Protocols by Charles Sieg

Testing

Lab tests worth knowing

The blood tests I think are worth understanding for heart, metabolic, kidney, and general health: what each measures, the cutoffs the sources back, and where Direct Labs lists it.

Overall evidence Mixed34 sourcesReviewed November 5, 2026

The lipid tests rest on strong causal evidence and current guidelines, the creatine and kidney point rests on small studies, and several popular tests have no guideline cutoff I could check, so the page as a whole is mixed.

The short version

  • These are the tests I think are worth understanding, not a list to order all at once. Which ones fit a given person is a decision for a doctor.
  • The heart numbers that carry the most weight are LDL-C, non-HDL-C, ApoB, and a one-time Lp(a)1,2,3, plus fasting glucose or HbA1c4 and a urine albumin test for anyone with high blood pressure5.
  • I take creatine, and creatine can raise serum creatinine without a significant change in GFR6. A kidney check built on creatinine alone can mislead, and adding cystatin C gives a more precise estimate7,8.
  • Several popular tests have no guideline cutoff I could check, and I say so instead of inventing a number.
  • Direct Labs sells these tests through an online store. Prices are on each Direct Labs page and they change, so none are listed here. Blood pressure, coronary calcium, DEXA, VO2 max, and spirometry are not blood tests; they are on Body, fitness, and imaging tests.

Direct Labs, briefly

Direct Labs sells lab tests through an online store at store.directlabs.com, grouped by category9. Each of the three test pages I could open gives an average processing time that the page calls an estimate, not a guarantee; two of them give a fasting rule (a 10- to 12-hour fast is required for the APEX-6 Panel and preferred but not required for OmegaCheck), and two name Quest Diagnostics as the lab10,11,12. The longevity panel also includes an optional AI-assisted analysis powered by Grok12.

I could not open Direct Labs' How It Works, FAQ, or state pages, so this page says nothing about who orders the tests, who reviews the results, where blood is drawn, or which states are excluded. The store's menu links How It Works, FAQs, and a Lab Locator9, and those are the pages that answer it. Prices are on each test's page and change, so none appear here, and there are no affiliate links on this site.

Lipids: the baseline

What it measures. Direct Labs' standard lipid panel reports total cholesterol, HDL, triglycerides, and calculated LDL, cholesterol/HDL ratio, and non-HDL cholesterol9.

Why it matters. In the ACC's summary of the 2026 ACC/AHA dyslipidemia guideline, the LDL-C goals are under 100 mg/dL for borderline or intermediate risk, under 70 for high risk, and under 55 for very-high-risk people with established disease1. For very-high-risk disease the non-HDL-C goal is under 85 mg/dL13. Those numbers come from ACC pages, not the full guideline, whose PubMed record links two later items in Circulation that I could not read, so the current text is the one to check14.

At Direct Labs. "Lipid Panel, standard (Cholesterol Panel)", in the Cardiovascular/Heart Health category9.

ApoB

What it measures. The number of atherogenic particles, because each carries one ApoB2.

Why it matters. In the ACC's summary, the 2026 guideline says ApoB may be used to assess leftover risk once LDL-C and non-HDL-C goals are met, in people with cardiovascular-kidney-metabolic syndrome, type 2 diabetes, high triglycerides, or known cardiovascular disease, and that in those groups it may be a more accurate risk marker than LDL-C; the summary gives no ApoB cutoff1. The broader case for ApoB as the better marker comes from advocates for the test2.

At Direct Labs. "Apolipoprotein B (ApoB)" on its own, or "Extended Lipid Profile", which adds ApoB and Lp(a) to a lipid panel, both in the Cardiovascular/Heart Health category9.

Lp(a)

What it measures. Lipoprotein(a), a particle that adds cardiovascular risk on its own, even when LDL is very low3.

