"My GP checks my blood pressure every year. Do I need anything else?" It is one of the questions we hear most often from people in their sixties and seventies. The honest answer depends on your health, your medicines and what has already been checked. Still, a handful of blood tests from 60 tend to tell you more than they did at 40, and knowing what each one measures makes the next conversation with your GP easier. This guide covers the usual ones, in plain words.
Why blood tests from 60 look a little different
Several things change quietly with age. The kidneys filter a little less each decade, the stomach absorbs vitamin B12 less well, the skin makes less vitamin D and the chance of heart disease and type 2 diabetes keeps climbing. Many of these changes give no symptoms for years. The NHS notes that chronic kidney disease, for example, is often only found when a routine blood or urine test done for another reason shows the kidneys may not be working normally.
Medicines add another layer. After 60, more people take something every day, and some common medicines change blood results or need regular tests to keep them safe. That monitoring is arranged by whoever prescribes the medicine. A check-up you choose yourself sits alongside it, never in place of it.
Kidneys: how well they filter
The main blood test for the kidneys measures creatinine, a waste product made by your muscles. From that level, together with your age and sex, the laboratory works out an estimated glomerular filtration rate (eGFR): a figure for how well your kidneys are filtering the blood (NHS).
The NHS recommends regular kidney testing for people with high blood pressure, diabetes or heart disease, and for people on long-term medicines that can affect the kidneys, such as lithium, omeprazole or anti-inflammatory painkillers. A urine test often goes with the blood test, so a single eGFR is only part of the picture.
Vitamin B12 and folate
Low vitamin B12 becomes more common with age, mostly because the body absorbs less of it from food, and it can build up slowly over years (Green et al., 2017). The NHS names pernicious anaemia, an autoimmune condition of the stomach, as the most common cause in the UK, and notes that it is more common in women around 60. Some everyday medicines can lower B12 too, including metformin and the acid reflux tablets known as proton pump inhibitors.
The signs are often vague: tiredness, pins and needles, a sore tongue, changes in memory or mood. That is why B12 is often part of a check-up from 60, usually together with folate, the vitamin that works alongside it to make healthy red blood cells.
Vitamin D through UK winters
From October to early March, the UK sun is not strong enough for the skin to make vitamin D. The NHS advises everyone to consider a daily 10 microgram supplement in autumn and winter, and all year round for people who are rarely outdoors, for example if they are frail, housebound or living in a care home. A blood test shows where your level stands, which can be useful if you have bone or muscle aches or have spent a lot of time indoors.
Heart and blood sugar
If you are between 40 and 74 and do not already have heart disease, kidney disease, diabetes or high blood pressure, you should be invited to an NHS Health Check every 5 years. It includes a cholesterol test and possibly a blood sugar test, and if you are over 65 you are also told about signs of dementia to look out for (NHS).
After 74, or in the years between invitations, the two tests people most often add are a cholesterol profile and HbA1c (glycated haemoglobin), which reflects your average blood sugar over the past 2 to 3 months. You can read more about what the Health Check covers in our article on check-ups from 40.
Thyroid and full blood count
An underactive thyroid tends to start slowly, with tiredness, feeling the cold, weight gain, constipation or low mood: all easy to put down to getting older (NHS). The usual first test measures thyroid stimulating hormone (TSH) and free thyroxine (free T4).
A full blood count (FBC) looks at your red cells, white cells and platelets. It is the test the NHS uses first to check for anaemia, which can come from low iron, low B12 or folate, or other causes that your GP may want to look into.
