Not medical advice. I am a software engineer, not a physician. This page documents my own protocol and the research I read while building it. Talk to a qualified clinician before changing your supplementation, diet or any treatment. Lab reference ranges quoted here vary by laboratory and by individual.
Affiliate disclosure: the iHerb links on this page carry a referral code and pay me a commission if you buy. It does not change your price, and I do not link anything I do not use myself.
Medellin Lab Prices (2026): Each test table includes minimum prices in COP from Medellin, Colombia labs (TRM ~4,200 COP/USD). Tests marked "N/A" have no affordable or available lab found yet in Medellin.
Annual preventive lab work is the single most cost-effective investment in longevity. Most chronic diseases—cardiovascular disease, type 2 diabetes, kidney failure, thyroid disorders—progress silently for years before symptoms appear. A structured blood panel catches deviations while they are still reversible. The USPSTF, AHA, and Endocrine Society all recommend routine screening for adults over 20, with expanded panels after 35.
This guide organizes tests into 9 tiers from essential to advanced. Tier 1 is for everyone annually; higher tiers add specificity for those optimizing health, managing risk factors, or pursuing longevity protocols.
These 10 tests form the minimum annual panel recommended by the AHA, USPSTF, and ADA. They screen for the top causes of preventable death: cardiovascular disease, diabetes, kidney and liver dysfunction, thyroid disorders, and chronic inflammation.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| CBC (Complete Blood Count) | RBC, WBC, hemoglobin, hematocrit, platelets | Detects anemia, infection, blood cancers, clotting disorders | $17,600 COP (~$4 USD) | Adilab | Iron, B12, Folate | Immune | All |
| Lipid Panel | Total cholesterol, LDL, HDL, triglycerides | Primary CVD risk predictor; LDL <100 mg/dL optimal | $28,700 COP (~$7 USD) | Cedimed | Omega-3, Berberine, Fiber, EGCG | Anti-inflammatory | All |
| Fasting Glucose | Blood sugar after 8-12h fast | Screens diabetes/prediabetes; optimal <90 mg/dL | $8,800 COP (~$2 USD) | Adilab | Berberine, Fiber, Creatine | Glucose/IR | All |
| HbA1c | 90-day average blood sugar | Gold standard for glycemic control; optimal <5.4% | $33,000 COP (~$8 USD) | Adilab | Berberine | Glucose/IR | All |
| Liver Panel (AST, ALT, GGT, ALP, Bilirubin) | Hepatocyte enzymes and bile metabolism | Detects fatty liver, hepatitis, alcohol damage early | $22,100 COP (~$5 USD) | Hosp. Alma Mater | NAC, Milk Thistle, Curcumin | Liver | All |
| Kidney Panel (BUN, Creatinine, eGFR) | Filtration capacity and waste clearance | CKD affects 15% of adults; eGFR >90 is optimal | $26,000 COP (~$6 USD) | CentroLab | NAC, Creatine (monitor) | — | All |
| TSH + Free T4 | Thyroid-stimulating hormone, active thyroid hormone | Thyroid dysfunction affects metabolism, mood, weight | $33,000 COP (~$8 USD) | Adilab | Ashwagandha, Zinc, Selenium | Hormonal | All |
| Vitamin D (25-OH) | Circulating vitamin D level | Deficiency in 42% of US adults; optimal 40-60 ng/mL | $79,000 COP (~$19 USD) | Hosp. Alma Mater | D3+K2 | Bone, Immune | All |
| CRP / hs-CRP | Systemic inflammation marker | Elevated CRP doubles CVD risk; optimal <1 mg/L | $22,000 COP (~$5 USD) | Adilab | Omega-3, Curcumin, NAC, Taurine | Anti-inflammatory | All |
| ESR (VSG) | Erythrocyte sedimentation rate | Non-specific inflammation screen | $2,700 COP (~$1 USD) | Hosp. Alma Mater | — | Anti-inflammatory | All |
| Urinalysis | Protein, glucose, blood, bacteria in urine | Early kidney damage, UTI, diabetes signs | $9,900 COP (~$2 USD) | Adilab | — | — | All |
