Doctors recommend more than a basic physical as you age.
There are some medical tests every man needs to have performed.
Jeffrey Donovan, 45, has never taken a sick day from work. He has never had the flu.
He is the picture of good health and he has the annual physicals from his job to prove it.
"All the testing I had through work and my history has always revealed normal cholesterol levels, a normal body type and my nutrition was always I would say average to above average. I ran six days a week and three to four marathons a year," said Donovan.
So when Donovan's doctor suggested getting an advanced cholesterol screening after his father passed away from what doctor's call a silent heart attack, Donovan thought nothing of it.
"I thought it would be another one of those visits where they tell you everything is great, just avoid that second glass of wine. This was much different. This was your good cholesterol is OK, but a closer look at the bad, a deeper look at the size particles of that cholesterol is not good," Donavon said.
Dr. Dian Ginsberg with Specialty Healthcare and Wellness said the results were that of a person on the path to dropping dead of a heart attack with very little notice.
"I think there is a feeling of invincibility if you are very active living a fairly healthy lifestyle," said Donovan.
Donovan said he wants people, men especially, to realize it can be a dangerous thing not to look deeper into some of these medical issues.
Ginsburg said the annual physical needs to be looked at like a tune-up for your car.
A basic check finds basic problems, but for better performance you need a better look.
Dr. John Ott, also with Specialty Healthcare and Wellness, said that isn't so easy to get since a recent federal task force started pushing for fewer tests in regular physicals.
"The guidelines seem to suggest we do less instead of more. Now that's a little worrisome when their guidelines leave us open to finding things a little bit too late. To me the doctor's biggest concern now is that the motive may be more financial than the individuals benefit. We don't have crystal balls. How are we going to find out a person has a problem? It can't strictly be based on their lifestyle or family history. We have to have some data and labs of some sort," said Ott.
Ott said people should all be wary of the in-and-out, check-the-box style of annual physicals.
"The tests are designed to find people who already have a problem. When you come in without a problem you don't have any way of knowing if you are headed that way or not with just the standard tests," said Ott.
But thanks to new science and new tests, there are ways to look past the surface results and spot some signs of problems to come.
A standard checklist for a 30-year-old man includes a basic cholesterol test and a check of the thyroid gland.
Men will also get a screening for skin cancer since it occurs in males more than females and a testicular exam because this cancer usually occurs before the age of 40.
Ott said in the thirties, the name of the game is prevention - making sure the body is working efficiently.
He suggested these men also add a micro-nutrient test to their physical to see what vitamins and minerals their bodies are absorbing.
He said having this in balance sets up a strong foundation.
"You can assume at 30 you are looking at preventing aging. At 40 you start repairing what aging has occurred. It takes a lot more effort to make 40 work. We want to find out if the body is building the initial blocks of heart disease because most people at 40 will still look good on conventional tests," said Ott.
The conventional tests at 40 are the same as 30 but more focus is put on blood pressure and a diabetes screening is added to the mix.
Doctors should also look at Vitamin D levels since the body doesn't collect it as well after 40.
Ott said this decade is when men should add that advanced cholesterol screening that helped Donovan.
It is called the lipoprotein profile, or LPP, and looks deeper at the density of cholesterol particles in the body, not just overall numbers.
By 50, the same tests apply but now hearing and colon checks are added along with screenings for bladder and prostate cancer. It also is a time where more focus is put on checking the metabolism.
"At 50 you want the whole package because we assume that something is wrong," said Dr. Ott.