ARUP

Short answer: the biomarkers that most reliably track longevity are those that reflect cardiometabolic health (glucose metabolism, lipids, blood pressure risk), systemic inflammation, kidney and liver function, hematologic status, and certain micronutrients/hormones. Several emerging tests (ApoB/Lp(a), NMR particle counts, IL‑6, telomere length, epigenetic clocks) add useful information for personalized risk. Below is a prioritized, practical list and where to get tested. High-priority (strong evidence for predicting mortality / age-related disease) Glycemic control: fasting glucose, fasting insulin (or HOMA‑IR), and HbA1c Why: chronic hyperglycemia/insulin resistance is strongly linked to cardiovascular disease, dementia, and shorter lifespan. Where to test: standard labs (Quest, LabCorp); insulin often available with routine bloodwork. Lipids and atherogenic burden: LDL‑cholesterol, triglycerides, HDL, plus ApoB and Lp(a) when possible Why: atherogenic lipoproteins drive cardiovascular mortality; ApoB and Lp(a) give additional risk beyond LDL. Where: LDL/HDL/TG via Quest/LabCorp; ApoB and Lp(a) offered by Quest, LabCorp, Boston Heart Diagnostics. Inflammation: high‑sensitivity C‑reactive protein (hs‑CRP) Why: chronic low‑grade inflammation predicts cardiovascular events and mortality. Where: standard labs (Quest, LabCorp). For deeper cytokine profiling (IL‑6, TNF‑α), see specialized labs below. Kidney function: serum creatinine, eGFR, and cystatin C (if available) Why: renal dysfunction strongly increases mortality risk. Where: routine labs; cystatin C available via Quest/LabCorp and some specialty labs. Liver health: ALT, AST, GGT, alkaline phosphatase, bilirubin Why: liver enzyme abnormalities correlate with metabolic dysfunction and mortality risk. Where: routine labs. Hematology and red‑cell markers: CBC including hemoglobin, hematocrit, red cell distribution width (RDW) Why: anemia and elevated RDW are independent predictors of mortality. Where: routine labs. Moderate / actionable biomarkers (add important nuance) Advanced lipoprotein testing: LDL particle number (LDL‑P) or NMR lipoprofile Why: particle number can predict risk better than calculated LDL in many people. Where: LabCorp (NMR LipoProfile/LipoScience historically), Quest/Boston Heart for advanced lipid panels. Omega‑3 index Why: higher omega‑3 index is associated with lower cardiovascular risk and may reflect dietary quality. Where: OmegaQuant (widely used specialty service). Ferritin and iron studies (serum iron, transferrin saturation) Why: iron excess and deficiency both link to adverse outcomes. Where: routine labs. Vitamin D (25‑OH vitamin D) Why: low levels associate with higher mortality and many age‑related conditions. Where: routine labs; also direct-to-consumer kits. Emerging / research‑grade markers (useful for deeper phenotyping) Lp(a) (if not already measured), ApoB (if not already measured) Why: genetically determined risk; guides CV prevention decisions. IL‑6 and other inflammatory cytokines Why: IL‑6 often outperforms CRP in predictive power for aging-related outcomes; cytokine panels are still evolving. Where: specialized labs (Cleveland HeartLab, ARUP, Boston Heart) or research labs. Homocysteine Why: associated with vascular and cognitive risk in some studies. Where: routine labs. Biomarkers of biological age: DNA methylation clocks (epigenetic age), GlycanAge, telomere length Why: may quantify biological (vs chronological) aging; useful for tracking interventions but not yet standard of care. Where: TruDiagnostic (methylation/epigenetic age), EpiAging services, GlycanAge, TeloYears or Life Length (telomeres). Composite scores: multi‑marker risk tests (cardio metabolic risk panels, inflammatory risk scores) Why: combining markers yields better prediction than any single value. Where: commercial services like InsideTracker, WellnessFX, Boston Heart Diagnostics, Cleveland HeartLab. Practical testing services and why you might choose them Quest Diagnostics and LabCorp — broad coverage, most standard and many specialty tests, accepted by clinicians and insurers. InsideTracker — consumer‑focused: selects tests and gives actionable, evidence‑based