Protocols
A rational, budget-tiered testing schedule for a healthy, asymptomatic adult, built directly from the grades on this site rather than from what's easiest to bundle and sell. Higher tiers add tests as evidence and cost both increase — they do not simply add more tests indiscriminately. This is a template for a conversation with your own doctor, not a prescription.
Basic
Foundational, guideline-backed screening appropriate for most healthy adults. Everything here is graded Strong.
Frequency: most components every 1–3 years once a baseline is established (see individual test pages); annually if you have metabolic risk factors or are on relevant medication.
Intermediate
Everything in Basic, plus risk-stratification tests with Moderate-to-Strong evidence, several of which are once-in-a-lifetime or targeted rather than annual.
- Apolipoprotein B (ApoB) — evidence card
- Lipoprotein(a) — once, lifetime · evidence card
- hs-CRP — once, if intermediate cardiovascular risk · evidence card
- Ferritin — if symptomatic or at-risk, not routine · evidence card
- Thyroid function — if symptomatic or risk factors
- Vitamin B12/folate — if in an at-risk group
- Testosterone — men, if symptomatic
- DEXA (bone density) — per age/risk guideline
Add tests here based on individual risk factors, not by default — see each test's "appropriate for" note.
Advanced
Higher-cost, indication-based imaging. Not annual, not for everyone — appropriate mainly from the 40s onward, or with specific risk factors, in consultation with a doctor.
- Coronary Artery Calcium (CAC) score — once, around age 40–50, if intermediate cardiovascular risk (is it worth it? full breakdown)
- Cardiac CT/MRI — only if CAC is abnormal, or symptomatic
- DEXA body composition — optional, for tracking a specific fitness/fat-loss goal
- APOE genotype — only with genetic counselling and a specific clinical indication (see Emerging & Overhyped)
Notably absent: carotid ultrasound, routine abdominal/brain MRI, gut microbiome testing, epigenetic clocks. See below for why.
Deliberately excluded from every tier
These tests appear frequently in premium executive-health packages but are graded Weak or Emerging on this site and are not part of any tier above, regardless of budget. See the Scans and Emerging & Overhyped pages for the full evidence discussion of each.
| Test | Grade | Why it's excluded from routine screening |
|---|---|---|
| Carotid ultrasound | Weak | USPSTF explicitly recommends against screening asymptomatic adults |
| Abdominal MRI (general screen) | Weak | No validated screening pathway; high incidental-finding rate |
| Brain MRI (general screen) | Weak | No validated screening pathway; high incidental-finding rate |
| Gut microbiome testing | Weak | No regulatory-approved clinical use; poor inter-provider reliability |
| Epigenetic clocks | Emerging | Not validated for individual-level decisions per current literature |
| Fasting insulin / HOMA-IR (routine) | Weak | Poor assay standardisation; no proven added value over HbA1c/glucose for screening |
| Homocysteine | Weak | Lowering it does not reduce cardiovascular events (HOPE-2) |
| Uric acid (routine) | Weak | Not causally validated as an independent cardiovascular/longevity marker |
| GGT (standalone) | Weak | Non-specific beyond its role in a standard liver panel |
| Vitamin D (routine) | Weak | USPSTF twice found insufficient evidence to screen asymptomatic adults; VITAL trial found supplementation doesn't cut cancer or CVD risk |
How to use this page
- Start with Basic — it covers the highest-value, cheapest, best-evidenced tests for almost everyone.
- Move to Intermediate selectively, based on your actual risk factors (family history, symptoms, metabolic risk) — not as a default upgrade.
- Only consider Advanced imaging from your 40s, or earlier with specific risk factors, and ideally after discussing your calculated cardiovascular risk with a doctor.
- If a clinic offers you a bundled package, ask which specific components are Strong/Moderate for you, and consider declining the Weak/Emerging components rather than paying a flat price for all of them — see real 2026 executive package pricing compared across 3 Singapore providers (S$398–S$12,888) before assuming a higher tier is a better buy.