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What Blood Tests Should I Get for Longevity?

Guideline-backed longevity bloodwork is short: lipids, a diabetes test, one-time Lp(a) and infection screens. No trial shows bigger panels add years.

12 min read · Longevity365 Editorial

A woman in a mask points to clipboard paperwork while another woman looks at it.
Illustrative discussion of unreadable paperwork. The image does not establish a lab result, diagnosis, ordered test, screening eligibility or health benefit. Photo by Gustavo Fring on Pexels.

Somewhere along the way, bloodwork became a lifestyle product. One popular consumer panel advertises more than 160 lab tests, while a routine physical can still produce one page of results and a shrug. At Humanic Blue, that raises a practical question if you’re thinking about living longer: what blood tests should you get for longevity?

The guideline answer is shorter than the ads. Current US guidelines name a cholesterol (lipid) panel to estimate heart risk, a diabetes test from about age 35 and a lipoprotein(a) test at least once in adulthood. They add one-time hepatitis C and HIV screens, plus hepatitis B screening if your risk is raised. Tests for cholesterol-carrying particles (ApoB), inflammation (hsCRP) and protein in urine (albumin) come in when they’d sharpen a specific decision. No trial has shown that ordering more blood tests helps people live longer. Below, each test lands in one of three tiers, set by how much guideline backing it has.

In This Article

Key Takeaways

  • The blood tests named in major US guidelines look for heart disease risk, diabetes and a few silent infections, because finding them early can lead to treatment.
  • ApoB, hsCRP and urine albumin help refine risk for selected people. Researchers and guideline writers disagree on whether everyone should get hsCRP.
  • In randomized trials of bundled general health checks, involving more than 230,000 people, the checks had little or no effect on deaths. That finding applies to the checks as tested; single tests weren’t isolated.
  • The Endocrine Society advises against routine vitamin D screening in generally healthy people. The US Preventive Services Task Force finds insufficient evidence to assess routine vitamin D or thyroid screening in people without symptoms.
  • Whether any big panel helps people live longer remains unknown. No trial has tested it.

Which tests do guidelines name for most adults?

These are the tests with a named guideline behind them. None of them measures aging directly. Each looks for a common, silent condition that can be treated.

  • Lipid panel (total, LDL and HDL cholesterol, triglycerides). Inputs for estimating heart attack and stroke risk. The 2026 American College of Cardiology and American Heart Association (ACC/AHA) guideline uses it with the PREVENT risk calculator for adults 30 to 79.
  • HbA1c or fasting glucose. HbA1c estimates average blood sugar over roughly three months; fasting glucose measures blood sugar after a period without food. Either can screen for prediabetes and type 2 diabetes. The US Preventive Services Task Force (USPSTF) names adults 35 to 70 with overweight or obesity; the American Diabetes Association names most adults from 35.
  • Lipoprotein(a), or Lp(a). An inherited heart risk factor. According to the ACC’s summary of the 2026 ACC/AHA guideline, every adult should have it measured at least once.
  • Hepatitis C antibody. Adults 18 to 79, per the USPSTF.
  • HIV. Ages 15 to 65, and older or younger people at increased risk, per the USPSTF.
  • Hepatitis B. Adolescents and adults at increased risk, per the USPSTF.

A few details change how this list reads.

The lipid panel has no stand-alone longevity cutoff. The USPSTF, an independent federal panel that grades preventive services, treats it as one input into a treatment decision. It recommends a statin for adults 40 to 75 with at least one heart risk factor and an estimated 10-year risk of 10% or more.

The two diabetes guidelines disagree on who gets tested. The USPSTF limits its recommendation to adults 35 to 70 with overweight or obesity. The American Diabetes Association’s 2026 Standards of Care tests some people with risk factors earlier, starts everyone else at 35 and repeats at least every three years after a normal result. What the HbA1c numbers mean

Lp(a) is the unusual one. It’s largely inherited and fairly stable, so the guideline asks for it once rather than every year. Our Lp(a) explainer covers the thresholds and the September 2026 trial result that complicated the treatment story.

The infection screens can look out of place on a longevity list. They’re there because hepatitis C and HIV can stay silent for years and have effective treatment.

Which tests sharpen a specific decision?

The second tier is the acronym-heavy corner of most longevity conversations. These tests have guideline support, but for selected people or selected decisions, not as universal screening.