Why it matters. The European consensus and the 2026 US guideline both call for measuring it at least once in adulthood, and the ACC's summary adds that lifestyle barely moves it, so repeat testing is generally not needed3,1. I found no numeric cutoff in a source I could check. For context, the Lp(a)HORIZON trial's main population had Lp(a) of 70 mg/dL or higher, and in September 2026 Novartis announced that pelacarsen lowered Lp(a) there without reducing cardiovascular events; that is a company press release, not yet peer-reviewed15. So a high number is a reason to manage everything else harder3, not yet a reason for an Lp(a) drug.

At Direct Labs. "Lipoprotein (a)", in the Cardiovascular/Heart Health category9.

hs-CRP

What it measures. Inflammation; Direct Labs lists it as used to assess the risk of cardiovascular and peripheral vascular disease9.

Why it matters. CANTOS and ZEUS both enrolled people with hsCRP of 2 mg/L or higher, which is a trial entry rule, not a guideline cutoff16,17. ZEUS lowered hsCRP without reducing cardiovascular events, according to Novo Nordisk's press release, so I treat hs-CRP as context and not as a target17.

At Direct Labs. "hs-CRP (C-Reactive Protein) (CRP, hs) (Cardio CRP)", in the Cardiovascular/Heart Health category9.

HbA1c, fasting glucose, and fasting insulin

What they measure. Direct Labs describes HbA1c as the three-month average amount of glucose in the blood, and its insulin test as a fasting insulin level18.

Why they matter. The American Heart Association's Life's Essential 8 score gives its top score to a fasting glucose under 100 mg/dL or an HbA1c under 5.7%, and labels 100 to 125 mg/dL or 5.7% to 6.4% prediabetes; it does not use fasting insulin4. The American Diabetes Association publishes its diagnostic criteria in its Standards of Care, which it updates every year19, and Blood sugar covers diagnosis in full. I found no guideline cutoff for fasting insulin. In people without diabetes, a meta-analysis of 65 studies linked the highest HOMA-IR (fasting glucose and insulin together) to higher coronary risk (RR 1.64), while fasting insulin alone was not significant; these are observational numbers20.

At Direct Labs. "Hemoglobin A1c with eAG (HgbA1c)" and "Insulin", in the Diabetes category18.

Kidney: eGFR, cystatin C, and urine albumin

What they measure. eGFR estimates how well the kidneys filter, usually from blood creatinine6. Cystatin C is a second filtration marker, and the two can be combined into one estimate, eGFRcr-cys8. The urine albumin-to-creatinine ratio (ACR) is a test of kidney health5.

Why it matters. The 2025 blood pressure guideline now recommends a urine ACR for everyone with high blood pressure5, and a European commentary on the 2024 KDIGO kidney guideline treats an ACR of 30 mg/g or higher as significant albuminuria8. I found no eGFR stage cutoffs in a source I could check, so none appear here.

Creatine can mislead the creatinine number. In a 2025 systematic review of 21 studies, 12 of them pooled for creatinine, serum creatinine ran slightly higher on creatine (mean difference 0.07, 95% CI 0.01 to 0.12), while GFR did not differ significantly from controls; the authors put the rise down to metabolic turnover, not kidney damage6. In 170 healthy people, creatinine tracked lean mass and was higher in the more active group than in sedentary people (1.04 versus 0.95 mg/dL), while cystatin C did not differ, and the authors suggest cystatin C may be the better measure in people with more muscle when mild kidney trouble is suspected7. The European commentary says the combined creatinine and cystatin C estimate should at minimum be considered when creatinine alone may be in error, as with muscle loss or special diets8. To be clear about the gap: none of these three tested cystatin C in people taking creatine. Reading them together as a reason to check it is my inference, and the call belongs to a doctor.

At Direct Labs. "Cystatin C with Glomerular Filtration Rate, Estimated (eGFR)"; "Albumin (Microalbumin), Random Urine With Creatinine", which Direct Labs describes as a urine test of whether the kidneys are working normally; and "Kidney Profile (Renal function)", which includes creatinine and a calculated eGFR. All three are in the Kidney category21.

Liver: ALT and GGT

What they measure. Direct Labs describes ALT as useful in diagnosing and managing liver diseases such as viral hepatitis and cirrhosis, and GGT as helping detect liver disease and bile duct obstruction22.

