If I had a dollar for every time one of my clients came to me saying, “My doctor says my bloodwork is fine, but I still feel awful,” I’d be rich. Fatigue, brain fog, weight struggles, poor sleep, and feeling “off” shouldn’t be the norm—these are signs that something deeper is going on. The problem? Most primary care physicians run a basic panel that doesn’t always tell the whole story.

Once a year, I encourage my clients to take a deep dive into their health with comprehensive testing. Time and time again, we find key imbalances—often related to hormones, thyroid function, inflammation, or blood sugar—that have been overlooked. Here are eleven tests I always run that most doctors don’t. For the full list of biomarkers I offer in my bloodwork bundles, scroll all the way to the bottom.

Hormones

1. DHEA

Dehydroepiandrosterone, or DHEA, is the precursor to estrogen and testosterone. It’s produced by the adrenal glands and plays a major role in energy, mood, and immune function. Low DHEA can be a sign of adrenal fatigue, chronic stress, or even autoimmune issues. Studies show that low DHEA levels are related to increased inflammation, higher cortisol, and reduced resilience to stress. Supplementing when deficient has been associated with improved energy and mood.

2. Pregnenolone

Pregnenolone is a key precursor hormone that plays a critical role in women’s health. It helps produce progesterone, estrogen, and testosterone—all essential for hormonal balance. Low pregnenolone can contribute to irregular menstrual cycles, perimenopausal symptoms, mood swings, and brain fog. As women age, pregnenolone levels naturally decline, which can lead to memory issues and fatigue. Meanwhile, research links pregnenolone to improved cognitive function, mood stability, and hormonal regulation. Ensuring optimal levels can be particularly beneficial for women going through perimenopause and menopause.

3. Fasting Glucose and Fasting Insulin

Testing fasting glucose and fasting insulin is crucial because they provide a clear picture of how your body is handling blood sugar and insulin sensitivity—long before issues like diabetes arise. Many doctors don’t routinely check fasting insulin, yet high levels can signal insulin resistance, a root cause of fatigue, stubborn weight gain, cravings, brain fog, hormonal imbalances, and even inflammation. Catching imbalances early allows you to make dietary and lifestyle changes before they turn into bigger health issues.

Thyroid Function

4. Free T3

Free T3 is the active thyroid hormone that drives metabolism, energy, and brain function. It’s what your body actually uses at the cellular level to energize you. Even if your TSH looks “normal,” low free T3 can be the missing piece behind sluggish metabolism, weight gain, fatigue, brain fog, hair thinning, and even depression. When free T3 is low, the body struggles to efficiently convert T4 (the storage form of thyroid hormone) into active T3. This can happen due to chronic stress, inflammation, nutrient deficiencies like selenium and zinc, or underlying gut issues. Many clients with low free T3 experience classic hypothyroid symptoms but are told their thyroid is fine because only TSH was checked.

5. Reverse T3 (rT3)

If your body is under stress from illness, trauma, chronic dieting, or inflammation, it can convert T4 into rT3 instead of active T3, slowing metabolism and leading to symptoms of hypothyroidism. High rT3 levels can indicate that your body is prioritizing conservation over energy expenditure, which is why looking at this marker alongside Free T3 is crucial. A high rT3:low Free T3 pattern is common in chronic illness, post-infection recovery, and even in individuals with undiagnosed adrenal dysfunction or nutrient deficiencies.

6. Anti-TPO & Anti-TG

Even if your thyroid hormones appear normal, autoimmune thyroid diseases can silently damage your thyroid. These two antibodies help detect early thyroid autoimmunity. Anti-TPO is the most common marker for Hashimoto’s thyroiditis, while anti-TG is often elevated in both Hashimoto’s and Graves’ disease. Elevated antibodies can indicate your immune system is attacking the thyroid, leading to chronic inflammation, thyroid tissue damage, and eventual hormone disruption. Testing for thyroid antibodies is essential for anyone with unexplained fatigue, weight gain, anxiety, depression, or a family history of thyroid conditions.

Inflammatory Markers

7. Homocysteine

Homocysteine is an amino acid linked to inflammation, cardiovascular disease, and neurological health. High levels can indicate poor methylation, affecting detox, brain health, energy production, or B-vitamin deficiencies. Elevated homocysteine is also associated with a higher risk of stroke, Alzheimer’s disease, and osteoporosis. Long-term high homocysteine levels can also contribute to endothelial damage, speeding up the aging process and increasing the risk of blood clots.

