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Comprehensive Guide
Your blood tells the truth about your health years before symptoms appear. This guide covers every major panel — CBC, CMP, lipids, thyroid, iron, hormones, inflammation markers — with optimal ranges, not just “normal” ranges. Learn what to test, when to test, and how to order your own labs.
50+
Individual markers explained
9
Major panel categories
100%
Optimal ranges included
5
Ways to order your own labs
The Core Problem
Understanding this distinction is the single most important concept in this guide. It changes how you read every lab result.
Population-based — includes sick people
Longevity-based — lowest mortality
The bottom line: Every marker in this guide includes both the standard reference range and the optimal range based on longevity research. When your doctor says your labs are “normal,” ask yourself: are they optimal? That question alone can change your healthspan trajectory.
Panel 1
The most commonly ordered blood test. The CBC evaluates your red blood cells (oxygen transport), white blood cells (immune defense), and platelets (clotting). It screens for anemia, infection, blood cancers, clotting disorders, and nutritional deficiencies.
Total white blood cell count — your immune system's army. Includes neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
Standard Range
4,500 - 11,000 /uL
Optimal Range
5,000 - 7,500 /uL
Causes If High
Infection, inflammation, stress, leukemia, steroid use, smoking
Causes If Low
Immune suppression, bone marrow disorders, autoimmune disease, viral infection
Oxygen-carrying cells. RBC count reflects bone marrow health, hydration status, and oxygen-carrying capacity.
Standard Range
4.5 - 5.5 M/uL (men), 4.0 - 5.0 M/uL (women)
Optimal Range
4.7 - 5.3 M/uL (men), 4.2 - 4.8 M/uL (women)
Causes If High
Dehydration, polycythemia vera, chronic hypoxia, high altitude, EPO use
Causes If Low
Anemia (iron, B12, or folate deficiency), chronic disease, blood loss, bone marrow failure
The protein inside red blood cells that binds oxygen. More functionally important than RBC count — determines actual oxygen delivery to tissues.
Standard Range
13.5 - 17.5 g/dL (men), 12.0 - 16.0 g/dL (women)
Optimal Range
14.5 - 16.5 g/dL (men), 13.0 - 15.0 g/dL (women)
Causes If High
Dehydration, polycythemia, COPD, testosterone use, high altitude
Causes If Low
Iron deficiency anemia, chronic disease, blood loss, B12/folate deficiency
Percentage of blood volume occupied by red blood cells. A high hematocrit means thick blood and increased clot risk.
Standard Range
38.3 - 48.6% (men), 35.5 - 44.9% (women)
Optimal Range
42 - 47% (men), 37 - 43% (women)
Causes If High
Dehydration, testosterone/TRT, polycythemia, sleep apnea, high altitude
Causes If Low
Anemia, overhydration, chronic disease, blood loss
Clotting cells. Essential for wound healing but excess platelets increase cardiovascular clot risk.
Standard Range
150,000 - 400,000 /uL
Optimal Range
200,000 - 300,000 /uL
Causes If High
Iron deficiency, inflammation, infection, myeloproliferative disorders, post-splenectomy
Causes If Low
Viral infections, autoimmune disorders (ITP), liver disease, B12/folate deficiency, medications
Average size of red blood cells. Small cells (microcytic) suggest iron deficiency. Large cells (macrocytic) suggest B12 or folate deficiency.
Standard Range
80 - 100 fL
Optimal Range
85 - 95 fL
Causes If High
B12 deficiency, folate deficiency, hypothyroidism, liver disease, alcohol use, certain medications
Causes If Low
Iron deficiency, thalassemia trait, chronic disease, lead poisoning
Panel 2
The CMP evaluates 14 markers covering glucose metabolism, kidney function, liver function, electrolytes, and protein status. It is the workhorse panel for assessing organ health and metabolic function.
Blood sugar after a 12-hour fast. The most basic metabolic marker but rises late in disease — insulin and HbA1c catch problems earlier.
Standard Range
70 - 100 mg/dL
Optimal Range
72 - 85 mg/dL
Waste product from protein metabolism filtered by kidneys. Reflects kidney function and protein intake. Very high BUN with normal creatinine may indicate dehydration or excessive protein.
Standard Range
7 - 20 mg/dL
Optimal Range
10 - 16 mg/dL
Byproduct of muscle metabolism filtered by kidneys. The primary marker for kidney function. Higher in muscular individuals — interpret in context of body composition.
