The Blood Work Protocol

Why Blood Work Is the Foundation of Any Health Strategy
What "Normal" Actually Means (And Why It Misleads You)
Level 0 ... The Absolute Basics Everyone Needs
Level 1 ... The Next Step: Sex-Specific and Metabolic Deep Cuts
Level 2 ... Advanced and Specialized Testing
What Function Health Actually Tests and Why It Matters
How to Draw Blood So Your Numbers Mean Something
Schedule A: Best Bang for Your Buck
Schedule B: The High-Performance Track
How to Test Whether Your Supplements Are Actually Working
Turning Results Into a Protocol
Beyond Blood: The Tests That May Matter More

1. Why Blood Work Is the Foundation of Any Health Strategy

Most people have no idea what is happening inside their own body. They feel fine, so they assume they are fine. Or they feel bad, get a physical, hear "your labs look normal," and go home with nothing actionable.

Both of those people are flying blind. The first one is guessing. The second one was measured too narrowly and told the wrong thing about the results.

A health strategy without measurement is a belief system. You can eat well, train hard, sleep properly, and still carry an inherited lipid risk that quietly triples your cardiovascular danger while you feel excellent. You will not feel insulin resistance building for years. You will not feel a thyroid drifting. You will not feel iron dropping until you have been tired for months and assumed it was stress or aging.

The value of a real baseline is not the day you get it. It is five years later, when you have a dozen data points under identical conditions and you can see exactly what direction you are moving and how fast ... before anything becomes a diagnosis.

What this guide does: It walks you through exactly what to test, in what order, how often, how to prepare for a blood draw so your numbers are comparable over time, and how to read results without panic or false reassurance. Two complete testing schedules ... one for people who want the basics done right, and one for high-performance optimization. Plus the methodology for testing whether a supplement is actually doing anything.

2. What "Normal" Actually Means (And Why It Misleads You)

This is the single most important concept in the entire guide, and it explains roughly ninety percent of the confusion people have about lab results.

A reference range is not a health target. It is a statistical description of a population.

When a lab prints a range next to your result, that range is typically the central 95% of a reference population. Not the healthiest 5%. Not the optimal value. The middle of a bell curve that includes sedentary people, people with undiagnosed conditions, and people who happened to be in the sample when the range was established.

Two things follow from this, and both matter enormously:

First: "in range" is not the same as healthy. It means you resemble most people who got tested. In a country where a large share of adults are metabolically unwell, resembling the average is a low bar. Your fasting glucose can sit at the top of normal for a decade while insulin resistance builds underneath it.

Second: roughly 5% of perfectly healthy people will fall outside range on any given test. By definition. Order 40 tests on a completely healthy person and you should expect about 2 flagged results ... not because something is wrong, but because that is how probability works.

This is why comprehensive panels create panic. You open a report with 100+ markers, see a screen full of yellow and red flags, and conclude you are falling apart. You are probably not. You ordered a lot of tests, and statistics did what statistics do. Clinical chemists are themselves debating whether to widen reference intervals to the central 99% precisely because of this false-positive problem.

The correct posture when reading results is not "which ones are red." It is: which ones matter, which ones are trending in a concerning direction, and which ones change what I actually do? A single mild out-of-range value in isolation is almost always noise. A marker moving consistently across three draws is signal. Hold onto that distinction. Everything below depends on it.

3. Level 0 ... The Absolute Basics Everyone Needs

This is the panel every adult should have as a baseline, regardless of age, sex, fitness level, or how good you feel. These tests are common to both men and women. Most are covered by insurance as part of a standard physical. If you do nothing else, do this.

Essential = Get this now, period Great to Have = High value, push for it Baseline Once = Test once, then only if needed Periodic Retest = Track over time

