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Most people think the bloodwork they get done at their annual physicals gives them a full picture of their health. These tests can provide you with a glimpse of your cholesterol, blood sugar level, and possibly your thyroid if your doctor tacked that on. But when it comes to truly seeing what’s going on inside your body, there are many more metrics to consider than what these standard panels cover. That’s why advanced labs are gaining popularity. They can reveal additional insights into hormone balance, inflammation, nutrient levels, and genetic risk factors, helping you make smart, proactive health choices.
From hormonal health to your blood iron levels, here are 10 tests to ask your doctor about.
Related: What your annual physical could be missing
1. MTHFR Gene Variant
What it is: This blood test checks for two common changes in a gene called MTHFR. This gene helps your body use folate, a type of B vitamin that supports things like energy, mood, and cell repair. Some people have variants in this gene that affect how efficiently folate is converted into its active form, which is essential for functions like DNA repair, detoxification, and making brain chemicals called neurotransmitters.
What it reveals: Certain MTHFR variants can lead to higher levels of homocysteine—an amino acid produced when the body breaks down protein. In some studies, having too much homocysteine has been linked to a higher risk of cardiovascular issues and clotting risks. Some people have variants in this gene that affect how efficiently folate is converted into its active form. Testing can show whether your body is processing folate properly and whether lifestyle or nutrient changes (like B vitamin supplementation) could be helpful.
Who it’s for: If you have a family history of heart disease, blood clots, or fertility issues, it may be worth asking your doctor whether MTHFR testing could offer helpful insights.
2. hs-CRP (High-Sensitivity C-Reactive Protein)
What it is: When we get a cut or burn, or are fighting off an infection, our bodies use inflammation as a first line of defense to help us heal and recover. But when inflammation becomes chronic, it can wreak havoc on the body and lead to a host of ailments, including cardiovascular disorders, autoimmune conditions, and even some forms of cancer. That’s why you’ve likely heard people say that “inflammation is the root of all disease.”
What it reveals: This test measures the level of C-reactive protein, a protein made by your liver that is released to the bloodstream in response to inflammation. Inflammation can be associated with:
- A higher risk of heart disease
- Autoimmune conditions like rheumatoid arthritis or lupus
- Metabolic disorders such as diabetes or insulin resistance
- Chronic fatigue or joint pain that doesn’t have a clear cause
- Certain bacterial or fungal infections
Unlike standard CRP tests, the “high-sensitivity” version can detect low levels of inflammation, which may help identify early risk for conditions like cardiovascular problems.
Who it’s for: This test can be helpful for people with family history of heart disease or autoimmune conditions and individuals experiencing unexplained fatigue, joint pain, or other inflammatory symptoms, and anyone interested in helping detect cardiovascular risk.
3. Homocysteine
What it is: Homocysteine is a chemical in the blood that usually exists in low levels. That’s because vitamins B6, B9 and B12 help break down homocysteine by changing it into other substances that your body needs.
What it reveals: This test measures the amount of homocysteine in your body. High levels can mean that this physiologic process isn’t working properly or that you are deficient in certain B vitamins. If homocysteine isn’t properly broken down, it can build up in your arteries, leading to an increased risk of blood clots, heart attack, stroke, blood vessel disorders, and heart disease. Testing for this could also get to the bottom of some unexplained symptoms like fatigue or cognitive changes.
Who it’s for: A homocysteine test can benefit people with family history of heart disease or stroke, individuals with unexplained fatigue or cognitive concerns, and anyone wanting to assess cardiovascular risk beyond standard cholesterol testing.
Related: What your bloodwork says about your health
4. Lipoprotein(a) [Lp(a)]
What it is: Lipoprotein (a) is a fatty particle that circulates in the bloodstream. It’s similar to LDL cholesterol but more dangerous. Lipoprotein (a) can cause plaque to slow down your blood’s ability to flow through your arteries. Having high levels can raise your risk of heart attack and stroke. Many people with higher levels of Lipoprotein (a) don’t have any symptoms. And you can have an elevated level while still maintaining a healthy lifestyle with other risk factors for heart disease control.
What it reveals: This test, which checks your lipoprotein (a) level, is not commonly included in a routine blood panel, as unlike some types of cholesterol, exercise and diet don’t have much of an effect on your Lipoprotein (a) levels. It’s mainly genetic and the amount you have as a child is usually the same level you have into adulthood. There haven’t traditionally been effective treatments to help lower Lipoportin (a) but modern advances, however, have some promising therapies to help lower it are on the horizon. Thus, the National Lipid Association now recommends at least a one-time test for Lipoprotein (a).
