Track biomarkers

Why biomarker tracking changes the game

Biomarkers are measurable indicators of what's happening inside your body, from blood glucose and cholesterol particles to epigenetic methylation patterns that estimate biological age. Tracking them shifts healthcare from a reactive model (wait for symptoms, then treat) to a proactive one (spot trends early, intervene precisely). A 35-year Swedish cohort study following over 44,000 people found that centenarians consistently displayed more favorable biomarker values from age 65 onward compared to those who died earlier, particularly in markers of metabolism, inflammation, and liver function ^[1]. That's a strong argument for paying attention to these numbers well before problems develop.

Blood biomarkers that matter most

A longevity-focused blood panel goes well beyond the standard annual physical. Here are the markers worth tracking every 3 to 6 months:

• ApoB and advanced lipids: ApoB counts the total number of atherogenic particles in your blood and outperforms LDL cholesterol for predicting cardiovascular events. A systematic review of 15 studies with over 593,000 participants confirmed ApoB as a more accurate risk marker than non-HDL cholesterol ^[2]. Optimal: below 90 mg/dL (below 65 mg/dL for high-risk individuals). Also test Lp(a) once since it's genetically determined.
• Metabolic markers: Fasting glucose (optimal 72-85 mg/dL), fasting insulin (below 5 uIU/mL), HbA1c (below 5.2%), and HOMA-IR. These catch insulin resistance years before a diabetes diagnosis.
• Inflammation: High-sensitivity CRP (hs-CRP) below 1.0 mg/L, homocysteine below 10 umol/L, and fibrinogen. Chronic low-grade inflammation drives nearly every age-related disease.
• Hormones: Total and free testosterone, estradiol, DHEA-S, cortisol, and a full thyroid panel (TSH, free T3, free T4, reverse T3). Always test in the morning when hormones peak.
• Micronutrients: 25-hydroxy vitamin D (optimal 40-60 ng/mL), RBC magnesium, ferritin, zinc, omega-3 index, B12, and folate.

Optimal ranges vs. "normal" ranges

Standard lab reference ranges are based on population averages that include many unhealthy people. A fasting glucose of 95 mg/dL gets a green flag on most lab reports, but it already signals impaired metabolic function. The same applies to vitamin D levels of 30 ng/mL (sufficient per guidelines, but research suggests 40-60 ng/mL for best outcomes) or an HbA1c of 5.6% (technically pre-diabetic, but often called "borderline normal"). Working with a physician who understands functional optimal ranges, not just disease thresholds, makes all the difference.

Wearables and continuous monitoring

Continuous glucose monitors (CGMs) have opened metabolic tracking to anyone, not just diabetics. A 2024 systematic review found that CGMs in non-diabetic populations can guide lifestyle interventions by revealing personal glycemic responses to food, exercise, and stress in real time ^[3]. A two-week CGM experiment often uncovers surprising glucose spikes from supposedly healthy meals. The limitation: CGM metrics don't correlate as well with HbA1c in people without diabetes, so they're best used as a behavioral feedback tool rather than a clinical diagnostic ^[4].

Heart rate variability (HRV), tracked by devices like the Oura Ring or WHOOP, reflects autonomic nervous system balance. A meta-analysis of 32 studies covering 38,008 participants found that lower HRV values significantly predict higher mortality across all ages and populations ^[5]. Daily HRV tracking reveals recovery status, stress load, and training readiness. Resting heart rate trends over months can flag cardiovascular fitness changes or overtraining before you feel any symptoms.

Biological age testing

Epigenetic clocks analyze DNA methylation patterns to estimate how fast your body is aging relative to your chronological age. Second-generation clocks like PhenoAge and GrimAge use nine clinical blood biomarkers to predict disease onset and mortality risk. A 2024 systematic review and meta-analysis confirmed that epigenetic age acceleration is associated with increased risks of cardiovascular disease, cancer, and all-cause mortality at the population level ^[6]. For individuals, though, these tools are still more research instruments than clinical diagnostics. A single test tells you less than repeated measurements over time, especially before and after lifestyle interventions.

Building your tracking protocol

Start with a comprehensive baseline blood panel. Retest every 3 to 6 months if you're actively making changes (supplements, diet, training). Once stable, annual panels are enough. Combine blood work with daily wearable data (sleep, HRV, resting heart rate, activity) and periodic functional tests like VO2max assessments or DEXA body composition scans. Log every intervention so you can match changes to outcomes. The goal is a closed feedback loop: data informs your decisions, results confirm or correct your approach.