Start with the four you can measure today for nothing: waist-to-height ratio, resting heart rate, a sit-to-stand score and a push-up count. Then ask your doctor for a standard fasting panel, which covers HbA1c, triglycerides and lipids. Only after both of those is there a case for paying out of pocket, and for most people that case is limited to ApoB and a single lifetime Lp(a).
Tier 1: nothing but a tape measure
Four measurements cost nothing and need no appointment. Take them before you consider spending anything.
- Waist-to-height ratio. One threshold, no age or sex adjustment, and it outperformed BMI across roughly 300,000 people.
- Resting heart rate. Your watch already has it, or count your pulse for a minute before getting out of bed.
- Sit-to-stand score. Two minutes on a floor, and costs nothing, takes two minutes, integrates several capacities at once, and produced a striking mortality signal in the cohort it was studied in.
- A push-up or muscular endurance count. If push-ups are not available, the 6-minute walk test covers the same domain without upper-body demand.
These four populate body composition and functional capacity, two of the six scored domains, before any money changes hands.
Tier 2: the panel your GP already runs
A standard fasting blood panel is routine, usually free or cheap through primary care, and delivers three markers that carry real weight: HbA1c, triglycerides and a lipid panel.
Ask for fasting insulin at the same time if you can. It is inexpensive, frequently omitted, and moves years earlier than glucose does, which the insulin resistance entry covers.
This tier is where the metabolic domain opens up. Skipping straight from Tier 1 to expensive private tests is the most common sequencing error.
Tier 3: the tests worth paying for
Two are worth it for most people.
ApoB counts atherogenic particles rather than the cholesterol inside them, and a standard panel will not include it unless you ask. It is the single most defensible private lipid purchase.
Lp(a) is a once-in-a-lifetime test. Levels are largely fixed, so you are buying a number you will never need to buy again, and it changes how aggressively everything else is worth managing.
Beyond those, a DEXA scan has a reasonable case if body composition or bone density is a live question, and hs-CRP is cheap enough to add to an existing draw.
Which tests most people should skip
Being specific matters more here than being diplomatic.
Biological age tests. Epigenetic clocks disagree with each other and with themselves on repeat sampling. See biological age tests for the detail. As a first or second purchase they are poor value.
Whole-body MRI screening. In asymptomatic people the dominant result is incidental findings that generate follow-up investigation, anxiety and cost without a demonstrated mortality benefit. Covered in full-body MRI screening.
Continuous glucose monitors, for most non-diabetics. Interesting, genuinely educational for a fortnight, and rarely worth an ongoing subscription once the lessons have landed. See CGMs.
Microbiome sequencing. The science is real and the consumer reports are ahead of it.
The testing sequence in full
| Tier | What it costs | Markers | Why here |
|---|---|---|---|
| 1 | Nothing | Waist-to-height, resting heart rate, sit-to-stand, push-ups or 6MWT | No barrier at all, and two full domains covered |
| 2 | Routine care | HbA1c, triglycerides, lipids, fasting insulin if available | Usually free, opens the metabolic domain |
| 3 | Out of pocket | ApoB, Lp(a) once, optionally DEXA and hs-CRP | Genuine additional information a standard panel misses |
| Skip | Out of pocket | Biological age tests, whole-body MRI, ongoing CGM, microbiome kits | Cost outruns what the result can tell you |
Longevity Coach IQ’s recommended testing order by cost and information gained.
How the testing tiers map to tracking depth
The three tiers line up with the three tracking modes in the see how the app scores you, which is not a coincidence: the modes were drawn around what people can actually obtain rather than around what would be ideal.
Tier 1 alone gives a Basic score. Tier 2 unlocks Advanced. Tier 3 completes it. A Basic score built on four honest measurements is worth more than a Complete one built on numbers you guessed, and the confidence indicator on the dashboard reflects which you have.
Sources
Key references for the claims on this page. Where a figure is attributed to a specific study or body, it is named here.
- Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity Reviews, 2012;13(3):275–286. The 0.5 threshold used in Tier 1.
- Brito LBB, Ricardo DR, Araújo DSMS, et al. Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology, 2014.
- Koschinsky ML, Bajaj A, Boffa MB, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. Journal of Clinical Lipidology, 2024. The once-in-a-lifetime measurement recommendation.
Frequently asked
What should I measure on day one?
Waist and height, because the ratio between them is the single most informative number you can produce with no equipment beyond a tape measure. It takes under a minute and needs no interpretation beyond one threshold.
Do I need a blood test to start?
No. Four of the six scored domains can be populated without one, and the app will score you at whatever depth you reach. A panel makes the picture more precise; it is not the entry fee.
Is a biological age test worth the money?
As a first purchase, no. Epigenetic clocks vary considerably between providers and between repeat samples from the same person, which is covered in the biological age tests entry. Money spent there buys less than the same money spent on an ApoB.
What if my GP will not run the panel?
Most will run HbA1c and a lipid panel on request, particularly with a family history. If not, those two are the cheapest things to buy privately, and considerably more useful than the tests usually marketed for longevity.