10 Essential Blood Tests for Women Over 40

As women age, their health needs change. Regular blood tests after 40 can help detect issues early, manage risks, and improve overall well-being. Here’s a quick summary of the 10 essential blood tests every woman over 40 should consider:

1. Complete Blood Count (CBC): Checks for anemia, infections, and blood disorders.
2. Basic Metabolic Panel (BMP): Monitors kidney function, blood sugar, and electrolyte balance.
3. Cholesterol Test (Lipid Panel): Tracks heart health by measuring LDL, HDL, and triglycerides.
4. Thyroid Function Test: Identifies thyroid issues that affect metabolism and energy.
5. Blood Sugar Test: Screens for diabetes or prediabetes.
6. Vitamin D Test: Ensures healthy bones and immune function.
7. Hormone Level Test: Tracks changes during perimenopause and menopause.
8. Inflammation Test (CRP, ESR): Detects risks for heart disease or autoimmune conditions.
9. Iron Storage Test (Ferritin): Checks for iron deficiency or overload.
10. Vitamin B12 Test: Monitors nerve health and energy levels.

Why These Tests Matter:

• Heart Health: High cholesterol or inflammation increases cardiovascular risks.
• Diabetes Prevention: Elevated blood sugar often shows no symptoms early on.
• Bone Strength: Vitamin D and hormone levels directly impact bone density.
• Early Detection: Thyroid and iron imbalances can lead to fatigue, weight changes, or more serious issues.

Quick Overview Table:

Pro Tip: Schedule these tests during your annual check-up or as recommended by your doctor. Early detection leads to better outcomes and peace of mind.

How to interpret your bloodwork in perimenopause and menopause

1. Complete Blood Count (CBC)

A CBC test gives a quick overview of your health by analyzing red blood cells, white blood cells, and platelets. For women over 40, it can help identify early signs of issues like anemia or infections.

Here’s what a healthy CBC might look like:

Why is this test important for women over 40? It can uncover:

• Anemia: As menopause approaches, iron deficiency becomes more common. Hemoglobin levels below 12.1 g/dL could indicate anemia, which often causes fatigue or weakness ^[3].
• Infections: High white blood cell counts (over 10,000/mcL) might mean your body is fighting an infection. This is especially useful as immune function can weaken with age ^[4].
• Blood Disorders: Irregular platelet counts may suggest clotting problems or other blood-related issues ^[3].

"A CBC can help diagnose a broad range of conditions, from anemia and infection to cancer." ^[5]

Your doctor might suggest more frequent CBC tests if you’re dealing with unexplained fatigue, taking medications that affect blood counts, managing chronic illnesses like kidney disease, or undergoing treatments that impact blood cell production ^[6].

No special preparation is needed for this test, and it’s a simple way to gain valuable insights into your health. Ask your doctor if it’s time to include a CBC in your routine check-ups.

2. Basic Metabolic Panel

The Basic Metabolic Panel (BMP) is a key blood test for women over 40, checking eight important substances that help assess fluid balance, metabolism, and kidney function.

Here’s what the BMP measures:

This test can help spot early signs of health concerns. For example, glucose levels can indicate a risk of diabetes, while BUN and creatinine levels provide a snapshot of kidney health. Sodium, potassium, and chloride levels reveal potential electrolyte imbalances.

How to prepare for the test:

• Fast for 8 hours beforehand but stay hydrated with water.
• Let your doctor know about any medications or supplements you’re taking.
• Try to schedule the test in the morning for the most reliable results.

Keep in mind, about 1 in 20 healthy individuals might have results slightly outside the normal range ^[7]. Services like Discounted Labs let you order a BMP test online and visit one of over 2,200 lab locations across the U.S. Results are typically ready within 2–7 business days.

If your results are abnormal, it might not always indicate a serious issue. Temporary changes, medications, or even diet can affect outcomes. Always review your results with a healthcare provider to understand what they mean for you.

