some of us, that's not possible. For others, maybe, maybe it is more possible than we thought. So thyroid hormone tests that I'm doing TSH, it's released by your brain to signal your thyroid gland. So it's kind of like your messenger, can be used to monitor dosing of thyroid medication or as a screening test for the presence of thyroid disease. So either, you know, that signal maybe is not happening or it is, but TSH levels are indicative to your practitioner of, okay, we have you at the right level or we need to adjust some things. Free T4, and I'm going to also talk about free T3. So remember, free testosterone, that's the circulating amount. Free T4, the thyroid makes— so what it creates in the factory is predominantly T4. Free T4 is what your body uses to make the active thyroid hormone called free T3. So what we really need for thyroid to function is free T3, but what it produces is free T4. So your body may be creating adequate free T4 and not converting it very well to free T3, or it may not be producing enough free T4. In which case you might need different kinds of kickstarts for your thyroid, not necessarily the same medication for all people, right? So these are advanced biomarker tests and they're not routinely done, but they're very helpful to determine if the thyroid can be affecting how you feel and get to the bottom of why. If it's not producing this free T4 What's the problem there? And if it's producing it and yet you don't have much free T3, what's the problem? Why isn't it converting? And do you need something to help that conversion? So symptoms like constipation, weight gain, tiredness, low libido of low thyroid, right? So don't just sweep this under the rug and say, oh, this is menopause. There may be something more going on, right? So those are symptoms of the low thyroid, but they can be missed or they get passed off as this is normal for where I'm at right now unless the active thyroid hormone free T3 is measured. So if we don't measure free T3, we don't know exactly why things might be happening to you. High levels of free T3 can indicate hyperthyroidism, and that's where your thyroid is like really fast. You're probably losing weight, not gaining weight, and that's fatigue, anxiety, sudden weight loss, rapid heart rate, irritability, more frequent bowel movements like diarrhea, difficulty sleeping, sweating, tremors. Free T3 is an advanced screening biomarker that helps screen routinely missed thyroid issues. So Free T4, free T3. Check on your last lab. Did you do those tests? Thyroid peroxidase antibodies, so TPA. You'll see this on your lab test results. Thyroid disease has become very common, and we can often pick up inflammation in the thyroid years before the thyroid feels. So if your other thyroid numbers seem fine, but your your TPA is elevated or something's off with it, we see it. It shows up in your lab before. So if those numbers— if you're looking at, here's my number, here's my number, here's my number— oh, this is like an outlier, you know, and you start seeing a trend. It's important because natural interventions that you can make might help you reverse the inflammation of the thyroid gland. You know, when I say natural interventions, I'm coming right back to the things that we should probably all be doing anyway, but sometimes we don't. You know, getting better sleep, decreasing your alcohol intake, you know, all the things that you just— sometimes we think, I don't really— it's not that important, don't need to do it. Yeah, yeah, you do. Okay, so the next is another antibodies, and this is thyroglobulin antibodies, TA. This test can be positive in people with inflammation of the thyroid gland. It can be seen again years before complete thyroid failure. So these two tests are really indicative of if these numbers are out of whack and let's— optimal, right? If they're out of optimal range, not just in norms, 'Cause there's a lot of people with thyroid issues that their scores are not going to be good. You don't want to be there. You don't want to be them. You're not average. Just saying. Okay, so these can be positive and they can be seen years before thyroid failure. So you have time to take some action. So this is really important. Reverse T3. And yes, we're still talking thyroid. Reverse T3 is the storage form of the active thyroid hormone. Many conditions can cause you to store thyroid instead of actually using that free T3. If your reverse T3 is high, then you may need to address the reasons why. You're gonna want to get to what's the root cause of this instead of— all too often, I hate to say this and throw anybody under the bus, but all too often someone may be a little bit quick on the trigger to say, well, let's give you medication because it's not working really well. But they may be giving you medication while in all the time, like this reverse 3 is sitting there, like you've got things in the downstairs freezer, you're just not going down to get them. You don't need to go to the grocery store, meaning the prescription, you need to figure out how to get those things upstairs. And you know, if you're just medicating and somebody's not looking at all these numbers, it's potentially you're medicating and you have this window to help yourself but may not get it. So important to think about those things. So my doc looks at all of these. So that was like another needle in my arm, but follicular levels— so levels of this hormone indicate phases of hormones including puberty, reproduction, and menopause. Levels rise significantly in this one after menopause. So this test can be helpful for somebody who isn't sure what's happening or wants to confirm that their levels are dropping. And this would be— we're talking broadly here with menopause, like probably somebody who is in perimenopause and wasn't sure what was going on. You know, if you're in your 40s and you've got strange things going on, not sleeping