These markers go beyond standard lipids and glucose to detect insulin resistance, subclinical atherosclerosis, and vascular inflammation years before clinical disease. Recommended for anyone over 35 or with family history of CVD or diabetes.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Fasting Insulin | Pancreatic insulin output at rest | Earliest insulin resistance marker; optimal <5 uIU/mL | $38,500 COP (~$9 USD) | Adilab | Berberine | Glucose/IR | All |
| Insulin (2h Post-Prandial) | Insulin response to a meal | Detects impaired clearance even with normal fasting | $38,500 COP (~$9 USD) | Adilab | Berberine | Glucose/IR | All |
| OGTT (Oral Glucose Tolerance) | Glucose response to 75g glucose load | Gold standard for prediabetes; 2h value <120 optimal | N/A | N/A | Berberine, Fiber | Glucose/IR | All |
| hs-CRP | High-sensitivity inflammatory marker | Predicts CVD events independently of LDL; <0.5 mg/L optimal | $26,341 COP (~$6 USD) | SURA | Omega-3, Curcumin, NAC, Taurine | Anti-inflammatory | All |
| Homocysteine | Amino acid linked to vascular damage | Elevated levels triple stroke risk; optimal <8 umol/L | $38,500 COP (~$9 USD) | Adilab | B-Complex, Folate, B12 | Brain | All |
| ApoB / ApoA1 | Atherogenic particle count / HDL protein | Better CVD predictor than LDL-C; optimal ApoB <80 mg/dL | $34,300 COP (~$8 USD) | Cedimed | Omega-3, Berberine | — | All |
| Lp(a) | Genetically determined atherogenic lipoprotein | Elevated in 20% of people; >50 nmol/L = high risk. Test once | $103,400 COP (~$25 USD) | Adilab | — | — | All |
| Calcium (Serum) | Ionized and total calcium | Bone, muscle, and cardiac function | $13,200 COP (~$3 USD) | Adilab | Ca Citrate, D3+K2 | Bone | All |
| NT-proBNP | Cardiac wall stress marker | Screens for subclinical heart failure; <125 pg/mL normal | N/A | N/A | — | — | All |
| hs-Troponin | Cardiac muscle damage at trace levels | Detects micro-injury; emerging longevity marker | N/A | N/A | — | — | All |
Hormonal decline is the primary driver of aging-related body composition changes. These tests are essential for anyone over 30 experiencing fatigue, muscle loss, mood changes, or fat gain despite consistent training.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Total Testosterone | Total circulating testosterone | Declines ~1%/yr after 30; optimal 500-900 ng/dL (men) | $27,500 COP (~$7 USD) | Adilab | Ashwagandha, Tribulus, Zinc, Vit D | Hormonal | All |
| Free Testosterone | Bioavailable (unbound) fraction | More clinically relevant than total; optimal >15 pg/mL | $38,500 COP (~$9 USD) | Adilab | Ashwagandha, Tribulus, Zinc, Vit D | Hormonal | All |
| DHT (Dihydrotestosterone) | Potent androgen converted from testosterone | Affects hair, prostate, muscle; context-dependent | $52,329 COP (~$12 USD) | SURA | — | Hormonal | All |
| Estradiol (E2) | Primary estrogen | Too high or low impairs mood, joints, CVD risk (both sexes) | $38,500 COP (~$9 USD) | Adilab | DIM | Hormonal | All |
| LH / FSH | Pituitary gonadotropins | Distinguishes primary vs secondary hypogonadism | $27,500 COP (~$7 USD) | Adilab | — | Hormonal | All |
| SHBG | Sex hormone-binding globulin | High SHBG lowers free testosterone; affected by insulin | N/A | N/A | — | Hormonal | All |
| Prolactin | Pituitary hormone | Elevated = pituitary issue or medication side effect | N/A | N/A | — | Hormonal | All |
| DHEA-S | Adrenal androgen precursor | Declines with age; marker of adrenal reserve | $34,775 COP (~$8 USD) | SURA | 7-Keto DHEA | Hormonal | All |
| IGF-1 | Growth hormone proxy (liver output) | Reflects GH status without stimulation testing | N/A | N/A | — | Longevity | All |