3. Cholesterol Test

A cholesterol test, often called a lipid panel, becomes increasingly important for women over 40, particularly as menopause approaches. This test measures key lipids in your blood that impact heart health.

Here’s a breakdown of what the test measures and the ideal levels:

After menopause, lower estrogen levels can alter cholesterol metabolism, significantly increasing cardiovascular risk. According to the American Heart Association's 2023 report, 36% of women have higher-than-recommended total cholesterol, often accompanied by rising LDL, lower HDL, and higher triglycerides ^[8][9]. Regular cholesterol testing is key to managing these risks.

How Often Should You Get Tested?

• Ages 40–54: Every 4–6 years (if results are normal)
• Ages 55–65: Every 1–2 years
• Over 65: Annually
• More frequent testing: If you have additional risk factors for heart disease

Preparing for the Test

To ensure accurate results, fast for 12 hours before the test - water is allowed. Continue taking prescribed medications unless your doctor advises otherwise.

The American Heart Association emphasizes:

"High cholesterol has no signs or symptoms, so the only way to know if you have it is to get your cholesterol checked by a doctor on a regular basis, especially after you go through menopause." ^[9]

Tips for Managing Cholesterol Naturally

• Add soluble fiber: Foods like legumes and whole grains can help.
• Incorporate omega-3s: Salmon, walnuts, and similar foods are great choices.
• Exercise regularly: Aim for 150 minutes of moderate aerobic activity weekly.
• Strength train: Include strength exercises twice a week.
• Limit saturated fats: Cut back on red meat and full-fat dairy products.

Taking these steps can help keep your cholesterol levels in check and support overall heart health.

4. Thyroid Function Test

A thyroid function test is especially important for women over 40, as thyroid issues tend to become more common with age. This blood test evaluates how effectively your thyroid gland manages metabolism and energy levels.

Here’s a breakdown of the main hormones included in a thyroid panel:

TSH is often the first hormone to show changes, even before other thyroid hormones become abnormal ^[11]. High TSH levels usually point to an underactive thyroid, while low levels suggest an overactive thyroid.

Why It Matters

Thyroid disorders are more common in women and often go undiagnosed:

• Around 25 million Americans have hypothyroidism, and nearly half are unaware of it ^[12].
• Women are 5–10 times more likely than men to experience thyroid issues ^[12].
• Roughly 5% of U.S. adults live with hypothyroidism ^[13].

Common Thyroid Patterns

Test results can reveal specific thyroid conditions:

How to Prepare

Avoid taking biotin supplements for at least three days before your test, and let your doctor know about any medications you’re using ^[11].

"Changes in TSH can serve as an 'early warning system' - often occurring before the actual level of thyroid hormones in the body becomes too high or too low."
– UCLA Health ^[11]

Signs You Might Need Testing

You may want to consider testing if you experience:

• Unexplained weight changes
• Persistent fatigue
• Sensitivity to temperature
• Irregular menstrual cycles
• Mood swings
• Sleep issues

The Cleveland Clinic highlights the importance of these tests:

"Thyroid tests tell your healthcare provider how well your thyroid gland works."
– Cleveland Clinic ^[10]

Since thyroid function directly impacts metabolism and heart rate, regular testing can help catch potential issues early.

5. Blood Sugar Test

Monitoring blood sugar levels is crucial for women over 40, as the likelihood of developing type 2 diabetes increases with age. Regular testing can identify potential problems before symptoms arise.

Understanding Blood Sugar Levels

A blood sugar test checks the amount of glucose in your blood. The results fall into specific ranges that help identify your health status:

These numbers provide a snapshot of your metabolic health and can guide you in deciding if further steps are necessary.

When Should You Get Tested?

