Longevity Lab Panel Builder.
Most annual physicals run the same five labs your doctor has ordered for 30 years. These are the 26 tests that actually predict and modify healthspan — with optimal ranges, costs, and the calculator that interprets each. Build your list, copy it, hand it over.
Lipids & Cardiovascular
ApoB$15–$30Optimal: 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–$80Optimal: <30 mg/dL or <75 nmol/L
Genetic risk factor. Test once in life. Elevated Lp(a) means standard risk calculators under-estimate your risk.
hs-CRP$10–$30Optimal: <1 mg/L (low risk) / <2 mg/L (acceptable)
Inflammation marker. JUPITER showed statin benefit at hs-CRP ≥2 even with normal LDL.
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.
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–$50Optimal: <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; combined with triglycerides → TyG index.
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.
CBC (hemoglobin, hematocrit, MCV)$10–$25 (covered)Optimal: Hb >12 F / >13.5 M; MCV 80–100 fL
Standard. Picks up overt anemia — and MCV, RDW and the white-cell counts are PhenoAge inputs.
Transferrin saturation$15–$30Optimal: 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, albumin, glucose. Foundational — and most of the PhenoAge inputs come from here.
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–$60Optimal: 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–$25Optimal: <30 U/L
Liver enzyme that responds to alcohol, fatty liver, oxidative stress. Subtle early marker.
Uric acid$10–$25Optimal: 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–$80Optimal: 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–$60Optimal: 20–80 nmol/L
Binds testosterone. High SHBG with normal total T can still mean low free T.
Estradiol (E2)$30–$60Optimal: M <40 pg/mL; F by cycle phase
Track for men on TRT or with high BMI. For women → fertility and menopause-timing context.
DHEA-sulfate$30–$60Optimal: Age- and sex-dependent
Adrenal precursor. Drops with age. Low DHEA-S correlates with frailty and CV risk in older adults.
IGF-1$50–$100Optimal: 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–$50Optimal: 40–80 ng/mL optimal (Endocrine Society)
Deficiency is endemic — under 30 ng/mL = supplement. Affects bone, immunity, mood.
Vitamin B12$15–$30Optimal: >500 pg/mL optimal
Vegans, older adults, and metformin users are at risk. Neurological symptoms are reversible if caught early.
Magnesium (RBC)$30–$60Optimal: >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–$100Optimal: >8% optimal
EPA + DHA as % of red-cell membrane fatty acids. Strong inverse association with cardiovascular events.
Folate / RBC folate$15–$30Optimal: >5 ng/mL (serum), >300 ng/mL (RBC)
Critical for methylation, blood, neurological function.
"Optimal" ranges are tighter than standard lab references — references flag overt disease, these targets aim to keep you out of it. Assembled from the AHA/ACC cholesterol guidelines, the JUPITER trial, and Endocrine Society guidance; see References below.
Frequently Asked Questions
Which longevity labs should I ask my doctor for at an annual physical?+
Start with the tests insurance usually covers: a lipid panel, HbA1c, fasting glucose, CBC, CMP, TSH, and ferritin. Then ask to add the high-value markers a default physical skips: ApoB, fasting insulin, hs-CRP, and vitamin D. Lp(a) is worth adding once in your life. Use the checklist above, uncheck what you do not want, and copy the list.
How much does a longevity lab panel cost?+
With insurance, the covered core (lipids, HbA1c, CBC, CMP, TSH) is often $0–$50 at an annual physical. The add-ons run roughly $15–$80 each cash-pay. Direct-to-consumer providers charge $200–$500 for a comprehensive panel; a "lab requisition only" referral to a local hospital lab is usually the cheapest cash-pay route for the full list.
Can I order these labs without a doctor?+
In most U.S. states, yes — Quest and Labcorp sell consumer-initiated tests, and services like Marek Health, Function Health, and InsideTracker bundle physician review with a large panel. A few states restrict direct-to-consumer testing. Abnormal results still need a clinician: the point of the panel is to start that conversation earlier, not to replace it.
What is in a cardiac longevity panel?+
The cardiovascular core is ApoB, Lp(a), hs-CRP, and a standard lipid panel — particle count, genetic risk, inflammation, and the insurance-covered baseline. Adults 40+ with any risk factors can add a one-time coronary artery calcium (CAC) scan, an imaging test rather than a blood draw, typically $100–$400 cash-pay.
How often should I repeat these tests?+
A practical cadence: yearly for the core (lipids, ApoB, HbA1c, fasting glucose and insulin, CBC, CMP, TSH, hs-CRP, ferritin, vitamin D, B12); every 2–3 years for hormones, omega-3 index, and RBC magnesium; once in life for Lp(a). Retest any marker you are actively working on at ~3 months — sooner is mostly noise.
Optimal is not the same as normal.
Standard lab reference ranges are built to flag overt disease: they describe where 95% of the tested population falls, sick or not. Longevity targets are tighter because they aim at a different question — not "do you have a diagnosis today" but "is this number on a trajectory that keeps you out of the disease state entirely". A fasting glucose of 99 mg/dL is "normal" on every lab report and still five points from a pre-diabetes label.
That is why the builder above lists optimal ranges rather than reference ranges. When your result lands between the two, nothing is wrong in the clinical sense — but the number is telling you which direction it is drifting, years before a flag appears.
How to actually order these tests.
Most U.S. patients can get the covered core — lipid panel, HbA1c, CBC, CMP, TSH — through their primary care annually for $0–$50 with insurance. The high-value add-ons (ApoB, fasting insulin, hs-CRP, Lp(a), vitamin D) usually need to be requested by name; the checklist exists so nothing gets lost between the waiting room and the requisition form.
Cash-pay routes: direct-to-consumer providers (Quest, Marek Health, Function Health, InsideTracker) charge $200–$500 for a comprehensive panel with physician review bundled. A "lab requisition only" referral to a local hospital lab is typically the cheapest way to bulk-order the full list.
What about advanced lipids, genetics, and imaging?
NMR particle testing (LDL-P, small dense LDL) was the "advanced lipid" panel before ApoB became widely available. ApoB now does the same job at lower cost with cleaner evidence; get NMR only if your insurance covers it and not ApoB.
Genetics: three tests are worth considering, none mandatory — APOE genotype (Alzheimer risk; APOE4 sharpens the case for cardiovascular and metabolic discipline), HFE (hemochromatosis, if ferritin runs persistently high or iron overload runs in the family), and 9p21 (coronary artery disease variant, useful with a family history of premature CAD). Full polygenic risk scores rarely change clinical action yet.
Imaging: one test earns a place here — the coronary artery calcium (CAC) score, a low-dose chest CT quantifying calcified plaque, $100–$400 cash-pay. A CAC of 0 at 40+ is genuinely reassuring; a CAC above 100 is a call to action regardless of what the cholesterol panel says.
A practical cadence.
Yearly: 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, RBC magnesium. Once in life: Lp(a) and APOE genotype. Every 5 years after 40: a CAC score, sooner with symptoms or family history.
Retest any single marker you are actively working on at about three months — the biology of most of these numbers does not move meaningfully faster than that, so earlier retests mostly measure noise.
- Grundy SM, et al. (2019). 2018 AHA/ACC/multisociety guideline on the management of blood cholesterol. Circulation, 139(25), e1082–e1143.
- Ridker PM, et al. (2008). Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein (JUPITER). N Engl J Med, 359(21), 2195–2207.
- Holick MF, et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 96(7), 1911–1930.
For education, not medical advice. Results are estimates, not a diagnosis — discuss any abnormal value or health concern with a qualified clinician.
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