If you’re considering bioidentical hormone replacement therapy (BHRT), you might be wondering: Why are there so many lab tests before getting started?

At Flow Wellness, we believe in delivering safe, personalized, and effective care. Before beginning BHRT, we run a comprehensive set of blood tests to better understand your overall health and to ensure hormone therapy will work for you. Think of it like checking your dashboard before a long road trip—we want to make sure your systems are ready to go.

Here’s what we test, and why each lab matters:

🩺 Why These Labs Matter

These labs help us:

• ✅ Confirm your body is ready for BHRT
• ✅ Identify any underlying issues (like thyroid imbalances or low iron) that could affect your response
• ✅ Personalize your BHRT plan to fit your needs
• ✅ Protect your health by checking on organs like the heart, liver, and kidneys

Now, let’s take a closer look at what’s included in your baseline lab panel.

🔬 Core Lab Tests and Their Purpose

1. Complete Blood Count (CBC w/ Differential)

This test checks your red and white blood cells and platelets to screen for anemia, infection, or clotting issues. It helps ensure your blood is healthy before starting BHRT.

2. Comprehensive Metabolic Panel (CMP)

Looks at your liver, kidneys, blood sugar, and electrolytes—key players in how your body processes hormones safely.

3. C-Reactive Protein (CRP-hs)

Measures inflammation in the body. High inflammation can reduce BHRT effectiveness or signal other health concerns we should address first.

4. Lipid Panel

Evaluates cholesterol levels (HDL, LDL, triglycerides). Since BHRT can affect cholesterol, we use this to assess your cardiovascular risk.

5. Hemoglobin A1c (HgA1c)

Shows your average blood sugar over the past 2–3 months. Important to rule out prediabetes or insulin resistance, which can alter how your body responds to hormones.

6. Insulin

Assesses how well your body regulates blood sugar. Insulin resistance can impact your energy, weight, and how well BHRT works.

💡 Hormone-Specific Labs

7. Thyroid Panel (TSH, Free T3, Free T4)

Thyroid function plays a big role in energy, mood, and metabolism. Thyroid issues can mimic or mask hormone imbalances, so we always check this first.

8. Follicle-Stimulating Hormone (FSH)

Helps assess where you are in your hormone lifecycle (perimenopause, menopause, or low testosterone) to guide the right treatment strategy.

9. Luteinizing Hormone (LH)

Works alongside FSH to regulate sex hormones. Abnormal levels can signal low testosterone or estrogen, helping us fine-tune your therapy.

10. Estradiol (via LC/MS)

A precise measurement of estrogen. Knowing your baseline helps us determine if and how much estrogen you may need.

11. Progesterone (via LC/MS)

Important for hormone balance, menstrual cycles, and sleep. This lab helps us determine whether progesterone should be part of your BHRT.

12. Testosterone (Total, Free + SHBG)

Both men and women need testosterone for strength, mood, and libido. This test helps us assess your levels and adjust your treatment accordingly.

13. DHEA-S

Produced by your adrenal glands, DHEA supports energy and hormone production. Low levels may mean your adrenal system needs support during BHRT.

14. Cortisol (AM)

This “stress hormone” impacts everything from energy to inflammation. We test it in the morning to check your adrenal rhythm and guide a hormone strategy that works with your body—not against it.

🛡️ Nutritional and Safety Labs

15. Iron and Ferritin

Iron is essential for energy, red blood cell production, and overall vitality. We check both iron and ferritin (iron stores) to make sure you’re not at risk for fatigue or anemia.

16. Vitamin D

Plays a role in bone health, immune support, and even mood. Low vitamin D levels can contribute to symptoms often confused with hormone issues.

17. Vitamin B12

B12 is essential for energy, nerve function, and healthy blood cells. If levels are low, you may feel tired or foggy—symptoms we don’t want to mistakenly attribute to hormones.

💬 Final Thoughts

By taking the time to evaluate your full health picture, we can create a customized BHRT plan that’s safe, effective, and built just for you. These lab results help us avoid guesswork and give you the best possible chance of feeling balanced, energized, and well.

If you have any questions about your labs or your hormone replacement therapy plan, our team at Flow Wellness is always here to help. We’re committed to walking with you every step of the way on your wellness journey.

Want to get started with BHRT?
Schedule your free 15-minute informational call or book a consultation today with one of our experienced providers.