lifestyle recommendations (good for people who want interpretation + coaching). Boston Heart Diagnostics and Cleveland HeartLab — cardiometabolic specialists offering advanced lipid testing, inflammation panels, and clinician reports focused on cardiovascular risk. OmegaQuant — gold standard for omega‑3 index testing. TruDiagnostic (or similar providers) — for DNA methylation/epigenetic age testing if you want a biological‑age readout and longitudinal tracking. TeloYears or Life Length — telomere length testing providers (research/monitoring use rather than clinical decision‑making). Everlywell, LetsGetChecked — convenient at‑home kits for some routine tests (glucose, lipids, HbA1c, vitamin D, etc.), but limited for advanced assays. How to use this information Prioritize glycemic markers, standard lipid panel (plus ApoB/Lp(a) if risk factors present), hs‑CRP, kidney and liver tests, CBC, vitamin D, and omega‑3 index when possible. Repeat testing based on risk: annually for routine monitoring if healthy; more often if abnormal or if starting an intervention. Interpret results in the context of age, sex, family history and medications. Don’t chase single numbers in isolation — trends and multi‑marker patterns matter more. Discuss abnormal or borderline findings with a clinician before starting medications or supplements. If you want, tell me your age, sex, major health history (e.g., diabetes, heart disease, family history), and whether you prefer clinic or at‑home testing, and I’ll recommend a specific test panel and one or two services/labs to use.

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Short version: choose a clinic that uses board‑certified physicians (menopause/endocrinology/OB‑GYN/family med), does a full medical workup and evidence‑based counseling, prefers FDA‑approved hormones when possible, uses CLIA labs, and — if compounding is needed — works only with accredited compounding pharmacies. Avoid clinics that sell “one‑size‑fits‑all” packages, rely only on saliva tests, or push pellet implants and proprietary blends without clear follow‑up. Concrete checklist — what to look for and questions to ask Provider credentials: Is the treating clinician an MD/DO (not only an NP/PA) and board‑certified in endocrinology, OB‑GYN, family medicine, or certified by The North American Menopause Society (NAMS) as a menopause practitioner? Ask to see their board certification. Full medical evaluation: Do they take a detailed history, do a physical exam, and order baseline labs (CBC, CMP, fasting lipids/glucose, TSH, estradiol/progesterone/testosterone as appropriate)? Beware clinics that skip labs. Lab quality: Labs should be CLIA‑certified — e.g., Quest Diagnostics, LabCorp, ARUP. Avoid clinics that use non‑CLIA home saliva tests as the sole test. Evidence‑based treatment & monitoring: Do they explain risks/benefits, prefer FDA‑approved formulations when reasonable, set target labs, and schedule follow‑up monitoring (3 months, 6 months, then yearly)? Compounding practices: If they use compounded bioidentical hormones, ask which compounding pharmacy they use and whether it is accredited (look for ACHC, URAC, or PCAB accreditation and USP <795> compliance). Ask about batch testing and sterility procedures. Informed consent: Ask for a written treatment plan, expected benefits, side effects, monitoring schedule, and cost breakdown. They should discuss alternatives and stopping rules. Red flags: Claims of “anti‑aging” cures, “no labs required,” blanket testosterone for all women, proprietary hormone cocktails, high‑pressure sales (pellet parties), cash‑only with huge upfront fees. Questions to ask the clinic before you commit Are you board‑certified? In what specialty? Which labs will you run, and which lab is used? Will you use FDA‑approved hormones or compounded products? If compounded, which pharmacy and what accreditations does it hold? How often will I be monitored? How are side effects handled? What are the costs (medication, pellet insertion, follow‑ups)? Reputable places/brands to consider (examples) Academic clinics (safer for evidence‑based care): Mayo Clinic Menopause Clinic, Cleveland Clinic Women’s Health / Menopause