blood biomarkers and direct-to-consumer test vendors

[kpfleger]

I've been building a list of blood biomarkers to track for long-term health, along the lines of the CRSociety tests and biomarkers page, but with target recommendations that are more specific than ref ranges and with the source of each rec linked. My main concern is long-term health and mortality risk rather than short-term performance.

 

The set of vendors offering direct-to-consumer blood tests seems to be exploding. So I've also made a list of a bunch of these with specific test packages to compare them on comprehensiveness and cost. Here is the resulting table:

https://docs.google.com/spreadsheets/d/1G65NGyMbIWr72QY7w00iobZ_IMXxQbC_Lhaxbss4ALk/edit?usp=sharing

 

The top half of the table is the list of tests and which biomarker each includes (based on the vendor's website). The bottom half of the table explains why each marker is included and gives the recommendations for specific target ranges. I welcome suggestions on both the list of biomarkers or the list of tests/vendors (or the set of linked sources of recommended target ranges), either here or by email. The table also has comments enabled, so anyone with the link can insert a comment into any cell.

 

Does anyone have any knowledge of significant differences of accuracy or customer service or other factors besides just tests and price to use to choose between the test providers? Most (all) providers are just using LabCorp (or maybe Quest) so I would expect accuracy to be the same for everyone.

 

InsideTracker and WellnessFX seem to provide their own proprietary interfaces to the results rather than only a typical LabCorp report (at least I think WellnessFX does this too). InsideTracker wraps into their report some explanations for lay-audiences about why each biomarker is important and how some of them interact, plus also an "optimal" range for each narrower than the lab-ref-range, plus also food (and maybe other lifestyle) recommendations, which most of the others seem not to do (not sure exactly what WellnessFX provides). Neither of these seem to provide a sample report linked directly from their test package page, though Googling them does find some reviews with some sample screenshots. Other than these things, I'm not sure what else there is to judge on other than price and set of tests.

 

Good deals:

 

Based on the prices I just found on their websites in late Sept 2016 (after the recent LifeExtension sale), the following seem like particularly good deals based on the set of biomarkers I am currently most interested in:

 

The ~$250 LifeExtension "Healthy Aging Panel (Comprehensive)" gets a lot of good stuff for a not high price, a good bit cheaper than their "Male Elite Panel" recently discussed in the recent sale thread. That test is now $643 w/ B12 added on. The $250 test loses IGF1, testosterone, PSA vs. the more expensive one.

 

A better deal for getting those other tests included than the LEF Male Elite Panel seems to be the PrivateMDLabs "Male Anti-Aging Ultimate w/ Free (Direct) Testosterone" for $535, which has been Dean's go-to test.

 

Also note-able for value is LifeExtension's basic "Chemistry & CBC" test which includes all 4 basic panels (CBC, lipids, metabolic, & liver) for only $35!

 

But another take-home is that there are at least a half-dozen places to order a fairly comprehensive set of blood tests direct-via-web with only minor variations in packaging of different individual tests. If many of them have sales from time to time it may be worth shopping around each time one wants a new test. OTOH, if you can live with testing the more expensive markers less frequently, the price differences for different levels of comprehensiveness dwarf the discounts available with even big sales. Eg, the non-sale $250 price for the LEF Healthy Aging Panel is still much less than the $431 price Dean reported getting for the more expensive Male Elite Panel.

 

-Karl

 

Disclaimer: I generated this info by hand from looking at the test webpages and it hasn't been double-checked. Feel free to let me know if you find an error. Also, I didn't look at every test package and especially didn't try to find the best deals at the sub-$100 level.

 

[Gordo]

Nice job putting that together.  I am about to get some testing done myself.  The only thing I want to test for that I didn't see in your spreadsheet (but maybe its there I just don't know what its included in) is Omega 3 Index (EPA/DHA).  Dr. Greger just released a video about this today actually (based on a new study specifically looking at supplementation):

 

https://youtu.be/h4LvCZ0KnKc

[Guest ken brett]

Just what I've been looking for. Thanks for putting it together Karl. 

[kpfleger]

Oh yeah, thanks for mentioning omega3s. I probably should have said the following originally:

I've been getting my fatty acid testing from OmegaQuant.com (at-home finger prick mailed away---you order the test kit and it comes and you test whenever you like and then mail it away and get results pretty quick).

$55 for the basic test up to $99 for the full fatty acid profile, but there are discounts sometimes or you can order more than 1 kit at a time for a discount (not sure if all the time). Gives omega3, omega6, saturated fat, trans-fat, 6:3 ratio, AA:EPA ratio, etc.

