Blood Tests After 50: What to Ask For and How Often

As a nurse, I wish patients felt more comfortable asking about what their doctors ordered for them and why.

It’s important to understand your body and how it changes with age. It also helps to know what types of blood tests are typically ordered for women after the age of 50, how often, and when you should speak with your doctor.

There are so many times when I’ve left the doctor’s office confused about why they ordered what they did.

Here, we’ll review some common lab tests your doctor might recommend and why. The goal is for you to feel better prepared for conversations with your provider and make collaborative decisions about your health.

What Your Annual Visit Actually Includes – and What It Doesn’t

During your annual visit, your provider typically reviews your medical history, medications, symptoms, and family history. It’s also a time to discuss any preventive care needs.

There are age-related preventive health screenings, but the right one for you may vary based on your age and risk factors. For example, your doctor may suggest an annual mammogram and colorectal testing.

They will also likely check and review your blood pressure, weight, and other basic vital signs. The data collected can help identify certain conditions, such as hypertension.

You shouldn’t expect blood work to be necessary with every visit. What your doctor will actually order depends on several factors. They’ll look for any new symptoms and medications or unexpected physical changes to trigger what blood tests or screenings are needed.

A Medicare Annual Wellness Visit can be confusing because it isn’t the same as a traditional physical. Like any wellness visit, it focuses on prevention, risk assessment, and planning for your health. Labs aren’t automatically included with your visit.

In a nutshell, your yearly checkup with your doctor may look different year after year.

Lipid Panel – Plus One Test You May Only Need Once

As you age, the cholesterol levels in your body may naturally rise. This can happen because the body becomes less efficient at clearing cholesterol from your blood.

During menopause, LDL levels may also increase in response to lower estrogen levels.

That’s why your doctor may order a lipid panel to measure your cholesterol and triglyceride levels. The test also looks at LDL and HDL cholesterol.

The results provide insight into whether you may be at risk for atherosclerotic cardiovascular conditions, such as heart attack or stroke.

Another cholesterol-related test worth asking your provider about is lipoprotein(a), or Lp(a). The 2026 ACC/AHA Guideline on the Management of Dyslipidemia recommends checking Lp(a) at least once in adulthood. The lipoprotein is associated with plaque formation and inflammation.

An elevated Lp(a) level means you may be at higher risk for heart disease and stroke.

A1C or Fasting Glucose

A hemoglobin A1C tells the clinician how well your blood glucose has been controlled over time, roughly the past 2–3 months.

A fasting glucose test measures your current blood glucose level at the time of testing after you’ve been fasting for a period of time.

Both are used to help diagnose diabetes or prediabetes. As you age, your risk for the condition grows due to changes in body composition, metabolism, and insulin sensitivity. But you may not need it tested every year.

The American Diabetes Association recommends starting diabetes screening by age 35 for adults who haven’t already been screened earlier because of additional risk factors. If the results are normal, you may not need another screen for a few more years.

If you’re in your 50s and your doctor hasn’t checked your blood sugar in several years, that’s worth bringing up. A normal A1C last year, however, doesn’t automatically mean you need another one today.

Complete Blood Count (CBC)

A complete blood count (CBC) lives up to the name. It provides counts of your blood cells, including red and white blood cells, hemoglobin, hematocrit, and platelets.

Clinicians often order it as a routine test since it gives them a quick overall health view and screens for conditions like anemia or infection. However, a test isn’t always necessary every year.

They might also order it if you’re showing signs of infection, bruising easily, or to monitor certain conditions. Women in perimenopause may be at an increased risk for anemia with heavy menstrual bleeding, and that would also warrant a check.

A CBC is useful, but it can’t diagnose the cause of your symptoms or a condition alone. It just gives them an initial picture of your overall health to help decide if any additional testing is necessary.

Comprehensive Metabolic Panel (CMP)

A comprehensive metabolic panel (CMP) is a blood test measuring 14 different substances in the body. It evaluates your metabolism, fluid balance, and kidney and liver function.

It’s often a routine test used to monitor a specific health condition. A clinician may also order it when you’re taking certain medications to monitor how the effects are impacting parts of the body.

