What to Actually Get Checked — and What You Can Ignore

Amara is a nurse in London, thirty-eight, and she has watched a lot of women arrive at a check-up carrying a printout.

The printouts are usually the same. A list of forty blood tests from a wellness clinic. Three supplements recommended before a single result has come back. A "full body scan" that found a nodule nobody needed to know about, and which has now cost four months of worry and two further scans.

She has one question she asks them now: "Which of these did a doctor say you actually need?"

Usually, the answer is none of them.

The myth of the exhaustive check-up

The myth: A proper check-up means dozens of blood tests. More testing is more thorough. Supplements cover whatever the tests miss.

The truth: Testing is not free. Every test has a chance of a false positive, and a false positive leads to more tests, more anxiety and occasionally a procedure you did not need. A good check-up is not exhaustive — it is targeted. It looks for the things that are common, that are silent, and that are treatable when caught. Everything else is noise dressed as diligence.

The 2026 Well-Woman Chart — the annual summary of preventive care for women, put together from the major national guidelines — is a useful reality check. The recommended list is short. It always has been.

Tier 1 — the basics, every time

These are not blood tests. They are cheaper and matter more.

• Blood pressure. Silent, common, and easy to treat.
• Weight and waist circumference. Not for judgement — as a signal, alongside everything else.
• Smoking, alcohol, activity, sleep and mood. Ask about all five. The mood one is the one that gets skipped.
• Whether you are up to date on screening — cervical, breast, bowel — on your country's schedule.

If your appointment contains only these, it is not a wasted appointment.

Tier 2 — the metabolic core

Where most of the long-term preventable risk actually lives.

• Fasting glucose, and/or HbA1c (a three-month average of your blood sugar).
• A lipid profile — cholesterol and triglycerides.

These matter especially with PMOS, a family history of type 2 diabetes or early heart disease, previous gestational diabetes, or rising blood pressure. They are cheap, they are standard, and they change what happens next.

Tier 3 — when there is a reason

Not routine. Ordered because of a symptom, a history, or a risk factor:

• Thyroid function — for fatigue, hair loss, cycle changes, unexplained weight change.
• Iron and ferritin — for heavy periods, exhaustion, breathlessness, hair thinning. Ferritin is the one that gets forgotten: your haemoglobin can be normal while your iron stores are empty.
• Vitamin D and B12 — particularly if you cover your skin, have darker skin, follow a vegetarian or vegan diet, or are over 65.
• Reproductive or fertility assessment — when you are trying, or when cycles are irregular.
• Cervical, breast and bowel screening — on the interval your country recommends, which varies. Know your schedule rather than guessing.

What to do with this

• Ask "why this test?" It is a fair question with a real answer, and it sorts the necessary from the fashionable.
• Ask "what will we do with the result?" If the answer is "nothing changes either way", the test may not be worth taking.
• Do not accept a one-line dismissal of a symptom. "It's probably stress" is a hypothesis, not a diagnosis.
• Red flags do not wait for a routine appointment. Chest pain, sudden severe headache, unexplained bleeding, a lump, bleeding after menopause, sudden shortness of breath, or weight loss you did not intend — go now, not at your annual.
• Book the next one before you leave. The single most effective screening intervention is the one that actually happens.
• Bring your list of symptoms, in writing, with dates. You will forget half of them in the room. Everyone does.
• Mood belongs on the list. Depression and anxiety are common, treatable, and screened for in the guidelines. Do not let them be the item you apologise for mentioning.

Amara has a line she uses with the printout women, and it is the one worth taking into your next appointment: "Let's start with what's common, silent and treatable. Then we'll add the rest if there's a reason."

Where this comes from

• Women's Preventive Services Initiative — 2026 Well-Woman Chart
• US Preventive Services Task Force — A and B recommendations
• NHS — NHS screening

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This post is adapted from the chapter "What to Actually Get Checked" in my book What She Was Told. It is education, not medical advice — screening schedules differ by country and by person, so please confirm yours with your own clinician.