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10 Essential Biomarkers to Track Your Health

10 Essential Biomarkers to Track Your Health

Tracking your health goes beyond routine check-ups. These 10 biomarkers provide critical insights into areas like blood sugar, inflammation, heart health, and more. Monitoring these can help you identify risks early and make informed decisions about your lifestyle and wellness.

Key Biomarkers:

  1. Hemoglobin A1c (HbA1c): Tracks long-term blood sugar control. Optimal range: 4.0–5.0%.
  2. Fasting Insulin: Detects early insulin resistance. Ideal range: 2–6 µIU/mL.
  3. Lipid Panel: Measures LDL, HDL, and triglycerides for heart health.
  4. Apolipoprotein B (ApoB): A better predictor of cardiovascular risk. Aim for <90 mg/dL.
  5. High-Sensitivity C-Reactive Protein (hs-CRP): Indicates inflammation. Keep it below 1.0 mg/L.
  6. Thyroid Stimulating Hormone (TSH): Evaluates thyroid health. Optimal range: 1.0–2.5 mIU/L.
  7. Vitamin D (25-hydroxyvitamin D): Supports immune and bone health. Target: 40–60 ng/mL.
  8. Liver Enzymes (ALT & AST): Reflect liver function. ALT: <25 U/L (men), <19 U/L (women); AST: <30 U/L.
  9. Cystatin C: Monitors kidney function. Ideal level: <0.95 mg/L.
  10. Total Testosterone: Vital for energy and muscle health. Men: 600–1,000 ng/dL; Women: 15–70 ng/dL.

Why It Matters:

  • HbA1c and fasting insulin reveal early signs of metabolic issues.
  • Lipid panel and ApoB help assess heart disease risk.
  • hs-CRP identifies low-level inflammation linked to chronic conditions.
  • TSH and testosterone highlight hormonal imbalances.
  • Vitamin D, liver enzymes, and cystatin C offer insights into overall health.

Testing Tips:

  • Fasting Required: For fasting insulin and lipid panel.
  • Morning Tests: Schedule TSH and testosterone testing early in the day.
  • Frequency: Test every 6–12 months or more often if managing specific conditions.

Monitoring these biomarkers regularly can help you stay ahead of potential health issues and maintain long-term wellness. Prioritize testing based on your health goals and consult your healthcare provider for personalized recommendations.

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1. Hemoglobin A1c (HbA1c)

TL;DR: The ideal HbA1c range is 4.0–5.0%, compared to the standard normal of less than 5.7%. This test reflects your average blood sugar levels over the past two to three months.

Hemoglobin A1c is a key indicator of long-term blood sugar control, offering insights into your metabolic health and potential disease risks. Unlike a fasting glucose test that provides a snapshot of your blood sugar at a single point in time, HbA1c reveals the bigger picture, accounting for how factors like meals, stress, and sleep influence your glucose levels over weeks.

What HbA1c Tells You

Think of HbA1c as a report card for your metabolic health. It measures the percentage of hemoglobin in your blood that’s been glycated, or coated with sugar, over the past two to three months. The higher the percentage, the higher your average blood sugar levels have been.

Understanding the Ranges

According to standard guidelines, HbA1c levels are categorized as:

  • Normal: Below 5.7%
  • Prediabetic: 5.7%–6.4%
  • Diabetic: 6.5% or higher

However, research suggests that aiming for an optimal range of 4.0–5.0% may better support metabolic health. Even "higher normal" levels within the standard range can hint at early insulin resistance and a greater risk of cardiovascular issues. These subtle differences in HbA1c levels can have a meaningful impact on your overall health.

Why It Matters

When HbA1c levels rise, so does the risk for several serious health conditions, including diabetes, heart disease, kidney complications, and nerve damage. Maintaining HbA1c within the optimal range can help promote more stable energy levels and support better metabolic function.

What Affects HbA1c Levels?

  • High HbA1c: Often linked to insulin resistance, diets heavy in refined carbs, chronic stress, poor sleep, or even certain medications like steroids.
  • Low HbA1c: Could signal hypoglycemia, anemia, or overtreatment of diabetes. Extremely low levels (below 4.0%) should prompt a discussion with a healthcare provider.

Testing for HbA1c

Testing is straightforward and doesn’t require fasting. A simple blood draw can provide results within one to two business days. For a more comprehensive analysis, look for services that not only deliver quick results but also include clear, actionable insights. For example, Superpower offers an HbA1c panel that highlights optimal ranges, is HSA/FSA eligible, and provides detailed feedback beyond what standard labs typically offer.

While at-home testing kits are an option, laboratory testing is generally more accurate and reliable due to stricter quality control.

Disclaimer: This information is for educational purposes and not a substitute for professional medical advice. Always consult your healthcare provider for personalized guidance.

2. Fasting Insulin

TL;DR: The ideal fasting insulin range is 2–6 µIU/mL, much lower than the standard reference range of up to 25 µIU/mL. This test measures the amount of insulin your body produces after fasting for 8–12 hours.

Fasting insulin is a powerful tool for detecting insulin resistance well before blood sugar levels show any abnormalities. While many people focus on glucose levels, insulin reveals how hard your pancreas is working to maintain stable blood sugar.

What Fasting Insulin Tells You

In a healthy metabolism, only small amounts of insulin are needed to keep blood sugar levels steady during fasting. However, when your cells become resistant to insulin, your pancreas compensates by producing more of it. This overproduction can quietly contribute to weight gain, inflammation, and an increased risk of heart disease.

