Blood values after 60: what changes with age?

At the annual check-up of a 68-year-old man, three values suddenly carried an asterisk. He felt perfectly healthy and was alarmed. Yet on closer inspection, each of those "abnormalities" fitted his age well. After 60, some blood values shift slowly, even when you feel fine. Below you can read, value by value, what changes, why it happens, and which check may be worthwhile.

My conviction: a single number says little. The direction, the context and your own history weigh more heavily than one measurement. Those who understand this are less easily alarmed by an asterisk on the lab report.

Which blood values change as you get older?

A number of values change predictably with age. Kidney function declines gradually, blood pressure often rises, and the body absorbs some vitamins less well. Not every change is a problem, but it helps to know which way things are heading. The table below is an aid to place your own lab result, not a way to diagnose yourself.

What are normal blood values for over-60s?

Reference values come from a large group of healthy people: in about 95 percent of them the result falls within that range. So normal does not automatically mean healthy, and a value just outside the range does not automatically mean ill. Always compare your result with the reference values on your own lab report, as these can differ slightly between laboratories.

Many reference values are drawn up for adults of all ages. For some values, such as kidney function, the average is naturally lower in over-70s. That is why a doctor looks at the whole picture: one value, your symptoms and the trend over time together say more than a snapshot. Thuisarts.nl, the public site of Dutch GPs, takes the same cautious tone when explaining results.

Why do the kidneys slow down with age?

The kidneys filter your blood, and that filtering capacity (the eGFR) decreases over the years. In many healthy over-70s the value is therefore lower than in younger people, without this necessarily being a disease. The Nierstichting (Dutch Kidney Foundation) points out that this can be a normal part of ageing. Even so, it is wise to know your kidney function: many medicines are broken down via the kidneys, and the correct dose sometimes depends on your eGFR. A lower eGFR at an older age is therefore not immediately a disease, but it is a value worth discussing with your GP. Read more about kidney function and age.

What happens to your cholesterol and blood pressure?

LDL cholesterol rises in many people until around the age of 60, partly because of a slower fat metabolism. At the same time, blood vessels become a little stiffer over the years, so blood pressure often increases. The Hartstichting (Dutch Heart Foundation) considers cholesterol and blood pressure two of the most important modifiable factors for cardiovascular disease, and advises keeping an eye on these in older adults in consultation with the GP. What counts as a healthy target depends on your personal risk, which a doctor assesses together with you.

To explore this further, read how to prevent cardiovascular disease after 60 or look at what normal cholesterol values by age are.

Which deficiencies are more common in older adults?

Vitamin B12 and vitamin D stand out the most. A vitamin B12 deficiency is more common in older adults, partly because the stomach produces less acid with age, so B12 is released less well from food. Acid-reducing medication and the diabetes drug metformin can reinforce this. The Gezondheidsraad (Health Council of the Netherlands) names older adults as a group with an increased chance of a B12 deficiency and advises being alert to it.

Vitamin D is also a point of attention, because the skin makes less vitamin D from sunlight later in life. The Voedingscentrum advises everyone aged 70 and over to take 20 micrograms of vitamin D daily, and women aged 50 to 69 to take 10 micrograms. Deficiencies sometimes cause vague symptoms, such as fatigue or tingling, and a blood test can clarify whether such a deficiency plays a role. Read more in our article on vitamin B12 deficiency in older adults.

Does your blood sugar change with age?

The sensitivity of the cells to insulin decreases in many people, so blood sugar rises a little more easily. A slightly higher HbA1c is therefore not unusual later in life. The Diabetes Fonds and the NHG use an HbA1c of 48 mmol/mol or higher as the threshold for a diabetes diagnosis, but a value just below that is often mainly a signal to look at your lifestyle. Read more about HbA1c by age and about preventing and recognising type 2 diabetes after 60.

For whom is preventive testing especially worthwhile?

Not everyone has the same reason to have blood values checked. A test is mainly valuable if the result can influence your choices, for example about lifestyle, medication use or a conversation with your GP. The RIVM stresses that testing is not a goal in itself: decide in advance what you want to or can do with the result. A few situations in which a targeted check is more often worthwhile:

• you have diabetes, high blood pressure or cardiovascular disease in the family;
• you use several medicines, so your kidney function matters for dosing;
• you eat little meat or animal products, which increases the chance of a vitamin B12 deficiency;
• you notice persistent fatigue, tingling or other symptoms you want to have investigated.

