Biomarkers

What to measure, what to consider optimal (not the lab reference), and what moves it. Take it to your next lab.

32 / 32 results

ApoB mg/dl

Optimal: < 80 mg/dl; < 60 at high risk

Every atherogenic lipoprotein particle carries one ApoB — it's the particle count, which predicts better than LDL cholesterol.

Yearly; 6–8 weeks after starting treatment.

Heart, metabolism

Lp(a) nmol/l

Optimal: < 75 nmol/l (< 30 mg/dl); high above 125

Genetically set, high in one in five people; an independent risk for heart attack and aortic stenosis that lifestyle doesn't move.

Once in a lifetime is enough (genetic).

Heart, metabolism

HbA1c %

Optimal: < 5.4%; 5.7–6.4% prediabetes

Average blood glucose over 2–3 months; even the prediabetic range raises dementia and heart-disease risk.

Yearly; every 6 months in prediabetes.

Heart, metabolism

Fasting insulin / HOMA-IR µIU/ml

Optimal: Insulin < 8 µIU/ml; HOMA-IR < 1.5

Insulin resistance precedes diabetes by 10–15 years; fasting glucose is still normal while insulin is already elevated.

Yearly after 40 or with abdominal obesity.

Inflammation

hs-CRP mg/l

Optimal: < 1 mg/l (below 0.5 is excellent)

Marker of low-grade chronic inflammation (“inflammaging”); above 3 doubles cardiovascular risk.

Yearly, measured without an acute infection.

Heart, metabolism

Blood pressure Hgmm / mmHg

Optimal: < 120/80 measured at home

The world's leading mortality risk; above 115/75 every +20/10 mmHg doubles cardiovascular death.

Monthly at home (7-day morning/evening average).

Fitness

VO2max ml/kg/perc

Optimal: Top 25% for your age and sex (e.g. man aged 50 > 42, woman > 34)

The strongest known mortality predictor; a fivefold mortality difference between “low” and “elite” fitness.

Yearly (lab CPET, or smartwatch estimate / Cooper test).

Fitness

Grip strength kg

Optimal: Men > 40 kg, women > 25 kg (also over 60)

A proxy for whole-body strength; in PURE every 5 kg drop meant +16% mortality — a stronger predictor than blood pressure.

Yearly with a hand dynamometer (€20).

Body composition

Waist-to-height ratio arány

Optimal: < 0.5 (waist less than half your height)

Flags visceral fat — the engine of inflammation and insulin resistance — better than BMI; NICE recommends it since 2022.

Monthly, tape at navel height.

Nutrients

25(OH) vitamin D ng/ml

Optimal: 30–50 ng/ml (75–125 nmol/l)

Below 20 bone, muscle and immunity suffer; above 60 no extra benefit and kidney-stone risk rises.

Yearly, in winter (the low point).

Nutrients

Ferritin ng/ml

Optimal: 30–150 ng/ml (women 30–100)

Iron stores; low means fatigue and poor training response, high (>300) means oxidative stress and possible haemochromatosis — both directions matter.

Yearly; certainly for menstruating women and vegetarians.

Organs

eGFR (cystatin C) ml/perc/1,73 m²

Optimal: > 90; after 40 a 1-unit yearly decline is normal

Kidney function declines silently; creatinine depends on muscle mass (misleads on creatine), cystatin C doesn't.

Yearly after 50 or with hypertension or diabetes.

Organs

ALT / GGT (liver) U/l

Optimal: ALT < 25 (women) / < 33 (men); GGT < 30

Fatty liver (MASLD) affects a third of adults silently; GGT independently predicts cardiovascular disease and mortality.

Yearly.

Nutrients

Omega-3 index %

Optimal: ≥ 8% (below 4% is high risk)

EPA+DHA share of red-cell membranes; above 8% means 30% lower all-cause mortality versus below 4% in the FORCE consortium.

Yearly; finger-prick kits exist.

Inflammation

Homocysteine µmol/l

Optimal: < 10 µmol/l

Marker of B-vitamin status and methylation health; above 12 means faster brain atrophy and dementia risk, reversible with B vitamins (VITACOG).

Every 2 years after 50.

