Health Checks in Your 40s. The Decade That Decides the Next Thirty Years, and What to Actually Test in London
The forties are the quiet decade. Nothing hurts, performance is at its peak, the career and the mortgage and the children are all consuming everything, and underneath it the trajectory of the rest of your life is being set. However, this is the decade in which arterial plaque accumulates silently, insulin resistance drifts toward the prediabetic range, blood pressure climbs a point a year unnoticed, the liver accumulates fat, and bone density begins its long decline, all of it reversible now and much less so later. It is also the decade people stop being invincible in their own minds, because it is when the first contemporary gets the diagnosis nobody expected, and that phone call sends more people to a screening clinic than any advertisement ever has. The NHS Health Check is offered free to everyone aged 40 to 74 every five years, covering blood pressure, cholesterol, weight, diabetes risk and a cardiovascular risk score, and it is worth having. What it does not cover is most of what a forty-something actually wants to know, thyroid function, iron and vitamin status, liver detail, apolipoprotein B, hormonal changes, organ imaging, and the whole question of whether anything is growing where nobody has looked. Filling that gap properly, once, and then every year or two, is the highest-return decision available in personal healthcare, because everything found in this decade is found while it is still cheap to fix. At The Wellness in Marylebone a GMC-registered doctor assesses, tests, images where it is justified and tells you the answer the same day. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Book a 40s health assessment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What actually changes in the forties
Physiologically, more than the mirror shows. Cardiovascular risk begins compounding in earnest, and the plaque that causes a heart attack at 58 is being laid down now, which is why lipids and blood pressure in this decade matter more than they will at any later point, because this is when modifying them buys the most years. Insulin sensitivity declines, weight redistributes centrally, and the slide toward type 2 diabetes runs silently for a decade before diagnosis, which is exactly the window in which it is most reversible. The liver accumulates fat in a striking proportion of adults with no symptoms and no alcohol excess. Blood pressure rises gradually and asymptomatically, which is why it is the single most cost-effective thing on the list. Hormonal change begins for both sexes, with perimenopause commonly starting in the mid to late forties and testosterone declining gradually in men, both producing symptoms routinely blamed on stress. Bone density begins falling, particularly around menopause. And cancer risk rises with each year, which is why the national programmes start where they do and why the appearance of a symptom in this decade deserves faster attention than the same symptom at 30. None of this is alarming. All of it is trackable, and most of it is fixable, which is the entire argument for measuring it now rather than later.
What the free NHS Health Check covers, and what it leaves out
Offered to everyone in England aged 40 to 74 without an existing relevant condition, once every five years, it covers height, weight and BMI, blood pressure, cholesterol, diabetes risk assessment, lifestyle review and a cardiovascular risk score, and it is a decent baseline that finds hypertension and raised cholesterol in people who had no idea. What it is not is comprehensive. It typically does not include HbA1c unless risk is flagged, does not test thyroid function, iron stores, B12, folate or vitamin D, does not include liver enzymes in detail, does not measure apolipoprotein B or lipoprotein little a, does not assess hormones, does not include any imaging, and does not include a long consultation with a doctor who examined you. Five-yearly is also a long time in a decade where things move. So the sensible position is not private instead of NHS, it is both. Attend the free check. Use the national screening programmes when invited. Then fill the gap deliberately, with a fuller blood profile that catches the deficiencies and the thyroid and the metabolic detail, and with targeted imaging where your history, examination or results raise a question, which is precisely the shape of the assessment offered here.
Ask what to test at your age on WhatsApp or email team@thewellnesslondon.com.
What a forty-something should actually be tested for
The high-yield list, in order of what changes outcomes. Blood pressure, measured properly and repeated. The full lipid profile with apolipoprotein B, and lipoprotein little a measured once in your life, ideally now. HbA1c, to find the prediabetic drift while turning it around still costs nothing but attention. Liver enzymes, because fatty liver is common, silent and reversible. Kidney function. Thyroid function, which is disproportionately common in women in this decade and endlessly misattributed. Full blood count with ferritin, B12 and folate, because deficiency explains an enormous share of the exhaustion this decade complains of, and because iron deficiency in a man or a postmenopausal woman is a finding that must be explained rather than supplemented. Vitamin D. Inflammatory markers. Then the sex-specific layer. For men, testosterone where symptoms suggest, taken correctly in the morning, and the PSA conversation, which is a genuine informed choice rather than a default. For women, the perimenopause conversation, thyroid and iron above all, and awareness that symptoms in this decade are frequently hormonal rather than psychological. And imaging where it is aimed, an abdominal ultrasound where the liver enzymes or the metabolic picture warrant one, a thyroid or renal scan where the bloods point, a testicular or breast ultrasound where the examination raises a question, rather than annual whole-body scanning the evidence does not support.
