Check-up guide
Which check-up is right for me?
Plain-words guidance on the blood tests that commonly make sense for your age, sex and situation, and why. Search, watch a short video, or answer 3 questions.
By age and sex
We use sex at birth because the reference ranges of some tests differ for women and men. If you are trans or non-binary, or take hormones, ask your GP which ranges apply to you.
Women
Women 18 to 29 VideoYour first numbers: iron, vitamin D, cholesterol and blood sugar.
- Most things worth knowing at this age give no symptoms. A first result gives you a baseline to compare with later.
- Low iron is common in young women, especially with heavy periods, and it can matter before anaemia shows.
- From October to early March, UK sunlight is not enough to make vitamin D.
Tests that commonly help
- General health profileA broad first look, with cholesterol, HbA1c and iron.
- Iron and iron storesIron stores, if your periods are heavy or you feel tired.
- Vitamin DBest checked in late winter.
- Vitamin B12If you eat a vegan or strict vegetarian diet.
Sources: NHS: Iron deficiency anaemia · NHS: Heavy periods · NHS: Vitamin D · NHS: High cholesterol
Women 30 to 39 VideoIron, thyroid, cholesterol and vitamin D.
- Low iron is most common in women before the menopause. Heavy periods and pregnancy are very common causes.
- A slow thyroid is more common in women and often starts between 30 and 50. Its signs look like many other things.
- High cholesterol gives no symptoms. A blood test is the only way to know your level.
Tests that commonly help
- General health profileA broad look, with cholesterol, HbA1c and iron.
- Iron and iron storesIron stores, with heavy periods or tiredness.
- Thyroid: TSH and free T4How your thyroid is working.
- Vitamin DBest checked in late winter.
Sources: NHS: Iron deficiency anaemia · NHS: Underactive thyroid · NHS: High cholesterol · NHS: Vitamin D
Women 40 to 49The NHS Health Check starts at 40. Cholesterol, blood sugar, thyroid and iron.
- From 40 to 74 the NHS offers a Health Check every 5 years, with a cholesterol test and possibly a blood sugar test. Your own results help in between.
- The perimenopause often starts in your 40s. There is no routine blood test for it: the useful tests look at what changes with it.
- While you still have periods, heavy periods are a very common cause of low iron. A slow thyroid can feel like the perimenopause.
Tests that commonly help
- Heart health profileFull cholesterol, HbA1c and high-sensitivity CRP.
- Thyroid: TSH and free T4When tiredness, weight or mood change.
- Iron and iron storesIf your periods are heavy.
- Vitamin DBest checked in late winter.
Sources: NHS Health Check · NHS: Menopause and perimenopause · NHS: Heavy periods · NHS: Underactive thyroid
Women 50 to 59Around and after the menopause: cholesterol, blood sugar, thyroid and vitamin D.
- The menopause usually happens between 45 and 55. From 45, with symptoms, it is recognised without a hormone test.
- Cholesterol tends to rise around your last period, and it gives no symptoms.
- Women lose bone quickly in the first years after the menopause, and UK winters lower vitamin D.
Tests that commonly help
- Heart health profileFull cholesterol, HbA1c and high-sensitivity CRP.
- Thyroid: TSH and free T4A slow thyroid can feel like the menopause.
- Vitamin DBest checked in late winter.
- Well Person Premier Plus ProfileEverything in one sample from a vein, at a collection point.
Sources: NHS: Menopause and perimenopause · NICE NG23: Menopause · NHS: High cholesterol · NHS: Osteoporosis · NHS: Vitamin D
Women 60 and over VideoCholesterol, thyroid, B12 and kidneys: the numbers that change with age.
- The NHS Health Check runs to 74, and cholesterol tends to be higher after the menopause.
- A slow thyroid becomes more common with age, especially in women.
- Low B12 becomes more common after 65, and some common medicines, such as metformin and acid reflux tablets, lower it.
Tests that commonly help
- General health profileCholesterol, HbA1c, liver and kidneys.
