A longevity blood panel is not a longer list of the same markers your GP already runs. It is a specific set: ApoB and Lp(a) rather than total cholesterol, fasting insulin and HOMA-IR rather than HbA1c alone, hs-CRP rather than standard CRP. Roughly 25 to 30 markers do most of the predictive work. This page covers which ones, what to aim for, which UK panels actually include them, and the two that most private longevity panels quietly leave out.
Longevity testing is not about volume. A focused set of the right markers beats a long list of the wrong ones. These are the ones with the strongest evidence behind them, grouped by what they tell you.
Every particle that can lodge in an arterial wall carries exactly one ApoB molecule, so ApoB counts particles rather than measuring the cholesterol inside them. The 2026 AHA/ACC guidelines now formally recommend ApoB measurement. Attia targets below 60 mg/dL, roughly the 5th percentile. Mainstream guidance is less aggressive. Either way, this is the single most important cardiovascular number and the NHS does not test it.
Genetically determined, elevated in roughly 20% of people, and stable across your entire life. The European Atherosclerosis Society recommends measuring it once per lifetime. You cannot change it meaningfully, but knowing it changes how aggressively you should manage everything else. Test it once. The NHS does not offer it.
Insulin resistance develops years, often more than a decade, before HbA1c moves out of range. Fasting insulin catches it in that window, when it is still reversible. HOMA-IR is calculated from fasting insulin and fasting glucose together. This is the pair most commonly missing from UK longevity panels, and the omission matters more than any other.
Standard CRP detects acute infection. High-sensitivity CRP measures the persistent low-grade inflammation associated with cardiovascular, metabolic and neurodegenerative risk. Different assay, different question. Below 1.0 mg/L is the target most longevity clinicians work to.
TSH alone misses poor T4 to T3 conversion, and Free T3 is the active hormone that sets metabolic rate. Many UK labs will not run Free T3 outside protocol even when a GP requests it. Thyroid antibodies can be raised for years before TSH shifts.
Testosterone, oestradiol, DHEA-S and cortisol, with SHBG so free hormone can be calculated. Total testosterone without SHBG is half a picture, because high SHBG means less biologically available hormone at the same total reading.
Elevated homocysteine is associated with endothelial damage and cognitive decline, and it is correctable with B12, folate and B6. One of the few longevity markers where the intervention is cheap, simple and well evidenced.
Both ends matter. Depletion drives fatigue and impairs performance long before anaemia appears. Overload is associated with oxidative stress and organ damage. Ferritin alone can mislead because it rises with inflammation, so it needs transferrin saturation and hs-CRP alongside it to interpret.
This is the most useful thing on this page, and it is not a marketing point. It is a genuine and well-documented gap in UK private testing.
Fasting insulin is not part of standard NHS testing. It also sits outside a lot of private panels, because it needs a properly fasted sample and adds to the assay cost. Without fasting insulin you cannot calculate HOMA-IR, which is the standard index of insulin resistance. So a panel can present itself as a longevity or optimisation panel, include HbA1c, and still be blind to insulin resistance in the decade before HbA1c moves.
This is not a fringe view. Lola Health, one of the better UK providers, says it plainly in their own Attia guide: fasting insulin is not part of standard NHS testing, "and even many private panels do not include it. HOMA-IR is therefore also unavailable unless you specifically seek out a panel that offers it. This is one of the genuine gaps between Attia's ideal panel and what is practically available in UK private testing."
What to do about it: before buying any longevity panel, search the marker list for "fasting insulin" and "HOMA-IR". If both are absent, the panel cannot assess early insulin resistance no matter how many other markers it runs. The TrueVitals Ultimate panel includes both as standard, alongside HbA1c, fasting glucose and C-peptide.
The core longevity markers, checked against the deepest panel each UK provider offers. Verified August 2026.
| Provider | ApoB | Lp(a) | Fasting insulin | HOMA-IR | hs-CRP | Free T3 | Homocysteine | Markers | Price |
|---|---|---|---|---|---|---|---|---|---|
| TrueVitals Signature | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 230 | £799 |
| TrueVitals Ultimate | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 114 | £368 |
| Randox Everyman/woman | Yes | Sometimes | Insulin only | No | Yes | Yes | Sometimes | ~100 | £416 |
| Lola Health Peak | Yes | Yes | No | No | Yes | No | No | ~70 | ~£285 |
| Medichecks Optimal | Add-on | Add-on | No | No | Yes | Add-on | Add-on | ~59 | £274-308 |
| Forth Vitality | No | No | No | No | Yes | Some panels | No | ~50 | ~£244 |
| Thriva | No | No | No | No | Some | No | No | ~40-50 | ~£99-149 |
| NHS (GP request) | No | No | No | No | CRP only | Rarely | No | 10-20 | Free |
Where a provider offers a marker only as a paid add-on, it is marked as such rather than as included. Marker availability varies by panel configuration, so check the current list before ordering. Full provider comparison.
We sell blood tests, so treat this section with appropriate scepticism. It is still true, and you should know it before spending anything.
In 2025 an international Delphi panel of ageing researchers proposed a set of 14 biomarkers of ageing for use in intervention studies. Several are not blood markers at all: muscle mass, muscle strength, grip strength, gait speed, standing balance and Timed-Up-and-Go. Alongside those, VO2 max is one of the most robust predictors of all-cause mortality in the literature, and no blood panel measures it.
