health check
Question: I’m a woman in my 40s and I’m more health conscious than ever, but I’ve never had a full physical. Is it worth it to get a full physical? How much does it cost? What tests are involved (needles, etc.)? And what would I learn?
Dr. Grant responds: If you want to know more about your current health and how to improve it, and if you have the time, money (around 400-800 euros depending on where you go and what is included) and the patience to wait for an appointment, I think a full medical check-up at a private clinic is a worthwhile investment in your future. Of course, a series of routine blood tests involves needle sticks. It is common for patients to have a phobia of needles, but please let the nurse/phlebotomist know and ask to lie down while your blood is taken. You will need to fast on the morning of the test (no breakfast until your blood is taken) and drink plenty of water.
Some of the most important things that we will discuss in detail include blood pressure (BP), cholesterol profile, and body composition (body fat and muscle mass). Understanding normal BP values is key to preventing age-related strokes, heart attacks, and vascular dementia. Reducing salt, caffeine, and alcohol intake, losing weight, and doing aerobic exercise daily can help lower systolic BP by about 10-15%.
Regarding the second point, cholesterol, there is really no safe upper limit. Therefore, the lower the better, with the exception of HDL (high density lipoprotein) cholesterol. This should be within the normal reference range, as low HDL cholesterol is a known risk factor for atherosclerosis (clogging of the arteries). Smoking and insulin resistance can lower HDL cholesterol. Whether you have insulin resistance is related to your body fat and waist circumference. A family history of cardiovascular disease should also be discussed as an important risk factor, as certain genetic conditions can cause a lower cholesterol profile. Only by being referred to a specialist cardiologist can you undergo further cardiac testing, which may identify genetic risk factors for cardiovascular disease.
Third, most health screening clinics offer some sort of body composition analysis, which can be very helpful in setting goals such as increasing lean muscle mass, as it can prevent insulin resistance and type 2 diabetes. Many people have a normal BMI (body mass index), but low overall muscle mass and high body fat, placing them in the “obese” range. Some people are surprised that clinicians don’t look closely at BMI or total weight, but looking at the other two parameters will reveal the issues that need to be addressed. This is where we talk about the importance of weight resistance training to build muscle and burn body fat (and visceral fat). The current recommendation is to do 20 minutes of strength training three days a week. The more muscle you have on your body, the higher your basal metabolic rate will be, which will allow you to eat more nutritious food every day.
Occasionally, an abnormal ECG (heart waveform) or chest x-ray may require further testing. If blood tests show very high iron, genetic testing for hemochromatosis may be recommended. Any abnormalities in thyroid blood tests, white blood cell, or platelet counts, mild anemia, slightly elevated PSA (prostate specific antigen), or blood in the urine should be retested by your doctor in a few weeks to see if they return to normal or persist. Any minor abnormalities will be noted with clear instructions for follow-up if necessary. Overall, a health check is generally a very pleasant experience.
Dr Jennifer Grant is a GP at Beacon Health Check
