Freedom from Silent Health Risks: Tests You Should Not Ignore

Why "Feeling Fine" Doesn't Mean You're Risk-Free

The human body compensates effectively for early disease. A person with one kidney functioning at 40% of capacity may feel entirely normal. Blood pressure high enough to double cardiovascular risk produces no sensation at all. According to studies most cancer diagnoses in India occur at stages III and IV, where five-year survival rates are substantially lower than at earlier stages.

Immunity Testing - What It Actually Measures

There is no single 'immunity test.' What is commonly called an immunity panel measures a complete blood count (CBC) with differential. It quantifies white blood cell types including neutrophils, lymphocytes, monocytes, eosinophils and basophils along with immunoglobulin levels (IgG, IgA, IgM) and complement proteins. Elevated neutrophils suggest acute infection. Elevated eosinophils raise the possibility of parasitic infection which is particularly relevant in India, where filariasis, strongyloidiasis and intestinal helminths remain prevalent. Persistent lymphocytopenia can indicate immune compromise. This gives a rough idea about some immune deficiency conditions you might be having.

Fever Profile Test Explained

The fever profile is a group of blood tests ordered to identify the most common infectious causes of prolonged fever in India. The standard panel includes: Widal test (for Typhoid fever caused by Salmonella typhi and S. paratyphi), malarial antigen test or peripheral smear, dengue NS1 antigen and IgM/IgG antibodies, leptospira IgM antibody, and a CBC with differential. Treatment for each condition differs entirely.

Hormonal Profile Testing

A hormonal profile panel varies by age, sex, and clinical presentation. The core components for preventive screening include: thyroid function tests (TSH, free T3, free T4), fasting insulin and HOMA-IR, fasting and post-prandial blood glucose, HbA1c and in women reproductive hormones (FSH, LH, oestradiol, and AMH). FOGSI and the Endocrine Society of India recommend thyroid screening in women planning pregnancy and in all symptomatic individuals. Insulin resistance (detectable through elevated fasting insulin and HOMA-IR before blood glucose becomes abnormal) is an early marker for type 2 diabetes; metabolic syndrome in India occurs at lower BMI thresholds.

Kidney Health Testing

Chronic kidney disease (CKD) affects many adults with diabetic nephropathy and hypertensive nephropathy as the two leading causes & both develop silently. The standard kidney function panel includes: serum creatinine, estimated glomerular filtration rate (eGFR), blood urea nitrogen, serum uric acid, serum electrolytes, and a urine protein-to-creatinine ratio. eGFR above 90 mL/min/1.73m² is normal; below 60 for more than three months defines CKD. Microalbuminuria is the earliest marker of diabetic or hypertensive kidney injury and is detectable before eGFR falls and should be checked annually in anyone with diabetes, hypertension, or a family history of kidney disease.

Full Body Cancer Screening

No single test screens for all cancers. A preventive cancer screening panel includes: 

• PAP smear and HPV co-testing for cervical cancer (women over 25); 

• Mammography for breast cancer (women over 40)

• PSA for men over 45

• Stool occult blood test or colonoscopy for colorectal cancer (over 45) 

• Tumour markers where clinically indicated like CA-125 (ovarian), CA 19-9 (pancreatic), CEA (colorectal, lung) and AFP (liver cancer, particularly relevant in India given the prevalence of hepatitis B and C). Tumour markers are not diagnostic in isolation.

How to Read Your Report - When to Follow Up

Reference ranges vary between laboratories and reagent manufacturers. A value flagged as 'abnormal' does not necessarily indicate disease; a value within range does not necessarily exclude it. A single mildly abnormal result in an asymptomatic individual warrants a repeat test before initiating treatment. Severely low haemoglobin (below 7 g/dL), eGFR below 30, TSH above 10 mIU/L, or any positive tumour marker should prompt same-day doctor review rather than watchful waiting. Results should be interpreted by a clinician with access to the full clinical picture, not compared with internet reference ranges alone.

FAQs

1. What is an immunity test and how is it done?

   An immunity test is not a single test but a panel that includes a complete blood count with differential, immunoglobulin levels (IgG, IgA, IgM), and sometimes specific antibody titres. Done from a routine blood draw, results are available within 24 hours and are used to identify immune deficiencies, chronic infections and autoimmune conditions.