Your kidney and liver function might need closer monitoring as you age. The organs play a role in metabolizing medications and substances, but certain medications you’re more likely to take in later life can affect their ability to do so.

Just like with a CBC, a CMP may not be needed annually just because of your age. Your clinician will likely order it if you take specific medications, are living with certain conditions, or are showing signs and symptoms.

TSH: Commonly Checked, But Not Automatically Necessary

Thyroid testing is common practice, especially as we age. TSH, or thyroid-stimulating hormone, tells a clinician how well the pituitary gland is signaling your thyroid gland.

A high TSH level may indicate an underactive thyroid. On the other hand, a low TSH level usually points to an overactive thyroid.

You need your thyroid gland to be top-notch since it produces hormones that regulate your body’s metabolism and energy. It also influences your heart rate, breathing, weight, and even mood.

If you tell your clinician that you’ve been feeling unusually tired, experiencing mood shifts, having weight or menstrual changes, or even having palpitations, they can be a sign of thyroid dysfunction. They might order a TSH level to ensure your thyroid is working okay.

The U.S. Preventive Services Task Force (USPSTF) says there still isn’t enough clinical evidence to recommend routine thyroid screening for every nonpregnant adult without symptoms. But thyroid disorders are common in women over 50 and their symptoms are often mistaken for menopause and other health conditions.

If your TSH level is abnormal, the clinician may order additional tests. For example, they may order a free T4 blood test to gain a closer look at your thyroid function.

Vitamin B12

Vitamin B12 is necessary for your body. It helps with red blood cell production, nerve function, and building DNA. A clinician may check it if you’re experiencing tiredness, weakness, or balance problems, among some other symptoms.

Your body may not be able to absorb the vitamin as well with age. Also, some medications or health conditions put you at higher risk of vitamin B12 deficiency.

Some medications that impact B12 levels are metformin and acid-suppressing drugs. Other risk factors include eating a vegan diet and a history of gastrointestinal surgery or conditions.

That can become more of an issue with age. The National Institutes of Health Office of Dietary Supplements notes that gastric acid-reducing medications can interfere with B12 absorption from food, and metformin can also reduce B12 absorption and lower blood levels.

A low B12 lab result is only the start. Your clinician may order additional testing to confirm deficiency and plan next steps. It’s not typically a routine lab if you don’t have any risk factors or aren’t showing possible deficiency symptoms.

Tests to Ask About, Not Assume

When reading about healthy aging, you may see some blood tests that frequently come up. That doesn’t mean you need them routinely. Instead, there should always be a reason for ordering them.

Vitamin D

A vitamin D test may show up on your lab results under the name “25-hydroxyvitamin D.” It’s not necessary as a routine healthy aging check.

Vitamin D aids the body in calcium absorption while supporting bone and muscle health. That’s really important in an aging body that is more prone to bone loss.

The USPSTF says there isn’t enough evidence to determine whether screening asymptomatic adults for vitamin D deficiency improves health outcomes. The Endocrine Society also suggests against routine vitamin D testing in healthy adults, including those ages 50 to 74.

However, it’s reasonable for a clinician to check it if you’re prone to bone fractures, have certain conditions, or show signs of osteoporosis. Another hurdle is that it isn’t always obvious if you’re deficient, since sometimes the body doesn’t show any symptoms.

You likely don’t need a vitamin D level every year simply because of your age. Testing and taking a vitamin D supplement needs a reason, and too much vitamin D in the body can be harmful.

Ferritin and Iron Studies

Iron deficiency isn’t a condition caused specifically by aging. That’s why you shouldn’t need routine ferritin and iron lab studies.

A ferritin level tells your clinician how much iron is stored in the body. They may order more iron studies, like transferrin, if your results are abnormal.

The NIH Office of Dietary Supplements notes that ferritin can fall before full iron-deficiency anemia develops. Ferritin can also be elevated with an illness or injury, so it’s not always an accurate representation.

If your body is low in iron, you might feel tired, short of breath, or experience hair loss. Heavy bleeding during perimenopause may also contribute to your risk of iron deficiency.

Aging women without these signs or symptoms aren’t likely to need testing.