Standard Range
0.7 - 1.3 mg/dL (men), 0.6 - 1.1 mg/dL (women)
Optimal Range
0.8 - 1.2 mg/dL (men), 0.6 - 1.0 mg/dL (women)
Calculated from creatinine, age, sex, and race. Estimates how well your kidneys filter blood. The gold standard for assessing kidney health.
Standard Range
> 60 mL/min
Optimal Range
> 90 mL/min
Liver enzyme also found in heart and muscle. Elevated by liver damage, strenuous exercise, heart attack, or medication toxicity. Always interpret alongside ALT.
Standard Range
10 - 40 U/L
Optimal Range
15 - 30 U/L
Most specific liver enzyme. Elevated ALT with normal AST usually means liver-specific damage (fatty liver, medication, alcohol). Elevated ALT is an early marker for non-alcoholic fatty liver disease (NAFLD).
Standard Range
7 - 56 U/L
Optimal Range
10 - 25 U/L
Protein made by the liver. Reflects liver function, nutritional status, and chronic inflammation. Low albumin is a strong predictor of all-cause mortality in elderly populations.
Standard Range
3.5 - 5.5 g/dL
Optimal Range
4.2 - 5.0 g/dL
Electrolyte panel. Governs nerve function, muscle contraction, fluid balance, and acid-base status. Imbalances can be life-threatening. Potassium is particularly important for heart rhythm.
Standard Range
Na: 136-145 | K: 3.5-5.0 | Cl: 98-106 | CO2: 23-29 (mEq/L)
Optimal Range
Na: 139-142 | K: 4.0-4.5 | Cl: 100-104 | CO2: 24-28 (mEq/L)
Critical for bone health, nerve signaling, muscle contraction, and heart rhythm. Consistently elevated calcium (hypercalcemia) should be investigated for hyperparathyroidism.
Standard Range
8.5 - 10.5 mg/dL
Optimal Range
9.2 - 10.0 mg/dL
Want This Personalized?
This guide gives you the science. A CryoCove coach gives you the personalization — the right dose, timing, and integration with your other 8 pillars.
Panel 3
The lipid panel is the most misunderstood set of labs in medicine. Total cholesterol and LDL-C dominate headlines but ApoB is the superior marker. This section explains what actually matters for cardiovascular risk.
Sum of all cholesterol fractions. A crude measure — total cholesterol alone is a poor predictor of cardiovascular risk. ApoB and particle count are far more informative.
Standard Range
< 200 mg/dL
Optimal Range
150 - 200 mg/dL
Clinical Note
Total cholesterol can be misleadingly 'high' if HDL is very high (which is protective). Always look at the breakdown.
Calculated or measured LDL cholesterol concentration. The traditional cardiovascular risk marker, but LDL-C measures cholesterol content, not particle number. Two people with the same LDL-C can have very different particle counts (and risk).
Standard Range
< 130 mg/dL (general), < 100 mg/dL (at-risk)
Optimal Range
< 100 mg/dL (ideally < 70 mg/dL for longevity)
Clinical Note
LDL-C can be falsely low in people with small, dense LDL particles (which are more atherogenic). ApoB is the superior marker.
Reverse cholesterol transport — HDL removes cholesterol from artery walls and returns it to the liver. Higher HDL is generally protective, though very high HDL (> 100) may reflect dysfunctional HDL in some genetic variants.
Standard Range
> 40 mg/dL (men), > 50 mg/dL (women)
Optimal Range
50 - 90 mg/dL
Clinical Note
Exercise, omega-3s, moderate alcohol, and niacin raise HDL. Low HDL is a strong independent risk factor for cardiovascular disease.
Fat in the blood, largely driven by carbohydrate and sugar intake (not dietary fat). Elevated triglycerides are a marker for insulin resistance and metabolic syndrome. The triglyceride-to-HDL ratio is a powerful proxy for insulin resistance.
Standard Range
< 150 mg/dL
Optimal Range
< 75 mg/dL
Clinical Note
Trig:HDL ratio < 1.0 = excellent insulin sensitivity. Ratio > 3.0 = likely insulin resistant. Fasting is essential for accurate measurement.
