Driver's Lifestyle Blood Test

Total protein measures the combined amount of albumin and globulins in your blood. These proteins perform essential functions including maintaining fluid balance, transporting hormones and medications, and immune function. Low total protein can indicate liver disease (reduced production), kidney disease (protein loss), malnutrition, or malabsorption. High total protein can indicate dehydration (concentration effect), chronic infection, or certain blood disorders. Total protein is a general screening marker that may prompt more specific testing if abnormal. Results outside the normal range may need a follow-up with your GP.

Albumin is the most abundant protein in blood, produced exclusively by the liver. It maintains fluid balance in blood vessels, transports hormones, fatty acids, and medications, and reflects nutritional status and liver function. Low albumin can indicate chronic liver disease, kidney disease (nephrotic syndrome), malnutrition, or chronic inflammation. Because albumin has a half-life of about 20 days, low albumin indicates a chronic rather than acute problem. For drivers, adequate protein nutrition is important for maintaining energy and alertness. Results outside the normal range may need a follow-up with your GP.

Globulins are a group of proteins including immunoglobulins (antibodies) produced by the immune system, and transport proteins produced by the liver. Globulin is calculated by subtracting albumin from total protein. Low globulin can indicate immune deficiency or certain kidney conditions. High globulin can indicate chronic infection, inflammation, autoimmune disease, or certain blood disorders (like multiple myeloma). The albumin:globulin ratio provides additional information—normally albumin is slightly higher than globulin. Results outside the normal range may need a follow-up with your GP.

Serum iron measures the amount of iron circulating in your blood, bound to the transport protein transferrin. Iron is essential for oxygen transport via haemoglobin—without adequate iron, your body can't make enough healthy red blood cells, leading to iron deficiency anaemia with symptoms including fatigue, weakness, and difficulty concentrating. For drivers, these symptoms can significantly impact alertness and safety. However, serum iron can fluctuate significantly throughout the day and after meals, so it's interpreted alongside other iron markers for a complete picture. Results outside the normal range may need a follow-up with your GP.

Total Iron-Binding Capacity (TIBC) measures the maximum amount of iron that the blood can carry, reflecting the total amount of transferrin available to bind iron. Transferrin is a protein produced by the liver that transports iron through the blood. When iron stores are low, the body produces more transferrin to capture as much iron as possible, so TIBC increases. Conversely, when there's too much iron, less transferrin is needed and TIBC decreases. High TIBC typically indicates iron deficiency, while low TIBC can suggest iron overload, chronic disease, or liver problems. Results outside the normal range may need a follow-up with your GP.

Unsaturated Iron-Binding Capacity (UIBC) represents the portion of transferrin that is not currently carrying iron—essentially the 'spare capacity' available to pick up more iron. UIBC is calculated or measured alongside serum iron and TIBC to provide a complete picture of iron transport. High UIBC indicates that there's plenty of capacity to carry more iron, which typically occurs in iron deficiency. Low UIBC indicates that most of the available transferrin is already carrying iron, which can occur in iron overload. Results outside the normal range may need a follow-up with your GP.

Transferrin saturation is calculated by dividing serum iron by TIBC, expressing what percentage of the iron-carrying capacity is actually being used. Normal transferrin saturation is typically 20-50%. Low transferrin saturation (below 20%) indicates iron deficiency—there's not enough iron to fill the available transport capacity. High transferrin saturation (above 45-50%) can indicate iron overload, as seen in haemochromatosis, where the body absorbs too much iron. Transferrin saturation is one of the most useful single markers for screening for both iron deficiency and iron overload. Results outside the normal range may need a follow-up with your GP.

Ferritin is the protein that stores iron in your body, making it the best single marker of total iron stores. Low ferritin indicates depleted iron stores and often precedes iron deficiency anaemia—you can have low ferritin and symptoms like fatigue before your haemoglobin drops. However, ferritin is also an acute phase reactant that rises with inflammation, infection, or liver disease, which can mask underlying iron deficiency. Elevated ferritin can indicate iron overload (haemochromatosis), inflammation, liver disease, or certain blood conditions. For drivers experiencing unexplained fatigue, checking ferritin is essential. Results outside the normal range may need a follow-up with your GP.

