Unveiling the Hidden Health Markers: A Midlife Woman's Guide to Blood Tests
As women approach midlife, they often find themselves grappling with a myriad of symptoms that can be attributed to perimenopause. From crushing fatigue and brain fog to poor sleep and weight changes, these symptoms can be overwhelming. However, what many women don't realize is that there are several important health markers worth checking, which can offer valuable insights into their overall well-being. In this article, I'll delve into the five blood tests that every woman over 40 should consider, and why they matter.
1. Ferritin, Iron, and Hemoglobin: Uncovering the Iron Deficiency
One of the most common health markers that women overlook is iron deficiency. Heavy periods or more frequent periods during perimenopause can deplete iron stores, leading to fatigue, dizziness, poor concentration, breathlessness, hair shedding, restless legs, itchy skin, anxiety, and a constant feeling of being wiped out. Ferritin, a crucial indicator of stored iron levels, is often overlooked. While you may fall within the 'normal' range, low ferritin stores can still cause symptoms. Personally, I think it's essential to aim for ferritin levels that are comfortably within the range, rather than scraping along the bottom end of 'normal'.
Foods rich in iron, such as red meat, lentils, tofu, beans, dark leafy greens, and fortified cereals, can help improve iron levels. However, pairing plant sources with vitamin C-rich foods and avoiding tea or coffee with meals can also enhance absorption. In some cases, supplementation or IV infusions may be necessary. What many people don't realize is that low iron levels can be easily overlooked as a cause of fatigue, and many women assume they're exhausted due to menopause.
2. HbA1c: Understanding Blood Sugar Levels
The HbA1c blood test provides an overview of average blood sugar levels over the previous three months. This test is crucial in identifying insulin resistance, pre-diabetes, or type 2 diabetes risk. Hormonal shifts, muscle mass loss, poor sleep, and increased abdominal fat during menopause can all affect blood sugar regulation, leading to energy crashes, cravings, and a constant feeling of needing to snack. Women often blame themselves for lacking willpower, but unstable blood sugar can have a significant impact on appetite, energy, and food choices.
In my opinion, HbA1c is a far more meaningful picture of blood sugar levels over time, compared to the fad Continuous Glucose Monitors (CGMs) being marketed to healthy people. While CGMs may be tempting, they're often expensive, unnecessary, and anxiety-provoking for most people without diabetes. Building meals around a plan-sized portion of protein, plenty of fiber-rich plants, and some healthy fats can help support steadier glucose levels throughout the day.
3. Cholesterol: Heart Health in Midlife
Cholesterol levels often rise after menopause due to changes in estrogen, even in women who eat well and exercise regularly. While cholesterol itself isn't something you can feel, elevated LDL cholesterol is a significant risk factor for cardiovascular disease, which becomes increasingly important for women in midlife and beyond. As a menopause expert, I strongly believe that the conversation around menopause needs to include heart health far more than it currently does.
Increasing viscous soluble fiber intake from foods like oats, beans, lentils, chia seeds, flaxseeds, and barley can help support healthy cholesterol levels, alongside exercise and overall diet quality. Women are often shocked when their cholesterol rises seemingly out of nowhere in their forties and fifties. It's crucial to address this issue to prevent cardiovascular disease.
4. Thyroid Function: Uncovering the Underactive Thyroid
Thyroid issues become increasingly common in women as they age, yet symptoms are often mistaken for menopause. An underactive thyroid can cause fatigue, weight gain, constipation, low mood, dry skin, brain fog, and hair thinning, all of which overlap heavily with perimenopausal symptoms. Women are sometimes told they simply need to accept feeling tired and sluggish, when there may actually be an underlying thyroid issue contributing.
If you're experiencing symptoms that feel 'off', it's essential to request a test of thyroid function. Nutrition won't cure thyroid conditions, but eating enough protein, iodine, selenium, and iron can help support normal thyroid function alongside any medical treatment prescribed. Personally, I think it's crucial to address thyroid issues, as they can significantly impact a woman's quality of life.
5. Vitamin D: The Sunlight Vitamin
Vitamin D deficiency is incredibly common in the UK, particularly during autumn and winter, and even low levels can contribute to fatigue, low mood, muscle aches, and poorer bone health. This becomes even more relevant during and after menopause, when declining estrogen levels can increase the risk of bone loss and osteoporosis. Vitamin D plays a key role in immune health, muscle function, and bone health, all of which become increasingly important as we age.
The problem is that it's pretty much impossible to get enough vitamin D from foods, so people in the UK are advised to consider a supplement during the winter months. The recommended dose is 10mcg (or 400IU), but you may need more. Knowing your vitamin D levels is crucial, as it's one of the nutrients I'm asked about most in my clinics.
Beyond Blood Tests: Blood Pressure
While the above blood tests are essential, there's one non-blood test that every woman should know her numbers for: blood pressure. High blood pressure often has no obvious symptoms, which is why it's sometimes referred to as a silent risk factor. Hormonal changes, stress, poor sleep, weight gain, and genetics can all contribute. However, the good news is that lifestyle changes can make a meaningful difference.
Regular movement, reducing excess alcohol, improving sleep quality, and eating a diet rich in fiber, potassium, and minimally processed foods can all help support healthy blood pressure. Midlife shouldn't be about ignoring symptoms or putting everything down to hormones. Understanding what's happening inside your body can be incredibly empowering and often allows you to make simple changes that help you feel significantly better.
In conclusion, as women approach midlife, it's crucial to be proactive about their health. By discussing these five blood tests with your GP and making informed decisions, you can gain valuable insights into your overall well-being and take control of your health. Remember, midlife shouldn't be about ignoring symptoms or putting everything down to hormones. It's a time to embrace change, make simple changes, and feel significantly better.
