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The Bloodwork Panel To Ask For At Your Next Physical
What a standard check-up usually includes, what it usually doesn't, and which extras are worth requesting.
Somewhere between the minimalist annual check-up and the £900 direct-to-consumer panel that measures ninety things and explains none of them, there is a sensible list.
We asked clinicians what they order for themselves, what they add when a patient asks, and where the enthusiasm for more testing starts to do harm.
What a standard panel already gives you
A full blood count, urea and electrolytes, liver function tests, a lipid profile and fasting glucose. Between them these cover anaemia, kidney and liver function, cardiovascular risk and diabetes screening.
It is a genuinely good baseline, and for a healthy asymptomatic person in their twenties it may be all that is warranted.
Four worth adding for most women
Ferritin. Iron stores fall long before haemoglobin does, and deficiency is common in menstruating women.
HbA1c. A three-month average of blood glucose, more informative than a single fasting sample and far less dependent on what you ate yesterday.
TSH. Thyroid disease is markedly more common in women and its symptoms overlap almost entirely with those of a busy life.
Vitamin D. Deficiency is widespread at northern latitudes and correction is cheap and safe.
Worth discussing, depending on you
Lipoprotein(a) is measured once in a lifetime and identifies a genetic cardiovascular risk that a standard lipid panel misses entirely. ApoB gives a more direct count of atherogenic particles than LDL cholesterol.
A coeliac screen is reasonable with unexplained iron deficiency or persistent gastrointestinal symptoms. AMH has a narrow legitimate use in fertility planning and is widely oversold as an ovarian 'score'.
Where more testing starts to hurt
Every test has a false positive rate. Run ninety of them on a well person and the probability of at least one abnormal result approaches certainty.
“The cost isn't the blood test, it's the CT scan it triggers,” says Dr Rahimi. “Incidental findings generate anxiety, radiation and occasionally biopsies, and most of them were never going to matter.”
How to read the results
Reference ranges describe the middle 95 percent of a reference population, not optimal health, and they vary by laboratory. A result marginally outside the range is often normal for you; a result inside it can still be wrong for you.
Trends beat snapshots. Keep your results. The most useful thing about this year's panel is usually last year's.
This article is general information reviewed for accuracy, not personal medical advice. Speak to a qualified clinician about your own health. WomenWelly is reader-supported and free to read; we buy the products we test.
Ruth Alvarez
Health Director
Ruth Alvarez runs WomenWelly's health desk. She has spent fourteen years covering medicine and public health, with a particular focus on the conditions that are under-researched in women — endometriosis, autoimmune disease and the long arc of perimenopause. She reads the study before she reads the press release.
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