center, UCSF Menopause Clinic, Johns Hopkins Menopause Clinic. Why: multidisciplinary teams, evidence‑based protocols, access to specialists and up‑to‑date research. National organizations and guidelines: The North American Menopause Society (NAMS), Endocrine Society, and American College of Obstetricians & Gynecologists (ACOG). Why: they publish guidelines you can use to judge a clinic’s practice. Labs: Quest Diagnostics, LabCorp, ARUP. Why: CLIA‑certified, widely used. FDA‑approved hormone products (prefer when appropriate): transdermal estradiol patches (e.g., Vivelle‑Dot, Climara), micronized progesterone (Prometrium). Why: standardized dosing, safety/efficacy data, regulated manufacturing. Compounding pharmacy accreditations to look for: ACHC, URAC, or Pharmacy Compounding Accreditation Board (PCAB) accreditation and compliance with USP standards (USP <795>). Why: accreditation reduces risk of poor compounding quality. Special note on pellet therapy and saliva testing Pellets: popular but have higher local complication rates and limited high‑quality RCT evidence of superior outcomes. Ask for data, complication rates, and what happens if a pellet causes problems. Treat pellets as a potential red flag unless carefully justified and monitored. Saliva hormone tests: not reliable as sole basis for dosing. Acceptable labs are blood (serum) tests from CLIA labs for most hormones; some specialists also use blood spot testing selectively. How to verify credentials and complaints State medical board lookup for malpractice or disciplinary actions (search “[state] medical board license lookup”). ABMS (Certification Matters) to confirm board certification. Check NAMS directory for certified menopause practitioners. If you’re unsure, get a second opinion at an academic center first. If you already have a primary care doctor, ask them for a referral to a board‑certified menopause or endocrinology specialist. If you want, tell me your city/zip and I can: Suggest a nearby reputable clinic or academic center, and Draft a short list of questions you can send to a clinic before scheduling an appointment.

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Short answer: there isn’t a single, validated “food sensitivity” blood test that reliably identifies non‑allergic food intolerances. The tests that are evidence‑based depend on the suspected problem (true allergy, celiac disease, lactose/fructose intolerance, SIBO/IBS). Avoid commercial IgG panels and similar direct‑to‑consumer “food sensitivity” tests — they’re not supported by good evidence and often lead to unnecessary restriction. Recommended, evidence‑based options (and brands/labs) 1) If you have immediate allergic reactions (hives, swelling, anaphylaxis) What to get: skin‑prick testing by an allergist and/or serum specific IgE testing. Trusted brand/lab: ImmunoCAP (Thermo Fisher) is the standard assay many allergists and clinical labs (Quest Diagnostics, LabCorp, ARUP) use. Why: Validated for IgE‑mediated allergy and interpreted by a clinician. 2) If you suspect celiac disease or gluten‑related disease What to get: tissue transglutaminase IgA (tTG‑IgA) plus total IgA; possibly deamidated gliadin peptide (DGP) IgG if IgA deficient. Where: standard labs (Quest, LabCorp, ARUP). Why: These serologies are the accepted diagnostic tests for celiac disease. Important: do NOT start a gluten‑free diet before testing. 3) If you suspect carbohydrate malabsorption (lactose, fructose) or SIBO What to get: hydrogen/methane breath tests (lactose breath test, fructose breath test, or glucose/lactulose breath test for SIBO). Where: GI clinics or labs that run breath testing (many hospitals and gastroenterology centers; QuinTron makes common testing equipment). Why: Breath testing (with correct prep and interpretation) is the clinically used method for these problems. 