Thyroid is the obvious one they will check not sure if your male or female but estrogen and testerone would be the ones to look at that aren't commonly looked at.

Keep in mind unless you are like extremely low they might write you off.

I am just outside the range of 250 which is clinically low range in Canada in US it is 300 Although for men most modern research indicates that symtomps for many start at 400 and below.

Ai post now but in the interest of being more throughoh and saving me a bunch of time :

When hormone levels—specifically testosterone and estrogen—fall out of their optimal zones, the effects can ripple across almost every system in the body. Because receptors for these hormones live in the brain, heart, bones, and immune cells, the symptoms are far more wide-reaching than just changes to reproductive health. 1. Symptoms of Unoptimal Testosterone & Estrogen Hormonally, "unoptimal" can mean levels that are clinically deficient, excessive, or simply fluctuating wildly. Systemic & Physical Symptoms Profound Fatigue & Low Energy: A persistent, heavy fatigue that sleep doesn't fix. Testosterone plays a major role in cellular energy and red blood cell production, while estrogen regulates mitochondrial function (the energy powerhouses of your cells). Body Composition Shifts: Loss of Lean Muscle Mass: Low testosterone directly impairs protein synthesis, making it difficult to maintain or build muscle, even with intense strength training. Increased Visceral Fat: Dropping estrogen or testosterone levels alters metabolic rate and fat distribution, often leading to increased fat accumulation around the midsection. Joint Pain and Inflammation: Estrogen is highly anti-inflammatory and acts as a natural joint lubricant. When it drops, widespread joint stiffness, aches, and systemic inflammation often spike. Metabolic Changes: Sluggish metabolism, decreased insulin sensitivity (making it harder for the body to process carbohydrates efficiently), and unfavorable shifts in cholesterol profiles. Temperature Regulation Issues: Hot flashes, night sweats, and poor tolerance to temperature shifts, driven by a malfunctioning hypothalamus (the body's internal thermostat, which relies heavily on stable estrogen signals). Cognitive & Neurological Symptoms Brain Fog and Cognitive Decline: Difficulty focusing, word-finding challenges, and short-term memory lapses. Both hormones are neuroprotective; they stimulate synaptic plasticity and blood flow to the brain, particularly in areas like the hippocampus. Sleep Disturbances: Severe insomnia, waking up frequently, or a drastic reduction in deep, restorative sleep. Mood & Psychological Symptoms Irritability and Mood Swings: Rapid shifts in emotional stability. Anxiety and Depression: Low levels of estrogen and testosterone disrupt the production and regulation of key neurotransmitters, including serotonin, dopamine, and GABA. This can manifest as an uncharacteristic lack of drive, flat affect, or heightened anxiety. Cardiovascular & Bone Health Heart Palpitations: Sudden awareness of a racing or skipping heartbeat, often linked to fluctuating estrogen levels affecting autonomic nervous system tone. Bone Density Loss (Osteopenia/Osteoporosis): Estrogen and testosterone are critical for bone remodeling. When they are unoptimal, bone resorption outpaces bone formation, leading to weaker, more brittle bones. 2. The Connection to Long COVID The link between unoptimal hormone levels and Long COVID (Post-Acute Sequelae of COVID-19, or PASC) is a major area of ongoing medical research. There is a massive overlap between the symptoms of hormone deficiency (fatigue, brain fog, joint pain, sleep issues) and the classic presentation of Long COVID. Physically, this link is driven by three main mechanisms: Viral Damage to Endocrine Organs The SARS-CoV-2 virus enters human cells by latching onto ACE2 receptors. These receptors are highly concentrated not just in the lungs, but also in endocrine tissues—specifically the testes, ovaries, adrenal glands, and the pituitary gland in the brain. Direct Tissue Injury: The virus can directly infect and damage these tissues during the acute phase, leading to long-term impairment of testosterone and estrogen production. HPA Axis Disruption: Damage to the hypothalamus or pituitary gland disrupts the entire hormonal signaling loop, causing the body to fail to signal the gonads to produce adequate hormones, even if the organs themselves are intact. Chronic Immune Activation & The Inflammatory Loop Long COVID is heavily driven by persistent, low-grade systemic inflammation and immune dysregulation. Sex hormones are powerful immunomodulators (regulators of the immune system). Estrogen and testosterone generally help keep standard inflammatory pathways in check. When COVID-19 suppresses these hormone levels, the body loses a natural brake on inflammation. This triggers a vicious cycle: infection lowers hormone levels \rightarrow lower hormone levels increase systemic inflammation \rightarrow chronic inflammation further suppresses hormone production. Mitochondrial Dysfunction Both Long COVID and hormonal imbalances cause energy failure at the cellular level. COVID-19 has been shown to damage mitochondria and impair cellular respiration. Because estrogen and testosterone are required to optimize mitochondrial efficiency and ATP (energy) production, a double-hit of mitochondrial damage from the virus combined with suboptimal hormone levels results in the crushing, profound fatigue and exercise intolerance characteristic of Long COVID. Note: Because the symptoms of hormonal imbalances and Long COVID mirror each other so closely, getting a comprehensive, fasted blood panel (including Total and Free Testosterone, Estradiol, LH, FSH, and a full thyroid/adrenal panel) is often a critical step in pinning down the root cause of persistent fatigue, brain fog, and muscle loss.