One ApoB molecule per atherogenic particle (LDL, VLDL, IDL, Lp(a)). This directly counts the number of particles that can deposit cholesterol in artery walls. ApoB is the single best predictor of cardiovascular risk — better than LDL-C, total cholesterol, or any ratio.
Standard Range
< 130 mg/dL
Optimal Range
< 60 mg/dL (longevity target)
Clinical Note
If you only test one lipid marker for cardiovascular risk, make it ApoB. Peter Attia and other longevity physicians consider this the most important cardiovascular biomarker.
Genetically determined lipoprotein particle — an LDL particle with an extra protein (apo(a)) attached. Highly atherogenic and prothrombotic. Lp(a) is 90%+ determined by genetics and does not respond to diet or lifestyle changes.
Standard Range
< 30 mg/dL (or < 75 nmol/L)
Optimal Range
< 14 mg/dL (or < 35 nmol/L)
Clinical Note
Test once in your lifetime — it does not change significantly. If elevated, you need more aggressive ApoB reduction to compensate. Approximately 20% of people have elevated Lp(a). Niacin and PCSK9 inhibitors can lower it modestly.
The key takeaway: If your doctor only orders a standard lipid panel (total cholesterol, LDL-C, HDL-C, triglycerides), request ApoB and Lp(a) in addition. ApoB is the single most predictive cardiovascular biomarker, and Lp(a) identifies a genetic risk that affects 1 in 5 people and is completely invisible on a standard panel.
Panel 4
The thyroid controls your metabolic rate, energy, weight, mood, body temperature, and cognitive speed. Most doctors only test TSH, missing the full picture. A complete thyroid panel requires five markers.
Pituitary hormone that signals the thyroid to produce hormones. The primary screening marker. Higher TSH means the pituitary is working harder to stimulate an underperforming thyroid.
Standard Range
0.45 - 4.5 mIU/L
Optimal Range
1.0 - 2.0 mIU/L
Clinical Note
A TSH of 3.5 mIU/L is 'normal' by standard criteria but may indicate subclinical hypothyroidism. Many people feel best with TSH between 1.0 and 2.0.
The main hormone produced by the thyroid gland. T4 is the 'storage' hormone — it must be converted to T3 (the active form) by the liver, gut, and peripheral tissues. Free T4 measures the unbound, bioavailable fraction.
Standard Range
0.82 - 1.77 ng/dL
Optimal Range
1.1 - 1.5 ng/dL
Clinical Note
Low free T4 with elevated TSH confirms hypothyroidism. Low free T4 with low/normal TSH may indicate pituitary dysfunction (secondary hypothyroidism).
The active thyroid hormone — 4-5x more potent than T4. T3 sets metabolic rate, body temperature, energy levels, heart rate, and cognitive speed. Many doctors skip this test but it is essential.
Standard Range
2.0 - 4.4 pg/mL
Optimal Range
3.0 - 3.8 pg/mL
Clinical Note
Low free T3 with normal T4 indicates a T4-to-T3 conversion problem, which is common with low iron, selenium deficiency, chronic stress, or gut dysfunction.
Inactive metabolite of T4. The body produces reverse T3 during chronic stress, illness, inflammation, or caloric restriction to slow metabolism. High rT3 blocks T3 receptors.
Standard Range
9.2 - 24.1 ng/dL
Optimal Range
< 15 ng/dL
Clinical Note
The free T3 to reverse T3 ratio matters more than rT3 alone. A ratio > 20 (when both are measured in the same units) indicates good conversion. A low ratio explains hypothyroid symptoms despite 'normal' TSH and T4.
Antibodies against thyroid tissue — markers for autoimmune thyroid disease (Hashimoto's or Graves'). TPO antibodies are found in 90%+ of Hashimoto's cases. Elevated antibodies can precede thyroid dysfunction by years.
Standard Range
TPO-Ab: < 34 IU/mL, TgAb: < 115 IU/mL
Optimal Range
As close to zero as possible
Clinical Note
If antibodies are elevated, aggressively address gut health (the gut-thyroid connection), reduce gluten (molecular mimicry with thyroid tissue in susceptible individuals), optimize selenium (200 mcg/day reduces TPO antibodies), and manage stress.