Interpreting the Ranges

Most labs consider fasting insulin levels up to 25 µIU/mL as "normal", but research suggests this range is too broad to accurately reflect optimal health. A range of 2–6 µIU/mL is considered ideal for maintaining good insulin sensitivity and metabolic balance.

  • 6–10 µIU/mL: May indicate early stages of insulin resistance.
  • Above 10 µIU/mL: Signals significant metabolic dysfunction and warrants immediate attention.

Even within the so-called "normal" range, higher insulin levels are linked to greater risks of type 2 diabetes, heart disease, and metabolic syndrome. These insights highlight the importance of understanding insulin levels as a marker for overall health.

Why Insulin Levels Matter

Elevated fasting insulin often shows up years before other markers of metabolic issues become apparent. High insulin levels can make losing weight incredibly challenging and contribute to chronic inflammation, high blood pressure, and even a higher risk of certain cancers.

On the other hand, low fasting insulin (below 2 µIU/mL) could indicate insufficient insulin production. This may point to conditions like type 1 diabetes, advanced type 2 diabetes, or pancreatic dysfunction. Extremely low levels should prompt a medical evaluation to rule out autoimmune diseases or pancreatic damage.

What Affects Your Insulin Levels?

Fasting insulin levels are influenced by both short-term habits and long-term lifestyle choices, including:

  • Diet: High intake of refined carbs, sugary foods, and oversized meals.
  • Physical activity: Exercise helps muscles absorb glucose more efficiently.
  • Stress and sleep: Poor sleep raises cortisol, which interferes with insulin sensitivity.
  • Body weight: Excess abdominal fat releases compounds that promote inflammation.
  • Medications: Certain drugs, like steroids or some blood pressure medications, can impact insulin levels.

Testing and Preparation

To measure fasting insulin, you’ll need to fast for 8–12 hours (water is allowed) and avoid intense exercise for 24 hours before the test. The blood draw is straightforward, and results are usually available within 1–2 business days.

Unfortunately, many standard lab panels focus only on glucose levels, leaving fasting insulin overlooked. This gap means insulin resistance often goes undetected until it progresses to more severe metabolic issues. Including both fasting glucose and fasting insulin in metabolic panels offers a clearer picture of your overall health.

Superpower includes fasting insulin as part of their metabolic health panels, offering detailed interpretations of your results along with actionable recommendations. Testing is available nationwide at Quest Diagnostics locations and is eligible for HSA/FSA reimbursement.

Disclaimer: This content is for educational purposes only and not a substitute for professional medical advice. Always consult your healthcare provider for personalized guidance.

3. Lipid Panel (LDL-C, HDL-C, Triglycerides)

TL;DR:
For better heart health, aim for LDL-C below 100 mg/dL, HDL-C above 60 mg/dL for women and 50 mg/dL for men, and triglycerides under 100 mg/dL.

A lipid panel provides a snapshot of the fats and cholesterol in your blood, offering valuable insights into your cardiovascular health. While cholesterol is often simplified into "good" (HDL) and "bad" (LDL), each component plays a unique role in your body.

What Each Component Measures

LDL Cholesterol (LDL-C):
Often called "bad" cholesterol, LDL-C can build up in your arteries, leading to plaque formation. Lower levels are better for heart health. While labs usually consider anything below 100 mg/dL acceptable, aiming for even lower levels may provide extra protection.

HDL Cholesterol (HDL-C):
HDL-C, the "good" cholesterol, helps move cholesterol from your tissues back to your liver for processing. Higher levels are generally beneficial, though extremely high levels (above 100 mg/dL) could have unintended effects.

Triglycerides:
These are a type of fat circulating in your blood. Elevated levels are linked to heart health risks. Although labs define "normal" as under 150 mg/dL, keeping triglycerides below 100 mg/dL is often considered better for reducing cardiovascular risk.

Optimal vs. Standard Ranges

Focusing on optimal levels rather than standard averages can improve your heart health. Many lab ranges reflect population averages, not necessarily the healthiest targets. For adults over 20, total cholesterol typically falls between 125 and 200 mg/dL. However, optimal targets are more precise:

  • LDL-C: Levels below 100 mg/dL are commonly recommended, but lower values may further reduce heart disease risk, especially for individuals with diabetes or high blood pressure.
  • HDL-C: Healthy ranges start at 40 mg/dL for men and 50 mg/dL for women, but aiming for above 60 mg/dL for women and 50 mg/dL for men offers added protection.
  • Triglycerides: While levels under 150 mg/dL are considered normal, keeping them below 100 mg/dL is linked to better heart health. Levels over 200 mg/dL significantly increase the risk of heart disease.

What Influences Your Lipid Levels?

Your lipid profile is shaped by both genetics and lifestyle. Factors like diet, exercise, body weight, stress, sleep habits, medications, and alcohol consumption all play a role. While dietary cholesterol may have less impact on blood cholesterol for many, your overall eating habits still matter.

Regular exercise can help raise HDL-C and lower triglycerides, while excess weight, chronic stress, and poor sleep can negatively impact your lipid levels by increasing inflammation and disrupting hormones. Some medications, like beta-blockers or steroids, can also affect your lipid profile. Alcohol presents a mixed picture - moderate intake might boost HDL-C, but excessive drinking can raise triglycerides.

