As a Traditional Chinese Medicine practitioner, my diagnostic approach begins before any blood work is ordered. When you come to see me there are two things I do that your GP likely doesn’t — and together with the right lab tests, they give us the most complete picture of what’s happening in your body.
I want to share something I’m genuinely excited about: a comprehensive lab checklist that every woman in her 40s and 50s should know about. But first, let me walk you through what I look for when you sit across from me in clinic.
What I see before any test is ordered
PULSE DIAGNOSIS
I take your pulse in both hands. Each position corresponds to a different organ system — lungs, spleen, stomach, kidney on the right; heart, liver, kidney on the left. Rate, depth, and quality all tell a story.
TONGUE DIAGNOSIS
The colour, coating, shape, and texture of your tongue reflect what’s happening in your digestive system, circulation, and organ function. It is one of the most reliable diagnostic tools in TCM.
Based on what I find, I will often recommend patients follow up with their GP for specific blood work. This is where Eastern and Western medicine work beautifully together.
THE MOST OVERLOOKED TEST
The most common issue I see in women — particularly in their 40s and 50s — is low iron. But a standard iron test won’t catch it. You need to specifically test Ferritin — your stored iron. If your ferritin is below 50, supplementation is warranted. Fatigue, brain fog, weakness, and low mood are classic signs — and they are completely fixable once you know.
I recently came across Dr. Mary Claire Haver’s checklist of labs every woman should be asking her doctor to run. Dr. Haver is a leading voice in women’s menopause health and this checklist is outstanding. I wanted to share it with you because this is the kind of information that empowers you to advocate for yourself at your next doctor’s appointment.
ADVANCED LIPID PANEL
ApoB · Lp(a) · Total Cholesterol · LDL & HDL · Small Dense LDL Particles
WHY: Estrogen loss changes how cholesterol moves in the body. LDL often rises and small dense LDL particles — which are more likely to stick inside artery walls — can increase. ApoB shows the total number of particles putting pressure on your arteries. Lp(a) is a genetic risk factor for heart disease that many women don’t even know they carry.
BLOOD SUGAR & INSULIN
Fasting Glucose · Fasting Insulin · Hemoglobin A1c · HOMA-IR
WHY: Hormone changes during menopause shift how your body stores fat and handles sugar. Many women develop insulin resistance that leads to stubborn weight gain and higher diabetes and heart risk — often years before a diagnosis is made.
BONE HEALTH
Baseline DEXA Scan · Vitamin D
WHY: After menopause the drop in estrogen accelerates bone loss. Many women lose up to 20% of their bone mass in the first years of menopause without knowing it. Vitamin D is essential for calcium absorption and is commonly low — and easily corrected.
THYROID CHECK
TSH · Free T4 · Free T3 (if needed)
WHY: An underactive thyroid can mimic menopause symptoms almost exactly — fatigue, hair loss, mood swings, brain fog. A simple blood test rules this out or finds a treatable cause for symptoms that should not be brushed off.
IRON & ANEMIA PANEL
Ferritin · Full Anemia Panel if Ferritin is Low
WHY: Many women enter menopause with years of heavy or irregular bleeding behind them which can deplete iron stores. Ferritin measures stored iron and can drop long before hemoglobin does — causing fatigue, weakness, and brain fog that is easily corrected when you know.
HORMONES OPTIONAL
Estradiol LC/MS · Testosterone Free & Total
WHY: Estradiol can confirm where you are on the menopause timeline. Testosterone is frequently overlooked yet declining levels in midlife can impact energy, motivation, sexual desire, muscle maintenance, and mental clarity. Testing guides conversations about treatment and overall wellbeing.
CHRONIC INFLAMMATION
HsCRP (High Sensitivity C-Reactive Protein) · ESR
WHY: These markers show whether inflammation is present in your body. They are excellent baseline markers to track the impact of nutrition and lifestyle changes over time — and since nutrition and lifestyle changes fight so many causes of chronic inflammation, it is worth testing.
BRINGING IT TOGETHER
How TCM and this Lab Work Fit Together
What I love about this checklist is that it aligns perfectly with the whole-body approach of Traditional Chinese Medicine. In TCM we have always looked at the body as an interconnected system — and the pulse and tongue findings I observe in clinic often point me toward exactly the markers on this list.
When your ferritin is low I can often see it in your pulse quality and complexion. When inflammation is present it frequently shows on the tongue. When hormone balance is shifting it affects the entire system — energy, sleep, digestion, mood, and pain levels all change together.
The combination of TCM diagnostics and targeted Western lab work gives you the most complete picture of what’s happening in your body — and the clearest path to feeling well again.
DOWNLOAD A PRINTABLE PDF OF THIS LIST!
