One of the most common things we hear from men in their late forties and fifties: they go to their GP, get a "full blood panel," and are told everything looks fine. Then six months later, having read more, they realise the test was much narrower than they'd assumed, and several of the most relevant markers for middle-aged men weren't even on it.

The standard NHS or insurance-company "comprehensive metabolic panel" was designed to catch acute disease in the general population. It's a perfectly fine baseline. It's not designed to characterise the suboptimal-but-not-clinical territory most middle-aged men live in. For that, you need a wider net.

Here's the panel we think every man over 45 should run annually. The whole thing costs €150–250 if you go private; some can be ordered through your GP if you ask politely; some are now available through direct-to-consumer lab services like Numan, Hone, or Forth.

The panel

Hormonal core

  • Total testosterone — the headline number.
  • Free testosterone — the active fraction (calculated or directly measured).
  • SHBG — required to interpret total testosterone. Without it, total T is half a story.
  • Oestradiol (sensitive assay) — checks for excessive aromatisation, especially in men with visceral fat.
  • LH and FSH — distinguishes primary (testicular) from secondary (pituitary) low T.
  • Cortisol (morning) — chronic stress marker, and a lever on testosterone via the cortisol-T trade-off.
  • DHEA-sulphate — a precursor hormone that drops with age.
  • TSH, Free T3, Free T4 — thyroid panel. Subclinical hypothyroidism in middle-aged men is more common than the diagnosis rate suggests.

Metabolic

  • HbA1c — three-month blood sugar average. Catches metabolic drift before fasting glucose moves.
  • Fasting insulin — insulin resistance, which suppresses testosterone via SHBG.
  • Lipid panel (full) — total cholesterol, LDL, HDL, triglycerides, and apolipoprotein B if you can get it.
  • Liver enzymes (AST, ALT, GGT) — fatty liver in middle-aged men is endemic and silent.

Micronutrients

  • 25-hydroxyvitamin D — see our Vitamin D article. Almost half of European men over 45 are deficient.
  • Ferritin — iron stores. Either too low or too high is a problem.
  • B12 and folate — deficiencies become more common after 50.
  • Magnesium (RBC, not serum) — serum is a poor proxy; RBC magnesium is what you actually want.

Inflammation and cardiovascular

  • hsCRP — high-sensitivity C-reactive protein. Chronic low-grade inflammation marker, predictive of cardiovascular and metabolic disease.
  • Homocysteine — methylation status, cardiovascular risk.

Standard but worth including

  • Full blood count — red cells, white cells, platelets.
  • Kidney function (creatinine, eGFR).
  • PSA — prostate baseline, especially over 50.

Reading the results

The single most important framing here: lab "reference ranges" represent the middle 95% of the testing population, not the optimal range for healthy aging. A result that's "in range" can still be suboptimal — and most reference ranges are particularly forgiving for hormones, because they were set by sampling a broad population that includes many men in the same suboptimal-but-not-clinical zone you're trying to escape.

Some rough optimal targets for adult men 45+ (these aren't medical advice, just the numbers most men's-health-aware doctors aim for):

  • Total testosterone: 600–900 ng/dL (20–30 nmol/L) in the upper-normal end is associated with better outcomes than mid-range.
  • Free testosterone: upper third of the lab range.
  • SHBG: 25–50 nmol/L. Above 70 is high; address it.
  • HbA1c: below 5.6% (38 mmol/mol). 5.7–6.4% is pre-diabetic.
  • 25-OH Vitamin D: 80–120 nmol/L (32–48 ng/mL).
  • hsCRP: below 1.0 mg/L. Above 3.0 is a flag.

What to do with the results

Track them year over year. The shape of the trend is more important than any single number. A man whose total testosterone is 18 nmol/L and trending down by 1 nmol/L per year is in a different situation than a man whose 18 nmol/L is trending up.

For markers that are clearly off, take them seriously. Vitamin D deficiency is fixable in 90 days. Elevated SHBG responds to body composition and insulin-sensitivity work over 6–12 months. Pre-diabetic HbA1c is reversible with diet and training. Ignoring them while taking supplements is a strange order of operations.

For markers in the suboptimal-but-not-clinical zone, this is where lifestyle, training, sleep, and yes — targeted supplementation — actually have the most leverage. It's the territory Testo Boost was built for, and the territory most men are in for far too many years before anyone notices.

The honest summary

Get tested. Get the right panel, not the cheap one. Track the trends. Act on the things that are clearly broken. Use the suboptimal numbers to guide where to apply leverage.

The men who do this annually in their fifties are the men who walk into their seventies in their own bodies. The men who don't, find out at 65 what was already trending at 50.