well, hot flashes or night sweats, or weight gain, or other— so many other, right, symptoms we don't necessarily naturally associate with menopause yet. If those things are going on and you have a blood test, your FSH numbers could be rising as an indication that, oh, you're potentially entering menopause. So this is why what's going on— that might be the first thing that makes you ask, well, should I be considering hormone replacement therapy? Dr. Felice Gersh was one of the probably most popular speakers on the What, When, and Why to Exercise for Women 40 and Over this past May. And, you know, I mean, she suggests the sooner you start HRT while your own body is still promoting some, the better off you're going to be. You're not going to be in that I'm going to go downhill crash, and then I'm going to start hormone replacement and come up again. If you never crashed, your plane would be in better shape, right? So you can keep it— you're going to experience a small dip, but you're going to keep things balanced. Your muscle, your bone, your brain health will probably fare better if you do that. Now, what I wish I would have known is that probably back in 2015, I began hormone replacement therapy, and then I didn't notice any difference. And I mean, and I don't know what I expected to notice, but I went off of it. It's not helping me, it's not doing anything. And I thought, you know, I guess I don't want to be on it if I don't have to be on it. I know so much more now. You know, that in my naivety. And maybe, you know, it could have been a practitioner who would have told me this, explained it to me in a different way, or, or in any way. I'm not sure I really had a sit-down with why would I want to be on this, that this is a long game, not just a short game about menopause symptoms. Because if you're listening and you don't have menopause symptoms You may be thinking, well, I don't want to do HRT, I don't need it. You might want this and wish 10 or 20 years down the road for your muscles, your bones, and your brain health that you had, because you won't be able to get this 20 years back of proactively protecting yourself. So there's a big difference in the way I think about it now versus the way that I did in 2015-16. When I first started it, I was on for about a year, and then I just was like, I don't need it. And I hadn't hit, um, I hadn't hit menopause. I'm trying to think what year that was. So 64 years ago, so that was in 2020, or I'm sorry, 2019, that I hit it. So that I was about 4 years prior to menopause when I started for the first time because I had been tested, my levels were low, but neither of the practitioners that I worked with were really speaking the right words to me to, to get it, to understand why stay on it. So I wish that I had. The last test that I did was sex hormone binding globulin, and that's used to keep excessive free estrogen out of the bloodstream. So looking at these levels can help identify if Hormone control health habits can improve overall health. Sex hormone binding globulin is a protein mainly produced by your liver. Studies show that diets high in simple sugars— so we don't do that here, by the way— can cause the liver to produce less, um, less of this hormone. So low levels of it are seen in obesity, prediabetes, insulin resistance, and type 2 diabetes. So it is something that anybody who's A woman in midlife, you may want to look at it, you know, even if you're somebody who like me would be like, I don't do that, right? I don't do sugars, I don't do simple sugars. You may be struggling with higher blood sugar, you know, unknowingly, you know, just due to the fact that you punched your ticket and you're a woman in midlife. We do have higher blood glucose levels, unfortunately, so we respond and react differently than we did pre-menopause. So just to mention a few other tests that I do in menopause, I do them with clients as well as for myself, or did mostly during perimenopause because I knew that they were so volatile. Total cortisol, so early morning cortisol screen for adrenal gland function, but my preference is not just the total cortisol that comes on a regular blood panel, but it's the 4-sample saliva test. So you're gonna actually spit and you're gonna be looking at the cortisol in real time. First thing you get up, lunch, dinner, and bedtime. So it measures it throughout the day. We get a look at how do you compare to the, the ideal function of cortisol during the course of a day. And ACTH stimulation test. So it's administered by a physician to test your response in case of adrenal function issues. So if cortisol is not great and lifestyle habits don't seem to change it, my recommendation would be a referral to a doctor who is able to do an adrenal test. So they are going to administer ACTH, which is basically going to trigger your adrenal system and see what is your response to it so that they can level— look at what level you're at and where are you, so we know what's the severity of, of where things are and what do we need to do that we ideally, hopefully haven't already done. Omega-3 and 3:6 ratio index. So that's not on my labs now, but that is something that I regularly test For number one, you know, we're testing those inflammatory markers like A1C and CRP. And as we look at those, ideally we're looking at omega-3 and the 3:6 ratio, that index, because for muscle and for joint aches and pains and brain health, knowing your omega-3 and 6 index can put you and help you, you know, improve your overall health and decrease your level of inflammation. So really important for you to, to take that in altogether. And if I were starting to drain for another endurance triathlon, for instance, I would love to know my baseline of my omega-3s and 3:6 ratio. And I would most likely also be associating it with my CRP, my A1C, and blood sugar levels. But then I would be boosting my omega-3s to help decrease