General wellness – unlike all other health checks the key initial questions we have are: what are your worries, any health matters you would like to discuss, and what were you hoping to achieve from this.
Mental health – we always look at aspects such as depression and anxiety, and other mental health problems in men, as this is such a big area and is poorly managed in the NHS where time is often a limiting factor.
Cardiovascular health – still the biggest killer in men, we look at lifestyle factors, family history, symptoms, sleep, exercise diet and nutrition. We measure blood pressure, pulse, heart sound, perform an ECG, and carry out blood tests for cholesterol, testosterone, diabetes and pre-diabetes.
General health at the next level – as you’d expect, we look for core health markers such as anaemia screen, immunity, kidney and liver function. But we do it properly. For example, we look at the underlying causes of anaemia including B12, folate, iron levels.
We look for true markers of prostate disease and the renal system – we check urine for protein and blood for markers of kidney disease, we test kidney function, we measure BP (closely related to kidney disease) and we test PSA for free PSA as well as calcium and other indicators of more sinister prostate disease. We go far beyond a standard PSA test by including a prostate and urinary system check that actually has true meaning and is a better measure of potential prostate and kidney disease.
Diabetes screening – the cheap/historical way to look for diabetes is to do a finger-prick blood test for glucose. However, this is not only old fashioned but also not that effective. We now have far more advanced ways of screening diabetes, and pre-diabetes by using an HBA1c blood test which can pick up early markers of diabetes years before you get symptoms. However, we know there is more to diabetes than just blood sugars. For many men, type 2 diabetes is an indicator of what is known as “metabolic syndrome”, which is actually a devastating process that puts us at risk of stroke, heart attack, kidney disease, peripheral vascular disease, fatty liver disease, and other problems. We assess patients for this by looking at their overall cardiac risk (Qrisk score), blood pressure, cholesterol, HBA1c, renal function, lifestyle, bodyweight, BMI, percentage fat, etc.. then we look at how to tackle it either via medication or referral to our nutritionist, exercise plans etc.
Male health – we look at all aspects of men’s health, erectile dysfunction, testosterone deficiency etc, but we do it in a way that makes patients feel comfortable talking about these difficult problems – we do the tests the NHS does not commonly do, for example, testosterone and free testosterone, and we look for the reasons why it occurs rather than just assuming “you’re tired and it’s normal for your age”.
Cancer – no matter what health check you do you cannot screen for all cancers. Any screen that boasts this should be questioned – even a “full body MRI” would still potentially miss some forms of cancer. What we should be doing is screening for those forms of cancer that we can look for, for example prostate cancer and bowel cancer in men, but then look for other markers of general health that might point us towards an underlying cancerous process, or other serious diseases. But just screening for a cancer is only part of the battle. We look for ways to reduce the risk of cancer – prevention is always better.