Enter your results to see how each compares with the categories clinicians use, such as the American Diabetes Association's HbA1c cut-offs or the NIH's vitamin D ranges. Every category links to its source.
Most standard annual bloodwork panels are designed to detect disease, not to optimize longevity. A longevity-focused panel is different in scope, in the reference ranges used for interpretation, and in how frequently certain markers should be tracked.
The following biomarkers should be tested at least annually for any adult over 35 interested in proactive longevity medicine. These are either widely available through standard lab orders or easily accessible through direct-to-consumer lab services.
LDL cholesterol, HDL cholesterol and triglycerides (the standard lipid panel), ApoB (counts atherogenic particles; most informative when it and LDL disagree), Lp(a) (levels are largely inherited) and hsCRP (an inflammation marker used to refine cardiovascular risk).
HbA1c and fasting glucose (the standard tests for prediabetes and diabetes), fasting insulin and HOMA-IR (useful for tracking insulin resistance, although there are no agreed cut-offs), ALT (a liver enzyme whose healthy upper limit is lower than many lab ranges), eGFR (kidney function) and uric acid.
TSH (with free T4 if TSH is abnormal), 25-OH vitamin D (20 to 50 ng/mL is generally adequate), vitamin B12, the omega-3 index and, for men with symptoms, a morning total testosterone.
Not all longevity biomarkers come from blood. VO₂max (strongly linked to lower mortality — test via graded exercise test or validated field test like the 12-minute Cooper test), grip strength (dynamometry — the Lancet PURE study found it predicted cardiovascular mortality better than blood pressure in 140,000 people), and resting heart rate (below 60 bpm reflects strong cardiovascular efficiency). HRV (heart rate variability) via a wearable adds daily trend data that lab tests cannot provide.
Once the Tier 1 panel is established as a baseline, the following tests add meaningful depth for adults serious about longevity optimization. They are more expensive and less universally available, but provide information not obtainable through standard panels.
CAC Score (Coronary Artery Calcium): A CT scan that measures calcified plaque in the heart’s arteries. Under the 2026 US dyslipidemia guideline it is used selectively, when a decision about cholesterol treatment is uncertain: a score of zero may support deferring treatment in selected people without major high-risk conditions, and detectable calcium increasingly favours treatment as the score rises. See our CAC scoring article for the details.
DEXA Scan (Body Composition): Measures lean mass, fat mass and bone density, and on many machines visceral fat. BMI cannot tell muscle from fat, and in older adults a low muscle mass index predicted higher mortality (Srikanthan et al., Am J Med 2014). Bone density screening is recommended for women 65 and older and for younger postmenopausal women at increased risk; guidelines do not set how often to repeat a scan for body composition alone.
Omega-3 Index: Measures EPA and DHA as a percentage of total fatty acids in red blood cell membranes — a 3-month average of omega-3 status. Below 4% is associated with high cardiovascular risk. In the paper that proposed it, 8% or more was linked to the lowest risk. Unlike blood plasma omega-3 tests, the RBC index is not acutely affected by recent fish consumption.
Epigenetic Age Testing: Consumer tests based on DNA methylation clocks, such as GrimAge or DunedinPACE, estimate biological age. In research cohorts these clocks predict health outcomes, but results can differ between tests and laboratories, and no guideline recommends them or uses them to guide treatment. Our epigenetic clocks article explains what they can and cannot tell you.
Enter your lab results and the tool places each one in a category based on the laboratory reference range and, where they exist, clinical guideline cut-offs, such as the cholesterol thresholds in the 2026 dyslipidemia guideline (ACC/AHA). Each category links to its source.
It does not use unofficial “optimal” ranges, because raising or lowering a marker to hit them is often unproven: in the VITAL trial, for example, vitamin D supplements did not lower cancer or cardiovascular events (VITAL). Units and reference ranges differ between laboratories.
A result outside the reference range is a prompt to discuss it with your clinician, who will consider repeat testing, your symptoms and your other results. One borderline value is rarely meaningful on its own.
A lab's reference range describes the middle 95% of results in healthy people. Clinical guidelines add cut-offs where the risk of disease or the need for treatment changes, such as the HbA1c levels that define prediabetes and diabetes. Those are the categories this tool uses, and each one links to its source.
Many longevity sites go further and grade results against tighter "optimal" ranges, such as an HbA1c below 5.3% or vitamin D of 40 to 60 ng/mL. For most markers no guideline defines such a range, and some are contradicted by the evidence: the NIH notes that vitamin D above 50 ng/mL can be associated with adverse effects, and in the VITAL trial, vitamin D supplements did not reduce cancer or cardiovascular events in generally healthy adults.
For some markers, risk keeps falling as the number improves. LDL cholesterol is the clearest example, which is why US guidelines base treatment on your overall cardiovascular risk rather than on a single "normal" value. A result in the usual range is reassuring but not a guarantee, and one outside it is a reason to talk with your clinician, not a diagnosis.
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