Building Your Longevity Testing Stack

With so many tests available, the question is not just what to test but how to combine tests into a coherent, cost-effective protocol that provides maximum insight. The ideal testing stack depends on your age, risk factors, family history, budget, and goals. Below we outline three tiers — essential, expanded, and comprehensive — along with recommended testing frequency.

Tier 1: Essential Stack ($300–$600/year)

This is the minimum recommended panel for any health-conscious adult over 30. It covers the biomarkers most predictive of cardiovascular disease, metabolic dysfunction, and chronic inflammation — the three drivers of most age-related disease.

• •Advanced lipid panel — ApoB, LDL-C, HDL-C, triglycerides, total cholesterol
• •Metabolic panel — Fasting glucose, HbA1c, fasting insulin
• •Inflammatory markers — hsCRP, homocysteine
• •Liver & kidney — ALT, GGT, eGFR, creatinine, cystatin C
• •CBC & thyroid — Complete blood count, TSH
• •Lp(a) — Once in a lifetime (add to first panel)
• •Frequency — Annually

Tier 2: Expanded Stack ($1,500–$3,000/year)

For adults over 40, those with family history of heart disease or cancer, or anyone actively optimizing health, this tier adds imaging and biological age testing to the essential panel.

• •Everything in Tier 1 plus:
• •Coronary artery calcium (CAC) score — Once at age 40–45, repeat every 3–5 years if score > 0 ($75–$200)
• •DEXA body composition — Annually. Tracks visceral fat, lean mass, and bone density ($50–$200)
• •Biological age testing (TruAge) — Every 6–12 months. Provides GrimAge, DunedinPACE ($229–$499)
• •Comprehensive blood panel — Function Health ($499/year for 100+ markers) or equivalent
• •Hormonal panel — DHEA-S, testosterone (total & free), estradiol, cortisol
• •Nutritional markers — Vitamin D, B12, folate, omega-3 index, magnesium RBC, ferritin

Tier 3: Comprehensive Stack ($5,000+/year)

This is the most thorough longevity testing protocol, incorporating every major testing modality: advanced blood work, full imaging, genetic sequencing, functional testing, and multi-cancer screening.

• •Everything in Tier 2 plus:
• •Whole-body MRI (Prenuvo) — Every 2–3 years ($1,500–$2,500). Screens for cancer, aneurysms, organ pathology.
• •CT angiography with Cleerly — If CAC > 0 or family history. Characterizes plaque composition ($500–$2,500).
• •Genetic testing — APOE, pharmacogenomics, polygenic risk scores. Once per lifetime ($200–$500).
• •Multi-cancer screening (GRAIL Galleri) — Annually for adults 50+ ($949).
• •VO2 max testing — Clinical test annually to track cardiorespiratory fitness ($150–$350).
• •Continuous glucose monitor (CGM) — 2–4 week session annually to assess glycemic patterns ($150–$400).
• •Gut microbiome testing — If digestive concerns or research interest ($150–$300).

How to Prioritize on a Budget

If you cannot afford a comprehensive stack, prioritize based on your personal risk factors. Family history of heart disease? Prioritize advanced lipids and CAC. Family history of cancer? Consider GRAIL Galleri. Concerned about metabolic health? Add fasting insulin and CGM. The single most important principle is consistency — testing annually and tracking trends over time is far more valuable than a single comprehensive snapshot.

Recommended Testing Timeline by Age

• •Age 30–39 — Start with Tier 1 annually. Add Lp(a) test once. Consider DEXA baseline.
• •Age 40–49 — Move to Tier 2. Get first CAC score. Add biological age testing. Consider genetic testing.
• •Age 50–59 — Consider Tier 3. Add MCED screening. Begin whole-body MRI. Increase screening frequency per guidelines.
• •Age 60+ — Full Tier 3 recommended. Close monitoring of cardiovascular, cancer, and metabolic risk. Annual CAC if previous score > 0.