Testing Requirements and Timing

For accurate triglyceride readings, most lipid panels require fasting for 9–12 hours. While non-fasting tests are now available, fasting remains the gold standard for a detailed assessment.

The test itself is quick, and results are typically ready in 1–2 business days. To ensure accuracy, avoid intense exercise for 24 hours before the test and stick to your usual diet in the days leading up to it.

Many wellness panels include basic lipid testing, but a more thorough cardiovascular evaluation might also measure additional markers like ApoB (covered in the next section). Superpower offers comprehensive lipid analysis with personalized insights at Quest Diagnostics locations nationwide. These tests are HSA/FSA eligible and come with an in-depth interpretation of your results, alongside other key heart health markers.

Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider for personalized recommendations.

4. Apolipoprotein B (ApoB)

TL;DR:
To protect your heart health, aim for ApoB levels below 90 mg/dL. If you're at higher risk, keeping levels under 80 mg/dL is even better.

Apolipoprotein B (ApoB) is a protein found on all atherogenic lipoproteins, like LDL and VLDL. It provides a direct count of the particles responsible for plaque buildup in arteries, offering a more accurate measure of cardiovascular risk than cholesterol levels alone.

What Does ApoB Measure?

ApoB is essentially a headcount of harmful lipoprotein particles in your blood. Each atherogenic particle carries one ApoB protein, so the test directly reflects the number of these particles. Even if two people have similar LDL cholesterol levels, someone with a higher ApoB count has more of these harmful particles - and a greater risk of heart disease. This precise particle count helps set clearer cardiovascular goals.

Optimal vs. Standard Ranges

Standard ApoB ranges are based on population averages, but for heart health, it's best to aim lower:

  • Below 90 mg/dL is ideal for most people.
  • Under 80 mg/dL is recommended for those at higher risk (e.g., with diabetes or a history of heart disease).
  • Below 65 mg/dL may be beneficial for individuals with multiple risk factors or existing cardiovascular disease.

ApoB testing is particularly valuable when your regular lipid panel looks fine, but ApoB is elevated. This mismatch, called discordant lipid profiles, happens in about 20-30% of people. It can reveal hidden risks that traditional cholesterol tests might miss, making ApoB a crucial tool for a complete cardiovascular assessment.

What Affects ApoB Levels?

Several lifestyle and medical factors can influence ApoB levels:

  • Diet: Cutting back on saturated fats, trans fats, and refined carbs can lower ApoB more effectively than just reducing LDL cholesterol.
  • Weight Loss: Losing visceral (belly) fat can significantly reduce ApoB levels.
  • Exercise: Aerobic activity can lower ApoB by 10-15% in some individuals, and resistance training adds further benefits when combined with cardio.
  • Medications: Statins can reduce ApoB by 25-35%, while newer treatments may achieve even greater reductions.
  • Sleep and Stress: Poor sleep and chronic stress can increase atherogenic particle production, so managing these can help keep ApoB in check.

Testing Details and Timing

ApoB testing is straightforward and doesn't require fasting, making it more convenient than traditional lipid panels. A simple blood draw is all it takes, and results are usually available within 1-2 business days.

When should you consider an ApoB test? If you have a family history of early heart disease, diabetes, metabolic syndrome, or if your cholesterol numbers don't seem to match your risk level, ApoB testing can provide valuable insights. Combining ApoB results with a standard lipid panel offers a more thorough picture of your cardiovascular health.

Superpower includes ApoB testing in its comprehensive cardiovascular panels, available through Quest Diagnostics nationwide. The test is HSA/FSA eligible and comes with an in-depth interpretation of your results, alongside other key heart health markers.

Disclaimer: This information is for educational purposes only and not a substitute for professional medical advice. Always consult your healthcare provider for personalized recommendations.

5. High-Sensitivity C-Reactive Protein (hs-CRP)

TL;DR:
Aim for hs-CRP levels below 1.0 mg/L to indicate low inflammation. Levels between 1.0–3.0 mg/L suggest moderate risk, while anything above 3.0 mg/L points to a higher risk of cardiovascular issues. Readings over 10.0 mg/L may signal an acute inflammatory response.

High-sensitivity C-reactive protein (hs-CRP) testing measures CRP at very low levels (down to 0.1 mg/L) to detect both acute and chronic inflammation.

What Does hs-CRP Measure?

hs-CRP assesses the amount of C-reactive protein in your blood. Unlike standard CRP tests that focus on acute inflammation, the high-sensitivity version identifies subtle increases, often tied to low-level systemic inflammation. Since chronic inflammation is linked to conditions like cardiovascular disease, tracking hs-CRP can help identify risks early - even before symptoms appear.

Optimal vs. Standard Ranges

Here’s how hs-CRP levels are typically categorized:

  • Below 1.0 mg/L: Indicates low risk and an optimal inflammatory state.
  • 1.0–3.0 mg/L: Suggests moderate risk and mild chronic inflammation.
  • Above 3.0 mg/L: Associated with a higher risk of cardiovascular problems.
  • Above 10.0 mg/L: Likely reflects an acute inflammatory response, often due to infection, injury, or illness, rather than chronic inflammation.

Knowing these ranges is crucial, especially since lifestyle and health factors can influence your results.

What Affects hs-CRP Levels?

