Peter Attia's Blood Test Panel: The Markers He Orders and Why
Peter Attia, a physician who focuses his practice on lifespan and healthspan, runs a broader blood panel than a standard annual physical and targets narrower ranges than a lab report flags as abnormal. Below are the markers he has cited across The Drive podcast and his own site, grouped by system, each with his stated target and the reasoning behind it.
16 markers across 6 categories
Every target attributed to Attia, sourced
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Reference ranges vs. optimal targets
Attia's targets are narrower than what a lab flags as abnormal, the same gap the optimal-vs-normal guide covers for blood markers generally.
See how "optimal" and "normal" ranges differ
How this panel differs from a standard physical
A standard annual blood panel (CBC + basic metabolic panel + lipid panel) screens for overt disease. Attia's panel adds markers most doctors don't order by default, and moves the target for several markers already on a standard panel.
This page is part of FixFirst's Longevity blood markers series, which attributes every target to the person who cited it rather than presenting it as clinical guidance. Attia's targets below are narrower than the reference range a standard lab prints, in the same way the optimal vs. normal blood test ranges guide compares functional-medicine ranges against lab-standard ones generally.
Some of the markers below (fasting glucose, triglycerides, HDL, ALT, AST, eGFR, albumin) are typically part of a standard comprehensive metabolic panel and lipid panel, so a routine blood draw already covers them. Others (ApoB, Lp(a), hs-CRP, homocysteine, fasting insulin) usually require asking for them by name, because they aren't part of a default order.
The 16 markers, by category
Grouped the way Attia discusses them: metabolic health, lipids and cardiovascular risk, inflammation, liver, kidney, and hormones/nutrition.
Cluster 1 of 6
Metabolic health
Attia treats fasting glucose, HbA1c, and fasting insulin as a triad rather than reading any one in isolation, because a person can have a normal fasting glucose while fasting insulin is already climbing — the targets below are as discussed in The Drive AMA #24 (glucose, insulin, HOMA-IR).
Core Usually in a standard panel
Ask Request specifically
Core
Fasting Glucose
Attia targets a fasting glucose of 70–85 mg/dL, well under the ADA prediabetes threshold of 100 mg/dL, and considers a single fasting reading the least sensitive of the three metabolic markers since it misses post-meal spikes.
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HbA1c
Attia targets HbA1c under 5.5%, versus the ADA prediabetes range starting at 5.7%. He pairs it with fasting insulin because haemoglobin turnover varies between people with the same average glucose.
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Fasting Insulin
Attia targets fasting insulin under 6 µIU/mL with a HOMA-IR under 1.0. He has largely shifted to CGM data in his own practice, but calls fasting insulin essential for anyone not wearing a CGM, since it can flag resistance while glucose is still under 100 mg/dL.
Cluster 2 of 6
Lipids & cardiovascular risk
Attia weights ApoB (particle count) and Lp(a) (genetic, non-modifiable) above LDL-C, and uses the triglyceride-to-HDL ratio as a rough insulin-resistance shorthand — covered in The Drive AMA #14 and cross-checked against independent breakdowns of his cited panel.
Core Usually in a standard panel
Ask Request specifically
Core
Triglycerides
Attia targets under 100 mg/dL, tighter than the standard clinical cutoff of 150 mg/dL, because elevated triglycerides track with small, dense LDL particle formation.
Core
HDL
Attia treats HDL as secondary to ApoB and prefers the triglyceride-to-HDL ratio: a ratio above 2 is his rough signal for insulin resistance and small dense LDL, even when both markers individually sit in range.
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ApoB
Attia's headline lipid marker. He targets under 65 mg/dL and pushes toward 30–40 mg/dL for patients with a family history of cardiovascular disease, arguing ApoB counts every atherogenic particle (LDL, VLDL, IDL, Lp(a)) that LDL-C alone underestimates.
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Lp(a)
Attia calls Lp(a) a "non-negotiable" one-time test because it is genetically set and not meaningfully modifiable by diet or exercise. He targets under 30 nmol/L and, when it is elevated, compensates by pushing ApoB lower than he otherwise would.
Cluster 3 of 6
Inflammation
Attia checks inflammatory markers independent of the lipid panel, because he views hs-CRP as predictive of cardiac events even when LDL is in range.
Core Usually in a standard panel
Ask Request specifically
Ask
hs-CRP
Attia targets under 1.0 mg/L, tighter than the standard clinical flag of 3.0 mg/L. He monitors it alongside other inflammatory markers as a cardiovascular signal independent of the lipid panel.
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Homocysteine
Attia targets under 10 µmol/L, below the standard lab flag of 15 µmol/L, treating it as a direct readout of methylation capacity and a driver of both vascular and cognitive risk.
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Uric Acid
Attia targets under 5.0 mg/dL, well under the standard clinical cutoff of 7.0 mg/L, because he views the 5–7 mg/dL range as an early signal of fructose intake and insulin resistance, before gout risk appears.
Cluster 4 of 6
Liver
Attia treats ALT and AST creep as one of the earliest detectable signs of metabolic dysfunction, often years before imaging changes — see his metabolic dysfunction case study.
