Outsmarting the System: 10 Health Tests I Think Everyone Should Consider

Curiosity, Spreadsheets, and a Quiet Wake-Up Call

I've long been known among friends as that guy — the one who tracks his biomarkers in Excel, experiments with wearable tech, and gets teased for reading lab results like others scroll through the headlines. It sounds geeky, and it is. But what started as curiosity gradually became a personal mission: to understand my own body better than anyone else could. Did I succeed? Not entirely. But I’ve made quite some progress along the way.

Some of this comes from living across borders for most of my adult life. I’ve lived across Asia Pacific for most of my adult life, which means I’ve never had a single “family doctor” watching over my health. No clinic has my childhood illnesses on file. No doctor remembers my family’s history. I've written about this before and how it forced me to take control of my own medical story and health data. You can find the article here.

Over a decade ago, I underwent genetic screening that revealed I carry a higher risk for colon cancer. There were no symptoms. Nothing urgent. But I booked a colonoscopy in my 40s anyway — well before the standard guideline of 50. I paired it with a gastroscopy (an upper endoscopy). Both procedures were done under propofol — the same sedative Michael Jackson famously died from, though in a clinical setting, it’s surprisingly pleasant. Honestly, the procedure was fine. The real ordeal? The prep: hours of laxatives and clinging to the toilet like it’s your new best friend.

The results surprised me: polyps in my colon and a Helicobacter pylori infection in my stomach — all with zero symptoms. That infection, if left unchecked, could have developed into a gastric ulcer or even cancer.

It was a quiet wake-up call that changed how I think about my body: not all warning signs announce themselves. And our healthcare systems aren’t built to catch what stays silent.

Why Most Standard Annual Health Checks Miss the Point

Let’s be honest: most modern healthcare is built to treat, not prevent. Most people don’t go to a doctor unless something’s obviously wrong.

But a lot of serious stuff starts long before that.

The incentives reflect this. Many doctors are overextended, and while some stay up to date, the system doesn’t always reward continued learning, especially when it comes to prevention. In most systems, there’s little financial incentive to keep people well. It’s a bit like the “lazy teacher” problem – not out of bad intent, but because the system encourages repetition over reinvention. Some doctors still rely on total cholesterol as the main indicator of cardiovascular risk, even though metrics like ApoB or Lipoprotein(a) offer more precise risk profiling and are now recommended by many cardiovascular experts.

Even when preventive care is offered, it’s often a checkbox exercise — a blood panel here, a chest X-ray there — designed more for insurance compliance than for truly personalized risk assessment. But that’s slowly changing. A new wave of preventive health clinics, longevity researchers, and personalized health advocates are shifting the conversation: from symptoms to systems, from treatment to prediction.

I’m not a doctor, and I don’t pretend to be one online. But I do believe this: there are tests that could quietly save your life. And most people — even the health-conscious — don’t know they exist.

The 10 Tests I Think Everyone Should Consider

These aren’t fringe ideas. Many of these are recommended by experts like Dr. Peter Attia, Dr. Rhonda Patrick, and others focused on proactive, data-driven prevention. They’re worth discussing with your doctor, ideally one who understands your family history, age, and personal risk factors.

Think of these as a menu, not a shopping list. Here’s how I’d prioritize:

Start here if you're over 40: Coronary Artery Calcium Score, Advanced Lipid Panel, Colonoscopy (especially if you have family history)

Consider these if you have unexplained symptoms: Comprehensive Hormone Panel, High-Sensitivity CRP, Fasting Insulin

Worth exploring if you're optimizing: Continuous Glucose Monitor, VO₂ Max, Genetic Testing

Proceed with caution: Whole-Body MRI (high false positive rate, but some find peace of mind worth it)

1. Coronary Artery Calcium (CAC) Score
A quick, non-invasive CT scan that measures plaque buildup in your arteries.
Why it matters: It’s one of the best predictors of cardiovascular risk — far more telling than LDL cholesterol alone. Especially useful for men over 40 or anyone with a family history of heart disease.

2. Advanced Lipid Panel (ApoB, Lp(a), LDL-P)
Goes well beyond the standard LDL/HDL panel.
Why it matters: You can have what looks like a “normal” cholesterol level but still be at risk for heart disease because standard tests don’t tell the full story. ApoB shows how many potentially harmful cholesterol particles are actually floating around in your bloodstream, not just how much cholesterol is there, but how many particles are doing the damage. It’s a more precise way to measure what’s clogging your arteries.
Lp(a), on the other hand, is a genetic wild card. You either inherit it or you don’t, and most standard tests skip it. Mine was never checked until I specifically asked for it.

3. High-Sensitivity CRP (hs-CRP)
A blood test that picks up low-grade, chronic inflammation.
Why it matters: Inflammation plays a role in everything from cardiovascular disease to cognitive decline. This is one of the few markers that can reveal trouble brewing beneath the surface, even if everything else looks “normal.” Lifestyle factors like poor sleep, stress, and diet can all drive it up. The good news? Most of those are within your control.

4. Fasting Insulin and HOMA-IR
Checks how efficiently your body manages blood sugar, years before diabetes shows up.
Why it matters: Most people get their blood sugar or HbA1c checked but those only flag problems once they’re already underway. Fasting insulin tells you how hard your body is working to keep your blood sugar stable. If your insulin is high, it means your system is under pressure, even if your glucose looks fine. This test can catch problems 5–10 years before traditional markers do — giving you time to make simple changes that actually work.