| Cortisol (AM serum + 4-point salivary) | Stress hormone diurnal pattern | Flat curve = adrenal dysfunction; AM optimal 10-18 ug/dL | $38,500 COP (~$9 USD) | Adilab | Ashwagandha, L-Theanine | Hormonal | All |
| PSA (Prostate-Specific Antigen) | Prostate gland protein marker | Screens prostate cancer; essential if on 5-alpha reductase inhibitors (dutasteride/finasteride); optimal <1.0 ng/mL (age 40-49) | $27,500 COP (~$7 USD) | Adilab | Saw Palmetto | Hair/DHT | Men |
Subclinical deficiencies are widespread even in well-fed populations. A 2022 Linus Pauling Institute review found that over 30% of adults are deficient in at least one vitamin or mineral. These tests guide targeted supplementation rather than guesswork.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Vitamin B12 + Folate (B9) | Methylation-critical B vitamins | Deficiency causes fatigue, neuropathy, high homocysteine | $38,500 COP (~$9 USD) | Adilab | B-Complex | Brain | All |
| B1 (Thiamine), B2, B3, B5, B6 | Energy metabolism cofactors | B6 deficiency common; affects neurotransmitter synthesis | N/A - Very expensive | $91k-190k+ | B-Complex | Brain | All |
| Vitamin A (Retinol) | Fat-soluble immune/vision vitamin | Deficiency impairs immunity; excess is hepatotoxic | $74,360 COP (~$18 USD) | Adilab | — | Immune | All |
| Vitamin C (Ascorbic Acid) | Antioxidant, collagen synthesis | Optimal >1 mg/dL; depleted by stress and smoking | N/A | N/A | — | Anti-inflammatory | All |
| Vitamin E (Alpha-Tocopherol) | Lipid-soluble antioxidant | Protects cell membranes; rarely deficient in healthy diets | N/A | N/A | — | Anti-inflammatory | All |
| Vitamin K (Phylloquinone) | Coagulation and bone mineralization | K2 deficiency linked to arterial calcification | N/A | N/A | — | Bone | All |
| Magnesium (RBC) | Intracellular Mg (better than serum) | Deficient in ~50% of population; affects 300+ enzymes | $13,900 COP (~$3 USD) | Adilab | Magtein, Mg Glycinate | Brain, Sleep | All |
| Calcium, Phosphorus | Bone minerals and cell signaling | Imbalance affects bones, muscle, and heart rhythm | $13,200 COP (~$3 USD) | Adilab | Ca Citrate, D3+K2 | Bone | All |
| Zinc, Copper, Selenium | Trace minerals for immunity and thyroid | Zn:Cu ratio matters; Se essential for T4-to-T3 conversion | $51,700 COP (~$12 USD) | Adilab | Zinc Picolinate | Immune | All |
| Iron + Ferritin + TIBC | Iron stores, transport, and binding capacity | Both deficiency and overload are harmful; ferritin 40-150 optimal | $11,000 COP (~$3 USD) | Adilab | Vitamin C | Hair | All |
| Omega-3 Index | EPA+DHA as % of RBC membranes | Optimal >8%; <4% doubles cardiac death risk | $300,000 COP (~$71 USD) | SURA | Omega-3 EPA/DHA | Brain | All |
The gut microbiome influences immunity, nutrient absorption, mood (via the gut-brain axis), and systemic inflammation. These tests are indicated for chronic GI symptoms, autoimmune conditions, or unexplained inflammation.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Fecal Calprotectin | Neutrophil protein in stool | Distinguishes IBD from IBS; <50 ug/g normal | N/A | N/A | — | — | All |
| Pancreatic Elastase | Exocrine pancreatic function | Low = malabsorption; >200 ug/g normal | N/A | N/A | — | — | All |
| Comprehensive Stool (Dysbiosis Panel) | Bacterial, fungal, parasitic diversity | Identifies overgrowth, pathogens, diversity loss | N/A | N/A | — | — | All |
| Bile Acids (Fecal) | Bile acid malabsorption | Cause of chronic diarrhea in up to 30% of IBS-D cases | N/A | N/A | — | — | All |
| OAT (Organic Acids Test) | Urine metabolites of gut flora and metabolism | Screens yeast overgrowth, mitochondrial function, neurotransmitters | N/A | N/A | — | — | All |