The Centers for Disease Control and Prevention (CDC) highlights the importance of early detection:

"That's why people with any risk factors are urged to ask their doctor if they should be screened. Being screened means getting tested when you don't have any symptoms." ^[14]

Screening is recommended starting at age 35 and should be repeated every three years. However, you may need more frequent testing if you have:

• A family history of diabetes
• High blood pressure
• A history of gestational diabetes
• Polycystic ovary syndrome
• Excess weight
• A sedentary lifestyle

Types of Blood Sugar Tests

Your doctor might suggest one or more of these tests:

• Fasting Blood Sugar: Requires fasting for at least 8 hours.
• Random Blood Sugar: Can be taken at any time of the day.
• A1C Test: Provides an average blood sugar level over the past 2–3 months.

These tests offer a comprehensive view of your blood sugar levels and help identify any need for further evaluation.

Warning Signs to Watch For

MedlinePlus points out:

"High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions." ^[2]

Managing Your Risk

If your results show prediabetes (fasting glucose between 100-125 mg/dL), there are steps you can take to lower your risk of developing type 2 diabetes:

• Stay physically active
• Follow a balanced diet
• Maintain a healthy weight
• Monitor your blood sugar regularly
• Work closely with your healthcare provider

Routine blood sugar testing is a powerful tool for understanding your metabolic health and taking control of your well-being.

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6. Vitamin D Level

Once you hit 40, keeping tabs on your vitamin D level becomes important for maintaining strong bones, a healthy immune system, and overall health. A simple blood test can measure your 25-hydroxyvitamin D levels, giving a clear picture of where you stand.

Vitamin D Ranges

Medical organizations have different recommendations for what your vitamin D levels should be:

Risk Factors for Low Vitamin D

"For perimenopausal women or other groups of people with higher fracture risk, certainly a level of 20 or above is ideal." ^[15]

Certain factors can increase your chances of having low vitamin D. These include limited exposure to sunlight, having darker skin (which needs more sun to produce vitamin D), obesity, and not eating enough foods rich in vitamin D. Knowing these risks can help you address potential deficiencies early.

Next Steps for Low Levels

If your test shows low vitamin D levels, your doctor might suggest ways to improve them. According to Dr. Donald Hensrud, taking 1,000–2,000 IU of vitamin D daily is often enough to bring levels up to a healthy range ^[17].

Natural Ways to Boost Vitamin D

Studies suggest that for white individuals living in the UK, about nine minutes of midday sun exposure on the arms and legs can provide enough vitamin D ^[16]. Here are some simple ways to increase your levels:

• Diet: Add foods like fatty fish, egg yolks, fortified milk, and liver to your meals.
• Sunlight: Safely expose your arms, legs, or back to sunlight for short periods.
• Supplements: Talk to your doctor about taking vitamin D₃ supplements if needed.

Warning Signs of Deficiency

Low vitamin D levels can cause symptoms like bone and muscle pain, fatigue, and even depression. Regular testing can help you catch and address deficiencies before they lead to more serious problems.

7. Hormone Level Test

For women over 40, especially during perimenopause and menopause, testing hormone levels can provide crucial health insights. One of the main hormones checked is Follicle Stimulating Hormone (FSH), which plays a key role in understanding ovarian function. Knowing your hormone levels can help you make informed decisions about your health.

Understanding FSH Levels

FSH levels naturally change throughout different life stages. Here's a quick breakdown:

These benchmarks provide a useful reference for assessing hormone levels at various points in life.

When to Get Tested

Timely hormone testing can help detect and manage health changes early. Dr. Shamita Misra, a Family Medicine Doctor at MU Health Care, notes:

"Between ages 40 to 45, we can assume your symptoms signify perimenopause and that your estrogen is low, as long as other causes have been excluded. In most cases, we can manage symptoms without further hormone testing. Before age 40, there's more need for estrogen testing. Your ovaries could be going through a change early or losing their function, and estrogen testing can guide our treatment." ^[20]

Testing Guidelines

For accurate results, FSH testing should be done on day 2 or 3 of your menstrual cycle ^[18]. An FSH level above 30 IU/L often signals perimenopause, while levels in postmenopausal women usually range between 70–90 IU/L ^[19].

