The Blood Tests You Should Be Asking Your Doctor For If You're Bloated
Routine bloodwork is inexpensive, widely accessible, and yet its value often goes completely unnoticed. If you've been to your primary care physician anytime in your adult life, you've likely had a Complete Blood Count (CBC), a Comprehensive Metabolic Panel (CMP), and a lipid panel run. Maybe you've even had your iron or thyroid checked. Chances are a couple of markers were slightly out of range, your doctor said it wasn't a concern, and you didn't think much more about it.
If you're a woman in your 30s who strength trains consistently and still deals with chronic bloating, it’s important to understand that bloodwork is a valuable tool for investigating the causes of your symptoms and that the standard way bloodwork gets reviewed has a major blind spot.
The Problem With "Normal" Bloodwork
The reference ranges on a standard lab report tell you where you fall compared to the general population. And unfortunately, if you fall into the “normal” range, that does not mean you’re healthy. That's because normal ranges are very different from optimal ranges, which are the tighter windows used in functional medicine to understand how your body is functioning, not just whether you've crossed into disease territory.
When I review bloodwork with clients, I'm looking for patterns across markers that point to what's driving your symptoms, even when nothing is technically "flagged" as out of range. I'm also interested in a handful of additional, inexpensive markers that rarely get ordered in a standard visit but are incredibly informative, especially for someone training hard and dealing with GI symptoms at the same time.
Here's what I'd recommend asking your doctor for.
The Foundational Panels
CBC (Complete Blood Count) Gives insight into how your immune system is functioning and your iron status, and can point toward bacterial, viral, or parasitic infection. For someone strength training multiple times a week, this is also a quick check on whether you're recovering appropriately between sessions; for example, chronically low white blood cells or red blood cell abnormalities can both help explain why you might be feeling run down and unable to fully recover from training sessions.
CMP (Comprehensive Metabolic Panel) Offers insight into blood sugar regulation, kidney function, adrenal function, electrolyte balance, stress load, and liver function. And, if you’re training hard, any electrolyte imbalances that show up here can contribute directly to bloating, cramping, and water retention.
Lipid Panel (total cholesterol, HDL, LDL, VLDL, triglycerides) Gives insight into insulin resistance, liver stress, diet quality, and nutrient status.
Hemoglobin A1c & Fasting Insulin A1c reflects blood sugar control over the past 2-3 months, which is a strong indicator of prediabetic or diabetic patterns and overall metabolic health. Fasting insulin tells us where things stand right now, and gives insight into insulin resistance, underlying infections or toxin load, diet, and stress. When these markers are high, it’s not always a blood sugar issue; chronic stress, low-grade inflammation, or an underlying infection or gut imbalance could be disrupting how your cells respond to insulin.
Vitamin D Low vitamin D can point to a fat-absorption issue in the gut, which is important if you’re experiencing chronic bloating, since vitamin D is fat-soluble and depends on healthy digestion and bile flow to be absorbed properly.
Hs-CRP A marker of overall inflammation in the body, giving insight into potential infection or chronic stress. It’s important to note that intense exercise can transiently raise CRP, so time this test on a day away from a hard session to get a cleaner picture.
Thyroid Panel (TSH, Total T4, Total T3, T3 Uptake, Reverse T3, Free T4, Free T3, TPO antibodies, Tg antibodies) Most women who ask their doctor for a thyroid check only get TSH and total T4, which form an incomplete picture. Together, this full panel helps identify where a thyroid issue is coming from: a conversion problem, an autoimmune process, or a pituitary signaling issue. This distinction matters enormously for training and bloating because an under-functioning thyroid can tank recovery, strength gains, and energy, while also slowing gut motility enough to cause bloating on its own.
Iron Panel (TIBC, UIBC, iron, ferritin) Gives insight into potential iron absorption issues in the gut, infection load, inflammation, and liver stress. Low ferritin in particular is common in women who train regularly and can show up as fatigue, poor recovery, and hair shedding well before it's "flagged" on a standard report.
What I'd Add to This List
The panels above are a strong foundation, but there are a few additional markers that can add a lot of valuable information for women with chronic bloating who strength train regularly:
RBC Magnesium (not serum; serum magnesium is a poor reflection of your actual stores). Magnesium is essential for muscle relaxation and recovery, and low levels are a common driver of constipation-related bloating.
RBC Zinc and Copper Zinc supports stomach acid production (low stomach acid is a common, under-diagnosed cause of bloating) and gut-lining repair, and is depleted by intense physical training.
Vitamin B12 and Folate Absorption depends on adequate stomach acid and a healthy gut lining, so these often run low in people with digestive symptoms, and low levels can mimic overtraining fatigue.
Homocysteine Fags B-vitamin and methylation issues that don't always show up on a standard B12/folate check.
Celiac panel (tTG-IgA + total IgA) An inexpensive rule-out that's frequently skipped despite ongoing GI symptoms.
Creatine Kinase (CK) Helps distinguish muscle breakdown from hard training (which can otherwise look like elevated liver enzymes or inflammation on other panels) from an actual liver or inflammatory issue.
Why Routine Bloodwork is Essential
Functional labs, which are the more specialized testing you may have seen recommended elsewhere, can get expensive fast, and they're not always covered by insurance or easy to access. The good news is that you don't need to start there. The bloodwork outlined above is inexpensive, widely available, and often something you can get run through your regular doctor. Chances are you're already sitting on more useful data than you realize from labs you've already had done.
And remember: bloating doesn't happen in isolation from the rest of your physiology, and neither does your ability to build muscle, recover, and feel good in your body. Blood sugar dysregulation, infection load, thyroid dysfunction, low iron, and micronutrient depletion all can show up as digestive symptoms and as plateaus, fatigue, or poor recovery in the gym. Pulling one thread without looking at the others means you're often treating a symptom instead of the underlying pattern.
Where to Go From Here
Getting these labs run is a great first step, but the real value comes from knowing how to put all of the results together. A single marker slightly out of range rarely tells the full story; it's the pattern across all of them that reveals what's actually driving your bloating.
If you're ready to stop guessing and get a clear, personalized answer, that's exactly what we do inside my Bloat Breakthrough Method. Working 1:1, I pull all of these labs together, identify the patterns explaining your specific symptoms, and build you a tailored plan from there.