Why it matters. The American College of Gastroenterology puts a truly healthy ALT at 29 to 33 IU/L for males and 19 to 25 IU/L for females, and says levels above that should be assessed23. Its workup for a raised ALT looks at causes from viral hepatitis to fatty liver and alcohol-related liver disease, so the number is a prompt to look, not a diagnosis23. I found no guideline cutoff for GGT.

At Direct Labs. "Alanine Aminotransferase (ALT/SGPT)" and "Gamma Glutamyl Transferase (GGT)", in the Liver category22.

CBC and CMP

What they measure. Direct Labs lists the CBC as a screening test for conditions including anemia, leukemia, and inflammation24. Its CMP includes glucose, electrolytes, creatinine with an estimated GFR, and the liver enzymes ALT and AST, among others18.

Why it matters. Each is a bundle of many values, so there is no single cutoff to quote. They are a broad first look, and the CMP carries the creatinine and ALT numbers above18.

At Direct Labs. "CBC (includes Differential And Platelets)", in the Anemia category24, and "Comprehensive Metabolic Panel (CMP)", in the Diabetes category18.

Thyroid, vitamin D, ferritin, B12, homocysteine, and uric acid

  • TSH. Direct Labs lists "TSH (Thyroid-Stimulating Hormone)" to screen for and help diagnose thyroid disorders, in its Thyroid category25. I found no cutoff I could check.
  • Vitamin D (25-hydroxy). The Endocrine Society found no clinical trial evidence for routine screening in the general population, and it suggests against routine 25(OH)D testing in the people it considered26. Direct Labs lists "Vitamin D, 25 Hydroxy" in Vitamins, Minerals & Nutrition27.
  • Ferritin. Direct Labs describes it as the protein that stores iron and reflects the amount of iron in the body, and lists "Ferritin" in its Anemia category24. I found no cutoff I could check.
  • Vitamin B12. Direct Labs lists "Vitamin B12 (Cobalamin)" as detecting B12 deficiency, in Vitamins, Minerals & Nutrition27. I found no cutoff I could check.
  • Homocysteine and uric acid. I found no guideline cutoff I could check for either, so they are context only. Direct Labs lists "Homocysteine" in its Cardiovascular/Heart Health category9, and "Uric Acid, Serum", which it says measures uric acid to diagnose gout, in its Liver category22.

Omega-3 Index

What it measures. The share of red blood cell fatty acids that are EPA plus DHA28.

Why it matters. Harris and von Schacky proposed 8% or higher as the most protective range and 4% or lower as the least28. That is observational; it does not prove that raising the number lowers risk. Rhonda Patrick's FoundMyFitness episode with Bill Harris, co-inventor of the index, covers using red blood cell omega-3 as a measure of long-term status29; it is a conversation, and it does not mean she endorses this site.

At Direct Labs.OmegaCheck (also named Omega -3 and -6 Fatty Acids) reports the Omega-3 (EPA + DHA) Index, the omega-6 to omega-3 ratio, the arachidonic acid to EPA ratio, and arachidonic acid, EPA, and DHA; the lab is Quest Diagnostics11.

Testosterone and estradiol

Why it matters. TRAVERSE enrolled 5,246 men aged 45 to 80 with symptoms of low testosterone and two fasting testosterone levels below 300 ng/dL; that was an entry rule, not a diagnostic standard. Major cardiovascular events were 7.0% on testosterone gel versus 7.3% on placebo (HR 0.96, 95% CI 0.78 to 1.17), with more atrial fibrillation, acute kidney injury, and pulmonary embolism on testosterone, and AbbVie and others funded it30. I found no guideline cutoff for estradiol in men.

At Direct Labs. "Testosterone, Total, Males (Adult), Immunoassay", in the Men's Health category31, and "Estradiol (E2) Hormone", in the Hormones category32.