Who it’s for: People with a family history of early heart disease, individuals with high cholesterol that’s not explained by lifestyle, and anyone wanting more precise cardiovascular risk information can benefit from this test.
5. ApoB (Apolipoprotein B)
What it is: An Apo B or Apolipoprotein B-100 test that can help you gain clarity on your risk of heart and blood vessel disease. It measures the amount of ApoB in your body, which is a protein that carries substances in your body that contribute to plaque build up in the arteries. Apo B carries bad lipids, like low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL). Thus, some healthcare providers consider ApoB to be a better way to predict hearts and blood vessel disease than a standard lipid profile alone.
What it reveals: People with an ApoB result higher than 130 mg/dL are at a higher risk of heart and blood vessel disease. Normal levels are typically around 66 to 133mg/dL for men and 60 to 117 mg/dL for females. If you test high, your doctor may prescribe medications or lifestyle modifications—like limiting saturating fats in your diet, exercising for 30 minutes a day, or obtaining a healthy weight—to help control it.
Who it’s for: ApoB can be a particularly helpful test for people with conditions like diabetes, fatty liver disease, or obesity, as their LDL may be smaller or denser. It’s also beneficial for anyone wanting a more accurate measure of atherogenic lipoproteins.
6. Ferritin & Iron Panel
What it is: Iron blood tests measure different substances in the body to give you a look at what your iron levels are. This is important, as iron is an important nutrient that the body uses to make a protein in red blood cells called hemoglobin, which carries oxygen from the lungs to the rest of your body. Iron is also important for muscle health, bone marrow, and organ function.
What it reveals: There are various types of iron tests, which include:
- Serum iron test: Measures the amount of iron in your blood.
- Transferrin test: Measures a protein that moves iron through the body called transferrin.
- Total iron-binding capacity (TIBC): Measures how well iron attaches to transferrin and other blood proteins
- Ferritin blood tests: This measures how much of a protein you have in your body, called ferritin. Low levels indicate that your iron reserves are low.
These tests can tell you if your iron and ferritin levels are within a healthy range, low, or high.
Signs of low iron can include:
- Lethargy, weakness or dizziness
- Heart palpitations
- A paler than usual complexion
- Shortness of breath
- Headache
- Hair loss
Signs of high iron can include:
- Fatigue or energy loss
- Pain in the joints
- Weight loss that is unexplained
- Stomach pain
- A reduced sex drive
Who it’s for: If you have any of the above symptoms, you may want to ask your doctor about getting your iron levels checked. People with heavy menstrual cycles, pregnant women, and those who follow a vegetarian or vegan diet may also be more at risk of having iron deficiency, making it a good idea to check in on your iron status periodically.
7. DHEA-S (Dehydroepiandrosterone Sulfate)
What it is: This blood test checks for the level of dehydroepiandrosterone sulfate (DHEAS) in your blood, a type of androgen (male sex hormone) that is found in both men and women. It’s made mainly in your adrenal glands and plays an important role in making testosterone and estrogen. Levels that aren’t within the normal range can indicate an issue with your adrenal glands or estrogen or testosterone levels.
What it reveals: In addition to checking your adrenal gland function, a DHEA-S test can diagnose tumors of the adrenal glands. DHEA-S plays an important role in puberty so testing levels can help bring clarity to the cause of early or late puberty in boys as well as look for the cause of development of masculine features in women or girls, like facial hair growth, a deepening voice, or excess body hair.
Who it’s for: People with suspected hormone imbalances, children with early or delayed puberty, and adults with reproductive concerns or adrenal disorders may want to consider getting this test.
8. Estradiol + Free & Total Testosterone (for men and women)
What it is: These blood tests measure levels of the sex hormones testosterone (both “total” — all the hormone in your blood — and “free” — the portion that’s unbound and active), as well as estradiol, the primary form of estrogen.
What it reveals: While we may think of testosterone as being important to men and estrogen to women, these hormones play an important role in everyone’s bodies. Yes, they are important when it comes to reproductive function, but they are also important for many functions, including metabolism, cardiovascular health, muscle development, mood, energy, and bone density.