Several factors, including lifestyle choices, diet, physical activity, and health conditions, can impact hs-CRP levels:

  • Lifestyle: Poor sleep, high stress, and excess abdominal fat are all linked to elevated hs-CRP levels.
  • Diet: Eating processed foods, refined sugars, and trans fats can increase inflammation. On the flip side, foods like fatty fish, leafy greens, berries, and olive oil may help reduce it over time.
  • Physical Activity: Moderate exercise tends to lower inflammation, but intense workouts can temporarily raise hs-CRP levels.
  • Medical Conditions: Infections, autoimmune diseases, gum disease, and other inflammatory conditions can also elevate hs-CRP.

Testing Details and Timing

Given these influencing factors, hs-CRP testing is simple - just a routine blood draw with no fasting required. However, it’s best to avoid testing during or right after an illness, injury, or surgery, as these can temporarily spike your levels. If your initial test shows elevated hs-CRP, a follow-up test 2–3 weeks later can confirm whether the increase is persistent.

Regular monitoring of hs-CRP is part of a broader approach to managing chronic conditions and improving overall health. Superpower offers comprehensive health panels that include hs-CRP testing, available at Quest Diagnostics locations across the country. These tests are HSA/FSA eligible and provide detailed insights into cardiovascular and inflammatory markers, helping you understand your health.

Disclaimer: This information is for educational purposes only and should not replace medical advice. Always consult your healthcare provider for personalized guidance.

6. Thyroid Stimulating Hormone (TSH)

TL;DR:
Aim for TSH levels between 1.0–2.5 mIU/L for optimal thyroid health. Standard lab ranges of 0.4–4.0 mIU/L may overlook subtle thyroid issues. Higher TSH levels suggest an underactive thyroid, while lower levels point to overactivity.

Thyroid Stimulating Hormone (TSH) is produced by the pituitary gland and plays a key role in regulating thyroid hormone production, which influences metabolism and energy levels.

What Does TSH Measure?

TSH serves as an indicator of how hard your pituitary gland is working to stimulate thyroid hormone production. When your thyroid isn’t making enough hormones (T3 and T4), the pituitary ramps up TSH production to compensate. On the flip side, when thyroid hormone levels are sufficient, TSH production decreases. This inverse relationship makes TSH a reliable marker for detecting thyroid issues.

Even minor thyroid imbalances can impact your heart rate, body temperature, weight, mood, and sleep patterns. Maintaining optimal TSH levels is critical for overall metabolic health and well-being.

Optimal vs. Standard Ranges

TSH testing provides insight into thyroid function by revealing how well the pituitary and thyroid glands are communicating. However, traditional lab ranges may not always catch mild thyroid dysfunction:

  • Optimal Range: 1.0–2.5 mIU/L
  • Subclinical Hypothyroidism: 2.5–4.0 mIU/L (normal T3/T4, elevated TSH)
  • Overt Hypothyroidism: Above 4.0 mIU/L
  • Subclinical Hyperthyroidism: 0.1–0.4 mIU/L
  • Overt Hyperthyroidism: Below 0.1 mIU/L

Because standard ranges are so broad, someone with a TSH of 3.8 mIU/L might be told their thyroid is "normal", even if they’re experiencing symptoms like fatigue, weight gain, or brain fog. Research suggests that TSH levels above 2.5 mIU/L could signal early thyroid issues, particularly in younger adults.

Recognizing these ranges underscores the importance of addressing even small TSH changes when exploring potential thyroid concerns.

What Affects TSH Levels?

High TSH (Signs of Hypothyroidism):

  • Symptoms: Fatigue, weight gain, cold sensitivity
  • Causes: Hashimoto’s thyroiditis, iodine deficiency, certain medications (e.g., lithium, amiodarone), aging, stress
  • Lifestyle Factors: Chronic stress, poor sleep, restrictive diets

Low TSH (Signs of Hyperthyroidism):

  • Symptoms: Rapid heartbeat, weight loss, heat sensitivity
  • Causes: Graves’ disease, thyroid nodules, excessive thyroid medication, iodine overuse
  • Lifestyle Factors: Supplements with high iodine levels

Both elevated and low TSH levels indicate different thyroid challenges that require careful evaluation.

Testing Details and Timing

TSH testing involves a simple blood draw, and fasting isn’t necessary. Since TSH levels peak in the morning and dip later in the day, it’s best to test at the same time each time for consistency.

For accurate results, schedule your test in the morning, take thyroid medication after your blood draw, and stop taking biotin supplements 2–3 days beforehand.

For a complete thyroid evaluation, consider testing TSH alongside free T3, free T4, and thyroid antibodies (TPO and thyroglobulin). This gives a more detailed view of thyroid health.

Superpower offers comprehensive thyroid panels that provide a clear snapshot of your thyroid function, helping you stay proactive about your health. These tests are available at Quest Diagnostics locations across the U.S., are HSA/FSA eligible, and offer detailed insights to support your wellness journey.

Disclaimer: This content is for educational purposes only and not a substitute for medical advice. Always consult your healthcare provider for personalized recommendations.

7. Vitamin D (25-hydroxyvitamin D)

TL;DR:
Aim for vitamin D levels between 40–60 ng/mL for the best health outcomes. Although many labs consider 30–100 ng/mL as "sufficient", staying within the narrower range may reduce risks tied to deficiency. Low vitamin D levels can lead to infections, bone issues, and other chronic conditions.

