How to Measure Your Healthspan: Biomarkers and Tracking
You can't optimize what you don't measure. This comprehensive guide covers the biomarkers, functional tests, and tracking systems proven to predict healthspan—from basic DIY assessments (free) to advanced commercial testing ($200-500/year). Learn optimal ranges, testing frequency, and how to close the feedback loop from measurement to intervention.
Standard "normal" lab ranges are based on the 88% unhealthy population. Being "normal" means you're average among a mostly sick population. For healthspan optimization, you need optimal ranges—the levels associated with lowest disease risk and longest healthy years.
❌ Normal (But Not Optimal)
- • hs-CRP: 2.5 mg/L ("normal")
- • Fasting insulin: 15 µIU/mL
- • HbA1c: 5.6%
- • ApoB: 120 mg/dL
These values predict accelerated aging despite being "within range"
✓ Optimal (Healthspan Target)
- • hs-CRP: <0.5 mg/L
- • Fasting insulin: 2-6 µIU/mL
- • HbA1c: <5.3%
- • ApoB: <80 mg/dL
These values predict healthiest aging and lowest disease risk
Critical Biomarkers with Optimal Ranges
These markers predict healthspan better than chronological age. Target optimal ranges, not just normal ranges, for maximum benefit.
Inflammatory Markers
Standard Normal
<3.0 mg/LOptimal for Healthspan
<0.5-0.7 mg/LWhy it matters: Predicts cardiovascular disease and all-cause mortality. Lower levels indicate reduced systemic inflammation.
Multiple prospective studies show optimal hs-CRP <0.5 mg/L associated with lowest cardiovascular risk
Standard Normal
<5 pg/mLOptimal for Healthspan
<2.08 pg/mLWhy it matters: Pro-inflammatory cytokine elevated in chronic disease. Optimal levels associated with healthy aging.
Ferrucci et al. found IL-6 <2.08 pg/mL predicts successful aging trajectories
Standard Normal
5-15 µmol/LOptimal for Healthspan
<7-10 µmol/LWhy it matters: Elevated levels increase cardiovascular and cognitive decline risk. Modifiable through B-vitamins and methylation support.
Meta-analyses show elevated homocysteine independently predicts CVD and cognitive decline
Metabolic Markers
Standard Normal
70-99 mg/dLOptimal for Healthspan
65-85 mg/dLWhy it matters: Even high-normal glucose increases glycation and oxidative stress. Optimal control preserves metabolic health.
Studies show fasting glucose >85 mg/dL associated with increased diabetes risk despite being 'normal'
Standard Normal
<25 µIU/mLOptimal for Healthspan
2-6 µIU/mLWhy it matters: Best marker of insulin sensitivity. High-normal insulin indicates insulin resistance years before glucose rises.
Kraft insulin assay research shows optimal fasting insulin 2-6 µIU/mL predicts metabolic health
Standard Normal
<5.7%Optimal for Healthspan
<5.3-5.4%Why it matters: 3-month average blood sugar. Each 0.1% increase above 5.0% increases mortality risk. Lower is better for longevity.
Prospective studies show HbA1c <5.4% associated with lowest all-cause mortality
Standard Normal
<130 mg/dLOptimal for Healthspan
<80-90 mg/dLWhy it matters: Superior to LDL cholesterol for cardiovascular risk. Each ApoB particle is atherogenic—lower dramatically reduces risk.
Mendelian randomization studies show lifelong ApoB <80 mg/dL reduces CVD risk by 50-80%
Standard Normal
<150 mg/dLOptimal for Healthspan
<70-100 mg/dLWhy it matters: Marker of insulin sensitivity and carbohydrate metabolism. Low triglycerides indicate excellent metabolic health.
Triglycerides <100 mg/dL predict insulin sensitivity and low CVD risk
Hormonal Markers
Standard Normal
264-916 ng/dLOptimal for Healthspan
700-900 ng/dLWhy it matters: Critical for muscle mass, bone density, cognitive function, and vitality. Optimization improves healthspan outcomes.
Testosterone Trials showed men 65+ with T >500 ng/dL had improved strength, sexual function, vitality
Standard Normal
0.4-4.0 mIU/LOptimal for Healthspan
1.0-2.0 mIU/LWhy it matters: Thyroid function regulates metabolism. High-normal TSH suggests subclinical hypothyroidism affecting energy and metabolism.
Studies show TSH >2.5 mIU/L associated with increased cardiovascular risk and metabolic dysfunction
Standard Normal
30-100 ng/mLOptimal for Healthspan
60-80 ng/mLWhy it matters: Impacts immune function, bone health, cardiovascular health, and mortality. Supplementation for 3+ years reduces mortality 6-7%.
Vitamin D at 60-80 ng/mL associated with lowest all-cause mortality; supplementation >3 years required for benefit
Key Findings:
- Lower scores associated with reduced risk of COPD, diabetes, heart failure, cancer, myocardial infarction, dementia, and stroke
- Superior to chronological age, BMI, and traditional biomarkers for predicting health outcomes
- Identifies biological aging trajectories before clinical symptoms appear
Availability: Currently research-only. Commercial testing expected within 2-3 years as costs decrease.