Body composition

DEXA (muscle, fat, bone) T-score / kg

Optimal: T-score > –1; ASMI men > 7.0, women > 5.5 kg/m²; visceral fat < 1 kg

One scan for the three “structural” ageing markers: bone density, appendicular muscle mass (sarcopenia) and visceral fat.

Every 2–3 years after 50; women after menopause.

Heart, metabolism

LDL cholesterol mg/dl

Optimal: < 100 mg/dl (2.6 mmol/l); < 55 with known vascular disease

The “bad cholesterol” — a causal factor in atherosclerosis (proven by Mendelian randomisation). ApoB is more precise, but LDL is available everywhere and guidelines rest on it. Lifetime exposure matters: keeping it under 100 at 30 is worth more than pushing it to 70 at 60.

Yearly; every adult from age 20.

Heart, metabolism

Triglycerides mg/dl

Optimal: < 100 mg/dl (1.1 mmol/l) fasting; TG/HDL ratio < 2

Fat circulating in the blood; a high value is the earliest lab sign of insulin resistance and fatty liver — years before glucose rises. The TG/HDL ratio is a cheap proxy for HOMA-IR.

Yearly, as part of the lipid panel.

Heart, metabolism

HDL cholesterol mg/dl

Optimal: 40–80 mg/dl; very high (>100) is NOT better

The “good cholesterol” — yet every trial raising HDL with drugs (niacin, CETP inhibitors) failed, and genetically high HDL doesn't protect. A marker, not a target: low HDL flags insulin resistance, to be fixed through lifestyle.

Yearly, as part of the lipid panel.

Heart, metabolism

Fasting glucose mg/dl

Optimal: 72–90 mg/dl (4.0–5.0 mmol/l); above 100 prediabetes

The cheapest metabolic marker, but a late one: the pancreas compensates for years before fasting glucose rises. So measure insulin and HbA1c alongside. A “normal” value above 90 already tracks with higher dementia risk (Crane 2013).

Yearly; every six months with prediabetes, or a 2-week CGM once a year.

Heart, metabolism

Uric acid mg/dl

Optimal: < 5.5 mg/dl (330 µmol/l); < 6 with gout

The end product of purine and fructose metabolism; it not only causes gout but independently flags hypertension, kidney damage and metabolic syndrome. Fructose (sugary drinks) is its strongest dietary driver — not meat.

Yearly; more often with gout or kidney disease.

Heart, metabolism

Coronary calcium (CAC) score Agatston

Optimal: 0; 1–99 mild, 100–399 moderate, ≥400 extensive

The one test that shows disease already laid down, not just risk. A score of 0 means <1% 10-year event risk (a statin can be deferred); above 100 treatment is warranted regardless of age. It misses soft, not-yet-calcified plaque.

Once between 40 and 50 (women 45–55); if 0, repeat after 5 years. Low-dose CT (~1 mSv).

Hormones

TSH (thyroid) mIU/l

Optimal: 0.5–2.5 mIU/l when young; 1–4 is normal above 70

The metabolic “thermostat”. Mild underactivity (TSH 4–10) causes fatigue, weight gain and high LDL, and affects 10% of women over 40 (Hashimoto's). Note: centenarians' TSH is slightly HIGHER — a “slower thyroid” in old age may be protective, so not everyone needs treatment.

Every five years from 35; yearly with symptoms, pregnancy or autoimmune disease, with anti-TPO.

Hormones

Testosterone (total + free) nmol/l

Optimal: Men: total 15–30 nmol/l (430–860 ng/dl), free in the upper half; women: 0.5–2

The hormone of muscle, bone, libido, mood and insulin sensitivity in both sexes. In men the post-30 decline is mostly lifestyle (belly fat aromatises it, sleep loss –15%). Low levels track with type 2 diabetes and mortality; replacement (TRT) is heart-safe per TRAVERSE, but only for confirmed deficiency.

Between 7 and 10 am, fasting, on two separate days — a single low value isn't a diagnosis. From 40 with symptoms; together with SHBG.

