Testosterone gets the headlines, but it is one marker out of dozens that determine how you feel, perform, and age. Here is what a men's health blood test should actually cover, what most services miss, and why checking five markers and hoping is not a strategy.
Most "men's health" blood tests check testosterone, cholesterol, and liver function. That covers maybe 10% of what is relevant to a man's health. Here are the markers that make a real difference.
Total testosterone alone is almost meaningless without context. SHBG (sex hormone binding globulin) determines how much of your testosterone is actually available to your body. A total testosterone of 18 nmol/L with an SHBG of 60 means very little free testosterone is available, even though the total looks "normal." TrueVitals tests total testosterone, SHBG, and calculates free androgen index. The Ultimate panel adds LH and FSH which reveal whether a low result is coming from the brain (pituitary) or the testes, which completely changes what you do about it.
Prostate-specific antigen is the primary screening marker for prostate cancer, the most common cancer in men in the UK. Most private blood testing services do not include PSA in their comprehensive panels. TrueVitals Ultimate includes PSA, free PSA, and the PSA ratio. The ratio is important because a low free-to-total PSA ratio is more concerning than a mildly elevated total PSA. Screening is particularly relevant from age 40, or earlier with a family history.
Heart disease is the leading cause of death in men in the UK. A standard cholesterol panel (total, LDL, HDL, triglycerides) is a starting point, but ApoB is a better predictor of risk than LDL cholesterol. Lp(a) is a genetic risk factor elevated in approximately 20% of the population that you only need to test once. Homocysteine adds another dimension. Most men's health tests check none of these. TrueVitals includes ApoB from the Advanced panel and adds Lp(a) in the Ultimate panel.
Type 2 diabetes does not appear overnight. Insulin resistance develops over years, sometimes decades, before glucose or HbA1c become abnormal. Testing insulin and HOMA-IR reveals metabolic dysfunction at the earliest stage, when it is most reversible through diet and exercise. By the time fasting glucose is elevated, you are already significantly insulin resistant. TrueVitals Ultimate includes insulin, C-peptide, and calculated HOMA-IR.
Thyroid dysfunction is often considered a women's health issue, but it affects men too. Subclinical hypothyroidism causes fatigue, weight gain, brain fog, low mood, and reduced exercise tolerance. A standard TSH check can miss conversion problems entirely. Free T3 is the active hormone. If your TSH is normal but Free T3 is low, your thyroid is underperforming and nobody is telling you. TrueVitals tests TSH, Free T3, Free T4, and thyroid antibodies in every panel.
Chronic stress suppresses testosterone, impairs recovery, disrupts sleep, and drives visceral fat accumulation. Cortisol and DHEA-S together reveal the state of your HPA axis. A high cortisol-to-DHEA-S ratio is a marker of chronic physiological stress that directly impacts testosterone production, body composition, and cardiovascular risk. Both are included in every TrueVitals panel.
Your testing priorities shift as you age, but a comprehensive panel covers all of them simultaneously. Here is what becomes more important at each stage.
This is the best time to test because your levels are closest to their natural peak. Testosterone, thyroid, iron, vitamin D, cholesterol, and metabolic markers give you a personal reference point to compare against for the rest of your life. Lp(a) should be tested at least once since it is genetically determined and does not change significantly over time.
Testosterone drops approximately 1-2% per year from age 30. Insulin sensitivity tends to decrease. Cardiovascular risk markers become more predictive. This is when trends matter most. A baseline from your 20s makes these changes visible. Without it, you have no comparison point.
PSA screening becomes particularly relevant. Cardiovascular disease risk accelerates. Thyroid dysfunction becomes more common. Metabolic syndrome prevalence increases. This is the decade where early detection has the highest impact. Annual comprehensive testing is strongly advisable.
Bone density markers (calcium, phosphate, ALP, vitamin D, PTH) join the priority list. Kidney function monitoring (cystatin C, eGFR) becomes important. Tumour markers provide ongoing screening value. Comprehensive annual testing is the most efficient way to catch changes early.
Services like Numan, Forth, and Thriva offer men's health blood tests that check 10-45 markers. They typically include testosterone, basic cholesterol, liver function, and vitamin D. Here is what they leave out.
The most common cancer in men, and most private tests do not screen for it.
The cardiovascular markers cardiologists actually use. Not included by most providers.
The active thyroid hormone. Missed by every provider that only tests TSH.
Insulin resistance detection years before glucose becomes abnormal.
Ferritin alone misses haemochromatosis (iron overload), which affects 1 in 200 men.
Immune function screening. Relevant for anyone with recurrent infections or autoimmune concerns.
The TrueVitals Ultimate panel includes all of these. 114 biomarkers. £349. The most complete men's health blood test available in the UK. See how TrueVitals compares to Numan or compare all providers.
At minimum: testosterone (total and free), SHBG, PSA (from 40+), full lipid panel including ApoB, HbA1c, insulin, full thyroid, liver and kidney function, iron studies, vitamin D, B12, and hs-CRP. A comprehensive panel like TrueVitals Ultimate covers all of these and more in a single test.
Any age is a good time to establish a baseline. Testosterone starts declining around 30. Cardiovascular risk markers like ApoB and Lp(a) are worth knowing at any age. PSA screening is most relevant from 40. The earlier you test, the more useful your baseline becomes for tracking changes over time.
PSA (prostate-specific antigen) is the primary screening marker for prostate cancer. It is not diagnostic on its own but elevated or rising PSA levels warrant further investigation. TrueVitals Ultimate includes PSA, free PSA, and the PSA ratio. Most private blood testing providers do not include PSA in their standard panels.
Low testosterone can be driven by poor sleep, chronic stress (elevated cortisol), excess body fat, insulin resistance, thyroid dysfunction, iron imbalance, overtraining, certain medications, or age-related decline. A comprehensive blood test helps identify which factor or combination is responsible, rather than treating the symptom without understanding the cause.
The TrueVitals Ultimate panel (114 biomarkers, £349) is the most comprehensive men's health blood test in the UK. It includes full testosterone profiling, PSA with free ratio, cardiovascular risk markers including ApoB and Lp(a), metabolic depth including insulin and HOMA-IR, full thyroid, and every other major health system. View the Ultimate panel.
114 biomarkers including full testosterone profiling, PSA screening, cardiovascular risk, and metabolic depth. AI-powered reporting. £349.
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