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Answer · longevity

What biomarkers matter most for longevity?

Short answer

The highest-signal longevity biomarkers cluster across four axes: cardiometabolic (ApoB, Lp(a), triglycerides, HDL, fasting insulin, A1C, HOMA-IR), inflammation (hs-CRP, homocysteine), hormonal (testosterone, estradiol, SHBG, thyroid, DHEA-S), and renal/hepatic context (eGFR, ALT/AST). VO2max and grip strength are non-blood signals worth tracking alongside.

Reviewed by Dr. Laura PurdyMay 29, 2026

Full answer

Longevity is not predicted by a single biomarker. The highest-signal panel clusters across four axes. Cardiometabolic: ApoB and Lp(a) for atherogenic particle burden, triglycerides and HDL for lipid context, fasting insulin and HOMA-IR for insulin-resistance trajectory, A1C for glycemic average. Inflammation: hs-CRP for systemic inflammation, homocysteine for methylation context. Hormonal: total and free testosterone, estradiol, SHBG, DHEA-S, and a complete thyroid read (TSH, fT3, fT4, reverse T3) because endocrine drift accelerates most aging axes. Renal and hepatic context: eGFR, ALT/AST — these gate which pharmacologic interventions are even available. Non-blood signals matter as much as the labs: VO2max, grip strength, resting heart rate, and HRV consistently track longevity in the literature. The Optimization Blueprint Volume III (The Longevity Code) covers this stack in depth.

Educational. Not a substitute for individualized provider review.

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Related answers

What is ApoB?
ApoB (apolipoprotein B) counts every atherogenic lipoprotein particle in the bloodstream. It is a stronger predictor of cardiovascular events than LDL cholesterol alone because it counts particles, not cargo. Modern cardiometabolic optimization treats ApoB as the primary lipid endpoint.
Metabolic syndrome criteria?
Metabolic syndrome is a cluster of five cardiometabolic markers — central adiposity, elevated triglycerides, low HDL, elevated blood pressure, and elevated fasting glucose. Diagnosis typically requires three of the five. It is an insulin-resistance-driven state that materially raises cardiovascular and type-2 diabetes risk and is reversible with provider-reviewed metabolic optimization.
What are NAD+ benefits?
NAD+ is a cellular cofactor central to mitochondrial energy production, DNA repair, and sirtuin signaling. Restoring NAD+ levels is associated with improvements in cellular energy, recovery, cognitive clarity, and longevity-axis markers in candidates with documented decline.
What biomarkers are tested?
The standardized oMeds biomarker panel for hormone optimization covers Hormones, Lipids, CBC, and CMP. For TRT and BHRT it is required at baseline and on a recalibration cadence. For all other pathways it is optional and never required.
Primary source
Biomarkers reference