The yearly core
Three checks do most of the work. Blood glucose or A1C: the USPSTF recommends screening adults 35 to 70 with overweight or obesity for prediabetes and type 2 diabetes, repeating about every three years while normal, so "yearly" only once something is borderline. A lipid panel (LDL, HDL, triglycerides): from 40 to 75 the USPSTF ties statin decisions to 10-year risk, and the panel is the input. And blood pressure at every visit, which is not a blood test but decides more than most of them.
The numbers that ride along
A basic metabolic panel and liver enzymes usually come bundled, and two of those numbers deserve reading rather than skimming. eGFR: below 60 for more than three months defines chronic kidney disease (KDIGO), and 60 to 89 without urine albumin is not disease, it is often normal aging. ALT: the ACG puts the truly healthy upper limit at 33 U/L for men and 25 for women, lower than many lab reports print, and the usual explanation for a creeping ALT is fatty liver that tracks with the glucose and triglyceride numbers above.
Worth doing once, not yearly
Two lipid add-ons carry lifetime information. ApoB counts atherogenic particles and exposes risk hiding behind a normal LDL, most often when triglycerides run high. Lp(a) is roughly 80 to 90% genetic, which is why the European Atherosclerosis Society recommends measuring it at least once in adulthood and then not again. Neither needs an annual slot; both change what "borderline" means for you.
What to skip by default
Routine vitamin D testing: the Endocrine Society's 2024 guideline found no trial evidence supporting 25(OH)D screening in the general population and suggests against routine testing without an indication. Ferritin is a targeted test, excellent when fatigue, heavy periods or anemia raise the iron question, not a default. Testosterone, thyroid (TSH) and PSA are symptom- and decision-driven tests with their own pages. The pattern: screen what has a screening rule, test what has a question.
Where to get them
Any primary-care visit covers the core, and results come with someone obliged to act on them. At-home panels can fill gaps between visits for specific numbers (A1C, lipids); treat them as screening, and bring anything abnormal to a clinician. Our screenings-by-age tool lays out the full schedule, blood work and beyond, for your decade.
Frequently asked questions
How often should I get a full blood panel?
There is no guideline for an annual "full panel" in healthy adults. The screening rules are test-specific: glucose about every 3 years when normal (USPSTF), lipids feeding the age 40 to 75 statin discussion, blood pressure at least yearly. Yearly everything is a habit, not a recommendation, though it is a mostly harmless one.
Do I need to fast before annual blood work?
Less often than clinics imply. A1C and ApoB need no fasting; modern lipid panels are commonly done non-fasting; fasting glucose, by definition, needs 8 hours. Ask what is being drawn.
Are at-home blood test kits accurate?
Kits that mail a sample to a CLIA-certified laboratory are running real assays; the finger-prick collection adds some variability. They are reasonable for screening numbers like A1C and lipids, and no substitute for confirmation when a result would change treatment.