 

Most of the other blood test vendors' packages above seemed not to include omega3 info, and the first 1 or 2 I saw that mentioned having omega3 info seemed like they were simply adding in OmegaQuant's product, so I just didn't include it in that table or dive into it in more detail since I've been happy with OmegaQuant. If anyone has any omega3 sources they like better for some reason or any comments about OmegaQuant, feel free to say so.

 

 

It's also worth noting that none of the packages include IGFBP-3, which Michael said is better to use than just IGF1, nor MMA, which is helpful in determining B12 sufficiency, so these would also have to be added separately (though could be part of the process/orders with these vendors and thus are included in the table though I didn't mention them in my post.

 

-Karl

[kpfleger]

Good deals:

 

Based on the prices I just found on their websites in late Sept 2016 (after the recent LifeExtension sale), the following seem like particularly good deals based on the set of biomarkers I am currently most interested in:

 

The ~$250 LifeExtension "Healthy Aging Panel (Comprehensive)" gets a lot of good stuff for a not high price, a good bit cheaper than their "Male Elite Panel" recently discussed in the recent sale thread. That test is now $643 w/ B12 added on. The $250 test loses IGF1, testosterone, PSA vs. the more expensive one.

 

A better deal for getting those other tests included than the LEF Male Elite Panel seems to be the PrivateMDLabs "Male Anti-Aging Ultimate w/ Free (Direct) Testosterone" for $535, which has been Dean's go-to test.

 

I made a couple updates to the table, adding in the cost of some of the "tier 2" biomarkers (and also adding PTH to the tier 2 list).

This makes it clear that the PrivateMDLabs package isn't as good a deal. It's tier-2 additions over the LEF "healthy aging panel", as noted in a comment in the cell for its price, were just 4 markers but simply adding those individually in an LEF purchase results in a total price still less than the PrivateMDLabs price ($393 vs. $535 currently). Plus, doing that gives IGFBP3, which I can't find as even available from PrivateMDLabs.

 

So that LEF test with various levels of add-ons looks like a pretty good deal, even after the end of the recent sale.

[Gordo]

I noticed that on the OmegaQuant site sample report says the desirable range for omega index is >8% while the QuestDiagnostics test shows the reference range for Omega Index to top out at 4.9%:

Reference Range(s)

 

Omega-3 (EPA+DHA) Index 1.4-4.9 % Risk:   Index <2.2: High Index 2.2-3.2: Moderate Index >3.2: Low Omega-6/Omega-3 Ratio 5.7-21.3 EPA/Arachidonic Acid Ratio ≤0.2 Arachidonic Acid 5.2-12.9% EPA 0.2-1.5 % DHA 1.2-3.9 %

 

Are these two tests supposed to be measuring the same thing?  The quest version seems to be equivalent to the $80 test from omegaquant.

I called QuestDiagnostics to see what the price of their test would be without insurance, and they told me $50 + a $21 blood draw fee.

Labcorp doesn't seem to offer this test at all, not sure why...

[kpfleger]

I noticed that on the OmegaQuant site sample report says the desirable range for omega index is >8% while the QuestDiagnostics test shows the reference range for Omega Index to top out at 4.9%:

Reference Range(s)

 

Omega-3 (EPA+DHA) Index 1.4-4.9 % Risk:   Index <2.2: High Index 2.2-3.2: Moderate Index >3.2: Low Omega-6/Omega-3 Ratio 5.7-21.3 EPA/Arachidonic Acid Ratio ≤0.2 Arachidonic Acid 5.2-12.9% EPA 0.2-1.5 % DHA 1.2-3.9 %

 

Are these two tests supposed to be measuring the same thing?  The quest version seems to be equivalent to the $80 test from omegaquant.

I called QuestDiagnostics to see what the price of their test would be without insurance, and they told me $50 + a $21 blood draw fee.

Labcorp doesn't seem to offer this test at all, not sure why...

 

I also saw a Dr. Greger piece that recommended 4.4% as a minimum index value (below which brain shrinkage occurs over time, his refs at the link). I haven't researched whether there is a difference in how this index is calculated by the different contexts of the recommendations or why OmegaQuant has a higher recommended value. I'd be curious to hear more depth if anyone goes into this more deeply. (And I haven't yet read the omega3-fa causes diabetes thread on these forums.)

