A standard annual physical includes some basic checks, but you can walk in with a clear list of tests to make sure nothing important gets missed. The exact tests you need depend on your age, sex, and risk factors, but certain blood panels and screenings form the foundation of preventive care for nearly every adult.
Blood Work That Covers the Basics
Two blood panels give you and your doctor a broad snapshot of how your body is functioning: a comprehensive metabolic panel (CMP) and a complete blood count (CBC).
A CMP measures 14 substances in your blood. It checks your blood sugar, calcium, electrolytes like sodium and potassium, and several markers of liver and kidney health. Liver enzymes (ALT, AST, and ALP) can flag problems long before you notice symptoms, and waste products like creatinine and blood urea nitrogen reveal how well your kidneys are filtering. A CMP also measures albumin and total protein, which reflect your nutritional status and liver function. A CBC, meanwhile, counts your red blood cells, white blood cells, and platelets, helping detect anemia, infection, and blood disorders.
These two panels are inexpensive, widely covered by insurance, and give your doctor a reason to investigate further if anything looks off. If your doctor doesn’t automatically order them, ask.
Cholesterol and Heart Health
A lipid panel measures your total cholesterol, LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides. For adults at low cardiovascular risk, the general target for LDL is under 130 mg/dL. People with additional risk factors like diabetes or a family history of heart disease have stricter targets, sometimes as low as 70 or even 55 mg/dL.
Your blood pressure reading is the other key cardiovascular number. The 2025 AHA guidelines define normal blood pressure as under 120/80 mm Hg. Readings of 120 to 129 systolic (the top number) with a bottom number still under 80 count as elevated. Once you hit 130/80, you’re in Stage 1 hypertension. Blood pressure is measured at every physical, but if your reading comes back elevated, ask whether it should be rechecked on a separate day before drawing conclusions.
Blood Sugar and Diabetes Risk
A hemoglobin A1c test measures your average blood sugar over the past two to three months. It’s more useful than a single fasting glucose reading because it isn’t affected by what you ate the night before. The thresholds are straightforward: below 5.7% is normal, 5.7% to 6.4% is prediabetes, and 6.5% or higher indicates diabetes.
Roughly one in three American adults has prediabetes, and most don’t know it. If you’re over 35, overweight, or have a family history of type 2 diabetes, this test is especially worth requesting. Catching prediabetes early gives you a window where diet and exercise changes can genuinely reverse course.
Thyroid Function
A TSH (thyroid-stimulating hormone) test is the standard way to check whether your thyroid is working properly. Your pituitary gland produces more TSH when your thyroid is underactive, trying to push it to work harder, so a high TSH level suggests hypothyroidism. A low TSH level means the opposite: your thyroid is producing too much hormone.
Thyroid problems are common, particularly in women over 40, and symptoms overlap with things people chalk up to aging or stress: fatigue, weight changes, brain fog, hair thinning, feeling cold all the time. A TSH test isn’t always part of a standard physical, so if you’re experiencing any of these symptoms, specifically ask for it.
Vitamin D and B12
Vitamin D and B12 tests aren’t part of a routine panel, but they’re worth requesting if you have risk factors or unexplained symptoms. B12 deficiency can cause fatigue, tingling or numbness in your hands and feet, difficulty with balance, brain fog, and even mood changes. People at higher risk include strict vegans (B12 is found almost exclusively in animal products), anyone who’s had gastric bypass or bowel surgery, people with Crohn’s disease or celiac disease, older adults, and anyone taking metformin or long-term acid reflux medication.
Vitamin D deficiency is extremely common, particularly if you live in a northern climate, spend most of your time indoors, or have darker skin. Symptoms include bone pain, muscle weakness, and persistent fatigue. If any of these apply, ask your doctor to add both tests to your blood draw.
Cancer Screenings by Age
Colorectal cancer screening should start at age 45 for people at average risk. You have options: a colonoscopy every 10 years, an annual stool test that checks for blood (FIT), or a stool DNA test every 3 years. The colonoscopy is the most thorough, but if you’re hesitant, a home stool test is far better than skipping screening entirely. Adults 45 to 75 should be screened regularly. Between 76 and 85, the decision becomes more individual.
For cervical cancer, women ages 21 to 29 should get a Pap test every 3 years. Starting at 30, the preferred approach shifts to an HPV test every 5 years, or a combined HPV and Pap test every 5 years. Self-collected HPV testing is now considered an appropriate option for women 30 to 65. If you’re at average risk, screening more often than every 3 years isn’t recommended.
For prostate cancer, PSA testing is not automatically recommended for all men. The decision to test involves weighing the benefits of early detection against the risks of false positives and unnecessary procedures. Black men and men with a family history of prostate cancer face higher risk and should bring this up with their doctor starting in their 40s. For other men, the conversation typically begins around age 50.
STI Screening
Everyone between ages 13 and 64 should be tested for HIV at least once. Beyond that, recommendations vary. Sexually active women under 25 should be tested for chlamydia and gonorrhea every year. Women 25 and older need annual testing if they have new or multiple partners. Men who have sex with men should be tested for syphilis, chlamydia, gonorrhea, and HIV at least yearly, and every 3 to 6 months if they have multiple partners.
STI tests are not automatically included in a physical. Many people assume their doctor ran “everything” with their blood work, but STI panels require a specific order. If you’re sexually active and haven’t been tested recently, you need to ask directly.
Mental Health Screening
Many primary care offices now use short questionnaires to screen for depression and anxiety during a physical. The PHQ-9 is a nine-item depression screener, and the GAD-7 is a seven-item anxiety screener. Both take just a few minutes to complete and are designed to flag symptoms that warrant a closer look, not to diagnose a condition on their own.
If your office doesn’t hand you one of these forms, you can still raise concerns about your mood, sleep, or stress levels. A physical is one of the few times you have a doctor’s undivided attention, and mental health is as measurable and treatable as high cholesterol.
Vaccines to Verify
Your physical is a good time to check whether you’re current on immunizations. Every adult should get an annual flu shot. If you haven’t had a tetanus booster (Tdap or Td) in the past 10 years, you’re due. Adults 50 and older, or younger adults with compromised immune systems, should ask about the shingles vaccine, which is given as two doses. Your doctor can pull up your immunization record and identify any gaps.
How to Prepare for the Conversation
Doctors work within time constraints, and a standard physical may default to the minimum: blood pressure, a stethoscope check, and maybe a basic blood panel. If you want more thorough testing, come prepared. Write down your family history of major conditions (heart disease, diabetes, cancer), any symptoms you’ve been brushing off, and the specific tests you want. Mention medications and supplements you take, since some (like metformin or proton pump inhibitors) change which deficiencies you should be screened for.
Insurance typically covers preventive screenings at no cost under the Affordable Care Act, but coverage can vary if a test is ordered for diagnostic rather than preventive reasons. If cost is a concern, ask your doctor which tests are classified as preventive for your age and risk profile before the blood draw.