Vitamin D functions as a steroid hormone, playing a role in calcium absorption, immune health, and overall wellness. The 25-hydroxyvitamin D test measures the main storage form of vitamin D in the blood.

What Does Vitamin D Measure?

This test evaluates the primary circulating form of vitamin D. When you get vitamin D from sunlight, food, or supplements, it’s first converted in the liver to 25-hydroxyvitamin D, which circulates in the blood. The kidneys then convert it to calcitriol, the active hormone responsible for calcium absorption and supporting immune, muscle, and heart health. Unlike most vitamins that act as simple cofactors, vitamin D functions more like a hormone, with receptors found throughout the body.

Optimal vs. Standard Ranges

Vitamin D levels are reported in nanograms per milliliter (ng/mL). Here's a breakdown:

  • Severe Deficiency: Below 10 ng/mL
  • Deficiency: 10–20 ng/mL
  • Insufficiency: 20–30 ng/mL
  • Standard "Sufficient": 30–100 ng/mL
  • Optimal Range: 40–60 ng/mL
  • Upper Safe Limit: 100 ng/mL

While levels above 30 ng/mL are often labeled as sufficient, research suggests that aiming for 40–60 ng/mL may better support immunity and overall health. Levels exceeding 100 ng/mL can lead to toxicity, typically caused by long-term overuse of supplements.

What Affects Vitamin D Levels?

Low Vitamin D Levels

  • Symptoms: Frequent infections, fatigue, bone pain, muscle weakness, mood swings, slow wound healing, and hair loss.
  • Common Causes: Limited sun exposure is the leading cause. Living in northern regions, staying indoors, regular sunscreen use, or having darker skin can all reduce vitamin D production. Seasonal changes, especially during winter, also contribute.
  • Additional Factors:
    • Aging reduces the skin's ability to synthesize vitamin D.
    • Obesity can lower levels since vitamin D gets trapped in fat tissue.
    • Certain medications, such as corticosteroids, anticonvulsants, and some cholesterol-lowering drugs, may interfere with vitamin D metabolism.

High Vitamin D Levels

  • Symptoms: Nausea, vomiting, weakness, and in rare cases, kidney problems.
  • Cause: High levels are almost always due to excessive supplementation, as the body naturally regulates vitamin D production from sunlight.

Maintaining vitamin D in the optimal range is key to supporting other biomarkers and overall health. Regular testing helps identify deficiencies or excesses, allowing you to adjust your supplementation accordingly.

Testing Details and Timing

Testing vitamin D levels involves a simple blood draw, and no fasting is required. Since vitamin D is fat-soluble and stored in body tissues, the test reflects your levels over the past 2–3 months. This makes it especially useful for tracking seasonal changes or the effectiveness of supplementation.

If you start supplementing, retest after 8–12 weeks to gauge progress. To get the most accurate results, test while continuing your usual supplement routine unless advised otherwise by your healthcare provider.

For the best insights, test your levels twice a year - once in late winter and again in late summer - to account for seasonal fluctuations and adjust your intake as needed.

Tracking your vitamin D levels is an essential step toward managing your overall health. Superpower's vitamin D testing offers accurate results nationwide, is HSA/FSA eligible, and provides actionable insights to guide your supplementation plan. By optimizing this key biomarker, you're laying the groundwork for better health all year long.

Disclaimer: This information is for educational purposes only and is not a substitute for medical advice. Always consult your healthcare provider for personalized recommendations.

8. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)

TL;DR:
Experts suggest that for optimal liver health, ALT levels should stay below 25 U/L for men and below 19 U/L for women, while AST levels should remain under 30 U/L for both sexes. Although standard lab ranges are broader, these tighter thresholds may provide a clearer picture of liver function and help identify potential risks earlier.

Liver enzymes like ALT and AST are essential markers for understanding your overall health. When liver cells are damaged, these enzymes leak into the bloodstream, serving as early indicators of potential liver issues.

What Do ALT and AST Measure?

Alanine Aminotransferase (ALT) is primarily found in the liver, making it a key marker for liver damage. On the other hand, Aspartate Aminotransferase (AST) is found in multiple tissues, including the liver, heart, muscles, kidneys, and brain. When both enzymes are elevated, it often points to liver-related problems. The ratio of AST to ALT can provide additional clues: an AST/ALT ratio above 2:1 is commonly linked to alcohol-related liver damage, while a ratio closer to 1:1 may indicate conditions like non-alcoholic fatty liver disease or viral hepatitis.

Optimal vs. Standard Ranges

Liver enzymes are measured in units per liter (U/L):

ALT (Alanine Aminotransferase):

  • Standard Lab Range: 7–56 U/L (men), 7–40 U/L (women)
  • Optimal Range: Below 25 U/L (men), below 19 U/L (women)

AST (Aspartate Aminotransferase):

  • Standard Lab Range: 10–40 U/L (both sexes)
  • Optimal Range: Below 30 U/L (both sexes)

What Affects ALT and AST Levels?

Elevated Levels

When ALT and AST levels are high, symptoms like fatigue, abdominal discomfort, nausea, or even jaundice in severe cases may occur.