Bilirubin is a yellow pigment produced when the body breaks down old red blood cells. The liver processes bilirubin, making it water-soluble so it can be excreted in bile. Elevated bilirubin causes jaundice (yellowing of skin and eyes). Raised bilirubin can indicate liver disease, bile duct obstruction, or increased red blood cell breakdown (haemolysis). A common cause of mildly elevated unconjugated bilirubin is Gilbert's syndrome, a benign inherited condition affecting about 5% of the population that causes intermittent mild jaundice, especially during fasting, illness, or stress. Results outside the normal range may need a follow-up with your GP.

ALP is an enzyme found in the liver (particularly bile ducts), bones, kidneys, and intestines. Elevated ALP can indicate liver conditions (especially those affecting bile flow, like bile duct obstruction), bone disorders (Paget's disease, bone metastases), or physiological causes (pregnancy, growing children). Because ALP comes from multiple sources, an elevated result needs to be interpreted alongside other tests—if Gamma GT is also elevated, the ALP is likely from the liver; if Gamma GT is normal, the ALP may be from bone. Results outside the normal range may need a follow-up with your GP.

ALT is an enzyme found primarily in liver cells. When liver cells are damaged or inflamed, ALT leaks into the bloodstream, making it one of the most specific markers of liver injury. Elevated ALT can indicate fatty liver disease (NAFLD/MASLD—increasingly common and associated with diet, weight, and sedentary lifestyle), alcohol-related liver damage, viral hepatitis, or medication effects. Fatty liver disease is particularly relevant for drivers, given the combination of sedentary work, irregular meals, and often limited access to healthy food options while on the road. Results outside the normal range may need a follow-up with your GP.

Gamma GT (gamma-glutamyl transferase) is an enzyme found primarily in the liver, particularly in bile duct cells. It's highly sensitive to alcohol consumption—elevated GGT is often the earliest liver enzyme abnormality in people who drink excessively, and levels typically fall within weeks of reducing alcohol intake. GGT is also elevated in bile duct obstruction, fatty liver disease, and with certain medications. Because GGT rises with alcohol while ALT may remain normal, GGT is particularly useful for assessing alcohol-related liver effects. For professional drivers subject to medical assessments, liver enzyme levels may be relevant to fitness to drive. Results outside the normal range may need a follow-up with your GP.

Urea is a waste product formed in the liver when protein is broken down. It's filtered from the blood by the kidneys and excreted in urine. Elevated urea can indicate reduced kidney function, dehydration (common in drivers who limit fluid intake to reduce toilet stops), high protein diet, or gastrointestinal bleeding. Low urea can indicate liver disease or malnutrition. Unlike creatinine, urea levels are more affected by diet and hydration status. For drivers, staying well hydrated is important both for kidney health and alertness. Results outside the normal range may need a follow-up with your GP.

Creatinine is a waste product produced by muscles from the breakdown of creatine phosphate during normal muscle metabolism. It's produced at a relatively constant rate and is filtered out by the kidneys, making it a useful marker of kidney function. Elevated creatinine indicates that the kidneys may not be filtering blood as efficiently as they should. However, creatinine is also influenced by muscle mass—very muscular people may have higher creatinine without kidney problems. Creatinine is used to calculate eGFR, which provides a standardised estimate of kidney function. Results outside the normal range may need a follow-up with your GP.

eGFR is a calculated estimate of how well your kidneys are filtering waste from your blood, expressed in mL/min/1.73m². It's derived from your creatinine level, adjusted for age, sex, and ethnicity. eGFR above 90 is normal; 60-89 indicates mildly reduced function; 45-59 is mild to moderately reduced; 30-44 is moderately to severely reduced; 15-29 is severely reduced; and below 15 indicates kidney failure. eGFR is the standard measure used to stage chronic kidney disease (CKD). A single reduced eGFR should be confirmed with repeat testing. Results outside the normal range may need a follow-up with your GP.

Total cholesterol measures all cholesterol in your blood, combining HDL, LDL, and other fractions. While cholesterol is essential for cell membranes, hormone production, and vitamin D synthesis, elevated total cholesterol is associated with increased cardiovascular risk. However, the breakdown into HDL and LDL is more informative than total cholesterol alone—high total cholesterol driven by protective HDL is very different from high total cholesterol driven by harmful LDL. For drivers, cardiovascular health is particularly important given the sedentary nature of driving. Results outside the normal range may need a follow-up with your GP.

