Life Extension Magazine®

Multiple vials being filled for testing age-related disease risks

The Most Important Annual Blood Tests

Annual blood tests can uncover smoldering risk factors before they manifest into clinically relevant disease.

Scientifically reviewed by Dr. Gary Gonzalez, MD, in August 2023. Written by: Scott Fogle, ND.

At Life Extension® we have long advocated annual blood testing as one of the most important ways to optimize and maintain health.

Some doctors don’t order yearly blood tests or only focus on a few basics unless a patient shows symptoms of disease. This is a losing strategy. If a disease is already symptomatic, it may be too late to stop it.

But many illnesses and risk factors for disease can be detected with a blood test long before symptoms begin to show. Identifying problem areas early allows you to work with your doctor to treat and correct them—ideally, before they manifest in disease.

Back in 1996, Life Extension® founded the first mail-order, blood-screening service offering the public state-of-the-art blood testing that helps identify many of the age-related diseases plaguing our society today.

Dr. Scott Fogle reviews what Life Extension® considers the top, critical, yearly blood tests and the importance of annual testing.

Hidden Benefits of Blood Tests

There are many reasons experts recommend annual blood testing. Blood tests can:

  • Detect preclinical disease. Blood tests can often reveal abnormalities long before a disease begins to show outward symptoms. Testing can detect elevated blood sugar before diabetes develops or show early warning signs of cancer. Most of these problems are far easier to treat or prevent when caught early.
  • Determine changes to make. Blood testing can also identify risk factors for future disease and loss of function. This knowledge can then be used by you and your doctor to make healthy changes in your life, from improved diet and exercise to taking specific supplements or medication.
  • Reveal causes of quality-of-life issues. Some tests can identify problems that may be impacting your general well-being. Abnormal hormone levels, for instance, can contribute to depressed mood, lack of energy, declining brain function, loss of libido, and more. Nutrients and/or medications can restore a better quality of life.
  • Track responses to treatment. After identifying a problem, additional blood tests can be helpful in confirming whether changes you’ve made are helping. If you start taking a new medication and/or supplement, you can see if your strategy is working by tracking that blood test over time.

Experts at Life Extension® have identified some of the most important yearly blood tests for identifying preclinical disease, risk factors for future problems, and issues that affect quality of life.

1. Chemistry Panel, Complete Blood Count (CBC), and Lipid Panel

This battery of tests is often ordered together as a general screening measure, giving an overall snapshot of current health.

The chemistry panel includes tests of general metabolic factors, such as blood glucose (sugar) and levels of minerals and electrolytes. High glucose levels can indicate evolving metabolic disease, such as metabolic syndrome and type II diabetes, and risk for future cardiovascular disease.

Blood chemistry abnormalities may indicate a kidney problem, thyroid disorder, or even possible cancer. The chemistry panel also includes other tests that are excellent in screening for kidney and liver disease.

The complete blood count (CBC) identifies types and numbers of blood components, including platelets, red blood cells, and various types of white blood cells. These can help identify infection, anemia, and other blood and bone marrow conditions.

The lipid panel evaluates healthy and unhealthy fats in the body, which are primary drivers of your risk for cardiovascular disease, including heart attack and stroke.

For example, high levels of LDL (“bad”) cholesterol strongly contribute to the dangerous buildup of plaque in blood vessels, and to cardiovascular risk.

By identifying any abnormalities, you and your doctor can decide on an effective strategy to address them and prevent future disease.

2. Fasting Insulin

Image of sugar cubes

Elevated fasting insulin is a hidden danger. It’s a major risk factor for hidden diabetes and other metabolic disease, but most people never get tested for it, so they don’t know if they have it.

Insulin is a hormone that helps the body process glucose absorbed after a meal. Levels rise after a meal but should then drop to a level just low enough to maintain optimal glucose. As your body ages and tries to compensate for poor diet, insulin can remain high even in a fasting state. High fasting insulin can be a sign of developing insulin resistance, a hallmark of type II diabetes.

Identifying high insulin levels early is critical.