PSA

Why it matters. The US Preventive Services Task Force's 2018 statement says that for men 55 to 69, PSA screening may prevent about 1.3 prostate cancer deaths per 1,000 men screened over about 13 years, so the decision should be an individual one (a C recommendation), and it recommends against PSA screening in men 70 and older (a D recommendation)33. I did not check whether the Task Force has updated it since.

At Direct Labs. "PSA, Total (Prostate Specific Antigen)" and "PSA (Prostate Specific Antigen) Free And Total", in the Men's Health category31.

Bundles that cover several of these

  • Biohacking Longevity & Cellular Optimization Panel: ApoB, Lp(a), homocysteine, fasting insulin, RBC magnesium, hs-CRP, ferritin, a CBC, and a CMP-14; the lab is Quest Diagnostics12.
  • "Biohacking Cardiovascular/Heart Health Panel": CMP, hemoglobin A1C, homocysteine, hs-CRP, and the Cardio IQ Advanced Lipid Panel, in the Test Packages category34.
  • "Low Carb Diet Vitamin Deficiency Panel": CMP, ferritin, vitamins B1, B6, B12, D, and E, folate, iodine, iron, magnesium, and zinc, also in Test Packages34.
  • APEX-6 Panel: the page lists the Comprehensive Wellness Profile, which it says holds over 50 tests, along with HbA1c, hs-CRP, homocysteine, and vitamin D, and it requires a 10- to 12-hour fast10.

How I use it

I take creatine and follow a keto diet, and I do a once-a-month 3-day fast on water and broth. I have no lab numbers, dates, or results from my own testing to put on this page yet.

Cautions

  • This is not medical advice. A test result is a prompt for a conversation with a clinician, not a diagnosis.
  • Cutoffs describe groups. Creatine can raise creatinine without a significant change in GFR6, and muscle and activity move it too7.
  • The 2026 dyslipidemia goals here come from the ACC's summary pages, not the full guideline, and the guideline's PubMed record links two later items I could not read14.
  • Buying a test online does not replace a clinician who knows your history.

References

  1. American College of Cardiology. ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia. American College of Cardiology (Journal Scan), March 13, 2026.ArticleRead

    What it found: ACC summary of the 2026 dyslipidemia guideline: LDL-C goals of under 100 mg/dL for borderline or intermediate risk, under 70 for high risk, and under 55 for very-high-risk ASCVD; ApoB may help assess residual risk once LDL-C and non-HDL-C goals are met; Lp(a) should be measured at least once in adulthood, with repeat testing generally not needed; selective coronary calcium scans for men over 40 and women over 45 at borderline or intermediate risk; PREVENT-ASCVD replaces the Pooled Cohort Equations for 10- and 30-year risk in ages 30 to 79; inclisiran is still being studied for outcomes.

    Limits: A summary page, not the guideline; it gives no numeric thresholds for non-HDL-C, ApoB, Lp(a), or calcium scores.

  2. Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, et al. Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiology. 2019;4(12):1287-1295.ReviewPubMed 31642874 · DOI

    What it found: Narrative review arguing that every atherogenic particle (VLDL, LDL, chylomicron remnant, Lp(a)) carries one apoB molecule, so plasma apoB counts the particles; cholesterol enters the artery wall only inside apoB particles, and the number entering depends mainly on how many are in the blood. The authors conclude that apoB is a better marker of atherogenic risk than LDL-C or non-HDL-C.

    Limits: A narrative review by authors who advocate apoB testing, not a systematic review or a trial.

  3. Kronenberg F, Mora S, Stroes ESG, Ference BA, Arsenault BJ, Berglund L, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. European Heart Journal. 2022;43(39):3925-3946.Position standPubMed 36036785 · DOI

    What it found: European Atherosclerosis Society consensus statement concluding that Lp(a) is a causal, continuous risk factor for cardiovascular disease and aortic valve stenosis across ethnic groups, including at very low LDL cholesterol. It recommends at least one Lp(a) measurement in every adult and early, intensive management of other risk factors when Lp(a) is high.

    Limits: A consensus statement, not a trial; the abstract notes that Lp(a)-specific drugs still need outcome trials to confirm clinical benefit.

