Lab Tests Everyone Over 40 Should Get
(WellnessPursuits.com) – No matter what age we are, it’s so much easier to prevent health problems than to treat them once they begin. But as we reach 40 and beyond, there are certain lab tests it’s a good idea to undergo so that we can stay on top of our health issues and increase our chances of living as well as possible for as long as possible.
While the tests we need may vary according to our personal and family medical histories, here are some of the most common lab results everyone over 40 should have.
Diabetes can occur at any age, but it’s more likely to strike when we’re 45 or older. Other risk factors include being overweight and not taking part in regular physical activity. When we’re over 50, the doctor should routinely check for diabetes. The lab tests the doctor will run include:
- Fasting blood glucose test –Done by a finger prick or during a blood draw, this measures glucose (blood sugar) after fasting for at least 8 hours. Most people schedule it first thing in the morning. A glucose reading of 99 mg/dL or lower is considered normal; a reading of 100-125 mg/dL indicates prediabetes, and 126 mg/dL or over indicates diabetes.
- A1C test – Done via a blood draw, this test reflects a 3-month average of blood sugar levels. This is also called a hemoglobin A1C or an HbA1C. An A1C below 5.7% is normal, while 5.7-6.4% means prediabetic. An A1C of 6.5% or above means diabetic.
Like diabetes, high cholesterol can affect anyone, but our bodies have a harder time clearing cholesterol as we age. Women become more prone to high cholesterol after menopause, or around 55 years old. Since cholesterol increases the risk of heart attack and stroke, it’s important to begin routine testing as early as possible.
A lipid panel is performed after fasting for 12 hours through a blood draw and will include the following cholesterol measurements:
- LDL cholesterol – Often referred to as “bad cholesterol,” low-density lipoprotein (LDL) builds up in your arteries, raising your cardiovascular risks. A normal LDL cholesterol is considered less than 100 mg/dL.
- HDL cholesterol – Known as “good cholesterol,” high-density lipoprotein (HDL) can help your arteries clear bad cholesterol buildup. Levels above 40 mg/dL or more are considered normal.
- Total cholesterol – This number is calculated from the LDL cholesterol and HDL cholesterol numbers. A total cholesterol should be less than 200 mg/dL to be considered normal.
- Triglycerides – This is a type of fat in the blood. The triglyceride level should be lower than 150 mg/dL.
Kidney disease can happen at any age, but kidney function decreases with age — even in those without kidney disease. Health issues that are more common in older people, such as high blood pressure and diabetes, can also increase your risk of kidney damage.
A full kidney evaluation requires both urine and blood samples. A urinalysis is done to check either for protein (albumin), or blood in the urine. Albumin should be less than 2 mg/L normally (results may vary slightly by the lab). Blood should not be present in the urine. If blood is present or albumin exceeds the normal levels, it might indicate a problem with the kidneys and your doctor may choose to pursue additional testing.
A blood sample is used to check the following:
- Serum Creatinine – Creatinine is a waste product from the normal breakdown of muscle tissue. The kidneys clear creatinine from the blood, so measuring creatinine in the blood is one measure of how well the kidneys are performing. For adult women, a normal test result range is 0.5 to 1.1 mg/dl. For an adult man, the normal test result range is 0.6 to 1.2 mg/dl.
- Blood Urea Nitrogen (BUN) – Urea nitrogen is another waste product produced in the liver during the breakdown of proteins. Normally, the kidneys filter urea nitrogen out of the blood and send it out with the urine. So checking BUN is another measure of how well the kidneys are performing. For women, a normal range is 6 to 21 mg/dL, while the normal range for men is 8 to 24 mg/dL. After the age of 60, the BUN level goes up slightly for most of us. Certain medications like diuretics, some antibiotics, and certain immunosuppressants may also increase BUN results.
In addition to the tests, there are 2 common formulas that are used as indicators of kidney health. These are:
- Albumin/Creatinine Ratio (ACR) – This ratio may indicate the severity of kidney damage. It uses the albumin level found in the urine, expressed in milligrams or mg, and the creatinine level found in the blood expressed in grams or g. A result of less than 30 mg/g is considered normal. Ratios between 30-300 mg/g are considered moderate and two readings in this range in less than 3 months may signal early kidney disease. A result greater than 300 mg/g is considered severe and may indicate advanced kidney disease.
- estimated Glomerular Filtration Rate (eGFR) – The formula to determine the eGFR uses the serum creatinine level found in the blood in a calculation that combines it with your age, race, and gender. It tells doctors, at a glance, how well your kidneys are performing and is a calculated estimate of kidney function efficiency expressed as a percentage. The stages of kidney failure are defined as follows:
- Stage 1 — eGFR greater than 90 — Normal Kidney Function
- Stage 2 — eGFR 60-89 — Mild Loss of Kidney Function
- Stage 3a — eGFR 45-59 — Mild to Moderate Loss of Kidney Function
- Stage 3b — eGFR 30-44 — Moderate to Severe Loss of Kidney Function
- Stage 4 — eGFR 15-29 — Severe Loss of Kidney Function
- Stage 5 — eGFR less than 15 — Kidney Failure
Alcoholic liver disease, viral hepatitis and fatty liver disease have all led to an increase in deaths among people 45-65 throughout the US. This may be a consequence of undiagnosed fatty liver disease, hepatitis C or hepatitis B, heavy drinking or even the use of used needles during injectable drug use. Alarmingly, fewer than 30% of baby boomers surveyed indicate that they have ever been tested for liver disease.