Test	Priority	What It Measures	Why It Matters
CBC with Differential	EssentialPeriodic	Red blood cells, white blood cells (5 types), hemoglobin, hematocrit, platelets, MCV, RDW	Your blood system snapshot. Catches anemia, infection, immune problems, and blood disorders. RDW (red cell distribution width) has emerged as an independent predictor of all-cause mortality in large studies. Cheap, routine, and dense with information.
Comprehensive Metabolic Panel (CMP)	EssentialPeriodic	Glucose, BUN, creatinine, eGFR, sodium, potassium, chloride, CO2, calcium, albumin, total protein, bilirubin, ALP, ALT, AST	Organ function scan covering kidneys, liver, electrolyte balance, and blood sugar. Note: a CMP does not include thyroid. That surprises most people and it needs to be ordered separately.
Lipid Panel	EssentialPeriodic	Total cholesterol, LDL-C, HDL-C, triglycerides	The standard cardiovascular risk screen. Useful but incomplete on its own ... which is why ApoB and Lp(a) below matter so much.
ApoB (Apolipoprotein B)	Great to HavePeriodic	Direct count of atherogenic (artery-clogging) particles	This is the single most important addition to a standard lipid panel. LDL-C measures the cholesterol inside particles. ApoB counts the particles themselves. Two people with identical LDL-C can have meaningfully different particle counts, and the one with more particles carries more risk. When LDL-C and ApoB disagree, ApoB tracks cardiovascular outcomes better. It is cheap, typically $15-30 out of pocket, and most standard panels still skip it. Ask for it by name.
Lipoprotein(a) / Lp(a)	Baseline Once	A genetically determined lipoprotein variant that independently raises cardiovascular and stroke risk	Test this exactly once. Lp(a) is largely inherited and does not move much with diet or exercise. Roughly 1 in 5 people carries an elevated level, and it is completely invisible on a standard lipid panel. Someone can have textbook cholesterol and a serious inherited risk sitting underneath, undetected for their entire life. The 2026 ACC/AHA dyslipidemia guideline now recommends measuring Lp(a) at least once in every adult's lifetime ... the first time American cardiology has recommended universal screening. Caution: Lp(a) is reported in two different units (mg/dL and nmol/L) that are not interchangeable. Know which one you received before comparing to any threshold.
HbA1c (Hemoglobin A1c)	EssentialPeriodic	Average blood sugar over roughly 3 months, based on red blood cell lifespan	The single best snapshot of blood sugar control over time. Because it tracks the lifespan of your red cells, testing it 4 weeks after a diet change is wasted money. Give it a full quarter to reflect reality.
Fasting Glucose	EssentialPeriodic	Blood sugar at the moment of the draw, after fasting	Included in a CMP. Useful in combination with HbA1c and insulin for the full metabolic picture.
Fasting Insulin	Great to HavePeriodic	How much insulin your body is producing to keep glucose in range	This is the test most doctors skip and the one that catches metabolic problems earliest. Your body compensates for insulin resistance by producing more insulin, holding blood sugar in the "normal" range for years while the underlying problem grows. Fasting insulin reveals that compensation while glucose still looks fine. Adding it to a standard panel costs very little.
TSH (Thyroid Stimulating Hormone)	EssentialPeriodic	Pituitary signal telling the thyroid how hard to work	The standard thyroid screen. Catches the most common form of hypothyroidism. But TSH alone can miss central hypothyroidism (where the problem is in the pituitary, not the thyroid) and tells you nothing about T4 to T3 conversion.
Free T4 and Free T3	Great to HavePeriodic	The actual thyroid hormones circulating in usable form	If you have symptoms and a normal TSH, these are what earn their cost. Free T4 is what the thyroid produces. Free T3 is the active form your cells use. Together with TSH they give the full thyroid picture rather than a single screening number.
Vitamin D (25-hydroxyvitamin D)	EssentialPeriodic	Circulating vitamin D status	Widely deficient, especially at higher latitudes. If you live somewhere with real winters, the difference between a February value and a July value can be dramatic. Know which season your number came from.
hs-CRP (High-Sensitivity C-Reactive Protein)	Great to HavePeriodic	A general marker of systemic inflammation	Useful for trend, not for a single reading, because it spikes with any recent infection, injury, dental work, or hard training session. Persistently elevated hs-CRP is meaningful. A one-time spike usually is not.
Ferritin + Iron Panel (iron, TIBC, saturation)	EssentialPeriodic	Iron stores and iron transport capacity	The most ignored high-yield test on this list, especially for women. Iron deficiency without anemia is extremely common and causes fatigue, hair loss, brain fog, and poor exercise tolerance ... while hemoglobin still reads perfectly normal. A CBC alone will miss it. Ferritin is also an acute-phase reactant (it rises with inflammation), so interpret it alongside hs-CRP.
GGT (Gamma-Glutamyl Transferase)	Great to HavePeriodic	Liver and bile duct enzyme, sensitive to alcohol and metabolic stress	More sensitive than ALT/AST for alcohol-related liver stress. Also elevated in metabolic syndrome, fatty liver, and bile duct obstruction. Not always included in a standard CMP.
Uric Acid	Great to HavePeriodic	End product of purine metabolism	Elevated levels are associated with gout, kidney stones, cardiovascular risk, and metabolic syndrome. Cheap to add.
Homocysteine	Great to HaveBaseline Once	Amino acid linked to B-vitamin status and cardiovascular risk	Elevated homocysteine is associated with increased cardiovascular risk and reflects B12, folate, and B6 status. A useful metabolic crossroads marker. Retest mainly if initially elevated or if supplementing to lower it.
Magnesium	Great to HavePeriodic	Intracellular mineral critical for hundreds of enzymatic reactions	Widely under-consumed. Serum magnesium is an imperfect measure (most magnesium is intracellular), but it is what is available and low serum values are meaningful.

