A standard thyroid test checks TSH only. TSH is a signalling hormone from the pituitary, not a thyroid hormone itself. It tells you whether the brain is asking the thyroid to work harder, but it tells you nothing about whether the thyroid is actually producing enough T4, converting it to the active T3, or whether thyroid antibodies are present. Many women with clear thyroid symptoms are told their thyroid is fine because TSH sits within range, while Free T3, Free T4, and antibody levels are never checked.

A standard iron check usually measures serum iron or haemoglobin, which only tells you whether you are anaemic. Ferritin, which reflects stored iron, is a completely different marker and one that has a huge impact on energy, hair, mood, and cognitive function. Ferritin can be critically low while serum iron looks fine. Most GPs do not include it as standard, which means iron deficiency without anaemia is missed constantly and dismissed as stress or burnout.

Standard hormone testing on the NHS is minimal at best. Oestrogen, progesterone, and testosterone are rarely tested together, rarely tested at the right point in the cycle, and rarely interpreted in relation to each other. Being told your hormones look normal for your age is not the same as understanding whether they are balanced, whether they are being metabolised well, or whether the ratio between them is contributing to how you feel.

Fatigue, low mood, brain fog, weight changes, poor sleep and loss of motivation are real, physical symptoms. They are not a personality trait or a sign that you need to rest more. They are the body's way of communicating that something is out of balance. When these symptoms are dismissed as stress without any real investigation, the underlying cause continues unchecked and the symptoms continue with it.