Science

5 Questions to Ask Your Doctor That Aren't on the Form

Fine is a word. It isn't a measurement.

By Kim Fisher · July 2026 · 8 min read

A calcium score of zero doesn't always mean your arteries are clear.

It can mean the plaque hasn't hardened yet.

That single distinction is the difference between a test that says fine and a test that tells you more. Soft plaque doesn't show up on a standard calcium score. In a large registry of people with chest symptoms and a calcium score of zero, about 16 percent still had plaque on a CT angiogram, and 3.5 percent had an artery at least half blocked.

Which is why I stopped walking into my annual check-up hoping to hear one word.

Fine doesn't mean thriving. Fine doesn't mean strong, joyful, or ageless. Fine often means no obvious fires to put out today.

Longevity isn't built on fine. It's built on curiosity. On asking better questions. On choosing to see your doctor as a partner in your vitality, not only a gatekeeper of prescriptions.

Here are five questions that turn a routine appointment into a conversation about living stronger, softer, and longer.

1. "Based on my age and lifestyle, what are my top three risks? And can we run deeper tests to clarify them?"

Worldwide, heart disease, cancer, lung disease and diabetes lead the list (World Health Organization). Your risks, though, depend on you... your family history, your habits, your hormones, even your zip code.

For example, if your doctor sees heart disease as a top concern, you could ask whether a coronary CT angiogram makes sense, sometimes read with AI plaque analysis such as Cleerly. Unlike a standard calcium score, it shows soft plaque as well as hardened plaque. Catching it early means you can step in with lifestyle changes before symptoms show up.

Honest framing: a CT angiogram uses contrast dye and some radiation, and insurance often won't cover it without symptoms. Ask what it costs and what you'd do differently with the result.

2. "Can we add fasting insulin, ApoB and cortisol to my usual bloodwork?"

Standard labs skim the surface. To see what's really happening, go deeper.

ApoB. A count of the particles that carry cholesterol into your artery walls. A 2019 review in JAMA Cardiology makes the case that it measures heart risk better than LDL cholesterol alone.

Fasting insulin. An early warning for insulin resistance, often before your blood sugar or HbA1c moves.

Cortisol. Your stress hormone. When it runs high for too long, it doesn't only weigh on your mood. It raises the risk of bone loss and high blood pressure. One blood draw is a snapshot, so ask your doctor which test fits your question.

These numbers don't only measure health. They measure resilience.

When “normal” isn’t the whole story

My own labs have always come back good, and I’ve been blessed with high energy. Yet I’ve sat with many clients whose labs came back “normal” while I could tell from our conversations that they didn’t feel well. So I encourage them to go back and ask more questions. Normal on paper and well in real life aren’t always the same thing.

3. "Can we check inflammation markers like C-reactive protein?"

Inflammation is the silent accelerant of aging. Researchers led by Claudio Franceschi call it inflammaging, a chronic, low-grade inflammation that builds with age and feeds age-related disease.

A simple high-sensitivity CRP blood test can show whether your body is quietly inflamed. Elevated CRP is linked to higher risk of heart disease. A cold or a hard workout can raise it for a few days, so one high number is a reason to retest, not to panic.

Heavy metal testing belongs only where there's a real exposure, like old paint or well water, and the "provoked" urine kits sold online aren't standard medical tests.

4. "Am I low on key nutrients like magnesium or zinc?"

Your body can't build strength or repair itself without its spark plugs: micronutrients.

Magnesium. Needed for muscle, for hormones, and for calm sleep. In U.S. survey data, about 48 percent of people got less magnesium from food than they need. A standard blood test can look normal even when stores run low, so your diet tells part of the story too.

Zinc. Vital for immunity, muscle repair, and even mood.

When these fall short, so does your energy. Testing where it's useful takes away the guesswork and lets you replenish with food first, and supplements where they make a real difference. CoQ10 often comes up here too. It isn't a routine lab, so I'd leave it off the list unless your doctor has a reason.

5. "Can we look at my brain health, like testing my APOE status?"

Alzheimer's doesn't begin when the memory fades. It begins decades earlier. The APOE e4 variant is the strongest common genetic risk factor for the late-onset form.

If you carry it, it doesn't mean you're destined. It means you're informed. And informed people can take action, through exercise, good food, deep sleep, and staying mentally and socially engaged.

Honest framing: APOE testing isn't routinely recommended for people without symptoms, and it can't tell you whether you'll get Alzheimer's. If you want it, ask for genetic counseling before and after. And know that the federal genetic privacy law, GINA, protects you in health insurance and at work, yet not in life, disability or long-term care insurance.

The deeper why

Asking these questions isn't about fear. It's about agency. It's about saying: I want to know the terrain of my body so I can navigate it well.

Your doctor brings the science. You bring the curiosity. Together you build a plan not only to add years to your life. To add life to your years.

Bring this: the five questions on one page

Print this, or screenshot it, and hand it over at the start of the visit, before the clock runs out. Write the answer next to each one.

Frequently asked questions about what to ask at your annual physical

Will insurance cover these extra blood tests?

Often some of them, not always all. ApoB, fasting insulin and hs-CRP are usually inexpensive blood tests, while CT angiograms and genetic tests can cost hundreds of dollars when insurance won't cover them. Ask your doctor's office for the billing codes and call your insurer before the draw.

Is APOE testing a good idea?

It's a personal choice, and it isn't routinely recommended for people without symptoms because it can't predict whether you'll get Alzheimer's. If you want to know, ask for genetic counseling before and after the test. GINA protects you in health insurance and employment, yet not in life, disability or long-term care insurance.

What if my doctor says no to a test?

Ask what the test would change and what they'd watch instead. A good answer is still an answer. If a test truly matters to you, a second opinion or a doctor who focuses on prevention can be a reasonable next step.

Prefer to simply talk? Fifteen minutes with me, free, no pitch and no script.

I see you. You're not behind, and I've got you.

With love, Kim

Asking about insulin? Get my free Insulin Resistance Carb Report, on why carbs land differently after 50.