The 12 Blood Biomarkers Every Serious Optimizer Should Track
Standard lab reference ranges are built for the average sick person, not the high performer. Here are the functional medicine targets.
When your doctor says your cholesterol is "normal," they mean it falls within the reference range established from the general population — a population with a 40% rate of cardiovascular disease. Normal is not optimal.
Functional medicine targets are not the same as reference ranges. The reference range is where most people fall. The functional target is where low-risk individuals sit. They are rarely the same number.
The 12 Biomarkers That Actually Matter
- ▸ApoB: The most predictive cardiovascular biomarker available. Optimal: <70 mg/dL. Standard range: <100 mg/dL. The difference matters enormously over 30 years.
- ▸Fasting insulin: Measures insulin resistance before glucose dysregulation appears. Optimal: <5 µIU/mL. "Normal" range extends to 25 — far too high.
- ▸HbA1c: 3-month glucose average. Optimal: <5.4%. The ADA does not flag pre-diabetes until 5.7%.
- ▸Homocysteine: Inflammatory amino acid linked to cardiovascular and cognitive disease. Optimal: <8 µmol/L.
- ▸hsCRP: High-sensitivity C-reactive protein measures systemic inflammation. Optimal: <0.5 mg/L. "Normal" extends to 3.0.
- ▸Ferritin: Iron storage marker that doubles as an inflammation marker. Optimal: 50–100 ng/mL. Both extremes are dangerous.
- ▸Free testosterone and SHBG: Total testosterone is nearly useless without SHBG to calculate the bioavailable fraction.
- ▸DHEA-S: Adrenal reserve marker and longevity indicator. Declines 2% per year after age 30.
- ▸Vitamin D (25-OH): Optimal: 60–80 ng/mL. Most people are at 25–35, which is technically deficient.
- ▸Omega-3 index: The ratio of EPA+DHA to total fatty acids in red blood cell membranes. Optimal: >8%. Most Western diets produce 3–4%.
- ▸TSH: Thyroid-stimulating hormone. Optimal: 0.5–2.0 mIU/L. "Normal" extends to 4.5.
- ▸GGT: Gamma-glutamyl transferase — a sensitive marker of liver stress and oxidative load. Optimal: <20 U/L.
How Often to Test
Test the full panel once per year as a minimum. If you are actively intervening — changing diet, adding supplementation, adjusting exercise — test every 90 days to see the delta. The trend is more informative than any single reading.
The cheapest and most accessible route: Marek Health, Function Health, or Ulta Lab Tests in the US allow you to order your own bloodwork without a physician referral.
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