Men's health blood tests: heart, blood sugar, hormones and PSA

Plenty of men only see a GP when something hurts. The trouble is that the things most worth knowing about in midlife, such as cholesterol and blood sugar, rarely hurt at all. The NHS is clear that high cholesterol does not usually cause symptoms and can only be found with a blood test (NHS, 2026). This guide walks through the men's health blood tests that commonly make sense, what each marker means, and the one test, the prostate specific antigen (PSA) test, that is worth talking through with a doctor before you have it.

Why men's health blood tests start with the heart

Much of the risk to the heart and circulation builds quietly, over years. The NHS notes that you are more likely to have high cholesterol if you are a man, over 50, or of South Asian or sub-Saharan African origin, and that it can run in families (NHS, 2026).

That is why the NHS Health Check, offered every 5 years in England to people aged 40 to 74 without existing heart, kidney or blood sugar conditions, includes a cholesterol test and possibly a blood sugar test, alongside blood pressure, weight and waist (NHS Health Check). NICE uses these numbers, together with age, smoking and family history, to estimate the risk of heart attack and stroke over the next 10 years (NICE, 2023).

Cholesterol and inflammation

A cholesterol profile usually reports total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, non-HDL cholesterol and triglycerides. Some heart panels add C-reactive protein (CRP), a general signal of inflammation. CRP on its own does not say where any inflammation is or why it is there, so it is read with the rest of the picture.

Blood sugar and diabetes risk

Type 2 diabetes happens when the hormone insulin does not work properly or there is not enough of it, so the glucose level in the blood rises too high (NHS). Many people have raised blood sugar for years before they notice anything. The test most often used is glycated haemoglobin (HbA1c), which reflects your average blood sugar over the past 2 to 3 months, so a single sample tells you more than a one-off glucose reading.

Liver and kidneys

General health panels usually include liver and kidney markers. Alcohol, some medicines and extra weight around the middle can all show up in the liver enzymes, while the kidney markers show how well your kidneys filter waste. These numbers are most useful as a baseline: a result you can compare against in a year or two, with your GP.

Testosterone: only when you have symptoms

Testosterone falls slowly with age, by about 1% a year from around 30 or 40, and the NHS points out that this steady fall is unlikely to cause problems in itself. Tiredness, low sex drive and low mood often have other causes, such as stress, poor sleep, alcohol or depression (NHS). A testosterone test is worth considering when you have symptoms, for example a low sex drive or fewer morning erections, and it should be taken in the morning, when levels are highest. The Endocrine Society guideline recommends a morning sample and a repeat test to confirm a low result (Bhasin et al., 2018).

PSA: worth talking through first

The PSA test is different from the others. The UK National Screening Committee does not recommend screening all men with PSA, because in the general population it is likely to do more harm than good; in 2026 it recommended targeted testing only for a small group of men with a specific inherited gene change (UK National Screening Committee, 2026). A large review of the trials found that screening at best leads to a small fall in deaths from prostate cancer and no change in deaths overall, while adding harms from biopsies and treatment (Ilic et al., 2018).

Any man can ask a GP about PSA, and the GP will talk through the benefits and risks. You do not need a referral to have the test: anyone can order it with us, as the total PSA test on its own, with free PSA, or in the prostate profile. Talking it through with a doctor first is still worthwhile, to understand what the result can and cannot tell you. It is guidance, not a requirement. A high PSA does not mean you have cancer. Our article on prostate health and the PSA test goes through it step by step.

What each marker means

• Total cholesterol: the total amount of cholesterol in your blood, a waxy substance the body needs. Too much can lead to plaque building up in the arteries, so it helps assess the risk of heart disease. You might be asked not to eat for up to 12 hours before a cholesterol test. Glossary
• HDL cholesterol: often called "good" cholesterol, it carries excess cholesterol back to the liver. A higher HDL suggests a lower risk; a low level may mean a higher risk. Glossary
• LDL cholesterol: often called "bad" cholesterol. Too much can build up in the artery walls, so it is one of the main markers of heart risk. It is usually calculated from the rest of the profile. Glossary
• Triglycerides: a type of fat in the blood used for energy. Diet, weight, smoking and inactivity can push it up. Glossary
• CRP: made by the liver in response to inflammation. It can rise with an infection, an injury or an inflammatory condition. Glossary
• HbA1c: your average blood sugar over the past 2 to 3 months, used to check for and follow diabetes. Glossary
• Alanine aminotransferase (ALT): a liver enzyme. When the liver is inflamed or under strain it releases ALT, so higher levels may point to conditions such as fatty liver, or to the effect of alcohol or some medicines. Glossary
• Gamma-glutamyl transferase (GGT): an enzyme found mainly in the liver. It can rise when the liver is not working well and with alcohol use. Glossary
• Estimated glomerular filtration rate (eGFR): how well the kidneys filter the blood, calculated from creatinine with age, sex and body size. Glossary
• Testosterone: an important sex hormone. In men, too little can cause tiredness, low mood and less muscle mass. The best time to give a sample is between 7am and 10am. Glossary
• Sex hormone binding globulin (SHBG): a protein from the liver that binds testosterone in the blood. It is read with the testosterone result. Glossary
• PSA: a protein made by the prostate. Higher levels can be linked to cancer but also to an enlarged prostate or infection; it cannot confirm cancer on its own. Glossary

Reference ranges vary; take your results to a doctor you trust, such as your GP.

Practical tips

• Start with the basics. Cholesterol and HbA1c come first for most men from their thirties and forties; testosterone only with symptoms; PSA after talking it through with a doctor.
• Time it right. Book hormone tests for the morning, and follow any fasting advice on the test page.
• Tell the whole story. Family history of heart disease, diabetes or prostate cancer changes what is worth checking, so mention it in the health questionnaire and to your GP.
• Keep a baseline. One result is a snapshot; two or three over the years show a trend. See why repeating tests over time helps.

If you have chest pain, sudden breathlessness, weakness on one side of the face or body, or slurred speech, call 999. For urgent advice when you are not sure, call NHS 111.

Frequently asked questions

At what age should a man start checking his cholesterol? The NHS Health Check starts at 40, but men with a family history of early heart disease or other risk factors often talk to their GP sooner. Our men aged 30 to 39 page explains why.

Is a low testosterone result a reason to start treatment? Not on its own. Results vary through the day and from one test to the next, so a low result is usually repeated in the morning and read with your symptoms by your GP.

Should PSA be part of every check-up? No. It is a personal choice, best made after talking to a doctor, not a routine test. You can order it with us without a referral.

Next steps

To see what men commonly check at each age, open the men's health card in the check-up guide and the pages for men aged 40 to 59 and men aged 60 and over. The test pages explain each panel in plain words: heart health profile, HbA1c, general health profile and male hormone profile. Tests are processed by our partner laboratory, and you can share your results with a doctor you trust from the app.

This content is for information and education only and does not replace an assessment or treatment by a qualified health professional. Always talk to your GP or a health professional for individual advice.

References

1. High cholesterol - NHS. nhs.uk
2. NHS Health Check - NHS. nhs.uk
3. Cardiovascular disease: risk assessment and reduction, including lipid modification (NICE guideline NG238): recommendations. nice.org.uk
4. The 'male menopause' - NHS. nhs.uk
5. Bhasin S, Brito JP, Cunningham GR, et al. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID 29562364
6. Type 2 diabetes - NHS. nhs.uk
7. UK National Screening Committee: minutes of the March 2026 meeting (prostate cancer screening) - GOV.UK. gov.uk
8. Ilic D, Djulbegovic M, Jung JH, et al. BMJ. 2018;362:k3519. PMID 30185521