[Sthira]

Thank you, KP for your work. My question is for those who have already invested in blood test$ like these: what did you learn? I'm not asking for embarrassing details, just a general overview. I'm wondering because this for me would be a big financial investment, and my opinion is that blood tests offer only a random snapshot of the dynamic body in process. Take a blood test right now, and you will get certain numbers; then take the same one later today or tomorrow and you'll get another set of numbers. How do know anything without testing repeatedly over a long term in order to spot some pattern? How you determine what's what? We fall into these generalized ranges; but what does any of it mean, what does this say about extending longevity? Perhaps blood tests can catch something weird on one test that indicates, yikes, there's something wrong with my body -- but if I test the same things again tomorrow or next week then maybe the first thing was a false alarm?

 

Where are the continuous monitors of values -- something like evidently Attia had inserted into his body for continuous BG monitoring?

[Gordo]

Sthira - I share your skepticism about blood tests, particularly expensive blood tests.  You are right that the values can fluctuate significantly depending on many variables, particularly what you ate in the last 48 hours and exactly how long you fasted before the test.  I suppose testing could pick up some serious problem, but in general I don't think its all that useful for already healthy people without any health complaints.

 

In the US anyway, basic bloodwork is covered for "free" as part of an "annual physical" for almost anyone with health insurance as far as I know, there isn't even a copay for the visit.  If you don't have health insurance and your income is low enough, you can get "free" health insurance. This gets you most of the important stuff like lipid profile, blood sugar, liver, etc.  At my recent last physical, I found out that there are doctor codes for "vegans" which allow additional "free" testing, so ask about that if you eat a plant based whole food diet.  For example I got my ferritin tested recently to make sure I didn't have hemochromatosis (my results came back "normal" by the way, apparently I'm getting all the iron I need from my plant diet without supplements, but there is no excessive build up either).  If/when you are older than 55 you can start monitoring the prostate (PSAs) for free as well which is probably a good idea.  I guess if you were having health problems, you'd want to check for vitamin deficiencies (D, B12, A) which would probably also be covered.

 

I guess some things not covered by insurance that would be of interest to many of us would be IGF-1 and Omega Index (for long term brain health).  I have yet to order any of these.  I'm sure my IGF-1 is low because of my diet.  The cost of buying the vegan DHA supplements is lower than getting the test that would tell you if you need the vegan DHA supplements, so I just take the supplement (which is also recommended by Greger and others).  Plus like you said, just because a test shows one value now,  that doesn't mean it will have the same result next time (for example ALA conversion is said to decline with age).

[kpfleger]

Thank you, KP for your work. My question is for those who have already invested in blood test$ like these: what did you learn? I'm not asking for embarrassing details, just a general overview. I'm wondering because this for me would be a big financial investment, and my opinion is that blood tests offer only a random snapshot of the dynamic body in process. Take a blood test right now, and you will get certain numbers; then take the same one later today or tomorrow and you'll get another set of numbers. How do know anything without testing repeatedly over a long term in order to spot some pattern? How you determine what's what? We fall into these generalized ranges; but what does any of it mean, what does this say about extending longevity? Perhaps blood tests can catch something weird on one test that indicates, yikes, there's something wrong with my body -- but if I test the same things again tomorrow or next week then maybe the first thing was a false alarm?

 

Where are the continuous monitors of values -- something like evidently Attia had inserted into his body for continuous BG monitoring?

 

The bottom half of the table I made (link in 1st post) is a set of recommendations I've collected. Each one has a link in the table so you can go read the source for the justification of why that rec was made. What someone might learn if one of their values is outside the recommended range is how you might bring it back into range and what claimed long-term benefits that change might bring, if you believe the justification.

 

If the cost is too much for you, try to get tests through your doctor, as Gordo just said. If you can't go through your doctor, dial back the cost of the tests by choosing the cheaper ones that omit the more expensive tests. The very basic one from LEF is $35. I would expect even a couple hundred dollars to be an insignificant cost relative to the cost of food + supplements for 3-12 months (typical testing intervals), so think of it as part of food budget.

 

Your fears about the values fluctuating wildly are overblown, especially if fasting. Some of them certainly do vary, but it's still useful to get snapshots. At the very least, it should help with dosing of some things CR or vegan folks probably ought to be supplementing (like D & B12).

[aducknamedjoe]

Great list; may be worth adding Jinfiniti to it now: https://www.longevityadvice.com/blood-tests/

Also, Lab Test Analyzer doesn't do their own blood tests, but do do longevity-focused analysis on test data you upload.