Kuo et al. PNAS 2025
Functional Assessments: Real-World Capacity
Functional tests measure what really matters—your physical capacity in the real world. These tests predict mortality as accurately as many expensive lab tests, and you can do most of them at home for free.
Optimal
>1.0 m/s (faster is better)
Warning Zone
<0.8 m/s signals frailty risk
Significance:
Each 0.1 m/s decrease = 12% increased mortality risk
How to Perform:
Mark a 4-meter course. Time yourself walking at normal pace. Calculate speed: 4 meters ÷ time in seconds.
Age-Specific Standards:
White et al. (2013) - 8-year study of 2,364 adults found gait speed more predictive of mortality than many clinical measures
Optimal
Men >40 kg, Women >25 kg (age-dependent)
Warning Zone
Men <26 kg, Women <16 kg
Significance:
Each 5 kg decrease = 16% increased all-cause mortality. Rivals blood pressure for cardiovascular prediction.
How to Perform:
Use hand dynamometer. Squeeze maximally for 3-5 seconds. Take best of 3 attempts per hand. Average both hands.
Age-Specific Standards:
Leong et al. Lancet study - Grip strength predicted cardiovascular mortality better than systolic blood pressure
Optimal
Age <50: 60+ seconds, Age 50-60: 30+ seconds, Age 60+: 10+ seconds
Warning Zone
Unable to hold 10 seconds (middle-age and older)
Significance:
Inability to balance 10 seconds almost doubles mortality risk in middle-aged and older adults (BMJ research).
How to Perform:
Stand barefoot on one leg, arms at sides or crossed over chest. Time how long you maintain balance without touching down. Best of 3 attempts.
Age-Specific Standards:
BMJ 2022 study - inability to balance 10 seconds associated with 84% increased mortality over 7 years
Optimal
Age 60-64: Men >14, Women >12; Age 65-69: Men >12, Women >11
Warning Zone
<8 stands indicates significant functional limitation
Significance:
Measures lower body strength and fall risk. Strong predictor of mobility disability and independence.
How to Perform:
Sit in straight-back chair (seat height 17"). Cross arms over chest. Stand fully and sit down repeatedly for 30 seconds. Count total stands.
Age-Specific Standards:
CDC functional fitness test - validated measure of lower body strength predicting disability risk
Commercial Testing Options
Multiple services offer comprehensive biomarker testing with varying levels of guidance, analysis, and cost. Choose based on your budget and preference for medical oversight.
Features:
- Physician review of all results
- Quest Diagnostics at 2,000+ locations
- Urgent result phone calls
- Optional whole-body MRI add-on
- Comprehensive inflammatory, metabolic, and hormonal panels
Best for: Comprehensive annual screening with medical oversight
Features:
- Personalized action plans
- Wearable device integration
- InnerAge biological age calculation
- Food and supplement recommendations
- Progress tracking dashboard
Best for: Optimization-focused with actionable recommendations
Features:
- 30+ page epigenetic age report
- Multiple clock algorithms (DunedinPACE, GrimAge, PhenoAge)
- Pace of aging measurement
- Immune system age
- Telomere length estimation
Best for: Epigenetic age and biological aging assessment
Features:
- No physician required
- Quest/LabCorp network
- Results in 1-3 days
- Order exactly what you need
- Budget-friendly comprehensive panels
Best for: Cost-conscious individuals who understand their testing needs
Testing Frequency: When and How Often
Testing frequency depends on your optimization phase. More frequent during active intervention, less frequent during maintenance.
Tests: Comprehensive panel (inflammatory, metabolic, hormonal markers) + functional tests + body composition
Purpose: Establish your current healthspan status and identify optimization targets
Tests: Core metabolic markers (glucose, insulin, HbA1c, lipids with ApoB, hs-CRP) + functional tests
Purpose: Track response to interventions and adjust protocols
Tests: Comprehensive panel 1-2x/year, core markers 2-4x/year, functional tests quarterly
Purpose: Maintain optimization and catch early decline
Tests: Relevant markers for specific intervention (e.g., lipids 8-12 weeks after diet change)
Purpose: Assess intervention effectiveness and adjust if needed
Pro tip: Test 6-12 weeks after implementing interventions to assess response. Some changes (like lipid improvements from diet) take 8-12 weeks to manifest. Testing too early wastes money and provides misleading data.
DIY Tracking: Free or Low-Cost Monitoring
You don't need expensive lab tests to track many important health markers. These DIY metrics provide valuable data at minimal cost and can be tracked daily or weekly.
Optimal
50-70 bpm
How to Measure:
Measure immediately upon waking, before getting out of bed. Track daily for 7 days, calculate average.
Lower RHR indicates better cardiovascular fitness. Each 10 bpm increase associated with increased mortality.
