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A comprehensive workup for fibroids typically includes: estradiol, FSH, LH, progesterone (timed to the luteal phase), SHBG (sex hormone binding globulin), total and free testosterone, DHEA-S, fasting insulin, fasting glucose, CBC with ferritin (to assess iron deficiency anemia from heavy bleeding), 25-OH vitamin D, thyroid panel (TSH, free T4, TPO antibodies), and in selected cases a urinary estrogen metabolite panel (e.g., DUTCH) to assess Phase I and Phase II estrogen metabolism