Standard practice is to test TSH only. If TSH is “normal” (0.45-4.5 mIU/L), your thyroid is considered fine. But this misses: (1) subclinical hypothyroidism with TSH in the 2.5-4.5 range, (2) T4-to-T3 conversion problems (normal TSH and T4 but low free T3), (3) excess reverse T3 blocking T3 receptors, and (4) autoimmune thyroid disease (Hashimoto’s) identified by antibodies before TSH ever moves. Always request the full five-marker panel.
Panel 5
Iron is essential for oxygen transport, energy production, and immune function, but both deficiency and excess are harmful. Iron deficiency is the most common nutritional deficiency worldwide. Hereditary iron overload (hemochromatosis) affects 1 in 200 people of European descent.
Iron storage protein. The most sensitive marker for iron deficiency (drops before hemoglobin) and iron overload. Also an acute-phase reactant — rises with inflammation, infection, and liver disease.
Standard Range
12 - 300 ng/mL (men), 12 - 150 ng/mL (women)
Optimal Range
40 - 100 ng/mL
Clinical Note
Ferritin < 30 ng/mL = iron deficiency, even if hemoglobin is still 'normal.' Ferritin > 200 ng/mL in men or > 150 ng/mL in women warrants investigation for hemochromatosis or inflammation. Always interpret alongside hs-CRP.
Amount of iron circulating in the blood bound to transferrin. Fluctuates significantly with meals and time of day. Less useful alone — always interpret as part of the full iron panel.
Standard Range
60 - 170 mcg/dL (men), 50 - 170 mcg/dL (women)
Optimal Range
80 - 130 mcg/dL
Clinical Note
Serum iron is highest in the morning and after meals. Always draw fasting and in the morning for consistency.
Measures the blood's capacity to bind iron with transferrin. TIBC rises when the body needs more iron (iron deficiency) and falls when iron is abundant (iron overload or inflammation).
Standard Range
250 - 370 mcg/dL
Optimal Range
260 - 340 mcg/dL
Clinical Note
High TIBC = body is iron-hungry (deficiency). Low TIBC = iron overload, chronic disease, or inflammation. TIBC and ferritin move in opposite directions in iron deficiency.
Percentage of transferrin protein that is loaded with iron. Calculated as (serum iron / TIBC) x 100. The most clinically useful iron panel marker after ferritin.
Standard Range
20 - 50%
Optimal Range
25 - 40%
Clinical Note
Saturation < 20% = iron deficiency. Saturation > 45% = investigate for hemochromatosis (hereditary iron overload affecting 1 in 200 people of European descent). High transferrin saturation causes oxidative damage to organs.
Panel 6
Metabolic dysfunction is the root cause of most chronic disease. HbA1c, fasting insulin, and HOMA-IR together give you the complete picture of your metabolic health. Fasting insulin is the earliest warning signal — it rises years before glucose.
Three-month average of blood sugar levels. Hemoglobin gets 'glycated' (sugar-coated) in proportion to blood glucose exposure. Unlike fasting glucose, HbA1c captures the full picture including post-meal spikes.
Standard Range
< 5.7% (normal), 5.7-6.4% (prediabetes), > 6.5% (diabetes)
Optimal Range
4.8 - 5.2%
Clinical Note
An HbA1c of 5.5% is 'normal' but correlates with higher cardiovascular and all-cause mortality than 5.0%. Every 0.1% reduction in HbA1c meaningfully reduces risk. False readings in people with anemia, hemoglobin variants, or very high red blood cell turnover.
The most important metabolic marker that most doctors never order. Insulin rises years before glucose or HbA1c in the progression toward metabolic disease. By the time fasting glucose is elevated, insulin resistance has been present for 5-10 years.
Standard Range
2.6 - 24.9 uIU/mL
Optimal Range
2 - 6 uIU/mL
Clinical Note
Fasting insulin > 8 uIU/mL = early insulin resistance. > 12 uIU/mL = significant insulin resistance. Must be drawn after a genuine 12-14 hour fast. Cold exposure, fasting, exercise, sleep, and low-carb diets all improve insulin sensitivity.
Calculated as (fasting glucose x fasting insulin) / 405. The best single estimate of insulin resistance — combines both glucose and insulin into one score. Requires both fasting glucose and fasting insulin to calculate.
Standard Range
< 2.5
Optimal Range
< 1.0
Clinical Note
HOMA-IR < 1.0 = excellent insulin sensitivity. 1.0 - 2.0 = normal. > 2.5 = insulin resistant. > 4.0 = severe insulin resistance. This is the single best metabolic screening tool and should be standard care.
