Life stage · Over 60
The problem after 60 is not that blood tests stop working. It is that several of them start to mislead in the same direction, and the errors all flatter you. Creatinine falls as muscle is lost, so kidney function looks better than it is. B12 deficiency becomes common and the standard test misses a proportion of it. Thyroid ranges shift with age. And the symptoms that would prompt investigation at 45 get put down to being sixty. A panel built for this decade corrects for all of that, and it is the difference between finding something while it is still a number and finding it when it is a diagnosis.
Venous draw at 103 UK clinics or at home anywhere in the UK. Written report within 4 working days. No GP referral.
Last reviewed 17 September 2026
The short answer
After 60, test kidney function with cystatin C as well as creatinine, B12 and folate, a full thyroid panel rather than TSH alone, ferritin with full iron studies, ApoB and Lp(a) for cardiovascular risk, HbA1c with fasting insulin, calcium with albumin, vitamin D, liver function, a full blood count, and PSA with the free ratio for men. Those are the tests where age either changes the interpretation or raises the stakes, and most of them are not in a routine NHS review.
See a GP first, not a blood test, if
You have unexplained weight loss, a persistent cough or hoarseness, a change in bowel habit lasting more than three weeks, blood in your stools or urine, a new lump, difficulty swallowing, or bleeding after the menopause. Those are symptoms that need examination and often a two-week-wait referral, and a private panel is the wrong first step. A blood test is for when you feel broadly well and want to know what is happening underneath.
The main thing
Creatinine is a waste product of muscle. The standard eGFR calculation assumes a typical amount of muscle for your age and sex, then works backwards. From about 60 onwards most people lose muscle steadily, so they produce less creatinine, so the blood level falls, so the calculated eGFR rises. Your kidneys have not improved. The measurement has drifted. This matters because chronic kidney disease is silent until it is advanced, it is common after 60, and it changes which medications are safe at which dose.
Cystatin C is made by almost every cell in the body at a steady rate and is largely independent of muscle mass, so it does not have this problem. Where the two disagree, the cystatin C reading is usually closer to the truth in older adults. It is a single extra blood marker, it is in the Ultimate and Signature panels, and for anyone over 60 it is the most useful thing on the list. Kidney function and cystatin C explained.
What to test
| Marker | Why it matters more now | What to look for | Routine NHS? |
|---|---|---|---|
| Cystatin C with creatinine and eGFR | Creatinine falls with muscle loss and overstates kidney function; cystatin C does not | A cystatin C eGFR lower than the creatinine one. Any eGFR below 60 needs a GP conversation | Creatinine yes, cystatin C rarely |
| Vitamin B12 and folate | Stomach acid falls with age and metformin and PPIs reduce absorption further. Low B12 causes fatigue, unsteadiness, pins and needles and memory problems that get mistaken for ageing | B12 below 300 pmol/L with symptoms is worth acting on; the standard test misses some cases, which is why symptoms matter | Sometimes |
| Thyroid (TSH, free T4, free T3, antibodies) | Underactive thyroid becomes much more common with age, and TSH reference ranges shift upwards, so interpretation needs the full panel rather than TSH alone | TSH above range with a low free T4; positive antibodies; free T3 low with fatigue | TSH usually |
| Ferritin and full iron studies | New iron deficiency after 60 is not just a nutrition question: it can be the first sign of bleeding from the gut and warrants investigation | Ferritin below 30; low transferrin saturation. Read against hs-CRP, since inflammation inflates ferritin | Blood count yes, ferritin rarely |
| ApoB, full lipids, Lp(a) | Cardiovascular risk is at its highest and most modifiable here. ApoB counts the particles that cause disease; Lp(a) is genetic and tested once for life | ApoB raised despite an acceptable cholesterol; Lp(a) above 125 nmol/L | Cholesterol yes, ApoB and Lp(a) no |
| HbA1c and fasting insulin | Type 2 diabetes incidence peaks in this decade, and insulin resistance precedes it by years | HbA1c 42 to 47 is prediabetes; fasting insulin above 10 mIU/L shows the problem earlier | HbA1c sometimes; insulin no |
| Calcium with albumin, and PTH where indicated | Primary hyperparathyroidism is a genuinely common and treatable condition after 60, and it presents as tiredness, aches, low mood and kidney stones | A raised adjusted calcium, particularly with a raised or inappropriately normal PTH. Low calcium matters too | Sometimes, often incidentally |
| Vitamin D | Skin makes less with age, and low levels contribute to muscle weakness, falls and bone loss | Below 30 nmol/L deficient; below 50 insufficient | Rarely |
| Full blood count | Anaemia is common and is always a symptom of something rather than a diagnosis in itself | Low haemoglobin; a raised MCV (often B12, folate or alcohol); abnormal white cells or platelets | Yes |
| Liver (ALT, GGT, ALP) and albumin | Fatty liver is common, medication load rises with age, and a low albumin is a marker of poor nutrition or chronic illness | Raised GGT or ALT; falling albumin | Usually |
| PSA with free PSA and ratio (men) | Prostate cancer incidence rises steeply, and the NHS does not screen: you have to ask | Age-specific thresholds matter more than a single cut-off; the free-to-total ratio helps separate benign enlargement from something to investigate | Only on request |
Thresholds are UK laboratory conventions and NICE guidance where it exists. Guides: kidney and cystatin C, B12, thyroid, ferritin, ApoB, Lp(a), PSA, vitamin D.
