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As you age, your body’s homeostasis mechanisms tend to falter and weaken. This can be seen in many different types of disease processes such as hormone imbalances, skin cancers, prostate enlargement, and heart disease, to name a few, where the body’s protective measures are not able to keep up with the burden they are tasked to monitor. (1)
Add 40 or 50 years of unhealthy foods, poor habits, and lack of exercise and disease processes can begin to manifest in the body.
Luckily, early testing and monitoring can sometimes alert you to imbalances seen in the body, which are often associated with chronic disease. This proactive approach helps you take ownership of your health and catch diseases in their early stages when they are easier to treat. (2)
This article will particularly focus on the screening tests recommended for men who are 40 or above.
Recommended Tests for Men Over 40 Years
If you are a man over the age of 40, these eight health screenings should ideally be a standard part of your regular checkup:
1. Prostate checks
Prostate cancer affects nearly 12.5% of men in their lifetime and kills 1 in 41 men, accounting for approximately 2.4% of male deaths in the United States. (3) Thus, it figures as a major health threat to the male population.
The good thing is that prostate cancer spreads slowly, and early detection can lead to successful treatment. In fact, early-stage prostate cancer has a very high survival rate.
There are two main screening exams for prostate cancer: prostate-specific antigen (PSA test) and the digital rectal exam (DRE).
- PSA involves testing your blood for prostate-specific antigen levels, which, if elevated, spell the need for a DRE. Just having a high PSA does not mean one has prostate cancer as there are multiple causes of elevated PSA, including infection, recent sexual activity, trauma, bicycle/motorcycle riding, and benign prostate enlargement.
- If the PSA is elevated, a DRE is the next test, wherein the doctor feels the prostate with a gloved finger looking for enlargement, nodules, and any other abnormalities.
The American Urologic Society (AUA) recommends screening mostly for males aged 55–69 years. (4)
If there are risk factors such as African race; immediate family history of prostate cancer (brother or father); family history of other related cancers such as ovarian, breast, colorectal, endometrial, or pancreatic cancer; or use of 5-alpha reductase inhibitors, screening in men 40–54 years of age is also recommended.
If both screening exams are positive, urologic referral with further testing is warranted.
Colorectal cancer (CRC) accounts for a lot of death and disease all over the world and is especially on the rise in the West. According to GLOBOCAN 2018 data, it figures as the third-most fatal and fourth-most commonly reported cancer in the world. (5)
In recent times, screening programs have increased early detections and have brought down the mortality rate due to CRC, but it is still quite prevalent.
Risk factors for CRC include the standard American diet (SAD), sedentary lifestyle, alcohol and tobacco use, obesity, and processed meat consumption. (6)
Fortunately, CRC is slow growing and is easily found with today’s advanced screening options such as immune histological screening tests (looking for blood in the stool) and a simple screening colonoscopy.
If small polyps/tumors are found on colonoscopy, they are easily removed, and the disease is stopped in its tracks. It is highly recommended to begin CRC screening at an earlier age if there is a family history of CRC.
3. Cholesterol check
Cholesterol tests have become a standard part of annual health checkups, since cholesterol is seen as a biomarker of potential disease. Although not everyone who has high cholesterol will have a heart attack or a stroke, it is significantly associated with such and with metabolic syndrome.
Metabolic syndrome refers to a collection of five risk factors that lead to cardiovascular disease and diabetes. (7) It includes:
- Large waistline
- Elevated triglyceride
- Low HDL cholesterol
- Elevated blood pressure
- Elevated fasting blood sugar
Many people have one or two of these risk factors, and when you have three or more, the diagnosis is metabolic syndrome. Needless to say, the risk for cardiovascular conditions, diabetes, and stroke increases if you have more of these risk factors.
4. Blood sugar tests
Blood sugar testing, and monitoring for good health, is paramount as it is one of the risk factors for metabolic syndrome. Blood sugar testing alone can alert providers that there may be a problem.
However, testing hemoglobin A1c (HbA1c) is often better as it shows the patient’s average blood sugar over the past three months. The levels of the hemoglobin A1c can help determine whether a patient will need to use insulin or not. (8)
An elevated hemoglobin A1c can also help motivate the patient to try to curb their carbohydrate intake and increase exercise to help bring this lab value down while improving the patient’s overall health.
Yearly electrocardiograms (ECG) can lead to early detection of cardiac abnormalities, even without any signs or symptoms of heart disease.
The ECG reads the electrical impulses of the heart, and many cardiac abnormalities can be inferred from these tests. In fact, previous heart attacks are often diagnosed via ECGs. (9)
6. Bone density tests
Low bone density leading to hip fractures is a major medical problem.
It is recommended that men with any of the above risk factors talk to their doctor and obtain bone density testing at recommended intervals.
7. Dental checkups
Dental health is reflective of an adult’s overall health and wellness. Although recommendations regarding the frequency of checkups vary between countries and dental healthcare systems, six-month dental checkups have traditionally been advocated for by general dental practitioners in developed western societies.
