Feel Sharp · Tiredness & focus
Brain Fog & Focus Check
Reading the same sentence again because it just won’t sink in?
Reading the same sentence again because it just won’t sink in? Forgetting what you were about to say? Finding that a simple task takes much more effort by the afternoon?
When your focus keeps slipping, it can affect your work and your everyday life. You want to know what to look at next, especially when getting more rest hasn’t settled it.
This check looks at thyroid function, vitamin B12, iron stores, vitamin D, magnesium and homocysteine. A Marham General Physician reviews the results alongside your symptoms, sleep, routine and medicines, then helps you decide what to do next. A blood test cannot explain every case of brain fog. If these results are normal, that is still useful information for the conversation with your doctor.
Take your difficulty focusing seriously and get a clearer next step. Feel sharp. Stay sharp.
کیا ایک ہی بات بار بار پڑھنے کے بعد بھی ذہن میں نہیں بیٹھتی؟ بات کرتے کرتے لفظ بھول جاتے ہیں؟ یا دوپہر تک چھوٹا سا کام بھی زیادہ مشکل لگنے لگتا ہے؟ جب توجہ کی کمی روزمرہ کام پر اثر ڈالنے لگے تو صرف اندازے سے کام نہیں چلتا۔ اس چیک میں تھائیرائیڈ، وٹامن B12، آئرن کے ذخیرے، وٹامن ڈی، میگنیشیم اور ہوموسسٹین کی جانچ شامل ہے۔ مرہم کا جنرل فزیشن رپورٹ کے ساتھ آپ کی علامات، نیند اور روٹین کو دیکھ کر اگلا قدم سمجھاتا ہے۔ اگر خون کے ٹیسٹ نارمل آئیں تو بھی ڈاکٹر کے ساتھ یہ گفتگو اہم ہے۔
Updated 28 September 2026
What’s tested, and why
25-OH Vitamin - D3
Free Thyroid Function Test (FT3,FT4,TSH)
About this testHomocysteine Level
About this testMagnesium (Serum)
About this testSerum Ferritin
About this testVitamin B-12 (Serum)
About this test
General Physician consultation, included — Online or In Clinic Consultation
Our team calls to arrange it once your reports are ready.
Six tests from one blood sample, plus the doctor who reads them together.
- Free Thyroid Function Test (FT3, FT4, TSH): the whole thyroid picture in one test instead of three. TSH is the screening number; free T3 and free T4 show what the gland is actually producing, which is what tells your doctor whether a borderline TSH matters. An underactive thyroid is among the most treatable causes of slow thinking, forgetfulness and mental fatigue, and it gets missed constantly because the other symptoms are easy to blame on overwork.
- Vitamin B-12 (Serum): B12 deficiency causes poor concentration, forgetfulness and pins and needles. It is common here, and more so on a low meat diet, on long term metformin, or on acid reducing tablets taken for months. If you already take B12 in any form, read the precautions before booking.
- Serum Ferritin: your iron stores. Iron deficiency drains concentration and energy long before it becomes anaemia and shows up on a blood count, which is why ferritin rather than haemoglobin is the test here.
- 25-OH Vitamin D3: deficiency affects roughly four in five women of reproductive age in Pakistan and is a frequent contributor to fatigue and flat mood.
- Homocysteine Level: rises when B12 or folate is short, so it helps your doctor judge whether a borderline B12 is genuinely causing trouble. It is here for that reason and not as a heart test. Trials that lowered homocysteine with B vitamins did not reduce heart attacks, and it should not be read as a cardiac risk marker.
- Magnesium (Serum): low magnesium causes fatigue, cramps and broken sleep. Worth measuring, with one honest limitation: most of the body's magnesium sits inside cells and bone, so a normal serum result does not completely rule a shortage out.
- General Physician consultation, included: a Marham doctor reads all six together and tells you which one is actually holding you back. Online or at a clinic, whichever suits you. Part of the package, not an add on.
What this does not measure. The commonest causes of brain fog in a working adult are sleep debt, untreated snoring, chronic stress, anxiety and low mood, and no blood test finds any of them. This panel exists to rule the physical causes in or out first, which is the right order to work in. If all six come back normal, that is a useful result, and your doctor can point you towards a Psychologist consultation, which Marham offers separately.