  4. Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146(5):e18-e43.Position standPubMed 35766027 · DOI

    What it found: A presidential advisory that updates the cardiovascular health score the American Heart Association defined in 2010 from 7 metrics to 8, with each metric scored from 0 to 100.

    Limits: A scoring framework, not a trial; the abstract does not say how much risk any score change removes.

  5. American College of Cardiology. New High Blood Pressure Guideline Emphasizes Prevention, Early Treatment to Reduce CVD Risk. American College of Cardiology (press release), August 14, 2025.ArticleRead

    What it found: ACC release on the 2025 guideline: categories unchanged from 2017 (normal under 120/80, elevated 120 to 129, stage 1 130 to 139 or 80 to 89, stage 2 140 or higher or 90 or higher), a goal of under 130/80 mm Hg, PREVENT for 10- and 30-year risk in ages 30 to 79, urine albumin-to-creatinine ratio for everyone with high blood pressure, sodium under 2,300 mg a day, alcohol ideally none (if any, no more than 2 drinks a day for men and 1 for women), and 75 to 150 minutes a week of exercise.

    Limits: A press release summarizing the guideline, so I did not see the class of recommendation or level of evidence for each point.

  6. Naeini EK, Eskandari M, Mortazavi M, Gholaminejad A, Karevan N. Effect of creatine supplementation on kidney function: a systematic review and meta-analysis. BMC Nephrology. 2025;26(1):622.Meta-analysisPubMed 41199218 · DOI

    What it found: Systematic review of 21 studies, with 12 pooled for serum creatinine (177 on creatine, 263 controls). Serum creatinine was slightly higher with creatine (mean difference 0.07, 95% CI 0.01 to 0.12, p = 0.03), while glomerular filtration rate did not differ significantly from controls.

    Limits: Small pooled groups, and the abstract gives no doses and does not report cystatin C or eGFR, so it shows creatinine rising without a significant GFR change but does not test cystatin C itself.

  7. Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM, et al. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clinical Journal of the American Society of Nephrology. 2008;3(2):348-354.Cross-sectional studyPubMed 18235143 · DOI

    What it found: In 170 healthy people, lean mass was significantly related to serum and urinary creatinine but not to cystatin C. Serum creatinine was 1.04 versus 0.95 mg/dL in the moderate or intense activity group versus the sedentary group, while cystatin C did not differ, and the authors conclude cystatin C may suit people with higher muscle mass better.

    Limits: A cross-sectional study of 170 healthy people that did not involve creatine supplements.

  8. Iatridi F, Carrero JJ, Cornec-Le Gall E, Kanbay M, Luyckx V, Shroff R, et al. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease in Children and Adults: a commentary from the European Renal Best Practice (ERBP). Nephrology Dialysis Transplantation. 2025;40(2):273-282.ReviewPubMed 39299913 · DOI

    What it found: A commentary on the 2024 KDIGO chronic kidney disease guideline: it says the new guidelines promote combining creatinine and cystatin C (eGFRcr-cys) when more precision is required, and that eGFRcr-cys should at minimum be considered where creatinine-based eGFR may be subject to error, with special diets listed among those situations.

    Limits: A commentary, not the guideline itself; it does not mention creatine supplements or high muscle mass by name.

  9. Direct Labs. Cardiovascular/Heart Health (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page listing tests including Apolipoprotein B (ApoB), Lipoprotein (a), hs-CRP (C-Reactive Protein) (CRP, hs) (Cardio CRP), Homocysteine, Lipid Panel, standard (Cholesterol Panel), Extended Lipid Profile (lipid panel, ApoB, and Lp(a)), and Cardio IQ Advanced Lipid Panel; the store menu links How It Works, FAQs, and a Lab Locator, and no prices appeared in the text I could read.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  10. Direct Labs. APEX-6 Panel. Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Panel page listing the Comprehensive Wellness Profile (over 50 tests, including lipids and a CBC) along with HbA1c, hs-CRP, homocysteine, and vitamin D (25-hydroxy); a 10- to 12-hour fast is required, and the average processing time of 5 to 7 days is called an estimate, not a guarantee.

