About a year ago, Sourya was feeling a little low and fatigued. So he got a blood test.

It showed low vitamin D. He took supplements, felt better, but soon he started getting blood tests again and again.

His doctor didn't tell him to do so, quite the opposite.

And Sourya isn't alone.

Many more people are getting tested now, even when their doctors didn't really ask them to.

India's diagnostics industry is already worth over one lakh crore rupees and is growing at around 12% annually, according to reports. The preventive and wellness segments are growing the fastest.

So what's behind this shift?

In the latest episode of The Signal Brief, I spoke to diagnostics companies, consumers, as well as psychologists to understand this.

Are we testing too much?

Tune in to the latest episode of The Signal Brief to learn more.

The Core produces The Signal Brief. Follow us wherever you get your favourite podcasts.

NOTE: A machine transcribed this episode. A human has looked at this text but there might still be errors. Please refer to the audio above, if you need to clarify something. If you want to give us feedback, please write to us at feedback@thecore.in.

TRANSCRIPT:

Kudrat (Host): Sourya is a public policy consultant in New Delhi.

About a year ago, he was feeling off: low energy, lethargic. Like so many of us juggling deadlines and city life.

Sourya: So I decided to do complete blood work, and back then it was because my vitamin D was low.

But even after it stabilized a bit, I took medicines and all. I had taken supplements. I decided it seemed like a good idea to keep doing more tests, right? So it went from being a vitamin D and B12 test to doing complete blood work to doing every other test that was there, and I keep doing them about every three to four months.

Kudrat (Host): Today, Sourya gets a battery of blood tests roughly every three months. He tracks the results on Pharmeasy, an app that lets you book tests and receive reports quickly.

He compares his numbers over time.

And no, his doctor didn't tell him to do this. Quite the opposite.

Sourya: While they were clear, okay, there isn't any harm in you regularly monitoring, there's absolutely no need for you to do it because sometimes those indicators might not change over three months, right?

Kudrat (Host): So why does he keep doing it?

Sourya: But yeah, most of these tests that I keep doing every three months are not because I feel I'm unwell right now. I'd much rather know, and it's a good idea to see these test results and compare my health over time, right? So I like to ensure that I'm currently in the proper range.

Kudrat (Host): Sourya isn’t alone.

Across urban India, getting tested has never been easier.

Book on an app, someone comes home to collect the sample, and by evening you have numbers on your cholesterol levels, vitamins, and more.

India’s diagnostics industry is now worth over Rs 1 lakh crore and growing at 10-12% annually, with the preventive and wellness segments expanding even faster.

Today, we have more tools and incentives than ever before to keep us healthy–there’s things like corporate wellness perks, including workplace health check-ups.

There’s step counters, smartwatches, and AI apps that analyse every blood report.

But, is all of this actually making us healthier.. Or just more anxious?

Kudrat (Host): My name is Kudrat Wadhwa and you’re listening to The Signal Brief. We don’t do hot takes. Instead, we bring you deep dives into the how and why of consumer trends.

Today: why are so many healthy Indians getting tested... and when does preventive healthcare become health anxiety?

Kudrat (Host): Before we get to the testing boom, let’s understand the other side of the story — this one still affects millions in this country.

Especially in smaller towns, villages, and among lower-income families, underdiagnosis and late diagnosis remain a serious, everyday challenge.

Studies based on the National Family Health Survey-5 show just how stark the gap is.

Screening rates for common cancers are low: cervical cancer screening has reached less than 2% of women who need it in many places.

Breast cancer screening is often below 1%.

Oral cancer screening sits at around 0.44% nationally. The numbers are even worse in rural areas and poorer households.

The result?

People show up at hospitals only when symptoms become impossible to ignore — and by then, the disease is often advanced.

So why has this been happening for so long?

Several reasons.

First, cost and access: travelling to a decent facility, losing a day’s wages, and paying out of pocket is just not possible for many.

