Recommended Laboratory Tests for Annual Wellness Visits
For routine annual wellness visits, a comprehensive assessment should include fasting lipid profile, fasting blood glucose or hemoglobin A1C, complete blood count, comprehensive metabolic panel, urinalysis, and thyroid-stimulating hormone testing. 1
Core Laboratory Tests for Annual Wellness Visits
Essential Laboratory Tests
- Complete Blood Count (CBC) 1
- Lipid Profile (total cholesterol, LDL, HDL cholesterol, triglycerides) 1, 2
- Should be measured at least every 5 years; every 2 years if risk factors are present 2
- Fasting Blood Glucose or Hemoglobin A1C 1
- Especially important for diabetes screening and monitoring
- Comprehensive Metabolic Panel 1
- Includes liver function tests, kidney function (creatinine, eGFR)
- Electrolytes (sodium, potassium, chloride)
- Urinalysis including spot urinary albumin-to-creatinine ratio 1
- Thyroid-Stimulating Hormone (TSH) 1
Age-Specific Considerations
Adults 20-39 years
- All core labs at least every 5 years 2
- More frequent testing (every 2 years) if risk factors present 2
Adults 40+ years
- All core labs annually 2, 1
- Risk assessment should include 10-year CHD risk calculation using multiple risk factors 2
Special Population Considerations
Patients with Diabetes
- Hemoglobin A1C (quarterly if therapy has changed or not meeting goals) 2
- Serum potassium (if on ACE inhibitors, ARBs, or diuretics) 1
- Vitamin B12 levels (if on metformin) 1
- Annual urine albumin testing 2
Patients with Cardiovascular Risk
- More frequent lipid testing (annually) 2
- Global risk estimation for CHD should be performed every 5 years (or more frequently if risk factors change) 2
- Adults over 40 or those with 2+ risk factors should have 10-year CHD risk assessed 2
Frequency of Testing
- Every visit (at least every 2 years): Blood pressure, body mass index, waist circumference, pulse 2
- Annual testing for adults 40+ or with risk factors: Lipid profile, fasting glucose, CBC, comprehensive metabolic panel 2, 1
- Every 5 years for low-risk adults under 40: Lipid profile, fasting glucose 2
Monitoring Considerations
- Lipid variability between visits can be a significant predictor of myocardial infarction and all-cause mortality 3
- Point-of-care testing for comprehensive metabolic panels can reduce wait times but may not be necessary for routine wellness visits 4
- Pre-analytical factors can significantly impact test results, particularly for lipid testing; fasting samples are preferred for accurate assessment 5
Common Pitfalls to Avoid
- Inadequate fasting: Patients should fast for 8-12 hours before lipid and glucose testing
- Inconsistent timing: Perform annual labs at approximately the same time each year for better comparison
- Over-testing: Avoid unnecessary testing in low-risk individuals
- Under-testing: Don't miss recommended screenings based on age and risk factors
By following these evidence-based recommendations for laboratory testing during annual wellness visits, clinicians can effectively screen for common conditions and monitor patients' health status to improve outcomes related to morbidity, mortality, and quality of life.