Blood tests for men by age: what to check in each decade

Blood tests for men by age share one core panel that runs from your 20s into your 80s: lipids, HbA1c (a three-month average of blood sugar), kidney and liver chemistry, and a complete blood count. Age changes two things about it: how often you repeat each test, and when a few decisions come due. Every age on this page comes from a named guideline: the US Preventive Services Task Force (USPSTF, the federal panel that rates screening tests), the American Diabetes Association (ADA), the American Urological Association (AUA), the American College of Cardiology and American Heart Association (ACC/AHA), the CDC, the European Atherosclerosis Society (EAS), KDIGO (the international kidney guideline group) or the Endocrine Society. Age sets the screening calendar; symptoms, not birthdays, decide the hormone tests.

Blood tests for men by age: the short answer

Read the table by your decade. Each row adds to the rows above it, so a man in his 50s still needs everything from his 20s, 30s and 40s, plus the new items. Intervals per test are in the how-often table further down.

The tests every man should have once, whatever his age

Four tests only need doing once in most men's lives. Lipoprotein(a), or Lp(a), is a cholesterol-carrying particle whose level is set mostly by your genes and barely moves with diet or exercise. The EAS recommends measuring it at least once in every adult's lifetime, and heart risk climbs noticeably above about 50 mg/dL, roughly 105 nmol/L ⁵. A routine lipid panel does not include Lp(a), so it has to be requested by name. Our page on high Lp(a) covers what a raised result means.

The other three are infection screens. The CDC recommends hepatitis C screening at least once for every adult 18 and over ⁷, hepatitis B screening at least once with a three-part panel (antigen and antibody tests that show current infection, past infection or vaccine protection) ⁸, and HIV testing at least once between 13 and 64 ⁹. Each infection can stay silent for years while it damages the liver or immune system, and each has effective treatment. The viral serology guide explains how to read the results.

Next step: at your next blood draw, ask your doctor by name to add Lp(a), ApoB, and hepatitis B, hepatitis C and HIV screens if you have never had them.

In your 20s and 30s: set a baseline

The 2018 AHA/ACC cholesterol guideline recommends assessing heart risk factors, including a lipid panel, every 4 to 6 years from age 20 to 39 ⁴. Most men do not need to fast for it ¹⁶. ApoB adds detail to LDL cholesterol. As our ApoB vs LDL comparison puts it, "LDL cholesterol measures how much cholesterol your LDL particles carry; ApoB counts the particles themselves." The lipid panel guide walks through each line.

A complete blood count (CBC) and a comprehensive metabolic panel round out the baseline. The CBC counts red cells, white cells and platelets; the metabolic panel covers kidney function, liver enzymes, electrolytes and glucose. A normal set at 28 is the reference point that makes a change at 48 visible. The CBC guide and metabolic panel guide explain each value.

Diabetes screening starts at 35. The ADA recommends testing all adults from 35, earlier with overweight plus another risk factor, and repeating at least every 3 years if the result is normal ⁶. On HbA1c, 5.7 to 6.4% (39 to 47 mmol/mol) is prediabetes and 6.5% (48 mmol/mol) or above is diabetes ⁶. The prediabetes page covers what to do with a borderline number.

Erection problems at any age are worth raising with a doctor, who will often check HbA1c and lipids, because they can be an early sign of diabetes or artery disease. Cortisol and fertility hormones such as FSH, LH and prolactin are not routine screens; they are tested for a reason, such as trying to conceive or specific symptoms.

Vitamin D is a test most healthy men can skip. The Endocrine Society's 2024 guideline suggests against routine vitamin D testing in healthy adults, because testing has not been shown to improve outcomes ¹⁷. If you already have a result, the vitamin D page explains the ranges, and high vitamin D covers results above them.

What blood tests should a man get at 40?

From 40, the lipid panel stops being read on its own. The AHA/ACC guideline uses it, with blood pressure, diabetes status and smoking, to estimate 10-year heart and stroke risk for adults 40 to 75, and that estimate guides whether to discuss a statin with a prescriber ⁴. When the estimate lands in the middle, a coronary calcium score can tip the decision either way.

In the 40s, a mildly raised ALT, often with a raised GGT, is the most common blood sign of fatty liver, which tracks waist size more than alcohol for many men. The liver enzymes guide explains which pattern points where. Fasting insulin is sometimes added to look for insulin resistance, but it is not part of guideline screening.

PSA comes up at 45. The AUA guideline says clinicians may offer a baseline PSA at 45 to 50 for average-risk men, and at 40 to 45 for men at higher risk: Black men, carriers of BRCA2 or similar gene changes, and men with a strong family history ². Colorectal screening also starts at 45 ¹⁰; a yearly fecal immunochemical test (FIT), a home stool test for hidden blood, is one accepted option alongside colonoscopy.

What blood tests should a man get at 50 and 60?

The USPSTF gives PSA screening for men 55 to 69 a Grade C, meaning the benefit is small and depends on the person, so the choice belongs to each man after a conversation about benefits and harms ¹.