4) If you have IBS or non‑IgE food triggers What to do: a structured elimination and reintroduction trial (for example low‑FODMAP), ideally guided by a registered dietitian experienced in GI disorders. Why: Many “sensitivities” are triggered by FODMAPs or other food groups; controlled elimination/rechallenge is the best diagnostic method. Tests and services to avoid (or use with caution) IgG food antibody panels sold direct‑to‑consumer (Everlywell, YorkTest, Vibrant Wellness, many clinic panels): Evidence shows IgG antibodies often reflect exposure, not harmful sensitivity. These tests can be misleading. ALCAT / MRT / some leukocyte‑activation tests and many multiplex “food reactivity” arrays (Cyrex arrays fall into more experimental category): poor or limited evidence for clinical usefulness; can generate unnecessary dietary restrictions. Broad “microbiome” testing or unvalidated biomarker panels claiming to identify food sensitivities — useful for research, not for diagnosing sensitivities. Practical next steps If you get acute/possibly dangerous reactions (difficulty breathing, lip/tongue/throat swelling): see an allergist or emergency care immediately. For ongoing GI or suspected sensitivity symptoms: start with a clinician visit (allergist or gastroenterologist) and/or an RD. Ask for evidence‑based tests above (ImmunoCAP/skin prick for allergy; tTG for celiac; breath tests for carbohydrate malabsorption). If you already have results from a commercial IgG panel, bring them to a clinician — but expect they will recommend confirmation via elimination trials or validated testing rather than acting on IgG results alone. If you want, tell me the symptoms you’re getting (timing, type of reaction, consistency) and I’ll suggest the most appropriate next test or the specialist to see.

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Short answer: there is no single reliable consumer “food sensitivity” test sold direct-to-consumer. The only evidence‑based testing depends on what problem you actually have — immediate (IgE) food allergy, celiac disease, or an intolerance — and should be done by a clinician using validated assays and/or supervised food challenge. What to use, by problem (with brand/lab names): Suspected immediate (IgE) food allergy (hives, swelling, anaphylaxis, wheeze, vomiting soon after eating) Best approach: evaluation by a board‑certified allergist who will do skin prick testing and/or serum specific IgE testing and, if needed, a supervised oral food challenge (the gold standard). Serum test: ImmunoCAP (Thermo Fisher/Phadia) is the widely used, validated sIgE assay used by major labs (Quest Diagnostics, LabCorp, ARUP). These are clinically meaningful when interpreted by an allergist. Suspected celiac disease (diarrhea, weight loss, anemia, etc., or family history) Best tests: tissue transglutaminase IgA (tTG‑IgA) plus total IgA; if IgA deficient, deamidated gliadin peptide (DGP) IgG. Reputable labs: Quest Diagnostics, LabCorp, ARUP — ask for standard tTG/DGP assays. Don’t start a gluten‑free diet before testing. Suspected carbohydrate intolerance (lactose, fructose, small intestinal bacterial overgrowth) Best test: hydrogen (and methane) breath test, performed by a GI clinic using clinical equipment (QuinTron is a commonly used clinical system). Some reliable GI labs/centers do these in‑clinic. Non‑celiac gluten sensitivity, histamine intolerance, or vague “food sensitivity” There is no validated laboratory test. Diagnosis is by careful elimination diet and symptom re‑challenge under medical/dietitian supervision. What to avoid (scams or low‑value tests) IgG or IgG4 food panels sold direct‑to‑consumer (Everlywell, YorkTest, Pinnertest, many others) or proprietary tests such as ALCAT, Mediator Release Test (MRT)/LEAP are not supported by allergy and gastroenterology societies for diagnosing food intolerance or sensitivity. IgG often simply reflects exposure and does not predict harmful reactions — acting on these results can lead to unnecessary and nutritionally harmful diets. Practical recommendation If you have concerning symptoms (hives, breathing problems, GI distress, weight loss, anemia), see an allergist or gastroenterologist. Ask for ImmunoCAP/skin testing for allergy, tTG/DGP for celiac, or a clinician‑supervised hydrogen breath test for suspected lactose/SIBO issues. If you want, tell me your symptoms and I can recommend the most appropriate test and how to find a local specialist or lab.

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