Common Causes:

  • Non-alcoholic fatty liver disease (NAFLD): The leading cause of elevated liver enzymes in the U.S., affecting around 25% of adults.
  • Medications: Drugs like acetaminophen, statins, certain antibiotics, and some supplements can increase enzyme levels.
  • Alcohol Consumption: Even moderate drinking may elevate these enzymes.
  • Viral Hepatitis: Hepatitis A, B, or C infections can cause significant spikes in enzyme levels.
  • Metabolic Conditions: Conditions like diabetes and obesity are linked to higher liver enzyme levels.

Lifestyle Factors:

  • Diet: Recent food intake can influence ALT levels.
  • Exercise: Intense physical activity may temporarily raise enzyme levels.
  • Weight Gain and Insulin Resistance: Both are associated with increased liver enzyme levels.

Normal or Low Levels

Normal levels indicate a healthy liver. Extremely low enzyme levels are rare but may occur in advanced liver disease when the liver's functional capacity is significantly reduced.

Testing Details and Timing

ALT and AST are measured through a simple blood test. Results are typically available within one to two business days. For reliable tracking, it's important to maintain consistent testing conditions.

Preparation Guidelines:

  • Fasting: If the test is part of a comprehensive metabolic panel (CMP), fasting for 10–12 hours is often required. For standalone liver enzyme tests, fasting may not be necessary.
  • Medication Disclosure: Let your provider know about all medications and supplements you're taking, as some can affect enzyme levels. You may be asked to pause certain medications temporarily - always follow your provider's advice.
  • Exercise: Avoid intense workouts for 24–48 hours before testing, as they can temporarily alter AST levels.

Timing Considerations:
Enzyme levels can fluctuate based on recent meals, exercise, or medication use. Testing under consistent conditions is essential for accurate tracking. If your results are elevated, your doctor may recommend retesting in 2–4 weeks to confirm the findings. For individuals with risk factors like obesity or diabetes, testing every 6–12 months can help catch potential issues early.

Regular monitoring of ALT and AST is a valuable tool for assessing liver and metabolic health. Superpower's comprehensive testing panels include these key markers, with results available nationwide through Quest Diagnostics. The tests are HSA/FSA eligible and provide actionable insights to help you maintain a healthy liver.

Disclaimer: This information is for educational purposes only and is not a substitute for medical advice. Always consult your healthcare provider for personalized recommendations.

9. Cystatin C

TL;DR:
Cystatin C levels should ideally stay below 0.95 mg/L (standard range up to 1.02 mg/L). This marker provides a more dependable way to evaluate kidney health compared to traditional creatinine tests, particularly for individuals with varying muscle mass.

Cystatin C offers a consistent measure of kidney filtration efficiency, unaffected by muscle mass, age, or diet.

What Does Cystatin C Measure?

Cystatin C is a protein that all cells produce at a steady rate. The kidneys filter this protein from your blood, making it a reliable marker for glomerular filtration rate (GFR) - a key measure of kidney function and blood filtration efficiency.

Unlike creatinine, which can fluctuate based on muscle mass or dietary protein, cystatin C levels remain more stable across different groups of people.

Optimal vs. Standard Ranges

Cystatin C is measured in milligrams per liter (mg/L):

  • Standard Lab Range: 0.62–1.02 mg/L
  • Optimal Range: Below 0.95 mg/L

For GFR, the thresholds are as follows:

  • Normal: Greater than 90 mL/min/1.73 m²
  • Mild Kidney Disease: 60–89 mL/min/1.73 m²
  • Moderate Kidney Disease: 30–59 mL/min/1.73 m²

What Affects Cystatin C Levels?

Elevated Levels
Higher cystatin C levels usually signal reduced kidney function. Since early kidney problems often show no symptoms, monitoring this marker is vital for early detection.

Common Causes of Elevated Levels:

  • Chronic Kidney Disease: The most common reason for increased cystatin C
  • Diabetes: Prolonged high blood sugar can damage kidney blood vessels
  • High Blood Pressure: Poorly controlled hypertension can harm kidney function
  • Autoimmune Disorders: Conditions like lupus can negatively impact kidney health
  • Medications: Certain drugs, such as some blood pressure medications, antibiotics, and pain relievers, may affect kidney function

Risk Factors:

  • Age: Kidney function naturally declines over time
  • Family History: A genetic predisposition to kidney issues increases risk
  • Cardiovascular Disease: Heart-related problems are often linked to kidney health

By understanding these factors, regular testing can help identify subtle changes in kidney function before they become serious.

Testing Details and Timing

Cystatin C testing is straightforward and reliable. A quick blood draw is all it takes, and results are typically ready within 1–2 business days. No special preparations are required.

Preparation Guidelines:
You don't need to fast before the test. Stay hydrated and continue taking prescribed medications unless your doctor advises otherwise.

Testing Frequency:
For most healthy adults, annual testing as part of a comprehensive health panel is sufficient. However, individuals with higher risk - such as those with diabetes, high blood pressure, or existing kidney conditions - may need testing every 3–6 months.

Clinical Applications:
Cystatin C testing is especially valuable for groups where creatinine-based tests may be less accurate - older adults, people with very low or high muscle mass, vegetarians, or those taking creatine supplements. Many nephrologists now prefer GFR calculations based on cystatin C because they provide a clearer picture of kidney function. Research even shows that cystatin C can detect kidney function declines earlier than traditional methods.

Superpower includes cystatin C testing in its comprehensive health panels, offering advanced kidney health insights alongside traditional markers. Tests are available nationwide through Quest Diagnostics and are HSA/FSA eligible, making it easier to prioritize proactive health monitoring.