- Thyroid: TSH and free T4How your thyroid is working.
- Vitamins D, B12 and folateVitamin D, B12 and folate.
Sources: NHS Health Check · NHS: Underactive thyroid · NHS: Vitamin B12 or folate deficiency anaemia · NHS: Chronic kidney disease
Men
Men 18 to 29 VideoYour first numbers: cholesterol, blood sugar and vitamin D.
- High cholesterol gives no symptoms, and about 1 in 250 people have a type that runs in families.
- The NHS lists a higher risk of type 2 diabetes from 25 for people of South Asian, Chinese, Black African or Black Caribbean background.
- From October to early March, UK sunlight is not enough to make vitamin D.
Tests that commonly help
- General health profileA broad first look, with cholesterol, HbA1c, liver and kidneys.
- Vitamin DBest checked in late winter.
- Vitamin B12If you eat a vegan or strict vegetarian diet.
Sources: NHS: High cholesterol · NHS: Type 2 diabetes symptoms · NHS: Vitamin D
Men 30 to 39 VideoCholesterol, blood sugar and vitamin D; testosterone only if you have symptoms.
- Men are more likely to have high cholesterol, and it gives no symptoms.
- Type 2 diabetes can start early, often without symptoms.
- Testosterone falls slowly with age, which on its own is unlikely to cause problems. It is worth measuring when you have symptoms such as a low sex drive.
Tests that commonly help
- General health profileA broad look, with cholesterol, HbA1c, liver and kidneys.
- Vitamin DBest checked in late winter.
- Male hormonesOnly if you have symptoms, and best taken in the morning.
Sources: NHS: High cholesterol · NHS: Type 2 diabetes symptoms · NHS: The 'male menopause' · NHS: Vitamin D
Men 40 to 49The NHS Health Check starts at 40. Cholesterol, blood sugar and kidneys.
- From 40 to 74 the NHS offers a Health Check every 5 years, looking at heart disease, stroke, type 2 diabetes and kidney disease.
- High cholesterol and early type 2 diabetes usually give no symptoms. A blood test shows your numbers while there is time to change them.
- Early kidney disease gives no warning. Creatinine and eGFR come in the same sample.
Tests that commonly help
- Heart health profileFull cholesterol, HbA1c and high-sensitivity CRP.
- General health profileAdds liver and kidneys.
- Vitamin DBest checked in late winter.
Sources: NHS Health Check · NHS: High cholesterol · NHS: Chronic kidney disease
Men 50 to 59Cholesterol, blood sugar and kidneys, and the PSA question to take to your GP.
- Men over 50 are more likely to have high cholesterol, and it gives no symptoms.
- The NHS Health Check every 5 years looks at heart disease, stroke, type 2 diabetes and kidney disease.
- From 50 you can ask your GP about a PSA test. It is a choice to make together, not a routine test.
PSA (prostate) is not a routine test on the NHS. From 50 you can ask your GP about it: a high PSA does not mean cancer, and the test has benefits and harms to weigh. Talk it through with your GP first.
Tests that commonly help
- Heart health profileFull cholesterol, HbA1c and high-sensitivity CRP.
- General health profileAdds liver and kidneys.
- Vitamin DBest checked in late winter.
Sources: NHS Health Check · NHS: High cholesterol · NHS: Chronic kidney disease · NHS: PSA test
Men 60 and over VideoCholesterol, blood sugar, kidneys and B12: the numbers that change with age.
- The NHS Health Check runs to 74. High cholesterol and early kidney disease give no symptoms.
- Low B12 becomes more common after 65. Metformin and acid reflux tablets can lower it.
- Being fit does not switch off heart risk: cholesterol still counts.
PSA (prostate) is not a routine test on the NHS. From 50 you can ask your GP about it: a high PSA does not mean cancer, and the test has benefits and harms to weigh. Talk it through with your GP first.
Tests that commonly help
- General health profileCholesterol, HbA1c, liver and kidneys.
