Vault by Wellness

Short answer: there’s no single “longevity” blood test, but a set of reliably predictive biomarkers track the biggest drivers of lifespan and healthy aging — cardiovascular disease, metabolic disease, inflammation, organ function, and nutritional deficits. Below I list the most important blood biomarkers, why they matter, what to watch for, how often to test, and a few specific labs/services that can run them or give extra interpretation. Top biomarkers to watch (what they say and why) Lipids and atherogenic markers LDL‑C, non‑HDL‑C, triglycerides, HDL‑C — core CVD risk markers. High LDL/non‑HDL and triglycerides → higher atherosclerotic risk. ApoB and LDL particle number (LDL‑P or NMR lipoprofile) — better predictors of atherosclerosis than LDL‑C alone. Lp(a) — genetically determined independent risk factor for early atherosclerosis; test once in adulthood. Why: cardiovascular disease is the leading cause of death; these markers predict risk and guide treatment. Glucose metabolism Fasting glucose, HbA1c, fasting insulin, (or OGTT if indicated), HOMA‑IR. Why: dysglycemia and insulin resistance drive diabetes, cardiovascular disease, dementia — major longevity determinants. Inflammation and immune activation hs‑CRP (high‑sensitivity C‑reactive protein), IL‑6 (if available), fibrinogen, neutrophil:lymphocyte ratio. Why: chronic low‑grade inflammation (“inflammaging”) predicts multimorbidity and mortality. Kidney function Serum creatinine/eGFR, cystatin C, urine albumin:creatinine ratio (ACR). Why: CKD raises mortality and accelerates other aging pathways. Cardiac injury/stress markers NT‑proBNP (heart stress), high‑sensitivity troponin. Why: detect subclinical heart disease/risk even when other tests look OK. Liver function & metabolic health ALT, AST, GGT, albumin, bilirubin. Why: fatty liver and liver dysfunction are linked to metabolic disease and mortality. Complete blood count (CBC) & related Hemoglobin, hematocrit, white cell count, platelets, RDW (red cell distribution width). Why: anemia, elevated RDW, and abnormal WBC patterns associate with frailty and higher mortality. Micronutrients & related 25‑OH vitamin D, vitamin B12, folate, iron studies/ferritin. Why: deficiencies cause frailty, cognitive problems, and increased disease risk — many are fixable. Hormones relevant to aging Total and free testosterone (in men if indicated), estradiol (women as appropriate), SHBG, DHEA‑S, TSH/free T4 (thyroid). Why: hormone deficiencies or imbalances affect muscle, bone, metabolism, cognition and frailty. Growth factors and other aging markers (interpret with nuance) IGF‑1 — associated with growth/cancer/aging pathways (U‑shaped relationships). Homocysteine — elevated levels linked to CVD and cognitive decline. Omega‑3 index — low index linked to higher cardiac risk. Why: these are informative but typically need contextual interpretation. Emerging/biological‑age tests (optional) DNA methylation clocks (epigenetic age; e.g., GrimAge) and telomere length assays. Why: give an estimate of biological age and response to interventions — still evolving, useful for tracking but not diagnostic. What to test and how often Core annual panel for most adults: fasting lipid panel (or advanced lipoprotein testing if family history), fasting glucose and/or HbA1c, hs‑CRP, CMP (kidney/liver/electrolytes), CBC, TSH, vitamin D, B12, ferritin. Add apoB/LDL‑P and Lp(a) if personal/family history of premature CVD — Lp(a) can be tested once. NT‑proBNP/hs‑troponin if heart disease risk or symptoms. Repeat frequency: annually for stable people; every 3–6 months if you’re treating an abnormality or making major lifestyle/medication changes. Specific labs/services (why you might use them) LabCorp or Quest Diagnostics — broad coverage, clinical‑grade testing, widely used by clinicians; good for standard panels, Lp(a), apoB, NT‑proBNP, IL‑6 (available). InsideTracker — consumer‑facing panel + personalized interpretation and lifestyle recommendations geared toward performance/longevity; useful if you want actionable coaching with lab data. WellnessFX (or Vault by Wellness) — similar consumer service with clinician review and lifestyle guidance. Everlywell, LetsGetChecked — convenient at‑home collection kits for common panels (glucose, lipids, hormones); good for screening but limited for some specialized markers. OmegaQuant — specialty lab for the omega‑3 index (most clinical labs don’t run this). TruDiagnostic (or Chronomics) — DNA methylation clocks/epigenetic age testing if you want biological age tracking. TeloYears (if still available) or SpectraCell — telomere length assays (useful but more experimental/monitoring). Cleveland HeartLab and specialized CVD labs — for advanced inflammatory and atherothrombotic biomarkers if your clinician is managing complex CVD risk. Interpreting results and next steps Targets vary by age, sex, and risk. For example, LDL goals are lower for people with known CVD or diabetes. Many biomarkers have U‑shaped relationships with outcomes (very low or very high can both be bad), so context matters. Abnormal tests should prompt discussion with a clinician before starting supplements/medications. Lifestyle modifications (exercise, Mediterranean/whole‑food diet, smoking cessation, sleep, stress reduction, weight control) move many of these markers in the right direction. Caveats Some tests (epigenetic clocks, telomere length) are still emerging and should be used for tracking trends, not diagnostic certainty. Don’t over‑test without a plan — focus on biomarkers that change management. Always review abnormal results with a qualified clinician. If you’d like, tell me: your age, sex, major medical history, and what you can test easily (lab access), and I’ll propose a specific baseline panel and testing frequency — and which services to use for each test.

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