Scientists have discovered that high insulin has harmful effects on health even before metabolic disease develops.1,2 On its own, elevated insulin can contribute to high blood pressure, atherosclerosis, obesity, cancer, abnormal blood lipids, gout, migraine, and cognitive decline.2-4

Stimulating the enzyme AMPK can help boost healthy metabolism, lower insulin levels, and ward off metabolic disease.5,6

In addition to exercise and improved diet, some nutrients have been shown to activate AMPK, including hesperidin, a compound found in citrus fruits, and the herb Gynostemma pentaphyllum. Medications are also available to activate AMPK if needed, such as metformin.

3. Hemoglobin A1c

Abnormally high blood levels of glucose are a major cause of long-term health issues, from cancer to heart disease–and of course, the hallmark sign of diabetes. Practically all tissues in the body are negatively impacted by high blood sugar.

A blood glucose test, however, is only a snapshot of a moment in time. Glucose levels rise and fall throughout the day, so this test may miss a problem.

A hemoglobin A1c test is a superior way to screen for glucose problems because it shows what levels have looked like over the past two to three months. The higher the level, the more severe the problem with blood glucose control.

In addition, studies have shown that high levels of hemoglobin A1c are an important predictor of risk for heart disease, even in individuals who do not have metabolic syndrome or diabetes.7

In those with existing metabolic syndrome or diabetes, hemoglobin A1c can be used to track response to treatment, confirming that blood glucose control is improving.

Dietary changes, exercise, nutrients (including magnesium and vitamin D),8,9 and medications can help bring elevated hemoglobin A1c and blood sugar under control.

Test tube being labeled


The Benefits of Blood Tests

  • Many diseases only reveal themselves when symptoms begin to show. By that point it may be too late to effectively treat them.
  • Simple annual blood tests can detect signs and risk factors for disease early on, giving you and your doctor the knowledge to enact a plan to achieve and maintain optimal health.
  • Scientists at Life Extension® have identified some of the most important yearly blood tests. They screen for common diseases, risk factors for future health problems, and issues that diminish quality of life.
  • The recommended tests include the chemistry panel/complete blood count/lipid panel, fasting insulin, hemoglobin A1c, DHEA, prostate-specific antigen, homocysteine, C-reactive protein, thyroid stimulating hormone, testosterone (free and total), estradiol/progesterone, apolipoprotein B100, magnesium, and vitamin D.


DHEA (dehydroepiandrosterone) is a hormone produced naturally in the adrenal glands. The body uses it to make other hormones, including the male and female sex hormones, testosterone and estrogen.

Levels of DHEA peak in the 20s, then steadily decline. This slow slide can compromise vitality and quality of life in older age to such a degree that DHEA is sometimes referred to as an “anti-aging” hormone.10

If a blood test shows low levels, DHEA can be taken orally to support healthy levels. It can also help support testosterone and estrogen levels to varying degrees.

DHEA itself also supports immune function, bone density, mood, libido, and healthy body composition.10

A 2017 study published in the Journal of the American Heart Association found that lower DHEA levels indicated a significant increased risk for all-cause mortality, fatal cardiovascular event, and nonfatal cardiovascular event in patients with cardiovascular disease.11

A 2019 study concluded that higher levels of DHEA are associated with a lower risk of falls and recurrent falls in older people, especially women.12 In addition, a 2018 meta-analysis on DHEA for depression pointed to a significant effect in favor of treatment with DHEA compared to placebo.13

5. Prostate-Specific Antigen (PSA) for Men

Image of a blood test tube

Prostate-specific antigen (PSA) is a protein made in the prostate gland of the male reproductive system.

Normally, PSA largely remains in the prostate. But several conditions cause it to be released into the bloodstream, where it is detectable on a simple blood test. These include age-related enlargement of the prostate, inflammation, infection, and prostate cancer.

Prostate cancer is extremely common in men and often causes no outward symptoms early in its development. Regular PSA screenings can identify it early, when it is still confined to the prostate gland and easiest to treat.

The American Cancer Society recommends annual testing for men beginning at 50, and at 40-45 in those deemed high risk, including men with a strong family history of prostate cancer.14

If an elevated PSA level is detected, further testing should be done under the direction of your physician.

