_edited.jpg)
The 12 Lab Tests You Should Run Each Year
- Drew Dreiling
- May 9
- 5 min read
Updated: Jun 11
One of the first steps in improving health and preventing disease is running the right tests.
But odds are your doctor isn’t running the right blood work for you.
I won’t get into WHY most doctors aren’t running the right tests today (or their common failure to analyze biomarkers properly).
Instead, let’s learn about 12 lab panels you should be running each year (these are the ones I run with my clients)…
#1. Testosterone (Total & Free) & Estradiol
The sex hormones testosterone & estrogen (estradiol being the main estrogen) play a major role in metabolism, your ability to build lean muscle & burn fat, your mood/motivation, libido, brain health, healthy menstrual cycle, skin health & bone density. For most adults, levels of both testosterone & estrogen start dropping in their 30s and decline rapidly after age 50. [1]
#2. Progesterone (for women) & PSA (for men)
Progesterone is a sex hormone crucial for healthy menstruation (and pregnancy). Even after menopause, progesterone plays an important role in sleep, mood and balancing the effects of estrogen. Prostate specific antigen (PSA) is a marker that, when elevated, can signal things like prostate cancer (the most common cancer in American men), BPH (non-cancerous prostate enlargement), and prostatitis. [2-3]
#3. FSH & LH
These 2 pituitary hormones play a major role in signaling your gonads (testes in men & ovaries in women) to do their hormone-producing magic. For men, low luteinizing hormone (LH) often leads to low testosterone. For women, follicle-stimulating hormone (FSH) tends to be the best marker for determining menopause in women under age 55 who’ve had a hysterectomy but still have at least 1 ovary. [4-5]
#4. TSH, Free T3, Free T4 & TPO
These 4 markers are all involved in thyroid health, which plays a major role in overall metabolism. TSH is a pituitary hormone that signals the thyroid to produce its main hormones- primarily T4 but also some T3. T4 is a prohormone and is only about 25% as strong as T3 (i.e. bioactive thyroid hormone). TPO is a thyroid antibody that’s often used to diagnose Hashimoto’s, the most common thyroid condition in the U.S. If TPO is negative (sufficiently low) for thyroiditis it generally doesn’t need to be run again, or at least not annually. [6]
#5. Ferritin (or an Iron Panel)
Ferritin is a protein that stores iron in the body. Of all the iron markers (there are several) it tends to be the best indicator of functional iron status- important because iron deficiency is one of the most common micronutrient deficiencies. That said, ferritin is also an acute phase reactant, meaning it’s often elevated in cases of inflammation and/or infection. An iron panel including serum iron, TIBC, transferrin saturation percentage and ferritin is even more helpful here. [7]
#6. Folate & B12
Along with iron, folate (aka vitamin B9) and vitamin B12 (aka cobalamin) are essential nutrients needed by the body for red blood cell production. If iron, folate or B12 are functionally low, energy levels often drop. B vitamins like folate & B12 also play major roles in nervous system health. [8]
#7. Vitamin D
Vitamin D is an essential nutrient that plays a major role in immunity, bone health, sleep and hormone optimization. Studies show anywhere from 40-80% of Americans are deficient in vitamin D. [9]
#8. Homocysteine
Homocysteine is an amino acid that’s a normal by-product of methionine metabolism (another protein-building amino acid). High levels of homocysteine are associated with increased risk of CVD, stroke and Alzheimer’s. Methylation is an essential process in the body where a methyl group is added to a molecule, and it’s essential for cellular detox, immunity & neurotransmitter production (think mood). Roughly 50% of Americans have at least 1 MTHFR gene mutation, which impairs their methylation ability, which often leads to elevated homocysteine levels. If homocysteine is elevated but folate & B12 levels are normal, I often suggest an MTHFR test. [10]
#9. Lipids (or an Advanced Lipid Panel)
Lipid markers include total cholesterol (TC), triglycerides (TG), LDL and HDL. One big problem here is the long-standing “lipid hypothesis”- the erroneous, often disproven but still popular idea that cardiovascular disease is PRIMARILY caused by high levels of things like cholesterol & LDL (“bad cholesterol”), which is primarily driven by genetic factors, dietary fat & cholesterol intake. Sadly, most providers are still operating from this broken & incomplete paradigm. If LDL is above optimal ranges (which is 100-150 mg/dL based on all-cause mortality data), then an Advanced Lipid Panel (sometimes called an LDL subfraction test) can be run to better determine risk, as markers like sdLDL and Lp(a), which show on the Advanced Lipid Panel, are more problematic (atherogenic) than other forms of LDL. [11-12]
Additionally, suppressing cholesterol to lower than optimal levels (<170) often has negative effects on adrenal & sex hormones, as cholesterol is needed to produce essential hormones like cortisol, testosterone, estradiol and progesterone.