    Limits: No price was readable in the captured text, and the page does not say who orders or reviews the panel.

  11. Direct Labs. OmegaCheck. Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Test page for OmegaCheck (also named Omega -3 and -6 Fatty Acids), which reports the Omega-3 (EPA + DHA) Index, Omega-6/Omega-3 Ratio, Arachidonic Acid/EPA Ratio, Arachidonic Acid, EPA, and DHA; fasting for 10 to 12 hours is preferred but not required; lab: Quest Diagnostics; average processing time 6 to 8 days, which the page calls an estimate.

    Limits: No price was readable in the captured text, and the page does not say who orders or reviews the test.

  12. Direct Labs. Biohacking Longevity & Cellular Optimization Panel. Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Panel page listing Apolipoprotein B (ApoB), Lipoprotein(a), Homocysteine, Fasting Insulin, Magnesium (RBC), High-Sensitivity C-Reactive Protein, Ferritin, and CBC and CMP-14; the lab is Quest Diagnostics, and the page says the panel includes access to an optional AI-assisted analysis powered by Grok.

    Limits: No price was readable in the captured text, and the page does not say who reviews results.

  13. Abuhalimeh BJ, Alhmouz M, Behrooz L. Implications of the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline for Lipid Management in Vascular Disease. American College of Cardiology (Expert Analysis), June 16, 2026.ArticleRead

    What it found: ACC expert analysis of the 2026 guideline: LDL-C under 55 mg/dL and non-HDL-C under 85 mg/dL for very-high-risk ASCVD, LDL-C under 70 mg/dL for ASCVD not classed as very high risk, PCSK9 inhibitors lowering LDL-C by about 60% versus 15 to 20% for ezetimibe, and bempedoic acid elevated to a first-line nonstatin option on the strength of CLEAR Outcomes.

    Limits: An expert commentary on vascular disease; it gives no numeric thresholds for Lp(a) or ApoB.

  14. Writing Committee Members, Blumenthal RS, Morris PB, Gaudino M, Johnson HM, Anderson TS, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276.GuidelinePubMed 41824552 · DOI

    What it found: The multisociety guideline that retires and replaces the 2018 AHA/ACC blood cholesterol guideline, covering evaluation, management, and monitoring of high cholesterol, hypertriglyceridemia, and elevated lipoprotein(a); published online in March 2026.

    Limits: I read the PubMed record and the ACC summaries, not the full guideline, so the numbers I quote come from the ACC pages; the PubMed record also links two later items in Circulation (June 23 and September 8, 2026) that I could not read.

  15. Novartis. Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD). Novartis media release, September 4, 2026.ArticleRead

    What it found: Company press release, not peer-reviewed. The trial of 8,323 patients with elevated Lp(a) and established cardiovascular disease did not meet its primary endpoint (cardiovascular death, nonfatal heart attack, nonfatal stroke, or urgent coronary revascularization requiring hospitalization); pelacarsen lowered Lp(a) but this did not translate into fewer cardiovascular events in the overall population (Lp(a) of 70 mg/dL or higher).

    Limits: A topline statement with no effect sizes, safety data, or dose; full results are promised at an unnamed medical congress.

  16. Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. The New England Journal of Medicine. 2017;377(12):1119-1131.Randomized trialPubMed 28845751 · DOI

    What it found: CANTOS randomized 10,061 patients with a prior heart attack and hsCRP of at least 2 mg/L to canakinumab (50, 150, or 300 mg every 3 months) or placebo for a median 3.7 years. Canakinumab did not lower LDL; the 150 mg dose cut the primary endpoint (HR 0.85, 95% CI 0.74 to 0.98) and the 300 mg dose gave HR 0.86 (0.75 to 0.99), while the 50 mg dose was not significant (0.93).

    Limits: Tested a drug in people who had already had a heart attack, with more fatal infections on canakinumab and no drop in all-cause mortality; it does not show that lowering CRP by other means helps.

