“Get everything tested, just in case”—it sounds like a thoughtful approach, but in practice it often leads to two extremes: either a person spends half their salary on endless blood tests, or they see alarming “red flags” in the results due to the lab’s specific reference ranges and start taking a handful of dietary supplements.
The body at ages 20, 30, and 40 is a completely different biological system. And the approach to health screening must be tailored to each specific stage.
Let's take a look at which checkups really make sense at different ages, and where you can save money.
20 Years: Energy Is Boiling Over, but We Need a Foundation
Many people believe that at age 20, your health is indestructible. And to some extent, that’s true: our reserves are enormous. But it’s precisely at this age that we lay the foundation for future longevity (and develop our first chronic health issues due to sleepless nights before exams and fast food).
What's really important to check:
- Complete blood count (CBC) + ferritin. Fatigue in 20-year-olds is often attributed to laziness, but it can be a sign of latent iron deficiency or anemia (especially in young women due to menstruation). Ferritin is the primary marker of iron stores; it’s essential to check it, not just hemoglobin.
- TSH (thyroid-stimulating hormone). The thyroid gland regulates metabolism, energy levels, and mood. A dysfunction can masquerade as depression or chronic fatigue.
- Fasting glucose. A basic test for carbohydrate metabolism.
- Sexually transmitted infections (STIs). An active sex life requires regular screening (once a year if you have multiple partners).
- For women: A visit to a gynecologist + a Pap smear (cytology test)—starting at age 21 or 3 years after becoming sexually active. Ultrasound of the pelvic organs and breasts.
30 Years Old: The First Warning Signs and Office Syndrome
By the time we reach 30, our lifestyles often change: we move less, spend more time sitting at a computer, and face career-related stress. Our metabolism begins to slow down gradually.
To the list from 20 years ago, we add:
- Lipid profile (cholesterol and its fractions: HDL, LDL, triglycerides). Atherosclerosis begins to develop not at age 50, but much earlier. This test is the only way to find out how your blood vessels are handling your love of burgers.
- Glycated hemoglobin. A more accurate indicator of blood sugar levels over the past 3 months than just fasting glucose. It helps detect prediabetes at a stage when it can be reversed through diet alone.
- Vitamin D (25-OH). In 90% of cases, people living in large cities are deficient in it. It affects the immune system, bone density, and energy levels.
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST). These are basic markers of liver function (especially important if you enjoy a glass of wine on Fridays or take a lot of medications).
40 Years: The Equator, Which Requires Systematic Monitoring
At age 40, the body enters a phase of hormonal changes (premenopause in women, a gradual decline in testosterone in men). The risks of cardiovascular disease and cancer increase, so the focus shifts to early diagnosis.
What we always check:
- Comprehensive lipid profile + C-reactive protein (high-sensitivity). We assess not only cholesterol but also hidden inflammation of the blood vessel walls—the main risk factor for heart attacks and strokes.
- Cancer screenings (vitally important!):
- For women: Mammogram (every 2 years) + regular gynecological exam with an HPV test (high-risk human papillomavirus).
- For men: A blood test for PSA (prostate-specific antigen) — a screening test for prostate health.
- Colonoscopy. Starting at age 40–45, gastroenterologists recommend undergoing this screening (ideally under anesthesia) to rule out polyps and early-stage colorectal cancer.
- Hormone levels (as indicated): FSH, LH, estradiol, prolactin (for women), total and free testosterone (for men).
Common Mistakes When Getting Tested:
- Getting every single test on the “100-marker check-up” list done at commercial labs. You don’t need 80% of these tests, and the remaining 20% may require complex interpretation—which the internet will only make more daunting.
- Interpret the results on your own. A number that is slightly above or below the lab’s reference range does not necessarily mean a diagnosis. Lab reference ranges represent the average values across a hospital population. Always discuss your test results with your doctor in the context of how you’re feeling.
- Get a checkup “once and for all.” It’s a good idea to have basic tests (complete blood count, glucose, cholesterol) done once a year. This is cheaper and more effective than treating advanced chronic conditions.