Read it in context
Tiredness
Three treatable causes, all commoner after 60, all routinely under-tested. If a full thyroid panel, ferritin with iron studies and B12 are all genuinely normal, then tiredness needs a different conversation, and that is worth knowing too. Always tired, tests normal?
Aches and low mood
Vague aching, low mood, thirst and feeling "not right" is the classic presentation of a high calcium from an overactive parathyroid gland, which is surgically curable and frequently missed for years. Low vitamin D causes deep aching too. Both are single blood markers.
Unsteadiness and forgetfulness
Long-standing B12 deficiency damages the nerves carrying position sense and affects memory. It is far more common in people on metformin or long-term PPIs. It is also reversible if caught, and less so if left. Dizziness and unsteadiness.
Slowing down
Sarcopenia is not on a blood panel directly, but the things that accelerate it are: low vitamin D, low protein intake showing as low albumin, an underactive thyroid, and insulin resistance. Fixing those, plus resistance training, is the intervention with the biggest effect on the next twenty years.
Which panel
Advanced
74 biomarkers · £269
Full blood count, full thyroid with antibodies, ferritin with iron studies, B12, folate, vitamin D, calcium and albumin, ApoB and lipids, HbA1c, hs-CRP, liver and kidney. Everything except cystatin C, Lp(a), insulin and PSA.
View AdvancedRecommended after 60
Ultimate
140 biomarkers · £349
Adds cystatin C (the kidney reading that does not misread with muscle loss), Lp(a), fasting insulin and HOMA-IR, PSA with the free ratio, tumour markers and the complete hormone set.
View UltimateSignature
230 biomarkers · £799
Randox laboratory and clinic collection with blood pressure and physical measurements on the day. Adds an autoimmune profile, digestive profile and extended cardiovascular and neurological markers.
View SignatureClinic draw £19, at home £39, included on Signature. Morning appointment, fast from 10pm. Bring your medication list: several common drugs change how these results read.
Honest comparison
The NHS Health Check is offered every five years between 40 and 74 and covers blood pressure, cholesterol, blood sugar and a cardiovascular risk score. If you have a long-term condition such as diabetes, hypertension or kidney disease you will also have an annual review with bloods, and that review is good: take it, and ask for a copy of the results. Over 60 you are also invited to bowel cancer screening, and men can request a PSA test from 50 even though there is no screening programme. What none of that covers is cystatin C, ApoB, Lp(a), fasting insulin, a full thyroid panel with free T3 and antibodies, ferritin unless anaemia is suspected, or vitamin D. Those are the gaps, and they are the markers where finding something early actually changes the next decade. A panel is not a replacement for the NHS review; it is the layer underneath it. What to ask your GP for.
FAQs
Kidney function including cystatin C, B12 and folate, a full thyroid panel with antibodies, ferritin with iron studies, ApoB and Lp(a), HbA1c with fasting insulin, calcium with albumin, vitamin D, liver function, a full blood count, and PSA with the free ratio for men.
Because the standard eGFR is calculated from creatinine, which comes from muscle. Less muscle means less creatinine, which makes the calculated figure look better than reality. Cystatin C is not affected by muscle mass and gives a truer reading in older adults.
Annually is sensible for most people, or every six months if you are managing a result or have changed medication. The value is in the trend: one panel tells you where you are, two tell you which direction you are moving.
Some slowing is normal; persistent exhaustion is not. The three commonest treatable causes in this age group are an underactive thyroid, iron deficiency and low B12, and all three are routinely under-tested. It is worth measuring before accepting it.
Yes, and it matters more with age because most people take more of them. Metformin and long-term PPIs lower B12. Statins alter lipids and occasionally liver enzymes. Diuretics affect sodium, potassium and kidney markers. Levothyroxine should be taken after the draw, not before. Tell us what you take in the lifestyle questions and the report reads your results with that in mind.
There is no PSA screening programme in the UK, but men over 50 can request one from their GP, and it is included with the free ratio in the Ultimate and Signature panels. It is worth understanding both what it can find and its limitations before testing. PSA explained.
Yes, anywhere in the UK for £39, which many people prefer to a clinic trip. The same registered phlebotomist takes the same venous sample and it goes to the same laboratory. How at-home testing works.
140 biomarkers including the ones that misread after 60, in one venous draw at a clinic or your own kitchen, with a written report within 4 working days.
Health check at 50 · Over 40 · Kidney function · Always tired · Find a clinic
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