Our Biomarkers

Homocysteine is a substance in your blood that can damage your blood vessels and increase your risk of heart attack and stroke when levels are too high. Your body normally uses B vitamins (B12, B6, and folic acid) to quickly break down homocysteine and turn it into other useful substances. When you don't have enough of these vitamins, homocysteine builds up in your blood and can harm the lining of your arteries, making it easier for blood clots to form. This test is especially important for women because homocysteine levels naturally rise after menopause when estrogen levels drop, and high levels are just as dangerous for women as they are for men.

hs-CRP measures inflammation in your body and helps predict your risk of heart disease. Your liver makes this protein whenever there's inflammation anywhere in your body. For women specifically, this test is particularly valuable because hs-CRP has been shown to predict heart problems better than cholesterol levels. Women with high hs-CRP levels (above 3.0 mg/L) have nearly twice the risk of future heart problems. Interestingly, hs-CRP levels change throughout your menstrual cycle, with higher levels during your period, which is why timing of the test matters for women of reproductive age.

Lipoprotein(a) is a genetically determined cholesterol particle that increases heart disease and stroke risk. Unlike regular cholesterol, Lp(a) levels remain stable throughout life and are not significantly affected by lifestyle. For every 50 nmol/L increase in Lp(a), cardiovascular risk increases by about 11%. In women, elevated Lp(a) in mid-life is associated with a 10-20% increased risk of future heart disease.

ApoB counts the number of harmful cholesterol particles and predicts heart disease risk more accurately than LDL cholesterol. Elevated ApoB in women significantly increases heart attack and cardiovascular disease risk.

A lipid panel measures cholesterol and triglycerides to assess heart disease and stroke risk. It includes total cholesterol, LDL, HDL, and triglycerides. Heart disease is the leading cause of death in women, and screening should begin at age 20 or earlier with risk factors.

The sedimentation rate measures inflammation by how quickly red blood cells settle in a test tube. Faster settling indicates more inflammation. This test does not identify the cause or location of inflammation but is useful for monitoring inflammatory diseases. Normal values are slightly higher in women and increase with age.

The CMP is a group of 14 tests that check how well your major organs are working, including your kidneys, liver, and blood sugar levels. It measures things like glucose (blood sugar), electrolytes (minerals like sodium and potassium that keep your body balanced), proteins, and waste products that show how your kidneys and liver are functioning. This panel is important for women because it can detect problems like diabetes, kidney disease, liver issues, and electrolyte imbalances that might not cause obvious symptoms early on.

Hemoglobin A1c measures your average blood sugar over the past 2-3 months and is used to diagnose diabetes and prediabetes. Sugar in your blood sticks to hemoglobin, and the more sugar present, the more sticks. A level of 6.5% or higher indicates diabetes, while 5.7%-6.4% indicates prediabetes. The eAG translates the percentage into the same units your home glucose meter uses, making it easier to understand. This test doesn't require fasting and is more convenient than traditional glucose tests.

Fasting insulin measures insulin levels after overnight fasting and identifies insulin resistance. When insulin resistance is present, your pancreas produces extra insulin even if blood sugar is normal. This increases risk for type 2 diabetes, heart disease, and metabolic syndrome. Fasting insulin is a stronger predictor of cardiovascular disease in women than in men. High fasting insulin is common in women with PCOS and contributes to irregular periods and difficulty getting pregnant.

C-peptide shows how much insulin your pancreas produces and helps distinguish between different types of diabetes. Low levels indicate the need for insulin therapy, while higher levels suggest other treatments may work.

Uric acid is a waste product that, when elevated, can cause gout, kidney stones, and indicates metabolic problems. Your kidneys normally filter it out, but high levels cause crystals to form in joints or kidneys. For women, elevated uric acid is linked to PCOS, infertility, pre-eclampsia during pregnancy, and increased cardiovascular risk after menopause. Levels above 4.8 mg/dL are associated with worse metabolic health, including high blood pressure and cholesterol problems.

TSH measures how well your thyroid is working and is the best screening test for thyroid disorders. Thyroid disease is far more common in women and can cause menstrual problems, infertility, and miscarriage. Normal TSH is generally below 4.0-4.5 mIU/L.

Free T3 measures the active thyroid hormone in your blood, which controls your metabolism and energy levels. Thyroid problems are more common in women than men and can cause irregular or absent periods, fatigue, weight changes, and difficulty getting pregnant. Testing T3 along with other thyroid hormones helps identify thyroid disorders that might be causing these symptoms. This is especially important if you're having menstrual problems or struggling with fertility.

Free T4 measures active thyroid hormone and is more accurate than total T4. Low free T4 with high TSH confirms hypothyroidism, while high free T4 with low TSH indicates hyperthyroidism. This test is essential for monitoring thyroid medication.

TPO antibodies indicate autoimmune thyroid disease. Many healthy women have detectable antibodies, but they carry a risk of developing hypothyroidism. Positive antibodies increase pregnancy-related risks including miscarriage and postpartum thyroid issues.