Being negligent towards your oral health can pave the way for several diseases such as:
- Endocarditis, an infection of the inner lining of the heart
- Cardiovascular disease, from an increased amount of inflammation from periodontal disease and bacteremia (bacteria in the blood)
- Pregnancy complications, which has been linked to low birth weight and premature birth
- Pneumonia, an overabundance of oral bacteria that make its way into the lungs
Another benefit of twice-yearly checkups is that the dentist will perform a thorough examination of your oral cavity, including checking for any signs of oral cancer.
According to the American Cancer Society, there are approximately 54,000 new cases of oral cavity or oropharyngeal cancer and about 11,230 deaths from oral cavity or oropharyngeal cancer per year in the United States. (10)
8. Eye exams
Yearly eye exams are crucial for maintaining good health. Some say the eyes are the gateway to the soul, but they can also be harbingers of chronic disease. Macular degeneration accounts for most cases of blindness in the elderly population. (11)
Regular eye exams can spot early signs of many chronic eye diseases, many of which do not have early symptoms. Luckily, they can be thwarted with early detection.
Glaucoma is one such disease that can lead to permanent blindness by damaging the optic nerve. It is only detected through a thorough eye exam, and the eye is the only place in the human body where blood vessels and nerves can be seen directly.
Thus, an eye exam can help diagnose systemic diseases such as hypertension, diabetes, high cholesterol, and some neurologic conditions. (12)
Lastly, cancer can develop in the eye, and the best way to spot and diagnose this is with thorough eye exams. Fortunately, early detection can often lead to a complete cure.
Other Yearly Tests for Men After the Age of 40
Given the fact that a man’s testosterone levels begin waning at about 35, in my practice I look at every man’s lab results, including testosterone, estradiol, DHT and DHEA, fasting insulin, IGF-1, CRP, homocysteine, and vitamin D.
With these labs, I can see if the patient has excess inflammation and is hormonally balanced or not. If the labs are abnormal, my first plan of care is to evaluate diet and lifestyle choices and see where improvement can be made.
Being board-certified in functional medicine, I often try to initiate diet and lifestyle modifications before going straight to medications. Remember, the body is genius and wants to be in a healthy state of homeostasis and just needs the right inputs. According to the functional medicine tenant: food first.
Why Is Regular Testing Important?
Maintaining peak physical, mental, and emotional health means educating yourself and knowing exactly where you stand when it comes to your health parameters.
Knowing your baseline laboratory values allows you to make smarter decisions about preventative health and may even affect your lifestyle choices. Often, many illnesses will only blossom after years of growing unchecked in your body.
According to the US Preventative Services Task Force (USPSTF), “Preventive services, such as screening tests, counseling services, and preventive medicines, are tests or treatments that your doctor or others provide to prevent illnesses before they cause you symptoms or problems.”
It’s always better to stop the disease in its tracks before it can become debilitating and/or deadly. The age-old adage is still true today: “An ounce of prevention is worth a pound of cure.”
How Often Should Regular Checkups Be Done?
Although no amount of testing, monitoring, and checkups can alleviate all risks of disease, at a minimum, yearly checkups would be recommended.
If possible, half-yearly checkups are recommended to improve one’s odds of catching a medical problem early in its course and allow ample time for the correct diagnosis, treatment, and avoidance of any further sequelae of such disease.
It is much better to catch any disease process early on in its course than later when there may be limited or no useful treatments available.
What Lifestyle Changes Should Be Made by Men After the Age of 40?
Diet plays a crucial role in shaping your overall health. I recommend a lifestyle gluten-free, dairy-free, and sugar-free. That alone will help you lose weight, decrease inflammation, and balance hormones back to a more natural state.
Once they do this diet consistently for 2–3 months, I then recommend a 90:10 rule. Eating like that 90% of the time will reap the benefits mentioned above, and this is more achievable for most people.
Healthy food choices should be accompanied by an active lifestyle to stay fit and healthy. I advise my patients to exercise regularly. The amount of exercise depends on the patient.
If you are a 45-year-old male who needs to shed a few pounds, I advise walking, jogging, and lifting weights. This will help you build lean muscle mass, which will replace the excess fat for desired weight loss. This kind of regular physical activity also helps increase your metabolism rate, which is necessary to avoid undue weight gain.
If you are an 87-year-old male, it may be a different story. I may advise to just get a couple of soup cans and do curls with them while watching TV and maybe some simple chair squats.
Men at the Age of 40 Are at a Higher Risk of What Diseases?
Diabetes, coronary artery disease, metabolic syndrome, multiple cancers, hormone imbalances, nonalcoholic fatty liver disease, and a number of autoimmune diseases.
Remember, embracing a diet and lifestyle that supports good health are the best steps to take in maintaining good health, and you can’t exercise your way out of a bad diet.
Sometimes, an objective analysis with lab values and examinations that don’t lie may be the wake-up call someone needs. Also, regular checkups garner good advice from health professionals that someone may not get otherwise.
The best time to stop disease is before it even starts, and that can oftentimes be achieved by having a qualified doctor give you the once over two times per year.
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