#1

Please post here blood tests you like. (deleted post)

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#2

There is a cost issue here. Hence it is often to go with a broad package that comes at a good price. There are also timing issues. Some labs can do same day service and that makes the results a lot more reliable.

For example if you can get a sensitive CRP test it is worth doing that a number of times so that you can find out what your CRP level is when not infected. When you are infected IL-6 goes up and that pushes up CRP. When not infected you get the background level of IL-6 which is in SASP.

(Interestingly IL-11 is a member of the IL-6 family)

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#3

The minimum list is here: Roadmap - How To Look Young & Feel Strong – Dr Brad Stanfield

I would add fasting insulin and glucose (to measure HOMA-IR and not just Hb A1c).

If you do the above then you can start interventions (e.g. SGLT2i and/or GLP-1RA if creatinine and/or HOMA-IR non optimal, telmisartan for BP, statin and/or ezetimibe for ApoB, etc.).

Homocysteine might also be interesting as a baseline risk factor for cardiovascular and neurological health.

[EDIT: I didn’t get it was “blood tests for longevity medications”, but I agree with RapAdmin’s answer below.]

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#4

Screening Blood Tests for Optimal Health

Screening blood tests are a cornerstone of preventive medicine. They can identify potential health issues before they become severe, guiding both treatment and lifestyle modifications. However, it’s essential to approach these tests judiciously. Not every test is necessary for every individual, and the concept of pre-test probability should guide decisions.

Pre-test Probability

Before ordering a test, it’s crucial to consider the pre-test probability. This concept refers to the likelihood that a person has the disease or condition in question before any tests are done. If the pre-test probability is very low, even a positive result might still mean the person doesn’t have the disease (false positive). Conversely, if the pre-test probability is very high, a negative test might not rule out the disease (false negative). Ordering tests with a low pre-test probability can lead to unnecessary treatments, anxiety, and costs.

Recommended Screening Algorithm

18-35 years:

  • Full Blood Count (FBC)
    • Measures different components of the blood, detecting disorders like anemia, infection, and other diseases.
  • Lp(a):
    • Elevated levels are associated with an increased risk of heart disease. Testing once in a lifetime is typically sufficient as the levels are primarily driven by genetics rather than lifestyle.[46]
    • Ideal level: <60nmol/L (<30mg/dL)
  • Cholesterol Blood Panel
    • Essential for assessing cardiovascular risk.
    • Ideal level: LDL-c <70mg/dL (but lower for longer is best).
    • For further information, please see the dedicated Cholesterol section.
  • ApoB:
    • Provides a more comprehensive view of heart disease risk.
    • Ideal level: <60mg/dL
  • HbA1c: Measures average blood sugar over three months, diagnosing and monitoring diabetes.
  • Creatinine: Assesses kidney function.
  • Sodium & Potassium: Essential electrolytes indicating various conditions

The Importance of Managing LDL-c & ApoB Levels

Research has conclusively shown that actively lowering a person’s LDL-cholesterol and ApoB levels can decrease their risk of heart attacks.[49] Moreover, recent studies suggest that using medications to lower LDL-cholesterol to very low levels (≤40 mg/dL) poses no significant risks.[50, 51] Importantly, these low cholesterol levels are not associated with cognitive impairment,[52] Alzheimer’s Disease,[53] or testosterone synthesis dysruption.[53] This aligns with the fact that our cells can make cholesterol on their own.

Guidelines on LDL-C Levels

The American Heart Association’s 2018 guidelines suggest:

  • While there’s no universally ideal LDL-C level, the principle remains that lower is generally better.[54]
  • An optimal total cholesterol level hovers around 150 mg/dL, with LDL-C at or below 100 mg/dL. Adults maintaining these levels tend to have reduced rates of heart disease and stroke.[54]
  • For those at moderate heart disease risk (due to factors like a family history of premature heart attacks or conditions like diabetes), an LDL-C level below 70 mg/dL is recommended.[54]

Interestingly, the PESA (Progression of Early Subclinical Atherosclerosis) study demonstrated that even if other risk factors (such as blood pressure, blood sugar, insulin sensitivity, etc) are optimized, atherosclerosis still occurs above an LDL-cholesterol threshold of 60mg/dL.[55] Therefore, it is possible that future guidelines will suggest to reduce LDL-C below 60mg/dL.

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#5

We also covered these types of blood tests in this thread: What are your top 10 biomarkers to track for improving healthspan and longevity?

with Peter Attia’s recommendations here: What are your top 10 biomarkers to track for improving healthspan and longevity? - #70 by RapAdmin

I know @AnUser positioned the question more as “blood tests for longevity medications” but really its not so much for the medications, as for overall health, with perhaps some specific things to watch for with different medications, for example LDL/APOB and A1C for rapamycin, etc.