C-Reactive Protein (CRP) and Heart Risk

A C-Reactive Protein (CRP) measures inflammation in the body. It doesn’t tell you what is causing the inflammation. A clinician will order it when they suspect you may have an infection or inflammatory condition.

A high-sensitivity C-reactive protein, or hs-CRP, looks for CRP increases to assess cardiovascular risk. However, the USPSTF says there isn’t enough evidence to know whether adding hs-CRP to traditional cardiovascular risk assessment in asymptomatic adults improves outcomes.

A CRP test isn’t routine since many conditions cause an elevated level. That makes an isolated result nonspecific and will likely need further testing and examination.

What’s Oversold

Advanced technology has made mega-panel tests more accessible. Direct-to-consumer companies market “longevity” panels as necessary when you’re over 50 years old.

They can sometimes do more harm than good. Any testing should answer a clinical question or change what you and your clinician do next. Unnecessary lab tests when you don’t have any risk factors or symptoms can lead to more questions and end up costing more money.

Routine vitamin or hormone panels are oversold to healthy adults. They often lead to borderline or incidental results that cause unnecessary anxiety and follow-up needs.

A normal reference range result also doesn’t always mean “optimal.” Sometimes the optimal targets are set by wellness companies and are unsupported by clinical evidence.

There are times when ordering your own test makes sense, especially if you already know exactly what you need checked.

One Important Test That Isn’t a Blood Test

I’ve talked a lot about blood testing, but we can’t forget about one very important test for women over 50.

A DEXA scan measures bone density and helps identify your osteoporosis or fracture risk. The USPSTF recommends screening women aged 65 and older. Postmenopausal women under 65 may also need screening if they have certain risk factors.

Not every woman automatically needs a DEXA scan. But as you get older or develop certain risk factors for osteoporosis, it may make more sense.

What to Say at Your Appointment

Before you start making a list of labs to discuss with your clinician, check to see what lab tests were recently done.

Then, think about how you’ve been feeling. Have you felt more tired than usual, experienced hair loss, or had heavy menstrual bleeding? You’ll want to make a list of symptoms to share with them.

Next, bring a complete list of medications and supplements. You’ll want to include dosages and frequencies for each. Finally, write down your top three questions or goals about your health.

You might ask:

• “Can we review what blood work I had last time?”
• “Which tests am I actually due for?”
• “Are there tests you recommend because of my medications, symptoms, or family history?”
• “Can I see the actual numbers rather than just hearing that everything was normal?”

Your clinician may disagree with you suggesting a specific test you think is necessary. It’s okay to ask why. It’s also okay to ask about any results that are abnormal or outside the normal range.

Reading Your Results

Reading an abnormal lab test may feel confusing or make you anxious. It’s important to know that it doesn’t automatically mean something is wrong. On the other hand, a “normal” test result doesn’t always mean everything is okay.

What matters most is how you’re feeling, your health history, what medications you’re taking, and what your previous results were.

Your clinician will often look for trends in your lab results. They can show how your body is changing over time and are often more telling than a single result. That’s why an abnormal lab test may only need to be monitored or repeated later.

Never be afraid to ask what they’re watching for or why they’re not taking action on a specific lab result. The goal is always for you to leave your appointment with a solid understanding of your health plan.

The Tests You Need Depend on You

After 50, you don’t have to have every possible lab checked. The tests you need depend on your age, symptoms, health history, risk factors, and medications.

Use the results as a conversation guide with your clinician. Ask them why they ordered the test, what the results mean, and when it needs to be checked again.

This allows you to take an active role in your care and better understand your health moving forward.

Stephanie Wright, RN, BSN

Stephanie Wright, RN, BSN, is a Registered Nurse with more than 15 years of experience in critical care, mental health, managed care, and clinical leadership. She is currently pursuing her MSN in Public Health and is passionate about translating medical research into clear, practical information readers can trust. Drawing on both her clinical background and health writing experience, Stephanie brings an evidence-based yet approachable perspective to topics related to sleep, wellness, and preventive health. She is passionate about helping people better understand their health and feel more confident making informed decisions about their care.

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