- Vitamins D, B12 and folateVitamin D, B12 and folate.
- Thyroid: TSH and free T4If you feel tired or slow.
Sources: NHS Health Check · NHS: Chronic kidney disease · NHS: Vitamin B12 or folate deficiency anaemia · NHS: PSA test
By situation or goal
Start from what is on your mind.
TirednessFeeling tired all the time: iron, B12, thyroid and vitamin D are the usual suspects.
- Tiredness has many causes, and most are not in the blood. The tests that help look at the common ones you can measure.
- Low iron, low B12 and a slow thyroid all cause tiredness, and their signs look alike.
- If tiredness comes with weight loss you cannot explain, or lasts for weeks, see your GP.
Tests that commonly help
- Tiredness profileIron, B12, folate, thyroid and more, in one test.
- Iron and iron storesIron stores on their own.
- Thyroid: TSH and free T4How your thyroid is working.
Sources: NHS: Iron deficiency anaemia · NHS: Vitamin B12 or folate deficiency anaemia · NHS: Underactive thyroid
Heart and cholesterolCholesterol and blood sugar are the numbers behind most heart risk, and they give no symptoms.
- High cholesterol does not usually cause symptoms. A blood test is the only way to know your level.
- Your GP uses cholesterol, with blood pressure, age and other factors, to estimate your heart risk.
- Chest pain, pressure or breathlessness is not a blood test question: call 999.
Tests that commonly help
- Heart health profileFull cholesterol, HbA1c and high-sensitivity CRP.
- Cholesterol profileCholesterol on its own.
Sources: NHS: High cholesterol · NICE NG238: Cardiovascular disease risk · NHS Health Check
Diabetes riskHbA1c shows your average blood sugar over the last 2 to 3 months.
- Type 2 diabetes does not always cause symptoms, and many people have it for years without knowing.
- The risk is higher with a family history, a larger waist, from 40, or from 25 for people of South Asian, Chinese, Black African or Black Caribbean background.
- Very thirsty, peeing a lot or losing weight without trying? See your GP soon.
Tests that commonly help
- Average blood sugar (HbA1c)Your average blood sugar (HbA1c).
- Heart health profileHbA1c together with cholesterol.
Sources: NHS: Type 2 diabetes symptoms · NICE PH38: Type 2 diabetes in people at high risk
ThyroidTSH and free T4 show how your thyroid is working.
- A slow thyroid is more common in women, and often starts between 30 and 50.
- Tiredness, weight gain, feeling cold, dry skin and low mood can come from the thyroid, and from many other things.
- If you already take thyroid tablets, your GP arranges your checks.
Tests that commonly help
Sources: NHS: Underactive thyroid · NICE NG145: Thyroid disease
Vitamins, vegan and vegetarianVitamin D in winter, and B12 if you eat little or no animal food.
- From October to early March, UK sunlight is not enough to make vitamin D.
- B12 comes mainly from animal foods. A vegan diet without B12 supplements is a known cause of low B12.
- Some medicines, such as metformin and acid reflux tablets, can lower B12.
Tests that commonly help
- Vitamins D, B12 and folateVitamin D, B12 and folate together.
- Vitamin DVitamin D on its own.
- Vitamin B12B12 on its own.
Sources: NHS: Vitamin D · NHS: Vitamin B12 or folate deficiency anaemia
Menopause VideoFrom 45, with symptoms, no hormone test is needed. The useful tests look at what changes with it.
- NICE says the menopause and perimenopause are recognised from symptoms in women over 45, without an FSH test.
- Cholesterol tends to rise around your last period, and the thyroid can feel like the menopause.
- Under 45, or with unusual symptoms, your GP may ask for hormone tests.
Tests that commonly help
- Heart health profileCholesterol, HbA1c and CRP.
- Thyroid: TSH and free T4A slow thyroid can feel like the menopause.
- Menopause hormonesHormones, mainly under 45 and with your GP.
