Unveiling the Hidden Health Markers: A Guide for Women Over 40
As women navigate the perimenopause and midlife transition, it's easy to dismiss the myriad of symptoms as simply 'aging' or 'hormones'. But what if there were more to it than that? What if there were specific health markers that could provide valuable insights into what's really going on inside our bodies? In this article, I'll delve into the five blood tests that every woman over 40 should consider discussing with her GP, and why they matter.
The Iron Connection: Ferritin, Iron, and Hemoglobin
One of the most common complaints during perimenopause is fatigue. But did you know that low iron stores could be the culprit? Heavy periods or frequent periods can deplete iron levels, leading to a host of symptoms such as dizziness, poor concentration, breathlessness, hair shedding, and anxiety. Ferritin, a key indicator of stored iron, is often overlooked. While you might fall within 'normal' ranges, feeling symptomatic could indicate low iron stores. Personally, I think it's crucial to aim for ferritin levels that are comfortably within range, rather than scraping along the bottom end of 'normal'.
Foods rich in iron, such as red meat, lentils, tofu, beans, dark leafy greens, and fortified cereals, can help boost iron levels. However, pairing plant sources with vitamin C-rich foods and avoiding tea or coffee with meals can improve absorption. In some cases, supplementation or IV infusions may be necessary. What's fascinating is how often low iron is misdiagnosed as menopause-related fatigue. Many women assume they're exhausted because of menopause, when in fact, it's low iron that's to blame.
Blood Sugar Control: HbA1c
Another critical marker is blood sugar control, assessed through the HbA1c test. This test provides an overview of average blood sugar levels over the previous three months, helping identify insulin resistance, pre-diabetes, or type 2 diabetes risk. Hormonal shifts, muscle mass loss, poor sleep, and increased abdominal fat during menopause can all affect blood sugar regulation, leading to energy crashes, cravings, and constant snacking. Women often blame themselves for lacking willpower, but unstable blood sugar can have a significant impact on appetite, energy, and food choices.
Instead of relying on fad Continuous Glucose Monitors (CGMs), I recommend the HbA1c test for a more meaningful picture of blood sugar trends over time. Building meals around protein, fiber-rich plants, and healthy fats can help support steadier glucose levels throughout the day.
Heart Health: Cholesterol
Cholesterol levels often rise after menopause due to changes in estrogen, even in women who eat well and exercise regularly. While cholesterol itself isn't something you can feel, elevated LDL cholesterol is a significant risk factor for cardiovascular disease. As a menopause expert, I believe the conversation around menopause needs to include heart health more than it currently does. Women are often shocked when cholesterol rises seemingly out of nowhere in their forties and fifties.
Increasing viscous soluble fiber intake from foods like oats, beans, lentils, chia seeds, flaxseeds, and barley can help support healthy cholesterol levels, alongside exercise and overall diet quality. What's often misunderstood is that cholesterol management is not just about diet and exercise; it's also about understanding the underlying hormonal changes that contribute to rising cholesterol levels.
Thyroid Function: TSH and T4
Thyroid issues become increasingly common in women as we age, yet symptoms are often mistaken for menopause. An underactive thyroid can cause fatigue, weight gain, constipation, low mood, dry skin, brain fog, and hair thinning, all of which overlap heavily with perimenopausal symptoms. Women are sometimes told they simply need to accept feeling tired and sluggish, when there may actually be an underlying thyroid issue contributing.
If you're experiencing symptoms that feel 'off', I advocate for requesting a test of thyroid function. Nutrition won't cure thyroid conditions, but eating enough protein, iodine, selenium, and iron can help support normal thyroid function alongside any medical treatment prescribed. What's particularly interesting is how thyroid issues can be easily overlooked, especially when symptoms overlap with menopause.
Vitamin D Deficiency: A Hidden Risk
Vitamin D deficiency is known to be incredibly common in the UK, particularly during autumn and winter, and even low levels (under 50 nmol/L) can contribute to fatigue, low mood, muscle aches, and poorer bone health. This becomes even more relevant during and after menopause, when declining estrogen levels can increase the risk of bone loss and osteoporosis. Vitamin D plays a key role in immune health, muscle function, and bone health, all of which become increasingly important as we age.
The problem is that it's pretty much impossible to get enough vitamin D from foods, so people in the UK are advised to consider a supplement during the winter months. The recommended dose is 10mcg (or 400IU), but you may need more. Knowing your vitamin D levels is crucial, as it's one of the nutrients I'm asked about most in my clinics.
Beyond Blood Tests: Blood Pressure
While blood pressure might not involve a needle, it's one of the most important health checks for women over 40. High blood pressure often has no obvious symptoms, which is why it's sometimes referred to as a silent risk factor. Hormonal changes, stress, poor sleep, weight gain, and genetics can all contribute. But the good news is that lifestyle changes can make a meaningful difference.
Regular movement, reducing excess alcohol, improving sleep quality, and eating a diet rich in fiber, potassium, and minimally processed foods can all help support healthy blood pressure. Ultimately, midlife shouldn't be about ignoring symptoms or putting everything down to hormones. Understanding what's happening inside your body can be incredibly empowering and often allows you to make simple changes that help you feel significantly better.
In conclusion, these five blood tests can provide valuable insights into what's really going on inside our bodies. By discussing these markers with your GP and making informed decisions about your health, you can take control of your well-being and feel your best during this transformative time of life. What's fascinating is how these seemingly unrelated markers can all be connected through the complex interplay of hormones, nutrition, and lifestyle.