If you cannot get fasting insulin tested, the triglyceride-to-HDL ratio from a standard lipid panel is a surprisingly good proxy for insulin resistance. Divide your triglycerides by your HDL: a ratio < 1.0 indicates excellent insulin sensitivity, 1.0-2.0 is normal, and > 3.0 strongly suggests insulin resistance. It is not as precise as fasting insulin, but it is free with any standard lipid panel.
Panel 7
Chronic inflammation is the root driver of cardiovascular disease, diabetes, cancer, neurodegeneration, and depression. These four markers give you a comprehensive view of your inflammatory status.
The gold standard general inflammation marker. CRP is produced by the liver in response to inflammatory cytokines (IL-6, TNF-alpha). Predicts cardiovascular events independently of cholesterol.
Standard Range
< 3.0 mg/L
Optimal Range
< 0.5 mg/L
Clinical Note
hs-CRP > 2.0 mg/L doubles cardiovascular risk. Common causes of chronic elevation: visceral fat, poor diet (seed oils, sugar), poor sleep, chronic stress, gut permeability, dental infections. Cold exposure and sauna use both reduce hs-CRP.
How quickly red blood cells settle in a tube over one hour. Inflammatory proteins cause red blood cells to clump and settle faster. Less specific than hs-CRP but useful as a complementary marker.
Standard Range
< 20 mm/hr (men), < 30 mm/hr (women)
Optimal Range
< 10 mm/hr
Clinical Note
ESR tends to be elevated with autoimmune conditions, chronic infections, and cancer. It increases with age. Very high ESR (> 100 mm/hr) warrants immediate investigation for serious conditions.
Amino acid that damages blood vessel endothelium when elevated. Reflects methylation status and B-vitamin sufficiency (B12, folate, B6). Independently linked to cardiovascular disease, stroke, dementia, and depression.
Standard Range
< 15 umol/L
Optimal Range
< 7 umol/L
Clinical Note
Elevated homocysteine is one of the most treatable cardiovascular risk factors — it often responds to methylated B-vitamins (methylfolate, methylcobalamin, P5P) within weeks. MTHFR gene variants impair folate metabolism and are a common cause.
Byproduct of purine metabolism. Elevated uric acid drives inflammation, oxidative stress, endothelial dysfunction, and is strongly associated with metabolic syndrome. Historically associated only with gout, but emerging research links it to cardiovascular disease, hypertension, and kidney disease.
Standard Range
3.5 - 7.2 mg/dL (men), 2.6 - 6.0 mg/dL (women)
Optimal Range
4.0 - 5.5 mg/dL
Clinical Note
Fructose is the primary dietary driver of uric acid elevation (fructose metabolism directly produces uric acid). Reducing sugar and fructose intake is more effective than limiting dietary purines. Adequate hydration helps kidneys excrete uric acid. Tart cherry extract can lower uric acid.
Panel 8
These three markers are among the most commonly deficient in the modern population. Deficiency in any of them causes fatigue, cognitive decline, immune dysfunction, and elevated disease risk. All are easily correctable once identified.
Not a vitamin but a steroid hormone that affects 2,000+ genes. Regulates immune function, calcium absorption, bone density, mood, muscle function, and cancer prevention. Deficiency (< 30 ng/mL) affects an estimated 40-50% of the global population.
Standard Range
30 - 100 ng/mL
Optimal Range
50 - 80 ng/mL
Clinical Note
Test the 25-OH form specifically. Supplement with D3 (not D2) plus K2 (MK-7) for proper calcium direction. Most adults need 5,000 IU/day to reach 50+ ng/mL. Dark-skinned individuals, those in northern latitudes, and indoor workers are at highest deficiency risk. Retest after 3 months of supplementation.
Essential for nerve function, DNA synthesis, red blood cell production, and methylation. Deficiency causes fatigue, neuropathy, cognitive decline, and macrocytic anemia. Absorption declines with age and is impaired by acid-blocking medications.
Standard Range
200 - 900 pg/mL
Optimal Range
500 - 800 pg/mL
Clinical Note
Serum B12 can be misleadingly 'normal' when functional B12 is low. If B12 is in the low-normal range (200-400 pg/mL), check methylmalonic acid (MMA) — elevated MMA confirms functional B12 deficiency even with 'normal' serum levels. Vegans must supplement. Methylcobalamin is the preferred form.
