A broad blood test panel or tests chosen for a question

Two ways to test

A panel is a set of tests chosen in advance for a well person, covering the blood count, liver and kidney function, cholesterol, blood sugar and a few hormones and vitamins. Clinically indicated testing starts from a question, such as a symptom, a medicine that needs monitoring or a family history, and picks the tests that answer it.

A panel suits someone who feels well and wants a baseline to compare against in future years. Indicated testing suits someone who has noticed a change, and it is often fewer tests that tell you more.

How the normal range works

The normal range printed beside each result is usually the middle 95% of values from healthy people [1]. By design, about 1 in 20 healthy people falls outside the range for any single test, with nothing wrong.

This is why a long panel almost always shows something flagged in a well person. A doctor who knows your history can tell a meaningful result from a statistical one, and often the answer is to repeat the test or simply to note it.

What the evidence says about broad checks

A Cochrane review of 17 trials, with outcome data on 251,891 people, found that general health checks in adults had little or no effect on deaths overall or deaths from cancer [2]. A check still has value as a baseline and a conversation with a doctor, and the finding is a good reason to choose each test with care.

For some single markers in people without symptoms, the evidence is still unsettled. The US Preventive Services Task Force found the evidence insufficient to recommend for or against screening for vitamin D deficiency [3], or for thyroid problems, where it names false positives, labelling and overtreatment among the possible harms [4].

When a panel helps

Some markers in a panel lead straight to a decision. Cholesterol and blood pressure feed the QRISK3 calculation that NICE uses to estimate the risk of heart attack and stroke over 10 years, for people aged 25 to 84, and a risk of 10% or more is a reason to talk about prevention [5]. HbA1c can show raised blood sugar years before symptoms appear.

A panel also helps when it is reviewed as a whole by a doctor and repeated in the same laboratory over time, so that a trend shows rather than a single number. Our Core Wellness panel covers 30 markers, including the blood count, liver function, a full lipid panel, HbA1c, thyroid, inflammation, ferritin and vitamin D, and a doctor reviews every result [6].

When tests should follow a question

If you are tired, losing weight without trying, bruising easily or noticing any other change, start with a doctor. The history and examination point to the tests that matter, which may include some outside any standard panel, and the result is read against your symptoms.

The same applies to a strong family history, a long-term condition or a medicine that needs monitoring. In each case the question chooses the test, and the doctor knows in advance what each result would change.

Who a broad panel is not for

A panel is the wrong first step when you are unwell. Chest pain, sudden breathlessness, heavy bleeding or a sudden severe headache need urgent care, so call 999 in the UK or the local emergency number. Symptoms that have built up over weeks need a doctor who can examine you, with tests chosen afterwards.

A panel may also not suit someone who would worry for weeks over a borderline flag that is very likely to be harmless. Talking it through with a doctor first, and agreeing which results you would act on, makes the same tests far more useful.

Risks and limits

A blood test itself is low risk, with a small chance of bruising. The larger risks are a false alarm that leads to more tests you did not need, and false reassurance from a normal panel when a new symptom deserves its own assessment. Choosing Wisely UK suggests weighing benefits, risks, alternatives and doing nothing before any test [7].

• What question is this test answering for me?
• What would we do differently if the result were abnormal?
• If something is flagged, will we repeat it before acting?
• Which of these markers should we track over the years?

How The Wellness can help

For a baseline, the Core Wellness blood test is £350, with results usually in 24 to 48 hours, reviewed by a doctor who writes you an action plan [6]. The Advanced Health and Longevity+ panels add markers such as full thyroid, iron studies, hormones, ApoB and Lp(a), and a doctor can tell you whether they add anything for you.

If something has changed, a GP appointment with a GMC registered doctor comes first, and the tests follow from what you describe. Samples go to accredited laboratories, and our clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia.