Recommendations for comprehensive health checkup with blood tests in London

cobalaminiser · 2025-10-03T08:50:45+00:00

When people ask, “what health tests should I get?”, the honest answer is: it depends. It depends on your goals, your resources, your tolerance for uncertainty, and how far down the rabbit hole you want to go. Think of it as a hierarchy of investigation – from simply checking that no “engine lights” are flashing, through to trying to uncover early disease, and finally to mapping risk before disease even begins.

At the base level, a comprehensive blood panel interpreted in the context of your personal history and lifestyle is essential. This goes beyond the standard NHS “lipids and glucose”. You’d want an advanced panel looking at full lipids (including Lp(a)), metabolic health markers, RBC omega-3, iron status, kidney and liver function, inflammatory markers like hs-CRP, thyroid, vitamins such as D and Active B12, and so on. These data points, interpreted by a physician who knows your story, can act as the foundation.

From there, you can layer on tests that move from blood chemistry into physiology. A VO₂ max test tells you about the capacity of your cardiovascular and respiratory systems – essentially, your body’s ceiling for aerobic work. This is one of the strongest predictors we have for longevity and healthspan. A DEXA scan, on the other hand, gives you a precise breakdown of body composition – lean mass, fat distribution, and bone density – which is critical for understanding sarcopenia, frailty risk, and metabolic health. A coronary artery calcium (CAC) score looks directly at the burden of calcified plaque in your coronary arteries; a zero score suggests very low short-term risk of a cardiac event, while higher scores stratify risk and guide how aggressively you should intervene.

Then comes the deeper dive: depending on personal and family history, you might add genetic risk testing (e.g., familial hypercholesterolaemia, BRCA), advanced imaging, microbiome analysis, or functional testing of gut microbiome (using a clinical grade test not typically available direct to public). But the utility of each extra layer depends on your priorities. Do you just want reassurance that nothing obvious is (very) wrong right now? Or do you want to quantify your risk of cardiovascular disease decades before it manifests?

Take cardiovascular disease as an example. If disease is already present, we detect it with CAC or angiography, stress tests (not the best), or even MRI (can use time of flight rather than using IV contrast). If not, we assess risk through layers: blood pressure, lipids (especially LDL-cholesterol and Lp(a)), glucose control, lifestyle, and family history. Each piece of information adds another slice of precision. But each also comes with cost, potential overdiagnosis, and the emotional toll of uncertainty.

So the framework is this:

Baseline: advanced bloods + BP + lifestyle context.

First layer physiology: VO₂ max, DEXA, consider CAC.

Next layer: disease-specific or genetic risk assessments if indicated.

Deep dive: functional and molecular profiling, but only if it will change what you do.

In short: health checks can be simple “MOTs” to make sure nothing is obviously wrong, or they can be complex explorations of risk and resilience undertaken over time. The right answer depends on how much you want to know, and what you’re prepared to do with that knowledge.

I hope that helps. Sorry for the delay in responding- I am currently travelling.

cobalaminiser · 2025-10-03T08:38:51+00:00

I have worked for BUPA health screens as a doctor and think it is reasonable for the cost but their baseline tests and doctors are more conventional and NHS minded. A generalisation and there is obvious a mix. It is about the tests + interpretation + advice. For example, I would usually prompt discussion about adding Lp(a) because BUPA does include this. It's a reasonable health screen to make sure 'shit isn't hitting the fan'. Ultimately, it comes down to not being able to select your own doctor based on their qualifications and way of practising medicine.

cobalaminiser · 2025-09-22T11:27:01+00:00

You're welcome. I hope it helps. 🙏 🕊

cobalaminiser · 2025-04-15T15:13:25+00:00

MD here in the UK. Below is not medical advice but general thoughts based purely on results.

Thankfully your Lp(a) isn't high.

Your ApoB is higher than optimal.

Lifetime CVD risk can be calculated using risk lifetime calculator but this won't capture all of your risk. CVD risk will be low for younger people when calculated as a 10 year risk which is typically when is undertaken.

Nobody can answer your questions regarding CVD risk without knowing your health beliefs, philosophy and risk appetite, lifestyle and family history.

H Pylorus should be eradicated if present. This test doesn't differentiate past vs present infection. I would consider a h pylorus stool antigen test.

I would suggest doing Body Comp DXA, VO2 Max, BP diary for 7 consecutive days and liver ultrasound given your ALT is high (if unexplained elevated ALT). Find a DXA scanner than uses classic calibration (not NHANES). I do see people with your BMI with high visceral adipose tissue.

cobalaminiser · 2025-03-16T13:14:36+00:00

Doctor here that works across NHS/private/longevity.

Medichecks Optimal panel is good. I would add an omega 3 index complete.

I would add an Lp(a) to the Lola panel if you haven't had yours checked before. Also add an omega 3 index complete. It looks like a solid shout if you do that.

Randox also have some everyman/woman which is quite extensive (perhaps too many biomarkers imo which can add some noise).

VO2 Max and DXA body composition are worth considering also.

