Knowing the recommended blood tests by age is one of the most proactive steps you can take for your health, yet many people are unsure which tests they actually need and when. Regular blood work can detect conditions like diabetes, high cholesterol, thyroid disorders, and even certain cancers years before symptoms appear, giving you the opportunity to intervene early when treatment is most effective. Understanding recommended blood tests by age helps you have informed conversations with your doctor about preventive care.
The screenings you need change as you move through different decades of life. What is appropriate for a healthy 25-year-old differs significantly from what a 55-year-old needs. The recommendations below draw from guidelines issued by the U.S. Preventive Services Task Force (USPSTF), the CDC, the American Heart Association, and other major health organizations. For a complete overview of preventive health, see our health screening guide and annual physical exam checklist. You can also explore our wellness guide for broader health tips.
Blood Tests for Your 20s
Your 20s are generally the healthiest decade, but establishing baseline values now provides comparison points for future testing and can catch early-onset conditions.
Complete Blood Count (CBC)
A CBC measures red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. It screens for anemia, infections, blood disorders, and immune system function. The NIH recommends a baseline CBC in early adulthood with repeat testing every 3 to 5 years if results are normal, or more frequently if you have symptoms or risk factors.
Basic Metabolic Panel (BMP)
This panel measures blood glucose, electrolytes (sodium, potassium, chloride, bicarbonate), blood urea nitrogen (BUN), and creatinine. It provides a snapshot of kidney function, blood sugar regulation, and electrolyte balance. A baseline test in your 20s establishes normal ranges for future comparison.
Lipid Panel
The USPSTF and American Heart Association recommend lipid screening starting at age 20 for individuals with cardiovascular risk factors (family history of heart disease, obesity, smoking, diabetes). For those without risk factors, screening should begin no later than age 35 for men and age 45 for women. A lipid panel measures total cholesterol, LDL, HDL, and triglycerides.
Sexually Transmitted Infection (STI) Screening
The CDC recommends HIV screening for all adults at least once, with more frequent testing for those at higher risk. Chlamydia and gonorrhea screening is recommended annually for sexually active women under 25. Hepatitis B and C screening may be recommended based on risk factors.
Thyroid Function (If Symptomatic)
Routine thyroid screening is not universally recommended in the 20s unless you have symptoms of thyroid dysfunction (unexplained weight changes, fatigue, temperature sensitivity) or a family history of thyroid disease. A TSH test is the standard initial screening.
Blood Tests for Your 30s
Your 30s are a bridge decade where baseline testing continues and some age-specific screenings begin.
Comprehensive Metabolic Panel (CMP)
Expanding from the basic panel, a CMP adds liver function tests (ALT, AST, alkaline phosphatase, bilirubin, albumin) and total protein. Liver disease, including non-alcoholic fatty liver disease, is increasingly common and often asymptomatic. The Cleveland Clinic recommends liver function screening as part of routine blood work starting in the 30s.
Fasting Blood Glucose or Hemoglobin A1C
The USPSTF recommends diabetes screening starting at age 35, but the American Diabetes Association recommends screening starting at age 35, or earlier for overweight or obese adults with at least one additional risk factor (family history, physical inactivity, history of gestational diabetes, or belonging to a high-risk ethnic group). A fasting glucose above 100 mg/dL or an A1C above 5.7 percent indicates prediabetes.
Lipid Panel (If Not Previously Done)
If you did not have a lipid panel in your 20s, your 30s is the time to get one. Men should be screened by age 35 and women by age 45, though earlier screening is appropriate if risk factors are present. Repeat every 5 years if results are normal.
Thyroid Panel
Thyroid disorders become more common starting in the 30s, particularly in women. The American Thyroid Association recommends thyroid screening beginning at age 35 and every 5 years thereafter. A TSH test is the primary screen, with free T4 and T3 added if TSH is abnormal.
Vitamin D Level
Vitamin D deficiency is widespread and linked to bone health, immune function, and mood. While not universally recommended for screening, many healthcare providers check vitamin D levels (25-hydroxyvitamin D) during routine blood work, especially for patients with risk factors such as limited sun exposure, darker skin, obesity, or northern latitude residence.
Blood Tests for Your 40s
Your 40s mark a transition where chronic disease screening becomes more important and routine testing frequency may increase.
Diabetes Screening (Universal)
If not already being screened, all adults should begin diabetes screening at age 35 to 45 per current guidelines. The USPSTF recommends screening for prediabetes and type 2 diabetes in adults ages 35 to 70 who are overweight or obese. Repeat every 3 years if normal.
Comprehensive Metabolic Panel (Annual)
Annual CMP testing becomes more important in the 40s to monitor kidney function, liver health, blood sugar, and electrolyte balance. Early detection of declining kidney function allows for intervention before permanent damage occurs.
Lipid Panel (Every 3-5 Years)
Cardiovascular risk increases in the 40s, and regular lipid monitoring helps guide decisions about lifestyle changes and potential statin therapy. The American Heart Association recommends cardiovascular risk assessment every 4 to 6 years for adults ages 40 to 75.
Hepatitis C Screening
The CDC and USPSTF recommend one-time hepatitis C screening for all adults aged 18 to 79. If you have not been screened, your 40s is an important time to do so, as chronic hepatitis C is often asymptomatic for decades before causing liver damage.
