In short
- The core is the same in every decade: complete blood count, sugar, lipids, liver, kidneys, thyroid and iron. Age only adds a few tests.
- Age 20–35: a first adult check-up and Lp(a) — once in a lifetime, because it is genetically determined.
- Age 40–55: HbA1c and ApoB move to the front. For women, a complete blood count because of heavy periods; for men, kidneys and uric acid.
- 55+: kidneys with more than one measure (creatinine, cystatin C, urine ACR), bones, NT-proBNP if risk factors are present, PSA as an informed choice.
- After 70, less is more: some screening is dropped because the benefit no longer outweighs the risk. That is just as evidence-based as adding tests.
- A blood test does not replace national screening programmes (in Slovenia: SVIT, DORA, ZORA) — these are free and proven to save lives.
The question “what should I test at my age” has a shorter answer than most providers promise. The core set of tests is the same in every decade. Age adds a handful of markers that only become meaningful then. The table below shows this without listing everything that could be measured.
The core that applies in every decade
Whatever your age, it makes sense to know: complete blood count (anaemia, inflammation), glucose and HbA1c (sugar), lipid panel (fats), ALT and GGT (liver), creatinine with eGFR (kidneys), TSH (thyroid) and ferritin with CRP (iron). Already have a report with these values? Upload it to Blood Lab 360 and get every value explained. Everything else is an add-on based on age, sex and risk.
What each decade adds
| Age | Women | Men | How often |
|---|---|---|---|
| 20–35 | Core + Lp(a) once, ferritin with CRP, B12 and folate (especially on a plant-based diet), TSH. | Core + Lp(a) once, ApoB, uric acid. | Once, then every 2–3 years if everything is within range. |
| 35–45 | + HbA1c, ApoB; complete blood count with heavy periods; vitamin D if risk factors are present. | + HbA1c, liver enzymes with a FIB-4 calculation if overweight or drinking alcohol. | Every 1–2 years. |
| 45–55 | Core + lipids with ApoB (risk rises after menopause), TSH with anti-TPO if abnormal, bone minerals if risk factors are present. | + kidneys (creatinine and cystatin C), NT-proBNP with high blood pressure or diabetes. | Yearly. |
| 55–70 | + urine ACR, calcium with albumin and ALP (bones), B12. | + urine ACR, PSA as an informed choice (age 50–70), B12. | Yearly. |
| 70+ | Less is more: the core stays, screening with little benefit is dropped (see below). | Yearly or as agreed with your doctor. | |
The table applies to people without a known disease. With diabetes, kidney or heart disease, monitoring is set by your doctor and is more frequent.
What is different for women
- Iron. Menstruation is the most common reason for depleted stores. In women of reproductive age, ferritin tells you more than a complete blood count.
- Thyroid. Autoimmune thyroid disease is much more common in women, so TSH belongs in the core already in your thirties.
- Transition to menopause. After 45, hormones are not measured for diagnosis (NICE NG23). What is measured is what mimics the symptoms and what changes after menopause — lipids, sugar, bones.
- Pregnancy. Before a planned pregnancy, iron, thyroid, vitamin D, rubella and sexually transmitted infections make sense. During pregnancy your gynaecologist takes over.
What is different for men
- Heart earlier. Risk rises already in your forties, so ApoB and Lp(a) are not “advanced” but basic.
- Kidneys. In muscular men, creatinine looks worse than it is. After 50, cystatin C makes sense.
- Testosterone only with signs. Screening without symptoms is not recommended. With signs, you need a morning blood draw and a second measurement to confirm.
- PSA is a decision. It is offered between 50 and 70 (from 45 with a family history). After 70 it is advised against.
After 70: what is dropped and why
In older people the balance between benefit and harm shifts. Take screening that would bring benefit in ten years. In someone with a life expectancy under ten years, it brings mostly extra tests, worry and procedures. So after 70, screening PSA, aggressive hunting for slight deviations and routine vitamin D testing without an indication are usually dropped. What stays: complete blood count, kidneys, sugar, thyroid and everything tied to the medicines a person takes.
Honestly: this is not cutting corners for older people. It is the same evidence-based logic as adding tests in your forties: you test what changes a decision.
What a blood test does not replace
In Slovenia, three national screening programmes are free and proven to reduce mortality. They are SVIT (bowel cancer, age 50–74), DORA (breast cancer, women 50–69) and ZORA (cervical cancer, women 20–64). No blood test replaces them — not even tumour markers, which we do not recommend for healthy people. If you receive an invitation, respond. It is the best prevention available to you.
Frequently asked questions
At what age should I have my first blood check-up?
A first adult check-up makes sense between 20 and 35, because that is when you get a baseline and a one-time Lp(a) measurement. If heart disease or diabetes runs in your family, earlier.
Do I need a check-up every year?
Up to age 40, every 2–3 years is enough for healthy people. After 40, usually yearly. After an intervention (a change in diet, a medicine) a follow-up after 3 months makes sense.
Does age change the reference values?
For some tests, yes. TSH is normally a little higher in older people, and creatinine and eGFR change with age. In women, hormones and lipids change after menopause. The app applies the appropriate age band.
What if I already have a report?
Upload it to Blood Lab 360 and get every value explained, using the age and sex band that applies to you.
Do older people need more tests?
Not necessarily. After 70, some screening is dropped because the benefit no longer outweighs the risk. What matters more is monitoring what is affected by medicines and known diseases.
Sources: ESC/EAS 2019 and EAS 2022 — lipids, ApoB, Lp(a) once in a lifetime · ADA Standards of Care 2024 — glucose and HbA1c · KDIGO 2024 — eGFR and urine ACR · EAU 2024 and USPSTF 2018 — PSA (age 50–70, advised against after 70) · NICE NG23 — hormones and menopause · Endocrine Society 2018 — testosterone · SVIT, DORA and ZORA programmes (NIJZ, Institute of Oncology Ljubljana) — national screening programmes.
