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Guide / Longevity

The Longevity Lab Panel.

Most annual physicals run the same five labs your doctor has ordered for 30 years. Here are the 25 tests that actually predict and modify healthspan — what to ask for, what counts as optimal, and what each costs.

How to use this list.

"Optimal" ranges below are tighter than standard lab reference ranges. Lab references are designed to flag overt disease; longevity targets are designed to keep you out of the disease state entirely. A "normal" lab result on the standard reference is not the same as an optimal one.

Most U.S. patients can get a baseline panel through their primary care annually for $0–$50 with insurance. Direct-to-consumer providers (Quest, Marek Health, Function Health, InsideTracker, LetsGetChecked) charge $200–$500 for a comprehensive panel. Bulk-order the panel at your local hospital lab via a "lab requisition only" doctor referral — typically the cheapest cash-pay option.

Many tests below cross-link to one of our interpreter tools — click through for a personalized read of your value.

Lipids & Cardiovascular

ApoB

$15–$30

Optimal: Optimal <80 mg/dL (<60 if known CVD or Lp(a) high)

The single best lipid marker for atherosclerotic risk. Counts the atherogenic particles directly.

Lp(a)

$30–$80

Optimal: <30 mg/dL or <75 nmol/L

Genetic risk factor. Test once in life. Elevated Lp(a) means PREVENT under-estimates your risk.

Interpret your value →

hs-CRP

$10–$30

Optimal: <1 mg/L (low risk) / <2 mg/L (acceptable)

Inflammation marker. JUPITER showed statin benefit at hs-CRP ≥2 even with normal LDL.

Interpret your value →

Lipid panel (TC, HDL, LDL, TG)

$10–$30 (often covered)

Optimal: TG <100, HDL >40 M / >50 F, LDL <100 (or <70 if high risk)

Standard panel. ApoB beats it, but most insurance covers this and not ApoB.

Interpret your value →

Glucose & Insulin

HbA1c

$10–$30 (often covered)

Optimal: <5.5% optimal, 5.7–6.4% pre-diabetes, ≥6.5% diabetes

3-month average glucose. Single best snapshot of long-term insulin function.

Fasting insulin

$30–$50

Optimal: <7 µIU/mL optimal, <10 acceptable

Catches insulin resistance before HbA1c moves. The earliest metabolic warning.

Fasting glucose

$5–$15 (often covered)

Optimal: 70–90 mg/dL optimal, <100 acceptable

Standard. Combined with fasting insulin → HOMA-IR insulin resistance score.

HOMA-IR (computed)

$0 (compute)

Optimal: <1.5 optimal, <2 acceptable, ≥2.5 insulin resistant

(Glucose × Insulin) / 405. Computed from the two values above. Better than either alone.

Iron & Anemia

Ferritin

$15–$30 (often covered)

Optimal: M / post-menop F: 50–300 ng/mL. Pre-menop F: 30–150

Iron stores. Low → deficiency; high → overload or inflammation.

Interpret your value →

CBC (hemoglobin, hematocrit, MCV)

$10–$25 (covered)

Optimal: Hb >12 F / >13.5 M; MCV 80–100 fL

Standard. Picks up overt anemia. Iron deficiency without anemia needs ferritin to catch.

Transferrin saturation

$15–$30

Optimal: 20–50%

Pair with ferritin to distinguish iron deficiency from anemia of chronic disease.

Liver, Kidney, Thyroid

Comprehensive metabolic panel (CMP)

$10–$30 (covered)

Optimal: See lab

Liver enzymes (AST, ALT), kidney function (creatinine, eGFR), electrolytes. Foundational.

TSH

$15–$30 (covered)

Optimal: 0.45–4.5 mIU/L (most labs); functional optimal 1.0–2.5

Thyroid screen. Subclinical hypothyroidism is common and treatable.

Free T4 + Free T3

$30–$60

Optimal: Free T4: 0.8–1.8 ng/dL; Free T3: 2.3–4.2 pg/mL

Add to TSH if you suspect thyroid dysfunction — TSH alone misses some cases.

GGT

$10–$25

Optimal: <30 U/L

Liver enzyme that responds to alcohol, fatty liver, oxidative stress. Subtle early marker.

