InsideTracker

How Often to Retest Blood Biomarkers The frequency depends on your situation, but here are general guidelines: General Healthy Adults Annually is a good baseline for standard panels Services like Inside Tracker, Function Health, or Quest Diagnostics offer yearly comprehensive panels More Frequent Testing (Every 3-6 Months) if you're: Actively changing diet or lifestyle Managing a chronic condition Optimizing athletic performance Adjusting supplements or medications Recommended Services by Use Case Function Health – 100+ biomarkers, good for comprehensive annual tracking Inside Tracker – Great if you want personalized recommendations with retesting built in Levels Health – If metabolic health/blood sugar is a focus LabCorp OnDemand – Affordable, flexible, no doctor required Ulta Lab Tests – Budget-friendly for frequent retesting Practical Tip Retest 8-12 weeks after making significant changes (diet, exercise, supplements) to see measurable impact Keep results consistent by testing at the same time of day, fasted Important Note Always consult your doctor or a registered dietitian to interpret results and determine the right frequency for your specific health needs.

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Blood Biomarkers That Actually Matter for Longevity Tier 1: Strong Evidence Metabolic Fasting insulin & HOMA-IR – insulin resistance is a root cause of many diseases HbA1c – long-term blood sugar control Fasting glucose – immediate metabolic health signal Triglycerides & triglyceride/HDL ratio – cardiovascular and metabolic risk Cardiovascular ApoB – better than LDL for predicting cardiovascular risk Lp(a) – genetic risk factor most people never check hs-CRP – systemic inflammation marker Organ Health eGFR/creatinine – kidney function ALT/AST – liver health Tier 2: Meaningful but Context-Dependent Homocysteine – inflammation/cardiovascular risk Vitamin D (25-OH) – immune and metabolic function Testosterone/estradiol – hormone optimization TSH – thyroid function Ferritin – iron storage and inflammation Who Can Help You Track These Function Health – comprehensive panels, Peter Attia-affiliated Inside Tracker – analyzes trends over time LabCorp/Quest – order through your doctor or Marek Health The Honest Reality Standard annual physicals often skip ApoB, Lp(a), fasting insulin, and homocysteine — the ones with arguably the strongest longevity signal. Want specifics on any of these?

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Short answer: No — they aren’t strict substitutes. Annual physical labs (done through your primary care visit and a clinical lab) are important for comprehensive preventive care and insurance coverage. At‑home blood tests are a convenient supplement for targeted, interim monitoring, but they can’t replace the physical exam, vaccinations, and full clinical context your PCP provides. Why they differ (quick): Annual physical labs: usually include a broad panel (CBC, CMP/metabolic panel, lipids, A1c, TSH, sometimes PSA, urinalysis, STD screening, etc.), are ordered and interpreted by your clinician, can be billed to insurance, and come with a visit for exam, counseling, and referrals. At‑home tests: convenient, fast, and private; good for single-item checks (A1c, vitamin D, testosterone, some STD screens). Many are finger‑stick kits or mail‑in vials and may not cover everything or be accepted by insurers. They don’t replace a hands‑on exam. When you might choose each Stick with annual physical + lab work if: you want preventive care, are due for screening, have new symptoms, chronic disease management, or want insurance-covered testing. Use at‑home tests if: you need quick repeat monitoring between visits (e.g., A1c, testosterone), live far from a lab, want convenience/privacy, or are tracking a specific marker. Always follow up with your PCP for abnormal results. Practical brand/service recommendations Full clinical labs (best for annual/insurance-covered testing): LabCorp and Quest Diagnostics — large national lab networks, high-quality CLIA labs, easy insurance billing, many local draw sites. Direct-to-consumer at‑home/mailer kits (convenient for targeted monitoring): LetsGetChecked — wide test menu, clinician follow-up/telehealth options, good for A1c, testosterone, hormones, STD screens. Everlywell — easy-to-use finger‑stick kits, clear consumer interface, good for single markers (STD, hormone, vitamin D). HealthLabs.com or DirectLabs — let you self‑order standard lab panels performed at local labs (can be cheaper than PCP-ordered tests but usually out‑of‑pocket). Vault Health — focused telehealth + labs for men’s health (testosterone, prostate screening) with coordinated care. InsideTracker — for personalized optimization and performance-focused panels (more expensive). Note: Check that any company uses CLIA‑certified labs and offers clinician review. Tips If you want insurance to cover labs, have your PCP order them (or use the lab’s patient‑portal options that bill insurance). For chronic conditions, follow the monitoring frequency your clinician recommends (A1c for diabetes every 3–6 months; lipids and TSH per your provider). If an at‑home test is abnormal, bring results to your PCP — they may repeat tests in a clinical lab and manage treatment. Verify sample type — some at‑home finger‑stick tests are less accurate for some analytes than venous draws. If you want, tell me which tests you’re considering or if you have chronic conditions — I can suggest which ones are safe to monitor at home and which you should get through your doctor.

