I’m Seeing a Doctor for the First Time In Years. What Tests Do I Need?

A runner turning 40 wonders what to request at an initial checkup.

A reader asks: I haven’t been to the doctor in quite a while. I’m turning 40 this year, and one of my goals is to get a full check-up. As a runner, are there any specific tests I should request? Or any pieces of information that I should share with my doctor about my running?

Congratulations! Getting a checkup is the first step in establishing a “health care home” – and having a primary care physician who can get to know you and keep track of your medical health. And being active through running is a significant ‘health risk positive’ that you have going for you.

The things I would ask you about – and you should have ready for your visit – relate to your past medical history including surgeries, your family history, any medications and supplements, your diet and nutrition, and habits like smoking, alcohol use, sexual history, and recreational drug use. I’d also want to know about your past injuries from running, other sports, work, any motor vehicle accidents you’ve been in and any childhood mishaps you had.

It is also important for you as a runner to talk with your physician about your running history, any excessive fatigue or decreased energy in your runs, and the potential impacts your activity has on your health. All this history is important and lends to recommendations that are based on you for health screening and your future health care.

What you should do or prepare for a screening is another issue. There are many recommendations floating around on the internet. Not all are good or evidence-informed. I use the United States Preventive Services Task Force  (USPSTF) recommendations in most circumstances. USPSTF screening recommendations are sorted by age, lifestyle and sex. The recommendations are vetted by a non-partisan group of physicians and scientists who have no conflicts of interest pertaining to the outcome of the recommendations. The USPSTF may differ from specialty organisation recommendations and part of a physician’s job is to individually reconcile these varying recommendations for each patient. The great thing for you as a patient is the USPSTF web site has a “widget calculator” that helps you find your age and sex-specific recommendations.

For a 40-year-old male, the widget recommends screenings for things like: STDs, alcohol misuse, depression, diabetes mellitus (type 2) as well as abnormal blood glucose and obesity.

For a 40-year-old female, screenings for cervical cancer, as well as breast and ovarian cancers are added to the list, among others.

I would add a cholesterol check to these lists. There are some specific tests which are not on the above list that people often expect like iron levels, vitamin D levels, thyroid function, and an electrocardiogram (ECG). These tests may be utilised in some circumstances, but are not done routinely as a part of a health screening evaluation.

Many 40 to 50 year olds come in because a relative, friend, or acquaintance recently had a catastrophic diagnosis or event that gets a person thinking about ‘vulnerability’, and the chances ‘this could happen to me’. Be sure to tell your physician up front about your concerns.


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