The Biomarkers I Track After 40 (And Why)

At some point, wellness becomes a measurement problem.

There is no shortage of things you can test. Depending on which podcast, doctor, or wellness account you follow, it is easy to feel like staying healthy requires dozens of biomarkers, specialty panels, and a spreadsheet that looks like a second job.

I am not against testing. I actually like data. I will pay for good information if I think it helps me understand my health more clearly.

The question is not whether a test is basic or advanced. The question is whether it tells me something useful.

These are the biomarkers I currently pay the most attention to.

The Bloodwork I Use to Assess Cardiovascular Risk

Heart disease remains one of the biggest health risks for women, and I want more than a standard “your cholesterol is fine” conversation.

ApoB

ApoB is one of the cardiovascular markers I care about most. It measures the number of atherogenic particles in the bloodstream, which can provide a clearer picture of cardiovascular risk than LDL cholesterol alone.

I still look at a standard lipid panel, but ApoB gives me additional context.

Standard Lipid Panel

I track LDL cholesterol, HDL cholesterol, triglycerides, and total cholesterol. These markers are widely available and useful, especially when viewed alongside ApoB.

hs-CRP

High-sensitivity C-reactive protein, or hs-CRP, is a marker of systemic inflammation.

A single elevated result does not tell the whole story. Infection, injury, dental issues, autoimmune activity, and many other things can affect inflammation. But as a trend, hs-CRP is useful to watch.

The Bloodwork I Track for Metabolic Health

Metabolic health can change slowly, often before anything feels obviously wrong. That is why I like tracking markers that give me a sense of blood sugar regulation and insulin sensitivity over time.

Hemoglobin A1C

A1C provides an estimate of average blood sugar over roughly three months. It is commonly used to evaluate diabetes and prediabetes risk, but I also think it is useful as a broader metabolic marker.

Fasting Glucose

Fasting glucose is simple and often included in routine bloodwork. On its own, it is not enough, but it is helpful when viewed with A1C and insulin.

Fasting Insulin

Fasting insulin is not always included in a standard physical, but I think it deserves more attention. Insulin regulation can shift before blood sugar becomes obviously abnormal, so fasting insulin can add useful context.

The Hormone Tests I Pay Attention To

Hormones become more relevant in the years leading up to menopause and beyond. I do not think one lab result explains everything, but I do think hormone testing can help make symptoms less mysterious.

Estradiol, Progesterone, FSH, and LH

These markers can provide context around menstrual changes, perimenopause, and the menopausal transition. They fluctuate, so timing and symptoms matter, but they are still useful pieces of the picture.

Testosterone and DHEA-S

Women need testosterone too. Low levels can sometimes be associated with changes in energy, strength, libido, and overall well-being. DHEA-S can also provide additional context around adrenal hormone production.

The Nutrient Markers Worth Monitoring

Nutrient status matters more than a lot of people realize, especially when symptoms like fatigue, hair shedding, low mood, or poor exercise tolerance start getting blamed on age or stress.

Vitamin D

Vitamin D is straightforward to test and relatively actionable. I like knowing where I stand rather than guessing.

Vitamin B12

As someone who has followed a vegan diet for many years, B12 is a marker I take seriously. It is one of the non-negotiables for me.

Ferritin

Ferritin reflects iron stores. Low ferritin can contribute to fatigue, hair shedding, and exercise intolerance even when other basic blood counts look normal.

Omega-3 Index

Omega-3 Index is a specialty marker I track because of its relationship to cardiovascular health and inflammation. It is also a marker where the result can influence what I do next.

There is more to say about Omega-3 testing, but that belongs in its own article. For this one, the important point is that it is part of the data I personally care about.

The Thyroid Tests I Prefer

Thyroid issues are common in women, and symptoms can overlap with many other things: fatigue, weight changes, mood changes, temperature sensitivity, and changes in hair or skin.

TSH, Free T4, and Free T3

TSH is important, but I prefer looking beyond TSH alone. Free T4 and Free T3 can provide additional context, especially when symptoms and basic labs do not seem to match.

Why Trends Matter More Than One Result

One lab result can be useful, but trends are usually more valuable.

A single number is a snapshot. A pattern over time tells a story.

This is especially true for markers like ApoB, hs-CRP, A1C, fasting insulin, ferritin, vitamin D, and hormones. I want to know not just whether something is technically “normal,” but whether it is moving in the right or wrong direction.

That is also why I do not like treating every blood draw as an isolated event. The value is in building a record over time.

How I Keep Track of It All

The hardest part of tracking biomarkers is not always getting the bloodwork done. It is keeping the results organized.

Labs often come from different places: a primary care doctor, a specialist, a direct-to-consumer panel, a patient portal, or a PDF sitting in a downloads folder. Over time, it becomes difficult to remember what was tested, when it was tested, and whether the result changed.

That is where I find a tracking platform useful.

I use InsideTracker as one place to organize my biomarkers and monitor changes over time. For me, the value is not just the testing itself. It is having a centralized place to see patterns instead of digging through old lab reports.

You could also use a spreadsheet or another system. The point is to avoid letting valuable health data disappear into disconnected portals and PDFs.

A Final Thought

The goal of health tracking is not to collect data for the sake of collecting data.

The goal is to understand what is happening in your body, identify risks earlier, and make better decisions.

For me, that means paying attention to cardiovascular risk, metabolic health, hormones, nutrient status, thyroid function, and a few specialty markers that help complete the picture.

There will always be another test available. The challenge is deciding which information is useful enough to track over time.