Iron Studies (If Indicated)
Iron deficiency is common in women with heavy menstrual periods, while iron overload (hemochromatosis) can begin causing damage in the 40s. Checking ferritin, serum iron, and total iron-binding capacity (TIBC) can identify both conditions.
Blood Tests for Your 50s
The 50s bring several important new screening recommendations as cancer and chronic disease risks increase significantly.
Colorectal Cancer Screening
While colonoscopy is the gold standard, several blood and stool-based tests are available. The FIT (fecal immunochemical test) detects blood in the stool, while newer blood-based tests like Cologuard combine stool DNA testing with immunochemical detection. The USPSTF recommends colorectal cancer screening for all adults beginning at age 45.
PSA Test (Men, Shared Decision-Making)
The prostate-specific antigen (PSA) blood test screens for prostate cancer in men. The USPSTF recommends that men ages 55 to 69 discuss the potential benefits and harms of PSA screening with their doctor (shared decision-making). Men at higher risk (African American men, those with a family history) may consider screening starting at age 40 to 45.
Comprehensive Metabolic Panel (Annual)
Annual monitoring continues with increased attention to kidney function (creatinine, GFR), liver enzymes, and blood sugar. The NIH notes that kidney function naturally declines with age, and early detection of chronic kidney disease allows for protective measures.
Thyroid Function
Thyroid disorders become increasingly common after age 50, particularly hypothyroidism in women. The Mayo Clinic recommends TSH screening every 5 years after age 50, or more frequently if symptoms develop.
Vitamin B12 Level
B12 absorption decreases with age due to declining stomach acid production and increasing prevalence of atrophic gastritis. The NIH recommends that adults over 50 pay attention to B12 status, as deficiency can cause neurological damage and anemia. Testing is particularly important for vegetarians, vegans, and people taking metformin or proton pump inhibitors.
Blood Tests for Your 60s and Beyond
In your 60s and beyond, monitoring existing conditions and screening for age-related diseases becomes the priority.
Comprehensive Annual Blood Work
Annual blood work should include a CBC, CMP, lipid panel, TSH, and fasting glucose or A1C. This comprehensive panel monitors for the development or progression of chronic conditions common in this age group.
Kidney Function Monitoring
GFR (glomerular filtration rate) calculated from creatinine levels should be monitored annually. Chronic kidney disease affects approximately 38 percent of adults over 65 according to the CDC. Early-stage kidney disease is often manageable with medication and lifestyle changes.
Inflammatory Markers
C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may be checked to assess systemic inflammation, which is linked to cardiovascular disease, autoimmune conditions, and cancer risk.
Cancer Markers (When Indicated)
While routine cancer marker screening (such as CA-125 for ovarian cancer) is generally not recommended for asymptomatic individuals, these tests may be used to monitor known conditions or evaluate suspicious symptoms. Discuss with your doctor whether any cancer-specific blood tests are appropriate for your situation.
Bone Health
While not a blood test, bone density screening (DEXA scan) is recommended for women at age 65 and men at age 70. Blood tests for calcium, vitamin D, and parathyroid hormone levels support bone health assessment.
Frequently Asked Questions
How often should I get blood work done?
For healthy adults in their 20s and 30s, basic blood work every 2 to 3 years is generally sufficient unless symptoms or risk factors are present. Starting in the 40s, annual blood work is recommended by most healthcare providers. After 50, annual comprehensive blood panels become increasingly important. If you have chronic conditions like diabetes, heart disease, or thyroid disorders, your doctor may recommend more frequent testing, sometimes every 3 to 6 months.
Do I need to fast before blood tests?
Fasting for 9 to 12 hours is recommended before a lipid panel and fasting glucose test to ensure accurate results. A comprehensive metabolic panel may also be more accurate with fasting. Most other blood tests, including CBC, thyroid function, and vitamin levels, do not require fasting. Your doctor or lab will provide specific instructions. Water is always allowed during the fasting period.
What blood tests should I request at my annual physical?
At a minimum, request a CBC, comprehensive metabolic panel, lipid panel, and fasting glucose or A1C. Depending on your age and risk factors, also consider thyroid function (TSH), vitamin D, and vitamin B12. If you have a family history of specific conditions, discuss additional screening with your doctor. Do not hesitate to ask your doctor to explain what each test measures and why it is or is not recommended for you.
Are at-home blood tests accurate?
At-home blood test kits have improved in accuracy but have limitations. Tests that use finger-prick blood collection may be less accurate than venous blood draws performed at a laboratory. The FDA regulates some but not all at-home tests. For screening purposes, at-home tests can be useful for identifying potential issues, but abnormal results should always be confirmed with standard laboratory testing ordered by a healthcare provider.
Key Takeaway
Following the recommended blood tests by age is one of the most effective and affordable preventive health strategies available. From baseline testing in your 20s to comprehensive annual panels in your 60s and beyond, regular blood work catches conditions early when they are most treatable. The specific tests you need depend on your age, sex, family history, and risk factors. Use this guide as a starting point for conversations with your healthcare provider, and do not hesitate to advocate for the screenings that are appropriate for your situation. Preventive testing is an investment in your future health that consistently pays dividends.