Dr. Stein’s Recommendations for Staying Healthy Through the Years

Dr. Stein has prepared a handy list of tests that you should have depending upon what age you are. Use this helpful tool to determine what tests are needed as you age.

Index by age group:

• 20's 30's
• 40's 50's
• 60's 70's and Beyond

YOUR TWENTIES
What Tests Should I Have?

Examination,Test or Procedure	How Often
Blood Pressure	Every two years
Cholesterol test	Nonfasting total cholesterol and HDL every 5 years
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Immunizations	Tetanus booster every 10 years
Eye Exam	Once during this decade or if vision changes
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

 Top 10 List For Staying Healthy - Your Twenties:

• Don't smoke
• Now that you can legally drink, don't do so in excess or when you'll be driving
• Use seat belts
• Limit your number of sexual partners and practice safe sex
• Don't forget to exercise-even if your body and weight seem fine
• Take a multivitamin that contains 400 micrograms of folic acid and consume 1,200 milligrams of calcium per day in the form of dairy products, calcium-fortified foods or supplements
• Eat a well balanced diet.
• Build a network of friends and colleagues to serve as your unofficial mental health support system
• Establish a relationship with a family or primary care physician
• Make sure you have adequate health insurance.
• What Can Go Wrong At My Age? Thyroid problems, Multiple Sclerosis

YOUR THIRTIES
What Tests Should I Have?

Examination,Test or Procedure	How Often
Blood Pressure	Every two years
Cholesterol test	Nonfasting total cholesterol and HDL every 5 years
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Immunizations	Tetanus booster every 10 years
Eye Exam	Once during this decade or if vision changes
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

 Top 10 List For Staying Healthy - Your Thirties:

• Don't smoke
• If you want to have children, start trying now and make sure your body is a healthy venue for pregnancy
• Periodically reevaluate your choice of contraception
• Practice safe sex with any new partners and get checked for STDs.
• Wear your seat belt
• Do not hesitate to seek help if you experience increasing PMS or depression
• Maintain a steady, healthy weight and return to it after pregnancy.
• Take a multivitamin that contains 400 micrograms of folic acid and consume 1,200 milligrams of calcium per day in the form of dairy products, calcium-fortified foods or supplements.
• Make sure you are informed about the results of all your lab tests, and if they are not normal (especially your PAP smear), get appropriate follow-up and/or therapy.
• Do some form of exercise for half an hour a day on most days.
• What Can Go Wrong At My Age? Thyroid problems, Multiple Sclerosis

YOUR FORTIES
What Tests Should I Have? 

Examination,Test or Procedure	How Often
Blood Pressure	Every two years
Cholesterol test	Nonfasting total cholesterol and HDL every 5 years
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
Rectal Exam	Annually
Fasting Plasma Glucose	Every three years
Thyroid Test	TSH every five years
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Mammogram	Annually
Electrocardiogram	Every 5 years
Bone Mineral Density	At you/your Doctor's discretion
Immunizations	Tetanus booster every 10 years
Eye Exam	Baseline exam at age 40 then every 3 years
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

  Top 10 List For Staying Healthy - Your Forties:

• Stop smoking
• Decrease your daily caloric intake by 100 to 200 calories
• Exercise regularly (30 minutes of moderate activity almost every day)
• Substitute complex carbohydrates (whole grains, fruits and vegetables) for simple ones such as white bread, potatoes and white rice
• Take a multivitamin and consume 1,200 milligrams of calcium from foods or supplements daily
• Moderate your alcohol and caffeine consumption as well as your sun exposure
• Establish distressing routines such as hot baths, meditation, reading and other pleasurable activities
• Seek help if stress or depression becomes unmanageable
• Build and maintain strong emotional bonds with your family and mate
• Cultivate and express your sexuality
• What Can Go Wrong At My Age? Weight gain, high blood pressure, tension headaches, migraine headaches

YOUR FIFTIES
What Tests Should I Have? 

Examination,Test or Procedure	How Often
Blood Pressure	Every two years
Cholesterol test	Nonfasting total cholesterol and HDL every 5 years
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
Rectal Exam	Annually
Fasting Plasma Glucose	Every three years
Thyroid Test	TSH every five years
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Mammogram	Annually
Electrocardiogram	Every 5 years
Bone Mineral Density	At you/your Doctor's discretion
Fecal Occult Testing	Annually
Sigmoidoscopy	Every 5 years
Colonoscopy	Every 10 years
Immunizations	Tetanus booster every 10 years
Eye Exam	Baseline exam at age 40 then every 3 years
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

Top 10 List For Staying Healthy - Your Fifties:

• Consider hormone replacement therapy; if you decide it's not or you, explore all other avenues of symptom control and heart and bone maintenance
• Stop smoking
• Exercise regularly (30 minutes of moderate activity almost every day). If you're not already doing some form of resistance training with weights, add this to your routine
• Make sure to get the checkups and screening tests recommended for your age group, including mammography and sigmoidoscopy or colonoscopy
• Take a multivitamin and consume 1,500 milligrams of calcium from foods or supplements daily
• Don't assume that vaginal dryness and diminished libido are inevitable in this decade. Take steps to address these problems
• Maintain a healthy weight with a diet low in fat (especially saturated and trans fats) and high in fruits, vegetables and fiber
• Limit alcohol intake to one drink a day or less
• Explore your family's medical history to look for clues to your genetic risks. Take any additional screening or preventive steps necessary.
• Allow yourself leisure time-you deserve it-and cultivate interests outside of hone and work
• What Can Go Wrong At My Age? Type II Diabetes, Autoimmune diseases (including Systemic Lupus Erythematosis, Rheumatoid Arthritis, Multiple Sclerosis, Scleroderma, Sjogren's Syndrome, and Myasthenia Gravis), thyroid nodules and cancer, lung cancer

YOUR SIXTIES
What Tests Should I Have?

Examination,Test or Procedure	How Often
Blood Pressure	Every two years
Cholesterol test	Nonfasting total cholesterol and HDL every 5 years
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
Rectal Exam	Annually
Fasting Plasma Glucose	Every three years
Thyroid Test	TSH every two years
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Mammogram	Annually
Electrocardiogram	Every 5 years
Bone Mineral Density	Once at age 65
Fecal Occult Testing	Annually
Sigmoidoscopy	Every 5 years
Colonoscopy	Every 10 years
Urinalisys	Annually
Immunizations	Tetanus booster every 10 years, Influenza vaccine annually, Pneumonial vaccine once at age 65
Eye Exam	Every 3 years
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

Top 10 List For Staying Healthy - Your Sixties:

• Continue (or start) doing regular, moderate physical activity
• If you have diabetes, hypertension, or abnormal lipids, make sure they are treated aggressively
• Increase your calcium to 1,500 milligrams at age 65; increase your vitamin D to 800 international units and take a multivitamin with at least 400 micrograms of folic acid. Also consider taking cardio protective vitamin E
• If you have not taken estrogen, have tests to see if your bones and heart would benefit from this or some other therapy
• Talk to your doctor about the possible benefits of taking baby aspirin
• Know what tests are recommended for your age group and demand them from your doctor and your insurance carrier
• Insist on referrals to specialists when necessary
• Consider getting media insurance to cover what Medicare won't; also determine whether you might want long-term care insurance
• Consider ways to maintain intimacy and your sexuality
• Continue to develop new interests-read good books, take up a new hobby, go out of your way to meet interesting people and do interesting things that will stimulate your brain
• What Can Go Wrong At My Age? Osteoporosis, heart disease, diverticulosis

YOUR SEVENTIES AND BEYOND
What Tests Should I Have?

Examination,Test or Procedure	How Often
Complete Physical	Annually
Blood Pressure	Annually
Cholesterol test	Every 5 years until age 85
Pelvic Exam & Pap Smear	Annually; Pap at doctors discretion after three negative tests
Rectal Exam	Annually
Fasting Plasma Glucose	Every three years
Thyroid Test	TSH every two years
STD Testing	At you/your doctors discretion
Clinical (physician) Breast Exam	Annually
Breast Self-Exam	Monthly
Mammogram	Annually
Electrocardiogram	Every 5 years
Bone Mineral Density	Once at age 65
Fecal Occult Testing	Annually
Sigmoidoscopy	Every 5 years
Colonoscopy	Every 10 years
Urinalisys	Annually
Immunizations	Tetanus booster every 10 years, Influenza vaccine annually, Pneumonial vaccine once at age 65
Eye Exam & Hearing Test	Once if never recieved then annually
Skin Exam by Dermatologist	Every two years
Skin Self-Exam	Annually

Top 10 List For Staying Healthy - Your Seventies and Beyond:

• Don't automatically attribute new physical or mental symptoms to getting older
• Eat a variety of foods and make sure you're getting your five portions of fruits and vegetables
• Take a multivitamin and make sure you're getting 800 units of vitamin D and 1,500 milligrams of calcium from foods or supplements
• Continue to evaluate your need for estrogen replacement therapy
• Get some form of aerobic and strength-training exercise for a total of at least 30 minutes most days of the week. Exercise your mind, too, by engaging in productive activities such volunteerism and hobbies
• Fall-proof your home
• Keep a list of every medication you take and go over it with your physician during your annual examination
• Seek immediate attention for any infection-everything from a skin sore to cold or flu
• Ask someone to trust to objectively assess your driving skills; give up your license if you're no longer safe behind the wheel
• Make sure your family and physician have and understand your advance directives (living will and durable power of attorney for health care)
• What Can Go Wrong At My Age? Stroke, Alzheimer's, Osteoarthritis 

Portions of this material printed with permission from Dr. Judith Reichman, M.D.