Disclaimer: This information is for educational purposes only and is not a substitute for medical advice. Always consult your healthcare provider for personalized recommendations.

10. Testosterone (Total)

TL;DR:
For men, total testosterone levels should ideally fall between 600–1,000 ng/dL, while for women, the range is 15–70 ng/dL. This hormone plays a major role in energy, muscle mass, bone strength, and overall vitality, making it a key marker for long-term health.

What Does Total Testosterone Measure?

Total testosterone measures the complete amount of testosterone in your blood. This includes the 98% that’s bound to proteins like SHBG (sex hormone-binding globulin) and albumin, as well as the 2% that’s free and biologically active. Testosterone is essential for muscle growth, bone density, fat regulation, and even cognitive health.

In men, testosterone levels peak in early adulthood and begin to decline gradually - about 1–2% per year - after age 30. Women produce smaller amounts of testosterone through their ovaries and adrenal glands, but it's no less important for maintaining energy, libido, and muscle strength.

Optimal vs. Standard Ranges

Testosterone levels are measured in nanograms per deciliter (ng/dL), but the ranges can vary depending on the lab.

Men:

  • Standard Lab Range: 300–1,000 ng/dL
  • Optimal Range: 600–1,000 ng/dL

Women:

  • Standard Lab Range: 8–60 ng/dL
  • Optimal Range: 15–70 ng/dL

Laboratories often use broad reference ranges that include older adults whose levels naturally decline with age. However, optimal ranges are based on levels that support better energy, body composition, and overall health. Understanding these ranges is crucial, as several factors can influence testosterone levels.

What Affects Testosterone Levels?

Testosterone levels can be influenced by lifestyle choices, age, and medical conditions.

Low Testosterone Levels
Symptoms of low levels include fatigue, loss of muscle mass, increased body fat, and reduced motivation.

Common Causes of Low Testosterone:

  • Age: Testosterone naturally starts to decline around age 30.
  • Obesity: Excess body fat can convert testosterone into estrogen.
  • Chronic Stress: High cortisol levels can suppress testosterone production.
  • Poor Sleep: Getting less than 7 hours of sleep a night can lower testosterone by 10–15%.
  • Medications: Certain drugs, like opioids and some antidepressants, may lower levels.
  • Medical Conditions: Diabetes, metabolic syndrome, and thyroid issues can impact testosterone.

High Testosterone Levels
Although less common, elevated testosterone levels can occur due to specific medical conditions or external factors.

Potential Causes of High Testosterone:

  • Polycystic Ovary Syndrome (PCOS): Affects up to 10% of women of reproductive age.
  • Adrenal Disorders: Tumors or adrenal gland hyperplasia can increase hormone production.
  • Thyroid Dysfunction: Conditions like hyperthyroidism may affect testosterone-binding proteins, altering total testosterone readings.

Testing Details and Timing

Since testosterone levels naturally fluctuate throughout the day, the most accurate readings come from morning tests, typically between 7:00–10:00 AM when levels are highest.

Preparation Tips:
Avoid intense exercise for at least 24 hours before testing, as heavy workouts can temporarily affect testosterone levels. Continue taking prescribed medications unless your doctor advises otherwise.

How Often Should You Test?
For most healthy adults, annual testing is sufficient. However, men over 40 or those experiencing symptoms like fatigue, mood changes, or muscle loss may benefit from testing twice a year.

Additional Testing Insights:
Total testosterone is often the first step in evaluating hormone health. If levels are low, additional tests - like free testosterone, SHBG, or luteinizing hormone - can provide a more detailed picture. Because testosterone levels can vary throughout the day, it's important to confirm low readings with a second morning test before making any treatment decisions.

Superpower includes total testosterone testing in its hormone panels, offering a convenient way to monitor your endocrine health. Testing is available nationwide through Quest Diagnostics and qualifies for HSA/FSA reimbursement, making it easier to prioritize your health.

Tracking your total testosterone alongside other biomarkers gives you a clearer picture of your overall health and metabolism.

Disclaimer: This content is for educational purposes and is not a substitute for medical advice. Always consult your healthcare provider for personalized guidance.

Biomarker Comparison Chart

Here's a quick reference chart summarizing the key details of the 10 biomarkers discussed earlier:

| Biomarker | Optimal Range | Primary Health Impact | Testing Method | Cost Range | | --- | --- | --- | --- | --- | | HbA1c | <5.4% | Blood sugar control, diabetes prevention | Blood draw (no fasting required) | $25–$50 | | Fasting Insulin | 2–6 μIU/mL | Metabolic health, insulin resistance | Blood draw after 8–12 h fast | $30–$60 | | Lipid Panel | LDL-C: <100 mg/dL; HDL-C: >60 mg/dL; Triglycerides: <100 mg/dL | Cardiovascular health, metabolic function | Blood draw (fasting recommended) | ~$30–$60 | | Apolipoprotein B | <90 mg/dL | Cardiovascular risk assessment | Blood draw (no fasting required) | $40–$80 | | hs-CRP | <1.0 mg/L | Inflammation levels | Blood draw (no fasting required) | $30–$60 | | TSH | 1.0–2.5 mIU/L | Thyroid function, metabolism | Blood draw (morning preferred) | $25–$50 | | Vitamin D (25-OH) | 40–60 ng/mL | Bone health, immune function | Blood draw (no fasting required) | $35–$70 | | Liver Enzymes | ALT: <25 U/L (men), <19 U/L (women); AST: <30 U/L (both sexes) | Liver health and function | Blood draw (no fasting required) | ~$30–$60 | | Cystatin C | 0.62–1.15 mg/L | Kidney function | Blood draw (no fasting required) | $40–$80 | | Total Testosterone | Men: 600–1,000 ng/dL; Women: 15–70 ng/dL | Energy, muscle mass, bone strength | Blood draw (morning 7–10 AM) | $30–$60 |