LDL (low-density lipoprotein) cholesterol is often called 'bad cholesterol' because elevated levels are strongly associated with atherosclerosis—the build-up of fatty plaques in arteries that underlies heart attacks and strokes. LDL particles transport cholesterol to tissues, but excess LDL can deposit cholesterol in artery walls, triggering inflammation and plaque formation. LDL is the primary target for cardiovascular risk reduction. Reducing saturated fat intake, increasing fibre, regular exercise, and maintaining healthy weight all help lower LDL. Results outside the normal range may need a follow-up with your GP.

Non-HDL cholesterol is calculated by subtracting protective HDL from total cholesterol, representing all potentially harmful cholesterol—LDL plus VLDL and other atherogenic particles. Many experts consider non-HDL a better cardiovascular risk marker than LDL alone because it captures the full atherogenic burden, particularly in people with elevated triglycerides. The recommended target is below 4.0 mmol/L, with lower targets for those at higher cardiovascular risk. Non-HDL remains accurate regardless of fasting status. Results outside the normal range may need a follow-up with your GP.

HDL (high-density lipoprotein) cholesterol is called 'good cholesterol' because it performs reverse cholesterol transport—collecting excess cholesterol from tissues and artery walls and returning it to the liver for disposal. Higher HDL levels are protective against cardiovascular disease. Levels above 1.0 mmol/L in men and 1.2 mmol/L in women are generally desirable. Regular aerobic exercise is one of the most effective ways to raise HDL—something that can be challenging for drivers who spend long hours seated. Results outside the normal range may need a follow-up with your GP.

The cholesterol: HDL ratio is calculated by dividing your total cholesterol by your HDL cholesterol level. This ratio provides insight into the proportion of your total cholesterol that is protective HDL versus potentially harmful LDL and other fractions. A lower ratio indicates a more favourable lipid profile. The ratio is used in cardiovascular risk assessment tools (such as QRISK) to help calculate your overall risk of having a heart attack or stroke. An ideal ratio is below 4, with lower being better. Results outside the normal range may need a follow-up with your GP.

Triglycerides are a type of fat (lipid) that circulate in your blood. After eating, your body converts excess calories (whether from fat, carbohydrate, or protein) into triglycerides, which are then transported to fat cells for storage. Elevated triglycerides are associated with increased cardiovascular risk, particularly when combined with low HDL cholesterol. High triglycerides are often linked to excess calorie intake, high sugar/refined carbohydrate consumption, alcohol, obesity, and poorly controlled diabetes. Irregular eating patterns common in professional driving can contribute to elevated triglycerides. The target is below 1.7 mmol/L. Results outside the normal range may need a follow-up with your GP.

HbA1c measures the percentage of haemoglobin with glucose attached, reflecting your average blood sugar over the past 2-3 months. It's the gold standard test for diabetes screening and monitoring. Normal is below 42 mmol/mol (6.0%); prediabetes is 42-47 mmol/mol (6.0-6.4%); diabetes is 48 mmol/mol (6.5%) or above. For professional drivers, diabetes screening is particularly important—poorly controlled diabetes can cause fatigue, blurred vision, and concentration difficulties that affect driving safety. Certain driving licence categories have specific medical requirements regarding diabetes control. Prediabetes is an important finding—lifestyle changes at this stage can often prevent progression to diabetes. Results outside the normal range may need a follow-up with your GP.

Active B12 (holotranscobalamin) measures the biologically available form of vitamin B12 that your cells can actually use, making it a more sensitive marker of B12 status than total B12. Vitamin B12 is essential for nerve function, red blood cell formation, and DNA synthesis. B12 deficiency can cause fatigue, weakness, neurological symptoms (numbness, tingling, balance problems), cognitive changes, and macrocytic anaemia. For drivers, B12 deficiency symptoms can significantly affect concentration and reaction times. Risk factors include vegetarian/vegan diet, older age, pernicious anaemia, metformin use, and certain GI conditions. Results outside the normal range may need a follow-up with your GP.

Vitamin D is essential for calcium absorption, bone health, muscle function, and immune system regulation. The body produces vitamin D when skin is exposed to sunlight, but in the UK, sun exposure is insufficient during autumn and winter. Professional drivers who spend most of their day inside a vehicle (glass blocks UVB rays) are at particular risk of vitamin D deficiency regardless of season. Deficiency can cause fatigue, muscle weakness, bone pain, and low mood—all of which can affect driving performance. Levels below 25 nmol/L indicate deficiency; 25-50 nmol/L is insufficient; above 50 nmol/L is adequate. Supplementation is recommended for most UK adults, particularly those with limited sun exposure. Results outside the normal range may need a follow-up with your GP.

