What are your top 10 biomarkers to track for improving healthspan and longevity?

Hello all,
I know about the Aging 3.0 AI and Levine age calculators and the blood biomarkers that they are based on. Unfortunately I cannot get one or two blood tests required for each test, like RBW or total protein.

I am interested in what you think are the best biomarkers to track for improving healthspan and longevity. I will use it to measure the effects of any supplements or medications I take and I am sure it will be useful to others.

I am specifically interested in the most important biomarkers to start with.

3 Likes

Something like this

combined with AI assessment of pics for your perceived age. Further, I’m not convinced that any of the aging clocks are of much value here.

2 Likes

Interesting, so you don’t believe that measuring blood biomarkers are that important?

CRP gives an indication of senescence load, but you need to measure it a few times to exclude infection.

3 Likes

Is that your most important biomarker? Do you have any others that you think are important?

I think that is the most important. However, the usual ones about organ function are relevant as well. I prefer Cystatin-C to Creatinine. I would prefer wearing a CGM to monitor glucose to HbA1c, but HbA1c is useful. In terms of cardiac function Blood Pressure, RHR and HRV are relevant as well as things like Creatinine Kinase. I would not want to give a definitive list. Generally the more the merrier.

2 Likes

ApoB, vo2max, fasting glucose, high-sensitive CRP and lymphocytes or neutrophil/ lymphocyte ratio are those I rate the highest.

3 Likes

It’s a great question. I think the fundamentals are the most important. I’m trying to sort out what to track, such as: apoB (ASCVD), HbA1c & HOMA-IR & body fat% (metabolic health), blood pressure and RHR (cardiovascular & mitochondrial health), hsCRP (immune system), Cystatin-C (kidney), HRV (adequate sleep & stress mgmt).

What am I missing?

1 Like

My HRV is extremely low, so that’s something I’m looking to increase. It’s around 27 ms which I believe is below the 5th percentile. In fact it was 32 ms in 2021, 29 ms in 2022 and 27 ms this year (measured daily). I have never exercised regularly which might be the reason. I am kind of deliberately deconditioned because I want to see how well I will improve.

Do you have an optimal range for those blood markers and how do you determine it?

Why do you think lymphocytes or the neutrophil/lymphycyte ratio is important to measure, is it because you’re taking rapamycin? Or is it important for everyone else too?

Yes, I am measuring apoB already. It’s top of my list, I don’t know about anything else right now.
Why is Cystatin-C better than Creatinine?
How do you measure HOMA-IR and why is it important?

1 Like

Those are really standard lab bloodwork test. Any lab can do it.
RBW is part of blood differential test
total protein is also a standard test, but can be calculated from albumin, globulin and fibrinogen

If you are doing tests and will track them, I recommend that you track also kidney and liver biomarkers, lipids, glucose and insulin, minerals, vitamins, hormones…

1 Like

btw PA recommends his patients to track these:

5 Likes

Move along, nothing to see here.

3 Likes

Creatinine can be misleading. Serum creatinine is a breakdown product of muscle. People with more muscle mass make more creatinine per day. Serum creatinine based equations underestimate GFR in patients with higher muscle mass.

HOMA-IR is a calculation based on fasting glucose and fasting insulin. It’s a marker of insulin resistance….metabolic flexibility.

2 Likes

apoB (ASCVD), HbA1c & HOMA-IR & body fat% (metabolic health), blood pressure and RHR (cardiovascular & mitochondrial health), hsCRP (immune system),

I think these are the important ones, everything else is (perhaps) nice to have but not gotta have.

2 Likes

Fasting glucose is totally meaningless.
I have a GCM and here is a typical fasted glucose plot from midnight to noon.
My glucose goes down to 84 at 2:30 am then start to ramp up linearly from 2:30am to 9:15am
Then I go for a 10k run and the glucose first goes down to 80 before the liver decides to make some and it goes up to 114 at 10:44am when I stop running. During the cooldown the glucose goes down to 96 at noon.
All that has been fasted and the last meal was at 6pm the day before so, depending when you take that fasting glucose, it can be between anywhere between 80 and 114 which makes it a totally useless measurement. A 42.5% variation which will also translate into a 42.5% variation of HOMA-IR BTW.

image

2 Likes

Right. Unless of course you have an ongoing medical condition that is being actively treated, I wouldn’t obsess over the blood bio-markers. I would focus instead on sleeping, keeping health bmi and daily exercise.

3 Likes

HRV asleep is different to awake. How do.you measure it?

2 Likes

The response I got regarding RBW is that Entrocytes, Hemoglobin, EVF, MCV and MCH is used to get the same answer hence it is not used. Is it possible to do your own calculation with albumin, globulin and fibrinogen test?

Do you track them to see the general function of the kidney and liver or do you also check if they’re optimal with regards to ACM from studies?

He doesn’t check entrocytes? Immune system?

It is average HRV throughout the night with an Oura ring.

1 Like

what would be the ideal neutrophil/lymphocyte ratio? Is age-adjusted?

1 Like

Red cell distribution width (RDW) is an important biomarker and I doubt they would not do it. Just ask for differential blood count or blood differential test, sometimes it is called blood morphology test, it is always part of that.
Yes if you take the three protein test and add the values you get total protein.

I mostly track to check the function, sometimes I would check ACM too, in case of liver and kidney it mostly corresponds with optimal values, but many blood markers change trough life and what is considered optimal in young age might not be optimal in old age… and things get too complex for my preference for less structured approach. If you start looking at all fine details one might get lost. For example my RDW went up from 11,8 to 13,2% on rapamycin. It is still in normal range. All other biomarkers “improved” but this one is showing a trend that I don’t like. But should I now concentrate on this biomarker? Or just say, the average is better?

IDK what do you mean, but since he is tracking hemoglobin which is part of complete blood count probably you track others too. Immunity is tracked trough hs-CRP I guess.

1 Like