Symptoms of these hormonal imbalances can include:
- Low sex drive, sexual dysfunction, or painful intercourse
- Infertility
- Lack of face or body hair or abnormal hair growth
- Thinning bones or anemia
- Loss of muscle mass
- Irregular or no menstrual periods
- Acne
- Moodiness, irritability, and difficulty concentrating
- Hot flashes and night sweats
- Fatigue and insomnia
- Weight gain in the belly area
- Vaginal dryness
Who it’s for: These tests can give you an idea of where your levels of these two hormones fall within a healthy range. They can be especially helpful to those who have the above symptoms or:
- Have a history of having abnormal levels in the past
- Are taking a medicine that may affect your hormone levels
- Are taking hormone therapy
If your levels come back in an abnormal range, a doctor may prescribe lifestyle modifications like stress reduction, modifying exercise intensity, as well as hormone replacement therapies.
9. Advanced Thyroid Panel
What it is: Your thyroid gland helps your body make thyroid hormones, which are then secreted into the blood and carried to every tissue within the body. These thyroid hormones serve many functions in the body, helping to regulate your metabolism, support bone health, and keep your brain, heart, and organs working their best.
Your thyroid makes a few different hormones. Triiodothyronine (T3) is one of the main ones, working alongside thyroxine (T4) to control how your body uses energy. Together, these hormones play a vital role in how you feel and function every day.
What it reveals: Most standard thyroid tests measure TSH (a hormone from the brain that signals the thyroid) and T4. But there are other ways to check in on your thyroid health. Free T4 Index, for instance, estimates the amount of thyroid hormone that is actually available for your body to use. And T3 Uptake is an indirect test of thyroid hormone–binding proteins, which can help to provide a more complete picture of how your thyroid hormones are being carried and used in your body.
This more detailed approach provides a fuller picture of your thyroid function, helping identify subtle imbalances that standard testing might miss.
An advanced thyroid test can help identify thyroid conditions, such as an overactive or underactive thyroid. It can help you to keep tabs on your thyroid levels if you are using thyroid replacement medication.
Symptoms of an overactive thyroid can include:
- Unexplained weight loss
- Feeling nervous or shaky
- More frequent bowel movements
- Rapid or irregular heartbeat
An underactive thyroid can result in:
- Weight gain
- Pale or dry skin
- Brittle nails and hair
- Depression
- Muscle or joint pain
- Irregular menstrual cycles
- Fatigue, weakness, or sensitivity to cold
- Constipation
Who it’s for: People with thyroid symptoms despite normal TSH or T4, individuals taking thyroid medication, and anyone with unexplained fatigue, weight changes, or metabolic concerns.
10. ApoE
What it is: The ApoE gene test is a genetic test that identifies which variant of the apolipoprotein E (APOE) genotype you have. This gene helps your body process fats and cholesterol and also plays a role in brain health. People with certain genotypes of ApoE may be at a higher risk of developing Alzheimer’s disease and may also influence cholesterol and cardiovascular risk. An increased risk or having certain variants of ApoE doesn’t mean you’ll definitely develop Alzheimer’s but it does mean you’re more likely to get it than others without those variants.
What it reveals: Knowing your ApoE status can help guide early preventive strategies. For example, your doctor may recommend lifestyle modifications, like diet, exercise, cognitive stimulation, and cardiovascular health management. These changes may help protect brain health and potentially delay the onset of Alzheimer’s. The test can also provide insight into how your body handles fats, helping guide heart-healthy choices. Early awareness allows for proactive monitoring and intervention long before symptoms appear, enabling you to prioritize a brain and heart healthy lifestyle on a daily basis.
Who it’s for: People with a family history of Alzheimer’s or other dementias, those looking to understand their genetic risk for brain and heart health, and anyone interested in taking early, proactive steps to support cognitive function and cardiovascular wellness can benefit from knowing their ApoE status.
Related: What happens when you combine whole body MRI and blood work?
Look deeper into your health
Advanced blood panels can tell you a lot about what’s happening inside your body beyond how you are feeling from day to day. But trying to pick and choose which blood tests to ask for can feel overwhelming. With Prenuvo, you’ll have the opportunity to work with our team to decide on the right labs for you and pair them with whole body imaging.
To learn more about how advanced bloodwork and whole body imaging can help provide you with a more comprehensive look at your health, book a call with a member of our care team.