For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)-based screening for prostate cancer should be an individual one.US Preventive Services Task Force, 2018 ¹

Most of those 18 men had slow cancers that would never have caused symptoms, but once found they faced biopsies and often treatment. Most men with a raised PSA who have a biopsy turn out not to have prostate cancer ¹. A PSA result also moves for reasons unrelated to cancer: ejaculation or a long cycle ride in the previous 48 hours, a urine infection or prostatitis, and an enlarged prostate all raise it. Finasteride and dutasteride lower PSA by about half, so a PSA taken on those drugs is usually doubled before it is read ². The AUA suggests repeating PSA every 2 to 4 years for men who choose screening, and a free/total PSA ratio can help sort a borderline result ². The tumor markers guide covers PSA alongside other cancer markers.

Men with diabetes or high blood pressure need two kidney tests: eGFR, a blood estimate of filtering capacity, and urine ACR (albumin-to-creatinine ratio), which catches kidney damage while eGFR is still normal. KDIGO's 2024 guideline recommends testing both in people at risk of kidney disease ¹¹, and with diabetes the check is usually repeated every year. The kidney function guide and chronic kidney disease page explain the stages, and foamy urine covers one sign of protein leaking.

Check ferritin if fatigue, joint pain or raised liver enzymes appear. Men show iron overload from hemochromatosis earlier than women, because they have no monthly blood loss to shed iron.

70 and over: what to stop and what to keep

The USPSTF recommends against PSA screening in men 70 and older (Grade D, meaning advised against), because the harms outweigh the benefits at that age ¹. Lipids, HbA1c, kidney function and a blood count stay on the list. The CBC matters more now because anemia becomes more common and is often the first sign of something else; hemoglobin is the number to watch. Men on metformin or long-term acid blockers are worth a vitamin B12 check, since both lower absorption; ask the prescriber when it was last done. The B12 deficiency page lists the signs.

Testosterone levels by age, and when to test

Testosterone is a test for symptoms. The Endocrine Society advises against screening the general population ³, and our low testosterone page puts the rule in one line: "Low testosterone is a two-part diagnosis. Symptoms of deficiency and a genuinely low morning testosterone, confirmed on a second morning, both have to be present." Symptoms that count include low libido, fewer morning erections, loss of body hair and unexplained low energy.

Two cutoffs are in use. The harmonised range, the same range across major US and European study labs, puts the lower limit for healthy non-obese men aged 19 to 39 at 264 ng/dL (9.2 nmol/L) ¹⁴, and the Endocrine Society adopted it ³. The AUA uses below 300 ng/dL on two early-morning tests, with symptoms ¹⁵. A result between 264 and 300 ng/dL is borderline, and the range is not adjusted for age.

Testosterone falls slowly with age. In the Massachusetts Male Aging Study, total testosterone fell about 1.6% a year in men aged 40 to 70, while free and bioavailable testosterone fell about 2 to 3% a year ¹³. Bioavailable testosterone is the free fraction plus the part loosely bound to albumin, the share not locked up by sex hormone binding globulin (SHBG). Free testosterone falls faster because SHBG rises with age, so a man of 65 can have a normal total and a low free level. At 1.6% a year, a man at 600 ng/dL at 40 would sit near 370 ng/dL at 70.

When a result comes back low, the next tests explain why. As our male hormone panel guide puts it, "high LH and FSH point to the testes (primary low testosterone), while low or normal LH and FSH point to the pituitary or hypothalamus (secondary)." LH and FSH are the pituitary signals that drive the testes; prolactin and estradiol add the cause checks, and gynecomastia covers the estradiol side. If one morning result is low and you have symptoms, ask for a repeat early-morning test plus SHBG and LH before any treatment talk. Our testosterone goal page pulls the topic together.

CalculatorFree testosterone calculatorEstimate free testosterone from your total, SHBG and albumin.Work it out

How often should a man get blood work?

A single result is a snapshot with lab error and daily variation built in. Two or three results from the same lab show direction, and direction is what changes a decision; the trends guide shows why, and the reference ranges guide explains where the normal band on your report comes from. A result outside the range, such as an HbA1c of 6.5% or above, an Lp(a) above 50 mg/dL or a low testosterone confirmed twice, is one to go through with your doctor rather than act on alone.

Getting a clean result

• Testosterone: draw between about 7 and 10 a.m., fasting, and repeat on a second morning before acting on a low.
• PSA: skip ejaculation and long cycle rides for 48 hours, and wait until a urine infection has cleared.
• Biotin: tell the lab if you take it, because it can skew many hormone tests, including testosterone and thyroid. See biotin and blood tests.
• Lipids: most men can eat beforehand ¹⁶. See fasting before a blood test.
• Coffee: black coffee can nudge glucose and some hormones. See coffee before a blood test.
• Creatinine and CK: dehydration raises creatinine, and heavy lifting can push CK and AST up for days.

The blood test prep guide covers the rest, and supplements that affect blood tests lists other products that shift results.

Already have results? Read them by age

If your last physical produced a PDF of numbers, the same decade logic applies: check which items on the table above are missing, and read each value against its range and your earlier results. Need the PDF first? See how to get your lab results; our guides to Labcorp and Quest reports walk through each layout.

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