You've been tired for months. Maybe your hair is thinning, or your cycle has gone rogue. You finally book in with your GP, get a blood test, and hear the words so many of us hear: "Everything looks normal."
I've been on the receiving end of that sentence myself. Naturopaths have GPs too, and I get my bloods done through Medicare like everyone else. What I've learned, from both sides of the desk, is that the answer you get depends heavily on the questions that were asked before the needle went in.
Here's how to walk into your next appointment knowing what to ask for.
Why the "standard" blood test might miss things
A routine panel usually covers a full blood count, kidney and liver function, and sometimes cholesterol or glucose. These are useful. But many of the things that cause the most common symptoms, like fatigue, hair loss, brain fog and irregular cycles, need specific tests that aren't automatically included.
If a marker isn't tested, it can't show up as a problem.
Blood tests worth asking about, by symptom
If you're tired all the time
Iron studies, including ferritin, transferrin and transferrin saturation, not just haemoglobin
Thyroid function: TSH, and ideally free T4 and free T3 (TSH is not an accurate marker of thyroid function)
Vitamin B12 and folate
Vitamin D
If your hair is falling out
Iron studies, as above
Thyroid function, including thyroid antibodies
Vitamin D, zinc and B12
Hormones, such as testosterone, if your cycle is also irregular
If your cycle is irregular, painful or missing
Reproductive hormones, timed to the right day of your cycle
Thyroid function
Prolactin
Iron studies, especially with heavy periods
This isn't a complete list, and your GP will decide what's appropriate for you. It's a starting point for a better conversation.
What Medicare covers (and what it doesn't)
Most common blood tests are rebated by Medicare when your GP orders them for a clinical reason. Vitamin D is one exception worth knowing about. Since 2014, a Medicare rebate for vitamin D testing applies only if you meet certain criteria, otherwise you pay for it yourself (RACGP). Your GP can tell you whether you qualify.
"Normal" isn't always optimal
Even with the right tests, there's a second hurdle. Lab reference ranges are wide, because they're built to cover a huge slice of the population. A result can sit inside the range and still be low enough to explain how you feel.
That's exactly what happened to me. My iron and vitamin D were both "in range" while my hair was coming out in handfuls. Nobody was wrong, exactly. "In range" and "right for you" just aren't the same thing.
How to make the most of your GP appointment
Write your symptoms down, including when they started and how they've changed.
Bring a list of the tests you'd like to discuss. It's much easier to point at a list than remember on the spot.
Ask for a copy of your results, not just a summary. You're entitled to them.
Keep your old results. Trends over time often tell you more than one test.
Get the free Blood Test Checklist
I've put the symptom-to-test list into a one-page checklist you can screenshot or print and take straight to your GP.
Download the free Blood Test Checklist →
Already have results and not sure what they're telling you? Ferritin normal but still tired?
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This article is general information only and isn't a substitute for advice from your own health practitioner.