Medical Tests You Should Be Taking

While we tend to think about our health in terms of how we subjectively feel, having some cold, hard data can give valuable insights into our physical well-being. According to the American Association for Clinical Chemistry (AACC), approximately 13 billion laboratory medical tests are performed each year in the United States. As the AACC noted: "Throughout an individual's lifespan, laboratory tests contribute to improved overall health and better disease management. In addition to testing performed to diagnose specific conditions and monitor treatment, lifelong health screenings .. can detect risk early, leading to better prognoses and more favorable outcomes."

The Oak Bend Medical Center explained that diagnostic testing can be done for a number of reasons. These include confirming or excluding suspected conditions, monitoring how a condition is progressing or how well a treatment is working, and screening for conditions in individuals who don't yet have any symptoms. Medical tests often require a blood draw, but some require other types of samples or use technology to visualize what's happening in the body.

It's always a good idea to talk with your doctor about what tests may be beneficial for you, given your unique situation and potential risk factors. It's also important to remember that, in most cases, a single abnormal test result isn't conclusive — it may not be any cause for alarm or it may simply mean that additional testing is needed.

Lipid panel

An estimated 93 million American adults have a total cholesterol level greater than 200 mg/dL, and approximately 29 million of those individuals have levels higher than 240 mg/dL. In addition, 18% of adults have an HDL ("good") cholesterol level below 40mg/dL. High cholesterol doesn't have any symptoms, but it's a risk factor for heart disease and stroke, the leading and fifth leading causes of death in the United States, respectively (via the Centers for Disease Control and Prevention).

Because high cholesterol is such a common and potentially serious problem, it's important to have your cholesterol levels tested regularly. Recommendations for how often individuals should be screened vary from one medical organization to another, but generally, you should expect to get a lipid panel every one to five years, depending on your age and other risk factors. If you already have high cholesterol, a lipid panel can help doctors monitor how well you're managing your condition with diet, lifestyle changes, or medication. The panel reports total cholesterol, HDL, LDL ("bad" cholesterol), and triglycerides. For accurate results, it's important to fast for 9 to 12 hours before your blood is drawn (via Lab Tests Online).

Hemoglobin A1C

Blood glucose testing is an easy way to know exactly what your blood sugar levels are in the moment, but there's another test that reveals what your blood sugar levels have been like over a longer time period. Hemoglobin is a protein in red blood cells that allows them to carry oxygen throughout your body. When glucose builds up in your blood, it binds to hemoglobin. A hemoglobin A1C (HbA1C) test measures how much glucose is attached to hemoglobin.

Since red blood cells have a lifespan of about two to three months, the HbA1C test gives doctors a valuable glimpse into the past. HbA1C is expressed in terms of percentages. An HbA1C of 5% corresponds to an average glucose level of 97, while 6% corresponds to an average glucose of 126 and 7% corresponds to 152. Normal HbA1c values range between 4% and 5.6%. A value between 5.7% and 6.4% is considered prediabetes, while a value of 6.5% or higher is considered diabetes. People with poorly managed diabetes may have an HbA1C as high as 14 (average glucose of 355). In addition to screening individuals for diabetes, the HbA1C test can be used to monitor how well an individual with diabetes or prediabetes is managing their condition (via WebMD).

According to the American Diabetes Association, approximately 34.2 million Americans have diabetes, and as many as 7.3 million of those don't realize they have the condition. Another 88 million have prediabetes.

Liver function panel

When it comes to the body's organs, your liver is a real workhorse. As WebMD explained, "It turns nutrients into chemicals your body needs. It filters out poisons. It helps turn food into energy." When the liver is damaged or not working correctly, it can have major, even life-threatening consequences. There are a number of conditions that can impact the liver. Hepatitis A, B, and C are common viral infections that affect the liver, while autoimmune hepatitis is one of several conditions in which the immune system mistakenly attacks the liver. Alcohol and drug abuse can also damage the liver. Nonalcoholic fatty liver disease is a condition in which fat builds up in the liver, preventing it from functioning properly. In addition to chronic liver issues, individuals may experience acute liver failure or cirrhosis (a buildup of scar tissue in the liver).

