The tests, in plain English
Start with your regular doctor and a thyroid test, because an underactive thyroid is one treatable cause of tiredness. A blood count can check for anemia, a shortage of healthy red blood cells. Testosterone, menopause hormones and cortisol, made by your adrenal glands, are worth testing when your symptoms point to them, not as a routine screen.
Think of hormones as messages your body sends through the mail. A blood test is a snapshot of what's in the mailbox at one moment, and some of these messages arrive in waves through the day or the month. That's why when you test can matter as much as what you test.
Thyroid (TSH)
Usually the first thyroid test.
Free T4 and thyroid antibodies
Free T4 measures the thyroid hormone itself.
Testosterone
Levels are highest in the morning, so the test is done early, after fasting, and repeated before anyone calls it low.
FSH and estradiol
FSH, follicle stimulating hormone, changes through the monthly cycle, and estradiol is the main estrogen before menopause. Both shift a lot during the menopause transition. After 45, menopause is usually recognized from your symptoms and periods, and a blood test often adds little.
Cortisol
Made by your adrenal glands, cortisol affects almost every organ in your body.
Blood count and iron
Not hormones, but often checked alongside them.
Saliva and urine hormone panels
Some clinics measure hormones in saliva or dried urine instead of blood. Menopause specialists have called saliva testing unreliable for guiding treatment. Before paying for either kind of panel, ask what a result would change.