Peak bone mass is reached by ~30. After that, preservation is key. These markers complement DEXA bone density scans by tracking the dynamic balance between bone formation and resorption.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| DEXA (Bone Density) | Bone mineral density at hip and spine | Gold standard; T-score >-1.0 is normal | N/A | N/A | — | Bone | All |
| PTH (Parathyroid Hormone) | Calcium-regulating hormone | High PTH = calcium being pulled from bones | N/A | N/A | — | Bone | All |
| NTx (N-Telopeptide) | Bone resorption marker | High = accelerated bone loss | N/A | N/A | — | Bone | All |
| CTx (C-Telopeptide) | Collagen crosslink from bone breakdown | Monitors osteoporosis treatment response | N/A | N/A | — | Bone | All |
| Osteocalcin | Bone formation marker | Low = reduced bone building activity | N/A | N/A | — | Bone | All |
| Calcium:Phosphorus Ratio | Mineral balance for bone health | Imbalance impairs mineralization; ratio ~2:1 optimal | N/A | N/A | — | Bone | All |
Chronic low-level heavy metal and environmental toxin exposure accumulates over decades. The WHO estimates that lead exposure alone accounts for 900,000 deaths annually. Testing is especially important for those in urban environments or with occupational exposure.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Blood Lead | Circulating lead level | No safe level; <3.5 ug/dL target; affects cognition, kidneys | N/A | N/A | — | — | All |
| Blood Mercury | Organic and inorganic mercury | Fish consumption main source; <5 ug/L reference | N/A | N/A | — | — | All |
| Urine Cadmium | Chronic cadmium exposure (kidneys) | Smoking and rice main sources; <1 ug/L target | N/A | N/A | — | — | All |
| Urine Arsenic (Speciated) | Inorganic arsenic exposure | Groundwater contamination risk; <15 ug/L target | N/A | N/A | — | — | All |
| Environmental Toxin Panel | Pesticides, phthalates, BPA, VOCs | Endocrine disruptors; linked to obesity, infertility, cancer | N/A | N/A | — | — | All |
These one-time or infrequent tests provide lifetime risk information. Genetic tests need only be done once; epigenetic and microbiome tests can be repeated to track biological aging.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| CV Genetic Panel (APOE, 9p21, LPA) | Genetic cardiovascular risk variants | APOE4 carriers have 3x Alzheimer risk; guides statin decisions | N/A | N/A | — | — | All |
| Pharmacogenomics (CYP450 panel) | Drug metabolism gene variants | Determines if you are a poor/rapid metabolizer for key drugs | N/A | N/A | — | — | All |
| Insulin Resistance Genetic (TCF7L2, FTO) | T2D and obesity susceptibility genes | FTO variant increases obesity risk ~1.7x; actionable with diet | N/A | N/A | — | Glucose/IR | All |
| Cancer Panel (BRCA1/2, Lynch, APC) | Hereditary cancer risk genes | BRCA1 carriers: 70% lifetime breast cancer risk | N/A | N/A | — | — | All |
| Telomere Length | Chromosomal aging marker | Shorter telomeres = accelerated biological aging | N/A | N/A | — | Longevity | All |
| Gut Microbiome Sequencing | Full metagenomic bacterial profile | Diversity predicts metabolic health and immune function | N/A | N/A | — | — | All |
| Epigenetic / Methylation Clock | DNA methylation age (Horvath, GrimAge) | Biological vs chronological age; tracks intervention effects | N/A | N/A | — | Longevity | All |
Imaging completes the picture that blood tests cannot fully reveal. These non-invasive or low-radiation studies detect structural and functional abnormalities in organs, heart, and lungs. Recommended baseline at 35-40, then per clinical indication.