Haemoglobin is the iron-containing protein inside red blood cells that carries oxygen from your lungs to every cell in your body. Low haemoglobin (anaemia) means reduced oxygen-carrying capacity, causing fatigue, weakness, shortness of breath, and difficulty concentrating—all significant concerns for drivers. Common causes of low haemoglobin include iron deficiency, vitamin B12 or folate deficiency, chronic disease, and blood loss. High haemoglobin can indicate dehydration, chronic lung disease, or polycythaemia. For professional drivers, maintaining healthy haemoglobin levels is essential for alertness and concentration. Results outside the normal range may need a follow-up with your GP.

Haematocrit measures the percentage of your blood volume that consists of red blood cells. It typically tracks with haemoglobin—low haematocrit indicates anaemia, while high haematocrit indicates polycythaemia or dehydration. Dehydration concentrates the blood, artificially raising haematocrit—this is relevant for drivers who may limit fluid intake. Very high haematocrit can make blood more viscous (thicker), potentially increasing the risk of blood clots. Normal haematocrit is roughly 40-52% for men and 36-48% for women. Results outside the normal range may need a follow-up with your GP.

The red blood cell (RBC) count measures the total number of red blood cells in your blood. Red blood cells are produced in the bone marrow and have a lifespan of about 120 days. Low RBC count occurs in various types of anaemia. High RBC count (polycythaemia) can be a response to chronic low oxygen levels (lung disease, high altitude, smoking) or a bone marrow disorder. The RBC count is interpreted alongside haemoglobin, haematocrit, and red cell indices (MCV, MCH, MCHC) for a complete picture of red blood cell health. Results outside the normal range may need a follow-up with your GP.

MCV measures the average size of your red blood cells. It's crucial for classifying different types of anaemia. Low MCV (microcytic anaemia) typically indicates iron deficiency or thalassaemia—the red cells are smaller than normal. High MCV (macrocytic anaemia) typically indicates vitamin B12 or folate deficiency—the red cells are larger than normal. Normal MCV with anaemia (normocytic) can indicate chronic disease, kidney disease, or recent blood loss. MCV helps direct further investigation to identify the cause of anaemia. Results outside the normal range may need a follow-up with your GP.

MCH measures the average amount of haemoglobin in each red blood cell. It typically correlates with MCV—small red cells (low MCV) contain less haemoglobin (low MCH), and large cells contain more. Low MCH (hypochromic) is seen in iron deficiency anaemia where there isn't enough iron to produce adequate haemoglobin. High MCH is seen in macrocytic anaemias like B12 or folate deficiency. MCH helps characterise the type of anaemia and guide further investigation. Results outside the normal range may need a follow-up with your GP.

MCHC measures the average concentration of haemoglobin within red blood cells—essentially how 'packed' with haemoglobin each cell is. Low MCHC indicates hypochromic (pale) red cells, typically seen in iron deficiency anaemia where there isn't enough iron to fully load each cell with haemoglobin. MCHC is less commonly elevated, but high values can occur in hereditary spherocytosis (where red cells are abnormally shaped and dense) or as a laboratory artefact. MCHC is one of the red cell indices that helps classify and investigate anaemia. Results outside the normal range may need a follow-up with your GP.

RDW measures the variation in size among your red blood cells. Normally, red cells are fairly uniform in size. Elevated RDW indicates anisocytosis—a mixture of different-sized cells—which can occur when the bone marrow is producing new cells of a different size (for example, during recovery from iron deficiency after starting supplements, or in mixed deficiencies). High RDW can help differentiate between different types of anaemia. For example, iron deficiency typically causes high RDW (varied cell sizes), while thalassaemia typically has normal RDW (uniformly small cells). Results outside the normal range may need a follow-up with your GP.

White blood cells (WBCs, also called leukocytes) are the cells of your immune system that fight infection and respond to inflammation. The total WBC count measures all types of white cells combined. Elevated WBC count (leukocytosis) most commonly indicates infection or inflammation, but can also occur with stress, smoking, corticosteroid use, or blood disorders. Low WBC count (leukopenia) can indicate viral infections, bone marrow problems, autoimmune conditions, or certain medications. The differential count (breakdown by cell type) provides more specific information. Results outside the normal range may need a follow-up with your GP.