ApoB. Apolipoprotein B estimates the number of cholesterol-carrying particles that can lodge in artery walls. According to the American College of Cardiology’s summary of the 2026 guideline, it may be used to check leftover risk and guide treatment in people with type 2 diabetes, high triglycerides, known heart disease or combined heart, kidney and metabolic disease who have already reached their cholesterol goals. The full picture is in What Is ApoB and Why Does It Matter?

hsCRP. High-sensitivity C-reactive protein is a blood marker of low-grade inflammation. In the ACC’s summary of the 2026 guideline, hsCRP sits alongside Lp(a), ApoB and triglycerides as markers that “can be used to refine an individual’s ASCVD risk,” meaning the risk of heart attack and stroke from artery disease.

Roger Blumenthal, MD, who chaired the guideline writing committee and directs the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, explained why the extras exist. “Having healthy LDL-cholesterol levels or high-density lipoprotein-cholesterol (HDL-C), traditionally thought of as ‘good’ cholesterol, isn’t necessarily a ‘get out of jail free’ card,” he said in the ACC announcement.

The point: a normal standard panel doesn’t settle heart risk for everyone, and the added markers are meant to catch some of the people it misses.

Urine albumin with eGFR. eGFR, the estimated glomerular filtration rate, is a kidney-function estimate calculated from creatinine on a routine metabolic panel. The National Institute of Diabetes and Digestive and Kidney Diseases names two separate key markers of kidney disease: “abnormal urine albumin levels and a persistent reduction in the estimated glomerular filtration rate (eGFR).” MedlinePlus adds that abnormal amounts of albumin in the urine “may be an early sign of kidney disease.” That makes the urine test relevant for people with diabetes or high blood pressure, which put the kidneys at higher risk.

Should everyone get hsCRP?

One cardiologist would move part of the second tier up. Paul Ridker, MD, directs the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital. He led a 30-year study of about 28,000 initially healthy US women in which a single baseline measurement of hsCRP, LDL cholesterol and Lp(a) each predicted heart attacks, strokes and related events over the next three decades. Each marker added its own information, and the three together separated risk most clearly. How the study worked

“Everyone, regardless of gender, should have all three of these measured together, preferably in your 30s or 40s, since prevention needs to start early,” Ridker told Harvard Health Publishing.

That goes further than the 2026 guideline, which treats hsCRP as an optional risk refiner rather than a test for everyone. The study was observational, included only women and measured each marker once. Ridker also holds patents on inflammatory biomarkers and has taken research support or consulting fees from companies developing inflammation and cholesterol treatments. Researchers and guideline writers currently disagree on how universal hsCRP testing should be.

What distinguishes a test that resolves a clinical question from one added to expand a panel?

Tier 3: Popular panel add-ons without screening evidence

This is the tier consumer panels are built on, and where the marker counts start to sound like stadium attendance figures. Some of these tests are common, some are useful in the right context, and none has evidence supporting routine screening in people without symptoms.

Vitamin D. The Endocrine Society’s 2024 clinical practice guideline found no clinical trial evidence to support routine vitamin D screening in the general population, and its panel suggests against routine 25(OH)D testing in every population it considered. The name stands for 25-hydroxyvitamin D, the main blood measure of vitamin D status. The USPSTF says the evidence is insufficient to weigh benefits against harms, which isn’t a recommendation against. Both positions are about screening people without symptoms; testing is a different matter when a clinician is evaluating a specific condition. The full wording

Thyroid tests. The USPSTF found the evidence insufficient to assess screening for thyroid problems in nonpregnant adults without symptoms. That 2015 statement remains current. Fatigue, weight change, a racing heart or a family history turn it into a diagnostic question, which is different.

Complete blood count and comprehensive metabolic panel. A complete blood count measures blood cells; a comprehensive metabolic panel measures blood sugar and several markers related to kidney function, liver function and chemical balance. Neither appears as a stand-alone screening test on the USPSTF list of recommended services. Clinicians use them constantly to investigate symptoms, monitor medications and set a baseline.

Everything else on a 100-plus-marker panel. Hormones, micronutrients, omega-3 indexes, heavy metals, cancer “signals” and composite “biological age” scores can each be a reasonable test in a specific clinical context. As population screening for longer life, none has trial evidence behind it.

Consumer panels have grown to match the interest. Function Health, for example, listed “160+ lab tests detecting 1000+ conditions” for “$365 per year—$1 per day” on its homepage when we checked on September 25, 2026 (prices change, so check before buying). The homepage quotes Mark Hyman, MD, calling it “The most powerful approach I’ve seen in my career.” Hyman is Function’s co-founder and chief medical officer, according to the company’s leadership page, so that endorsement comes from inside the company.

Do more tests automatically add years?

