If you’ve ever gotten a blood test back, you’re familiar with the routine. You scan the list, see your numbers fall within the "standard range," and your doctor gives you a thumbs-up. Everything is "normal."
But for those of us serious about not just avoiding disease, but achieving peak performance and a long, vibrant healthspan, a critical question arises: Is "normal" good enough?
In reality, the "normal" range on your lab report is typically just a statistical average of the population—a population that, on the whole, is not a shining example of perfect health. These ranges are designed to flag outright disease and are not useful for those of us chasing optimal health and trying to reduce our risk of disease long before it happens.
My definition of an "optimal" range is the level associated with the lowest risk of future disease and a reduction in all-cause mortality. I've spent hundreds of hours digging through observational studies and longevity research to find these optimal ranges for key blood markers. Based on this data, the gap between "normal" and "optimal" for certain biomarkers is massive.
Today, let's look at the markers where this gap is most significant and explore how the standard reference ranges your Medicine 2.0 doctor uses may be failing you.
1. ApoB (Apolipoprotein B): The True Driver of Heart Disease
- What it is: Forget just LDL cholesterol. ApoB is a direct measurement of the number of all atherogenic (plaque-causing) particles in your blood. Think of it as a traffic count on the highway to your arteries. More cars (ApoB) means a higher chance of a traffic jam (plaque).
- Standard "Normal": < 130 mg/dL
- Longevity Optimal: < 60 mg/dL
- The Science: The evidence linking ApoB to atherosclerotic cardiovascular disease (ASCVD) is overwhelming. A massive 2020 consensus statement from the European Atherosclerosis Society concluded that ApoB-containing lipoproteins are causally linked to ASCVD. The data is so strong that for every 38.7 mg/dL (1 mmol/L) reduction in ApoB, there is a corresponding ~20-25% reduction in the risk of major vascular events. Experts in the longevity space, like Dr. Tom Dayspring , often advocate for getting this number as low as possible.
2. hs-CRP (High-Sensitivity C-Reactive Protein): The Silent Fire
- What it is: hs-CRP is the most reliable measure of chronic, low-grade inflammation in your body. Think of it as a smoke detector for a fire you can't see—a fire that is a root cause of nearly every major age-related disease.
- Standard "Normal": < 3.0 mg/L
- Longevity Optimal: < 1.0 mg/L (ideally < 0.5 mg/L)
- The Science: The connection between hs-CRP and all-cause mortality is well-established. A study in the New England Journal of Medicine found that individuals with hs-CRP levels in the highest quartile had a significantly higher risk of cardiovascular events. For longevity, the goal is to have as little inflammation as possible. A level below 1.0 mg/L indicates a very low inflammatory state and studies show <0.5mg/L have lowest risk factors.
3. Homocysteine: The Unsung Risk Factor
- What it is: An amino acid that, when elevated, can damage the delicate lining of your arteries (the endothelium) and is associated with an increased risk for blood clots, cardiovascular events, and cognitive decline.
- Standard "Normal": < 15 µmol/L
- Longevity Optimal: < 9 µmol/L
- The Science: While often overlooked, a meta-analysis in the BMJ found a strong, graded relationship between homocysteine levels and the risk of ischemic heart disease and stroke. The data suggests that for each 5 µmol/L increase, the risk of coronary heart disease can rise by approximately 20%. The good news? This marker is often highly responsive to increased intake of B vitamins (folate, B12, B6).
4. Metabolic Health: Fasting Insulin & Glucose
- What they are: These two markers provide a complete picture of your metabolic health. Glucose is a snapshot, but fasting insulin tells you how hard your pancreas is working to keep it there. High insulin is a much earlier warning sign of trouble.
- Standard "Normal": Glucose < 100 mg/dL; Insulin < 25 µIU/mL
- Longevity Optimal: Glucose 75-90 mg/dL; Insulin < 10 µIU/mL (ideally < 5)
- The Science: Chronically high fasting insulin (hyperinsulinemia) precedes the development of type 2 diabetes by years. Research has shown that elevated fasting insulin is an independent risk factor for heart disease and all-cause mortality.
- Alternatives: One can also look at HbA1c as an alternative but it is subject to being less accurate and most useful for trend analysis. One should aim for an HbA1c <5.1% for an optimal longevity target.
5. Vitamin D: The Sunshine Hormone
- What it is: Far more than a vitamin, Vitamin D acts as a pro-hormone that regulates thousands of bodily functions, most critically bone health and immune system function.
- Standard "Normal": > 30 ng/mL
- Longevity Optimal: 40 - 60 ng/mL (I like to target 50 ng/mL)
- The Science: The standard range is based on the level needed to prevent overt bone diseases like rickets. However, a large 2014 meta-analysis in the BMJ found a clear link between Vitamin D levels and all-cause mortality. The study showed that mortality risk was lowest for individuals with levels between 40-60 ng/mL, suggesting this range is optimal for supporting overall health.
6. Triglyceride / HDL Ratio: The Simple Litmus Test
- What it is: A simple calculation you can do from any standard lipid panel (Triglycerides ÷ HDL). It serves as a powerful and surprisingly accurate proxy for insulin resistance and the size of your LDL particles.
- Standard "Normal": < 4.0
- Longevity Optimal: < 1.5 (ideally < 1.0)
- The Science: A high ratio is a major red flag for metabolic syndrome. Research in journals like Circulation has shown this ratio is a strong, independent predictor of cardiovascular events. A low ratio (ideally close to 1:1) suggests you have large, fluffy LDL particles and excellent insulin sensitivity.
7. Omega-3 Index: Your Cellular Health Scorecard
- What it is: This test measures the percentage of EPA and DHA (the two key omega-3s) in your red blood cell membranes. It's a direct, stable measure of your long-term omega-3 status and a powerful indicator of cardiovascular and brain health.
- Standard "Normal": > 4%
- Longevity Optimal: > 8%
- The Science: A landmark study found that individuals with an Omega-3 Index of 8% or higher had a significantly lower risk of all-cause mortality compared to those with an index below 4%. A higher index is strongly associated with a reduced risk of fatal coronary heart disease and better cognitive function over time. It's a crucial marker that is almost never included in a standard panel.
Putting It All Together
I know this is a lot to track. After spending hundreds of hours poring over this research for myself, I began helping friends and family make sense of their own lab results. I quickly realized that everyone needed the same thing: a way to translate confusing numbers into a simple, actionable health blueprint.
That’s why I built The Kestrel Report.
It’s a system designed to do all the heavy lifting for you, transforming your standard lab results into a clear guide showing exactly where you can optimize your health for longevity and performance.
It's called the Kestrel Report.
This project is new, and I personally create each report and ensure one walks away with new health insights. To thank the readers who are supporting this work from the beginning, I want to offer you my direct expertise for those not wanting to spend all their evenings combing through NIH papers.
If you're serious about your healthspan, let me do the heavy lifting for you. I guarantee you’ll walk away with newfound clarity and a plan to improve.
Learn more and become an early adopter at KestrelReport.com