Critical for DNA synthesis, methylation, cell division, and neural tube development. Works synergistically with B12 — deficiency of either causes similar symptoms. Low folate drives elevated homocysteine.
Standard Range
> 3.0 ng/mL
Optimal Range
> 10 ng/mL
Clinical Note
MTHFR gene variants (affecting 40-60% of the population) impair conversion of folic acid to active methylfolate. If you have an MTHFR variant, supplement with methylfolate (5-MTHF) rather than folic acid. Dark leafy greens, liver, and legumes are the best food sources.
Panel 9
Hormones regulate muscle mass, fat distribution, libido, mood, cognitive function, bone density, and cardiovascular health. Declining sex hormones are a hallmark of aging and are strongly associated with increased all-cause mortality. Testing reveals opportunities for lifestyle optimization.
Primary androgen hormone. Drives muscle mass, bone density, fat metabolism, libido, mood, cognitive function, and cardiovascular health. Declining testosterone in men is associated with increased all-cause mortality.
Standard Range
264 - 916 ng/dL (men), 15 - 70 ng/dL (women)
Optimal Range
600 - 900 ng/dL (men), 30 - 60 ng/dL (women)
The unbound, bioavailable fraction of testosterone — the portion your cells can actually use. Only 1-3% of total testosterone circulates as free T. This is what determines symptoms and function.
Standard Range
9 - 30 ng/dL (men), 0.3 - 1.9 ng/dL (women)
Optimal Range
15 - 25 ng/dL (men), 0.8 - 1.5 ng/dL (women)
Protein that binds testosterone and estradiol, making them inactive. High SHBG = less free testosterone available. Low SHBG = more free testosterone but potentially more estrogen conversion.
Standard Range
10 - 57 nmol/L (men), 18 - 144 nmol/L (women)
Optimal Range
20 - 40 nmol/L (men), 40 - 80 nmol/L (women)
The primary estrogen. In men, some estradiol is protective (bone health, brain function, cardiovascular) but excess drives gynecomastia, water retention, and mood disruption. Produced by aromatase conversion of testosterone.
Standard Range
10 - 40 pg/mL (men), varies widely in women by cycle phase
Optimal Range
20 - 35 pg/mL (men)
Adrenal androgen precursor — the body's most abundant circulating steroid. DHEA-S declines ~2% per year after age 25. It serves as a precursor to both testosterone and estrogen. Low DHEA-S is associated with aging, chronic stress, and adrenal fatigue.
Standard Range
80 - 560 mcg/dL (age/sex-dependent)
Optimal Range
Top quartile for your age and sex
Preparation
Not all blood tests require fasting. This table clarifies which tests need a fasted state, how long to fast, and why it matters.
| Test | Fasting? | Duration |
|---|---|---|
| Lipid panel (cholesterol, triglycerides, ApoB) | Yes | 12-14 hours |
| Fasting glucose | Yes | 12-14 hours |
| Fasting insulin | Yes | 12-14 hours |
| HbA1c | Not required | N/A |
| CBC (complete blood count) | Not required | N/A |
| Thyroid panel (TSH, T3, T4) | Recommended | Overnight |
| Iron panel / Ferritin | Recommended | Overnight |
| Vitamin D, B12 | Not required | N/A |
| hs-CRP, ESR | Not required | N/A |
| Sex hormones (testosterone, estradiol) | Recommended | Overnight |
Lipid panel (cholesterol, triglycerides, ApoB)
YesTriglycerides especially affected — can inflate 20-30% post-meal
Fasting glucose
YesDefinition requires fasting. Non-fasting glucose is a different test.
Fasting insulin
YesInsulin spikes dramatically after eating — non-fasting insulin is meaningless
HbA1c
Not required3-month average, not affected by recent food intake
CBC (complete blood count)
Not requiredWhite and red blood cells not significantly affected by food
Thyroid panel (TSH, T3, T4)
RecommendedTSH is slightly lower after eating. Morning fasting draw provides most consistent results.
Iron panel / Ferritin
RecommendedSerum iron fluctuates with meals. Ferritin is less affected but fasting improves consistency.
Vitamin D, B12
Not requiredStable markers, not affected by meals
hs-CRP, ESR
Not requiredInflammation markers are not meal-dependent
Sex hormones (testosterone, estradiol)
RecommendedDraw between 7-9 AM for peak testosterone. Fasting reduces variability.