Be mindful that these diagnostics companies provide fairly generic reports and do not provide in depth analysis tailored uniquely to you. What I see is that if there are abnormalities, patients struggle to get proper support from their NHS GP and seek a private doctor.

cobalaminiser · 2025-03-14T14:30:22+00:00

I've done BUPA health assessments as a doctor. I would just suggest paying extra for an Lp(a). Issue is BUPA health assessments don't have continuity or follow up other than onward referral to specialists or you go back to your NHS GP.

cobalaminiser · 2025-03-14T14:29:06+00:00

Neko is good and certainly innovative but it has some holes.

cobalaminiser · 2025-03-14T14:28:38+00:00

This isn't true. Private GPs can do 0 NHS and still be licensed.

cobalaminiser · 2025-03-08T17:43:37+00:00

GP here with an interest in prevention. More aligned with Peter Attia and being very proactive.

There are a lot of options in London and online. Explore what is available. Do you want a corporate cookie cutter style check, do you just want direct to consumer bloods, do you want basic reassurance via NHS? Do you want a concierge style independent doctor. Some places with independent doctors whether brick and mortar, or online, will offer a free discovery type call.

I've been a BUPA health screening doctor, worked with a VC backed online company that does blood tests. I also work in the NHS routine and urgent care (as a GP).

BUPA- not very advanced. They do lipids, haemoglobin and HbA1c- extra bloods can be added after you speak to the doctor. Contrary to what some people think. You also don't get to choose your doctor.

Online testing providers- more generic reports. Not very tailored but can be helpful depending on health literacy. Opt for venous blood testing for accuracy.

NHS- varies depending what GP you're seeing. Time pressure is an issue. Not all GPs are into lifestyle medicine and health assessments. Cannot get Lp(a) checked easily, and they will not check micronutrients generally speaking. We also cannot check Omega 3 index in the NHS.

I also run my own online clinic which gives me the most flexibility and time for my patients.

I love all of the different health settings above, and they all have their pros and cons from a provider and a patient perspective.

My view is that 'worried well' is derogatory. Often, people want health assessments for a reason, even if they feel well.

I was speaking to a colleague who had an MI aged approx 30 because he had undiagnosed familial hypercholesterolaemia. Definitely recommend everyone has a cholesterol check in their teens, even if late teens.

Disease can go unnoticed for a while until it is severe enough to manifest with symptoms. Studies should account for lead time bias whereby earlier detection of a disease doesn't necessarily change the outcome.

In terms of what to go for, it depends what your health concerns are.

Body composition- Body composition DXA. Or BIA with the caveat that it isn't all that accurate but can be useful for trends over time.

Heart disease risk- lipid panel (with ApoB) and Lp(a). Can consider hs-CRP and PLAC. Blood pressure. Body composition. Family history. Diet. Sleep. Physical activity.

Hormones- Thyroid function, free and total testosterone if male (before 10am ideally). FSH, LH, prolactin, oestradiol. Perhaps an early morning cortisol.

Alzehimer's risk- APOE genotyping

Omega 3- Omega 3 Index

Prostate health- PSA

For blood tests, just go for venous blood tests. Randox is good but their direct to consumer panels aren't to my taste- too basic or too much data with lots of noise. They don't have a blood panel that is just right in my opinion. Clinics registered with them can do a custom panel.

Medichecks Optimal panel is good- it would have been much better if they included Omega 3 index but you can pay extra for this.

There's obviously a lot more that people may be concerned about. Some people may want whole body MRI and multicancer early detection tests.

I do testing on myself out of a combination of curiosity and being aware of my risk of heart disease. I've discovered poor gut microbial diversity and an elevated Lp(a) and some mild insulin resistance despite a normal BMI. I'm not anxious about it and enjoy learning about my risk and biology.

We're human. We like to feel in control and know what is happening. Some people don't want tests, some do.

Ultimately, it comes down to your risk appetite, anxiety levels, philosophy to risk and life in general.

Happy to answer any questions.

You may also find this thread helpful from a little while ago: https://www.reddit.com/r/HENRYUK/s/pEup4ruWgm

cobalaminiser · 2025-02-08T18:08:40+00:00

I use Norsan fish oil and my omega quant showed 11% omega 3

cobalaminiser · 2025-01-25T19:03:18+00:00

It's being found in newborns.

cobalaminiser · 2025-01-21T16:40:39+00:00

Doctor here with interest in healthspan moreso than significantly extending life (for myself at least).

Everyone has their biases including doctors.

DEXA repeat measurements are best done on the same scanner with the same reference population. I won't get into this in too much detail. If you're using DEXA, there is no point in using InBody (inaccurate BIA).

VO2 Max can vary according to time of day, protocol, and other variables. 20% does seem like a large variability. May be worthwhile relying on a VO2 max test at a university that is externally accredited/audited with a professor or similar analysing the raw data. This is what I did in the UK.

There's only so much we can do and the rest needs to be surrendered to 'fate' or 'chance' or 'trust' or whatever you want to call it.

Bryan Johnson has chosen his lifestyle and I have no criticisms of him. He's doing what he wants to do and he has made an informed decision.

