Bloodwork Decoded — Optimal Biomarker Ranges for Longevity

Metabolic Health

Metabolic Biomarkers

Insulin resistance is the silent driver behind cardiovascular disease, neurodegeneration, and accelerated aging. These markers catch it years before fasting glucose moves.

Biomarker	"Normal" Range	Optimal for Longevity	Why It Matters
Fasting Glucose	70–99 mg/dL	< 85 mg/dL	Every point above 85 incrementally increases glycation damage. At 99 you're "normal" but already insulin resistant.
Fasting Insulin	2.6–24.9 µIU/mL	< 5 µIU/mL	The earliest metabolic warning sign. Above 10 signals resistance even with normal glucose. Most docs don't test this — request it.
HbA1c	< 5.7%	< 5.2%	3-month glucose average. More reliable than a single fasting glucose. Reflects sustained metabolic health.
HOMA-IR	< 2.5	< 1.0	Calculated from fasting glucose × fasting insulin ÷ 405. The gold standard for insulin sensitivity without a clamp test.

Cardiovascular Risk

Cardiovascular Biomarkers

Heart disease is still the #1 killer. These markers — especially ApoB — predict risk far better than the standard lipid panel your doctor orders.

Biomarker	"Normal" Range	Optimal for Longevity	Why It Matters
ApoB	< 130 mg/dL	< 80 mg/dL	One ApoB per atherogenic particle. Best single predictor of cardiovascular events. Superior to LDL-C alone. Peter Attia calls this "the most important blood test."
Lp(a)	< 30 mg/dL	< 30 mg/dL (genetic)	90% genetically determined — test once, it won't change. If elevated, it substantially multiplies your ASCVD risk and changes your intervention strategy.
Triglycerides	< 150 mg/dL	< 70 mg/dL	High triglycerides signal metabolic dysfunction and small dense LDL. The triglyceride/HDL ratio is a proxy for insulin resistance.
HDL-C	> 40 mg/dL (M) / > 50 (F)	> 55 mg/dL	Reverse cholesterol transport. Higher is generally better up to a point. Exercise, omega-3s, and moderate alcohol intake raise it.
Homocysteine	5–15 µmol/L	< 8 µmol/L	Elevated levels damage blood vessel walls and correlate with cardiovascular events and cognitive decline. Methylated B vitamins bring it down.

Inflammation

Inflammation Biomarkers

Chronic low-grade inflammation — "inflammaging" — is a hallmark of biological aging. These markers quantify it.

Biomarker	"Normal" Range	Optimal for Longevity	Why It Matters
hs-CRP	< 3.0 mg/L	< 0.5 mg/L	The most validated inflammation marker. Under 1.0 is "low risk" but under 0.5 is what centenarians average. Above 3.0 warrants investigation.
IL-6	< 7 pg/mL	< 1.5 pg/mL	Master inflammatory cytokine. Rises with age, visceral fat, and poor sleep. Chronically elevated IL-6 accelerates every aging pathway.
Fibrinogen	200–400 mg/dL	200–300 mg/dL	Acute phase reactant and clotting factor. Elevated levels indicate chronic inflammation and increased clot risk.

Hormones & Nutrients

Hormonal & Nutrient Biomarkers

Hormone optimization is one of the highest-impact interventions available, especially after 35. These aren't just about deficiency — they're about optimal function.

Biomarker	"Normal" Range	Optimal for Longevity	Why It Matters
Vitamin D (25-OH)	30–100 ng/mL	50–80 ng/mL	Regulates 1,000+ genes. Below 40 impairs immune function. Test quarterly if supplementing 5,000 IU+.
Testosterone (Total)	264–916 ng/dL (M)	600–900 ng/dL	Declines ~1% per year after 30. Low T accelerates sarcopenia, bone loss, cognitive decline, and cardiovascular risk.
Free T3	2.0–4.4 pg/mL	3.0–4.0 pg/mL	The active thyroid hormone. Low-normal T3 slows metabolism, impairs cognition, and correlates with depression. TSH alone misses this.
DHEA-S	Age-dependent	Upper quartile for age	The "mother hormone" — precursor to both testosterone and estrogen. Declines steeply with age. Tracks biological aging.
Ferritin	12–300 ng/mL (M)	40–100 ng/mL	Iron storage protein. Too low = anemia. Too high = oxidative stress and organ damage. Blood donation is the most effective way to lower it.
RBC Magnesium	4.2–6.8 mg/dL	> 5.5 mg/dL	Serum magnesium misses 80% of deficiency. RBC mag reflects true cellular status. Most people are deficient.

Testing Strategy

How to Build Your Panel

Baseline Panel (Everyone)

Start here. Get a comprehensive metabolic panel (CMP), complete blood count (CBC), lipid panel, HbA1c, fasting insulin, hs-CRP, vitamin D, and thyroid panel (TSH, Free T3, Free T4). Total cost through direct-to-consumer labs: $150–$300.

Optimization Panel (Add at 30+)

Add ApoB, Lp(a) (once), homocysteine, testosterone (total + free), DHEA-S, IGF-1, and RBC magnesium. This catches cardiovascular risk and hormonal decline years before symptoms appear.

Advanced Panel (Add at 40+)

Add fasting insulin, HOMA-IR, IL-6, fibrinogen, and GlycanAge or TruAge for epigenetic clock testing. Consider a coronary artery calcium (CAC) score — the single best predictor of cardiovascular events.

Testing Frequency

Baseline: every 6 months for the first year (to establish your trajectory). After that: annually minimum, quarterly if actively intervening. Lp(a) is one-and-done. CAC every 3–5 years. Directionality matters more than any single value — track the trend.

Your Blood Tells the Real Story