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The Year-End Lab Check Every Woman 35+ Should Do Before January

  • Writer: Rena Mattingly
    Rena Mattingly
  • 1 day ago
  • 3 min read

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As we move into a new year, most women set goals around their health—more energy, better sleep, improved metabolism, weight loss, less stress. But very few start with the most important step:

Understanding what’s actually happening inside their body.


December is the ideal time to run your labs so you can begin January with clarity, a plan, and a real understanding of what your metabolism and hormones need. Below is the complete list I recommend for all women 35+, along with the optimal ranges I use in practice.


1. Full Thyroid Panel (Not Just TSH)

Thyroid changes are extremely common in perimenopause and menopause, yet most women only get a TSH—and often hear “everything is normal” even when it doesn’t feel that way.

What to test:

  • TSH

  • Free T4

  • Free T3

  • Reverse T3

  • TPO Antibodies

  • Tg Antibodies

Optimal ranges I use:

  • TSH: 0.5–2.0

  • Free T4: 0.90–1.20

  • Free T3: 3.5–4.2

  • Reverse T3: 10–15

These give us a full picture of thyroid conversion, inflammation, and whether your thyroid is actually doing its job—even when TSH looks “fine.”


2. Complete Sex Hormone Panel

Even if you're still having cycles, hormones can fluctuate dramatically in perimenopause. Testing them reveals where you are in the transition and how your body is responding.

What to test:

  • Estradiol

  • Progesterone

  • Total Testosterone

  • Free Testosterone

  • SHBG

  • FSH & LH

Optimal ranges:

  • Total Testosterone: 30–50 ng/dL for women 40+

  • Free Testosterone: 2.0–4.5 pg/mL (functional optimal)

    • Some women feel best at 3.0–5.0 pg/mL

When testosterone is optimized, women often see improvements in strength, libido, mood, energy, and metabolic health.


3. Metabolic Markers

This group of labs helps us understand insulin sensitivity, inflammation, cardiovascular risk, and how your metabolism is functioning as hormones decline.

What to test (and optimal ranges):

  • Fasting Insulin: <6

  • Hemoglobin A1C: <5.4

  • Fasting Glucose: <100

  • HS-CRP: <1.0 mg/L (low inflammation)

These markers tell us whether blood sugar is contributing to fatigue, belly weight gain, cravings, or stalled weight loss.


4. Nutrient Status

Deficiencies become increasingly common after 35 and can directly impact metabolism, hair growth, mood, energy, and hormone balance.

What to test:

  • Ferritin: Optimal 50–125

  • Vitamin D: Goal 50–80

  • Vitamin B12: Goal >500

It's extremely common to see low ferritin and low vitamin D in midlife—two of the biggest drivers of fatigue.


5. Full Lipid Panel

Cholesterol naturally rises in perimenopause because the body uses cholesterol to make hormones. Instead of flagging this as “bad,” we look at patterns and optimal values to understand metabolic healh.

What to test:

  • Total Cholesterol

  • LDL

  • HDL

  • Triglycerides

  • Non-HDL Cholesterol(Optional: ApoB, LDL particle size, Lipoprotein(a))


Optimal functional lipid targets:

  • Total Cholesterol: <200 mg/dL (context matters)

  • LDL: <100 mg/dL

  • HDL: >50 mg/dL

  • Triglycerides: <100 mg/dL (best <80)

  • Non-HDL: <130 mg/dL

  • Triglyceride:HDL Ratio: <2.0

  • ApoB: <80 mg/dL

Looking at optimal—not just “normal”—is essential for understanding true cardiovascular risk.


Why December Is the Best Time to Check Your Labs

Running a comprehensive lab panel before January gives you:

  • A data-driven plan for the new year

  • Clear explanations for your symptoms

  • The ability to target hormones, metabolism, and thyroid more precisely

  • Insight into where to focus your energy instead of guessing

  • A way to measure progress as you move into 2026


Most importantly:

Your symptoms aren't random. They’re biochemical. When you test the right markers, the story becomes clear.


Ready to Get Clarity for the New Year?

If you’re feeling like your metabolism has slowed, your energy has tanked, or your weight has changed in ways that don’t make sense, running a midlife hormone and metabolic panel can be life-changing.

I help women interpret these results through a functional, whole-body lens—and build a personalized plan that actually fits their physiology.

If you’d like to run your labs or review your results, you can schedule a consultation and we’ll create your 2026 roadmap together.

 
 
 
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