Symptoms That May Indicate Testing Is Needed

If you're experiencing any of the following, it may be time to consider hormone testing:

• Irregular menstrual cycles
• Hot flashes or night sweats
• Unexplained weight changes
• Mood swings
• Decreased libido
• Persistent fatigue

Testing Process

Hormone tests are accessible at more than 2,200 lab locations across the U.S. Results are typically available within 2–7 business days. While you can order these tests without visiting a doctor, it's a good idea to review the results with your healthcare provider for personalized advice.

Clinical Insights

A regular menstrual cycle often reflects balanced hormone levels. By monitoring these levels, you can track changes over time and take action if needed. Regular testing ensures you stay on top of potential shifts in your health.

8. Inflammation Test

Inflammation tests are an important tool for monitoring health, especially for women over 40. These tests help identify markers linked to heart disease and autoimmune conditions, offering insights into potential health risks.

Key Markers Measured

Inflammation tests focus on three main markers:

These markers provide a clearer picture of how inflammation impacts heart health.

Cardiovascular Connection

Dr. Paul M. Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital, explains:

"We can't treat what we don't measure, and we hope these findings move the field closer to identifying even earlier ways to detect and prevent heart disease." ^[21]

Research shows that elevated CRP levels can increase heart disease risk by 70% ^[21].

When to Get Tested

Your doctor may suggest inflammation testing if you experience:

• Unexplained joint pain or swelling
• Persistent fatigue
• Frequent fever
• Unexpected weight changes
• A family history of autoimmune disorders

Managing Inflammation Naturally

Dr. Robert H. Shmerling from Harvard Health Publishing emphasizes:

"A better approach is to adopt healthy habits and get routine medical care that can identify and treat the conditions that contribute to harmful inflammation." ^[22]

Simple lifestyle changes can help reduce inflammation:

• Follow a Mediterranean diet
• Exercise for at least 150 minutes each week
• Maintain a healthy weight
• Get 7–9 hours of sleep daily
• Include omega-3-rich foods like salmon
• Practice stress management techniques like meditation or yoga

Medical Implications

Dr. Ahmed A.K. Hasan from the National Heart, Lung, and Blood Institute highlights:

"In recent years, we've learned more about how increased levels of inflammation can interact with lipids to compound cardiovascular disease risks. This helps explain why lower levels are often better." ^[21]

Testing for inflammation plays an important role in identifying risks and guiding both treatment options and lifestyle changes, especially when cardiovascular health is a concern.

9. Iron Storage Test

Iron storage testing becomes especially important for women over 40, particularly during and after menopause. This test measures ferritin levels, which show how much iron your body has stored for future use.

How Iron Levels Change After 40

Menopause can cause a noticeable shift in iron levels. Research highlights that serum ferritin levels often increase two- to threefold after menopause^[23]. Before menopause, menstruation helps regulate iron by depleting it each month. Once menstruation stops, iron starts to build up in the body.

Typical Iron Levels by Age

Why This Matters for Your Health

"Serum ferritin is the most sensitive test for iron deficiency as ferritin represents the 'stores' or reserve supply of iron in the body."^[24]

Iron imbalances can have serious effects. Iron deficiency affects 20% of nonpregnant women in developed countries and over 40% in developing regions^[23]. On the other hand, iron overload affects more than 1 million Americans^[25], potentially leading to organ damage.

Signs You Should Get Tested

Talk to your doctor about testing if you notice symptoms like unexplained fatigue, dizziness, weakness, joint pain, changes in skin color, or abdominal discomfort.

How to Manage Iron Levels

• For Low Iron:

  • Eat more iron-rich foods (like spinach and red meat) paired with vitamin C to improve absorption.
  • Consider iron supplements, but only under medical guidance.
  • Address underlying issues, such as heavy menstrual bleeding^[26].

• For High Iron:

  • Cut back on iron-rich foods.
  • Avoid pairing meals with vitamin C, which can increase iron absorption.
  • If recommended by your doctor, therapeutic phlebotomy (removing blood) may help^[26].

