Bloodwork Testing: The Panels That Actually Matter for Long-Term Health

The Basics


What it is	Comprehensive blood testing to measure biomarkers that predict long-term health outcomes before symptoms appear
Primary use	Early detection of metabolic dysfunction, hormonal imbalances, cardiovascular risk, and nutrient deficiencies
Evidence level	Strong — well-established clinical utility for disease prediction and prevention
Safety profile	Very Safe — minimal risk venipuncture procedure
Best for	Anyone optimizing health, tracking aging biomarkers, or addressing chronic fatigue, weight issues, or metabolic concerns

⚡ Key Facts at a Glance

Fasting insulin rises years before glucose, making it the earliest marker of insulin resistance
ApoB is a better predictor of cardiovascular risk than standard LDL cholesterol
Triglycerides/HDL ratio under 1.0 is optimal; above 2.0 signals insulin resistance
Optimal vitamin D is 40–70 ng/mL, but over 30% of adults are deficient below 30 ng/mL
Most "normal" reference ranges reflect population averages, not optimal health targets

Most people have never seen their own bloodwork. Of those who have, most have only seen the standard panel their doctor ordered — which, depending on the doctor, may be missing the biomarkers most predictive of how you'll age.

Testing isn't a substitute for lifestyle. But it gives you a map. And most people are navigating without one.

Why Bloodwork Matters

Blood biomarkers provide a window into metabolic function, hormonal health, inflammation, cardiovascular risk, nutrient status, and organ function — often years before symptoms appear.

The goal isn't to find disease. It's to find trends early enough to reverse them.

The Core Panel (Annual Minimum)

Comprehensive Metabolic Panel (CMP) Covers glucose, kidney function (creatinine, BUN), liver enzymes (ALT, AST), and electrolytes. Establishes a baseline for metabolic and organ health.

Complete Blood Count (CBC) Red and white blood cell counts, hemoglobin, hematocrit, platelet count. Screens for anemia, infection, and immune abnormalities.

Lipid Panel (with calculated ratios) Total cholesterol, LDL, HDL, triglycerides. More important than individual numbers are the ratios:

Triglycerides/HDL ratio — one of the strongest predictors of insulin resistance and cardiovascular risk. Under 2.0 is good; under 1.0 is excellent.
Total cholesterol/HDL ratio — under 3.5 is optimal.

Fasting Insulin + Fasting Glucose Standard bloodwork checks fasting glucose, but not insulin. Insulin rises years before glucose to compensate for early insulin resistance. Checking both gives you the full picture. Optimal fasting insulin: under 7 μIU/mL.

HbA1c (Glycated Hemoglobin) Three-month average blood sugar. Catches prediabetes before fasting glucose alone would. Optimal: under 5.4%. Prediabetes range: 5.7–6.4%.

The Extended Panel (Recommended Annually or Semi-Annually)

ApoB The most accurate marker of atherogenic particle count — outperforms LDL-C for cardiovascular risk prediction. Optimal: under 80 mg/dL if you're aiming for aggressive prevention.

hsCRP (High-Sensitivity C-Reactive Protein) A marker of systemic inflammation. Under 1.0 mg/L is low risk. Above 3.0 mg/L warrants investigation.

Homocysteine Elevated homocysteine (above 10–12 μmol/L) is associated with cardiovascular disease, cognitive decline, and B vitamin deficiency. Treatable with B6, B12, and folate.

Vitamin D (25-OH) Widespread deficiency. Optimal for most people: 40–70 ng/mL. Below 30 ng/mL is insufficiency.

Thyroid Panel (TSH + Free T3 + Free T4) TSH alone misses early thyroid dysfunction. Free T3 is the active hormone; low Free T3 with normal TSH is common and often goes untreated.

Testosterone (Total + Free) — Males Total testosterone gives a general picture. Free testosterone (the bioavailable fraction) is more clinically meaningful. Age-related decline is common and addressable.

Estradiol — Females Particularly important during perimenopause. Helps contextualize mood, energy, bone density, and cardiovascular risk.