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At-Home Blood Tests vs. Annual Physical Labs: Do You Need Both? Short answer: Probably not both, but they serve different purposes. Annual Physical Labs (Through Your Doctor) Best for: Insurance-covered comprehensive panels Results interpreted by your physician Tracking health history in your medical record Diagnosing and treating conditions Tests requiring clinical oversight At-Home Tests Can Add Value If: You want more frequent monitoring between annual visits: Everlywell – Wide variety of panels, easy to use, HSA/FSA eligible Function Health – 100+ biomarkers, great for health optimization enthusiasts Inside Tracker – Good if you're fitness-focused, links results to lifestyle recommendations You want specific tests your doctor won't order: Hormone panels, food sensitivities, micronutrient levels My Honest Recommendation: Don't skip your annual physical – it's usually covered by insurance and your doctor catches things you might miss Add at-home testing only if you have specific health goals, symptoms between visits, or want deeper data Function Health is worth considering if you want a genuinely comprehensive picture Bottom Line Your annual physical labs are the foundation. At-home tests are a supplement, not a replacement. What specific health goals are you trying to track?

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Short answer: several routine and a few advanced blood biomarkers are consistently linked to long-term mortality and healthy lifespan. The most useful ones are those that track metabolic health, atherosclerotic risk, inflammation, kidney/liver function, oxygen-carrying capacity, and key micronutrient deficiencies. Focus first on modifiable, well‑validated tests (glucose control, ApoB/LDL, inflammation, kidney function, A1c), then add advanced tests (LDL‑particle number, Lp(a), NMR/GlycA, cystatin C) if you want deeper risk stratification. Below is a practical, prioritized list with why each matters, typical “good” targets (approximate — individual targets vary), and how to improve results. Top priorities Hemoglobin A1c (HbA1c) and fasting glucose / fasting insulin Why: Chronic hyperglycemia and insulin resistance predict diabetes, cardiovascular disease, dementia, and higher mortality. Rough target: HbA1c in the non‑diabetic range (generally <5.7%); many healthy people target ~5.0–5.6%. Fasting glucose <100 mg/dL. Lower fasting insulin / HOMA‑IR indicates better insulin sensitivity. How to improve: weight loss, improved diet (lower refined carbs), resistance + aerobic exercise, sleep, and medications when appropriate (metformin, GLP‑1 agonists). Lipids with particle measures: ApoB, LDL‑particle number (LDL‑P), LDL‑C, non‑HDL, triglycerides, HDL Why: Atherosclerotic cardiovascular disease (the leading cause of death) is best tracked by particle burden (ApoB/LDL‑P) rather than LDL‑C alone. Rough target: ApoB <80 mg/dL (lower if high risk), LDL‑P and non‑HDL as low as your risk profile warrants (many high‑risk patients aim LDL <70 mg/dL). Triglycerides <150 mg/dL; HDL higher is usually better. How to improve: diet quality, weight loss, statins/ezetimibe/PCSK9 inhibitors as indicated, exercise, reduce refined carbs and alcohol. Important and actionable High‑sensitivity CRP (hs‑CRP) and other inflammation markers (IL‑6, GlycA) Why: Chronic low‑grade inflammation (“inflammaging”) predicts mortality, cardiovascular events, and disability. Rough target: hs‑CRP <1 mg/L is low risk; 1–3 mg/L moderate; >3 mg/L higher risk. How to improve: weight loss, exercise, smoking cessation, statins, dietary improvements; specific anti‑inflammatory drugs are used in selected cases but are not routine. Lipoprotein(a) — Lp(a) Why: Strong genetic driver of atherosclerotic and valvular disease; one‑time test is usually enough because levels are largely inherited. Rough target: ideally <30–50 nmol/L (or <30–50 mg/dL depending on units); elevated levels merit specialist input. How to improve: limited; some PCSK9 inhibitors modestly lower Lp(a); new therapies (antisense oligonucleotides) are in development. Kidney function: serum creatinine/eGFR, cystatin C, urine albumin‑to‑creatinine ratio (UACR) Why: Reduced kidney function and albuminuria strongly predict cardiovascular disease and death. Rough target: eGFR >60 mL/min/1.73m2; UACR <30 mg/g. How to improve: blood pressure control (ACEi/ARB), glycemic control, avoid nephrotoxins, treat underlying causes. Complete blood count components — hemoglobin, hematocrit, RDW (red cell distribution width), WBC Why: Low hemoglobin (anemia) and high RDW/WBC count associate with higher mortality and