inflammation, and, and not just taking it at baseline, but actually taking it 2 to 3 times a day as the training got more significant to offset that inflammation that I know I'm causing, right? So I know that it's going to be there and then be able to monitor that. Throughout based on how I feel. Food sensitivity testing is another thing that I would do, and as a coach, I would do this on the regular with someone who's doing an elimination diet, but we cannot possibly check. So depending on which level of comprehensive test you do, you can test for 90 common food sensitivities or more, and you learn what you're low and what is moderate, what is a high sensitivity for you. And avoiding generally all of the moderate and higher food sensitivities for 3 months while you also take extra care of your gut. Maybe you're doing glutamine, you're adding probiotics and prebiotics, and you're cleaning up the gut lining to help reduce symptoms of gas and bloating, constipation, diarrhea stemming from leaky gut. And you— oregano oil, by the way, can be another one that can be helpful. To support gut bacteria, and all to help improve the gut before attempting to reintroduce foods. The reason to do that food sensitivity test is— the lab test, at least— is that, you know, if you're getting a cumulative effect, you may not realize ever that because we react to food sensitivities in such a way that, you know, we may eat a food on Thursday, not react or have a reaction until Sunday. And the reaction can be a skin rash, it could be, you know, lethargy and fatigue, but you may never connect the dots that it was a food that you ate 4 days ago. And if it's not a food that is on your awareness level of, you know, I know I'm really sensitive to that If it's several foods that you have a low sensitivity to, that cumulative effect could be enough at any one meal or within a short span of time to also trigger a reaction. And the reactions that most of us hate the most is the weight gain, weight loss resistance, and belly fat, the bloating, the kind of padding in the cushions that we're like I don't deserve this, right? I work hard and I eat well. But the foods that you're eating that are quote unquote your eating well are not the same as someone else's. There's no such thing as healthy snacks that I like to eat. And if you go to Instagram, you could probably do a search for healthy snacks. And you'll get a whole list of somebody's, but they may not be yours. So you've really got to realize that it doesn't— it's not the same for everybody anymore. And then last one would be a GI map. So again, I've done this one myself periodically. There have been times when even though I'm working with a physician that they haven't felt the need to test, and I just didn't— like, I know my own gut. And I avoid the food sensitivities. I've been doing that, but this— I just am like, this is a very unusual reaction. So for gut issues that aren't resolved with dietary changes, these scores will tell you your gut bacteria levels. So you could have something going on in your gut that, you know, you've got a +4 in something that should be a 0 or a 1 in healthy range. Or maybe it's a -2 and it's supposed to be a 0 or 1. Okay, so you know what to do because the interpretation for that will tell you here's certain probiotics that you need. And that way you don't just go to the store and you're not just buying this one off the shelf. And by the way, when you do that, the probiotics that you should be buying should have live strains in it, and you know it because there's numbers. After the list of what kind it is. There should be numbers after it. This I learned from Dr. Vincent Pedre. I would not have known that otherwise. And if you're getting back a GI test map, you're gonna go to the one specifically you're gonna go and buy and say, oh, I, I need this, so I'm going to take that for like a month, and maybe the second month I'll do that as well, but then I'll retest. So it's important that you take the right kind because there's good, there's bad gut bacteria. You could be just feeding the bad ones, right, and ignoring the good ones and not, not bringing yourself back into a balance. So these are reasons why I test, and, and I hope that you can see why, you know, some of these tests, when they would be ordered by a physician, what you're looking at, why you're going to learn them, and why if your physician is not ordering them, that you might ask, ask about doing that and ask about the value of it. Some Western-trained docs are not ordering tests because they've never been taught how to order, but most importantly, how to interpret them. So they wouldn't know how to treat even after they got the results. So you really have to— this is where we start looking closely at, are you working with the right practitioner for the needs that you have right now? And other lab tests, you know, the cortisol, you can do that yourself. You know, the omega-3 and 6 can be really helpful with inflammation. Food sensitivity and the GI map— that's your stool test— also can be really helpful. And you can do those for yourself and read those labs, or if you're working with a coach like myself, that's also a possibility. So I'll put a link in the resources if you're interested in doing, you know, a quick ultimate consultation. It's not quick, actually, we spend 90 minutes together about where you should go, what you should start with, what makes sense based on what's happening for you. We also dive into the exercise, into the nutrition. I'll put the link for that in the show notes, and the show notes for today will be at flipping50.com/labtestsinmenopause. And what are you waiting for? Let's start flipping 50 today. Thank you for listening. To listen to a decade of episodes and to get the show notes, visit flipping50.com where you'll be able to find all the previous episodes. 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