6. Homocysteine

Studies have linked high levels of the amino acid homocysteine with increased risk for several health problems, including heart attack, bone fractures,
macular degeneration, gallstones, and declining cognitive function.15-19

In fact, even in people with no history of cardiovascular disease, those with the highest homocysteine levels had more than a 3-fold increased risk of heart attack over a five-year period, compared to those with the lowest levels.20

High levels of homocysteine can be lowered by increasing intake of the B vitamins folate, B2, B6, and B12. Supplementation with active forms pyridoxal-5-phosphate (B6), methylcobalamin (B12), and 5-MTHF (folic acid) provides the exact form of these vitamins that your body can use best.

7. C-Reactive Protein

Couple sitting together

Chronic inflammation is a major contributor to nearly all forms of age-related disease and dysfunction, including diabetes, cardiovascular disease, Alzheimer’s, cancer, and more.21

We now know that chronic inflammation accelerates the aging process itself, leading scientists to coin the term inflammaging to describe the connection.22

C-reactive protein (CRP) level in the blood is one of the most used clinical indicators of inflammation throughout the body.

The most recent technology in C-reactive protein testing is a test called Cardiac CRP (or High Sensitivity CRP). This is a highly sensitive test, able to detect even small changes in C-reactive protein levels. Despite its name, it indicates levels of inflammation throughout the entire body.

Elevated levels of C-reactive protein are predictive of cardiovascular disease, type II diabetes, age-related macular degeneration, cognitive decline, and more.23-26

Many nutrients can reduce inflammation, including omega-3 fatty acids from fish oil, curcumin (a compound found in turmeric), magnesium and zinc, vitamin D, and various polyphenols including flavonoids.27

8. Thyroid Stimulating Hormone

The thyroid gland in the neck secretes thyroid hormone. It can be thought of as a master regulator that sets the base level of metabolism in the body.

Several disorders can lead to either hyperthyroidism (excess levels of thyroid hormone) or hypothyroidism (low levels).

Hyperthyroidism can cause rapid or irregular heartbeat, anxiety, irritability, tremors, and difficulty sleeping.28

Hypothyroidism , which is more common in women, can cause unexplained fatigue, depression or anxiety, constipation, dry skin, low libido, and weight gain.29

Thyroid stimulating hormone is produced in the pituitary gland and exerts control over the secretion of thyroid hormone. If there is something wrong with
thyroid function, levels of thyroid stimulating hormone are usually disturbed. This shows up on a blood test, helping to identify various thyroid problems.

Both hyperthyroidism and hypothyroidism can be treated with medications and several nutrients can support healthy thyroid function like selenium,
vitamins A and B12, iodine, magnesium, ashwagandha root extract, L-tyrosine, and fermented Korean ginseng root extract.30,31

9. Testosterone (Free and Total)

Testosterone is the primary sex hormone in men, while healthy women produce smaller amounts. It is mostly made by the testes, but the ovaries in women and the adrenal glands in both genders also make small amounts of testosterone.

Levels fall with advancing age, which has a significant impact on health.

In men, testosterone drops to about 60% of their youthful levels by age 75.32 These lower levels contribute to diminished libido, erectile dysfunction, loss
of muscle mass and strength, increased body fat, lower bone density, depressed mood, and trouble concentrating.33-35

Low testosterone is also linked to an increased risk of life-threatening conditions such as cardiovascular disease, type II diabetes, and metabolic syndrome.36-38

Levels of testosterone in women also drop with age and significantly impact quality of life. As in men, maintaining adequate levels helps to prevent loss of libido, depressed mood, loss of muscle, and more.

Testing can reveal levels of free testosterone (testosterone that is not bound to any other proteins) and total testosterone (all testosterone, free and bound, in the blood). The most comprehensive test measures both.

Your physician can discuss various treatments for low testosterone levels.

10. Estradiol and Progesterone

In women, the ovaries produce two primary sex hormones, estrogen (which mainly circulates in a form called estradiol) and progesterone. Men also produce small amounts of these hormones.

Both hormones are involved in fertility and reproductive function. But like testosterone, they have diverse effects on other aspects of health in men and women.

Testing estradiol and progesterone in women during reproductive years can help evaluate fertility and identify possible reasons for difficulty conceiving or maintaining a healthy pregnancy.

In women after menopause and in older men, these hormones support healthy bone mineral density. In fact, lower levels of estradiol are directly associated with increased risk of osteoporosis and bone fractures.39-42

Some health conditions can also cause unnaturally high levels of these hormones, such as ovarian cysts and rare forms of ovarian cancer. Screening for these hormones can both help maximize bone health and catch signs of disease that would have otherwise gone undetected.

