Longevity Blood Tests: The 10 Markers That Predict Healthspan
Standard annual blood tests screen for disease. Longevity blood tests go further — measuring the biological processes that predict healthspan decline decades before any disease is diagnosable. Here are the 10 markers leading longevity researchers track.
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Standard preventive blood tests — lipid panel, CBC, CMP, HbA1c — are designed to identify established disease and treatment targets defined by population-level guidelines. They were not designed to measure the rate of biological ageing or optimise function in healthy people. Longevity medicine adds a layer of biomarkers that reflect the underlying processes driving ageing: insulin resistance, chronic inflammation, metabolic efficiency, hormonal decline, and nutrient depletion.
| Marker | Why It Predicts Longevity | Target Level |
|---|---|---|
| Fasting insulin and HOMA-IR | Insulin resistance is the single most powerful modifiable predictor of all-cause mortality in non-diabetic adults — it precedes diabetes, CVD, dementia, and cancer | Fasting insulin below 5 µIU/mL; HOMA-IR below 1.0 |
| ApoB | Counts atherogenic particles — better predictor of ASCVD events than LDL. Atherosclerosis begins silently in the 30s. | Below 70–80 mg/dL |
| Lipoprotein(a) | Independent, genetically determined CVD risk — responsible for 10–15% of premature heart disease; measure once in every adult | Below 30 mg/dL (optimal below 20) |
| hs-CRP | Chronic low-grade inflammation ("inflammageing") drives atherosclerosis, neurodegeneration, insulin resistance, and accelerated biological ageing | Below 0.5 mg/L (optimal) |
| Homocysteine | Elevated homocysteine (above 10 µmol/L) is associated with CVD, cognitive decline, and all-cause mortality; reflects B vitamin status and methylation capacity | Below 7–8 µmol/L |
| 25-OH Vitamin D | Low vitamin D is associated with higher all-cause mortality across multiple large cohort studies; affects immune function, cardiovascular risk, and cognitive decline | 40–60 ng/mL |
| Testosterone (total + free) | Low testosterone in both men and women is associated with sarcopenia, cardiovascular risk, cognitive decline, and overall mortality | Men: above 600 ng/dL total; women: free testosterone in upper quartile |
| IGF-1 | Growth hormone/IGF-1 axis reflects cellular regeneration capacity; falls with age; very low IGF-1 associated with frailty; very high associated with cancer risk | Age-appropriate mid-normal range |
| HbA1c | Each 1% increase in HbA1c in the non-diabetic range (5.0–6.4%) is associated with increased mortality; hyperglycaemia drives glycation and mitochondrial dysfunction | Below 5.3% (optimal) |
| Ferritin | Both high and low ferritin predict adverse outcomes. Very high ferritin (above 300 ng/mL) is associated with ferroptosis and increased cancer risk. Low ferritin impairs energy and immune function. | 50–150 ng/mL |
The Longevity Blood Panel — Key Markers
What Differentiates Long-Lived Populations' Blood Work
Centenarian studies consistently identify: low fasting insulin and HOMA-IR, low ApoB and particle count, low hs-CRP (under 0.5 mg/L), high albumin (above 4.0 g/dL), and preserved muscle mass markers. The absence of metabolic dysfunction — not any single 'longevity biomarker' — is the consistent finding. Getting these to optimal, not just 'normal', is the goal.
The Insulin Resistance Priority
Peter Attia, Ivor Cummins, and other longevity researchers identify insulin resistance as the most impactful, most common, and most modifiable of all longevity biomarkers. HOMA-IR above 2 is associated with dramatically increased risk of type 2 diabetes, ASCVD, Alzheimer's disease, and certain cancers — yet it is never included in standard preventive panels. Fasting insulin is the single highest-yield test addition for any adult not already getting it. It costs under $30 at DTC labs.
Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. Reference ranges, supplement dosages, and nutritional information mentioned are general educational guidance from published research—not personalised recommendations. Do not use this content to self-diagnose or self-treat any condition. Always consult a qualified healthcare provider before making any changes to your health regimen, medications, or supplements.
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