The Most Important Blood Tests for Unlocking Peak Health and Performance
Understanding your blood work can give you unmatched insight into your internal health, risk for chronic disease, and opportunities to improve how long you live as well as the quality of that time.
As a friend once said, relying on a doctor to interpret your blood work is a lot like relying on your priest to read the bible for you. While doctors can be invaluable when it comes to treating acute disease and managing complex conditions, they rarely have the mindset or knowledge to help you optimize your health and fitness via your blood work.
I’m going to break it down for you—the key blood markers you need to measure and optimize if you want to feel superhuman.
** DISCLAIMER**
This is a blog post meant to inform and empower. It is NOT medical advice nor is it intended to treat any medical condition. If you have a medical condition these tests and ranges may not be applicable to you. Consult your physician or one of our Functional Health Coaches before taking action.
1. Blood Health (CBC)
Think of this as a snapshot of your white and red blood cell health, critical for oxygen delivery, immune function, and inflammation detection.
Hemoglobin or hematocrit: These two markers are measures of your body’s ability to deliver oxygen to your tissues. If they’re low you might have an iron deficiency or low testosterone which can disrupt sleep and cause overall energy issues.
Optimal Hemoglobin:
Men: 14-17.5 g/dL
Women: 12.3-15.3 g/dL
Optimal Hematocrit:
Men: 40-50%
Women: 36-45%
White blood cells: Elevated WBC counts, or unexpected ratios of white blood cells can signal an inflammatory condition or latent infection. Generally speaking, it’s healthy to see the number of white blood cells decrease as you step down the list from neutrophils all the way to Immature Granulocytes.
2. Metabolic Health
We look at three tests to assess overall metabolic health. Our goal is to see how much fuel in the form of sugar (glucose) or fat (triglycerides) you have in your bloodstream. If you haven’t eaten recently (you should do these tests fasted) it’s healthy to see moderate to low levels of circulating sugar and fat. High levels of circulating sugar and fat signal poor metabolic health and is the primary cause of most chronic diseases including heart disease, type II diabetes, Alzheimers and dementia, and many cancers.
Fasting glucose: This is a spot measurement of how much sugar is circulating in your blood at the time of the test. We look for optimal levels well below 100 mg/dL.
HbA1C: While fasting blood glucose is a spot measurement of blood sugar, HbA1c is a 90 day retrospective look at your blood sugar. It measures a type of damage to your red blood cells called glycation. If your A1C is above 5.6%, you’re moving toward insulin resistance and potentially even type II diabetes. Optimal HbA1c is ~5.2% or lower.
Triglycerides: This is a measure of circulating fat in your bloodstream. Levels around or below 100 mg/dL are optimal and > 150 mg/dL is the true danger zone.
3. Kidney Health
Your kidneys are your body’s filtration system, working 24/7 to clear toxins, regulate electrolytes, and maintain hydration. But most people don’t even think about kidney health—until there’s a problem.
By the time kidney disease shows symptoms, you’ve already lost significant function. That’s why checking your creatinine and estimated glomerular filtration rate (eGFR) is critical for early detection and optimization.
Creatinine: Creatinine is a waste product from muscle metabolism, filtered out by the kidneys. If your kidneys aren’t clearing it efficiently, levels rise in your blood—which can indicate kidney dysfunction. We generally look for values < 1.0mg/dL, although depending on your training program it might be ok for this value to be slightly elevated
eGFR: Your estimated glomerular filtration rate measures how well your kidneys are filtering waste. Over 90 is optimal, however this should be adjusted for age and other conditions.
3. Liver Health
Your liver is the command center of detoxification, metabolism, and hormone balance. If your liver is struggling, you might experience fatigue, brain fog, stubborn fat gain, or digestive issues
ALT: ALT is the most sensitive enzyme for liver stress. When your liver is damaged or inflamed, ALT leaks into the bloodstream. We look for values under 30U/L for men and 25U/L for women
AST: AST is another enzyme released when liver or muscle cells are damaged. Unlike ALT, AST is also found in heart and muscle tissue, so it’s not as liver-specific. Look for an AST/ALT ratio of 1.0-2.0.
