Where Do I Start?
New to longevity testing? This guide walks you through the essential first panel every adult should get, what the results mean, and how to build from there.
Key Takeaways
- →A comprehensive metabolic and lipid panel is the best starting point for any adult over 30.
- →Adding ApoB, hsCRP, and fasting insulin to a standard panel dramatically increases its predictive value.
- →Test at least annually; semi-annually if you are actively optimizing lifestyle or medication.
- →Always interpret results in context with a knowledgeable physician — isolated numbers rarely tell the full story.
If you are new to longevity testing, the sheer number of available biomarkers can feel overwhelming. Hundreds of tests exist, ranging from a simple lipid panel to whole-genome sequencing. The good news: you do not need all of them. A well-chosen starting panel of 15–20 markers can reveal the vast majority of modifiable risk factors for cardiovascular disease, metabolic dysfunction, and chronic inflammation — the three pillars that drive most age-related disease.
The Essential Starting Panel
The American Heart Association, European Society of Cardiology, and leading longevity physicians broadly agree on a core set of markers. Below is the panel we recommend as a minimum baseline for any health-conscious adult.
- •Lipid panel — Total cholesterol, LDL-C, HDL-C, triglycerides, and ideally ApoB. ApoB is increasingly recognized as the single best lipid marker for cardiovascular risk, superior to LDL-C alone (European Heart Journal, 2021).
- •Metabolic markers — Fasting glucose, HbA1c, and fasting insulin. HbA1c reflects your average blood sugar over 2–3 months. Fasting insulin can detect insulin resistance years before glucose rises.
- •Inflammatory markers — High-sensitivity C-reactive protein (hsCRP). Elevated hsCRP is independently associated with increased cardiovascular events, even when cholesterol is normal (JUPITER trial, NEJM 2008).
- •Liver function — ALT and GGT. Elevated ALT may indicate non-alcoholic fatty liver disease (NAFLD), which affects roughly 25% of adults globally (Journal of Hepatology, 2016).
- •Kidney function — eGFR and creatinine. Chronic kidney disease is often asymptomatic until advanced stages.
- •Thyroid — TSH at minimum, plus free T4 if TSH is abnormal.
- •Complete blood count (CBC) — Screens for anemia, infection, and blood disorders.
Why ApoB should be in every panel
A 2022 meta-analysis in JAMA Cardiology found that ApoB was a stronger predictor of cardiovascular events than LDL-C across all levels of discordance. The European Atherosclerosis Society now recommends ApoB as a primary target for lipid-lowering therapy.
How to Interpret Your Results
Lab reference ranges are based on population averages — not optimal health. A result that falls within the "normal" range may still indicate elevated risk. For example, a fasting glucose of 99 mg/dL is technically normal but sits at the upper boundary of the reference range and may reflect early metabolic dysfunction. Longevity-oriented physicians often target tighter optimal ranges.
Do not self-diagnose from lab results
Biomarkers should always be interpreted by a qualified physician in the context of your full medical history, medications, and symptoms. A single out-of-range result does not necessarily indicate disease.
How Often to Test
For most adults, annual testing is sufficient to track trends. If you are making significant lifestyle changes (diet, exercise, sleep) or starting a new medication (such as a statin), retesting after 3–6 months helps assess your response. Some markers like Lp(a) are genetically determined and only need to be tested once.
Where to Get Tested
You have several options: your primary care physician can order most of these tests and they may be covered by insurance. Direct-to-consumer services like Function Health and InsideTracker offer comprehensive panels without a doctor's order. Quest Diagnostics and Labcorp also offer self-pay options. Whichever route you choose, consistency matters — try to use the same lab each time for comparable results.
Next Steps After Your First Panel
Once you have baseline results, you can make informed decisions about which advanced tests to pursue. If your cardiovascular markers are borderline, consider a coronary artery calcium (CAC) score. If metabolic markers are concerning, continuous glucose monitoring (CGM) may provide actionable insight. If everything looks good, retest in 12 months and consider adding biological age testing to track your rate of aging over time.