8. High-sensitivity CRP (hs-CRP)

Hs-CRP is a key marker of chronic inflammation, which plays a role in developing diseases like cardiovascular conditions, autoimmune disorders, and diabetes. Unlike traditional CRP tests, hs-CRP detects low levels of persistent inflammation that can damage the body over time. Elevated hs-CRP levels are associated with an increased risk of heart disease, as inflammation contributes to plaque buildup and arterial damage. It also serves as a useful biomarker for tracking autoimmune conditions and metabolic dysfunction. Since factors like poor diet, stress, and inactivity can raise hs-CRP, regular testing can help detect hidden inflammation and guide early interventions to reduce disease risk and improve overall health.

9. Erythrocyte Sedimentation Rate (ESR)

ESR measures how quickly red blood cells settle in a blood sample and serves as a general marker of inflammation. It helps detect chronic inflammatory conditions, infections, and some cancers. Elevated ESR is often seen in autoimmune diseases like rheumatoid arthritis, lupus, and vasculitis, as well as in infections and certain cancers such as lymphoma and multiple myeloma. While not specific to any condition, ESR is useful when combined with other tests to monitor inflammation and treatment progress.

10. Heavy Metals

Most people don’t realize that exposure to heavy metals, like mercury, lead, and cadmium, can affect energy, brain function, and detox pathways. I run this test on clients who struggle with unexplained fatigue, neurological symptoms, or hormone imbalances. Studies have linked chronic heavy metal exposure to neurodegenerative diseases, hormone disruption, and mitochondrial dysfunction.

Metabolism

11. CBC Differential 

A basic CBC (Complete Blood Count) is common, but I dig deeper into the differential—looking at lymphocytes, monocytes, eosinophils, and neutrophils. These numbers help determine whether someone has an underlying viral or bacterial infection or if their immune system is struggling. Patterns in WBC differentials can indicate chronic infections, immune suppression, and even early signs of autoimmunity.

***

If you’ve been told your lab work is “normal” but still don’t feel 100%, it’s time to dig deeper into the root cause. I’ve helped so many clients uncover hidden imbalances by looking beyond standard tests, and the difference it makes is often mind-blowing. The goal isn’t just to be in range—it’s to feel your absolute best. That’s exactly why I put together my Bloodwork + Session Bundle, which includes key biomarker testing and a personalized plan to get your health where it should be. And if you’re ready for an even deeper dive, my Premium Micronutrient Bloodwork + Session Bundle gives you a full picture of your vitamin and nutrient levels so you can fine-tune your supplement routine and overall lifestyle to what your unique body actually needs. You can find more information about both options and book a session with me here. 

I’m also so excited to share that I go even deeper into this topic in my upcoming book, where I dedicate an entire chapter to these lab tests and why they can be life-changing. Stay tuned—there’s so much more to come.

Here is the full list of biomarkers you can run with me. If you have any questions, feel free to email info@elissagoodman.com.

C-Reactive Protein, High Sensitivity (CRP, HS)

CBC w/ Diff

Calcium

Comprehensive Metabolic Panel

Cortisol

DHEA-Sulfate

Estradiol (E2)

ESR – Sedimentation Rate

Ferritin

Heavy Metals Screening, Whole Blood (Arsenic, Lead, Mercury)

Hemoglobin A1c

Homocysteine

Insulin, Fasting

Iron + Total Iron Binding Capacity

Lipid Panel

LP[a]

Apo[e]

Apo[B]

Magnesium

Pregnenolone

Progesterone

Testosterone, Free & Total w/ SHBG

Thyroid Panel Comprehensive

Vitamin B12

Vitamin D, 25-OH, Total

Zinc

Micronutrient Test (alpha-lipoic acid, asparagine, biotin, calcium, carnitine, choline, chromium, CoQ10, copper, cysteine, folate, fructose sensitivity, glucose-insulin metabolism, glutamine, glutathione, inositol, magnesium, manganese, oleic acid, pantothenic acid, selenium, serine, total antioxidant function, total immune function, vitamin A, vitamin B1, vitamin B12, vitamin B2, vitamin B3, vitamin B6, vitamin C, vitamin D3, vitamin #, vitamin K2, zinc) 

MTHFR Gene Mutation