Ferritin + Iron Studies Low ferritin is one of the most common and underdiagnosed causes of fatigue, particularly in women. High ferritin can indicate inflammation or iron overload.

DHEA-S An adrenal androgen that declines with age. Low levels correlate with accelerated aging, fatigue, and mood issues.

How to Get Tested

Through your doctor: Request a specific panel at your annual physical. Know what you want and ask for it. Many doctors will add panels on request.

Direct-to-consumer labs: Services like Marek Health, LabCorp (direct), Quest Diagnostics, and Function Health allow you to order panels without a physician's order. Cost is often comparable to or lower than insurance copays.

Frequency: Annual at minimum. Semi-annual for people actively optimizing or addressing specific issues.

What To Do With Results

Reference ranges on lab reports are based on population averages — not optimal health. "Normal" means you're within the range of the average person, which may not mean much.

Learn what optimal looks like for each marker (distinct from the lab's "normal" range). Track trends over time. A single number tells you where you are. A trend tells you where you're going.

The most powerful use of bloodwork is not diagnosis — it's direction. A rising fasting insulin, declining free testosterone, or creeping HbA1c tells you to change something before it becomes a problem.

What the Experts Say

Opinions below are paraphrased from each expert's public work, interviews, and podcasts — not direct quotes.

🧠 Andrew Huberman

Andrew Huberman strongly advocates for comprehensive bloodwork as the foundation of any personalized health protocol. He recommends testing at minimum twice per year and getting panels that include hormones (testosterone, free testosterone, DHEA, cortisol), metabolic markers (fasting glucose, insulin, HbA1c), lipids (full particle counts), inflammatory markers (CRP, homocysteine), and micronutrients (vitamin D, magnesium, iron panel). He views self-knowledge through data as essential to targeted optimization.

⚡ Dave Asprey

Dave Asprey has been a proponent of comprehensive bloodwork and continuous health monitoring for decades, regularly testing dozens of biomarkers and using the data to guide his biohacking protocols. He views annual physicals with basic panels as woefully inadequate and advocates for regular, comprehensive testing as a performance tool rather than just disease screening.

🎙️ Joe Rogan

Joe Rogan has discussed comprehensive bloodwork on the JRE in the context of his own health monitoring, particularly around hormone optimization. He's noted the difference between "within range" and "optimal" and has had multiple physicians on the show discuss how standard reference ranges often reflect disease thresholds rather than health optimization targets.

Sources & Further Reading

Fasting Insulin as a Predictor of Cardiovascular Disease — Diabetes Care Journal — https://diabetesjournals.org/care/article/25/6/1129/22116/Fasting-Insulin-and-Outcome-in-Nondiabetic
Apolipoprotein B vs LDL-Cholesterol for Cardiovascular Risk Assessment — Journal of the American College of Cardiology — https://www.jacc.org/doi/10.1016/j.jacc.2019.03.534
Triglyceride/HDL Ratio and Insulin Resistance — The Journal of Clinical Endocrinology & Metabolism — https://academic.oup.com/jcem/article/88/11/5154/2656267
High-Sensitivity C-Reactive Protein and Cardiovascular Risk — New England Journal of Medicine — https://www.nejm.org/doi/full/10.1056/nejmoa021993
Vitamin D Insufficiency and Clinical Outcomes — National Institutes of Health — https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
Homocysteine and Cardiovascular Disease — American Heart Association — https://www.ahajournals.org/doi/10.1161/01.CIR.102.19.2479

Where to Buy / Find This

Function Health — Comprehensive annual bloodwork with 100+ biomarkers, includes physician review and trend tracking — https://www.functionhealth.com/
Marek Health — Direct-to-consumer lab testing with specialist consultation for optimization — https://marekhealth.com/
LabCorp OnDemand — Order specific panels online without physician order, results in 1-3 days — https://www.labcorp.com/labs-and-appointments/ondemand
Quest Direct — Self-order lab testing at Quest locations nationwide — https://www.questhealth.com/
Ulta Lab Tests — Discounted direct-access lab testing through LabCorp and Quest networks — https://www.ultalabtests.com/