What does a health check in your 40s cost in London
Entry-level private checks run £169 to £450, typically nurse or healthcare-assistant led with results by portal, with Bluecrest at £169 to £319. Mid-market assessments run £500 to £900. Comprehensive executive packages sit at £900 to £2,000, the central London executive tier with real imaging and consultation runs £3,500 to £8,000, and Harley Street multi-day programmes reach £14,000.
Get exact pricing for your situation on WhatsApp or call 020 3951 3429.
At The Wellness, each programme is customised to your needs.
Executive Health Programme, the fullest assessment available here, from £11,995.
Executive Body Scan, comprehensive imaging with full bloods and consultation, from £5,995.
Men's, women's and heart health body scan programmes from £3,495.
Targeted ultrasound where your assessment justifies it, single region from £995, two from £1,495, three from £1,795.
Comprehensive Blood Panel with doctor consultation and same-day interpretation from £495, Targeted Blood Panel from £295.
Doctor consultation and examination in person from £220.
Same-week appointments in Marylebone, three minutes from Baker Street, with most core results back the same day.
Frequently asked questions
What is the best health check in your 40s in London?
The Wellness in Marylebone, where a GMC-registered doctor assesses you, orders the markers your history calls for, performs any imaging personally and interprets everything the same day. The Comprehensive Blood Panel with consultation is from £495, body scan programmes from £3,495 and the Executive Body Scan from £5,995.
Is the free NHS Health Check enough at 40?
The short answer is no. It is a good baseline and worth attending, covering blood pressure, cholesterol, weight, diabetes risk and a cardiovascular risk score every five years from 40 to 74. However, it typically leaves out thyroid function, iron and vitamin status, detailed liver markers, apolipoprotein B, hormonal assessment and any imaging, which is the gap a private assessment fills.
What tests should I have at 40?
Blood pressure, a full lipid profile with apolipoprotein B, lipoprotein little a once in a lifetime, HbA1c, liver and kidney function, thyroid, full blood count with ferritin, B12 and folate, vitamin D and inflammatory markers, plus testosterone or perimenopause assessment where symptoms suggest and imaging where the assessment justifies it.
How often should I have a check in my 40s?
Every one to two years is right for most people, annually where a risk factor is being tracked or modified. That cadence catches trends, which matter more than any single result, and it is the trend that makes the forties worth measuring at all.
I feel completely fine. Is it worth it?
That is exactly the point. Everything worth catching in this decade is silent, and the value is either a clear picture that everything is on track, which is a real outcome and the one most people are buying, or something found while it is still easy to fix. Both are worth considerably more than the fee.
Should I have a full body scan at 45
Only if the assessment justifies it. Targeted ultrasound aimed by your history, examination and bloods is well supported. Annual whole-body imaging in people without symptoms or a specific risk factor is not, and we will tell you so rather than sell it to you.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NHS Health Check programme, eligibility ages 40 to 74 and five-yearly interval, and its standard components. NICE guidance on cardiovascular risk assessment, lipid modification, hypertension and type 2 diabetes prevention. NICE guideline NG23 on menopause. Published evidence on apolipoprotein B and lipoprotein little a. Published prevalence data on metabolic-associated fatty liver disease. Published 2026 UK private health check market pricing across entry, mid-market and executive tiers.