As a woman ages and starts moving toward menopause, the first hormone that typically drops is progesterone.

During a typical 28-day menstrual cycle progesterone peaks around day 21. This is the best day to test progesterone for a woman still having cycles but feeling that her hormones may be off or diminishing. Blood testing can help identify the ideal dose of bioidentical progesterone for sleep, libido, depression, mood changes, anxiety, a racing mind, and hot flashes.

11. Apolipoprotein B100

Apolipoprotein B100 (Apo B) is a component of low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein (VLDL) cholesterol. It is present in all the lipoprotein particles that are not HDL.

Non-HDL particles are known as “bad” cholesterol because higher levels contribute to the development of atherosclerosis, the buildup of plaque on artery walls. Atherosclerosis leads to cardiovascular disease and raises risk of heart attack and stroke.

Although cholesterol levels by themselves are an indicator of risk for cardiovascular disease, research shows that apolipoprotein B100 is an even better predictor of heart disease and other cardiovascular conditions.43-46

The higher the number of the Apo B blood test, the greater the risk for future cardiovascular disease.

12. Vitamin D

For decades, science has recognized the importance of vitamin D for the health of bones. Lower levels put people at risk for osteoporosis and bone fractures.

In recent years, research has found that vitamin D is far more important to many different aspects of health than was previously understood. Low levels have now been found to be associated with increased risk for cardiovascular disease, autoimmune diseases, neurological disorders, diabetes, depression, and cancer.47,48

Vitamin D is also tied to overall longevity: Those with the highest levels generally lead longer, healthier lives.49

Most people do not get enough vitamin D. More than 40% of Americans have insufficient blood levels of vitamin D (defined as less than 30 mg/dL) in this study,50 however Life Extension advocates an optimal level of 50 to 80 ng/mL.

Low levels of vitamin D do not cause any symptoms until diseases begin to arise, so testing is critical. Correcting a deficiency is as simple as taking regular doses of vitamin D to raise levels into the optimal range.

13. Magnesium


Most Americans aren’t getting nearly enough magnesium.

By recent estimates, roughly 64% of all men and 67% of all women in the U.S. have inadequate intake of magnesium.51 For those over 71, who have diminished ability to absorb the mineral, that number rises to more than 80%.

Suboptimal intake of magnesium can lead to magnesium deficiency.

Severe magnesium deficiency leads to nausea, vomiting, fatigue, and weakness.

But even mild deficiency is thought to eventually contribute to life-threatening disease.

Magnesium deficiency is linked to high blood pressure, arterial stiffening, dysfunction of the blood vessels, and atherosclerosis, all of which lead to cardiovascular disease .52

Indeed, human studies have found that lower levels of magnesium are significantly associated with higher rates of heart attack and stroke.51-53

Low magnesium is also a major contributor to other chronic illnesses, including type II diabetes, osteoporosis, and cognitive decline and dementia.54-59

Fortunately, simple blood tests can identify low magnesium levels. Experts in magnesium research concluded that the regular lab reference range for serum magnesium is not adequate for maintaining health. They determined a person should be in approximately the upper half of the reference range for good health. At the lower end of the reference range their research indicated magnesium was being pulled from the bones and other tissues.60

Annual testing of magnesium can indicate the need for magnesium supplementation and determines whether increased intake is bringing levels into an optimal range.


Many disorders and risk factors for disease are hidden. They don’t present any outward symptoms in their early stages.

Annual blood testing can reveal these problems, years or even decades before disease would occur.

Once identified, problem areas can be discussed with a doctor and addressed through various interventions, including dietary changes, exercise, nutrients, and, when necessary, medication.

The most important yearly tests are:

  • Chemistry panel/complete blood count/lipid panel,
  • Fasting insulin,
  • Hemoglobin A1c,
  • DHEA,
  • Prostate-specific antigen (for men),
  • Homocysteine,
  • C-reactive protein,
  • Thyroid stimulating hormone,
  • Testosterone (free and total),
  • Estradiol/progesterone,
  • Magnesium,
  • Apolipoprotein B100, and
  • Vitamin D.

Having these blood tests done annually lets you make informed decisions to optimize current health and reduce risk for future disease.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.


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