Common Tests Everyone Should Have Done
It’s important to get a yearly checkup in order to properly assess your health. Preventive medicine is an important part of your life you should not neglect. As the old adage goes: “An ounce of prevention is worth a pound of cure.” Yearly checkups, vaccines, various monitors of your health, should be a standard part of your regimen to keep you fit. There is some confusion as to what tests should be performed and what they mean, so here is a list of laboratory tests everyone should have performed as part of their yearly checkup. Everyone should be health literate. The best advocate you will have in this life for your health is yourself! No one will care more about you than you do so take the steps necessary to have a basic working knowledge of your health.
Typical bell curve showing "normal range" in the middle with out of range values to the left and right of it
As with all laboratory tests, the reference range (the range determining what “normal” is), will be written next to the value obtained from your specimens. Use this to guide you to determine whether a given value is above, below, or within normal range.
Complete blood count with differential. This test involves counting the number of red blood cells you have (RBCs), hemoglobin, and hematocrit. This will help determine if you’re bleeding and/or anemic. Don’t let these words scare you. Hemoglobin is simply a protein in your red blood cells that helps you carry oxygen. If it’s low, it means you’re carrying less oxygen than you should be and this will cause problems. But, it could be a simple fix like better nutrition or iron supplementation. Your hematocrit is simply the volume of blood you possess. Next up is your platelets. These help to form clots to plug up tears in tissue. Too low and you risk bleeding, too high and you risk forming an embolism (blood clot). Finally, you have the differential which counts the number and types of white blood cells you have.
White Blood Cells commonly seen in your blood and counted as part of the differential
Comprehensive metabolic panel. This is the part of your blood work that tests your typical blood “chemistries.” Sometimes this is referred to as a complete metabolic panel. Sometimes your physician will only order a BMP (basic metabolic panel/profile). I recommend always asking for a CMP as this will provide a more complete picture. A CMP detects your electrolytes (sodium, chloride, carbon dioxide, and potassium). These will help determine if you have any type of electrolyte imbalance. Next, it detects your renal function (BUN, creatinine). These are waste products in your body (BUN, protein waste product, creatinine, muscle waste product). If these are abnormally high, it means your kidneys are not filtering properly. Next, we have your calcium which helps determine various disorders (hyperparathyroidism (too high), osteoporosis, etc.). Continuing on we have your sugar (glucose). This will help to indicate sugar metabolism (too high=possible diabetes, too low=possible hypoglycemia). I recommend having your blood work drawn while you’ve been fasting, at least 8 hours. Otherwise, certain values will be off. Finally we test your liver function (ALT, AST, ALP, total bilirubin). If these values are high they indicate probable liver dysfunction.
Hemoglobin A1c. This test is used to help diagnose diabetes. If it’s under 6% that’s good. It allows you to determine your average blood glucose utilization over the past 2-3 months. This is because it detects glucose attached to a hemoglobin fraction on your RBCs. Since RBCs only survive for about 120 days, that’s as long as we can detect for. If you have any underlying medical conditions involving shortened survival of RBCs (bleeding disorders, hemoglobin abnormalities (e.g., sickle cell)), this test cannot be used because the values will be falsely low.
Lipids are of course your values regarding fat etc. Generally, you would ask for triglycerides, cholesterol, HDL and LDL. If your triglycerides are high you have considerable amount of fat in your blood. If your cholesterol is high this will likely cause a buildup of plaque along your blood vessels (atherosclerosis). If your LDL is high, usually considered your "bad" cholesterol (your cholesterol test is your total cholesterol), it means a higher probability of plaque and various syndromes and diseases. If your HDL is high, this is good. To remember the difference, HDL is "happy" for good cholesterol, and therefore LDL is bad. Your HDL helps to remove and prevent plaque buildup. Very important, please fast for these tests.
Having those tests performed on your blood will give you a fairly good picture of your overall health. One other test to have performed would be your TSH which helps determine your thyroid function. Though TSH isn’t secreted by your thyroid, it will be higher or lower depending upon the hormones your thyroid does secrete, since it is highly affected by them. Finally, though not a blood test, a urinalysis should be ordered on a random urine specimen you provide. The values will help support diagnoses determined based upon your blood work.
Depending upon your age you may get certain other tests (e.g., PSA if your male over 40 or 50). Also, certain tests for cancer are really only measures of treatment monitoring. For example, CA 15-3 is a breast cancer antigen. Having it tested to tell whether you have cancer is generally contraindicated. That’s because CA 15-3 is produced in various other parts of your body as well. A high number wouldn't necessarily indicate breast cancer. But, if you have already been diagnosed, testing your CA 15-3 level will help to determine if the treatment is working (i.e., if it goes down the treatment is working, if it remains the same or goes higher it’s probably not working).
This is just an illustrative list not exhaustive but should empower you with enough knowledge to be able to meaningfully discuss with your physician as well as comprehend your laboratory report.