| Test | What It Measures | Why It Matters | Min Price | Lab | Supplements | Benefit | Who |
|---|---|---|---|---|---|---|---|
| Abdominal Ultrasound | Liver, gallbladder, kidneys, pancreas, aorta | Detects fatty liver (NAFLD), gallstones, AAA, masses | N/A | N/A | — | Liver | All |
| FibroScan (Transient Elastography) | Liver stiffness / fibrosis degree | NAFLD affects 25% globally; catches fibrosis before cirrhosis | N/A | N/A | — | Liver | All |
| Echocardiogram | Heart structure, valves, ejection fraction | Detects cardiomyopathy, valve disease, wall motion abnormalities | N/A | N/A | — | — | All |
| Chest X-Ray | Lungs, heart silhouette, mediastinum | Screens masses, effusions, cardiomegaly; low radiation | N/A | N/A | — | — | All |
| Spirometry (PFT) | FEV1, FVC, FEV1/FVC ratio | Detects COPD, asthma, restrictive disease early | N/A | N/A | — | — | All |
A comprehensive catalog of all imaging modalities ranked from most to least expensive. Approximate costs are for Medellin, Colombia (private labs, self-pay). Whole-body MRI is trending as a preventive screening tool for early cancer detection.
| Study | Use | Radiation? | Min Price | Who |
|---|---|---|---|---|
| PET Scan (Positron Emission Tomography) | Detects metabolic activity: cancer, metastasis, cardiac viability. Uses cyclotron-produced radiopharmaceuticals (FDG) | Yes (radiotracer + CT) | N/A (no lab found in Medellin) | All |
| MRI (Magnetic Resonance Imaging) | Whole-body MRI for preventive screening. High resolution for soft tissues, brain, spine, joints, abdominal organs. No ionizing radiation | No | $1,500,000 COP (~$357 USD) per region | All |
| CT Scan (Computed Tomography) | Simple or contrast-enhanced, multi-region. 3D reconstructions of blood vessels, internal organs, bones. Coronary calcium score | Yes | $300,000 COP (~$71 USD) per region | All |
| Angiography | Invasive/minimally invasive visualization of arteries and veins. Requires hemodynamics equipment. Coronary, cerebral, peripheral vascular assessment | Yes (fluoroscopy) | $2,000,000 COP (~$476 USD) | All |
| Scintigraphy / Nuclear Medicine | Gamma cameras track radioactive tracers. Renal function, thyroid uptake, bone metastasis search, cardiac perfusion | Yes (radiotracer) | $400,000 COP (~$95 USD) | All |
| Fluoroscopy | Real-time X-ray video. Digestive tract studies (barium swallow, enema), surgical/procedural guidance | Yes (continuous X-ray) | $200,000 COP (~$48 USD) | All |
| Ultrasound (Sonography) | No radiation. Abdominal organs, thyroid, superficial tissues, pregnancy, Doppler vascular flow | No | $80,000 COP (~$19 USD) | All |
| Mammography | Low-dose radiation breast imaging. Early breast cancer detection, microcalcifications, masses. Recommended from age 40 (or earlier with family history) | Yes (low dose) | $80,000 COP (~$19 USD) | Women |
| X-ray (Radiography) | Basic and cheapest modality. Bones, chest, quick structural checks, fracture assessment | Yes (minimal) | $30,000 COP (~$7 USD) | All |
| DEXA Bone Densitometry | Bone calcium density measurement (osteoporosis screening). Also provides metabolic body composition analysis (lean mass, fat mass, visceral fat) | Yes (very low) | $60,000 COP (~$14 USD) | All |
Note: Prices are approximate for Medellin, Colombia (private labs, self-pay, 2025-2026). Actual costs vary by institution, contrast requirements, and number of regions scanned. For PET scans, referral to Bogota or a major oncology center may be necessary.