Ultrasensitive estradiol measures very low levels of estradiol using highly accurate technology. Estradiol controls menstrual cycles, fertility, and bone health. Standard tests are not accurate at very low levels, making this test essential for evaluating postmenopausal women, menstrual disorders, fertility issues, and monitoring breast cancer treatment. Estradiol varies widely during the menstrual cycle and drops below 30 pg/mL after menopause.

FSH and LH are pituitary hormones that control your menstrual cycle, ovulation, and fertility. Testing helps diagnose infertility, irregular or absent periods, and confirms menopause. Patterns of results distinguish different causes of hormone imbalance. Women with PCOS often have higher LH than FSH, and FSH levels rise as menopause approaches.

Progesterone confirms ovulation and evaluates fertility. Levels above 3 ng/mL one week before a period confirm ovulation. LC/MS provides the most accurate measurement.

Total testosterone measures the amount of this hormone in your blood, which is important even though women have much lower levels than men. Elevated testosterone in women can indicate conditions like PCOS, which causes irregular periods, difficulty getting pregnant, excess hair growth, and acne. Mass spectrometry is the most accurate way to measure the low testosterone levels found in women, making it superior to standard testosterone tests. This test is particularly important if you're experiencing menstrual irregularities, infertility, or signs of excess male hormones.

Free testosterone measures biologically active testosterone and is more sensitive than total testosterone in women. It is particularly important for diagnosing PCOS. Free testosterone should be calculated using total testosterone and SHBG.

SHBG is a protein that binds to sex hormones like testosterone and estrogen, controlling how much of these hormones are available for your body to use. When SHBG levels change, it affects the amount of free or active hormones circulating in your body. This test helps evaluate hormonal imbalances that can cause irregular periods, excess hair growth, acne, or difficulty getting pregnant. SHBG levels can be altered in conditions like polycystic ovary syndrome (PCOS) and thyroid disorders.

Prolactin regulates milk production and menstrual cycles. Elevated levels are a common cause of irregular or absent periods and infertility. High prolactin may indicate a pituitary tumor, medication effects, or thyroid disease.

Morning cortisol measures your stress hormone at its daily peak to diagnose adrenal gland problems. Cortisol regulates metabolism, blood pressure, and stress response, with highest levels occurring around 8 AM. Very low levels suggest adrenal insufficiency, while very high levels suggest Cushing's syndrome. Birth control pills and estrogen therapy can increase cortisol levels, so tell your doctor if you're taking these.

GGT is an enzyme from your liver that can be elevated when your liver is stressed or damaged. While it's part of routine liver function testing, GGT levels can be affected by alcohol use, certain medications, and liver disease. For women, this test helps identify liver problems that might not show symptoms initially, and it can be particularly important if you have risk factors like heavy alcohol use, certain medications, or conditions that affect the liver.

Direct bilirubin measures processed bilirubin in your blood and helps identify liver problems or bile duct blockages. Bilirubin is a yellow substance from broken-down red blood cells that your liver processes for elimination. Elevated levels usually mean your liver isn't working properly or bile flow is blocked, which can occur with hepatitis, cirrhosis, or gallstones.

Amylase is an enzyme made by your pancreas and salivary glands that helps digest food. While primarily used to detect pancreatic problems, elevated amylase can also indicate parotid gland (salivary gland) swelling, which can occur with certain eating disorders involving vomiting. This test is less commonly ordered as a routine screening test but may be included when evaluating digestive symptoms or specific conditions.

Lipase helps digest fats and is used to diagnose pancreatitis. Levels more than three times normal strongly suggest pancreatitis, though elevations can occur in other conditions.

Each menstrual period causes iron loss, and heavy periods that affect about 20% of women, with half of them developing iron deficiency. Iron deficiency causes fatigue, difficulty concentrating, irritability, depression, restless legs, and exercise intolerance - symptoms that significantly impact daily life but are often dismissed as "normal." The panel includes ferritin (which shows your iron stores), serum iron, and TIBC (total iron binding capacity), which together determine if you have enough iron. This is especially important during pregnancy, when up to 84% of women develop iron deficiency.

This test measures vitamin D levels to determine if you have enough for bone health. Your body makes vitamin D from sunlight and gets it from certain foods. Low levels can lead to bone loss and fractures, especially after menopause, and about 75% of postmenopausal women have levels below 30 ng/mL. Testing is most appropriate if you have risk factors like dark skin, obesity, limited sun exposure, or bone health concerns.

Vitamin B12 and folate are essential for red blood cells, DNA, and nerve health. Deficiency is common in women of childbearing age and increases pregnancy-related risks. Testing is important for pregnancy planning, anemia, and certain diets or medications.

Magnesium is essential for muscle, nerve, heart, and bone health. Deficiency is common in women, especially during pregnancy, and increases risks such as preeclampsia and osteoporosis. Hormonal changes affect magnesium balance.

Phosphate is essential for bone health and energy production. Levels increase after menopause. Abnormal levels can affect muscles, bones, and pregnancy outcomes. Testing is recommended for bone symptoms, kidney disease, and high-risk pregnancies.

A CBC measures red blood cells, white blood cells, and platelets to detect anemia, infections, and blood disorders. It is especially important for women due to the high prevalence of iron deficiency anemia.