Perimenopause 101: Labs to thrive in your 30s

Let’s talk about something we don’t always hear enough about: perimenopause. While the transition into menopause might seem far off, perimenopause can actually begin as early as your mid-30s. This phase brings significant changes to your body—many of which can be confusing or even frustrating. You might notice things are a little off, for example you may feel more fatigue, irregular periods, or mood swings. If you’re like many women, these changes can feel overwhelming or even frustrating.

But here’s the good news: you don’t have to wait for things to get unmanageable. In fact, being proactive with your health can make all the difference. By understanding how your body is changing and taking steps to support it, you can thrive during this transition. And one of the most powerful tools at your disposal? Functional lab tests.

Here are 10 key labs that can help you understand what’s going on with your hormones, metabolism, and overall health as you approach perimenopause. Let’s explore how these tests can give you the insights you need to make informed decisions and create a personalized care plan that supports your well-being.

1. Assessing Sex Hormones (Estrogen, Progesterone, Testosterone)
   Hormonal balance plays a huge role in how you feel during perimenopause. Estrogen and progesterone levels begin to fluctuate, and testosterone, often thought of as a “male hormone,” also plays a crucial part in women’s health, especially when it comes to energy, mood, and libido. A comprehensive hormone panel will give you insight into your levels and help your dietitian determine if any adjustments are needed to keep you feeling your best. Hormone replacement therapy may be an option along with vitamin, minerals and gut healing protocols to target the root of hormone imbalances: a complex interplay of gut dysbiosis, stress, genetics and more. These labs cab be assessed through a DUTCH Hormone Panel.

2. Thyroid Panel: TSH, Free T3, Free T4, and Antibodies
   Your thyroid is responsible for regulating metabolism, energy, and even mood. If it’s underactive (hypothyroidism) or overactive (hyperthyroidism), it can exacerbate perimenopausal symptoms like fatigue, weight gain, and brain fog. A full thyroid panel, including TSH (Thyroid Stimulating Hormone), Free T3, Free T4, and thyroid antibodies, helps identify any imbalances, ensuring you get the right support to keep things in check. Did you know women who have used hormonal birth control for 10+ years have about 25% higher risk of developing hypothyroidism? (Gloe, Shawna and Carroll, Ty, 2024)

3. Vitamin D
   Vitamin D is a vital nutrient for immune function, mood regulation, and bone health. As estrogen levels decline in perimenopause, your bones can become more vulnerable. Vitamin D helps to ensure that your body can absorb calcium and keep your bones strong. If your levels are low, a boost in vitamin D could make a world of difference, both physically and mentally.

4. DHEA and Cortisol
   DHEA (dehydroepiandrosterone) is a hormone produced by your adrenal glands, and it’s often referred to as the “mother hormone” because it’s a precursor to both estrogen and testosterone. During perimenopause, the adrenal glands can become stressed, which might lead to imbalances in DHEA. Testing your levels can help gauge your body’s ability to manage stress and produce the hormones you need to stay balanced. These labs can be assessed through a DUTCH Hormone Panel.

5. Lipid Panel
   A lipid panel tests for cholesterol and triglyceride levels, which are important for heart health. Perimenopausal women can experience changes in their cholesterol, and elevated levels can increase the risk of cardiovascular disease. Regular monitoring can help detect any issues early and guide dietary or lifestyle changes to keep your heart healthy.

6. Blood Sugar Markers
   As you approach perimenopause, changes in insulin sensitivity are common, and many women experience fluctuations in blood sugar levels. Fasting glucose and HbA1c (which measures your average blood sugar over the past 3 months) help assess how well your body is handling sugar. Keeping blood sugar stable is crucial for overall health and energy levels, especially during times of hormonal fluctuation.

7. Liver Function
   Your liver plays a crucial role in detoxification, metabolizing hormones, and regulating blood sugar. As hormones shift, your liver may be under more strain. Liver function tests can ensure that your detox pathways are working effectively and that there’s no underlying dysfunction hindering your hormonal health.

8. Iron Panel
   If you experience heavy periods, you may be at risk for iron deficiency. An iron panel measures ferritin (the stored form of iron) and total iron levels, which are important for energy production. Low iron can contribute to fatigue, making it even harder to manage perimenopausal symptoms. Ensuring you have adequate iron levels can make a significant impact on how you feel. There can also be genetic defects in the iron recycling system leading to increased risk of iron overload.

9. Inflammation and Stress
   Markers such as MPO, hs-CRP cortisol and homocysteine can indicate underlying inflammation and stress, all of which can disrupt progesterone levels. Progesterone is essential for maintaining a healthy pregnancy, and when it's low, it can significantly affect fertility. These markers can help identify root causes that may be impacting your fertility hormones, providing valuable insights into potential imbalances that need to be addressed for optimal reproductive health.
   

Kelli offers comprehensive lab monitoring in her Flourish Membership (Tier 2). Once you have the results of these labs, she can help you interpret the findings and create a tailored care plan based on your unique body.

A well-balanced diet, stress management techniques, and targeted supplements will all be part of your plan. Here are some of the most common strategies she see’s need for:

1. Thyroid is sluggish, meaning may benefit from iodine, magnesium, sodium and selenium.

2. Inflammation levels are high, meaning reducing sugar intake and focusing on anti-inflammatory foods may help you feel your best. A gut healing protocol may also be beneficial.

3. DHEA and Cortisol are dysregulated, meaning potentially many things. Do you need to work on self care? Boundaries? Less people pleasing? Releasing trauma? Better quality sleep and recovery habits? We can try all the adrenal support (and we will!) but we also need to commit to the journey of inner healing and self discovery to calm our body’s stress load. More on that in my podcast (Unfiltered Nourishment) and on my socials.

You deserve to feel your best at every stage of life, and we’re here to help you get there!

References: Gloe, Shawna and Carroll, Ty. 2024. Hormonal Contraceptive Use is Associated with a Decreased Incidence of Hypothyroidism. DOI: 10.1016/j.eprac.2023.10.129