What laboratory tests are recommended for a general health assessment?

Laboratory Tests for General Health Assessment

For a general health assessment in asymptomatic adults, a complete blood count (CBC), comprehensive metabolic panel (including glucose, electrolytes, renal and liver function), lipid profile, and thyroid-stimulating hormone (TSH) form the core screening battery.

Core Laboratory Panel

Hematologic Assessment

• Complete blood count (CBC) with differential is fundamental for detecting anemia, infection, and hematologic disorders that may be asymptomatic 1, 2
• The CBC evaluates hemoglobin, white blood cell count, and platelet count, providing broad screening for multiple disease states 3, 4

Metabolic and Renal Function

• Comprehensive metabolic panel should include electrolytes (sodium, potassium, calcium, magnesium), renal function (creatinine with estimated glomerular filtration rate), and hepatic function (ALT, AST, alkaline phosphatase, bilirubin) 1, 5, 2
• Creatinine measurement and estimation of renal function are essential baseline tests 1
• Liver function tests establish baseline hepatic status 1, 5

Glucose Metabolism Screening

• Fasting plasma glucose and glycated hemoglobin (HbA1c) should be measured to screen for diabetes and prediabetes 1
• If both fasting glucose and HbA1c are inconclusive, an oral glucose tolerance test should be added 1
• This screening is critical given the strong association between glucose abnormalities and cardiovascular outcomes 1

Lipid Assessment

• Lipid profile (fasting or non-fasting) should be obtained to assess cardiovascular risk 1
• Annual lipid monitoring is recommended for ongoing health surveillance 1

Thyroid Function

• Thyroid-stimulating hormone (TSH) screening detects hypo- or hyperthyroidism, which are common reversible causes of multiple symptoms 2
• TSH should be measured when clinically indicated by suspicion of thyroid disorder 1

Additional Considerations Based on Risk Factors

Vitamin Deficiencies

• Vitamin B12 testing should be considered, particularly in older adults or those with risk factors for deficiency 2
• Homocysteine levels may be added if B12 deficiency is suspected 2

Inflammatory Markers

• Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) can be considered when inflammatory conditions are suspected 2
• These are not routine screening tests but should be obtained based on clinical context 1

Urinalysis

• Urinalysis provides screening for renal disease, diabetes, and urinary tract abnormalities 1
• This is particularly important in patients with hypertension or diabetes risk factors 1

Monitoring Schedule

• Annual reassessment of lipids, glucose metabolism, and creatinine is recommended for ongoing health maintenance 1
• More frequent monitoring may be necessary based on abnormal baseline results or development of chronic conditions 1

Critical Interpretation Points

• The CBC must be interpreted in conjunction with clinical history and physical examination to maximize diagnostic utility 6, 4
• Normal baseline values are essential for interpreting future abnormalities, particularly for liver function tests if hepatotoxic medications are later prescribed 5
• Approximately 10-20% of CBC results are reported as abnormal, requiring structured follow-up algorithms 4
• Age-appropriate cancer screening (cervical, colorectal, breast) should be incorporated into the overall health assessment strategy 1