Midlife Blood Tests
When it comes to improving our health, I'm a firm believer that the first step is understanding where our health is today. Once we understand this, we can act with purpose to shift our health in the right direction. Knowing what to measure and how to intervene through lifestyle, is key.
What many women don’t know, is that cardiovascular disease is the leading cause of death in women. In menopause, the risk of dying from heart attack or stroke is greater than the risk of dying from the next five most common causes combined, including breast cancer.
Some of the earliest warning signs appear in blood work. Even if your blood work has been perfect your whole life and your diet and exercise routine hasn't changed, you'll want to watch for these common menopausal changes.
During the menopausal transition, many women see a gradual rise in cholesterol. Levels of low-density lipoprotein (LDL) cholesterol, sometimes called “bad” cholesterol, rise. The liver produces cholesterol, which is used to build cell membranes and produce certain vitamins and hormones. Without adequate oestrogen, the liver overproduces LDL cholesterol, and the liver's ability to reabsorb and eliminate unnecessary LDL is reduced. Unhealthy cholesterol levels contribute to atherosclerosis, the build up of plaque in arteries, and increase the risk of cardiovascular disease.
Then there are serum triglycerides, which are circulating fats your body can use for energy. We all need fat stores, but too much is problematic. During perimenopause, triglycerides often increase, which can indicate cardiac risk, insulin resistance, diabetes, fatty liver, thyroid issues, or other conditions. These fats often get stored in the belly or embedded in the heart, liver, and muscles.
Another standard health metric is insulin sensitivity. Perimenopausal women often show signs of elevated blood sugar and fasting insulin, along with rising haemoglobin A1C, a marker of a person's average blood sugar over 3 months. Insulin resistance contributes to heart disease and can progress to diabetes. Poor sleep, abdominal weight gain, and systemic inflammation - all of which are strongly linked to oestrogen deficiency - contribute to insulin resistance.
Depending on your personal history and risk factors, you may want to ask your GP to monitor additional metrics, including thyroid hormones (when low can mimic many of the symptoms we see in perimenopause such as low mood, weight gain, irritability, hair loss and lack of energy), advanced lipid markers (Lipoprotein(a) and ApoB are considered better predictors of heart disease risk compared to standard cholesterol testing but are not routinely measured), inflammation markers, signs of nutrient deficiencies (including Vitamin D which influences bone health, mood, energy and sleep) and autoimmune diseases.
Many perimenopausal women find that their health markers decline, even if their lifestyle stays the same. Poor diet, lack of exercise, and other lifestyle issues definitely impact lab test results, but that's not the whole story. Virtually every organ and structure in the body has oestrogen receptors, including immune cells, kidneys, the liver, cardiovascular structures, and the pancreas.
One way to think about it is that oestrogen supplies the female body with resiliency. Earlier in life, your body may not have been negatively affected by poor dietary choices, lack of exercise, stress, and erratic sleep, but once oestrogen levels drop, it's important to know you might not bounce back as easily.
Blood work is not only a fascinating insight into where your health is at right now, it helps you take full control over your future wellbeing.
One last thing. Standard laboratory reference ranges are based on the average population, but it's crucial to note that the "average" doesn't necessarily mean "healthy”. Unfortunately, the overall health of Australians seems to be declining. The challenge with most reference ranges lies in their broad scope, often labelling those on either end as "normal”. If you’ve recently undergone blood tests and been assured that everything is "normal" and falls "within range" but still have a sense that something isn't quite right, come and see me and I'll take a closer look at them for you.
Bobbie X