Your annual physical is keeping you alive, but it's probably not helping you thrive in midlife or in your later years. Here's what's missing and what you can do about it, if you don't mind me doing some show and tell.

I recently spent 30 minutes reviewing my nutritional and metabolic test results with Dr. Renee Young, a naturopathic doctor in Los Gatos, California, who specializes in longevity medicine. The readout of my blood, urine and cheek swab tests made me realize something unsettling: the normal lab test covered by my health insurance wasn't picking up some potentially important problems. Despite eating well, exercising each week and maintaining 15% body fat, one simple test revealed I'm loaded with plastics and deficient in key nutrients that help my liver clear toxins.

My primary-care doctor never would have found this. Not because of incompetence or lack of interest. But because the health care system created by insurance companies isn't designed to optimize your health. It's designed to minimize costs — its costs.

That's why even many doctors, including Young, refer to the American system as "sick care" instead of health care: primary care physicians are likely really good at identifying diseases that will kill you — heart attacks, strokes, cancers. But they're not equipped to optimize the cellular-level functioning that determines whether you'll spend your 70s hiking mountains or shuffling to doctor appointments.

To take control of my health, Young told me to do two things: 1) Create a personal health care budget, the same way I'd save up for a vacation or a home renovation, and 2) consider using that budget to buy a few tests that insurance may not cover (and your primary care doctor probably won't suggest).

Tests your doctor should recommend but probably won't

Comprehensive hormone panel. For men, this panel examines testosterone, DHEA and estrogen levels. For women, it's a full female hormone panel. Declining hormones — one great hallmark of aging — create inflammation, affect recovery and mess with your gut-brain connection. If you don't know your hormone status, start here.

Calcium score. This $150 test measures arterial calcification; essentially, how clogged your heart's pipes are. Since cardiovascular disease kills most of us, knowing whether you have a half-inch pipe that's narrowed to an eighth-inch could save your life. If it's elevated, your doctor can order more sophisticated tests.

Advanced metabolic testing. Ask about a NutrEval test ($179-$450 depending on insurance). This examines your mitochondrial health — how well your cells actually function. It reveals nutrient deficiencies, environmental toxin exposure and cellular energy production.

Cancer screening beyond the basics. Standard mammograms and colonoscopies are important, but consider adding: a 3D mammogram for women, PSA monitoring for men and a Cologuard test (you swab your poop to check for cancer DNA — fun!). For higher-risk individuals, companies like Galleri offer blood tests that screen for multiple cancer types simultaneously.

Advanced cardiac testing. If your calcium score is concerning, ask about an AI-driven cardiac CTA scan. It's $1,500 out of pocket and provides detailed imaging of your coronary arteries, which is far more precise than basic stress tests.

What these tests cost

Young is sensitive to asking people to spend extra money on their own wellness and health. It's a very personal choice. Maybe you budget $400; maybe $4,000, depending on your risk factors and financial capacity. It can sound like a lot until you consider that cancer treatment or managing diabetes costs exponentially more. Not to mention the years of life you might lose for not paying for some incisive testing now.

Some questions to ask your doctor.

When you next see your doctor, don't just accept "everything looks normal." Ask:

"What's my actual testosterone/estrogen level?"

"Should I get a calcium score, given my family history?"

"Can you order a more comprehensive metabolic panel that looks at cellular function?"

"What environmental toxins should I be concerned about at my age, where I live, and my occupation and regular activities?"

The answers you get will tell you a lot about what you need to be proactive about. It's not unlike being the CEO of your health and wellness. Ask yourself what disease will likely get you, and then work backward. Most of us suspect, somewhere in our hearts, the kinds of health problems that are likely to hit us hard. Go deeper on those hunches.

The traditional health care (or sick care) system will take care of you when you're ill. But if you want to age with strength in all the important ways — physical, cognitive and nutritional, to name just three — you'll need to invest in answers our sick care system isn't designed to provide.

Your annual physical keeps you alive. But staying healthy at the cellular level? You're the CEO of that venture.

To find out more about Paul Von Zielbauer and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

Photo credit: Marcelo Leal at Unsplash