5. Colonoscopy (Earlier if At Risk)
A visual exam of the colon that can detect and remove precancerous polyps.
Why it matters: Colon cancer is one of the most preventable cancers, if it’s caught early. I had my first one done in my early 40s, after a genetic screening flagged elevated risk. Since then, I’ve tried to schedule one every 3-5 years.
The American Cancer Society now recommends starting at age 45, and many Western countries followed suit.

6. Genetic Testing for Cancer Risk (maybe Alzheimer’s)
Screens for hereditary mutations like BRCA1/2, Lynch Syndrome, and others tied to higher cancer risk.
Why it matters: Many of these mutations are silent but significant. Knowing you carry one can prompt earlier or more frequent screenings. In my case, a genetic test revealed an elevated risk for colon cancer — as well as APOE4, a marker associated with increased risk of Alzheimer’s.
Knowing your genetic risk isn’t always easy, but for me, it’s helped shape smarter decisions around screening, diet, and lifestyle.

7. Whole-Body MRI (Optional, Not for Everyone)
A non-invasive scan that detects structural issues, tumours, or abnormalities, all without radiation.
Why it matters: This one’s a bit controversial. It can catch hidden issues early, but it also has a high rate of false positives, which can lead to stress, over-testing, or unnecessary follow-ups. I’ve done a brain MRI for peace of mind but haven’t gone for the full-body scan. If you’re someone who’d rather know (and can afford the cost) it’s an option to discuss.

8. Comprehensive Hormone Panel
Goes beyond TSH to assess thyroid, adrenal, and sex hormones like testosterone, estrogen, and cortisol.
Why it matters: Hormones affect everything: energy, sleep, mood, metabolism, even brain fog. A basic thyroid test (TSH) might look fine, while free T3 or reverse T3 tell a very different story. This is especially relevant in midlife, or if you’re feeling “off” but your standard labs say you’re fine. These panels aren’t always covered by insurance and can be pricey, but if you’ve got symptoms that doctors can’t explain, it’s a good place to dig deeper.

9. Continuous Glucose Monitor (CGM)
A small wearable that tracks your blood sugar throughout the day.
Why it matters: I used one for two weeks and was shocked by how much certain “healthy” meals spiked my glucose. Even for non-diabetics, it’s a fascinating way to understand how your body responds to food, sleep, stress, and movement. The insights are personal, immediate, and often surprising. That said, you still need to manually log your meals to figure out what triggered each spike, so it takes some patience and detective work.

10. VO₂ Max
Measures how efficiently your body uses oxygen during exertion — a proxy for aerobic fitness and biological aging.
Why it matters: VO₂ max is one of the most powerful predictors of all-cause mortality. It’s also highly trainable. Just knowing your baseline can guide smarter, more effective exercise. Improving this number is one of the simplest, science-backed ways to add healthy years to your life. The actual lab test is pretty uncomfortable, so I rely on my Garmin watch to estimate VO₂ max and track the trend over time.

There’s No One-Size-Fits-All

Your decisions should reflect your context, your age, genetics, and goals. For example, a friend of mine discovered he carries the APOE E3/E4 genotype. The APOE gene, particularly the ε4 allele, is a major genetic risk factor for Alzheimer's disease, while the ε3 allele is considered neutral. In people with one ε4 allele (E3/E4), studies suggest the lifetime risk of developing Alzheimer's may be two to five times higher than for those with the more common E3/E3 genotype.
The news hit him hard even though that knowledge isn’t a death sentence. He already had a family history of dementia, so this felt like confirmation of his worst fears. But after the initial shock, something shifted. That knowledge became a catalyst. He overhauled his lifestyle, got his insurance and legal affairs in order, updated his living will. The genetic result didn't just tell him about risk, it empowered him.

Some people ask: "Wouldn't it be better not to know?" I get that fear. But if you have a family or others who rely on you, knowledge becomes a form of responsibility. You can't act on what you ignore.

That doesn't mean chasing every screen or test. Some carry costs, both emotional and financial. False positives can create anxiety or lead to unnecessary procedures. Before pursuing any of these tests, it's worth having a conversation with your doctor about which ones make sense for your specific situation—and checking whether your insurance covers them under certain circumstances.

I've also learned that geography matters more than you'd expect. Living across Asia Pacific has taught me to shop around. Tests that cost a fortune in Hong Kong or Singapore can be significantly cheaper in Thailand, and sometimes insurers are more willing to cover costs when there's a clear price advantage. The key is asking the right questions upfront.

But in my view, the risk of not knowing is greater.

The Quiet Math of Prevention

Disease doesn’t usually knock. It accumulates, quietly. And while no one test guarantees a long or healthy life, some offer just enough early notice to change course.

These tests don’t give you certainty, they give you options, and the chance to act while the stakes are still low. The chance to treat, or tweak, before the consequences become irreversible.

As I’ve written before in "Stop Outsourcing Your Health", no one will care about your body as much as you do. And the system isn’t designed to catch what it can’t see.

So ask more. Know more. And don’t be afraid to dig beneath the surface.

What Might You Be Missing?

If even one of these tests leads to a small early intervention, it’s worth it.
So here’s the question I’d leave you with:

What’s one test you’ve never considered but now want to ask about?