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You cannot change what you have never measured.

How well you are doing at seventy is being decided now, and most of it is visible in a blood test long before it becomes a problem. This page is about getting the right one: which markers change a decision, what the free NHS check covers, and which UK provider to use for the rest.

Start with the free one

Book it if you are eligible. It is free, it uses the same accredited labs, and it covers the basics properly. Then pay only for what it leaves out.

NHS Health Check covers
  • Total cholesterol, HDL and a ratio
  • Blood sugar (HbA1c or fasting glucose)
  • Blood pressure
  • Height, weight and BMI
  • A cardiovascular risk score

Free every 5 years, ages 40-74, no pre-existing qualifying condition

What it leaves out
  • ApoB — the better particle-count measure
  • Lp(a) — inherited, worth knowing once, never routinely offered
  • hs-CRP — inflammation
  • Fasting insulin — the earliest metabolic signal
  • Homocysteine, ferritin, vitamin D, B12

This gap is the entire case for paying. Nothing else.

The five that change a decision

A 100-marker panel mostly returns numbers you have no plan for, which invites over-interpretation and worry. These five are the ones where knowing the answer changes what a reasonable person would do next.

ApoB

Atherosclerosis is driven by how many particles cross the arterial wall, not how much cholesterol those particles happen to carry. Two people with identical LDL-C can differ substantially in particle number, and it is the particle number that tracks with risk. ApoB outperforms LDL-C as a predictor in every head-to-head comparison, which is why preventive cardiology has increasingly moved to it.

Lp(a)

Elevated Lp(a) is an independent, largely inherited risk factor affecting roughly one adult in five, and it is invisible on a standard lipid panel. Because it barely moves with diet or exercise, its value is in risk stratification: a high Lp(a) is the argument for treating every other modifiable risk factor more aggressively.

hs-CRP

The most accessible marker of chronic low-grade inflammation, which sits upstream of most age-related disease. Elevated hs-CRP predicts cardiovascular events independently of lipids, and the JUPITER trial showed that treating people selected on hs-CRP rather than LDL alone reduced events.

HbA1c

The standard measure of chronic glucose exposure, and the one glycaemic number with hard outcome data behind its thresholds. Its value for healthspan is that it integrates over months, so it cannot be gamed by a good day.

Fasting insulin

The earliest routinely available signal of insulin resistance, and the one most often left off a standard panel. Insulin rises for years to compensate before glucose or HbA1c budge, so a normal glucose with a high insulin is a warning that a glucose-only panel misses entirely.

Worth adding once you have those: Homocysteine, GGT, ALT, Ferritin, Vitamin D (25-OH), Albumin.

Where to get them done

All of these use UKAS-accredited laboratories — the same ones the NHS uses — so the results are real clinical data wherever you buy. What differs is the marker menu, whether a clinician reviews it, and whether repeat testing is easy.

Prices checked August 2026 and quoted at list. These providers discount often, so confirm before buying. We have no commercial relationship with any of them.

Then what

A result you file away changes nothing. Put the numbers in and the site will tell you where each one sits, what the evidence says moves it, and when retesting will actually show a difference.