AST/ALT ratio < 1.0 → Fatty liver, insulin resistance, metabolic dysfunction
AST/ALT ratio > 2.0 → Alcohol-related liver stress or cirrhosis
If ALT is higher than AST, it usually means non-alcoholic fatty liver (NAFLD) due to diet and insulin resistance.
Alkaline Phosphatase (ALP): ALP is an enzyme involved in bile production, digestion, and bone metabolism. Elevated ALP often signals liver, gallbladder, or bone issues. Optimal ALP Levels are 40-120 U/L
4. Vitamin D
Almost everyone that isn’t supplementing aggressively with Vitamin D is deficient. This isn’t just a vitamin; it’s a hormone that regulates immunity, mood, testosterone, and fat metabolism as well as being a necessary component of optimal bone mineral density and soft tissue health. .
Ideal range: 60-80 ng/mL (not the outdated “normal” range of 30-50).
5. Testosterone (For Both Men and Women)
Testosterone isn’t just for muscle—it impacts energy, metabolism, cognitive function, and recovery. Low levels can lead to fat gain, low libido, and brain fog. While more is generally better, most middle aged men should strive for total testosterone > 600 ng/dL and middle aged women enjoy the benefits of optimal total testosterone > 20ng/dL.
Our approach is most often to raise clients’ testosterone levels as much as possible through holistic means like nutrition, supplementation, sleep, and exercise. If those adjustments aren’t sufficient to achieve optimal levels, TRT run through a knowledgeable physician can be safe, effective, and dramatically improve quality of life.
It’s also important to note that hormone replacement therapy doesn’t cause cancer in men or women, despite what you may have heard. These claims are based on old studies poorly interpreted.
6. Lipids
Cholesterol is one of the most misunderstood markers in medicine. For years, people have been told that LDL is “bad” and HDL is “good”, but the truth is far more nuanced.
If you’re only looking at total cholesterol, you’re missing the real story about your heart health, metabolism, and inflammation levels. Let’s break it down the right way so you know exactly what to look for.
HDL: High-Density Lipoprotein acts like a garbage truck, removing excess cholesterol and delivering it back to the liver for processing. More HDL = better cholesterol transport and lower inflammation. Men should have HDL > 50 ng/mL and woman > 60 ng/ML. Low levels of HDL can be a sign of systemic inflammation or insulin resistance.
LDL: Low-Density Lipoprotein (LDL) has been unfairly labeled as “bad” cholesterol, but here’s the truth: LDL isn’t inherently harmful—it depends on the type and size of LDL particles.
Large, fluffy LDL? Not a problem.
Small, dense LDL? Higher risk for heart disease (oxidizes easily, sticks to arteries).
Standard medical guidelines say <100 mg/dL is ideal, but if your HDL is high and triglycerides are low, higher LDL is not necessarily dangerous. If LDL is high (>130 mg/dL) with high triglycerides, it signals metabolic issues. A large metaanalysis has identified the “sweet spot” for LDL to be in the range of 100-189 ng/mL
7. TSH (Thyroid-Stimulating Hormone)
Your thyroid is your body’s thermostat—controlling metabolism, energy, and even mood. We recommend women get their TSH tested as a high level test of thyroid health. If TSH comes back high that might indicate further investigation via a full thyroid panel and a TPO test to assess for an autoimmune based thyroid condition.
Optimal Ranges for TSH: 0.5 - 2.0 μIU/mL
The Bottom Line: Test, Don’t Guess
We recommend our clients run their own blood work, or have their PCP do so, on an annual basis. This provides a powerful time series of data from which you can identify any areas that need work or risk factors you’d like to take control of.
If you want to run this check-up through your primary care physician, simply ask them to run the following tests as a part of your annual health check up:
Total and Free Testosterone
Vit D
CBC
CMP
Lipid Panel (HDL, LDL, triglycerides)
HBa1c
TSH and TPO (Female only
You can also run your own blood work. We use the direct to consumer service Ulta Labs. You can purchase your lab tests without a prescription for competitive prices, schedule a blood draw at a lab near you, and you’ll receive your results in roughly 5 days. It's very convenient!
Let us know if you’d like some expert guidance interpreting your lab work and building a plan to improve your markers!