What blood tests should I ask my doctor for after 40?

On Ep. 375, Nikkiey explains why the list matters. Standard annual blood work usually checks thyroid, often only TSH, and that is about it for hormones. Estrogen, progesterone, testosterone, DHEA, cortisol and insulin are rarely tested unless you ask. So you get told everything is in the normal range and walk out knowing nothing more than when you walked in.

On ApoB, Nikkiey's point is that standard LDL measures the cholesterol inside LDL particles, while the number of particles is what better reflects cardiovascular risk. Two women can have the same LDL and very different risk profiles. On cortisol, she notes it is usually measured once, and that saliva tests across a whole day can show the pattern.

On Ep. 406 she adds why this matters for fat loss. Many women who believe they are in perimenopause have never had a comprehensive panel, so they are building a story without data. Test first, then look honestly at protein, strength training and sleep. Hormones can be real and the plan can still need work; both are true. If your doctor won't run these, Nikkiey says you can use direct-to-consumer labs, get a second opinion or change doctors. Interpreting the results and any treatment decisions belong with your doctor.