Early detection is key, so your doctor may run a liver (hepatic) panel, which includes:
- Alanine aminotransferase (ALT) – This enzyme plays a role in metabolism, converting protein into energy. If the liver is injured or damaged by diseases like hepatitis, ALT may be released into the bloodstream at higher levels. Normal levels range from 7 to 55 units per liter (U/L).
- Aspartate aminotransferase (AST) – This enzyme helps metabolize amino acids. It’s normally present in the blood at low levels so increased levels might indicate liver damage or disease or muscle damage. Normal levels range from 8 to 48 U/L.
- Alkaline phosphatase (ALP) – This is another enzyme that is important for breaking down proteins. If levels that are higher than normal are found, it may indicate a blocked bile duct, bone disease, or liver damage or disease. Normal levels range from 40 to 129 U/L.
- Total Bilirubin, Direct Bilirubin and Indirect Bilirubin – Bilirubin is a normal breakdown product of red blood cells that is cleared by the liver and excreted in the stool. It is sometimes bound to albumin and is called unconjugated or indirect bilirubin. Direct bilirubin, also called conjugated, may travel to the small intestines and a very small amount may pass to the kidneys where it may be excreted in the urine. Testing measures total and direct bilirubin and indirect bilirubin is calculated by the difference. For an adult, the normal level for total bilirubin is 1.2 milligrams per deciliter (mg/dL). The normal level for direct bilirubin is 0.3 mg/dL. Levels may vary by laboratory and may be affected by medications.
- Albumin and Total Protein levels – Albumin is one of several proteins made in the liver. Protein is one of the main building components in the body. This test measures both albumin and total protein levels in the blood. The normal range for albumin is 3.5 to 5.0 grams per deciliter (g/dL). The normal range for total protein is 6.3 to 7.9 g/dL.
If these levels are too high or too low, they may indicate liver disease. It might also be a good idea to be tested for Hepatitis C because many people exhibit no symptoms, but the damage may still be ongoing. Hepatitis C can be contracted from contaminated blood products, sharing needles or from unsterile tattoo equipment.
PSA Levels (For Men)
The risk of prostate cancer increases with age, and men over the age of 55 are most at risk. Therefore, it’s important for men over 50 to have their prostate-specific antigen (PSA) levels checked regularly. While low levels of PSA indicate a healthy prostate, rapid increases may indicate that you have prostate cancer. High PSA levels can also be a sign of prostatitis or inflammation of the prostate.
Anyone can experience hypothyroidism, but the risk increases with age. Underactive thyroid tends to go undiagnosed because a lot of the symptoms of an underactive thyroid — such as fatigue, weight gain, depression and cold intolerance — tend to be attributed to older age. If you suspect you may be suffering from hypothyroidism, ask your doctor to check your thyroid-stimulating hormone (TSH) and thyroid hormones: free thyroxine (T4) and free triiodothyronine (T3) levels.
Other Diagnostic Tests
While lab work is one key to good health, there are a number of other routine exams and diagnostic tests we should have done after 40. These include the following:
- Blood pressure checks – In people over 40, having a high systolic reading (the top number) can increase your risk of developing heart disease. Take your blood pressure at home and attend regular doctor’s appointments so they can take your readings, as well. Normal blood pressure readings are now considered less than 120/80, according to the American Heart Association.
- Skin cancer exams – Skin cancer can affect people of any age, but people over 50 are more prone to basal cell and squamous cell carcinomas. A primary care physician might do a preliminary screening but might also recommend that you see a dermatologist at least yearly for regular skin exams if there are areas of concern.
- Colonoscopies – The American Cancer Society recommends colonoscopies beginning at the age of 45. If you haven’t already started getting yours, now’s the time to start.
- Pap smears – You might think gynecologist appointments aren’t important after you’re done having children, but the risk of cervical cancer exists at all ages. Pap smears are recommended every 3 years or a pap smear and HPV test every 5 years.
- Mammograms – Nearly 7 out of 10 cases of breast cancer are found in women over the age of 55. How often should you undergo a mammogram? Women over 50 should have a mammogram done yearly, while women 55 and older can get one every 2 years.
A little bit of prevention might be so much easier and less painful than finding remedies after the fact. Staying up-to-date on your lab work, doctor’s appointments and diagnostic screening might be the best gift you ever give yourself. Early detection may help you live a much longer, healthier life.
~Here’s to Your Healthy Pursuits!
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