If something needs following up, your doctor orders only what is needed, charged separately: thyroid antibodies, a full blood count, folate, an HbA1c, or a sleep assessment.
Feel Sharp. Stay Sharp.
The doctor tells you which result explains how you feel, what to take, and when to test again so you know the treatment has worked.
If everything is normal, that is useful too: it rules out the commonest causes and moves the conversation to the next question, such as sleep, blood sugar or mood.
Not just a report. An answer.
Before your test
- No fasting. Eat and drink normally before the sample.
- If you take B12 in any form, this is the most important line on this page. An injection, tablet or syrup, or a multivitamin containing B12, lifts the blood level for weeks to months and can make a real deficiency read as perfectly normal. Tell the doctor exactly what you take and when you last took it. If you have had injections, ask before booking, because the sensible plan is usually to test before the next course rather than after one.
- Stop biotin supplements 48 to 72 hours before. Biotin sits in almost every hair, skin and nail supplement, and it interferes with the laboratory method used for thyroid and B12 testing. It is the commonest reason a thyroid result comes back looking alarming when nothing is wrong.
- If you already take a thyroid tablet, take it after the sample rather than before. Levothyroxine swallowed an hour before the draw raises the free T4 reading and makes the dose look bigger than it is. Do not skip the dose, just delay it.
- Postpone if you are unwell. Ferritin rises during any infection or fever, so a result taken while you are ill can look normal when your stores are actually empty.
- Tell the doctor about every supplement and medicine you take, including metformin, acid reducing tablets such as omeprazole, and any iron or multivitamin.
- Mention if you are pregnant or trying to conceive, since thyroid reference ranges are different in pregnancy and the threshold for treating is lower.
- Have your sleep pattern ready for the consultation: how many hours, how broken, whether you snore, and when you last woke up feeling properly rested. It matters as much as the numbers do, and the doctor will ask.
- Not for under 18s.
- Homocysteine takes longer than the rest. The other five are usually ready the same day and homocysteine can follow within 24 to 48 hours, so book the consultation for once the full report is in.
Questions people ask
کیا وٹامن B12 کے انجکشن لگوانے سے پہلے ٹیسٹ کروانا ضروری ہے؟
تھائیرائیڈ کی خرابی کی علامات کیا ہوتی ہیں؟
تھائیرائیڈ گلٹی جسم کی رفتار کنٹرول کرتی ہے، اس لیے اس کی خرابی کی علامات پورے جسم پر ظاہر ہوتی ہیں۔ اگر یہ کم کام کرے تو تھکن، وزن کا بڑھنا، سردی زیادہ لگنا، بالوں کا گرنا، قبض، جلد کا خشک ہونا، طبیعت کا بجھا بجھا رہنا اور سوچنے سمجھنے میں سستی ہوتی ہے۔ اگر زیادہ کام کرے تو دل کی دھڑکن تیز ہونا، وزن کم ہونا، بے چینی، ہاتھوں کا کپکپانا اور نیند کا خراب ہونا شامل ہیں۔ خواتین میں پیریڈز کا بے قاعدہ ہو جانا بھی ایک عام علامت ہے۔ چونکہ یہ ساری علامات کسی اور وجہ سے بھی ہو سکتی ہیں، اس لیے اندازے کے بجائے خون کا ٹیسٹ ہی درست جواب دیتا ہے۔ مزید پڑھیں: تھائیرائیڈ کی بیماریاں
What if all six come back normal and I still cannot concentrate?
Should I stop my supplements before the test?
Two of them, and it matters more than people expect. Biotin, which is in nearly every hair, skin and nail supplement, interferes with the laboratory method used for thyroid and B12 testing and can produce a result that looks like an overactive thyroid when nothing at all is wrong. Stop it 48 to 72 hours before the sample. B12 in any form, including a multivitamin, raises the blood level for weeks, so stopping it the day before achieves nothing; tell the doctor what you take instead. Everything else you can carry on with, including your thyroid tablet if you are on one, though that is best taken after the sample rather than before. If you are unsure, bring the boxes to the consultation and let the doctor look.
Can I just book a TSH and a B12 instead?
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