  17. Novo Nordisk. Novo Nordisk provides update on the ZEUS phase 3 trial in people with ASCVD, CKD and inflammation. BioSpace (Novo Nordisk company announcement), July 31, 2026.ArticleRead

    What it found: Company press release, not peer-reviewed. ZEUS enrolled over 6,300 people with atherosclerotic cardiovascular disease, chronic kidney disease, and hsCRP of 2 mg/L or higher; once-monthly ziltivekimab 15 mg lowered IL-6 and hsCRP but did not reduce major adverse cardiovascular events (HR 0.99, 95% CI 0.88 to 1.11), and serious infections were more frequent.

    Limits: A topline statement; the full data are still to be presented, and it tested one IL-6 antibody in people with kidney disease.

  18. Direct Labs. Diabetes (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page listing tests including Hemoglobin A1c with eAG (HgbA1c), Insulin (fasting), Comprehensive Metabolic Panel (CMP), Cystatin C with Glomerular Filtration Rate, Estimated (eGFR), and several diabetes panels.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  19. American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2026. Diabetes Care. 2026;49(Supplement_1):S27-S49.GuidelinePubMed 41358893 · DOI

    What it found: The American Diabetes Association's 2026 Standards of Care chapter on the diagnosis and classification of diabetes; the ADA's Professional Practice Committee updates the Standards of Care every year.

    Limits: I could not read the chapter's text or tables (the cached PMC copy is front matter only), so no ADA cutoff is quoted from it.

  20. Gast KB, Tjeerdema N, Stijnen T, Smit JWA, Dekkers OM. Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis. PLoS One. 2012;7(12):e52036.Meta-analysisPubMed 23300589 · DOI

    What it found: Meta-analysis of 65 studies (516,325 participants without diabetes). Highest versus lowest HOMA-IR carried a coronary heart disease RR of 1.64 (95% CI 1.35 to 2.00); fasting insulin alone gave RR 1.12 (0.92 to 1.37), which was not significant.

    Limits: Pooled observational studies, so the numbers are associations, and the fasting-insulin result had a confidence interval that crossed 1.

  21. Direct Labs. Kidney (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page listing tests including Cystatin C with Glomerular Filtration Rate, Estimated (eGFR); Albumin (Microalbumin), Random Urine With Creatinine; Creatinine; Kidney Profile (Renal function); and CBC (includes Differential And Platelets).

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  22. Direct Labs. Liver (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page listing tests including Alanine Aminotransferase (ALT/SGPT), Gamma Glutamyl Transferase (GGT), Hepatic Function Panel (Liver Panel), Uric Acid, Serum, and Apolipoprotein B (ApoB).

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  23. Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. The American Journal of Gastroenterology. 2017;112(1):18-35.GuidelinePubMed 27995906 · DOI

    What it found: American College of Gastroenterology guideline that gives a true healthy normal ALT of 29 to 33 IU/L for males and 19 to 25 IU/L for females, and says levels above those ranges should be assessed.

    Limits: A guideline, not a trial; a raised ALT starts a workup (viral hepatitis, fatty liver, alcohol-related liver disease, and other causes) rather than giving a diagnosis.

  24. Direct Labs. Anemia (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page that lists Ferritin (described as the protein that stores iron in the cells and reflects the amount of iron in the body), an Iron Panel, and CBC (includes Differential And Platelets), described as a screening test for disease states including anemia, leukemia, and inflammatory processes.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  25. Direct Labs. Thyroid (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page that lists TSH (Thyroid-Stimulating Hormone), Thyroid Panel with TSH, T4 Free (FT4), and T3 Free (FT3).

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  26. Demay MB, Pittas AG, Bikle DD, Diab DL, Kiely ME, Lazaretti-Castro M, et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2024;109(8):1907-1947.GuidelinePubMed 38828931 · DOI

    What it found: Endocrine Society guideline: no clinical trial evidence supports routine screening for 25-hydroxyvitamin D in the general population, and the panel suggests against routine 25(OH)D testing in all populations it considered or in the absence of established indications.

