Jenny, age 26, is frustrated by weight gain, constipation and dry skin. Mary, age 53 and a vegetarian, experiences hair loss, peeling fingernails and lacks energy. Nancy, age 37, has no sex drive. Yet their doctors have told them all their diagnostic tests are normal and they just have to live with their symptoms.

Some standard blood tests have normal reference ranges that are just too broad, and as a result some women are told their results are normal even when they have a myriad of symptoms. Some tests must be performed at a certain time in a woman’s cycle, while others just aren’t being done properly — or at all. How is a woman to know what tests should be performed, and when?

1. Nearly one in four women have low thyroid

Every woman should have a thyroid test performed annually after age 19. Low thyroid, or Hypothyroidism, is a common health concern. More than 23% of the population is currently taking thyroid medication and another 30% have the symptoms of low thyroid but have not been diagnosed yet.

The standard thyroid test is called a Thyroid Stimulating Hormone test or TSH. The range of normal in Canada is 0.5 to 5.5. In order to be diagnosed with low thyroid your TSH would have to be over 5.5. Research has shown that a TSH over 2.0 will cause symptoms like weight gain, eyebrow hair loss, ovarian cysts, heavy periods, constipation, feeling cold, anxiety, depression, raging hot flashes and night sweats, infertility and recurring miscarriage.

It is important to get a copy of your laboratory tests so that you can familiarize yourself with your test results. Jenny had many of the symptoms of low thyroid, but her TSH was 4.6 so her doctor advised her she was in the normal range.

Physicians will generally not treat thyroid until the TSH is over 5.5. Once Jenny realized her TSH was above 2.0 she was able to support her thyroid with nutrition to bring her TSH below 2.0.

2. Iron deficiency all too common

From teens to seniors, testing for iron levels is essential. Doctors routinely test for iron in menstruating or pregnant women but new research has discovered that most Canadian women are iron deficient.

We should be getting 20mg per day of iron from our diet but we are receiving approximately 8mg per day because we have reduced our red meat consumption dramatically.

You need two tests for iron: Hemoglobin and ferritin. The normal range for hemoglobin in women is 117-160 g/L and for ferritin 15 to 160 ug/L. But a ferritin below 70 ug/L will cause dramatic hair loss, peeling fingernails, no energy, dark circles under the eye, pale skin, heart palpitations and an inability to exercise due to fatigue.

Because Mary was 53 and she had not had periods for years, her doctor stopped testing for hemoglobin and ferritin. Mary’s hair loss and lack of energy were chocked up to aging. Low iron is also associated with cognitive decline and memory loss. Natural iron supplements restored Mary’s hair within months.

3. Testosterone: The hormone of desire

According to the Canadian Medical Association, doctors should be asking about our sex life as part of our annual office visit, as it can be an indicator of other health concerns like diabetes. But rarely are women’s concerns about having a lack of libido investigated.

According to Dr. Pettle, gynecologist, bioidentical hormone expert and coauthor of A Smart Woman’s Guide to Hormones, in his practice he tests every woman’s testosterone levels. Most women have testosterone levels that are so low their libido will be affected.

There are a couple of testosterone tests, so ask for the correct one called a free testosterone test. Free testosterone measures the blood testosterone concentration, which is a more accurate test. If your testosterone is low you will be like Nancy — no libido, difficulty achieving orgasm, lack of energy and poor muscle tone. Low testosterone can also be a measure of aging as muscle wasting occurs as a result. Raising testosterone levels can be achieved through regular weight bearing exercise. Birth control pills can also inhibit testosterone, so if your libido is suffering you may want to switch to an alternative method.

4. PAP tests save lives

The College of Pathology states that four out of five women who died of cervical cancer had not had a Pap test in the previous five years. According to Health Canada, the highest incidence of cervical cancer and the highest death rates occur in women over age 55, a group that often stops having annual Pap tests after menopause.

Pap tests save lives by discovering abnormal cells called cervical dysplasia early enough to prevent loss of life from cervical cancer. All adult women from age 18 should have an annual Pap test. The main risk factors that promote abnormal cervical cells include using the birth control pill; increasing age; infection with the Human Papilloma Virus; smoking; and nutritional deficiencies of folic acid, vitamin A and C.

Insist on an annual Pap test and ask for the result. Too many women are advised their test is abnormal and told to come back in six months for another test. We can reverse abnormal Pap tests with nutrients and lifestyle changes, so it is important to know your test results.

Get to know your body. Symptoms are a sign that something is not right.

Understanding your test results is important. Asking for diagnostic tests is your right. Get a copy of all your diagnostic tests and put them in your home health file.

Lorna Vanderhaeghe is Canada’s women’s health expert who has been researching and writing on women’s health for more than 30 years. She has a Masters in Nutrition and has authored 11 books including A Smart Woman’s Guide to Hormones. For more information visit

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