Most lab reference ranges are built from the middle 95% of results in a healthy reference group, according to the patient-education site Testing.com. The arithmetic follows: on any single test, about one healthy result in 20 lands outside the range by design. Put 160 of them on one report and flags become likely.

MedlinePlus, the National Library of Medicine’s consumer site, makes the same point: because ranges vary, “the term ‘normal’ can be misleading.”

Flags lead somewhere. In a 2019 national survey of US internists by researchers at Brigham and Women’s Hospital and Harvard Medical School, almost all had seen “cascades of care,” the follow-up tests and treatments set off by an incidental finding. Most said those cascades had caused patients psychological harm or financial burden, though nine in ten had also seen one uncover something important. The survey numbers

One of the most-cited tests of the more-checking-is-better idea comes from Cochrane, an international network that produces systematic reviews of medical evidence. Researchers at the Nordic Cochrane Centre in Copenhagen pooled randomized trials that offered adults general health checks, meaning screening for several diseases or risk factors at once. Across trials covering more than 230,000 people, the checks had little or no effect on deaths from any cause, and the reviewers rated that evidence high-certainty. They concluded that general health checks are unlikely to bring benefit. The review in detail

That review tested bundled checks. It didn’t isolate any single blood test, and it can’t show that targeted testing is useless. The separate question of whether expanded consumer blood panels add years of life remains untested.

How would a panel comparison account for false alarms as well as useful findings?

What’s Interesting

Your own history can serve as a reference range. A 2025 study in Nature led by researchers at Massachusetts General Hospital found that each healthy adult’s complete blood count settles around personal “setpoints.” Those setpoints stayed distinct for at least 20 years. People whose setpoints sat near the edges of the normal range had different 10-year death rates from people in the middle.

Senior author John Higgins, MD, a pathologist at Massachusetts General Hospital, told Harvard Health Publishing, “Normal ranges are too broad and should be narrowed for each person.”

It’s a slightly odd, rather lovely thought: a useful comparison group for your blood might be you. A change in your own numbers over time may carry information that a single reading against a population range misses. This is early work, and the hospital system has filed a provisional patent on it that names Higgins as an inventor. The study details

What This Means in Practice

At an appointment, these tiers are questions about which guidance applies, not a preset order form.

Every tier above comes from guidelines and trials that describe groups of people, not any one patient. A family history of early heart disease, a particular ancestry or an existing kidney or blood-sugar diagnosis can move a test from optional to relevant. Two people asking this same question can reasonably walk out with different lab slips.

  • Which screening guidance applies? Age, risk and prior testing determine whether the guideline-backed lipid, diabetes, Lp(a), hepatitis C and HIV tests above are relevant to a particular person. A clinician can review which, if any, are due.
  • Could history change the discussion? A family history of heart disease, diabetes, kidney disease and a higher-risk ancestry are among the “risk enhancers” listed in the ACC’s summary of the 2026 guideline. A clinician can assess whether ApoB, hsCRP or a urine albumin test would clarify a decision.
  • Do earlier results add context? If personal setpoints matter, a new result may be more informative alongside previous results, especially from the same lab.
  • Who would interpret a large panel? A clinician’s role in reviewing flagged or borderline results, and arranging any follow-up, is worth clarifying before a panel is ordered.

A primary care clinician can determine which tests, if any, fit a person’s age and history and interpret the results. A preventive cardiologist or lipid specialist is the usual referral for complicated lipid or Lp(a) results, and a nephrologist for kidney findings. Our guide to health screenings in your 40s covers the non-blood screenings, such as blood pressure and cancer, that sit alongside these tests.

Bottom Line

Guidelines address selected blood tests for heart disease risk, diabetes and silent infections, each with its own age or risk criteria. Other tests may clarify a specific clinical question. Large consumer panels measure much more, but no trial has shown that ordering them helps people live longer, and bundled health checks haven’t reduced deaths in randomized trials. The open questions are about targeting: which tests, for whom, and what to do with a borderline result. A primary care clinician can discuss how the guidance applies to an individual.

A NOTE FROM LONGEVITY365

We read research, consult expert perspectives and work to make complicated health information easier to understand. What you’re reading here reflects how we’ve interpreted and organized that information. It is educational content—not personal medical advice, diagnosis or treatment guidance.

We’re not perfect, and neither is the available research. Evidence changes, new studies emerge and what’s appropriate for one person may not be appropriate for another.

Use this article as a starting point for your own research and conversations with qualified professionals. Always talk with your doctor or another trusted healthcare professional before making decisions that could affect your health, particularly if you take medications, are receiving treatment, have existing health conditions, are pregnant or have other circumstances that could affect what’s appropriate for you.