Prioritizing and Scheduling Tests

Where to Start:
The "Big 4" markers - HbA1c, fasting insulin, lipid panel, and hs-CRP - are essential for gaining a broad understanding of your metabolic and cardiovascular health. If you're dealing with fatigue, mood swings, or a history of thyroid or liver concerns, consider adding TSH, vitamin D, and liver enzymes to your list. For those seeking more detailed insights, advanced markers like ApoB, cystatin C, and testosterone can provide a more thorough evaluation.

How Often to Test:
Most biomarkers are best checked every 6–12 months. However, if you're monitoring specific conditions or symptoms, testing more often - every 3 to 6 months - may be a better fit.

Timing Matters:

  • Test hormone-related markers like testosterone and TSH in the morning (7:00–10:00 AM) for consistent results.
  • For fasting-related tests like fasting insulin and the lipid panel, aim for 8–12 hours without food and schedule your appointment early in the day to minimize any inconvenience.

Tips for Saving on Testing

  • Look for bundled panels that combine multiple tests for a lower overall cost.
  • Check if your provider accepts HSA/FSA funds, which can reduce out-of-pocket expenses.

Note: This chart is for educational purposes only and not a substitute for medical advice. Always consult your healthcare provider for personalized recommendations. For a detailed and transparent testing panel, consider using Superpower.

Conclusion

Keeping an eye on these 10 biomarkers can provide deep insights into your health, offering much more than what routine checkups typically reveal. By diving into areas like metabolic health, cardiovascular risk, and overall wellness, you gain a more complete understanding of your body.

Thanks to advancements in testing, it's easier than ever to take charge of your health. Today, you don't have to wait for an annual physical - direct-to-consumer platforms have teamed up with major lab networks to make testing accessible nationwide. With convenient sample collection options, you can get these tests done on your schedule.

Begin with the key biomarkers outlined above, and then consider expanding your testing based on specific symptoms or health objectives. While a single test provides valuable information, regular testing over time helps you spot trends, enabling you to make targeted lifestyle changes - whether that's tweaking your diet, adjusting your exercise routine, or managing stress more effectively.

Consistency is key. Testing every 6–12 months allows you to catch potential issues early and track the results of your health efforts. Many biomarker tests are eligible for HSA or FSA funds, so take advantage of these resources when possible.

Your health is one of your greatest assets, and regular biomarker testing acts as an early warning system to help prevent illness while also enhancing longevity and performance. Whether you work with your healthcare provider or explore comprehensive testing services like those offered by Superpower, the important thing is to make biomarker tracking a regular part of your health routine.

This content is for educational purposes only and should not replace medical advice. Always consult your healthcare provider before making changes to your health monitoring or treatment plan.

FAQs

Which biomarkers should I focus on to achieve my health goals?

To figure out which biomarkers matter most for your health goals, start by looking at those that shed light on your metabolic health, inflammation levels, and risk for chronic diseases. Some commonly recommended biomarkers include fasting blood glucose, HbA1c, a lipid panel (covering cholesterol and triglycerides), vitamin D, and hs-CRP. These are backed by research as reliable indicators for monitoring cardiovascular health, aging, and overall well-being.

It's important to choose biomarkers that align with your specific health priorities. For instance, if improving metabolic function is your focus, glucose and insulin-related markers should take center stage. On the other hand, if reducing inflammation is a key goal, hs-CRP can provide valuable insights. By regularly testing and tracking these markers, you can make better-informed choices about your diet, lifestyle, and other interventions. Be sure to work closely with a healthcare provider to customize your testing plan and interpret your results accurately.

Can making lifestyle changes improve biomarker levels, and how does this work?

Yes, lifestyle changes can directly influence biomarker levels in the body. Simple adjustments - like eating nutritious meals, staying active, managing stress, and prioritizing sleep - can lead to improvements in key health indicators such as blood pressure, cholesterol, blood sugar, and inflammation. These shifts contribute to better heart health, improved metabolism, and overall wellness.

Take diet as an example: adding more whole foods like fruits, vegetables, and lean proteins to your meals can help lower inflammation and improve cholesterol levels. Regular physical activity not only boosts heart health but also aids in better glucose regulation. On the other hand, stress management techniques, such as mindfulness or meditation, can help reduce cortisol levels and other stress-related biomarkers. By embracing these habits, you can actively work toward healthier biomarker levels and enhance your long-term health.

How often should I check my biomarkers to stay on top of my health?

The frequency of retesting biomarkers largely depends on the specific marker in question and your personal health situation. For individuals in stable health, testing every 6 to 12 months is generally enough to monitor progress and detect any early changes. On the other hand, if you're managing a medical condition or making significant lifestyle adjustments, testing more often - every 3 to 6 months - may be a better fit.

To determine the right schedule for your needs, it's best to consult your healthcare provider. They can provide personalized guidance based on your medical history, current treatments, and health objectives.

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