Because liver health is so critical for overall health, a battery of tests that gauge liver function is usually incorporated into annual bloodwork or done when individuals have symptoms of liver problems. Although the exact tests vary from lab to lab, a liver function panel usually includes the following: alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), albumin, and bilirubin. If one or more of these tests turns up an abnormal result, your doctor will perform additional testing to pinpoint the issue (via Mayo Clinic).

Bone density test (DEXA scan)

Osteoporosis is a condition in which the bones become thin, weak, and prone to fractures. According to the National Osteoporosis Foundation, 10 million Americans have osteoporosis and another 44 million have osteopenia (low bone density).

If you think osteoporosis is something you don't need to worry about until you're much older, think again. As WebMD explained, bone thinning can happen at any age and often has no symptoms until the first broken bone. While the hormonal changes of menopause put women at a significantly higher risk for osteoporosis, a number of factors can increase an individual's chances of getting osteoporosis at a younger age. These include low body weight, smoking, not getting enough exercise, a history of eating disorders, celiac disease, and steroid use.

If you have these or other risk factors, or if you've broken a bone when you really shouldn't have, your doctor may order a bone density test, also known as a DEXA scan. This test uses X-rays to determine how much calcium and other bone-building minerals are present in a particular volume of bone. The spine and hip are the areas most commonly tested. You'll receive two results. The Z-score compares your bone density to an average person of your same age and sex, while the T-score compares your bone density to an average healthy young adult of your same sex (via Mayo Clinic).

STI testing

While it's not something most people like to think about, getting regularly screened for sexually transmitted infections (STIs) is a very important part of being sexually active. The Centers for Disease Control and Prevention recommends that all individuals aged 13 to 64 be tested at least once for HIV. Anyone who has unsafe sex should be tested for HIV a minimum of once a year, and sexually active bisexual and gay men may benefit from HIV testing every three to six months. Sexually active women under age 25 or over age 25 with certain risk factors should be tested for gonorrhea and chlamydia once a year. Additionally, pregnant women should be tested for syphilis early in pregnancy.

Many people have an "it'll never happen to me" attitude about STIs, but the truth is that they're actually quite common and infection rates are on the rise. Approximately 2.5 million Americans have an active STI, including 115,000 cases of syphilis, roughly 600,000 cases of gonorrhea, and nearly 1.8 million cases of chlamydia. About two-thirds of Americans surveyed in February 2020 didn't realize STI rates are on the rise, and only 8% were worried about contracting an STI (via MedicineNet).

C reactive protein test

C-reactive protein (CRP) is a protein in your blood that rises when there's inflammation in the body. Doctors may order a CRP test if you have signs or symptoms of an inflammatory condition such as rheumatoid arthritis or lupus. A CRP test can also be used to help gauge your risk for heart disease, since high levels of CRP have been linked to heart attack. Normal CRP levels are under 10 mg/L; anything higher is considered abnormal and potentially cause for concern. Unfortunately, a CRP test won't shed any light on what exactly is causing the inflammation in your body (via Mayo Clinic).

Inflammation isn't always a bad thing. According to the Harvard Medical School, acute inflammation occurs immediately after an injury and produces warmth, redness, swelling, and pain. This brings white blood cells to the area, where they can begin the healing process. Problems arise, however, if the inflammatory response becomes chronic. In these cases, the body can get confused and begin attacking healthy tissue. Chronic, low-grade inflammation is believed to cause or worsen a number of conditions, such as heart disease, diabetes, cancer, and arthritis. Chronic inflammation doesn't produce the telltale signs that acute inflammation causes, so it often goes unnoticed and unaddressed. That's why CRP and other tests for inflammation are so important.

Renal function panel

Kidney disease is an umbrella term for any condition that causes damage to the kidneys and impairs their ability to perform their important tasks of filtering the blood, balancing electrolytes and fluid in the body, and regulating blood pressure. Chronic kidney disease is most commonly caused by diabetes or high blood pressure, and many people don't realize they have kidney issues until the damage is moderate or severe. Kidney disease is a progressive condition with five stages. Once a person's kidneys are severely compromised, they require dialysis, a procedure in which blood is passed through a machine that removes waste products (via Nephcure Kidney International).