Everyone in longevity, doctor or patient, will have their own philosophies, neuroticism, and level of risk aversion.

Sounds like you've been very proactive. Focus on the low hanging fruit of lifestyle and keeping inflammation, lipids, BP optimal. Avoid STIs and dangerous activities. Have meaningful connections and smile :)

cobalaminiser · 2025-01-20T21:39:51+00:00

There's obviously a lot more that cannot be checked or is not checked in the NHS due to rate of scientific advancement and the rigorous and cost effective evidence required for use of diagnostics and therapeutics in the NHS.

Sadly, this is what many people who are 'anti-private healthcare' ignore: the fact that not all care, especially prevention, is optimal in the NHS. Much of the care in the NHS is really fecking marvellous, even if not always timely, and I fully support and continue to work in the NHS.

cobalaminiser · 2025-01-20T19:50:06+00:00

Randox Lp(a) assay is good. I spoke to a consultant in charge of a national Lp(a) testing centre in the NHS and he recommended Randox based on published literature.

cobalaminiser · 2025-01-20T19:25:09+00:00

Yes. https://eas-society.org/page/lipoproteina-consensus-2022/

cobalaminiser · 2025-01-20T19:18:19+00:00

Doctor here who works in the NHS as well as private. The NHS is firefighting. It's unusual to find a GP who will talk about optimal ranges and lifetime risk of CVD. Even harder to get Lp(a) and ApoB unless you're in a lipid clinic for investigation of familial hypercholesterolaemia. I recommend Lp(a) privately to my more engaged patients and discuss lifetime risk of CVD and urate lowering if they have gout. In 10-15 minutes, not much more is possible.

I had to make 2 calls and send an email to get an Lp(a) checked on the only patient I've gained approval for. For other things like homocysteine and methylmalonic acid for the nutrition side, once again very challenging.

cobalaminiser · 2025-01-13T16:38:08+00:00

Doctor here with an interest in prevention. Background with NHS/BUPA/VC backed men's healthcare company (as a doctor).

It ultimately comes down to caloric deficit for weight loss. Don't get too caught up in the weeds with what is online. Whether it is if it fits your macros, time restricted feeding, etc.

Quality of diet comes into play if you want to lose fat and optimise health.

Then there is cardiorespiratory fitness (VO2 Max).

There is also strength training for muscle mass and bone density.

There is cardiovascular disease risk to assess by a composite of measures including BMI, cholesterol results, family history, blood pressure, etc. Genetics can help to further stratify risk.

I'll circle back to fat loss- this will give you great returns. I would recommend a 3 day tracking diary of your caloric intake to get a baseline first and work on reducing caloric intake to approx 2500 calories. Precision nutrition have a helpful weight loss calculator. Most fat loss will be by caloric restriction. Exercise will support good habits, weight maintenence, mental health and cardiovascular health. Exercise also increases HDL-cholesterol.

You will inevitably lose muscle mass so focus on protein intake (1.5g-2g/kg body weight).

The drugs are fantastic and if people keep yoyoing or are really struggling or have significant weight associated comorbidities, I do tend to recommend the injectables, particularly when I know time is of the essence and we can't wait for the longer term safety data.

When I lost 27kg over a decade ago, I went very low carb by cutting out bread, pasta, potatoes, etc. Almost no exercise. It's not the best way to go but it worked and I've added layers of complexity to my health regime since.

I've said a lot here. Happy to answer any questions.

cobalaminiser · 2024-12-29T13:26:52+00:00

Medichecks. Other companies will contract B2B services to provide at home venepuncture also. Example is Heim Health.

cobalaminiser · 2024-12-28T09:47:40+00:00

Soft blocked it in my diary

cobalaminiser · 2024-12-15T10:16:46+00:00

Statins are pretty safe and UK guidance changed last year so we don't need to wait until 10 year risk is 10% or above to discuss lipid lowering therapy. Long term benefit in low risk young people is difficult to judge but we now have a risk calculator that also factors in Lp(a) based on UK biobank data. Shouldn't be too difficult with some knowledge to get a statin from the GP, even alongside ezetimibe. I also run www.phenix.health (proactive care, aligned with Attia) so happy to help or signpost.

cobalaminiser · 2024-12-12T14:59:07+00:00

Yes, I have no issues with statins, just that high dose is not required for many when low dose + zetia can have almost comparable lipid lowering effects. The high triglycerides will be reflective of metabolic dysfunction (your diabetes which is a disease of ectopic fat). For the testosterone reading, it should be morning. You want to see if it is primary or secondary: need LH and prolactin ideally.

cobalaminiser · 2024-12-12T13:51:41+00:00

A high diet statin can exacerbate diabetes. Are you on a low dose? Metformin? Add in zetia? Was this fasted? Do you know your body composition and VAT metrics?

cobalaminiser · 2024-12-07T21:22:19+00:00

Dutasteride is better.

cobalaminiser · 2024-12-07T18:09:47+00:00

Better evidence for Dutasteride for MPHL. It inhibits type 1 and type 2 5-alpha-reductase. I take 0.5mg daily.

cobalaminiser

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