Once a year you go in, they draw blood, and a few days later you get told your annual bloodwork looks good. Most women assume that means everything got checked. It is worth knowing what actually did.
More testing is not automatically better care. I am not interested in selling anybody a longer list.
What your annual bloodwork is looking at
A routine annual draw is generally answering four questions.
How well are your liver and kidneys working. What does your blood count look like. And what is your cholesterol doing.
That is it. That is your standard labs.
And that panel is doing exactly what it was built to do. It tells me you do not have a large, obvious problem I need to deal with this minute. That is worth knowing, and it is not nothing.
It just does not speak to the symptoms you have been living with.
What annual bloodwork was never designed to look at
None of the following is typically part of a routine panel.
Whether you have food allergies. Whether you have food sensitivities, which are a different thing. Whether you have environmental allergies that could be affecting how you feel every day.
Whether you have vitamin deficiencies. And separately, whether you are actually absorbing what you take. Those are two different questions and only one of them gets asked. You can take your B every morning and not absorb it, and the bottle on your counter will tell you nothing about which of those is happening.
Whether your gut is in bad shape.
Whether you have thyroid antibodies, or whether your body is set up for a thyroid problem down the road.
And if you are already on hormone therapy, whether you are absorbing it properly. That one matters more than people expect. If a patch is not working for you, the answer may be moving to something else rather than deciding hormones did not help.
So annual bloodwork does not really cover much. It omits a great many things. That is not a scandal. It is a scope, and once you know the scope you can stop reading “normal” as “everything.”
Something is not missing every time
I want to say this plainly, because it is where a lot of wellness content goes wrong.
If someone comes in having just had routine labs, and we talk, and her sleep is where it should be and her diet is where it should be and she feels good, then I am not going on a hunt. There is not always something buried. More testing is not automatically better care, and I am not interested in selling anybody a longer list.
The deep dive earns its place when there is a gap between how you feel and what the paper says. That gap is the signal. Without it, the extra tests are just extra tests.
How you know a deeper look is worth it
The honest test is simple.
You have symptoms that have not been explained. Your annual bloodwork came back unremarkable. And no one has sat with you long enough to connect those two facts.
That is the moment to look further. Not because something is definitely hiding, but because the question you have has not been asked yet by any test you have had. It is also the whole reason I built Elle Medicine the way I did, with enough time in the room to ask it.
Your annual bloodwork is a good place to start. It was never built to be the finish.
