Still not feeling right, even after doing the basics? You’re not alone, and it’s not in your head. Sometimes one more piece of the picture helps show why.
Your starting Functional Lab Panel covers a lot of ground. Sometimes one more panel, or even one more number, answers a question it raised. Every panel on this page is drawn at Quest Diagnostics, and none of them is part of the Functional Lab Panel or the $539 package.
Only when it helps. Barbie recommends this test only after she has reviewed your history and your first results, and only when it would change what you do next. It is separate from the $539 New Leaf Mineral Reset, and it is not sold on this site.
Thyroid panel
A full thyroid panel looks well beyond TSH. It shows how much hormone your thyroid is making, how much is being turned into its active form, and whether your immune system is reacting to the thyroid.
What it measures: TSH (the brain’s signal to the thyroid), Free T4 and Total T4 (the storage hormone), Free T3 and Total T3 (the active hormone), Reverse T3 (an inactive form the body makes more of under stress), and TPO and thyroglobulin antibodies (signs of an immune reaction to the thyroid).
When Barbie may consider it
- Your HTMA shows a high calcium-to-potassium ratio, which can mean thyroid hormone is having trouble getting into your cells
- Fatigue, feeling cold, constipation, thinning hair, weight that will not move, or low mood
- A known thyroid diagnosis, or thyroid conditions in the family
- Fertility goals or pregnancy
- Before certain steps in your protocol, so there is a starting point
What it can and can’t tell you: It shows thyroid signaling, production, conversion and immune activity. It can’t directly show how well hormone is getting into or being used by your cells; that is where the HTMA helps. TSH alone can look normal while someone still has thyroid symptoms, which is why Barbie looks at the full panel.
How it fits: The HTMA points to how thyroid hormone is working at the cell. The Functional Lab Panel shows leptin, iron and other nutrients the thyroid depends on. The thyroid panel completes the picture, read against functional ranges, not only the lab’s standard range.
Practical notes: A blood draw at Quest. If it is drawn with your Functional Lab Panel, follow that panel’s fasting instructions. This panel is not part of the starting package. Questions about thyroid medication always go to your prescriber.
“Your hair test shows how your thyroid is working at the level of the cell. This panel shows what your thyroid is making and converting, so we can see where along the path things are getting stuck.”
Hormone panels
Barbie uses four hormone panels, and which one she chooses depends on your cycle and your goals. For women who still cycle, she orders either the hormone panel or the PCOS panel, never both. Every hormone panel is a baseline for tracking change over time, not a diagnosis.
| Panel | Who it is for | What it measures | When it is drawn |
|---|---|---|---|
| Hormone panel | Regular cycles; peri- and postmenopause | Progesterone, estradiol, DHEA-S, testosterone (free, bioavailable and total) | About a week after ovulation (around days 19 to 22 of a 28-day cycle); any day after menopause |
| PCOS / androgen panel | Irregular cycles | Androstenedione, DHEA-S, estradiol, FSH, LH, testosterone, prolactin, plus insulin, A1c, leptin and hs-CRP | Cycle day 3 (anywhere from day 2 to 5) |
| Female fertility panel | Specific fertility questions | DHEA-S, estradiol, FSH, LH, testosterone | Cycle day 3 (anywhere from day 2 to 5) |
| Testosterone markers panel | Mainly men | Testosterone, DHEA-S, estradiol, FSH, LH, plus a CBC and A1c | Morning |
Want to see how hormones are being broken down, or your cortisol rhythm across a whole day? That is what the DUTCH test adds; blood panels show a single snapshot of circulating levels.
When Barbie may consider them
- Hormone panel: PMS, painful periods, mood that shifts with your cycle, spotting, fertility goals with regular cycles, or perimenopause and menopause symptoms such as hot flashes, night sweats and sleep changes.
- PCOS / androgen panel: irregular or missing periods, acne, unwanted hair growth, or hair thinning alongside cycle changes.
- Female fertility panel: a specific fertility question where early-cycle hormones are what need to be seen.
- Testosterone markers panel: low energy, low drive or motivation, or loss of muscle in men; also for anyone already on testosterone.
What they can and can’t tell you: They show where hormone levels sit at one point in your cycle, and how hormones relate to each other, such as progesterone to estrogen. They can’t capture a whole month from one draw, and they don’t show how hormones are being cleared by the liver. Hormones respond to minerals, blood sugar, stress and sleep, so Barbie reads them alongside everything else.
How they fit: The HTMA zinc-to-copper and calcium-to-potassium ratios relate closely to hormone balance. Insulin and leptin on the Functional Lab Panel often drive cycle problems, especially in PCOS. Hormone panels show whether that foundation work is reaching your hormones.