Neutrophils are the most abundant type of white blood cell, making up 50-70% of the total WBC count. They are the first responders to bacterial infections, rapidly arriving at infection sites to engulf and destroy bacteria. Elevated neutrophils (neutrophilia) typically indicate bacterial infection, inflammation, stress, or corticosteroid use. Low neutrophils (neutropenia) can occur with viral infections, certain medications, autoimmune conditions, or bone marrow disorders. Severe neutropenia increases susceptibility to serious bacterial infections. Results outside the normal range may need a follow-up with your GP.

Lymphocytes are white blood cells responsible for adaptive immunity—the specific, targeted immune response. They include T cells (which directly attack infected cells and coordinate immune responses), B cells (which produce antibodies), and natural killer cells. Elevated lymphocytes (lymphocytosis) typically indicate viral infections (including COVID, EBV/glandular fever), certain chronic infections, or lymphoproliferative disorders. Low lymphocytes (lymphopenia) can occur with acute stress, corticosteroid use, certain viral infections (including HIV), or autoimmune conditions. Results outside the normal range may need a follow-up with your GP.

Monocytes are large white blood cells that circulate in the blood before migrating into tissues where they become macrophages—cells that engulf and digest pathogens, dead cells, and debris. They play a role in both innate immunity and inflammation. Elevated monocytes (monocytosis) can indicate chronic infections (such as tuberculosis), chronic inflammatory conditions, certain blood disorders, or recovery from acute infections. Mildly elevated monocytes are often a non-specific finding. Low monocytes are less common and can occur with bone marrow disorders or certain infections. Results outside the normal range may need a follow-up with your GP.

Eosinophils are white blood cells that play a role in fighting parasitic infections and in allergic responses. They make up only 1-4% of white blood cells normally. Elevated eosinophils (eosinophilia) most commonly indicate allergic conditions (asthma, hay fever, eczema, drug allergies), parasitic infections, or certain skin conditions. Less commonly, eosinophilia can indicate autoimmune diseases or certain blood disorders. For drivers, awareness of allergic conditions is relevant as they (and their treatments) can affect alertness. Results outside the normal range may need a follow-up with your GP.

Basophils are the rarest type of white blood cell, typically making up less than 1% of the total WBC count. They play a role in allergic reactions by releasing histamine and other inflammatory mediators, and also help defend against parasites. Elevated basophils (basophilia) are uncommon and can indicate allergic reactions, chronic inflammatory conditions, certain infections, or myeloproliferative disorders. Because basophils are present in such small numbers, slight variations are usually not clinically significant. Results outside the normal range may need a follow-up with your GP.

High-sensitivity CRP (hs-CRP) measures low levels of C-reactive protein, an inflammation marker produced by the liver. While standard CRP tests detect inflammation from acute conditions like infections, hs-CRP detects the subtle, chronic low-grade inflammation associated with cardiovascular disease. Atherosclerosis (artery disease) is now understood to be an inflammatory process, and elevated hs-CRP is associated with increased cardiovascular risk even when cholesterol levels are normal. Risk categories: below 1 mg/L is lower risk; 1-3 mg/L is intermediate risk; above 3 mg/L is higher risk. Values above 10 mg/L usually indicate acute inflammation (infection, injury) rather than chronic cardiovascular risk—the test should be repeated when well. Results outside the normal range may need a follow-up with your GP.

Platelets (thrombocytes) are small cell fragments produced in the bone marrow that play an essential role in blood clotting. When you cut yourself, platelets clump together at the injury site to form a plug that stops bleeding. Low platelet counts (thrombocytopenia) can cause increased bruising and bleeding, while high counts (thrombocytosis) can increase the risk of blood clots. Platelet counts can be affected by infections, bone marrow disorders, certain medications, and autoimmune conditions. For drivers, awareness of clotting status is relevant given the increased risk of deep vein thrombosis (DVT) associated with prolonged sitting. Results outside the normal range may need a follow-up with your GP.

Mean Platelet Volume (MPV) measures the average size of your platelets. Larger platelets are generally younger and more reactive, while smaller platelets are older. MPV provides information about platelet production in the bone marrow. High MPV can indicate that the bone marrow is producing platelets rapidly (often in response to platelet destruction or consumption), while low MPV may suggest reduced bone marrow production. MPV is interpreted alongside platelet count to help understand platelet-related conditions. Results outside the normal range may need a follow-up with your GP.