Extra Insights & Sources

Reader Questions

A few questions to carry into the comments or your next conversation. Please leave out identifying or personal medical details.

  • 01After reading this, what would you want a test result to actually help you decide?
  • 02Which distinction changed how you read the evidence: "Which tests do guidelines name for most adults" or "Do more tests automatically add years"?
  • 03What would you ask a clinician, lab, or qualified professional before letting a number change a health decision?

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Extra Insights & Sources

For readers who want the details behind each claim above.

What We Know

  • A short list of blood tests has formal US guideline support for adults without symptoms: a lipid panel within cardiovascular risk assessment, diabetes screening, one-time Lp(a), and hepatitis C and HIV screening, plus hepatitis B screening when risk is raised. Established.
  • ApoB, hsCRP and urine albumin are guideline-recognized for refining risk in selected people. Supported.
  • Randomized trials of general health checks found little or no effect on total or cancer mortality (high certainty) and probably little or no effect on cardiovascular mortality (moderate certainty). Established for the checks as studied.
  • The Endocrine Society suggests against routine vitamin D testing, and the USPSTF finds insufficient evidence for vitamin D or thyroid screening in people without symptoms. Unsupported as routine screening.

What We Don’t Know

  • Whether any expanded panel, used as population screening, helps people live longer. No randomized trial has tested it. Unknown.
  • Whether measuring hsCRP in everyone improves outcomes beyond the standard risk calculators. The women’s study that supports it is observational, and the guideline treats it as optional. Contested.
  • How to act on many results that fall just outside a range in people with no symptoms. Follow-up guidance often doesn’t exist; 53.2% of the internists in the cascade survey said none existed, to their knowledge, for their most recent case.

The guideline details

Lipids and statins. The 2026 ACC/AHA dyslipidemia guideline (published in Circulation) recommends the PREVENT-ASCVD equations, instead of the older Pooled Cohort Equations, for 10- and 30-year risk assessment in primary prevention for adults aged 30 to 79, according to the ACC’s guideline summary. The USPSTF recommends a statin (grade B) for adults aged 40 to 75 with one or more cardiovascular risk factors (dyslipidemia, diabetes, hypertension or smoking) and an estimated 10-year cardiovascular event risk of 10% or greater.

Lp(a) and ApoB. Per the ACC press release, “Lp(a) should be measured at least once in adulthood,” because levels are largely genetically determined and relatively stable, and repeat testing is generally not needed. The ACC’s summaries say measuring apoB “may be used to assess any residual ASCVD risk and guide treatment among people with cardiovascular-kidney-metabolic syndrome, type 2 diabetes, high triglycerides or known cardiovascular disease who have reached their LDL-C and non-HDL-C goals.” The guideline’s risk enhancers include a family history of heart disease, chronic inflammatory conditions, overweight or obesity, diabetes, chronic kidney disease, higher-risk ancestry and reproductive factors such as early menopause and preeclampsia.

Diabetes. The USPSTF recommends screening for prediabetes and type 2 diabetes (grade B) in adults aged 35 to 70 who have overweight or obesity. The American Diabetes Association’s 2026 Standards of Care (recommendation 2.12b) says “For all other people, screening should begin at age 35 years,” and (2.12c) that repeat screening at a minimum of 3-year intervals is reasonable after a normal result, sooner with symptoms or a change in risk. On an HbA1c test, 5.7% to 6.4% falls in the prediabetes range and 6.5% or higher meets the diagnostic threshold for diabetes, according to the ADA. A diagnosis usually needs a confirming test on a second day.

Infections. USPSTF grades: hepatitis C screening for adults 18 to 79 (B); HIV screening for ages 15 to 65, and younger or older people at increased risk (A); hepatitis B screening for adolescents and adults at increased risk (B).

The 30-year hsCRP study, and Ridker’s disclosures

In the Women’s Health Study analysis published in the New England Journal of Medicine in 2024, researchers measured high-sensitivity CRP, LDL cholesterol and Lp(a) once, at baseline, in 27,939 initially healthy US women (mean age 54.7) and followed them for 30 years. There were 3,662 first major cardiovascular events, defined as heart attack, coronary revascularization, stroke or cardiovascular death. Comparing the top with the bottom fifth of each marker, adjusted hazard ratios were 1.70 for hsCRP, 1.36 for LDL cholesterol and 1.33 for Lp(a). A hazard ratio compares the rate at which events occur during follow-up after accounting for other measured risk factors. Here, 1.70 means the event rate was 70% higher in the highest hsCRP fifth than in the lowest fifth; it does not mean a 70% chance of an event or a 70-percentage-point increase in anyone’s risk. These associations do not show that changing a marker changes the outcome. Each biomarker contributed independently, and the authors reported that risk separated most widely in models that combined all three. The study was funded by the National Institutes of Health.

