5 Overlooked Lab Tests Every Woman on Hormones Should Be Getting

At Essential Woman LLC, we believe hormone optimization is more than a prescription. It’s a precise, personalized process rooted in functional lab testing, clinical wisdom, and real-life results. If you’re on hormone therapy and still feeling tired, moody, foggy, or off—there’s a good chance something’s being missed. And often, it’s in the labs.

Here are five commonly overlooked lab tests that can make all the difference in your hormone journey:

1. SHBG (Sex Hormone-Binding Globulin)

Why it matters: SHBG determines how much of your hormones are actually available for use. Even if your total testosterone or estradiol levels look fine, high SHBG can bind them up—leaving you depleted and symptomatic.

Who needs it: Women on estrogens, thyroid meds, or with high stress often have elevated SHBG. If your libido is missing or you're not seeing benefits from your hormones, this test is a must.

2. DHT (Dihydrotestosterone)

Why it matters: DHT is a powerful androgen that can be responsible for hair thinning, oily skin, or acne—especially in women using topical testosterone. If you're noticing unwanted changes, don’t just adjust your testosterone dose blindly—check your DHT.

Who needs it: Any woman on testosterone therapy experiencing hair loss, skin changes, or irritability.

3. Reverse T3 (rT3)

Why it matters: rT3 is the “brake pedal” of your thyroid system. When it’s high, it blocks your active T3—even if your TSH and free T3 look okay. This can leave you feeling sluggish, cold, and mentally foggy.

Who needs it: Women with Hashimoto’s, adrenal dysfunction, or ongoing fatigue despite thyroid medication.

4. Ferritin (Stored Iron)

Why it matters: Ferritin supports thyroid function, hair growth, and oxygen delivery. Low ferritin levels (even in the "normal" range) can leave you exhausted, lightheaded, and prone to hair shedding.

Who needs it: All menstruating women, and especially those with heavy periods or vegetarian/vegan diets.

5. Vitamin B12 and Methylmalonic Acid (MMA)

Why it matters: B12 supports mood, cognition, and energy—but serum B12 alone isn’t always accurate. MMA helps confirm whether your body is using B12 properly.

Who needs it: Women on metformin, PPIs, or vegetarian diets, or those experiencing fatigue, memory issues, or tingling in the hands and feet.

Bonus Tip: Test Smarter, Not Just More

At Essential Woman LLC, Cindy Lombard, WHNP-BC, doesn’t just “check the box” with routine hormone labs. She reads between the lines—understanding your body’s deeper story so you can stop surviving and start thriving.

Ready to take your hormone therapy to the next level?

Book your personalized lab review today.