Optimal Lab Ranges

I’m curious to find a list of ‘optimal’ lab ranges. I don’t put much stock in ‘traditional’ lab ranges - I think they’re far too lenient on basically every metric.

I was shocked today to find out the NHS believe 4 mmol/l non-HDL is acceptable. In my view, >3mmol/l is acceptable. Same story for markers like blood sugar, blood pressure, etc.

Any good list of ‘optimal’ ranges online? Or would anyone like to draft up a list based on the current literature?

TIA

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Using ChatGPT you can find details on what each health service deems appropriate for levels. I find the NHS largely better than the NIH in terms of better reporting on acceptable ranges.

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I use this app Carrot Care. It list normal values and optimal values where applicable. Seems good guidance.
For above non-HDL there is no optimal values but normal is listed up to 3,37 mmol/L.
But I wouldn’t get too OCD about it like Peter Attia or Bryan Johnson (and his team)… Markers in my opinion tell just one side. There are also some marker correlations and there is lifestyle and genetics involved too.
I would not trust ChatGPT, it is very untrustworthy… makes things up and hallucinates a lot. :no_mouth:

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Trust but verify of course.

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Michael Lustgarten has ideas on optimal bllood test ranges. Life Extension has also had their own optimal ranges but I couldn’t find the link to it today. I have the document saved in Notes for my use though.
From the Life Extension document:
"Triglycerides (serum or plasma)
Triglyceride levels are used to identify risk for developing coronary heart disease and if fat metabolism disorders are suspected.

  • Reference Range: 0-149 mg/dL
  • LE’s Optimal Range:
    • Fasting: <100 mg/dL (<80 mg/dL if any risk factors; <60 mg/dL if pre-existing cardiovascular disease);
    • Non-fasting: <116 mg/dL
      Total Cholesterol (serum or plasma)
      Total cholesterol is used to assess risk of coronary heart disease and stroke (Kinosian 1994; Ansell 2000; Foroughi 2013).
  • Reference Range: 100-199 mg/dL (over age 19)
  • LE’s Optimal Range: 160-180 mg/dL
    HDL (serum or plasma)
    High-density lipoprotein (HDL) is known as the “good” cholesterol because it helps transport cholesterol from cells to the liver for removal. Low HDL levels are used as a predictor of heart disease risk.
  • Reference Range: >39 mg/dL
  • LE’s Optimal Range: ≥50 mg/dL
    LDL (serum or plasma)
    Low-density lipoprotein (LDL) is known as the “bad” cholesterol because it carries cholesterol and fats from the liver to the rest of the body. Elevated LDL levels are used as a predictor of heart disease risk.
  • Reference Range: 0-99 mg/dL (over age 19)
  • LE’s Optimal Range:
    • Good: 80-100 mg/dL
    • Ideal: <80 mg/dL (<70 mg/dL for those with pre-existing, or who are at high risk, for cardiovascular disease)"
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This is exactly what I would love to get… I am reading Peter Attia’s book right now - I hope it has something like this, it seems a perfect place for something like this.

Otherwise I think we may have to pull one together ourselves. What I think we want is the target range for all the key lab tests that are associated with the lowest all cause mortality levels.

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That could be useful, but it should include also correlations between markers which is sometimes even more important than markers alone. e.g. since dyslipidemia is a concern of many on this forum since rapamycin might cause it I did some research and talked to few doctors and for example the main focus on lipoproteins seems justified (in general population, we don’t know how rapamycin affects ASCVD) but it is not apoB that predicts alone the risk but the ratio to apoA-1 seems more important and in older people it is not apoB or ratio to apoA-1 that is the most important indicator, but other markers of metabolic health need to be considered too. Then there is lifestyle, exercise etc. Get’s really complex. I think longevity app that I posted the other day might include some of that or that’s how it seems…

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I was listening to a really old AMA episode a month or so ago and Peter listed off a whole bunch of his ‘optimal’ lab range targets for patients. It must have been somewhere around AMA 5 or 6 - early days. I only recently subscribed to The Drive member only - so I have been going back through the old episodes. I was out running at the time so I didn’t get to note it down and once I was home I had already forgotten. I will go back to the episode again if possible.

Bu I am rambling. Yes, the reason I made this post is for exactly what you said - optimal ranges based on all cause mortality (and potentially morbidity/DALY) data. That’s the ticket. Would be a big job to put that list together but would be so handy.

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Its such an obvious and significant need… I’m surprised it isn’t widely published already somewhere!

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Levels Health polled some of their medical advisors on some key tests and included a discussion.

“The “normal” ranges for cholesterol and other blood tests are far from optimal. We asked eight leading metabolic health experts what you should really aim for.”

The discussion where one can see where their is consensus and where those experts saw things a bit differently might also be valuable.

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Has anyone used InsideTracker?

I think they have spent a lot of effort on this question. And if so, should have optimal ranges at least for the 40 or so markets in their comprehensive panel.

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One problem is that even the normal ranges will vary by analyzer. So it is hard to specify absolute optimal ranges, there needs to be some real detail in this.

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Yeah, I’ve been using InsideTracker for a few years now. The blog below seems to indicate that they develop optimised and differentiated lab ranges based on a number of factors (I.e. gender, ethnicity, etc). Being a private company they unfortunately only make those ranges available on an individual basis once you subscribe……

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Thanks. Given that you’ve used them for a number of years am I correct you think they still are good as of today?

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I’ve used them for two years now. I get the Blood Results Upload plan for $119 US a year. It gives unlimited uploads for that calendar year.

As I live in Australia, most blood tests are covered under our Medicare system. I try to get a test every 4 months or so.

I find the app is good for tracking changes over time. It also provides food and supplement based advice for those bio markers that need work. The advice is linked to Pub Med articles.

As someone that doesn’t have a medical / biology based background, I’ve found the app has improved my health literacy.

So, to eventually answer your question, yes - I still find the product a worthwhile investment.

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Thanks DMac! Very helpful.

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There is no good guide for optimal ranges AFAIK. LEF had some decent ranges somewhere. It’s also useful to look at which values are associated with lowest risk of mortality or diseases and there are some sources for that, as long as you are aware of possible reverse causation. Ultimately I’ve found that I have to look into many things myself using PubMed, which is frustrating. There is a need for blood test ranges that indicate what is bad, decent, good, optimal etc. for longevity. But putting something like that together is a huge amount of work. If I had twenty clones I would do it myself.

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I am working on getting such information into a structured form on my biohacking.tools website, we are some distance off at the moment.

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It all depends on the child/DHL ratio and risk for men verses women too
My cholesterol total is , 229 , optimal is 100 to 199
My LDL cholesterol is also high which is good 133, although optimal is , according to life extension , 0 to 99. However, because the ratio is 2.8 I am below the average risk of a heart attack as a woman, half of average risk for a woman is 3.3 my ratio is 2.8.l am therefore very low risk. The male ratio for half average risk of a heart attack is 3.44 average risk is 5.0 ratio. I hope this helps.

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