# Lifelong health checklist: screenings & vaccines by age *Based on CDC, USPSTF, AHA, ACS, and functional medicine guidelines. Customize with your doctor based on risk factors (family history, lifestyle, etc.). If you are younger than 18, seek medical advise from a health professional* | Age | Screening/test | Frequency | Why it matters | Notes | |----------|----------------------------------|-----------------------------|-----------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------| | 18+ | Blood pressure | Every 2 years (annually if ≥120/80) | Hypertension is silent but damages arteries, heart, and brain. | Optimal: <120/80. Lifestyle fixes (DASH diet, exercise) can reverse pre-hypertension. | | | BMI/waist circumference | Annually | Obesity links to diabetes, heart disease, and cancer. | Waist >35" (women) or >40" (men) = higher risk, even if BMI is "normal." | | | Chlamydia/gonorrhea | Annually if sexually active | STIs often asymptomatic but can cause infertility or chronic pain. | Urine test. CDC recommends up to age 25 (or older if new/risky partners). | | | HIV | At least once; more if at risk | 1 in 7 with HIV don’t know they have it. | Rapid finger-prick test. PrEP available for high-risk individuals. | | | HPV vaccine | 1 dose (if unvaccinated) | Prevents 6 cancer types (cervical, throat, anal, etc.). | Approved up to age 45. Gardasil-9 covers 9 strains. | | | Hepatitis B vaccine | 2-3 doses if unvaccinated | Hep B is 100x more infectious than HIV; causes liver cancer. | Required for healthcare workers. | | | Mental health screening | Annually | Depression/anxiety often missed but treatable. | Tools: PHQ-9 (depression), GAD-7 (anxiety). | | | Skin check | Annually (self-exam monthly) | Melanoma is deadly but curable if caught early. | Use ABCDE rule for moles. High-risk? See a dermatologist. | | 20+ | Cholesterol panel | Every 5 years (sooner if risk factors) | High LDL/low HDL = heart attack/stroke risk. | Test: LDL-P (particle number) is better than standard LDL. Optimal: LDL <100, HDL >60. | | | Type 2 diabetes screening | Every 3 years if BMI ≥25 | Prediabetes is reversible; diabetes cuts 10 years off life expectancy. | Tests: HbA1c <5.4% (optimal), fasting glucose <85. | | | Dental exam + cleaning | Every 6 months | Gum disease links to heart disease, Alzheimer’s, and cancer. | Flossing adds 6 years to life expectancy (study: *BMJ*). | | 21+ (women) | Pap smear | Every 3 years (21-65) | Detects cervical cancer early. | HPV test every 5 years (preferred if >30). | | 25+ | Full thyroid panel | Baseline; repeat if symptoms | Hypothyroidism (fatigue, weight gain) affects 20% of women and 10% of men. | Test: TSH, Free T3, Free T4, TPO antibodies. Optimal TSH: 1.0-2.0. | | | Vitamin D | Baseline; repeat annually | Low D links to cancer, autoimmune disease, and depression. | Optimal: 50-80 ng/mL. Supplement if <30. | | | Ferritin + iron panel | If fatigued | Low iron = fatigue; high iron = organ damage. | Ferritin <50 = deficiency; >200 (men) or >150 (women) = hemochromatosis risk. | | 30+ | Hepatitis C test | One-time | Baby boomers (born 1945-1965) have highest risk, but all adults should test. | Curable with antivirals. | | | Eye exam | Every 2 years | Glaucoma (silent vision loss) and diabetic retinopathy are preventable. | Dilated exam checks for early signs. | | | Homocysteine | Baseline; repeat if high | High levels = 3x heart attack risk + Alzheimer’s risk. | Fix with B vitamins (B6, B12, folate). Optimal: <7 µmol/L. | | | CRP (hs-CRP) | Baseline; repeat if high | Inflammation predicts heart disease, cancer, and diabetes. | Optimal: <1.0 mg/L. | | 35+ | Lipoprotein(a) [Lp(a)] | One-time | Genetic marker for heart attack/stroke (1 in 5 people). | No good treatment yet, but lifestyle helps. | | | Fasting insulin | If overweight/pre-diabetic | Early sign of insulin resistance (10+ years before diabetes). | Optimal: <5 µU/mL. | | 40+ | Mammogram (women) | Every 1-2 years | Breast cancer risk increases with age. | Controversial: USPSTF says 50+, but ACS says 40+. Thermography is an option. | | | Colonoscopy | Every 10 years (or FIT test annually) | Colon cancer is 90% curable if caught early. | FIT test (stool DNA) is non-invasive and effective. | | | Lung cancer screening (LDCT) | Annually (50-80 if smoker/ex-smoker) | Catches cancer early when 90% curable. | For 20+ pack-year smokers (or quit <15 years ago). | | | Bone density (DEXA) | Baseline at 50 (earlier if risk factors) | Osteoporosis is silent until you fracture a hip. | Weight-bearing exercise (jumping, lifting) builds bone better than calcium pills. | | 45+ | Prediabetes/diabetes screening| Every 3 years | 1 in 3 Americans has prediabetes (reversible!). | Tests: HbA1c, fasting glucose, fasting insulin. | | | Hearing test | Every 3 years | Hearing loss accelerates dementia (5x risk if severe). | Hearing aids reduce cognitive decline. | | 50+ | Shingles vaccine (Shingrix) | 2 doses (even if had Zostavax) | Shingles causes excruciating nerve pain (postherpetic neuralgia). | Shingrix is 97% effective. | | | Prostate screening (men) | Discuss with doctor | Prostate cancer is slow-growing; PSA test is controversial. | Shared decision: Weigh risks (false positives) vs. benefits. | | | Breast MRI (women) | If high-risk (BRCA gene, dense breasts) | Misses fewer cancers than mammogram in high-risk women. | Not for average risk-overdiagnosis risk. | | 55+ | Abdominal aortic aneurysm (AAA) screening (men) | One-time if ever smoked | AAA is silent but deadly if it ruptures. | Ultrasound test. | | 60+ | Pneumococcal vaccines | PPSV23 + PCV15/20 | Pneumonia is a top killer of seniors. | PCV15/20 first, then PPSV23 1 year later. | | | Hepatitis A vaccine | If unvaccinated/traveling | Hep A is rising in the U.S. (foodborne outbreaks). | 2-dose series. | | | Fall risk assessment | Annually | Falls are the #1 cause of injury in seniors. | Test: Timed Up and Go (TUG). Strength training prevents falls. | | 65+ | Medicare wellness visit | Annually | Free preventive visit to create a personalized prevention plan. | Includes cognitive impairment screening. | | | Cognitive impairment screening| Annually | Early dementia is reversible in some cases (e.g., B12 deficiency, thyroid issues). | Tools: MoCA test. | | | Peripheral artery disease (PAD) screening | If smoker/diabetic | PAD = narrowed leg arteries (risk of amputation). | Test: ABI (ankle-brachial index). | | 70+ | Bone density (DEXA) repeat | Every 2-5 years | Osteoporosis worsens with age; fractures can be fatal. | Weight training is more effective than calcium for bone strength. | | | Vision + glaucoma screening | Every 1-2 years | Age-related macular degeneration (AMD) is the #1 cause of blindness. | AREDS2 vitamins (lutein, zeaxanthin) slow AMD progression. | | 75+ | Colonoscopy decision | Discuss stopping | Risks (perforation) may outweigh benefits. | USPSTF says stop at 75 unless high risk. | | | Advance directive review | Every 5 years or with health changes | Ensures your end-of-life wishes are honored. | Specify DNR, DNI, comfort care preferences. | | All ages | Functional medicine tests | As needed | Catches root causes before disease develops. | Consider if chronic symptoms: | | | - HbA1c + fasting insulin | Prediabetes/diabetes risk | | Optimal: HbA1c <5.4%, fasting insulin <5. | | | - NMR lipoprotein test | Heart disease risk | Measures LDL particle size (small = dangerous). | Standard cholesterol tests miss this. | | | - Gut microbiome test | Digestive/autoimmune issues | Imbalances link to depression, obesity, and autoimmune disease. | Companies: Viome, Thryve. | | | - Heavy metal test | If exposed (fish, old pipes) | Lead, mercury, arsenic damage nerves and organs. | Test: Urinary toxic metals (provoked with DMSA/EDTA). | | | - Food sensitivity test | Chronic inflammation | Gluten, dairy, etc., can cause silent inflammation. | Elimination diet is gold standard; tests (like MRT) are controversial. | --- ## Vaccine schedule summary | Vaccine | Recommended age | Notes | |---------------------------|---------------------------|-----------------------------------------------------------------------------------------------| | HPV (Gardasil-9) | 11-12 (up to 45) | Prevents 6 cancers. 2 doses if started before 15; 3 doses if 15+. | | Tdap (tetanus, diphtheria, pertussis) | Every 10 years (Td booster) | Pertussis (whooping cough) is deadly for babies-get Tdap if around infants. | | MMR (measles, mumps, rubella) | 1-2 doses if unvaccinated | Measles is highly contagious (90% unvaccinated exposure → infection). | | Varicella (chickenpox)| If unvaccinated/no history | Shingrix later in life if you’ve had chickenpox. | | Hepatitis A | All adults (if unvaccinated) | 2 doses. Hep A outbreaks linked to contaminated food. | | Hepatitis B | All adults (if unvaccinated) | 3 doses. Hep B causes liver cancer. | | Meningococcal (MenACWY) | 16-23 (college students) | MenB also recommended for high-risk groups. | | Pneumococcal (PCV15/20 + PPSV23) | 65+ (or younger if high-risk) | PCV15/20 first, then PPSV23 1 year later. | | Shingrix | 50+ | 97% effective at preventing shingles. 2 doses, even if had Zostavax. | | Flu shot | Annually (all ages) | High-dose or adjuvanted for 65+. | | RSV | 60+ | New in 2023! Protects against severe respiratory illness. | | COVID-19 | Updated booster annually | High-risk groups (65+, immunocompromised) should prioritize. | --- ## How to use this checklist 1. Bookmark it and review at birthdays/annual physicals. 2. Customize with your doctor based on: - Family history (e.g., early heart disease, cancer). - Lifestyle (e.g., smoking, diet, exercise). - Symptoms (e.g., fatigue, digestive issues). 3. Prioritize preventive tests (e.g., CRP, homocysteine, Lp(a))-they’re rarely ordered but predict disease before it starts. 4. Advocate for yourself: - *"I’d like to discuss my risk factors for [X]."* - *"Are there lifestyle changes I can try before medication?"* - *"What’s the evidence behind this test/treatment?"* --- > Pro tip: Bring this table to your next doctor’s visit and ask: > *"Which of these screenings do I need based on my health history?"* > > Prevention is power. The earlier you catch issues, the easier they are to reverse.