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Good question — an annual blood-work “baseline” is a great way to catch problems early and track trends. Which exact tests you need depends on your age, sex, family history, medications and risk factors (smoking, obesity, diabetes, heart disease, sexual activity). Below I give a practical core panel that applies to most adults, then additional tests to consider based on common situations, plus where you can get them and some practical tips.
Core annual blood tests (recommended for most adults)
- Complete blood count (CBC) — checks for anemia, infection, platelet problems.
- Comprehensive metabolic panel (CMP) — assesses kidney function, liver enzymes, electrolytes and blood glucose if not doing a separate test.
- Lipid panel (total cholesterol, LDL, HDL, triglycerides) — cardiovascular risk screening.
- Fasting glucose and/or hemoglobin A1c — diabetes screening and control (A1c gives 2–3 month average; fasting glucose is useful for immediate metabolic status).
- Thyroid stimulating hormone (TSH) — screens for hypo- or hyperthyroidism.
- Vitamin D (25‑OH) — common deficiency linked to bone and immune health.
- Vitamin B12 — important for nerve function and anemia, especially if you’re older, vegan, or on metformin.
- High-sensitivity C‑reactive protein (hs‑CRP) — general marker of inflammation and cardiovascular risk (optional, but useful for risk stratification).
- Urinalysis — screens for kidney disease, blood, infection and some metabolic problems.
Additional tests to consider (based on age, sex, medication, risks)
- Ferritin and iron studies — if you have heavy menses, fatigue, or suspect iron deficiency.
- PSA (prostate specific antigen) — discussion with your clinician; commonly considered for men 50+, earlier if higher risk (family history, Black men). Shared decision-making recommended.
- Sexually transmitted infection screening (HIV, syphilis, chlamydia/gonorrhea as appropriate) — at least once for most adults (HIV) and more often if high‑risk.
- Hepatitis C screening — CDC recommends at least once for all adults (and more often if risk).
- Kidney-specific tests (urine albumin/creatinine ratio) — especially if diabetic or hypertensive.
- Vitamin folate (folic acid) — if you’re pregnant or planning pregnancy.
- Sex hormones (estradiol, FSH/LH, testosterone) — if you have symptoms such as low libido, irregular periods, hot flashes, erectile dysfunction — frequency and necessity depend on symptoms and age.
- Hemoglobin A1c more frequently or fasting glucose more often if prediabetes/diabetes.
- Bone-health labs (calcium, parathyroid hormone, 25‑OH vitamin D, sometimes bone turnover markers) — in older adults or those at fracture risk.
- Autoimmune or specialty tests (thyroid antibodies, ANA, rheumatoid factor, homocysteine, methylmalonic acid) — only if indicated by symptoms or history.
How often?
- Annual for the core panel is reasonable for most. Tests like lipids and glucose may be more or less frequent depending on results and risk (e.g., every 3 years if all normal and low risk; yearly if abnormal or high risk).
- If you start a medication that affects labs (statins, thyroid meds, warfarin, metformin), you’ll need follow-up labs more often.
Where to get the tests (brands/services)
- Traditional nationwide labs: Quest Diagnostics and LabCorp — accepted by most doctors and insurance, wide test menus, easy to schedule phlebotomy.
- Direct-to-consumer / at-home options: Everlywell and LetsGetChecked — convenient for many routine tests and include a clinician review to order the labs; good if you don’t have a primary care provider.
- Personalized health platforms: InsideTracker and WellnessFX — focus on more extensive biomarker panels and coaching/interpretation (paid, subscription models).
- Primary-care or concierge services: One Medical, Forward, or your own PCP — best for integrated interpretation and follow-up when something is abnormal.
Practical tips
- Talk with your primary care provider about which of the above are most appropriate given your history — they can help tailor testing and interpret trends.
- Many lipid and fasting-glucose tests require an 8–12 hour fast — ask when scheduling.
- Bring a list of medications and supplements (some affect labs: B12 supplements, biotin can interfere with certain assays).
- If any result is abnormal, don’t rely on a single reading — many values are confirmed with repeat testing and clinical correlation.
If you want, tell me your age, sex, major medical history and any medications and I’ll give a more tailored yearly-lab checklist.