    Limits: A guideline about disease prevention in people without a known deficiency, so it does not cover testing for a symptom, a bone or kidney condition, or a malabsorption problem.

  27. Direct Labs. Vitamins, Minerals & Nutrition (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page that lists Vitamin D, 25 Hydroxy; Vitamin B12 (Cobalamin); Folate, Serum (Folic Acid); and Magnesium, RBC as standalone tests.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  28. Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease?. Preventive Medicine. 2004;39(1):212-220.ReviewPubMed 15208005 · DOI

    What it found: Review that proposes red blood cell EPA plus DHA (the Omega-3 Index) as a graded, modifiable risk factor for death from coronary heart disease: an index of 8% or higher was associated with the greatest cardioprotection and 4% or lower with the least.

    Limits: A 2004 proposal built on observational data and older trials; it does not show that raising the index causes lower risk.

  29. Patrick R. #068 Dr. Bill Harris on the Omega-3 Index: Increasing Omega-3 to Promote Longevity & Transform Health. FoundMyFitness, September 10, 2021.PodcastListen

    What it found: Podcast interview with Bill Harris, co-inventor of the Omega-3 Index: red blood cell omega-3 as a measure of long-term status, plant versus marine sources, genetic variants that change omega-3 needs, whether the index predicts life expectancy, and omega-3 metabolites that resolve inflammation.

    Limits: A podcast conversation, not a study; the episode description gives no numeric index ranges.

  30. Lincoff AM, Bhasin S, Flevaris P, Mitchell LM, Basaria S, Boden WE, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. The New England Journal of Medicine. 2023;389(2):107-117.Randomized trialPubMed 37326322 · DOI

    What it found: TRAVERSE randomized 5,246 men aged 45 to 80 with symptoms of hypogonadism, two fasting testosterone levels below 300 ng/dL, and existing or high risk of cardiovascular disease to testosterone gel or placebo. Major cardiovascular events were 7.0% versus 7.3% (HR 0.96, 95% CI 0.78 to 1.17), meeting the noninferiority margin, with more atrial fibrillation, acute kidney injury, and pulmonary embolism on testosterone.

    Limits: It tested replacement in men with symptoms and low levels, so it says nothing about testosterone in men with normal levels, and the 300 ng/dL line was an entry rule, not a diagnostic standard; AbbVie and others funded it.

  31. Direct Labs. Men's Health (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page that lists PSA, Total (Prostate Specific Antigen); PSA (Prostate Specific Antigen) Free And Total; Testosterone, Total, Males (Adult), Immunoassay; Testosterone, Free; and Sex Hormone Binding Globulin (SHBG).

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  32. Direct Labs. Hormones (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs category page that lists Estradiol (E2) Hormone, Estradiol (E2), Free, and Estradiol (E2), Ultrasensitive, LC/MS.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.

  33. US Preventive Services Task Force, Grossman DC, Curry SJ, Owens DK, Bibbins-Domingo K, Caughey AB, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913.GuidelinePubMed 29801017 · DOI

    What it found: USPSTF recommendation: for men aged 55 to 69, PSA screening may prevent about 1.3 prostate cancer deaths per 1,000 men screened over about 13 years, and the decision should be individual (grade C); for men 70 and older it recommends against PSA-based screening (grade D).

    Limits: The 2018 statement was the current USPSTF recommendation in the record I opened; I did not check whether an update is in progress, and it covers screening in men without symptoms, not testing for a reason.

  34. Direct Labs. Test Packages (test category). Direct Labs store (store.directlabs.com), November 5, 2026.Product pageRead

    What it found: Direct Labs packages page listing panels including Biohacking Cardiovascular/Heart Health Panel, Biohacking Longevity & Cellular Optimization Panel, Comprehensive Wellness Profile (CWP), General Health Panel (CMP-14 and CBC), Low Carb Diet Vitamin Deficiency Panel, and Men's Health Check Extended.

    Limits: A store category listing; no prices appeared in the captured text, and I did not open each test's own page.