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Home › What Labs Should I Ask For?

A Practical Guide

What Labs Should You Actually Ask For?

Take this list to any provider. It is what we order and why, by symptom, with the reasoning behind each one. You do not have to use us to benefit from knowing what to ask for.

The short answer. It depends entirely on the symptom, which is why a single "full panel" does not exist. Below is what to ask for by complaint, and the specific tests that are commonly left off and shouldnot be.

I am exhausted all the time. What should I ask for?

  • Iron, TIBC and ferritin. Not a blood count alone. Ferritin is your iron reserve and it falls long before hemoglobin, so anemia screening misses depleted iron entirely.
  • B12 and folate. More common than expected in vegetarians, on metformin, on long-term acid reducers, after bariatric surgery, and with age.
  • Magnesium. Not on a standard metabolic panel. Behind cellular energy, sleep and cramping.
  • Vitamin D, 25-hydroxy. Common to be low even in Texas.
  • TSH with reflex to free T4. Reflex matters, so the follow-up runs on the same sample.
  • Hemoglobin A1c. Three months of average blood sugar in one number.
  • CBC and a comprehensive metabolic panel. The baseline everything else is read against.

That is our Fatigue and Energy Evaluation at $199, and it returns in two to five days because none of it is a send-out.

I think it is my thyroid. What should be on the panel?

  • TSH. The screening test, and on its own it is not enough.
  • Free T4 and free T3. Free T3 is the active hormone your cells use. A normal TSH with a low free T3 is a conversion problem that a TSH alone will never show.
  • TPO and thyroglobulin antibodies. These can be positive years before TSH moves, and they change the entire outlook.
  • Ferritin. Low iron impairs the conversion of T4 to T3 directly.

What we do not routinely order: reverse T3. It does not change management in most cases and it costs $22. We removed it from our standard thyroid panel for that reason, which is the opposite of what most functional clinics do.

If you take levothyroxine, draw before your morning dose.

My hair is falling out. What finds the cause?

  • Full thyroid panel with antibodies, as above.
  • Iron, TIBC and ferritin. The single most common finding in women.
  • Zinc. Deficiency causes shedding directly and is correctable with a supplement rather than a prescription. Needs a trace-element-free tube, so ask for it specifically.
  • Vitamin D.
  • Testosterone and DHEA-S.
  • Prolactin.
  • A1c and fasting insulin.
  • PSA for men over 40, before starting finasteride, because 5-alpha reductase inhibitors halve PSA and you can never interpret a future result without a pre-treatment number.

Stop biotin for 72 hours before the draw. Hair, skin and nail supplements are loaded with it and it interferes with thyroid and hormone immunoassays badly enough to produce convincing wrong answers.

I want my hormones checked. What does that mean?

It means something different for men and women, and the assay matters more than the list.

  • Women: estradiol, progesterone, FSH, LH, prolactin, DHEA-S, and testosterone measured by mass spectrometry. Not immunoassay, which is unreliable at female concentrations. Plus thyroid with antibodies, fasting insulin, A1c and iron studies, because those cause the same symptoms.
  • Men: total, free and bioavailable testosterone by mass spectrometry with SHBG, estradiol, FSH, LH, prolactin and PSA. Draw between 7 and 10am, and if you are already on testosterone, draw at trough on the morning of your next injection.

If cycles are irregular with acne or unwanted hair growth, add fasting insulin and ask specifically about SHBG, which drops with insulin resistance and is often the first abnormal number in PCOS.

Why do so many panels leave these out?

Cost and coverage, mostly. Insurance frequently denies tests ordered without an existing diagnosis, so providers order conservatively to avoid leaving you with a bill. A standard annual panel is built to catch disease efficiently, not to explain symptoms.

That is a reasonable system constraint and not a conspiracy. It is also why ordering your own panel exists as an option.

Can I order these myself?

Yes. In Texas and most states you can order your own laboratory testing, and at Navara every panel includes a provider consultation to choose the right one and a scheduled visit to go through the results.

That review is the part that matters. A results portal with sixty numbers and no explanation is how people end up more anxious than before they tested.

Practical Questions

Can I take this list to my own doctor? ▾

Yes, please do. It is written to be useful whether or not you ever book with us. If your provider will order it, that is the cheapest path, particularly if you have insurance.

Do I need to fast? ▾

For anything including a metabolic panel, lipids or insulin, yes. Eight to twelve hours, water only. That covers nearly every panel worth ordering.

What is the single most useful test nobody runs? ▾

Ferritin, by a distance. It is inexpensive, it is left off almost every standard panel, and low iron with a normal blood count explains an enormous amount of fatigue, brain fog and hair shedding, particularly in menstruating women.

Why does testosterone need mass spectrometry? ▾

The cheaper immunoassay loses accuracy at the low concentrations found in women and at the extremes in men, which is exactly where treatment decisions are made. It is the reason our hormone panels take seven to fourteen days rather than two.

What does it cost to order my own? ▾

From $149 for the Complete Thyroid Evaluation to $449 for the Advanced Health Evaluation. Every price includes the consultation, the testing and the results review, and every price is published.

What if I already have recent results? ▾

Bring them. The Existing Lab Review is $100 and we will go through what you have rather than repeating tests you already paid for. Results from the last 90 days are generally still useful.

Order the Right Panel the First Time.

Eight evaluations from $149, each including the consultation, the testing and a visit to go through every result with you. No referral needed.

See Every Panel and Price (469) 653-3124

Related

Keep Going

Self-Order Labs Every panel, what is in it, and what it costs. Read more › My Labs Were Normal But I Feel Awful Why a standard panel misses so much. Read more › Complete Thyroid Evaluation, $149 Free T3, free T4 and both antibody markers. Read more › Free Biological Age Calculator No signup, results explained. Read more ›

Written and clinically reviewed by Jessica Boggs, MSN, APRN, FNP-C, ENP-C, founder of Navara Health. Medical oversight by Simal Patel, MD.

Last reviewed September 6, 2026. This page is general information, not medical advice, and does not create a provider relationship.

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