Reference ranges are not optimal ranges. Lab reference intervals represent the middle 95% of the tested population—which includes sick, sedentary, and metabolically unhealthy people. "Normal" does not mean "ideal." For example, a fasting glucose of 99 mg/dL is within the reference range but already indicates prediabetes risk.
Rule of thumb: Aim for the 25th-50th percentile of the reference range for markers where lower is better (glucose, insulin, CRP, LDL), and the 50th-75th percentile where higher is better (vitamin D, HDL, testosterone).
Always track your results over time. A single snapshot is less valuable than a trend over 2-3 years. Use a spreadsheet or health app to plot values and identify directional changes before they leave even the optimal range.
| Tier | Frequency | Notes |
|---|---|---|
| Tier 1 — Essential | Annually | Twice/year if managing a condition |
| Tier 2 — Metabolic/CV | Annually (35+) | Lp(a) once in lifetime; insulin if metabolic risk |
| Tier 3 — Hormonal | Annually (30+) | Twice/year if on HRT or TRT |
| Tier 4 — Micronutrients | Every 1-2 years | Recheck 3 months after supplementation changes |
| Tier 5 — Gut Health | As needed | Baseline if GI symptoms; repeat after interventions |
| Tier 6 — Bone | Every 2-3 years (40+) | DEXA baseline at 40 (women) or 50 (men) |
| Tier 7 — Toxicology | Every 3-5 years | More often with occupational exposure |
| Tier 8 — Genetic | Once (genetic); annually (epigenetic) | Methylation clock 1-2x/year if tracking bio-age |
| Tier 9 — Imaging | Baseline at 35-40, then per indication | Echo every 3-5 years; abdominal US per liver risk |
| Tier 10 — Imaging Catalog | Per clinical indication or preventive screening | Whole-body MRI trending for early cancer detection; DEXA for body composition |
Preparation matters: Most blood tests require 10-12 hour fasting. Avoid intense exercise 24h before. Draw blood in the morning (7-10 AM) for accurate cortisol and testosterone. Hydrate normally with water only. Bring your previous results for comparison.
The 2025 USPSTF updated several key screening recommendations. Colorectal cancer screening was reaffirmed starting at age 45 (Grade B for ages 45-49, Grade A for 50-75). Osteoporosis screening was reinforced for all women aged 65 and older and high-risk younger postmenopausal women. The USPSTF also updated cardiovascular risk assessment guidance, with statin therapy recommendations now incorporating updated pooled cohort equations. Notably, the task force continues to evaluate expanding lung cancer screening criteria and refining breast cancer screening intervals based on ongoing evidence reviews through 2026.
For longevity-focused individuals, the ADA's 2025 Standards of Care now recommends CGM (continuous glucose monitoring) metrics as a validated complement to HbA1c, and the consensus on MASLD (formerly NAFLD) screening suggests liver enzyme panels combined with FIB-4 scoring for at-risk adults. The emergence of multi-cancer early detection (MCED) blood tests, such as Galleri, continues to show promise in 2025-2026 clinical trials for detecting 50+ cancer types from a single blood draw, though these remain investigational and are not yet USPSTF-recommended.
USPSTF (2025). A and B Recommendations. USPSTF