Practical notes: All are blood draws at Quest. The draw day matters, and Barbie gives you the exact day with your lab order. If a hormone panel is drawn with your Functional Lab Panel, the whole draw happens on the hormone panel’s day, fasting. Fertility testing works alongside, never instead of, your doctor or fertility specialist.
“This gives us a starting picture of your hormones so we can track how they respond as your minerals and blood sugar steady. It is a baseline to measure against, not a label.”
Kidney function panel
Your kidneys decide which minerals you keep and which you let go. This panel helps Barbie make sure they are ready for the mineral support she wants to give.
What it measures: a CBC, a comprehensive metabolic panel (which includes kidney filtering markers and electrolytes), A1c, red blood cell (RBC) magnesium, and phosphorus.
RBC magnesium reflects the magnesium stored inside your cells, which tells more than the small amount floating in the blood. It is a separate, optional marker here; it is not part of the Functional Lab Panel.
When Barbie may consider it
- A very high sodium-to-potassium ratio on the HTMA, which can signal stress on the liver and kidneys
- A history of kidney stones or kidney concerns
- High blood pressure or swelling
- Long-term use of acid-reducing medications or water pills
- Palpitations, irregular heartbeat, or muscle cramps that are not improving
- Before adding magnesium beyond what is in your blend
What it can and can’t tell you: It shows how well your kidneys are filtering and how your cells are holding magnesium. It can’t explain the reason behind a kidney finding by itself, and any kidney finding goes to your doctor.
How it fits: It overlaps with the Functional Lab Panel. When Barbie orders both together, she only adds the markers you don’t already have.
Practical notes: A blood draw at Quest. If it is drawn with the Functional Lab Panel, fast as you would for that panel.
“Your kidneys are the gatekeepers for your minerals. Before I lean harder on certain minerals, I want to know they are ready to handle them.”
Celiac panel
Celiac disease is an immune reaction to gluten that damages the small intestine and can block mineral absorption. This blood panel screens for it.
What it measures: antibodies the immune system makes in celiac disease, such as tissue transglutaminase IgA, along with total IgA. Total IgA shows whether the antibody results can be trusted, because some people naturally make little IgA.
When Barbie may consider it
- Digestive symptoms plus celiac or autoimmune conditions in the family
- A personal autoimmune condition
- Low iron that does not respond to support
- Minerals that stay low despite good support
What it can and can’t tell you: A positive result is a strong reason for medical follow-up, since celiac disease is diagnosed by a physician. A negative result makes celiac less likely, but it does not rule out gluten sensitivity that isn’t celiac.
How it fits: Absorption problems can hold minerals down no matter how well you supplement. When HTMA and blood work stay low, this helps rule out one of the bigger reasons.
Practical notes: A blood draw at Quest. You need to be eating gluten regularly in the weeks before the test for the result to be accurate, so please don’t go gluten-free before testing without talking with Barbie.
“If your body can’t absorb well, even the best supplements struggle to help. This rules out one of the most important reasons that can happen.”
Single-marker add-ons
Sometimes one extra number answers the question. These are added to a blood draw you are already having at Quest, so there is no extra trip. They are separate, optional markers, not part of the Functional Lab Panel.
| Marker | What it shows | When Barbie may consider it | What it can’t tell you |
|---|---|---|---|
| RBC folate | Folate stored in your red blood cells over the past few months | Fertility goals, pregnancy or breastfeeding; a known MTHFR variant; high homocysteine; red blood cells that run large | How well folate is being used inside the cell |
| Plasma zinc | Zinc circulating in the blood | When the HTMA leaves it unclear whether zinc is truly high or being lost; frequent infections, slow healing, or changes in taste or smell | Zinc stored in tissues |
| MMA (methylmalonic acid) | Whether B12 is actually working at the cell level | B12 in a borderline range, or B12 that reads high from supplements while symptoms such as tingling or fatigue continue | The reason B12 isn’t working, such as low stomach acid |
How they fit: Each one settles a question the HTMA or first blood work raised but couldn’t answer alone.
Zinc is a good example: the HTMA can’t always tell whether a high hair zinc reflects too much zinc or zinc being lost, and plasma zinc helps sort that out.
Practical notes: These follow the fasting and timing instructions of the draw they are added to.
“Your results raised one specific question, and this one extra marker will answer it.”
This page is educational and is not intended to diagnose, treat, cure, or prevent any disease. Barbie Fisher is a certified HTMA practitioner and health coach, not a medical doctor; these tests are not sold on this site, and nothing here replaces care from your own doctor. Please keep your physician involved in your care, especially for any result that needs medical follow-up.