frailty. How to improve: identify causes (iron/B12 deficiency, chronic disease), treat appropriately. Liver enzymes and markers of fatty liver (ALT, AST, GGT, fasting triglycerides) Why: NAFLD and elevated GGT/ALT associate with metabolic disease and worse long‑term outcomes. How to improve: weight loss, exercise, treat metabolic syndrome. Useful micronutrients / endocrine markers 25‑hydroxy vitamin D Why: Very low levels associate with poor health; supplementation corrects deficiency. Typical target: 30–50 ng/mL for most adults (individualize). Vitamin B12/folate, ferritin (if indicated) Why: Deficiencies cause anemia, neuropathy, and poor functional outcomes. Thyroid tests (TSH, free T4; free T3 if symptomatic) Why: Untreated hypo/hyperthyroidism affects metabolism, cognition, and cardiovascular risk. Advanced/specialty markers (for deeper risk stratification) ApoB and LDL‑P (NMR or apoB lab) Why: Better predictors of atherosclerotic risk than LDL‑C alone. How to get it: NMR Lipoprofile (LabCorp), ApoB via Quest or LabCorp, or advanced lipid panels from specialty labs. GlycA (NMR inflammation signal), IL‑6, TNF‑alpha Why: Emerging, strong predictors of long‑term risk and frailty. Cystatin C (refined eGFR) and urine biomarkers for earlier kidney disease detection. How often to test Healthy adults: basic panels (CBC, CMP, fasting lipids, HbA1c) annually. If abnormalities or higher risk: every 3–6 months while optimizing or on therapy. One‑time tests: Lp(a) (once unless family history or therapy change), ApoB/LDL‑P if you want a better baseline. Practical next steps (what I’d recommend) Start with: fasting metabolic panel + lipid panel + HbA1c + hs‑CRP + CBC + kidney/liver tests + vitamin D. Add ApoB or NMR/LDL‑P if you want precise CV risk. If you have personal/family CVD or early CVD: add Lp(a) and consider referral to a lipid specialist. Where to get these tests (brands/services) LabCorp and Quest Diagnostics — widely available, full panels and specialty tests (ApoB, Lp(a), NMR LipoProfile via LabCorp). InsideTracker or WellnessFX — consumer‑facing platforms that combine lab testing with personalized interpretation and lifestyle recommendations. Nightingale Health — advanced NMR metabolomics (more common in Europe) for GlycA and detailed metabolite profiling. Everlywell or LetsGetChecked — convenient home sample kits for common tests (A1c, lipids, vitamin D, etc.) if you prefer at‑home draws. Local primary care or a preventive cardiology/lipid clinic — for interpretation and prescription decisions (statins, BP meds, advanced therapies). Cautions Associations ≠ causation: some markers predict risk but lowering them does not always change outcomes (interpret with clinician). Targets must be individualized by age, sex, comorbidities, and medications; very low values in older adults can sometimes be harmful. Don’t chase single numbers — focus on overall risk reduction: blood pressure control, smoking cessation, body composition, cardiorespiratory fitness, good sleep, diet, and control of diabetes/lipids. If you want, tell me your age, sex, major medical history, and any recent lab results and I’ll prioritize which tests to get and give more specific target ranges and action steps.

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Blood Biomarkers That Actually Matter for Longevity Core Panel (High Evidence) Metabolic Health Fasting glucose & insulin – insulin resistance is a root cause of many age-related diseases HbA1c – 3-month blood sugar average; strong predictor of metabolic aging Triglycerides & HDL ratio – better cardiovascular risk indicator than total cholesterol alone Inflammation hs-CRP – high-sensitivity C-reactive protein; chronic inflammation marker IL-6 – interleukin-6; stronger predictor than CRP in some studies Organ Function ALT/AST – liver health Creatinine/eGFR – kidney function TSH – thyroid function affects nearly everything Increasingly Validated ApoB – better LDL cardiovascular risk marker than standard LDL Lp(a) – largely genetic cardiovascular risk; important to know once Homocysteine – cardiovascular and cognitive risk Vitamin D – immune, bone, metabolic function Emerging (Promising But Less Established) IGF-1 – growth factor linked to aging pathways DHEA-S – adrenal aging marker Epigenetic clocks (DNA methylation) – biological age testing Where to Get Tested Function Health – comprehensive panel, physician-reviewed Inside Tracker – adds personalized recommendations Quest/LabCorp – affordable basics through your doctor Bottom line: Metabolic markers and ApoB are probably the highest-yield starting point.

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