Blood work is the highest-signal data in biohacking. Wearables estimate; blood measures. A well-chosen panel, repeated annually, shows what is happening inside your body years before symptoms appear, and gives every lifestyle experiment a real scoreboard. Get the panel through your doctor, ideally once a year: morning, fasted, rested, not the day after a brutal workout.
The Cardiovascular Panel: Where Most Longevity Is Won or Lost
Heart disease remains the leading cause of death, and lipids are the most actionable numbers here.
1. Apolipoprotein B (ApoB)
ApoB counts the actual number of atherogenic particles, predicting cardiovascular risk more accurately than LDL cholesterol alone. The 2026 ACC/AHA dyslipidemia guideline sets ApoB goals by risk level: under 55 mg/dL for very high risk, under 70 for high risk, under 90 for borderline-to-intermediate risk. If you track one lipid number, make it this one.
2. Lipoprotein(a), or Lp(a)
A genetically determined, highly atherogenic particle that standard lipid panels miss. Levels are set mostly by genes and barely budge with lifestyle, which is exactly why you need to know yours. The 2026 ACC/AHA guideline gives Lp(a) measurement a Class I recommendation for every adult, once in a lifetime. A level of 125 nmol/L (about 50 mg/dL) or above is a formal risk enhancer. Order it once; you will likely never need to repeat it.
3. Standard lipid panel with LDL
The 2026 guideline targets: LDL under 100 mg/dL for borderline or intermediate risk, under 70 for high risk, under 55 for very high risk. High triglycerides with low HDL flags insulin resistance even when LDL looks fine.
The Metabolic Panel: Catching Insulin Resistance Early
4. HbA1c
Per the American Diabetes Association: under 5.7% is normal, 5.7 to 6.4% is prediabetes, 6.5% or above is diabetes. For longevity, staying well under 5.7 matters more than most realize.
5. Fasting glucose and fasting insulin
Fasting glucose under 100 mg/dL is the standard normal cutoff. But glucose alone misses early insulin resistance, when the pancreas compensates with more insulin. Adding fasting insulin, typically optimal in the low single digits to around 10 uIU/mL, catches the problem years earlier.
6. hs-CRP
High-sensitivity C-reactive protein measures systemic inflammation. AHA cutoffs: under 1 mg/L is low cardiovascular risk, 1 to 3 is average, above 3 is high. Chronically elevated hs-CRP is one of the most consistent predictors of age-related disease. Test twice to confirm, since a cold or hard workout can spike it temporarily. Also see how dogs age faster for a fun parallel on biomarkers across species.
The Hormone Panel: Know Your Baseline Before You Need It
7. Thyroid: TSH and free T4
Thyroid dysfunction mimics aging: fatigue, weight gain, brain fog, low mood. Typical TSH range is about 0.4 to 4.5 mIU/L. Always test free T4 alongside TSH; TSH alone is incomplete.
8. Testosterone (total and free), plus SHBG and LH
For men, a typical reference range is roughly 249 to 836 ng/dL for ages 19 to 49. Test between 7 and 10 AM, since levels peak in the morning, and confirm any low result with a repeat test.
9. Estradiol and progesterone (for women)
A baseline in your 30s or early 40s, timed appropriately in your cycle, becomes invaluable later when perimenopause symptoms arrive. Discuss timing with your doctor.
The Nutrient and Organ Panel
10. Vitamin D (25-OH)
Under 20 ng/mL is deficiency; 30 to 50 ng/mL is the range most clinicians target. Test before supplementing, supplement to a target, retest.
11. Vitamin B12 and homocysteine
B12 deficiency causes fatigue and cognitive symptoms; homocysteine above roughly 15 umol/L suggests impaired methylation. Both are cheap to test and fix.
12. Comprehensive metabolic panel and CBC
The unglamorous basics: liver enzymes, kidney function, electrolytes, plus a complete blood count. Never skip the basics chasing exotic markers.
What About Biological Age Tests
Epigenetic “biological age” tests are interesting but not yet actionable. Estimates can swing substantially between companies, with no established clinical protocol for the number. Get the fundamentals tracked first; revisit the exotic tests when the science gives them something to say.
How Often to Test, and What to Do With Results
Longevity Biomarker Tracker
The biomarker categories from the article. Use this as a discussion list with your doctor, not a self-ordered lab panel.
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Inflammation
Metabolic
Hormonal
Nutrients and organs
One-time
Test the full panel annually, Lp(a) only once ever, and recheck anything abnormal in 3 to 6 months after an intervention. The point of tracking is trend lines, not single snapshots. Bring results to a doctor who understands preventive medicine. You want a clinician who treats trends and risk, not just flags. Blood work will not make you live longer by itself. But it is the difference between guessing and knowing. Also see our best longevity clinics in Los Angeles and the supplement stack cost comparison.