Second, low awareness about the importance of regular testing, especially in rural and lower-income communities.

Third, deep-rooted gender norms that make women less likely to seek screening.

And finally, public health infrastructure that, despite programmes like NPCDCS, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, struggles with implementation on the ground.

So given this background, the rise of easier, more widespread testing is actually positive. In fact, for many high-risk people, it can be life-saving.

I spoke to Dr. Rajiva Gupta, a senior consultant in internal medicine and diabetes based in Gurugram.

Dr. Rajiva: Suppose somebody is not at a healthy weight, or somebody has got a family history of diabetes. For such people, routine health checkups are important because they pick up diseases earlier. Suppose somebody has what we call pre-diabetes.

Now, if the person has pre-diabetes, then probably I would be more insistent upon them to follow lifestyle measures, diet control, weight control and exercise, etc., and the person will also be more motivated to follow them. So that is the plus side.

Otherwise, picking up existing illnesses also helps in certain circumstances.

For example, breast cancer. Many cases of breast cancer are asymptomatic. So if a woman palpates her breast and finds a lump, or if there is a strong family history of breast cancer, then going in for breast mammography and ultrasound of the breast, as per the protocols...

Cervical smear, Pap smear for detection of cancer of the cervix, that is also one of the tests which is useful.

Kudrat (Host): Targeted, timely testing clearly has value.

But as testing became easier something else started happening, especially in bigger cities and among people with more disposable income.

Increasingly, testing is something that consumers like Sourya are seeking out themselves.

And some of them may be testing too much, says Dr Rajiva.

Dr. Rajiva: This shift has happened, based on my experience, because of the growing awareness of people about their health, one.

The growing insecurity about health, because by and large, especially in corporate life, the lifestyle is not healthy because of odd working hours, too much pressure, timelines, and all those things. That's a different story in itself.

Third, lucrative pricing of the packages and the abundance of packages.

Fourth, I said earlier how companies offer reimbursement for these tests. So they don't require a doctor's prescription. They'll go...

And see, it's an industry.

In fact, industry studies have been done across all the big companies, and... I mean, it is growing. As you said, your opening sentence was that the industry is growing.

Kudrat (Host): Nishant Singhal, the CEO of Healthians, an at-home diagnostics company, confirmed that the cost of getting tested has gone down and that the company has seen a massive boom in their sales.

Nishant: So in 2020, we serviced about 500,000 customers in 12 months, in FY20. In FY26, we serviced more than 5 million, right? So you can understand that the volumes have grown 10x just for us, right?

Another major factor we see playing out is the overall affordability of diagnostics, right?

Historically, preventive and wellness diagnostics have been very expensive in the country because they are provided by a certain set of large players in the country. I don't want to take names. And their pricing is quite high, right?

So if you have to take a test package of 80 to 90 tests, which gives you a complete holistic view of all your body parts, organs and health conditions, that will cost you anywhere between Rs 4,000 and Rs 5,000.

Whereas players like us, who are focused on the middle-income group, are able to... and obviously we have a large network of our own labs, so we have created massive efficiency in our operations and are able to pass those benefits to customers.

We are able to provide this to customers at Rs 1,500 to Rs 2,000 per person.

Kudrat (Host): Sourya’s story is the perfect example.

He started off with just one test.

But soon, thanks to app-based trackers, he found himself getting these tests every three months.

And unlike a decade ago, keeping tabs on his health wasn't prohibitively expensive. A comprehensive blood panel today can cost a fraction of what it once did, making repeat testing much easier to justify.

Now, Sourya is only getting blood tests. But Dr Rajiva says he increasingly sees people who arrive asking for more complex investigations, even when they have no clear symptoms.

Dr. Rajiva: So let's see. Somebody has very non-specific chest discomfort. Chest discomfort means it's most likely a person who has no significant risk factors, is younger, around 30 or 32, has no family history of cardiac disease and otherwise has a healthy lifestyle. But they say, "No, no, I want to know how my heart arteries are working."