A kidney (renal) function panel can help alert doctors to issues with the kidneys before a patient is even aware there's a problem. It can also be done to help diagnose a specific condition if someone is experiencing signs and symptoms of kidney trouble. The exact lineup of tests varies from lab to lab but usually includes tests to gauge levels of electrolytes, minerals such as phosphorous and calcium, and waste products such as creatinine and blood urea nitrogen (BUN). If a single result is out of the normal range it may not be cause for alarm, but if numerous results are out of whack, this can provide valuable clues to what exactly is going wrong in the kidneys (via Lab Tests Online).

Pap smear

It can feel awkward to ... ahem ... open up to your gynecologist, but the humble Pap smear (aka Pap test) changed the course of women's health in the 20th century. According to the American Cancer Society, "Cervical cancer was once one of the most common causes of cancer death for American women. The cervical cancer death rate dropped significantly with the increased use of the Pap test."

A Pap test can detect precancerous changes to the cervix long before they become invasive cervical cancer. Even so, more than 14,000 women are diagnosed with invasive cervical cancer each year, and nearly 4,300 die annually. Cervical cancer is most often diagnosed in women between the ages of 35 and 44.

A doctor performs a Pap smear by using a brush and flat spatula-like tool to collect a small sample of cells from your cervix. This is usually done during the course of a more comprehensive pelvic exam and may also be combined with a screening for human papillomavirus (HPV), the most common cause of cervical cancer. Most experts recommend beginning Pap testing at age 21, although there's some debate about how often they should be performed. Generally, women between the ages of 21 and 65 should get a Pap smear every three years, although those over 30 may be advised that they only need to be tested every five years if they've never had an abnormal result (via Mayo Clinic).

Thyroid-stimulating hormone (TSH) test

According to the American Thyroid Association, thyroid disease is a major issue in the United States. The thyroid is a small butterfly-shaped gland in the neck that produces hormones that influence every cell in the body. The thyroid controls metabolism as well as body functions such as heart rate and energy level. Hypothyroidism (underactive thyroid) occurs when the thyroid doesn't produce enough hormones, while high levels of thyroid hormones lead to hyperthyroidism (overactive thyroid). Approximately 20 million Americans have some form of thyroid disease, although as many as 60% are unaware of their condition. Women are much more likely than men to experience hypothyroidism or hyperthyroidism.

If you have signs and symptoms of a thyroid problem, such as unexplained weight loss or gain, your doctor may order a thyroid-stimulating hormone (TSH) test. TSH isn't actually produced by your thyroid; it's made by the pituitary gland and tells the thyroid how much thyroid hormones (known as T3 and T4) to produce. It may seem counterintuitive, but a high TSH level means your thyroid is underactive, while a TSH result that's below the normal range indicates your thyroid is overactive. An abnormal TSH result will prompt further, more specialized tests to gauge what's going on in your thyroid (via WebMD).

Immunoglobulin test

When your immune system goes haywire, it can cause all sorts of issues — from allergies to autoimmune conditions. If your doctor suspects there may be a problem with your immune system, they may order an immunoglobulin test. According to WebMD, immunoglobulins are "proteins that your immune cells make to fight off bacteria, viruses, and other harmful invaders." Making too many or too few of certain immunoglobulins is associated with particular conditions, although an abnormal result on an immunoglobulin test can't provide a definitive diagnosis — it simply tells doctors where they need to investigate further.

The body makes several types of immunoglobulins. Immunoglobulin G (IgG) is the most plentiful type of immunoglobulin and protects the body from infections by "remembering" pathogens encountered in the past. Conversely, immunoglobulin M (IgM) is produced when you're first infected by a new bacteria or virus. Immunoglobulin A (IgA) is found in the mucous membranes of the lungs, sinuses, stomach, and intestines, as well as the fluids these membranes produce. Immunoglobulin E (IgE) is produced when your immune system overreacts to non-dangerous substances such as pollen or pet dander. High immunoglobulin levels may indicate allergies, autoimmune conditions, chronic infections, cancer, or liver disease. Low levels might indicate you have a compromised immune system, kidney disease, or complications from diabetes.

Coronary calcium scan

Heart disease is the leading cause of death in the United States. According to the Centers for Disease Control and Prevention, about 655,000 Americans die each year of heart disease — one person every 36 seconds.

