Medicine is 90% prevention and 10% treatment; thus, our focus is on the age-old question: which screening tests are recommended based on age?

We have many labs that charge patients exorbitant amounts of money for tests that are futile. Avoid those street vendor 300-panel lab tests, as they are of no consequence and mostly have little scientific evidence of their utility in making any meaningful changes in your lifestyle or habits.

Age 18-44

Anyone 18-44 years of age is in the carefree age where everything works smoothly before the downward slope of wear and tear of body parts. Staying healthy by exercising 3-4 times a week, avoiding smoking and alcohol, and staying hydrated will prevent the most common diseases in the long term .

Diabetes

Diabetes, as determined by a lab called A1c, is the single most important lab that determines your future chances of getting diabetes.

The fun part is that if you keep your A1c below 5.7, you can stay away from diabetes even if you are genetically predisposed due to your family history of diabetes.

Hypertension

Hypertension, measured with a machine: Do not measure when you are anxious, running around, or stressed.

The proper way is to lie down for 5 minutes, then slowly get up, then measure your blood pressure 3 times, and then take the average of your blood pressure.

If your systolic blood pressure, the top part, is >130, you have stage 1 hypertension and may need medications if this persists for >6 months despite diet and exercise modifiers.

If systolic is >140, then you have hypertension if that’s recorded 2 separate times on separate days.

Total Cholesterol

Total cholesterol is measured via a blood sample.

We do yearly LDL levels, as it’s the important factor that determines your long-term risk for heart attack, stroke, and other diseases that happen due to clogging of arteries.

In 2026, a test is getting a lot of attention, as now APO-lipoprotein A is recommended in all patients at least once in their lifetime and should be included in all yearly exams with your primary care physician. We do not have to repeat this yearly, so don’t repeat it again. The good news is that we do not have to repeat this test yearly, but only once, due to the fact that it’s a genetic predisposition for cardiovascular risk, and it’s like a genetic test you need only once in your lifetime.

Apo-B lipoprotein is another test that is not mandatory but is basically important to address the high-risk ALL particles in your blood. Again, it’s recommended in patients who have high-risk factors like diabetes, hypertension, and central obesity.

CBC

CBC, blood test short form for complete blood count, is most useful for reproductive-age females, but both males and females can have ailments that affect your soldier cells, white blood cells, thus helping us identify bone marrow dysfunction, as your white and red blood cells are produced in your long bones, and the bone marrow can get mad and produce cancer cells.

Early testing is the key, as we have medications that can slow the progression of many blood cancers.

The red blood cells are the main carriers of oxygen molecules from your lungs to your body parts, which is facilitated by hemoglobin present in red blood cells.

Kidney Function Test

Kidney function test, which includes a blood test called BMP, basic metabolic test, is best described by a lab test with lab values of blood creatinine, not the same as the sound-alike creatine used in gyms, and no correlation, along with a urine test, which we like to check for any protein that can in turn, alarm physicians for kidney damage.

There is a specific urine test we do yearly on diabetes patients called urine microalbumin, which is the smallest protein particle slipping through the mesh of kidney cells, thus alarming the physician to look deeper into your kidney function and order further tests to rule out many different kinds of kidney diseases.

Many kidney specialists identify 5 stages of kidney disease, and identifying at stages 1 and 2 can be reversed to normal, but once you reach stage 3 chronic kidney disease, chances of progression are very high.

Thyroid Function Test

We do check thyroid function test, again, blood testing.

Other Recommended Tests to Ask Your PCP to Include

Other tests that are recommended and you can ask your PCP to include in your blood draw panel:

B12 Serum

B12 serum is important for the maturation of your red blood cells, thus affecting chronic fatigue, as well as making the important sheath around your nerve cells.

The analogy is like a plastic cover around a copper wire. We have a myelin sheath made by B12 around nerve cells, thus affecting memory and sensations, especially if you are feeling numbness.

Vitamin D

Vitamin D has many important functions, basically keeping your bones healthy and helping if you have bone pains, constipation, and fatigue.

It’s an expensive test, like $400 plus, so make sure your primary care doctor addresses the codes that are required for the insurance company; otherwise, you may end up paying for the cost of the test.

Fasting Before Labs

Many patients ask what to eat, fast the day before, and the day of labs.

A smart way is to get labs done early in the morning so you can have breakfast after blood work.

Your labs that get affected by this are lipids and your sugar levels, not A1c, as that’s an average of 3 months of your sugars and thus not affected by the day-of-blood-draw sugar levels.

Few patients don’t drink enough water, thinking fasting means both liquids and solids, which is not recommended.

Have a small toast with black coffee; it will likely be another safe choice if you have diabetes or issues with sugar-related problems and are taking medications that can make your sugars go dangerously down in case the wait in the lab is prolonged.

Gender-Specific Screenings

Now specific to gender:

Females

Every 3-4 years after age 21, get a Pap smear done either by PCP or your gynecologist.

It is a very simple procedure where your PCP takes a special brush and takes some samples of cells to get them examined for cancer cells.

After age 40, get a breast mammogram done to rule out breast cancer.

It is done by a radiology office, where you go and get the breast radiographed for any calcifications or anomalies pointing toward breast cancer.

It’s a very important test, as early detection saves lives.

Men

We check testosterone and PSA, usually starting at age 35, especially in patients who are African American and who have a family history of early prostate cancer in father or other siblings.

Testosterone helps us identify if there are any issues with your erection and libido, which is essentially the feeling of wanting sex.

Low testosterone is always confirmed by 3 lab tests, especially ones from 8 a.m. to 9 a.m., as that is the highest level of testosterone we have.

Testosterone supplements usually do not help with erection, but testosterone supplementation has important improvement in memory, removing fogginess of thinking, and fatigue accompanied by low libido.

Colon Cancer Screening

All individuals are recommended to get a colonoscopy or stool test at age 45 and older, as the chances of colon cancer start to rise at this age.

This we screen every 10 years with colonoscopy and stool test for cancer DNA every 3 years.

Discuss with your PCP the right choice for you, as if you have history of polyps or family history of colon cancer, you should not be doing stool test, but the only option is colonoscopy.

Age 45 to 65

All above, except females get FSH levels to check for menopause, plus all tests we mentioned for age 18-45 years.

This is the age when all hormones, especially dropping estrogen levels, are getting whacky, especially getting low.

It’s especially troublesome for women who are around their menopause and who get sleepless nights, anxiety, anger, mood changes, and night sweats.

Your PCP can prescribe HRT, hormone replacement therapy, after evaluating safety guidelines.

Bone Scan / DEXA Scan

Another test, especially for menopausal women and low-testosterone males: Bone scan / DEXA scan, which is a special scan done to check your bone density.

If low, your PCP can prescribe medications that can improve bone density and decrease risk of fractures.

Age 65>

You are getting retired here, most likely, and planning to spend golden years in peace.

Without proper health checks, sudden complications can arise, which may be impactful not just financially but also in morbidity.

All labs and tests as mentioned above for age 18-65.

Plus, we recommend yearly eye exam to check for cataract and whisper test or tuning fork test by PCP to check your hearing.

This is important because you start to lose brain cells more rapidly if you have sensory defect due to either poor eyesight or decreased hearing, potentially accelerating your memory loss.

We check for any cognitive decline and discuss advance care directives if pertinent.

Your PCP may see you more often if you have any major chronic disease like diabetes, hypertension, cholesterol, or any insults like stroke or heart attack history; otherwise, semi-yearly checkups are sufficient.

Same-day appointments are available for your medical issues at Quality Primary Care Associates and for all your primary care needs.