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Brain Fog & Focus Check

Updated 10 September 2026
Tests + consultation6 testsGeneral Physician included

You read the same line three times and it still does not go in. You walk into a room and forget why. Meetings blur, names go missing, and by four in the afternoon your head feels like it is running through water. Most of the time the answer really is sleep and stress. But there is a short list of physical causes that produce exactly this, all of them treatable, and all of them a blood test away. Six of them are measured here, from one sample taken at your home in Lahore, and a doctor reads them with you afterwards.

The largest single cause on the list is the thyroid, so this panel measures it properly: TSH as the screening number, plus free T3 and free T4 to show what the gland is actually producing, which is what settles a borderline result. Then the deficiencies that drain concentration: vitamin B12, ferritin for your iron stores, since iron runs low long before it shows up as anaemia, vitamin D, which is short in most Pakistani adults, and magnesium. Homocysteine is included last, and for one specific job: it rises when B12 or folate is short, so it tells your doctor whether a borderline B12 is genuinely doing damage.

Your report is mostly ready the same day, with homocysteine following within 24 to 48 hours. A PMC verified General Physician then reads all six together, online or at a clinic, whichever suits you. One thing to settle before you book: if you are already taking B12 injections, tablets or syrup, the blood level will read normal whether or not you were deficient, so read the precautions first. And if everything comes back clear, that is a real answer too, because it moves the search to sleep, stress and mood, where it very often belongs.

کام پر توجہ نہ لگنا، بات بھول جانا اور دماغ کا مسلسل تھکا رہنا اکثر نیند کی کمی یا ذہنی دباؤ کی وجہ سے ہوتا ہے، مگر کئی بار اس کے پیچھے ایسی جسمانی وجوہات ہوتی ہیں جن کا علاج ممکن ہے: تھائیرائیڈ کی خرابی، وٹامن B12 کی کمی، آئرن کے ذخیرے کا کم ہونا، اور وٹامن ڈی یا میگنیشیم کی کمی۔ اس چیک اپ میں یہ سب ایک ہی نمونے سے دیکھ لیے جاتے ہیں۔ نمونہ لاہور میں گھر بیٹھے لیا جاتا ہے اور مرہم کا ڈاکٹر آن لائن یا کلینک پر بتاتا ہے کہ اصل وجہ کیا ہے۔ ایک اہم بات: اگر آپ پہلے سے B12 کے انجکشن یا گولیاں لے رہے ہیں تو ٹیسٹ سے پہلے ڈاکٹر کو ضرور بتائیں، ورنہ رپورٹ نارمل آ سکتی ہے۔

Tests included

25-OH Vitamin - D3

Free Thyroid Function Test (FT3,FT4,TSH)

Homocysteine Level

Magnesium (Serum)

Serum Ferritin

Vitamin B-12 (Serum)

What's included

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.

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.

How it works

1

Book the package

Confirm the patient’s details and pick a home-collection slot, then pay online or have our team call to confirm.

2

Home sample collection

A Marham Lab phlebotomist collects the sample from your home in Lahore.

3

Get your reports

Your reports are delivered through Marham once the lab has processed them.

4

Doctor consultation

Our team calls to arrange your included consultation once your reports are ready.

Frequently asked questions

ہاں، اور اس کی ایک بہت اہم وجہ ہے۔ ہمارے ہاں تھکن اور کمزوری پر اکثر بغیر ٹیسٹ کے B12 کے انجکشن یا سیرپ شروع کر دیے جاتے ہیں۔ مسئلہ یہ ہے کہ ایک بار انجکشن لگ جائے تو خون میں B12 کی مقدار کئی ہفتوں بلکہ مہینوں تک بڑھی ہوئی رہتی ہے، اور اس کے بعد ٹیسٹ کروائیں تو رپورٹ نارمل آ جائے گی چاہے اصل میں کمی موجود ہو۔ اس لیے بہتر یہ ہے کہ ٹیسٹ پہلے کروایا جائے۔ اگر آپ پہلے ہی انجکشن لگوا چکے ہیں تو ڈاکٹر کو تاریخ بتا دیں، وہ رپورٹ کو اسی حساب سے پڑھیں گے یا دوبارہ ٹیسٹ کا مناسب وقت بتا دیں گے۔ دوسری بات یہ کہ کمی کی وجہ معلوم کرنا بھی ضروری ہے، کیونکہ صرف انجکشن لگواتے رہنے سے وجہ ختم نہیں ہوتی۔

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

Then you have learned something worth knowing, and the search moves somewhere more likely. In a working adult the commonest causes of brain fog are not in the blood at all: broken or insufficient sleep, untreated snoring and sleep apnoea, chronic stress, anxiety, low mood, and plain overload. None of them show up on a panel like this one. What the panel does is clear the physical explanations out of the way first, which is the right order to work in, because fixing your sleep while an underactive thyroid or an empty iron store goes untreated gets you nowhere. Your doctor can talk you through what to look at next, and Marham offers a Psychologist consultation separately if that is where the conversation lands.

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.

You can, and if money is tight that is a reasonable place to start. Two things are worth knowing first. A TSH on its own leaves you guessing when it comes back borderline, which is exactly the situation where the free T3 and free T4 in this panel earn their place. And the usual finding in someone with brain fog is not one deficiency but a combination, typically low iron stores sitting next to a marginal B12 or vitamin D, which you only see if you look at them together. Booked separately at list price the six tests come to Rs. 16,550. This check prices them well below that and adds a General Physician consultation, included rather than charged on top. Home sample collection in Lahore is free, and the consultation can be online or at a clinic.

Book this package

Rs. 11,400

Rs. 17,55035% off

Tests

6

General Physician

Online or In Clinic Consultation

Sample collection

At home · Lahore

Book this packageHome sample collection — Lahore only