I want a full picture of my health. What blood tests should I get every year?

Good plan — getting a yearly set of blood tests is one of the best ways to track your overall health and pick up problems early. Below is a practical, prioritized list: core annual tests for most adults, additional tests to consider based on sex/age/risk, optional advanced tests, and where/how to get them. Discuss this with your primary care clinician so the panel is tailored to your needs.

Core annual blood tests (recommended for most adults)

• Complete Blood Count (CBC) — screens for anemia, infection, and some blood disorders.
• Comprehensive Metabolic Panel (CMP) — evaluates electrolytes, kidney function (creatinine, BUN), liver enzymes (ALT, AST, ALP, bilirubin) and blood glucose.
• Lipid panel (total cholesterol, LDL, HDL, triglycerides) — cardiovascular risk. (Fasting often recommended, though nonfasting is acceptable for many.)
• Hemoglobin A1c (A1c) — average blood sugar over ~3 months (diabetes/prediabetes screening).
• Thyroid-stimulating hormone (TSH) ± free T4 — basic thyroid screening.
• 25‑Hydroxy Vitamin D — common deficiency that affects bone and immune health.
• Vitamin B12 — important for energy, nerves, cognition (especially if vegan/vegetarian or age >60).
• Ferritin (iron stores) — especially for premenopausal women, people with fatigue, or suspected iron deficiency.

Additional tests to consider (based on age, sex, family history, medications, or risk)

• High-sensitivity C‑reactive protein (hs‑CRP) — general inflammation and added cardiovascular risk info.
• Apolipoprotein B (ApoB) or LDL particle number (e.g., NMR LipoProfile) — more precise cardiovascular risk assessment if you have a strong family history or abnormal lipids.
• Lipoprotein(a) — one-time check for inherited cardiovascular risk.
• Hepatitis C antibody (HCV) — CDC recommends at least once for adults and during pregnancy; repeat if ongoing risk.
• HIV antigen/antibody and syphilis serology — at least once and more often if sexually active with new/ multiple partners or high risk.
• Hepatitis B surface antigen/antibody — if unvaccinated or risk factors.
• PSA (prostate-specific antigen) — discuss with your clinician; generally considered for men 50+ (earlier if high risk).
• Ferritin/iron studies more often for women with heavy periods; serum iron/TIBC if ferritin abnormal.
• Hormone tests (total testosterone in men, FSH/estradiol in women) — only if symptoms (low libido, menopausal symptoms, etc.).
• Pregnancy test (hCG) where relevant.

Optional/advanced testing (useful for optimization or specific concerns)

• Homocysteine (cardiovascular/stroke risk when elevated)
• Vitamin K, magnesium, or other micronutrients — only if deficiency suspected.
• Specialty cardiac biomarkers or genetic panels — for high-risk people or early-onset heart disease in family.
• Comprehensive male/female hormone panels (DHEA‑S, free testosterone, estradiol) — for specific symptoms or performance optimization.

How often

• Annual for the “core” set unless your doctor recommends otherwise.
• Some tests (ApoB, Lp[a]) can be checked once or less frequently unless therapy/abnormal result demands repeat testing.
• If results are abnormal, your clinician will advise follow-up testing intervals.

Practical tips

• Fast 8–12 hours before lipid panel and fasting glucose if ordered. (Ask if nonfasting is okay.)
• Take meds as instructed; tell the lab if you are pregnant or taking supplements that affect labs (e.g., biotin can interfere with some assays).
• Keep consistent timing (morning draws) if comparing year-to-year for certain hormones/metabolites.
• Always review abnormal results with your primary care clinician to interpret in context.

Where to get tests (brands/services and why)

• Labcorp and Quest Diagnostics — two nationwide clinical labs accepted by most providers and insurers; wide test menus including specialty tests (ApoB, Lp[a], NMR profiles). Good for clinician-ordered, insurance-covered testing.
• Your primary care clinic or health system lab — convenient if you already have a doctor; results go straight into your medical record.
• Direct-to-consumer / at‑home options (if convenience or privacy matters): Everlywell and LetsGetChecked — affordable, mail-in/finger‑prick kits for common panels (lipids, A1c, thyroid, some STI screens); good for convenience but sometimes limited test range and may cost out‑of‑pocket.
• InsideTracker or WellnessFX — consumer labs focused on optimization and longevity with deeper panels and coaching; pricier but useful for performance tracking and targeted optimization.
• DirectLab or HealthLabs — let you order many common tests online without a doctor’s order in some states (pay out‑of‑pocket).

Insurance and costs

• Many routine preventive tests are covered when ordered by a clinician; DTC tests are usually out-of-pocket. Check your insurance and whether your clinician will order the panel.

Next steps

1. Bring this list to your primary care clinician (or request a preventive health visit).
2. Ask which tests are most important for you given your age, family history, medications, and symptoms.
3. Decide whether to use your clinician + Quest/Labcorp (insurance friendly) or a DTC option for convenience.

If you want, tell me your age, sex, major medical conditions, family history (early heart disease, diabetes, cancer), and whether you’re on any medications — I’ll give a tailored testing checklist and frequency.