2. Can I check my immunity level at home without a lab test?

   No. Immunity testing requires a laboratory blood test. Home pulse oximeters and symptom tracking provide no information about immune cell counts or immunoglobulin levels. Some rapid home test kits exist for specific conditions (dengue, malaria) but these are not general immunity assessments. A CBC with differential from an accredited laboratory is required.

3. What does a fever profile test check for?

   The fever profile typically tests for the most common infectious causes of prolonged fever in India: typhoid (Widal test), malaria (antigen test or blood smear), dengue (NS1 antigen and IgM/IgG antibodies), leptospirosis (IgM antibody) and a complete blood count. Some panels also include chikungunya serology and blood culture. 

4. How is a fever blood test report different from a routine blood test?

   A routine blood test measures general parameters (haemoglobin, white cell count, kidney & liver function) without targeting specific infections. A fever profile adds serology and antigen tests to identify specific pathogens. A CBC is included in the fever profile; the profile as a whole answers a specific clinical question: what organism is responsible for this fever.

5. What does a vitamin test panel usually include?

   A standard vitamin panel includes serum vitamin B12 (normal: 200 to 900 pg/mL), serum 25-hydroxyvitamin D (normal: above 30 ng/mL), serum ferritin, haemoglobin and often folate. Some extended panels add vitamins B6, B1, A and zinc. Results are available within 24 to 48 hours.

6. What is a hormonal profile test and who should get one?

   A hormonal profile test measures endocrine function across one or more systems. The thyroid panel (TSH, free T3, free T4) is appropriate for anyone with fatigue, weight changes, cold or heat intolerance, or hair loss. A reproductive hormone panel (FSH, LH, oestradiol, testosterone) is appropriate for women with irregular menstrual cycles, infertility or PCOS. A metabolic hormone panel is appropriate for anyone with overweight or a family history of type 2 diabetes.

7. How often should I get my kidney health checked?

   People with diabetes, hypertension, or a family history of kidney disease should have kidney function tested annually which includes serum creatinine, eGFR, and urine protein-to-creatinine ratio. Those without these risk factors should be tested at least every three to five years from age 40.

8. What is included in a full body cancer screening?

   A full body cancer screening panel in India typically includes: PAP smear and HPV test (women), mammography (women over 40), PSA test (men over 45), stool occult blood test or colonoscopy (over 45) and targeted tumour markers (CA-125, CEA, AFP, CA 19-9) based on family history and risk factors. The choice of tests should be guided by age, sex and risk profile.

9. Is full body cancer screening recommended for everyone, or only high-risk individuals?

   Age and sex-appropriate cancer screening (including PAP smear, mammography, colorectal cancer screening) is recommended for all adults meeting the relevant age thresholds. Additional tests such as tumour markers are reserved for those with elevated risk: family history of cancer, known genetic mutations (BRCA1/2), chronic hepatitis B or C, or tobacco use. Broad tumour marker panels in low-risk individuals produce many false positives and are not recommended.

10. How do I know if my test report values are actually a cause for concern?

    A flagged value in a report is a starting point, not a diagnosis. Mildly abnormal results in asymptomatic individuals often normalise on repeat testing. Haemoglobin below 7 g/dL, eGFR below 30 or any positive tumour marker requires same-day physician review.

 References

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63. https://doi.org/10.3322/caac.21834

2. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–72. https://doi.org/10.1016/S0140-6736(13)60687-X

3. Unnikrishnan R, Anjana RM, Mohan V. Diabetes mellitus and its complications in India. Nat Rev Endocrinol. 2016;12(6):357–70. https://doi.org/10.1038/nrendo.2016.53

4. International Institute for Population Sciences. National Family Health Survey (NFHS-5), 2019-21: India. IIPS. 2021. https://dhsprogram.com/pubs/pdf/FR374/FR374.pdf

5. Marwaha RK, Tandon N, Garg MK, et al. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India. 2011;59:706–9. https://www.japi.org/october_2011/article_06.pdf