Timing
How often you should test depends on your current health status and goals. Here is a practical framework.
CBC, CMP, lipid panel with ApoB, thyroid panel (TSH, free T3, free T4), HbA1c, fasting insulin, vitamin D, B12, hs-CRP, homocysteine
Fasting insulin, HbA1c, hs-CRP, lipid panel with ApoB, vitamin D (if supplementing), any markers you are actively trying to improve
Lp(a) — genetically determined, does not change. Test once and know your risk level permanently. MTHFR genetic testing if homocysteine is elevated.
Full thyroid panel (if fatigue, weight gain, cold intolerance), iron panel with ferritin (if fatigue, hair loss, pallor), sex hormones (if low energy, low libido, mood changes), cortisol (if suspected adrenal dysfunction)
Take Control
You do not need to wait for a doctor to order labs. Direct-to-consumer lab services let you test anything in this guide on your own schedule, often at a lower cost than insurance copays.
Largest draw network in the US. Wide test selection. Frequent sales. Results in 1-3 business days.
$50-$250 depending on panel
Second largest network. Life Extension offers discounted comprehensive panels. Good for hormone panels.
$50-$200 depending on panel
Comprehensive male and female hormone panels. Physician consult included. Popular in fitness and optimization communities.
$150-$350 for comprehensive panels
AI-powered analysis with personalized recommendations. Tracks results over time. Great user interface. Optional InnerAge biological age score.
$200-$600 depending on tier
Covered by insurance for annual checkups. Familiar with your history. Can order any test.
Copay only (but may resist ordering 'non-standard' tests like ApoB, fasting insulin, or free T3)
If you are starting from scratch, order this comprehensive panel to establish your baseline. It covers metabolic, cardiovascular, thyroid, hormonal, and inflammatory health in one draw.
Tier 1 — Essential (everyone)
Tier 2 — Expanded (optimizers)
The Evidence
The optimal ranges and recommendations in this guide are grounded in peer-reviewed research and clinical longevity practice.
Sniderman et al., The Lancet, 2019
ApoB outperforms LDL-C, non-HDL-C, and all lipid ratios for predicting cardiovascular events. ApoB captures risk from all atherogenic particles including Lp(a), VLDL, and IDL that LDL-C misses.
Kraft, Diabetes Epidemic & You, 2008; multiple longitudinal studies
Fasting insulin rises 5-10 years before fasting glucose reaches the 'prediabetic' range. By the time glucose is elevated, 80%+ of insulin-producing beta cells are already dysfunctional. Fasting insulin is the earliest metabolic warning signal.
Multiple sources including Attia, Outlive, 2023
Standard lab reference ranges identify disease, not health. Longevity-optimized ranges — based on the healthiest population segments — identify the narrow windows associated with the lowest all-cause mortality for each marker.
Biondi & Cooper, Endocrine Reviews, 2008
TSH in the upper 'normal' range (2.5-4.5 mIU/L) is associated with increased cardiovascular risk, weight gain, and cognitive decline. Treating subclinical hypothyroidism improves lipid profiles, energy, and cognitive function in many patients.
Pilz et al., Archives of Internal Medicine, 2009
Vitamin D levels below 30 ng/mL are associated with significantly increased all-cause mortality. Levels between 50-80 ng/mL are associated with the lowest mortality across multiple large cohort studies.
Nordestgaard et al., European Heart Journal, 2010
Elevated Lp(a) affects approximately 20% of the global population and is associated with a 2-3x increased risk of myocardial infarction and aortic valve stenosis, independent of LDL-C levels. Testing should be performed at least once.
FAQ
Biomarkers
The 20 key blood, body, and functional markers to track for healthspan with optimal ranges.
Inflammation
Deep dive into hs-CRP, IL-6, TNF-alpha, anti-inflammatory nutrition, and resolution protocols.
Hormones
Evidence-based protocols to naturally optimize testosterone, SHBG, and estradiol balance.
This guide teaches you to read your labs. A CryoCove coach will analyze your full panel, identify your weakest markers, and build a personalized protocol targeting the specific pillars that will move your numbers fastest.
Disclaimer: This guide is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your health regimen. Blood test results should be interpreted by a licensed medical professional in the context of your complete health history. See our full disclaimer.