---
title: "What Blood Work Should Women Get? A Naturopathic Guide to Every Hormonal Stage"
entity: "blog"
canonical_url: "https://www.bodycotoronto.com/blog/blood-work-for-women-naturopathic-guide"
markdown_url: "https://www.bodycotoronto.com/llms/blog/blood-work-for-women-naturopathic-guide"
lastmod: "2026-11-10T17:00:58.000Z"
---

Beyond the Standard Panel: Blood Work Through Pregnancy Prep, Postpartum and Perimenopause

The short answer: The most useful blood work for women depends on your hormonal stage.

Before pregnancy, Dr. Margot looks at iron, a full thyroid panel, vitamin D, B12 and blood sugar markers, ideally starting 3 months before trying to conceive.

After baby, she checks iron, thyroid function (including screening for postpartum thyroiditis), vitamin D, B12 and blood sugar around 6 to 12 weeks postpartum.

In perimenopause, the focus moves to ruling out thyroid issues, protecting iron stores and setting a metabolic and bone health baseline, since no single hormone test can confirm perimenopause.

Ever been told your blood work is "normal," but you still don't feel like yourself?

Sometimes it's not that nothing is going on. It's that the picture is incomplete.

TSH on its own doesn't tell the full thyroid story, and ferritin can look fine when inflammation is hiding low iron stores. As a Naturopathic Doctor, I believe blood work for women is one of the clearest ways to see what's actually going on inside, and the most useful tests shift depending on where you are in your hormonal journey. Planning a pregnancy, recovering after baby and heading into perimenopause each call for a slightly different set of tests.

## Why Blood Work Is Always My Starting Point

Blood work is always my starting point. Before choosing a supplement plan or moving on to more in-depth functional testing, it's the best way to rule things in or out and get a clear baseline to work from. And it may not be the hormones you think!

Hormones are so much more than estrogen and progesterone. Your thyroid, insulin and cortisol all play a big role in how you feel, and imbalances there often get missed. Sometimes it's not a hormone at all. Nutrient deficiencies like low iron, B12 or vitamin D can cause fatigue, low mood and hair thinning that look a lot like a hormonal issue.

In my professional opinion, blood work should be checked at least once a year. That's the whole idea behind my Naturopathic Annual Physical Assessment: a yearly check-in where we look at where you are right now and pick the blood work that makes sense for this stage of life.

## Blood Work at a Glance: What to Test at Each Stage

## Can a Naturopathic Doctor Order Blood Work in Ontario?

Yes, and it's one of the most underused parts of naturopathic care. In Ontario, naturopathic doctors can order a wide range of lab tests, including hormones, full thyroid panels, iron studies, vitamin levels and metabolic markers. That means we can look at markers that don't always make it onto a routine panel.

Vitamin D is a good example: since 2010, OHIP has only covered vitamin D testing for specific medical conditions, so most people don't have it checked unless they ask.

## Blood Work Before Pregnancy (Preconception)

If you're thinking about trying to conceive, I recommend starting your prep at least 3 months ahead. That gives you time to correct anything that's low before pregnancy increases the demand. Here are some examples of what I commonly look at:

- Ferritin and CBC: Your iron needs climb during pregnancy, so it helps to start with your stores topped up.
- Full thyroid panel: TSH, free T4, free T3 and thyroid antibodies. Thyroid function plays a big role in fertility and early pregnancy, and TSH alone doesn't always show the full picture.
- Vitamin D: Low levels are very common in Canada, especially through the fall and winter, and have been linked to fertility outcomes.
- Vitamin B12: Important for energy and for building healthy red blood cells.
- Blood sugar markers: Fasting glucose, A1C and sometimes fasting insulin, since blood sugar balance affects ovulation and cycle health.

## Blood Work After Baby (Postpartum)

The postpartum months are often when women feel the most depleted, and it can be hard to tell normal new-parent exhaustion apart from something worth treating. That's where blood work comes in, and I recommend checking around 6 to 12 weeks postpartum, and again later in the first year if symptoms show up.

- Ferritin and CBC: Blood loss during birth and the demands of the newborn months can leave iron stores low.
- Thyroid panel: Postpartum thyroiditis is a thyroid condition that shows up in the first year after delivery. Research suggests it affects roughly 1 in 20 women, and it often looks like an overactive phase followed by an underactive one. The symptoms (fatigue, mood changes, hair loss, feeling wired or flat) overlap a lot with life with a newborn, which is why testing matters.
- Vitamin D and B12: These can dip after pregnancy and affect both energy and mood.
- Fasting insulin, glucose and A1C: Insulin resistance can leave you feeling drained, with energy crashes through the day. It's especially worth checking if you had gestational diabetes, since that raises your risk of blood sugar issues down the road.
If you had thyroid antibodies during pregnancy, your risk of postpartum thyroiditis is higher, so don't skip this one.