Hormones

Oestradiol + FSH (women) pmol/l · IU/l

Optimal: Cycle-dependent; FSH > 25 IU/l on two tests = perimenopause. On HRT oestradiol 200–400 pmol/l

Oestrogen protects bone, vessels and brain; its loss at menopause is the main driver of women's “accelerated ageing”: 10% bone loss in 5 years, LDL +10–15%, more visceral fat. Recognising perimenopause (FSH, symptoms) enables timely hormone therapy — before 60 or within 10 years of menopause the benefit mostly outweighs the risk.

From 40 with symptoms (hot flushes, sleep disruption, cycle changes); the diagnosis is clinical, the lab confirms. Yearly on HRT.

Hormones

DHEA-S µmol/l

Optimal: Age-dependent; the upper third of your age group. Over 50: men > 3, women > 2 µmol/l

The adrenal's most abundant hormone, a precursor of sex hormones; it falls 80–90% from its peak at 25 to age 80 — the steepest-declining hormone. Low levels in men track with cardiovascular death (Rancho Bernardo). Supplementing it didn't improve muscle or cognition in RCTs — a marker, not a drug.

Not routine; as part of a hormone panel from 45, or when chronic stress or exhaustion is suspected.

Nutrients

B12 (holo-TC) + folate pmol/l · nmol/l

Optimal: B12 > 300 pmol/l (holo-TC > 50); folate > 15 nmol/l; homocysteine < 10 is the real yardstick

The two methylation vitamins; deficiency causes anaemia, nerve damage and high homocysteine. B12 deficiency hits 20% over 60, 50–80% of vegans, 30% of metformin and PPI users — and plain serum B12 misses half the cases. In VITACOG, supplementation halved brain shrinkage in people with high homocysteine.

Yearly over 60, in vegans, on metformin/PPI; otherwise every 3–5 years.

Inflammation

White cells + neutrophil/lymphocyte ratio G/l · arány

Optimal: WBC 3.5–6.0 G/l; NLR 1–2

Free with the routine blood count: even within the reference range, a HIGHER white count (>7) signals chronic low-grade inflammation and scales with mortality. NLR (neutrophils ÷ lymphocytes) above 3 predicts cardiovascular and cancer risk independently of CRP.

Yearly, as part of the blood count. Wait 4 weeks after an infection.

Organs

Albumin g/l

Optimal: > 42 g/l; below 38 a warning, below 35 abnormal

The main plasma protein made by the liver; a fall signals inflammation, malnutrition or liver/kidney disease. One of the strongest components of Levine's phenotypic age: every –1 g/l ≈ +5% mortality in older adults. Simple, cheap, measurable anywhere.

Yearly, as part of the liver panel.

Fitness

HRV + resting heart rate ms · bpm

Optimal: Resting HR 50–60; HRV: above your own 30-day average (absolute number varies by person)

The only daily, at-home, free biomarker pair (watch, ring). Every +10 beats of resting HR tracks with 10–20% excess mortality; a drop in HRV is a sensitive signal of poor sleep, alcohol, illness and overtraining — days before symptoms. The trend matters, not one day's number.

Continuously, from overnight readings; look at weekly averages.

Fitness

Gait speed + chair stand m/s · mp

Optimal: > 1.2 m/s; 5× sit-to-stand < 10 s (< 12 over 65)

Two equipment-free tests that predict mortality better than lab values in old age. Gait speed (Studenski 2011, n=34,485): below 0.8 m/s signals frailty, every +0.1 m/s means 12% lower mortality. The 5× sit-to-stand measures lower-body strength and power — the functional screen for sarcopenia.

Yearly from 50, at home: 4 metres at usual pace with a stopwatch; 5× stand without arms.

Body composition

Body-fat percentage and muscle mass %

Optimal: Men 12–20%, women 20–30% (DEXA); appendicular lean mass index men > 7.0, women > 5.5 kg/m²

BMI can't tell muscle from fat: the “normal BMI, high body fat” (skinny-fat) phenotype is a hidden form of metabolic risk, and 20–30% of people over 60 fit it. The goal isn't minimal fat but enough muscle: low muscle mass independently predicts mortality after 50.

DEXA every 1–2 years from 40; smart scales only for trends.

Last reviewed: 6 September 2026

This site is educational and does not replace medical advice. Start any supplement or drug only after consulting a doctor or pharmacist.