What Biomarkers Should You Track for Long-Term Health

In an era of biohacking and personalized medicine, it is easy to feel overwhelmed by the sheer number of health markers you could measure. From basic blood counts to advanced genetic screenings, the options are nearly limitless.

However, for most people interested in longevity, the goal isn't to measure everything—it's to measure the right things consistently.

Understanding what biomarkers should you track is about identifying "high-leverage" markers: those that provide a clear window into your body’s most critical systems and offer early warning signs of change.

Metabolic Health Markers

Your metabolic health is the foundation of your long-term wellness. It determines how your body processes energy and is a primary predictor of chronic conditions like type 2 diabetes.

Fasting Glucose

Fasting glucose measures your blood sugar after an overnight fast. While it can fluctuate based on stress or sleep, your long-term average is vital. A gradual upward trend, even within the "normal" range, is a strong signal that your body is beginning to struggle with blood sugar regulation.

HbA1c: The 3-Month Average

While glucose is a snapshot, HbA1c is a panoramic view. It measures your average blood sugar levels over the past 90 days. It is significantly more stable than fasting glucose because it isn't affected by what you ate yesterday.

Fasting Insulin

This is perhaps the most underrated metabolic marker. Often, your body will keep blood sugar normal by overproducing insulin—a state called hyperinsulinemia. By the time your fasting glucose rises, insulin resistance has often been present for years.

Cardiovascular Markers

Cardiovascular disease remains the leading cause of mortality in Europe. Tracking your lipid profile is about understanding the specific particles that contribute to arterial health.

The Standard Lipid Panel

A basic panel includes Total Cholesterol, LDL ("bad"), HDL ("good"), and Triglycerides. The ratios often matter more than the individual numbers:

• Triglyceride-to-HDL ratio: A frequent sign of metabolic stress.
• LDL level: A standard measure of cardiovascular risk.

ApoB: A Deeper Look at Risk

Apolipoprotein B (ApoB) is becoming the gold standard for risk assessment. While LDL measures the amount of cholesterol, ApoB measures the number of potentially plaque-forming particles. If you have a family history of heart disease, this is a high-priority marker.

Blood Pressure

Though not a blood test, blood pressure is a fundamental biomarker. Home monitoring avoids the "white coat effect" and provides a much more accurate picture of your true cardiovascular strain.

Organ Function Markers

Your liver and kidneys are your body's primary filtration plants. Tracking their function helps identify early signs of stress from diet, medications, or environmental factors.

Liver Enzymes (ALT and AST)

ALT and AST are enzymes that spill into your blood when liver cells are stressed. A consistent upward trend can indicate early stages of fatty liver disease. Because the liver is remarkably regenerative, catching these trends early allows for highly effective lifestyle interventions.

Kidney Function (eGFR and Creatinine)

Kidney function is tracked through Creatinine and eGFR. While it is normal for these to shift slightly with age, a rapid change requires investigation. Kidney function often declines silently, so consistent tracking is vital.

Thyroid Health (TSH)

The thyroid is the master regulator of your metabolism. A TSH test is usually the first step. If your TSH is rising over time, it indicates your thyroid is struggling to keep up, even if you are still within the reference range.

Nutrient Status

Common nutrient deficiencies can significantly impact your energy, immunity, and long-term health.

• Vitamin D: Deficiency is exceptionally common in Northern Europe during winter. Since Vitamin D acts like a hormone, tracking it twice a year is essential.
• Iron and Ferritin: Critical for oxygen transport. Ferritin measures your body's iron stores—a key marker for energy levels.
• Vitamin B12: Essential for nerve health and cognitive function. Absorption often decreases as we age.

How Often Should You Test?

The frequency of testing depends on your goals:

• Healthy adults: An annual comprehensive panel is the standard for creating a "baseline."
• Tracking interventions: Every 3 to 6 months if you are making major changes to diet or exercise.
• Managing conditions: As recommended by your healthcare provider.

Testing too frequently can be counterproductive, as you may end up chasing normal biological "noise" rather than real health signals.

Building Your Personal Tracking System

The true value of these markers isn't found in a single test, but in longitudinal data.

By keeping your records organized and viewing them as a continuous timeline, you empower yourself to make data-driven decisions. This proactive approach is the core of preventive health tracking.

For more on managing this data effectively, see our guide on how to track health metrics long-term. To understand how your "normal" values might shift over time, read about how blood test values change age.

FAQ

Do I need to track all of these biomarkers?

No. Start with the core metabolic and organ function markers (Glucose, HbA1c, Lipids, Kidney/Liver enzymes). You can add more specific markers as needed.

How do I get these tests?

Start with an open conversation with your doctor. In many EU countries, you can also access these tests through private laboratories for routine screening.

What is the absolute minimum I should track?

At a minimum: a metabolic panel (glucose and lipids), kidney and liver function, and a complete blood count (CBC).

Should my tracking change as I get older?

Yes. Certain markers, like cardiovascular risk and kidney function, become more critical with age. Regular reviews with your physician will help you adjust your list.