So they go for an ECG. The ECG may show some non-specific problem.

Then they go for a stress test. It shows something, and then they're advised to get a CT angiogram.

Now, a CT angiogram is a semi-invasive test which discovers blockages in the coronary arteries. So now, if it shows blocks... see, so far nothing is there which is actionable. But now it shows blocks, and then it depends upon the treating doctor.

He might say, "Oh, let us get a coronary angiogram done. It will help you and we will fix those things up."

So this is a cascade of events, and finally, a prudent doctor will say, "Okay, don't have to worry. We'll just focus on your healthier lifestyle. Just follow that and keep coming for regular clinical examinations, and report to us whenever any symptoms arise."

So the end result is the same, but the person has gone through a series of tests and has not been able to sleep in peace. "Oh, I've got something. I've got something."

So that is a very typical example.

Sometimes people discover asymptomatic cysts in the kidney or the liver. Now they get anxious. Why are the cysts there?

They start searching the internet or ChatGPT, etc., and they'll find that there's a possibility of malignancy, but they will not see the underlying factors which could actually be associated with a malignancy.

But then anxiety is generated.

The radiologist will also write at the end, "This is only a radiological opinion," and recommend going for a CT scan.

Asymptomatic cysts, non-significant, going for a CT scan, and then finally they're told, "Okay, everything is fine. Just relax."

These things keep happening, and then we have to counsel people and allay their anxieties. So that is the situation.

Kudrat (Host): Like Dr Rajiva said, all this information doesn’t always bring peace. Sometimes it brings the opposite.

Even Sourya has experienced a version of this.

Sourya: But yeah, there is slight anxiety every time the results come, and I'm looking to see, okay, I hope everything's all good this time, and that no other indicator is going to come back because it's happened before.

The first time I started testing, it was because my vitamin D was low and everything else was fine.

By the third test it showed vitamin D had stabilized, but B12 had crashed.

By the time B12 stabilized, I found my cholesterol levels were a bit off, right?

So that anxiety is slightly there. Oh, what if next time it comes back saying cholesterol has stabilized, but because I was trying to stabilize that, something else went way off, right?

And that anxiety of, okay... do I even feel better right now?

Kudrat (Host): And then, of course, there’s the obvious financial cost. Even if individual tests have become cheaper, repeated blood work, scans and specialist consultations can quickly add up over months and years.

But Dr Rajiva says the bigger cost may not be the one on your credit card bill. And that we shouldn’t undermine the emotional cost.

Dr. Rajiva: See, I wouldn't undermine that emotional aspect.

There was an analysis, and it was found that more tests did not result in better health. In fact, people just kept pondering over this.

Some of them, as you asked in one of the questions, are they really convinced?

Some of them may not be convinced, and then they go on getting tests done.

Maybe somebody gets a CT angiogram done, and he or she develops an allergic reaction to the dye. Yes, of course. Or a kidney problem because of it.

So that is obviously a big downside.

Kudrat (Host): I wanted to get a psychologist’s perspective to understand this emotional cost better, so I reached out to Delhi-based psychologist Harshmeet Kaur.

She told me that she sees about 3-5 clients with health anxiety every week.

Dr Harshmeet: Because medicine cannot offer 100% certainty many times, so many people find themselves getting trapped in a cycle of checking, testing, Googling, monitoring and worrying.

As a psychologist, I often tell people that health anxiety is not really about illness. It's basically about our relationship with uncertainty.

I remember working with someone who was an engineer by profession. He approached his health exactly the way he approached machinery.

So every three months, he booked an extensive panel of blood tests. He described it to me in every session like, "I went for this routine maintenance."

Initially, he believed he was simply being responsible by getting them done time and again.

But as therapy progressed, something interesting emerged.