## Blood Work in Perimenopause

This is where I see the most confusion. Many women go looking for a blood test that will "prove" they're in perimenopause, but a single hormone test can be misleading because estrogen and FSH can swing a lot during this transition. Perimenopause is usually diagnosed based on your age, cycle changes and symptoms.

But perimenopause is also the best time to set your foundation. Getting a baseline now, before falling hormone levels start to affect your metabolism, gives us something to compare against as things change. Blood work also helps us rule out other causes and track what's changing underneath:

- Thyroid panel: Thyroid issues can look a lot like perimenopause, so it's important to rule them out.
- Ferritin and CBC: Heavier or more frequent periods are common in perimenopause and can drain iron stores.
- Metabolic markers: Lipids, A1C and fasting insulin. Metabolism and cardiovascular risk shift as estrogen declines, so these are key numbers to watch.
- Vitamin D: Bone health becomes more of a priority as estrogen drops.
- Hormone testing: Still useful in the right context, like when symptoms show up earlier than expected or when we're planning treatment options such as HRT/MHT. We just interpret it alongside your symptoms and cycle, not on its own.

Curious where HRT fits in? Read my post on [perimenopause, HRT and naturopathic medicine](/blog/perimenopause-naturopathic-medicine).

## What Happens at a Naturopathic Annual Physical Assessment?

Think of it as a proactive, whole-person yearly check-in. It's a great fit for new patients who want to start with blood work, and for current patients who haven't been in for a while and are due for a check-in. Here's what's included:

- A 60-minute visit, in person at Body Co in The Junction or virtually anywhere in Ontario
- A physical exam tailored to you
- A review of your current medications and supplements
- A discussion of screening tests and blood work options for your stage of life
- A lab requisition when appropriate
Already had blood work done with your family doctor? Bring it! I'm happy to review recent results so we're not repeating anything unnecessarily. If we order new tests, we'll set up a follow-up to go through your results together.

The visit is billed as a naturopathic appointment, and Body Co direct bills to most insurance providers.

## Ready to Book Your Annual Physical?

Whether you're planning for a baby, finding your feet after one or noticing the first signs of perimenopause, your blood work should match where you are right now. Let's sit down, look at the full picture and choose the tests that actually make sense for you.

[Book your Naturopathic Annual Physical Assessment with Dr. Margot at Body Co](https://bodyco.janeapp.com/#/staff_member/56)

## Frequently Asked Questions About Blood Work for Women

### How often should women get blood work done?

Dr. Margot recommends checking blood work at least once a year. The tests that make sense change with your stage of life, so a yearly check-in gives you a baseline to compare against as your body changes.

### Why does my blood work come back normal when I still don't feel well?

Often the panel was incomplete. TSH on its own doesn't show the full thyroid picture, and ferritin can look fine when inflammation is hiding low iron stores. A naturopathic doctor can look at a wider set of markers, like free T4, free T3, thyroid antibodies, vitamin D and fasting insulin, to fill in what a routine panel leaves out.

### How far ahead of trying to conceive should I get blood work?

Start at least 3 months before you begin trying. That gives you time to correct low iron, vitamin D or B12 before pregnancy increases the demand on your body.

### When should I get blood work after having a baby?

Around 6 to 12 weeks postpartum is a good first check, with another round later in the first year if symptoms show up. It matters even more if you had thyroid antibodies or gestational diabetes during pregnancy, since both raise your risk of issues after birth.

### Is there a blood test that can confirm perimenopause?

Not reliably. Estrogen and FSH swing a lot during this transition, so a single hormone test can be misleading. Perimenopause is usually diagnosed based on your age, cycle changes and symptoms. Blood work is still valuable in perimenopause to rule out thyroid issues, check iron stores and set a metabolic baseline.

### Can I bring blood work from my family doctor?

Yes. Dr. Margot is happy to review recent results so nothing gets repeated unnecessarily.

### Can I book a Naturopathic Annual Physical Assessment virtually?

Yes. The 60-minute visit is available in person at Body Co in The Junction or virtually anywhere in Ontario.

### Is a naturopathic annual physical covered by insurance?

The visit is billed as a naturopathic appointment, and Body Co direct bills to most insurance providers. Coverage depends on your plan, so check your naturopathic benefits before you book.

## About Dr. Margot Lattanzi, ND

As a naturopathic doctor, Dr. Margot focuses her practice on helping women and families optimize their health and show up feeling their best each day. She helps women balance their hormones, correct deficiencies, and optimize their gut health. She is currently accepting new adult and pediatric patients at Body Co for both naturopathic care and acupuncture. For more information on her practice style, additional readings and more, head over to her website at [www.doctormargotnd.com](https://www.doctormargotnd.com) or follow her on social media @doctormargotnd.

Disclaimer: Any information is for informational purposes only and is not intended to be used in place of professional medical advice. Always seek the advice of a qualified health care practitioner with any questions or health concerns you may have and before starting any new treatments (including supplements).