If you’ve ever been told “everything looks normal” but you still don’t feel like yourself, it can be hard to know what to test next—and what actually matters.

In functional and integrative medicine, the goal of testing isn’t to order “everything.” It’s to choose the right labs for your symptoms, your history, and your goals, then interpret them in context (including trends over time).

Why Testing Is Personalized

Two people can have the same symptom (fatigue, weight changes, brain fog, irregular cycles) for very different reasons. That’s why a thoughtful work-up usually includes:

• Your symptom timeline and patterns
• Your health history and family history
• Medications and supplements
• Sleep, stress load, and nutrition
• Prior labs and trends

Testing is often most helpful when it’s used to confirm patterns we already suspect—rather than chasing single numbers.

Hormone Testing

Depending on your symptoms and stage of life, hormone testing may include bloodwork such as:

• Estrogen, progesterone
• Testosterone (when appropriate)

It’s also important to know that hormones can fluctuate significantly, especially during perimenopause—so a single value may not tell the full story. In many cases, symptoms and patterns matter just as much as labs.

Some clinicians also use hormone metabolism testing to understand how your body processes and clears hormones (which can be relevant for symptoms, sensitivity, and personalized planning).

Thyroid Testing

Thyroid patterns can overlap with many “hormone” complaints—fatigue, brain fog, mood changes, weight shifts, and menstrual changes.

A more complete thyroid evaluation may include:

• TSH
• Free T4
• Free T3
• Reverse T3 (in select cases)
• Thyroid antibodies (to evaluate for autoimmune thyroid disease)

TSH is commonly used as a first-line screening tool, with other thyroid labs added based on the clinical picture. American Thyroid Association+1

Stress Physiology And Sleep Support Labs

When sleep is disrupted, energy is crashing, or anxiety feels “wired but tired,” it’s often helpful to evaluate stress physiology.

A common option is:

• Cortisol rhythm testing (to assess daily cortisol patterns that can influence energy, sleep, and resilience)

This is typically interpreted alongside real-life factors like sleep timing, caffeine/alcohol, overtraining, under-eating, and chronic stress load.

Metabolic And Cardiometabolic Labs

Metabolic health can shift quietly over time—often before standard screening flags a problem. Depending on your symptoms and history, labs may include:

• Fasting glucose
• Hemoglobin A1C (a longer-term blood sugar marker) Diabetes Journals+1
• Fasting insulin
• HOMA-IR (a calculated marker of insulin sensitivity using fasting glucose and insulin) NCBI

Many women are told their glucose is “normal,” yet still struggle with energy crashes, cravings, and stubborn weight. That’s one reason insulin-related patterns (not just glucose alone) can be helpful to evaluate early.

Iron, Nutrients, And Foundational Wellness Labs

If fatigue, hair changes, heavy periods, low mood, or poor recovery are part of the picture, foundational labs can make a big difference. These may include:

• Iron studies: ferritin, iron, TIBC
• Vitamin B12
• Vitamin D

These don’t replace a deeper evaluation—but they often reveal common, fixable contributors.

Inflammation And Lipids

Inflammation and lipid patterns can help assess cardiometabolic risk and guide prevention strategies, especially in midlife.

Common labs include:

• hs-CRP (a marker of inflammation that can add context to cardiovascular risk) professional.heart.org+1
• Standard lipid panel
• Advanced cardiometabolic markers (when appropriate), such as ApoB and Lp(a), plus particle size/insulin-resistance patterns

Lp(a) is often discussed as a genetically influenced risk marker that may be measured at least once in adulthood for risk stratification in some guidance. American College of Cardiology+1

Gut Health Testing

If you’re dealing with bloating, constipation/diarrhea, reflux, skin issues, frequent infections, unexplained inflammation, or food sensitivities, gut testing may be considered.

This can include:

• Gut microbiome analysis

It’s worth noting that microbiome testing is a fast-evolving area, and interpretation is complex. There’s growing emphasis on standardization and appropriate use (and avoiding overpromising what a microbiome test can “diagnose”). PubMed+1

Specialized Functional Medicine Testing

Depending on your symptoms, history, and goals, some clinicians may consider additional functional labs, such as:

• Organic Acids Test (OAT) to look at patterns related to mitochondrial metabolites, neurotransmitter metabolites, detoxification pathways, and nutrient metabolism (results require careful interpretation and clinical context) PMC
• Micronutrient mapping to identify deficiencies or imbalances that may impact energy, hormones, and metabolism

These are typically most useful when they’re chosen for a clear reason (not as a broad “wellness panel”).

How Peace And Calm Health Functional Medicine Can Help

I use a thoughtful blend of conventional and functional testing to understand how your body is functioning as a whole— not just whether a value falls inside a reference range.

Testing is always personalized to your symptoms, history, and goals, and may include:

• Hormone blood panels (estrogen, progesterone, testosterone when appropriate)
• Hormone metabolism testing (how your body processes and clears hormones)
• Full thyroid panel (TSH, Free T4, Free T3, Reverse T3, thyroid antibodies)
• Cortisol rhythm testing (to assess stress physiology and sleep patterns)
• Metabolic labs:
  • Fasting glucose
  • Fasting insulin
  • HOMA-IR
  • Hemoglobin A1C
• Iron studies: ferritin, iron, TIBC
• Key nutrients: vitamin B12, vitamin D
• Inflammation markers: HS-CRP
• Lipid panel + advanced cardiometabolic markers (ApoB, Lp(a), particle size, insulin resistance patterns)
• Organic Acids Test (OAT) for mitochondrial, neurotransmitter metabolites, detoxification pathways and nutrient metabolism
• Gut microbiome analysis
• Micronutrient mapping (to identify deficiencies or imbalances impacting energy, hormones, and metabolism)

All results are explained in clear, practical language and used to guide a personalized treatment plan — never a one-size-fits-all protocol.

To explore next steps, book a Clarity Call here:
https://www.drjenniferhorton.com/work-with-me

You can learn more about wellness programs here:
https://www.drjenniferhorton.com/wellness-programs

Science Section (Selected References)

• American Thyroid Association: Thyroid Function Tests (TSH, Free T4/T3, antibody context)
• American Diabetes Association: Diagnosis And Classification Of Diabetes (A1C, fasting glucose, OGTT criteria)
• NCBI Bookshelf: Assessing Insulin Sensitivity And Resistance In Humans (HOMA-IR concept and calculation)
• NIST: Evaluating The Analytical Performance Of Direct-To-Consumer Gut Microbiome Testing Services (provider variability)

Medically reviewed by Dr. Jennifer Horton, DO, ABFM, IFMCP

This content is for educational purposes and does not substitute personalized medical advice.