Sources: NICE NG23: Menopause · NHS: Menopause and perimenopause · NHS: High cholesterol
Planning a baby VideoWhat is worth checking before you try, and what your GP offers.
- The NHS suggests folic acid before you try, and vitamin D. Neither needs a test first.
- A blood test helps with iron and, with symptoms, the thyroid. For rubella, check you have had 2 doses of the MMR vaccine with your GP.
- After a year of trying without a pregnancy, UK guidance says both partners should be assessed by your GP.
Tests that commonly help
- Iron and iron storesIron stores, especially with heavy periods.
- Thyroid: TSH and free T4With symptoms, how your thyroid is working.
- Fertility hormonesOnly for irregular cycles, after a year of trying, with your GP.
Sources: NHS: Planning your pregnancy · NICE NG257: Fertility problems
Sport and training VideoIron, vitamin D and recovery, compared with your own baseline.
- Low iron is the most common problem in endurance sport, and it can show up before anaemia.
- Hard training raises CK, the muscle marker. Test away from a hard session or a match.
- Your own baseline tells you more than one result on its own.
Tests that commonly help
- Sports fitness profileA sports panel with CK, kidneys and more.
- Iron and iron storesIron stores.
- Vitamin DVitamin D.
Sources: NHS: Iron deficiency anaemia · NHS: Vitamin D
WeightBlood sugar, cholesterol and thyroid, and the checks for weight-loss injections.
- A larger waist raises the risk of type 2 diabetes and heart disease, often without symptoms.
- A slow thyroid can add weight, but it is rarely the only reason.
- If you use prescribed weight-loss injections, a panel can follow kidneys, liver, cholesterol and blood sugar. Your prescriber decides your care.
Tests that commonly help
- Heart health profileCholesterol, HbA1c and CRP.
- Thyroid: TSH and free T4How your thyroid is working.
- Weight-loss managementIf you use prescribed weight-loss injections.
Sources: NHS: Type 2 diabetes symptoms · NHS: Underactive thyroid · NHS: High cholesterol
Men's healthHeart and blood sugar first; testosterone when you have symptoms; PSA only after a conversation with your GP.
- Men are more likely to have high cholesterol, and it gives no symptoms.
- Testosterone is worth measuring when you have symptoms such as a low sex drive or fewer morning erections, in a morning sample.
- PSA is a choice to make with your GP, not a routine test.
PSA (prostate) is not a routine test on the NHS. From 50 you can ask your GP about it: a high PSA does not mean cancer, and the test has benefits and harms to weigh. Talk it through with your GP first.
Tests that commonly help
- Heart health profileCholesterol, HbA1c and CRP.
- Male hormonesTestosterone and related hormones, with symptoms.
- Prostate profile (PSA)Only after talking it through with your GP.
Sources: NHS: High cholesterol · NHS: The 'male menopause' · NHS: PSA test
Long-term medicinesSome medicines need regular blood tests. Those are arranged by whoever prescribes them.
- If a medicine needs monitoring, your GP or specialist arranges those tests. A test here does not replace them.
- Some common medicines, such as metformin and acid reflux tablets, can lower B12.
- Supplements count too: biotin can change some results. Tell us in the health questionnaire, and never stop a medicine because of a result: talk to your GP.
Never start, stop or change a medicine because of a result. Talk to your GP or pharmacist.
Tests that commonly help
- General health profileLiver and kidneys, cholesterol and HbA1c.
- Vitamin B12If you take metformin or acid reflux tablets.
Sources: NHS: Vitamin B12 or folate deficiency anaemia · NHS: Chronic kidney disease
Before you choose
- Chest pain, trouble breathing, fainting or sudden weakness: call 999. For urgent advice, call NHS 111. A blood test is not the right step then.
- This guide is general information. It does not replace your GP, and a result does not tell you what to do on its own: share it with your GP.
- We cannot promise what a result will show. Your result comes with the reference range, within the timeframe shown for each test.
Questions? Write to us through the form, in the app, or at [email protected].