Disclosures: Ridker is listed as a co-inventor on Brigham and Women’s Hospital patents relating to the use of inflammatory biomarkers in cardiovascular disease and diabetes, licensed to Siemens and AstraZeneca, according to a 2017 competing-interests statement in CMAJ. The press release for the 2024 study adds that he has received research grant support and/or consulting fees from entities “developing preventive strategies and treatments that target inflammation, cholesterol, and lipoprotein(a).” The companies it lists include Novo Nordisk, Novartis, Pfizer, Agepha and Kowa.

Vitamin D and thyroid screening, in the guidelines’ words

The Endocrine Society’s guideline page sets out each recommendation. For healthy adults: “In healthy adults, we suggest against routine screening for 25(OH)D levels.” It adds that “In healthy adults, 25(OH)D levels that provide outcome-specific benefits have not been established in clinical trials.” It makes the same call for adults with dark complexion, adults with obesity, pregnancy and each adult age group it considered.

The systematic review behind it, from the Mayo Clinic Evidence-Based Practice Center, reported that it found no trials on the benefits and harms of screening with serum 25(OH)D.

The USPSTF issued its vitamin D statement in April 2021. It’s an I statement, meaning the evidence is insufficient to assess benefits and harms; it is not a recommendation against screening. The USPSTF thyroid statement dates from March 2015; a literature scan in May 2024 found a lack of new evidence to support an updated review.

Reference ranges and care cascades

Testing.com says reference ranges for many tests cover values reported “for the middle 95% of the reference population,” so about 5% of healthy people will fall outside the limits on any one test.

The cascades survey (JAMA Network Open, 2019) was emailed to 991 internists in an American College of Physicians research panel; 376 completed it (a 44.7% response rate), and responses were weighted to be nationally representative. Of respondents, 99.4% reported experiencing cascades; 90.9% had seen cascades with clinically important, treatable outcomes and 94.4% had seen cascades with no such outcome. Physicians reported that cascades caused patients psychological harm (68.4%), physical harm (15.6%) and financial burden (57.5%). For their most recent cascade, 53.2% said follow-up guidelines did not exist to their knowledge.

The Cochrane review of general health checks

The 2019 Cochrane review by Krogsbøll, Jørgensen and Gøtzsche included randomized trials comparing health checks with no health checks in adults not selected for disease or risk factors; geriatric trials were excluded. Health checks were defined as screening for more than one disease or risk factor in more than one organ system. Of 17 included trials, 15 reported outcome data (251,891 participants).

OutcomeTrialsParticipantsDeathsRisk ratio (95% confidence interval)Certainty
Total mortality11233,29821,5351.00 (0.97–1.03)High
Cancer mortality8139,2903,6631.01 (0.92–1.12)High
Cardiovascular mortality9170,2276,2371.05 (0.94–1.16)Moderate

A risk ratio of 1 means the groups had the same risk; the confidence interval shows the uncertainty around that estimate. The authors reported no known conflicts of interest.

The blood-count setpoint study

The Nature study (Foy et al., published online December 2024, in print January 2025) analyzed routine complete blood counts from thousands of patients at an academic medical center. The typical healthy adult’s nine blood-count setpoints were distinguishable as a group from those of 98% of other healthy adults, and setpoint differences persisted for at least 20 years. Absolute risk of all-cause 10-year mortality varied by more than 5% across setpoints: a gap of more than five percentage points between the groups’ risk percentages. This was an association between setpoints and death rates, not evidence that changing a setpoint reduces the chance of death. Harvard Health Publishing summarized that people whose setpoints fell at the lowermost or uppermost end of the normal range had higher rates of disease diagnosis and death within 10 years. The analysis was retrospective and from a single health system. Per the paper’s competing-interests statement, Mass General Brigham submitted a provisional patent application (63/695,679) on diagnostic and prognostic applications of the setpoints, naming Foy, Roth, Tozzo and Higgins as inventors.

Sources

Notes

Note 1: Guideline wording in this article comes from published summaries, not the official report: the American College of Cardiology’s press release and guideline summary.

The companion comparison describes named blood-panel packages, sample collection, memberships and interpretation arrangements.

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