Core Usually in a standard panel
Ask Request specifically
Core
ALT
Attia targets under 20 U/L, well under the standard lab flag of 40–56 U/L. He notes values in the 20–40 U/L range still correlate with early non-alcoholic fatty liver disease in population studies, particularly alongside elevated triglycerides.
Core
AST
Attia applies the same under-20 U/L target to AST and reads it against ALT: an AST:ALT ratio above 2 points toward alcoholic liver disease, a ratio under 1 with both elevated points toward fatty liver. He also flags that intense exercise can transiently raise AST without liver pathology.
Cluster 5 of 6
Kidney
Attia calls kidney function one of the most under-monitored longevity organs, since eGFR decline predicts cardiovascular and all-cause mortality independent of other risk factors — discussed in The Drive AMA #49 (kidney function).
Core Usually in a standard panel
Ask Request specifically
Core
eGFR
Attia targets above 90 mL/min/1.73m² and prefers cystatin C–based eGFR over the standard creatinine-based version, because creatinine is confounded by muscle mass, understating kidney function in muscular people and overstating it in sarcopenic ones.
Cluster 6 of 6
Hormones & nutrition
Attia treats total testosterone and total B12 as incomplete readings on their own, pairing each with a second marker (SHBG for testosterone, homocysteine for B12) to see whether the hormone or vitamin is actually available to tissue — cross-checked against independent summaries of his cited recommendations.
Core Usually in a standard panel
Ask Request specifically
Ask
Testosterone (Free T + SHBG)
Attia targets free testosterone at roughly 2% of total testosterone and always tests SHBG alongside, since SHBG binding determines how much testosterone is biologically active regardless of the total number.
Ask
Vitamin B12
Attia targets above 500 pg/mL, well above the standard clinical floor of 200 pg/mL, using methylated B12 (methylcobalamin) primarily as a tool to keep homocysteine under 9 µmol/L rather than as an isolated target.
Core
Albumin
Attia targets above 4.5 g/dL and treats a declining trend, not a single reading, as the signal, since albumin sits in the "normal" range for nearly everyone until nutritional inadequacy or chronic inflammation is advanced.
Frequently asked questions
What blood tests does Peter Attia recommend?
Attia has cited targets across six categories: metabolic health (fasting glucose, HbA1c, fasting insulin), lipids and cardiovascular risk (triglycerides, HDL, ApoB, Lp(a)), inflammation (hs-CRP, homocysteine, uric acid), liver (ALT, AST), kidney (eGFR), and hormones and nutrition (testosterone with SHBG, vitamin B12, albumin). Several of these, ApoB, Lp(a), hs-CRP, homocysteine, and fasting insulin, are not part of a standard blood panel and need to be requested specifically.
How is Attia's panel different from a standard annual physical?
A standard annual physical typically covers a CBC, basic metabolic panel, and standard lipid panel, screening for overt disease against population-wide reference ranges. Attia's panel adds markers a standard panel omits (ApoB, Lp(a), hs-CRP, homocysteine, fasting insulin) and targets narrower ranges for several markers already covered (triglycerides, ALT, AST, uric acid), aiming for what he considers optimal rather than merely not-flagged.
Can my regular doctor order these tests?
Most of these markers can be ordered by a primary care physician or through a direct-to-consumer lab service; ApoB and Lp(a) sometimes require asking specifically, since they aren't part of a default lipid panel. Insurance coverage for ApoB, Lp(a), and fasting insulin varies by provider and is worth confirming before ordering.
What is Attia's triglyceride-to-HDL ratio, and why does he use it?
The TG:HDL ratio divides your triglyceride value by your HDL value. Attia treats a ratio above 2 as a rough signal of insulin resistance and small, dense LDL particle formation, useful because it can flag risk even when triglycerides and HDL individually fall inside their reference ranges.
Why does Attia target ApoB instead of LDL cholesterol?
ApoB counts every atherogenic lipoprotein particle (LDL, VLDL, IDL, and Lp(a)) with a single number, while LDL-C estimates cholesterol content and can underrepresent risk in people with many small, dense LDL particles. Attia targets ApoB under 65 mg/dL, tighter than the standard guideline threshold of under 100 mg/dL.
References & Guidelines
- Peter Attia — The Drive AMA #14 (metabolic health)
- Peter Attia — The Drive AMA #24 (glucose, insulin, HOMA-IR)
- Peter Attia — The Drive AMA #49 (kidney function)
- Peter Attia — metabolic dysfunction case study (ALT/AST)
- Peter Attia's cited blood test panel and targets (lolahealth.com)
- Peter Attia's key insights on longevity and health optimization (serenityways.com)
- What Are Dr. Peter Attia's Recommendations (gethealthy.com)
- Peter Attia's supplements for longevity (fastlifehacks.com)
- Functional Age Biomarkers Part 4: Albumin (optimaldx.com)
- Peter Attia's top blood tests (jakesjourney.co)
- American Diabetes Association — Standards of Care in Diabetes 2024
Once you have your results
Attia targets an optimal zone, not the lab-flagged abnormal threshold. Seeing where your own results sit against the standard clinical range is the first comparison point.
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