#10. CBC
The Complete Blood Count or CBC includes red blood cell, white blood cell and platelet markers. Mainstream providers often miss more subtle signs of disease here because the reference ranges are quite different from the optimal, functional ranges. [13]
#11. CMP
The Comprehensive Metabolic Panel (CMP) includes glucose plus several kidney, liver and electrolyte markers. Many providers either miss or misinterpret results here. For example, normal liver enzymes may be shown despite significant liver fibrosis or cirrhosis (not to mention liver enzymes are not exclusive to liver issues). [14-15]
#12. A1c & Insulin
A1c is a 3-month blood sugar reading. Diabetes & pre-diabetes diagnoses are based off A1c readings. Insulin is a pancreatic hormone that allows cells to absorb glucose (i.e. blood sugar) to use for energy. All too often insulin isn’t run, despite roughly 70 million Americans having insulin resistance. [16-17]
You're often wasting your time and money (and sometimes putting your health at risk) if you’re not working with a qualified health pro who understands these tests, their biomarkers and how to analyze from a functional perspective using optimal ranges.
If you’re ready to feel & look your best while reducing risk factors & getting the tools to take control of your health once and for all, reach out today to schedule your complimentary discovery call.
(770) 744-1864
SOURCES
1 https://pmc.ncbi.nlm.nih.gov/articles/PMC3636678/ (2012 review on age related drops in sex hormones)
2 https://pubmed.ncbi.nlm.nih.gov/29962247/ (2018 review on progesterone/prometrium)
3 https://pubmed.ncbi.nlm.nih.gov/32491427/ (2024 StatPearl on PSA)
4 https://www.ncbi.nlm.nih.gov/books/NBK539692/ (2025 StatPearl on LH in men)
5 https://pmc.ncbi.nlm.nih.gov/articles/PMC6992500/ (2019 review of roles of FSH in menopause)
6 https://www.ncbi.nlm.nih.gov/books/NBK279414/ (2024 brief on understanding Thyroid tests)
7 https://pmc.ncbi.nlm.nih.gov/articles/PMC5986027/ (2018 review of iron deficiency without anemia)
8 https://pmc.ncbi.nlm.nih.gov/articles/PMC3142735/ (2011 review of B12 and folate testing)
9 https://pmc.ncbi.nlm.nih.gov/articles/PMC5682995/ (2017 review of vitamin D status in the population)
10 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.013311 (2015 homocysteine & MTHFR)
11 https://pubmed.ncbi.nlm.nih.gov/17284906/ (2007 sdLDL and Lp(a) correlated with severity of CAD)
12 https://pmc.ncbi.nlm.nih.gov/articles/PMC8174280/ (2021 sdLDL as most atherogenic lipid marker)
13 https://www.ncbi.nlm.nih.gov/books/NBK604207/ (2025 StatPearl on CBC)
14 https://medlineplus.gov/lab-tests/comprehensive-metabolic-panel-cmp/ (2023 article on CMP)
15 https://www.ncbi.nlm.nih.gov/books/NBK482489/ (2025 StatPearl on liver function tests)
16 https://www.ncbi.nlm.nih.gov/books/NBK549816/ (2025 StatPearl on A1c)
17 https://www.ncbi.nlm.nih.gov/books/NBK507839/ (2025 StatPearl on insulin resistance)
Comments