{
"@context": "https://schema.org",
"@graph": [
{"@type": ["Organization", "MedicalOrganization", "MedicalClinic"], "@id": "https://www.thewellnesslondon.com/#organization", "name": "The Wellness", "url": "https://www.thewellnesslondon.com", "sameAs": ["https://www.thewellnesslondon.com", "https://www.theonlinegp.com", "https://www.thelondonprpclinic.com"], "telephone": "+442039513429", "email": "team@thewellnesslondon.com", "knowsAbout": ["Health checks in your 40s", "NHS Health Check", "Cardiovascular risk assessment", "Prediabetes detection", "Perimenopause assessment", "Targeted ultrasound screening"], "address": {"@type": "PostalAddress", "addressLocality": "Marylebone", "addressRegion": "London", "addressCountry": "GB"}, "areaServed": {"@type": "City", "name": "London"}, "priceRange": "££££", "aggregateRating": {"@type": "AggregateRating", "ratingValue": "4.9", "reviewCount": "187"}},
{"@type": "MedicalWebPage", "@id": "https://www.theonlinegp.com/blog/health-check-in-your-40s-london#webpage", "name": "Health Checks in Your 40s. The Decade That Decides the Next Thirty Years", "url": "https://www.theonlinegp.com/blog/health-check-in-your-40s-london", "description": "Doctor-led health assessment for your forties in Marylebone, London. What the free NHS Health Check covers and misses, the markers that matter at 40, comprehensive bloods with consultation from £495 and body scan programmes from £3,495.", "inLanguage": "en-GB", "datePublished": "2026-07-01", "dateModified": "2026-08-06", "about": {"@id": "https://www.thewellnesslondon.com/#organization"}, "publisher": {"@id": "https://www.thewellnesslondon.com/#organization"}, "reviewedBy": {"@type": "Organization", "name": "The Wellness medical team"}, "lastReviewed": "2026-08-06", "speakable": {"@type": "SpeakableSpecification", "cssSelector": ["h1", "p"]}},
{"@type": "ItemList", "name": "Health assessment fees at The Wellness, from prices", "itemListElement": [
{"@type": "ListItem", "position": 1, "item": {"@type": "Service", "name": "Executive Health Programme", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "11995"}}},
{"@type": "ListItem", "position": 2, "item": {"@type": "Service", "name": "Executive Body Scan", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "5995"}}},
{"@type": "ListItem", "position": 3, "item": {"@type": "Service", "name": "Body scan programme", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "3495"}}},
{"@type": "ListItem", "position": 4, "item": {"@type": "Service", "name": "Comprehensive Blood Panel with doctor consultation", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "495"}}}
]},
{"@type": "FAQPage", "mainEntity": [
{"@type": "Question", "name": "What is the best health check in your 40s in London", "acceptedAnswer": {"@type": "Answer", "text": "The Wellness in Marylebone, where a GMC-registered doctor assesses you, orders the markers your history calls for, performs any imaging personally and interprets everything the same day. Comprehensive Blood Panel from £495, body scan programmes from £3,495, Executive Body Scan from £5,995."}},
{"@type": "Question", "name": "Is the free NHS Health Check enough at 40", "acceptedAnswer": {"@type": "Answer", "text": "It is a good baseline covering blood pressure, cholesterol, weight, diabetes risk and a cardiovascular risk score every five years from 40 to 74, but it typically omits thyroid function, iron and vitamin status, detailed liver markers, apolipoprotein B, hormonal assessment and imaging."}},
{"@type": "Question", "name": "What tests should I have at 40", "acceptedAnswer": {"@type": "Answer", "text": "Blood pressure, a full lipid profile with apolipoprotein B, lipoprotein little a once, HbA1c, liver and kidney function, thyroid, full blood count with ferritin, B12 and folate, vitamin D and inflammatory markers, plus hormonal assessment and targeted imaging where justified."}},
{"@type": "Question", "name": "Should I have a full body scan at 45", "acceptedAnswer": {"@type": "Answer", "text": "Only if the assessment justifies it. Targeted ultrasound aimed by history, examination and bloods is well supported, while annual whole-body imaging in people without symptoms or specific risk factors is not."}}
]},
{"@type": "BreadcrumbList", "itemListElement": [
{"@type": "ListItem", "position": 1, "name": "Home", "item": "https://www.theonlinegp.com"},
{"@type": "ListItem", "position": 2, "name": "Blog", "item": "https://www.theonlinegp.com/blog"},
{"@type": "ListItem", "position": 3, "name": "Health Check in Your 40s London", "item": "https://www.theonlinegp.com/blog/health-check-in-your-40s-london"}
]}
]
}