What labwork is recommended for a healthy adult?

Recommended Laboratory Work for Healthy Adults

For healthy adults, routine laboratory screening should focus on age-appropriate metabolic and cardiovascular risk assessment rather than comprehensive annual testing, with diabetes screening starting at age 35, lipid profiles every 2-5 years based on risk, and blood pressure at every visit.

Core Metabolic Screening

Diabetes Screening

• Start at age 35 for all adults regardless of risk factors 1
• Earlier screening for any age with overweight/obesity plus additional risk factors 1
• Options: fasting glucose, 2-hour OGTT, or A1C 1
• Repeat every 3 years if normal 2
• Annual testing if prediabetes identified 2

Lipid Profile

• Screen adults with low-risk values every 2 years 1
• Annual testing for high-risk lipid values 1
• More frequent monitoring for those 20+ years with cardiovascular risk factors 3

Blood Pressure

• At every clinical visit for all adults 1, 4
• More frequent for high-risk groups: African Americans, high-normal BP, obesity, age >40 1

Age-Specific Recommendations

Ages 35-65 Years

• Blood pressure screening annually if increased risk, otherwise every 3-5 years 1
• Diabetes and lipid screening as above 1

Ages 65+ Years

• Add comprehensive metabolic panel (kidney, liver, electrolytes) 4, 2
• Complete blood count to screen for anemia and blood disorders 4, 2
• TSH for thyroid screening (disorders increase with age) 4, 2
• Urinalysis with albumin-to-creatinine ratio for kidney disease 4, 2
• Annual cognitive screening 1, 2

Cancer Screening Labs

These are not routine labs but age-appropriate screening tests:

• Colorectal cancer screening starting age 45-50 (stool-based or structural exams, not routine labs) 5, 2
• PSA testing may be offered to men ≥50 with shared decision-making 5
• Cervical cancer screening (Pap/HPV) ages 21-65 5
• Breast cancer screening (mammography) starting age 40-45 5

What NOT to Do

Avoid comprehensive "wellness panels" without indication - general health checks show no mortality benefit and may lead to overdiagnosis 6, 7

Common Pitfalls

• Ordering extensive lab panels in truly asymptomatic, low-risk adults wastes resources 8
• False positives cause anxiety and unnecessary procedures 9
• Focus on evidence-based screening tied to specific age and risk factors 8, 9

Risk-Based Additional Testing

Only add these if specific conditions present:

• Vitamin B12: if on metformin 4, 2
• Serum potassium: if on ACE inhibitors, ARBs, or diuretics 4, 2
• Urinary albumin and creatinine: if diabetes diagnosed 1
• A1C every 6 months: if diabetes diagnosed and meeting goals 1, 2