Walk into a standard annual physical and you will usually get a CBC, a basic metabolic panel, and a cholesterol test. That is a reasonable disease screen. It is a poor longevity panel. It will tell you whether something is wrong today, but it misses most of the markers that predict how you will age over the next twenty years — the ones that are still quietly reversible while a standard panel calls you "normal."
Over the last few years, the list of tests that longevity-focused physicians actually order has become fairly settled, and in 2026 it is what high-performers and preventive-medicine clinics build their baseline around. This guide walks through that panel marker by marker, grouped by system, with what each one tells you, roughly what it costs, and how often to repeat it. None of this is medical advice — it is a map of what to discuss with your doctor or order yourself.
Why the Standard Panel Isn't Enough
The problem with the standard panel is not that it is wrong. It is that it was designed to catch disease, not to measure aging. Three examples make the gap concrete.
Your standard lipid panel reports LDL cholesterol, but the number that actually drives cardiovascular risk is ApoB — a direct count of the artery-clogging particles, which can be high even when your LDL looks fine. Your metabolic panel reports fasting glucose, but glucose is the last thing to break; fasting insulin rises years earlier and is almost never ordered. And almost no standard checkup includes Lp(a), a largely genetic particle that roughly one in five people carry at high levels and that meaningfully raises heart-attack risk — despite it being a once-in-a-lifetime test.
A longevity panel exists to close exactly these gaps: to see the drivers of aging while they are still early and movable.
Cardiovascular: Look Past LDL
Heart disease is the leading cause of death, so this is where the panel earns its keep. Order ApoB as your primary cardiovascular number — it captures your true particle burden better than LDL, and it is the marker to track as you make changes. Add Lp(a) once: if it is high, it changes how aggressively you and your doctor manage everything else; if it is low, you never need it again. Keep a standard lipid panel for context, but treat ApoB as the headline. If you want the full reasoning, see why ApoB is your real heart-risk number and why Lp(a) is the genetic risk factor you cannot ignore.
Metabolic: Catch It at Insulin, Not Glucose
Metabolic dysfunction is upstream of an enormous share of aging and chronic disease, and it is the most reversible thing on this list if you catch it early. The panel: fasting insulin, HbA1c, and fasting glucose. From fasting insulin and glucose you can calculate HOMA-IR, a simple insulin-resistance score that flags trouble years before glucose drifts up. Most doctors run glucose and HbA1c but skip insulin — which is like checking the smoke alarm but not the smoke. The details are in why fasting insulin is the test your doctor isn't running and the HOMA-IR score most doctors never calculate.
Inflammation: The Quiet Accelerant
Chronic, low-grade inflammation — "inflammaging" — is a through-line of the diseases that shorten life, and you can measure it cheaply. The core marker is hs-CRP (high-sensitivity C-reactive protein); you want it low, not merely "normal." Add homocysteine, an amino acid tied to cardiovascular and cognitive risk that is easily lowered with B vitamins when high, and consider GGT and uric acid, two underrated markers that flag metabolic and inflammatory stress beyond their textbook uses. Start with understanding your hs-CRP and why high homocysteine is a missed heart risk.
Nutrients: The Cheap, High-Yield Fixes
These are the markers where a deficiency is common, silent, and easy to correct — the best return on the panel. Measure vitamin D, vitamin B12, ferritin (iron stores, which run low far more often than a standard CBC reveals), magnesium, and the omega-3 index. The omega-3 index is a standout: it measures the omega-3 content of your red blood cells and predicts cardiovascular risk better than most people expect, and it responds directly to what you eat. See the omega-3 index test and why most doctors won't fix a vitamin D deficiency.
Hormones and Thyroid: The Full Picture
Hormones govern energy, body composition, mood, and how well you hold muscle as you age, yet they are rarely tested properly. Order a full thyroid panel — TSH plus free T4 (and free T3), not TSH alone, since TSH can read normal while the fuller panel does not. Test testosterone as both total and free (relevant for women as well as men), ideally with SHBG to interpret it correctly. For men tracking this over time, testosterone by age gives the context; for anyone whose thyroid feels off despite a "normal" TSH, the case for the full thyroid panel explains why.
Kidney and Advanced Markers
Round out the baseline with cystatin C, a kidney-function marker that is more accurate than creatinine alone and correlates with longevity — see why cystatin C beats creatinine. Two advanced, optional additions round out a serious panel: IGF-1, a growth factor with a genuine longevity trade-off (useful for muscle, but very high lifelong levels carry risk — covered in what IGF-1 levels mean), and a CAC scan (coronary artery calcium), which is imaging rather than blood but is one of the single best predictors of heart risk — see what your CAC score really means.
How Often to Test
You do not need to run all of this constantly. Establish a full baseline once, then be selective. The markers you are actively working on — ApoB, HbA1c, hs-CRP, fasting insulin — are worth retesting every three to six months, because that is how long they take to respond to real change. Everything else can go on a once- or twice-a-year cadence. Genetic or one-time markers like Lp(a) never need repeating. Testing monthly mostly captures biological noise, not progress. The fuller logic is in how often you should actually get blood work.
Where to Get It (and What It Costs)
You have two broad routes. You can ask your doctor to add these markers to your next requisition, which may be covered by insurance — though some, like Lp(a) or the omega-3 index, are often not, and you may have to advocate for them. Or you can order the panel yourself directly through a consumer lab, which is faster and fully transparent on price: a solid longevity panel typically runs $150–350 out of pocket, and comprehensive membership services that bundle 100+ markers run roughly $400–500 a year. If you want to go the self-order route, how to get blood work without a doctor walks through the options and the state-by-state rules.
Turning the Panel Into a Longevity Signal
Ordering the panel is the easy part. The value comes from what you do next: comparing each marker to optimal ranges rather than the wide "normal" bands, tracking the trend over time, and connecting the numbers to what you actually do. That is the whole idea behind the biomarkers that predict longevity — and the payoff is seeing your own feedback loop, whether the foods you eat for longevity pull your ApoB and CRP down, or whether the levers that lower your biological age show up in your metabolic markers a few months later.
The standard annual panel tells you if you are sick. The longevity panel tells you how fast you are aging — early enough to change it. Order the fuller set once, get your baseline, and then let the trend do the talking. Merios reads your uploaded panel, extracts every one of these markers, and tracks each against both standard and optimal ranges over time — so a page of numbers becomes a picture of how you are actually aging, and whether the work you are putting in is moving it.