Optimal
110-120/70-75 mmHg
How to Measure:
Measure at same time daily, seated, after 5 minutes rest. Take 2-3 readings, average the results.
Optimal BP <120/80. Each 20/10 mmHg increase doubles cardiovascular risk.
Optimal
Men <94 cm (37"), Women <80 cm (31.5")
How to Measure:
Measure at level of belly button, standing relaxed, at end of normal exhalation. Track monthly.
Better predictor of metabolic health than BMI. Visceral fat accumulation indicates insulin resistance.
Optimal
Stable within 2-3 lbs week-to-week (maintenance), or 0.5-1% loss/week (fat loss phase)
How to Measure:
Weigh daily at same time (upon waking, after bathroom), calculate weekly average to smooth fluctuations.
Track trends, not daily fluctuations. Sudden changes may indicate health issues.
Optimal
7-8 hours total sleep with <20 min to fall asleep, <1-2 awakenings
How to Measure:
Track total sleep time, time to fall asleep, number of awakenings, subjective quality rating.
Sleep <7 or >8 hours increases mortality 14-34%. Quality matters as much as duration.
Optimal
8,000-10,000 steps/day
How to Measure:
Track automatically with phone or wearable. Focus on consistency, not perfection.
2,517 steps/day minimum for mortality benefit. 8,000-10,000 optimal for most adults.
Your Healthspan Measurement Implementation Plan
Follow this structured timeline to establish baseline, optimize markers, and maintain tracking long-term.
- Order comprehensive blood panel (or schedule with Function Health/InsideTracker)
- Perform all functional tests at home (gait speed, grip strength if have dynamometer, balance, chair stand)
- Track DIY metrics for 7 days (RHR, BP, sleep, steps, waist circumference, weight)
- Take baseline photos (front, side, back) and measurements
- Document current health status, symptoms, energy levels, cognitive function
- Review all biomarker results, identify markers outside optimal range
- Calculate healthspan gap: how many markers are 'normal' but not 'optimal'?
- Prioritize top 3-5 markers to optimize first (typically: insulin sensitivity, inflammation, body composition)
- Set specific 90-day targets for each priority marker
- Design intervention protocol targeting priority areas
- Implement resistance training 2-3x/week (targets insulin sensitivity, body composition, functional capacity)
- Optimize nutrition (Mediterranean pattern targets inflammation, metabolic markers)
- Sleep optimization to 7-8 hours consistently (impacts all biomarkers)
- Track functional tests monthly (gait, balance, chair stand)
- Track DIY metrics weekly (RHR, BP, waist, weight trend)
- Retest core metabolic markers at Week 12 (glucose, insulin, HbA1c, lipids, hs-CRP)
- Comprehensive panel every 6 months
- Core metabolic markers every 3 months
- Functional tests quarterly
- DIY tracking ongoing (becomes automatic habit)
- Adjust protocols based on results and goals
- Consider advanced testing (epigenetic age) annually
Common Measurement Mistakes to Avoid
Reality:
Standard ranges based on 88% unhealthy population. Optimal targets for healthspan differ significantly.
ApoB <130 mg/dL is 'normal' but optimal for healthspan is <80 mg/dL—a massive difference in cardiovascular risk.
Reality:
Healthspan measurement requires tracking trends over time. Single snapshots miss the trajectory.
Solution:
Establish baseline, retest during optimization phase (3 months), then maintain 2-4x yearly testing.
Reality:
You can have 'perfect' labs but poor functional capacity. Real-world performance matters more than numbers.
Solution:
Balance biomarker optimization with functional capacity. Grip strength and gait speed predict mortality as well as many lab values.
Reality:
Measurement without intervention wastes money and time. Data only matters if it drives action.
Solution:
Test → Analyze → Intervene → Retest to confirm improvement. Close the feedback loop.
Reality:
Epigenetic age testing costs $300-500 but resistance training, sleep, and diet are free and more impactful.
Solution:
Start with basic comprehensive panel ($200-300) + functional tests (free) + DIY tracking (minimal cost). Add advanced testing once basics are optimized.
The Bottom Line
Measuring your healthspan transforms vague goals into concrete targets. You can't optimize what you don't measure. The combination of biomarkers (what's happening inside) and functional tests (what you can do) provides comprehensive healthspan assessment.
Start with basics: Comprehensive blood panel ($200-400) + functional tests (free) + DIY tracking (minimal cost) gives 80% of value
Target optimal, not normal: Standard ranges predict average outcomes among mostly unhealthy population. Optimal ranges predict exceptional outcomes
Test → Intervene → Retest: Close the feedback loop. Measurement without intervention is data collection, not optimization
Balance biomarkers with function: Perfect labs mean nothing if you can't walk up stairs. Functional capacity is the ultimate healthspan measure
Track trends, not snapshots: Single measurements fluctuate. Weekly/monthly/quarterly trends reveal true trajectory
The best predictor of your healthspan 10 years from now is what you measure and optimize today. Start tracking this week.