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.