A comprehensive blood testing panel for longevity

As mentioned in my research-based protocol for longevity, I am religious about blood testing and believe it's one of the best tools to help understand how each of my health systems is performing.

Every January, I get a very comprehensive blood testing panel done that includes over 100 biomarkers (127 to be precise). When paired with my annual Ezra full-body MRI, it's the perfect way to get a complete overview of my body.

Based on my January test results, I then do a set of monthly or quarterly tests depending on what I’m trying to improve or optimize. For example, over the past year, I have been doing cholesterol and testosterone testing almost monthly (I have high cholesterol and my testosterone has been trending down).

Here are all the tests I get, with a short explanation as to why. You can also find a link to my Google Sheets template at the end of this article. Important to note before we get started: a phlebotomist will need to extract about 15 blood vials to get all these done (oddly enough, I always enjoy it).

Overall health markers

First off, I start with a complete blood count and a few other markers that look at general inflammation and potential infection in the body.

Overall health markers
White Blood Cell Count (WBC Count)
Red Blood Cell Count (RBC Count)
Lymphocytes
Hemoglobin (Hgb)
Mean Corpuscular Volume (MCV)
Red Blood Cell Distribution Width (RDW)
Creatine kinase
Erythrocyte Sedimentation Rate (ESR)
Immunoglobulin A (IgA)
Hematocrit (Hct)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin Concentration (MCHC)
POLYS
MONOS
Eosinophils %
Basophils %
Neutrophils %
Monocytes %
Immature Granulocyte Automated
Platelet Count
Mean Platelet Volume

Metabolic health

I then do a super comprehensive metabolic health panel. The metabolic system is the body's energy factory, so I want to make sure it's running optimally. A comprehensive metabolic panel will also detect chronic disease such as diabetes.

Metabolic Health
Glucose (Blood)
Gamma GT (GGT)
Total Protein (Blood)
Globulin
Albumin/Globulin Ratio
Sodium
Potassium
Chloride
Carbon Dioxide
Calcium
Bilirubin
Aspartate Aminotransferase (AST, also SGOT)
Alanine Aminotransferase (ALT, also SGPT)
HighSensitivity CReactive Protein (hsCRP)
Insulin, Fasting
Hemoglobin A1C (ha1c)

Cardiovascular health

Next up, cardiovascular health. This is especially important for me personally, as I'm genetically predisposed to having high cholesterol and have a family history of heart disease. I have actually had high cholesterol for the past few years, so this year I decided to give up alcohol.

Cardiovascular health
Total Cholesterol
High Density Lipoprotein (HDL)
Low Density Lipoprotein (LDL), Direct
Very Low Density Lipoprotein (VLDL)
Cholesterol/HDL Ratio
HDL as % of Cholesterol
LDL/HDL Ratio
Triglyceride
Triglyceride/HDL ratio
NonHDL Cholesterol
Omega 3 levels
Apolipoprotein B - ApoB
Lipoprotein a - Lp(a)
LDLP
LDL III
LDL IV
HDLP
HDL 2b
RLP
NON HDLP
VLDL PARTICLES
Coenzyme Q10

Reproductive health

My reproductive health panel was designed for males, so it might not include everything a woman might want to test. That said, I do include some estrogen testing (such as estradiol), which is more frequently tested in women.

Reproductive health
Testosterone, Total
Sex Hormone Binding Globulin
Testosterone, Free (Calc)
Estradiol
DHEA-S
FSH
LH
Prostate Specific Ag (PSA)
Free PSA Component
Percent Free PSA

Vitamins, minerals, and micronutrients

This is one of the panels I sometimes do more frequently (monthly or quarterly), depending on what the results look like. I modify my supplement & vitamin intake based on these blood tests.

I also recently invested in a startup (still in stealth) that creates personalized supplements based on your blood tests. More on this when they launch.

Vitamins / Minerals / Micronutrients
VITB1,THIAMINE,TOTAL
VIT.B2,RIBOFLAVIN
VIT.B6,PYRIDOX.PHOS
Vitamin B12
HOMOCYSTEINE, SERUM
ZINC, RBC
Methylmalonic Acid(MMA)
Vitamin D, 25Hydroxy
MAGNESIUM, RBC
IODINE, SERUM/PLASMA
25OH Vitamin D2
25OH Vitamin D3
SELENIUM,SER/PLASMA

Metals

I live in a very urban area, so it's a good idea to test for environmental pollutants. One of the pollutants we're constantly exposed to - in our food, environment, water is metals, so it's a good idea to test for them. Also, some people are genetically predisposed to iron overload, which can lead to serious damage to the heart, liver, and pancreas.

Metals
Ferritin
Hematocrit (Hct)
RBC FOLATE
Iron
LEAD, BLOOD (ADULT)
COPPER,PLASMA/SERUM
MERCURY, BLOOD

Organ-specific tests

I then do a few blood tests that look for potential issues in specific organs - thyroid, liver, and kidneys, and a complete urinalysis (mostly for kidney issues & infections).

Liver
Alkaline Phosphatase (ALP)
Lactate dehydrogenase (LDH)
Kidneys
Albumin (g/dL)
Creatinine
Uric Acid
Blood Urea Nitrogen (BUN)
Estimated Glomerular Filtration Rate non African American (eGFR nonAA)
Estimated Glomerular Filtration Rate African American (eGFR African American)
BUN/Creatinine Ratio
Cystatin-C
Urinalysis
Specific Gravity
pH
Protein (Urine)
Glucose (Urine)
Ketone
Urobilinogen
Bilirubin Indirect (Urine)
Blood (Urine)
Nitrite
Crystals
White Blood Cells (Urine)
Red Blood Cells (Urine)
CAST, RBC, URINE
Hyaline Casts
Epithelial Cells
Granular Casts
Bacteria (Urine)
CRYSTAL, AMOUNT
Leukocyte Esterase
Color
CHARACTER, URINE

To wrap up, what's most important about all these blood tests is tracking the trends over time. It's likely that 90% of them will look fine for you, and what you want to make sure is that they continue to look fine as you age. The easiest way I've found to track the data over time is a google spreadsheet, so I've created a template you can duplicate and use. You can find it here.

Finally, if you'll need a primary care physician to prescribe these tests and a lab to do them. For physicians, I recommend a service such as Parsley Health. For blood testing, I recommend Quest Diagnostics as they can do all the tests described above.

If you have any questions, please feel free to email or DM me on Twitter.