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#6

The thread is specifically what blood tests are required for safety, although less known blood tests for safety, and tests for efficacy is okay too. Before and after initiation of statin therapy for example, liver tests are taken. I don’t know what those are for many other longevity meds.

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#7

That’s why it’s best to start with what the medications require when prescribed by a doctor, and what’s in the literature. Just testing a bunch of stuff on a whim seem like it can cause a lot of false positives?

#8

I quite like having baseline figures. That enables knowing what the values are when I have no symptoms of illness.

Now and again a test goes wrong as well.

I am not a fan of the idea that people should only test when they have some certainty there is a problem.

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#9

Why do doctors do that?

#10

In the uk doctors funded by NHS do run panels every so often simply to track the numbers, not only when there is a problem.

#11

Doctors do that because otherwise the Insurance Co. will not pay for the test.

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#12

The medical system tends to prioritise fixing identified problems rather than keeping people in optimal health.

https://twitter.com/cremieuxrecueil/status/1817249178017321257

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#13

My typical set of labs for a longevity medicine patient will include (there may be others added)
Apolipoprotein B
Lp(a) if no prior result
Lipid panel (if patient wants this for historical interest)
CBC
Comprehensive Panel
Fasting Insulin level, HbA1C, IGF-1
Iron panel including ferritin
HsCRP
ApoE (if not done prior)
Vitamin B12/Folate/Homocysteine
Cystatin C
Vitamin D (25-OH)
Thyroid panel (TSH, FT4, FT3) — often add antithyroid antibodies
Testosterone panel, DHT, Estradiol
Omega 3 Index

With specific indications:
Heavy metals, PFAS/BPA testing, Mold testing, Gut Microbiome testing, PSA/Free with discussion, Food sensitivity/altered gut permeability (KBMO 176 for example), Salivary Cortisol/Melatonin curve, Organic acids, at times Estrogen metabolism, Neurotransmitter assessment, Vibrant testing sometimes for toxins/tick borne illness

Those would be the most common.

Oftentimes, the top tests will be done initially, and only ones that have abnormalities are done serially. That top list ends up costing under $375 done self pay - so not cheap, but gives a pretty good look at multiple items.

Patients with funny symptoms that could be paraneoplastic syndrome or unusual mild cognition, inflammatory conditions - I’m now favoring adding a Whole Body MRI/MRA Brain with Neuroquant as an option.

I know there are items I’ve forgotten - but this is from memory just quickly going through my usual approach.

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#14

I have all on your list except the ones in BOLD (IGF-1, ApoE, B12, Folate, Thyroid Panel, DHT, Estradiol)
I also have ApoA1 - for the ApoB/ApoA1 ratio.
I will get ApoE when I get a chance. Also IGF-1.
Others that look useful would be IL-6 And 2 new NMR (nuclear magnetic resonance) tests - LP-IR and GlycA.

https://www.rupahealth.com/biomarkers/lp-ir-score

for GlycA

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#15

I would include the fatty15 test after watching that video this morning and reading the paper:

https://www.gdx.net/products

last one under Nutritional Status Testing.

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#16

I agree. I read the paper that @JuanDaw posted on the C15 thread and think it’s important. Here’s a link direct to the test: (but it’s $184+15)

https://connect.gdx.net/products/fatty15-test

#17

Thieves! Of course they have to add the $15 physicians fee. Do you think a doctor is going to ever look at it?

I thank them for figuring this out and teaching us about it, but the cost of the pills and the cost of the test make it so that it will not save the world at this time.

I need to figure out what to feed my goats. Much more complicated than I thought and there is more than one C15? There’s a iso form and anteiso? Which one am I looking at?

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#18

One-off test of LP(a):

I started a 10mg rosuvastatin 9/29/23.

LP(a)
10/16/23 156 nmol/L
02/22/24 156
04/29/24 175
06/26/24 204

April test at Quest, rest at Labcorp.

It may be relevant that I started ezetimibe in February.

I recently figured out that the statin was causing severe neck pain, so discontinued. And I just ran out of ezetimibe.

Will check LP(a) again in a month or two, before trying new ldl management scheme. Hopefully back to 156 baseline.

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#19

There are studies that show vitamin C, lysine, and proline (the so-called linus pauling protocol) will help lp(a). Also more saturated fat (without increasing calories) will help like 20%.

Interesting info!

#20

I have deleted this thread since people didn’t understand the point, will remake.

1 Like