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When I turned 40, I decided to visit my doctor and asked him to give me a 40,000 mile checkup. So, the doctor ordered some blood work, an EKG, and scheduled a full physical. On my scheduled physical, he asked me some questions about my lifestyle and if I had any issues. He checked my vitals, listened to my heart and lungs, and did a rectal exam to verify I did not have enlarged prostates. He reviewed my lab results and EKG. And, told me “everything was normal”. So I assumed I was in perfect health.

I repeated that same process every few years.

Few years ago, I started questioning, whether that process of physicals was sufficient for living an Optimal Health. As I started to study this subject, I learned that was not the case.

First of all, and as we discussed in my last blog post, that “everything is normal” does not necessarily mean I am living an Optimal Health. If my cholesterol or fasting glucose numbers are within the “reference range”, it does not mean that they are the best that may be desired for an optimal health.

Next, I started questioning whether the tests that my primary physician was conducting were adequate for optimal health. And, the answer came out be: no, it was not. For living an optimal health, my objective is to detect any issues at the earliest possible moment in time, which the physicals alone were not accomplishing.

Sooner I can detect an issue, I believe easier it is for me to do something about it. As my flight instructor drilled in my head when I was learning flying, “It is easier to make small corrections sooner than big corrections later”. I believe the same is definitely true for health as well.

So, what other tests should I undergo to detect any issues early? As I studied this topic some more, here is what I learned are the basic numbers I should know.

I am sure everyone is already well aware of measuring Total Cholesterol, HDL, LDL and Triglycerides, which most physicians very faithfully measure these days.

Hemogloblin A1c

Excess blood sugar is a huge issue for health. It has so many different implications to health.

Fasting Glucose level often measured by primary physicians is not adequate for early detection of blood sugar and insulin issues. Commonly called A1c, measured as percent of A1c or glycated blood cells is a very important to know to really understand if one is diabetic or pre-diabetic.

Last year, when for the first time I measured my A1c, I found that it was elevated and was in the pre-diabetic range. I had no data to compare with since none of my labs during physicals in the last twenty years had measured A1c. My physicians did not feel the need to measure it since my fasting glucose has always been and still is under 90 which is within the reference range and is considered “normal”.

Having tested it multiple times during the last 15 months, I noticed it is going up and I have been further investigating its root cause and aggressively treating it with further changes in my lifestyle.

Vitamin D, 25-Hydroxy

Although, called a Vitamin, it is really a hormone. When I leaned that every single cell in the body has receptors for Vitamin D, I really finally understood Vitamin D’s significance. It is implicated in so many health issues and is responsible for turning on/off as many as 500 different genes. Although, many labs don’t consider your Vitamin D deficient until below the reference range minimum of 30, many studies support a value of 50 to 60 as the optimal range.


Thyroids, either underactive or over-active, can be an issue and cause of a wide variety of symptoms. The thyroid-stimulating hormone (TSH) test is often the test of choice for evaluating thyroid function and/or symptoms of a thyroid disorder, including hyperthyroidism or hypothyroidism. TSH is good screening test and if noted abnormal doctors will want to further investigate by examining free T3 and T4.


Homocysteine is an amino acid and breakdown product of protein metabolism that, when present in high concentrations, has been linked to an increased risk of heart attacks, strokes and Alzhiemer’s disease. High Homocysteine level also indicate deficiency in B12 and folic acid. There are no immediate symptoms associated with high levels of Homocysteine. So, it is useful to know your levels and make necessary adjustments in lifestyle if needed to prevent future issues.

C-Reactive Protein (CRP)

CRP is a protein made by the liver. The level of CRP rises when there is inflammation throughout the body. So, the CRP test is a general test to check for inflammation in the body. It is not a specific test. That means it can reveal that you have inflammation somewhere in your body, but it cannot pinpoint the exact location. Many consider a high CRP level to be a risk factor for heart disease. However, it is not known whether CRP is merely a sign of cardiovascular disease or if it actually plays a role in causing heart problems. Some researchers assert that Homocysteine and CRP are more important to monitor for cardiovascular health than cholesterol.


Both men and women have testosterone. In men, testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate as well as promoting secondary sexual characteristics such as increased muscle, bone mass, and the growth of body hair. In addition, testosterone is essential for health and well-being as well as the prevention of osteoporosis. Low Testosterone (Low-T) can cause issues such as losing muscle mass, pre-maturely developing “man boobs”, losing “get-up and go”, erectile dysfunction, and low libido or sexual desire.

There is controversy over what the “normal” range should be as testosterone tends to decline as men age. Often, receiving testosterone through hormone replacement therapy can restore “get-up and go” and sexual desires and performance and other youthful traits. It is not only important to measure Total Testosterone, but also even more importantly Free Testosterone, which is the testosterone available for use by the body.


DHEA-sulfate is a weak male hormone (androgen) produced by the adrenal gland in both men and women. DHEA is a pre-cursor of both Testosterone and Estradiol. A shortage of DHEA can lead to shortage of testosterone in men or estradiol in women.


Estradiol is a human sex hormone and the primary female sex hormone. It is named for and is important in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is essential for the development and maintenance of female reproductive tissues but it also has important effects in many other tissues including bone. While estrogen levels in men are lower compared to women, estrogens have essential functions in men as well.

 So, how do you get these tests done?

First stop to get these tests should be your primary physician. Mark Hyman, M.D. has a very helpful report on his website:  How to work with your doctor to get what you need?  That report may be useful to read and bring along.

Your doctor may be reluctant to order these test even after you express your desire to have these test done. That was the case with my primary physician. So, I went ahead and found a place that will run these tests in the U.S.: Life Extension Foundation. You can order a variety of tests from them, but their Male Panel and Female Panel include all of the tests mentioned above. Additionally, these tests include metabolic panel with lipids (i.e., Cholesterol), Complete Blood Count and PSA (for men) and Progesterone (for women)

From Life Extension Foundation, you can order these tests online or over the phone. Your will then go to a local lab for blood draw and then receive results on hardcopy, email or online. They even have folks you can call to discuss the results.

Having studied these basic tests and their implication to optimal health, I even asked our twenty three year old twin boys to do their blood work for full male panel. They don’t have any health issues, but I thought it was important for them to have this information as their baselines when they are in top health and establish what is “normal” for them.

So, when they are 60 year old or if an issue arises they have baselines to compare against. They will not have to wonder like was the case for me, “How do my current testosterone levels or A1c compare to what I had when I was twenty three and in top shape?”

So, there you have it – the basic information you may want to know for optimal health.

What are your thoughts?

Is there something else basic that is important to measure to live optimal health?

I would love to hear from you!