What are the best lab tests to request specifically for longevity? – The Peter Attia Drive

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This is Peter’s (@PeterAttiaMD) new short podcast series, The Qualys, available only to paying subscribers (except for periodic episodes like this one)

Key Takeaways

  • With a blood test, Peter looks for the following in regards to longevity:
    • What is this person’s risk of atherosclerotic disease or stroke? (this is largely driven by – lipoprotiens, inflammation, and endothelial dysfunction)
      • With a blood test, in the lipoprotein department, you can measure – Lp(a), LDL, LDL particle number, cholesterol, and vLDL
        • Note – The higher your Lp(a) – the greater your chance of cardiovascular mortality
      • On the inflammation side, you can measure specific and non-specific markers of inflammation (specific in regards to where the inflammation is coming from)
        • Non-specific – Fibrinogen, C-reactive protein (CRP)
        • Specific – Oxidized LDL (Ox-LDL), Lp-PLA2, Oxidized Phospholipid (Ox-PL)
      • For endothelial health, a blood test allows one to measure – insulin, homocysteine, ADMA and SDMA (both inhibitors of nitric oxide synthase)
      • In general – the younger you are, the more a blood tells you about your risk of cardiovascular diseaser 
    • What is this person’s risk of cancer?
      • “This is where blood gives us the least insight”
      • Cancer really comes down to understanding inflammation and metabolic health
        • One key factor here – minimizing hyperinsulinemia 
    • What is this person’s risk of neurodegenerative disease?
      • Alzheimer’s Disease is closely related to cardiovascular disease in terms of risk stratification 
        • Your ApoE genotype (measured with a DNA analysis) immediately qualifies you as low, medium, or high risk
  • What about fasting blood glucose?
    • If you’re fasting blood glucose level is 150 mg/dL – there’s clearly a problem
    • “Now that I wear a continuous glucose monitor and I know my glucose 24/7, the difference between a fasting glucose of 90 and 105 in the morning is much more a function of my cortisol level than it is anything to do with insulin sensitivity”
      • In simple terms – stress and a lack of sleep can raise your fasting blood glucose