So if you are serious about healthspan rather than collecting data, the honest hierarchy is roughly this. Cardiorespiratory fitness and strength do more for your life expectancy than any biomarker you can optimise. Blood work tells you where the metabolic and cardiovascular risk sits, and which interventions are working. Both matter. Only one of them is something we sell.
Be sceptical of single-number biological age. Composite scores like PhenoAge use blood markers and have genuine research backing, but a single "your biological age is 34" headline from a blood panel compresses a lot of uncertainty into one confident-sounding number. The underlying markers are more useful than the score built on top of them.
The Signature panel includes physical measurements alongside blood work, which partially closes this gap: blood pressure, waist and hip circumference, weight and resting pulse are taken at your appointment and read alongside your metabolic markers. It still does not measure VO2 max or grip strength, and no blood test does.
Longevity targets are frequently tighter than standard NHS reference ranges. That gap is not a conspiracy. Reference ranges describe the middle 95% of a population that is not especially healthy, while optimisation targets aim at the healthiest end. Both are legitimate for different purposes. Here is where they diverge, and what a longevity-minded clinician typically works to.
Attia targets below 60 mg/dL, roughly the 5th percentile. Below 80 mg/dL is a common clinical goal at moderate risk. The NHS does not routinely measure it at all.
Below 125 nmol/L, or below 50 mg/dL. Elevated in roughly 20% of people. Measure once. If raised, first-degree relatives should be tested too.
Below 1.0 mg/L is the target most longevity clinicians work to. The NHS flags standard CRP only above 5 mg/L, which is a different assay answering a different question.
Below 1.0 is generally considered optimal insulin sensitivity. Above 2.0 suggests meaningful insulin resistance. There is no validated UK diagnostic cut-off, which is part of why it is under-tested here.
Below 36 mmol/mol is the optimisation target. NICE defines pre-diabetes at 42 to 47, so there is a wide band that is technically normal and metabolically drifting.
75 to 125 nmol/L is the commonly cited optimal range. The NHS deficiency threshold is below 25 nmol/L, which leaves a large insufficient-but-not-flagged zone.
Roughly 50 to 150 ug/L for most people. The NHS flags low only below 15. Above 200 in men or 150 in women warrants investigation for overload.
Below 10 umol/L is a common target. Correctable with B12, folate and B6 where elevated, making it one of the more actionable markers on the list.
These are general targets discussed in longevity medicine, not personal medical advice. Your appropriate target depends on your overall risk profile, family history and existing conditions, and should be set with a clinician. How to read your results.
Every longevity marker on this page is in the Ultimate panel at £349. ApoB, Lp(a), fasting insulin, HOMA-IR, C-peptide, hs-CRP, homocysteine, full thyroid with antibodies, complete hormones with SHBG, full iron studies, vitamin D, B12, folate, cystatin C and liver and kidney function. For most people tracking healthspan, that is the panel.
The Signature panel at £799 tests 230 markers through Randox Health laboratories and adds neurological markers, digestive and gastric health, extended autoimmune and tumour screening, Epstein-Barr antibodies, and the physical measurements described above. Clinic phlebotomy is included. For context, Randox's own comparable programme costs around £2,112.
The honest split: start with Ultimate if you want the longevity core and intend to retest annually to watch trends. Choose Signature if you want maximum coverage in a single sitting, have specific concerns beyond the core, or want the physical measurements integrated into the same report.
ApoB and Lp(a) for cardiovascular risk, HbA1c with fasting insulin and HOMA-IR for metabolic health, hs-CRP for inflammation, homocysteine, full thyroid including Free T3, sex hormones with SHBG, vitamin D, ferritin with full iron studies, and liver and kidney function. Roughly 25 to 30 markers do the predictive work. Fasting insulin and HOMA-IR are the two most commonly omitted from UK panels.
Attia recommends below 60 mg/dL for the general population, roughly the 5th percentile. Mainstream cardiology is less aggressive, and the 2026 AHA/ACC guidelines recommend measuring ApoB without setting one universal target. Below 80 mg/dL is a common goal at moderate risk. Your target depends on your risk profile. More on ApoB and Lp(a).
It is not standard NHS testing and it needs a properly fasted sample, which adds cost and complexity. Without it, HOMA-IR cannot be calculated. That matters because insulin resistance develops years before HbA1c moves, so a panel with HbA1c alone reads normal while insulin resistance is establishing. More on insulin resistance.
Not reliably on its own. Blood markers feed composite estimates like PhenoAge, but several of the strongest healthspan predictors are not blood markers: VO2 max, grip strength, muscle mass and gait speed. A 2025 international Delphi panel proposed 14 biomarkers of ageing and several are physical rather than biochemical. Treat any single-number biological age from blood alone with scepticism.
Annually for most people. Every six months if you are actively intervening on a marker and want to know whether it worked. Lp(a) is genetic and stable, so test it once. Trends matter more than single readings, which is why a consistent interval beats frequent erratic testing. Why trends beat snapshots.
No. Both are US-only. Function Health runs a membership at roughly $365 to $499 a year for 100 plus markers, and Superpower is around $199 a year. Neither operates in the UK. The closest UK equivalents by depth are the TrueVitals Ultimate panel at 114 markers and Signature at 230, both one-off purchases rather than memberships.
ApoB, Lp(a), fasting insulin, HOMA-IR, hs-CRP, homocysteine, full thyroid and complete hormones. 114 biomarkers with AI cross-system analysis and medical review, in 4 working days.
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