Whenever work became stressful, whenever there was conflict at home, whenever life felt unpredictable, he booked another set of investigations. Not because he had symptoms, but because the normal report gave him something he wasn't getting anywhere else in life: a sense of certainty.

So many times it is also an escape mechanism.

Once he recognized the pattern and we began working on the anxiety itself, rather than repeatedly trying to reassure something which was not there...

I would also like to say that medical tests are designed to answer medical questions, but they cannot answer emotional questions like, "Can you guarantee that nothing bad will ever happen to me?"

Kudrat (Host): Dr Harshmeet says psychologists have a name for behaviour like repeated testing.

They call it a safety behaviour.

The tests can reduce anxiety for a while, but soon enough, it returns.

So how do you know if you've crossed the line from being health-conscious to becoming health-anxious?

Dr Harshmeet: If you end up doing repeated body checks more than required, like measuring your pulse even when the sensation is going high for multiple reasons...

And then little things like skin scratches or having some extra moles, and you're getting too worried about them and thinking that it might be cancer, then that's a pointer that you need to seek help.

Second is if you are Googling symptoms more than you previously would. Like Googling the Google results, which is the term I mentioned, cyberchondria.

And then if you are planning to seek multiple doctor opinions for the same complaint, and also if you're reaching out to alternative health practitioners along with your medical treatment but you're not really getting satisfaction, then that is another thing to ponder upon.

Kudrat (Host): And the testing boom may only be getting started.

Beyond routine blood work, a whole new frontier is gaining popularity — things like gut microbiome analysis, advanced hormone panels, full-body scans, and food sensitivity tests that promise to tell you exactly which foods are making you tired or bloated.

Nishant from Healthians says demand in areas like allergy testing, food sensitivity, and genetic screening is likely to grow significantly as awareness spreads.

I wanted to see this world up close, so I visited one upscale wellness clinic in Delhi.

The space felt more like a luxury hotel than a clinic — lemongrass scent in the air, soft waterfall sounds, pictures of glowing, healthy people on the walls, and offers for cryotherapy and IV drips interspersed across the space.

After a short consultation with an MBBS doctor with a functional medicine specialty, she made the recommendations: a Rs 10k worth food sensitivity panel, a 50k worth Oligo scan which will tell me the degree of how much I’m absorbing vitamins and minerals and future cryotherapy sessions, all cost over 6k each.

I won’t lie–I was tempted to sign up.

Despite everything I’d learned while reporting this story, more information still felt reassuring.

But was that enough reason to buy another test?

Dr Rajiva: This is a big fad nowadays. People are just talking about inflammatory diets and gluten-free diets.

There is no scientific validity for that, and these tests are also pretty expensive.

Food allergy testing, unless there is a specific reason to suspect that certain types of food make the person sick and cause gastrointestinal symptoms, and specifically the same type of food, then that may be justified.

Again, first, examination by a doctor.

Kudrat (Host): His recommendation: be conservative. Always trust qualified medical professionals.

India's diagnostics industry is growing rapidly.

And that's largely a good thing.

For millions of Indians, the problem is still too little testing and diagnoses that come too late.

But for some people, especially in urban India, the challenge is looking different.

When every new test promises more information, it's easy to believe that more data will always lead to better health.

Sometimes it does.

But as psychologist Harshmeet Kaur reminded me, medical tests can answer medical questions. They can't answer emotional ones.

Or guarantee that nothing bad will ever happen.

And, for it’s worth, I did not buy that Rs 50,000 Oligo scan.

Outro: That's all for today. You just heard The Signal Brief. We don't do hot takes. Instead, we bring you deep dives into the how and why of consumer trends. The Core produces The Signal Brief. Follow us wherever you get your favourite podcasts.

To check out the rest of our work, go to www.thecore.in.

If you have feedback, we'd love to hear from you. Write to us at feedback@thecore.in or you can write to me personally at kudrat@thecore.in.

Thank you for listening.