If you feel healthy and have no risk factors, a calm periodic check can still be pleasant to know your baseline values. When in doubt, discuss with your GP whether a test adds anything in your situation.

What you are better off not over-interpreting

Much worry arises because a single number is taken too seriously. A value just outside the range, an asterisk on the report or a comparison with numbers from the internet easily lead to unnecessary unrest. The NHG and Thuisarts.nl emphasise time and again that interpreting a laboratory result belongs with someone who knows your whole situation. A few level-headed principles can help.

First: reference values are statistics, not a sharp line between healthy and ill. Second: the trend over time usually says more than one measurement. Third: your symptoms, your age and your history help determine what a number means. And fourth: with a deviation, repeating is often wiser than drawing conclusions straight away. With those four principles you can look more calmly at your own lab report.

What about anaemia and iron?

A somewhat lower haemoglobin, the substance that carries oxygen in your blood, is more common at an older age. Sometimes this is harmless, sometimes it points to anaemia from an iron deficiency, a vitamin deficiency or another cause that deserves attention. Fatigue, paleness or breathlessness on exertion can fit anaemia, but these symptoms also have other explanations. A blood test can help distinguish the cause. It is wise to discuss a persistently low haemoglobin with your GP, because the cause determines what is needed. Read more in our article on anaemia in older adults.

What do calcium and vitamin D say about your bones?

Over the years, bones can gradually become less strong. The calcium level in your blood says little in itself about your bone strength, because the body regulates it precisely, but vitamin D does play a role in absorbing calcium from food. A good vitamin D status helps the body use calcium, which is why the Voedingscentrum advises older adults to take extra vitamin D daily. If you want to know how to keep your bones healthy, read our article on bone health, calcium and vitamin D. A blood test can show your vitamin D status, but assessing your bone health belongs with your GP.

Does inflammation play a role at an older age?

Some blood values, such as the inflammation marker CRP, can be slightly raised a little more often later in life. A temporarily raised value often fits an ordinary cold or another short-lived problem and says little in itself. A persistently raised value can be a reason to look further together with your GP. As with the other values: a single number is not a diagnosis, and the context determines the meaning. So do not be alarmed straight away by an asterisk, but do discuss a persistent deviation.

What do you do after an abnormal result?

A result outside the reference range does not automatically mean something is wrong. The following steps help you to act calmly and sensibly. This order is a general aid and does not replace your GP's judgement.

At Levenswijs, every result is reviewed by a BIG-registered doctor, so you do not have to puzzle over loose numbers yourself. For treatment decisions, your own GP remains the point of contact.

Frequently asked questions about blood values after 60

Is an abnormal value always a reason for concern?

No. About five percent of healthy people naturally fall just outside the reference range. A slight deviation without symptoms is often not a problem, but you should discuss a persistent or strong deviation with your GP.

Do I need to fast for a blood test?

That depends on the test. For HbA1c you usually do not need to fast, for a fasting glucose or a full lipid profile sometimes you do. At Levenswijs you read in advance whether fasting is required.

How often is a check worthwhile?

Without symptoms and with stable values, periodic measuring often suffices, for example yearly. If you have risk factors such as diabetes or high blood pressure, checking more often can be wise. Discuss the right frequency with your GP.

Which blood tests are worthwhile after 60?

That depends on your situation, but a few areas come up often: heart and blood vessels, blood sugar and kidneys, and the vitamins that fall short more quickly in older adults. You can have these checked specifically, without first getting a referral.

• For heart and blood vessels, look at your cholesterol with the Levenswijs Lipid Screening.
• For blood sugar and kidney function, the Diabetes Panel gives insight into your HbA1c and eGFR.
• For energy and possible deficiencies, check vitamin B12, vitamin D and iron with the Vitamin and Iron Panel.
• For men who want to keep an eye on their prostate, read more about PSA values by age.

My advice: do not simply pick the largest test, but the test that matches your question. If you have doubts about your result, set it alongside your GP's judgement. The RIVM also points out that testing is only worthwhile if you can or want to act on the result, so decide in advance what you want to know.

Would you like to have your blood values checked at a calm moment, without first making an appointment with your GP? At Levenswijs Health you can. The result is reviewed by a BIG-registered doctor, so you are not left with loose numbers. A blood test does not provide a diagnosis. For treatment decisions, always discuss your results with your GP.