Long-term Health Monitoring

By age 60, post-menopausal women typically store around 12 mg of iron per kilogram of body weight, compared to just 4.8 mg/kg at age 45^[23]. This rise in iron levels can affect your risk of heart disease, cancer, diabetes, and neurodegenerative conditions^[23]. Regular testing can help you stay ahead of potential complications caused by either too little or too much iron.

Next, we’ll look at why testing for B12 is essential for maintaining overall health.

10. B12 Blood Test

Testing for vitamin B12 is particularly important for women over 40, as deficiencies become more common with age. Studies reveal that 4% of individuals aged 40–59 are deficient in B12. This figure increases to 5% for those aged 65–74 and jumps to 10% for individuals over 75 ^[27][28].

Understanding B12 Levels

Here’s a quick guide to interpreting B12 levels:

Symptoms to Look Out For

B12 deficiency often develops without obvious signs at first. However, symptoms can include:

• Physical issues like severe fatigue, unexplained weakness, and pale or yellowish skin
• Neurological symptoms such as numbness, tingling in extremities, or balance problems
• Cognitive challenges, including memory loss, confusion, or trouble focusing ^[27]

"Vitamin B12 is a nutrient that plays a vital role in some of the body's most important functions. These include the development and performance of the central nervous system, the formation of healthy red blood cells and the synthesis of DNA."

• Ask the Doctors ^[30]

Potential Long-term Effects

If left untreated, a B12 deficiency can lead to nerve damage, reduced physical ability, and complications with conditions like Alzheimer's, multiple sclerosis, heart disease, and autoimmune disorders ^[29][31].

When to Get Tested

Routine B12 testing is recommended for women over 40, especially if you have risk factors or notice symptoms. If your results fall under 407 pg/mL, your doctor may order additional tests, such as a methylmalonic acid test, to confirm the deficiency ^[32]. Staying proactive helps ensure better long-term health.

Keeping Your B12 Levels in Check

Women over 40 should aim for 2.4 micrograms of vitamin B12 daily ^[31]. To maintain healthy levels:

• Diet: Add B12-rich foods like meat, fish, eggs, or fortified cereals to your meals.
• Supplements: Consider taking B12 supplements, especially as your absorption may decrease with age.
• Monitoring: Regular blood tests can help track and manage your levels effectively.

It’s estimated that up to 60% of people have insufficient B12 levels (below 407 pg/mL) ^[33]. Early detection and treatment are key, as severe deficiencies can cause permanent nerve damage ^[28].

Conclusion

Blood testing plays a crucial role in women’s health after 40. Heart disease, for example, is responsible for about 22% of deaths in women - more than all cancers combined ^[35]. This highlights the importance of a personalized approach to testing based on individual risk factors.

Creating Your Testing Schedule

The types and frequency of blood tests depend on several factors:

Dr. Mia Finkelston explains:

"As you get older, there is an increased incidence in many diseases, including heart disease, cancer, and arthritis. Starting to see your doctor a little more regularly can help prevent, predict, and treat diseases before they become significant problems" ^[35].

Taking Action

Having a clear testing schedule helps you act quickly on your health results. For example, it’s estimated that 13% of women aged 35–65 live with undiagnosed hypothyroidism ^[35]. Understanding your results is key to addressing issues early.

Dr. Anna Cabeca adds:

"Equally important, it gives my patients peace of mind knowing they can reduce their risk for specific health issues like diabetes or cancer when we use these tests" ^[34].

Essential Screening Timeline

Medical guidelines suggest the following screenings:

• Annual physical exam ^[35]
• Cholesterol screening starting at age 45 (or earlier if risk factors exist) ^[2]
• Diabetes screening beginning at age 35, repeated every 3 years if overweight ^[2]
• Bone density test starting at age 65 ^[1]

These blood tests work together to provide a clear picture of your health, enabling early detection when treatment is most effective. Regular monitoring and consultations with your doctor are key to staying healthy as you age.

For added convenience, consider using FDA-approved testing through local labs. Many facilities now offer online ordering and quick results, making it easier than ever to keep track of your health.