Heart disease is actually an umbrella term for a number of conditions. Coronary artery disease (CAD) is the most common type of heart disease and is caused by a buildup of plaque in the arteries that supply the heart. Many people don't realize they have CAD until they have a heart attack (via Healthline).

Fortunately, a coronary calcium scan can alert doctors to dangerous plaque buildup before a heart attack occurs or before other signs of CAD appear. This test uses specialized X-rays to provide an image of the heart that shows where and how much plaque has been deposited and hardened (calcified). A coronary calcium scan is most often used for individuals with low to moderate heart disease risk or in cases where a patient's risk level is unclear. A score of zero means no plaque is present, while a score of 100 to 300 indicates moderate plaque buildup and relatively high risk for CAD. Anything over 300 is considered extremely high risk (via Mayo Clinic).

Ferritin test

Iron plays a number of important roles in the body, including helping red blood cells transport oxygen. It's also critical for growth, muscle and nerve function, and the creation of certain hormones (via National Institutes of Health). Unfortunately, deficiency in this essential mineral is very common. According to WebMD, 20% of non-pregnant women, 50% of pregnant women, and 3% of men in the United States don't have enough iron in their bodies. The Mayo Clinic outlined four potential causes of iron deficiency. Some individuals, particularly vegetarians and vegans, may not get enough iron in their diet. Others may have difficulty absorbing iron in the intestines because of gastrointestinal surgery or a condition such as celiac disease. A temporary increase in iron needs, such as during pregnancy, can also lead to deficiency. Blood loss, such as from a heavy period, ulcer, or physical trauma, can also rapidly deplete iron stores.

If you're showing signs of iron deficiency, such as chronic fatigue and weakness, your doctor may order a ferritin test. Ferritin is the storage form of iron, and an abnormally low result may mean you're low on iron. An abnormally high value may indicate you have one of several conditions affecting your ability to metabolize and use iron, such as hemochromatosis. If your ferritin levels aren't in the normal range, your doctor will likely order additional iron-related tests to pinpoint the issue (via Lab Tests Online).

BRCA genetic testing

You likely already know how important it is to get regular mammograms once you hit your 40s, but women with certain breast cancer risk factors should consider getting BRCA genetic testing as well. Approximately 5 to 10% of breast cancer patients have a mutation on the BRCA1 or BRCA2 genes. While this is a small percentage of the overall number of breast cancer cases, a woman with a BRCA1 mutation has up to a 72% lifetime risk of developing breast cancer, while those with a BRCA2 mutation have a 69% risk. Having a BRCA mutation also increases the risk of ovarian cancer and breast cancer in men. Women with a BRCA mutation who develop breast cancer tend to do so earlier in life (via BreastCancer.org).

Genetic testing for BRCA mutations (either via a blood or saliva sample) is usually only recommended if you have certain risk factors. These include a personal or family history of breast cancer diagnosed before age 45, male breast cancer, or ovarian cancer; Ashkenazi Jewish heritage; or a relative with a BRCA mutation (via Mayo Clinic). It's important to remember, however, that even if you carry the BRCA genetic mutation, this doesn't mean you're destined to have breast cancer.

Panoramic dental X-rays

When it comes to medical tests that can spot problems before they become major issues, don't forget about your teeth. Although visiting the dentist has become the yardstick by which all unpleasant experiences are measured, most people realize how important oral health is.

According to research conducted by the Delta Dental Plans Association in 2018 and reported on by the American Dental Association, 85% of Americans believe that oral health is "extremely" for "very" important to overall health. Despite this, only 58% reported going to a dentist at least once in the previous year, and 42% admitted they don't go to the dentist as often as they'd like. Only 25% of those surveyed were extremely satisfied with the health of their teeth and mouth.

A panoramic dental X-ray is an excellent way for dentists to get a clear view of what's going on in your mouth. Unlike the more common intraoral (bite wing) X-rays, a panoramic X-ray moves in an arc in front of the patient, creating a more comprehensive image of the teeth, jawbones, and surrounding tissues. Panoramic X-rays can identify dental and medical issues such as advanced gum disease, jawbone cysts and tumors, problems with the jaw joint, impacted wisdom teeth, and even sinusitis. If you need to get dentures, braces, or implants, a panoramic X-ray will help ensure an optimal fit (via RadiologyInfo.org).