Routine blood work can sometimes appear reassuring while leaving questions about persistent symptoms unanswered. Standard health panels commonly include measures such as blood counts, glucose and cholesterol, but additional testing may be considered when someone continues to experience fatigue, low mood, acne, hair loss or symptoms associated with PCOS. Dietician and health coach Nikita Bardia has highlighted nine tests that she says may provide additional information about nutritional, metabolic, inflammatory and hormonal health. Her recommendations were shared in an Instagram video, and the claims have not been independently verified.

The first test she highlighted was ferritin, which reflects the body's stored iron. Bardia noted that a person can have normal haemoglobin while still having low iron stores. Ferritin testing can therefore be useful when iron deficiency is suspected, particularly in people experiencing persistent tiredness or hair loss. However, ferritin levels need to be interpreted alongside symptoms and other iron studies rather than against a single universal target, as reference ranges and clinical requirements vary.

She also recommended homocysteine, which can be affected by deficiencies of vitamin B12 and folate, and high-sensitivity C-reactive protein (hsCRP), a marker associated with inflammation. Bardia suggested that these tests may be worth discussing in people with symptoms such as fatigue, bloating or other concerns. The third recommendation in this group was reverse T3, which she linked to persistent symptoms despite apparently normal thyroid results. However, thyroid evaluation is generally based on clinically appropriate tests such as TSH and, when indicated, free T4 or other investigations rather than routinely ordering every thyroid marker.

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For nutritional and metabolic assessment, Bardia suggested checking vitamin D3 alongside ionised calcium, particularly when deficiency or absorption concerns exist. She also pointed to ApoB or lipoprotein(a), or Lp(a), as additional cardiovascular-risk markers beyond the standard LDL cholesterol measurement. These tests can be particularly relevant when there is a personal or family history suggesting increased cardiovascular risk. They are not, however, tests that everyone necessarily needs as part of an annual health check.

The list also included a gut-health panel or zonulin test, which Bardia associated with digestive and skin-related symptoms, and fasting insulin, which she said could provide information about insulin resistance even when blood glucose appears normal. Insulin resistance is particularly relevant when evaluating the metabolic health of people with PCOS. Established PCOS guidance supports assessment of glucose-related metabolic risk, although the exact tests used should be determined according to the individual clinical situation rather than automatically ordering a large panel.

Her ninth recommendation was serum magnesium, which she linked to issues including sleep, muscle cramps, cravings and premenstrual symptoms. Taken together, the nine tests discussed were ferritin, homocysteine, hsCRP, reverse T3, vitamin D3 with ionised calcium, ApoB or Lp(a), a gut-health or zonulin assessment, fasting insulin and serum magnesium. The list is best viewed as a set of possible investigations rather than a universal checklist. Persistent fatigue, mood changes, acne or suspected PCOS can have many causes, and a doctor may recommend a smaller or different group of tests after reviewing symptoms, medical history, medications and diet.

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