Short answer: there’s no single “longevity” blood test. But several routinely measured biomarkers are strongly tied to long-term mortality and age-related disease risk — and they’re actionable. Below I list the highest‑value markers, what they indicate, rough “good” targets used in longevity medicine, how often to check them, and a few reputable labs/services you can use. Highest‑value biomarkers (why they matter and practical targets) Lipids / atherosclerosis risk LDL‑cholesterol (and non‑HDL): main driver of atherosclerotic cardiovascular disease. Lower is usually better for longevity. Practical targets: LDL <100 mg/dL for most people; <70 mg/dL if high risk. Non‑HDL <130 mg/dL. Apolipoprotein B (ApoB): better predictor than LDL mass for particle number. ApoB <80 mg/dL is commonly used as a target. Lipoprotein(a) [Lp(a)]: genetically determined risk factor — high Lp(a) markedly raises CVD risk; measured once to know baseline. Glycemia / metabolic health HbA1c: long‑term glucose control. Higher levels predict diabetes and vascular disease. Aim <5.7% for normal; many longevity clinicians prefer <5.5% if safe. Fasting glucose, fasting insulin, HOMA‑IR: help catch insulin resistance earlier than A1c. Inflammation & immune activation High‑sensitivity CRP (hs‑CRP): a robust predictor of cardiovascular events and mortality. Desirable <1 mg/L; 1–3 moderate; >3 high. (Research/optional) IL‑6 and TNFα are informative but less available clinically. Kidney & filtration markers Serum creatinine / eGFR: chronic kidney disease increases mortality risk. Cystatin C: more sensitive eGFR marker in some people and useful for combined eGFR equations. Urine albumin/creatinine ratio: early kidney damage predictor. Liver health / metabolic stress ALT, AST, GGT: elevated GGT especially correlates with metabolic disease and mortality risk. Hematology & frailty signals Complete blood count (CBC), especially hemoglobin and RDW (red cell distribution width). High RDW consistently predicts higher mortality and frailty. Cardiac stress NT‑proBNP or BNP: sensitive for occult heart strain/failure and predictive of outcomes even at “low” elevations. Nutrition / modifiable deficiencies 25‑hydroxy vitamin D (target commonly 30–50 ng/mL), B12, ferritin (iron stores) — extremes relate to poor outcomes. Thyroid TSH (with free T4/free T3 as needed): both low and high thyroid function affect aging/metabolism. Coagulation markers (in some situations) D‑dimer, fibrinogen: higher levels associate with clotting risk and mortality in older adults. Advanced/optional markers for a deeper view ApoB particle count, advanced lipoprotein testing. Lp‑PLA2, lipoprotein subfractions. Telomere length and epigenetic clocks (DNAm GrimAge, Horvath clocks): give a biological‑aging estimate (research/interpretive, not diagnostic). Proteomics/metabolomics (e.g., SomaLogic, Nightingale) can predict risk decades ahead but are mainly for research/precision programs. Which tests and services to use (reputable options) Clinical labs (standard, clinician‑grade) Quest Diagnostics and Labcorp — broad menu (lipids, ApoB, hs‑CRP, HbA1c, cystatin C, NT‑proBNP, vitamins). Your local hospital/academic center for specialty tests and nephrology/cardiology follow‑up. Consumer/precision wellness services (good for integrated interpretation) InsideTracker — aggregates labs, gives personalized targets and lifestyle interventions. Thorne WellConnect — at‑home sample kits tied to practitioners and actionable plans. Everlywell / LetsGetChecked — convenient at‑home collection for core panels, but verify what’s included. Advanced aging / research‑grade tests TruDiagnostic (epigenetic clocks), Life Length / TeloYears (telomere length), and SomaLogic or Nightingale Health for proteomics/metabolomics. How often to test Baseline: get a comprehensive baseline (CBC, CMP, lipid panel + ApoB/Lp(a), hs‑CRP, HbA1c, fasting glucose+insulin, vitamin D, TSH, urine albumin). Routine: annually for most healthy adults; every 3–6 months if you’re changing therapy (statins, weight loss, glucose management) or if abnormalities exist. Advanced tests (epigenetic/proteomic): once yearly or as recommended by the testing service — they’re best used to track trends over time. What to do with abnormal results Most of these markers are modifiable: diet (Mediterranean/plant‑forward), exercise (aerobic + resistance), sleep, smoking cessation, weight loss, and blood‑pressure control lower risk across markers. Medications (e.g., statins, antihypertensives, metformin) can be highly effective where appropriate — discuss with a clinician. Recheck after lifestyle changes or treatment adjustments to confirm improvement. Caveats Biomarkers are risk indicators, not guarantees. They must be interpreted in context (age, sex, family history, medications). Some advanced tests are still research-focused and add cost without clear, evidence‑based interventions. Always review results with a qualified clinician before starting or stopping medications. If you want, I can: Suggest a single “starter” lab panel you can order now (exact test names and typical targets), or Recommend which advanced test(s) make sense given your age, family history, and current health.
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