When you’re 25 years old and want a check up and some screening blood tests, what should you have done? What tests are important, even mandatory?
There’s no simple answer to that question because there are always factors to take into consideration. The two biggest factors to consider are family history and lifestyle habits and behaviors. Before a decision is made, questions about a family history of diabetes, heart disease, cancer, high blood pressure, high cholesterol, or hereditary disease must be answered. Secondly, we must know if the individual smokes, drinks, exercises, sleeps around, or leads a life of Puritanical celibacy. The answers to these questions give us most of what we, or the patient, would want to know.
Tests of this nature are usually considered screening tests so unless something in the history points in a certain direction, they will not be covered by your health insurance. If there is some historical information, such as a family, or personal, history of diabetes, you might get an A1C covered. The same is true for many other disorders considered to be familial.
Lifestyle habits are a big factor, too. The major area of concern is that of risky behaviors, eg. promiscuity, alcohol, tobacco, illicit drug use, etc. These might prompt tests for STI’s, HIV, Hepatitis B, or C.
For “straight arrow” Joe Smith who leads an unblemished life I would recommend the following:
CBC—complete blood count; a test for anemia and blood diseases
UA—urinalysis; the best test for kidney problems
CMP—comprehensive metabolic panel; tests for diabetes, liver diseases, metabolic
disorders, and kidney function
Lipid Panel—cholesterol panel; or you might just have a total cholesterol.
These tests should cover most of the problems a healthy 25 year old might encounter. Additional tests should be done based on the information provided in the personal, family, and lifestyle habits sections of the patient’s history.
What about a man or a woman of Medicare age? The family history probably doesn’t differ much from a 25 year old, but there will be a lot more personal past medical history. The patient will be on medication(s) for the diagnoses they have acquired, and testing for these disorders is appropriate. Lifestyle behaviors will most likely have been altered as the individual matures emotionally. Eliminating tobacco, alcohol, and drugs, and being in a stable relationship changes the selection of lifestyle testing done unless a risky behavior-related chronic disease has been acquired. At this life juncture, dementia concerns also appear and possibly need attention.
For “Medicare Mike” Jones, I recommend the following:
CBC—same as for a 25 year old
UA—same as for youth
CMP— include thyroid tests this time, also any chemistry tests appropriate for confirmed
diagnoses, eg. Sed Rate, CRP for autoimmune disorders
Lipid Panel-whether the patient is on meds or not
Any tests used to monitor drug therapy for confirmed diagnoses
PSA-yes, a PSA! How else will you have an inkling if a man has prostate cancer. Chide me
if you like, but I would still do a PSA and respond cautiously if it’s elevated.
That gives the doctor a lot to consider when maintaining quality care and monitoring the patient. These tests will give the doctor the information needed to have a clue if a new problem is developing.
What precedes here are merely the tests I would recommend if someone walked in off the street and wanted blood work. The other half, or three-fourths, of this process is responding to abnormalities found on physical exam. Those are incredibly important to investigate not only with blood work, but also with imaging studies (CT, MRI, US, X-ray), EKG, Stress testing, etc.
It’s just not as simple as it might seem.
Reference: Vega CP. A healthy young patient wants labs. What do you order? medscape.com 2026 October 22.