Uric acid

$10–$25

Optimal: M <6.0, F <5.5 mg/dL

Marker of metabolic dysfunction + gout risk. Elevated uric acid increases CV risk.

Hormones (men + women)

Testosterone (total + free)

$40–$80

Optimal: M: total 400–800 ng/dL, free 8–25 pg/mL

Below 300 ng/dL with symptoms → hypogonadism workup. For women, total <70 ng/dL with symptoms is investigated.

SHBG

$30–$60

Optimal: 20–80 nmol/L

Binds testosterone. High SHBG with normal total T can still mean low free T.

Estradiol (E2)

$30–$60

Optimal: M <40 pg/mL; F by cycle phase

Track for men on TRT or with high BMI. For women → fertility / menopause context.

DHEA-sulfate

$30–$60

Optimal: Age- and sex-dependent

Adrenal precursor. Drops with age. Low DHEA-S correlates with frailty and CV risk in older adults.

IGF-1

$50–$100

Optimal: 90–360 ng/mL (age-dependent)

Growth hormone signaling. Low → growth hormone deficiency; very high → potential cancer / acromegaly risk.

Vitamins, Minerals, Omega-3

Vitamin D (25-OH)

$30–$50

Optimal: 40–80 ng/mL optimal (Endocrine Society)

Deficiency is endemic — under 30 ng/mL = supplement. Affects bone, immunity, mood.

Vitamin B12

$15–$30

Optimal: >500 pg/mL optimal

Vegans, older adults, and metformin users are at risk. Neurological symptoms are reversible if caught early.

Magnesium (RBC)

$30–$60

Optimal: >5.5 mg/dL (RBC measurement, not serum)

Serum magnesium misses deficiency. RBC magnesium is the better marker. Affects sleep, BP, glucose.

Omega-3 index

$50–$100

Optimal: >8% optimal

EPA + DHA as % of red-cell membrane fatty acids. Strong inverse association with cardiovascular events.

Folate / RBC folate

$15–$30

Optimal: >5 ng/mL (serum), >300 ng/mL (RBC)

Critical for methylation, blood, neurological function.

What about advanced lipid testing (NMR, particle size)?

NMR LipoProfile (LDL-P, small dense LDL, large HDL) was the standard "advanced lipid" panel pre-ApoB. ApoB now does the same job at a lower cost and with cleaner evidence — most preventive cardiologists have moved on from NMR. If your insurance covers NMR but not ApoB, get NMR; otherwise, just get ApoB.

What about genetic testing?

Three are worth considering, none are mandatory:

  • APOE genotype — Alzheimer\'s risk. APOE4 heterozygotes have ~2–3× risk; homozygotes ~10–12×. Actionable in that it intensifies the case for cardiovascular and metabolic discipline.
  • HFE — Hemochromatosis. Worth testing if family history of iron overload or persistently elevated ferritin.
  • 9p21 — Coronary artery disease risk variant. Moderate effect, useful if family history of premature CAD.

Full polygenic risk scores (Genomic Health, 23andMe Health+) are interesting but rarely change clinical action. Skip for now.

What about imaging?

One imaging test is worth flagging here: the coronary artery calcium (CAC) score. It is a low-dose chest CT that quantifies calcified plaque in the coronary arteries. Cost: $100–$400 cash-pay. A CAC score of 0 in an adult 40+ is reassuring; a CAC >100 is a strong call-to-action regardless of what your cholesterol panel says. Recommended for adults 40+ with any cardiovascular risk factors.

A practical annual cadence.

  • Every year: Lipid panel, ApoB, HbA1c, fasting glucose, fasting insulin, CBC, CMP, TSH, hs-CRP, ferritin, vitamin D, B12.
  • Every 2–3 years: Hormones (testosterone, SHBG, estradiol, DHEA-S, IGF-1), omega-3 index, magnesium.
  • Once in life: Lp(a), APOE genotype.
  • Every 5 years after 40: Coronary artery calcium (CAC) score. Sooner if symptomatic or family history.

Interpret your results

This is a general guide assembled from peer-reviewed literature, the 2018 / 2026 AHA/ACC cholesterol guidelines, Peter Attia\'s Outlive, Andrew Huberman\'s lab-test newsletters, and standard preventive cardiology practice. Not a substitute for working with a clinician who can interpret these in your specific context.

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