The bottom line for Level 0: If you walk into your doctor's office and ask for "a CBC, CMP, lipid panel, HbA1c, fasting insulin, TSH with free T4 and free T3, vitamin D, hs-CRP, ferritin with a full iron panel, GGT, and Lp(a) once," you have a legitimate baseline that covers metabolic health, cardiovascular risk, organ function, thyroid, inflammation, and nutrient status. Most of this is covered by insurance. The items your doctor might push back on (ApoB, fasting insulin, free T3, Lp(a)) can be added out of pocket for under $100 total through a direct-to-consumer lab.

4. Level 1 ... Sex-Specific and Metabolic Deep Cuts

Once your Level 0 baseline is established, Level 1 adds the tests that are specific to your biology and life stage. These are not exotic. They are what a good endocrinologist or reproductive specialist would order ... most people just never get referred to one.

For Men

Test	Priority	What It Measures	Why It Matters
Total Testosterone	EssentialPeriodic	Total circulating testosterone, bound plus free	The screening anchor for male hormonal health. Must be drawn early morning (before 10 AM), fasting. Both the AUA and Endocrine Society require at least two separate morning measurements, at the same lab using the same assay, before diagnosing deficiency. A single afternoon draw after lunch is close to meaningless due to diurnal variation. If a clinic runs one convenience draw and offers you testosterone that same week, they skipped the standard of care.
Free Testosterone	EssentialPeriodic	The unbound, biologically active fraction	Matters because SHBG shifts can move total T without moving free T. Method warning: direct/analog free-T immunoassays are widely considered unreliable. Calculated free T (from total T, SHBG, and albumin) or equilibrium dialysis are preferred. A consumer paying for "free testosterone" may be buying a bad assay.
SHBG	EssentialPeriodic	Sex Hormone Binding Globulin, the carrier protein for testosterone	Determines how much T is actually free and available. Low SHBG is associated with insulin resistance. High SHBG with aging, hyperthyroidism, and liver disease. Without it, total T is hard to interpret.
Estradiol (Sensitive, LC-MS/MS)	EssentialPeriodic	Primary estrogen, measured by mass spectrometry	Men need the sensitive assay. The standard immunoassay was designed for female physiologic ranges and is inaccurate at male concentrations. Ordering the wrong estradiol test is one of the most common mistakes in male hormone panels.
LH and FSH	EssentialBaseline Once	Pituitary hormones that signal the testes	These separate primary testicular failure (low T, high LH/FSH) from secondary/central causes (low T, low or normal LH/FSH). Without them, you cannot tell why testosterone is low, which completely changes what should be done about it. Any clinic that prescribes testosterone without checking LH/FSH skipped the differential diagnosis.
Prolactin	Great to HaveBaseline Once	Pituitary hormone	Elevated prolactin can suppress gonadal function and can signal a pituitary adenoma. Cheap, and it catches the rare but serious cause.
DHEA-S	Great to HavePeriodic	Adrenal androgen precursor	Declines predictably with age. Useful context for the overall hormonal picture.
PSA (Total and Free)	Great to HavePeriodic	Prostate Specific Antigen	Screening is genuinely controversial due to overdiagnosis. Generally discussed starting age 50, or 40-45 for higher-risk groups (Black men, strong family history, BRCA2 carriers). Practical caveat: PSA rises with ejaculation, cycling, prostatitis, and digital rectal exam. Abstain 48 hours and avoid cycling before the draw.
IGF-1	Optional	Growth hormone axis proxy	Useful context. But be aware: this is the marker most aggressively used to sell growth hormone and peptide protocols. Higher is not simply better. IGF-1 has a complicated relationship with longevity and cancer risk.

For Women

Test	Priority	What It Measures	Cycle Timing
FSH	Essential	Ovarian reserve and axis communication	Day 2-4 (early follicular)
LH	Essential	Pituitary-ovarian signaling	Day 2-4
Estradiol	Essential	Primary estrogen	Day 2-4
Progesterone	Essential	Confirms ovulation, luteal adequacy	7 days post-ovulation (see note below)
AMH	Great to Have	Ovarian reserve marker	Any day (relatively cycle-stable)
Testosterone (Total + Free)	Great to Have	Androgen status, PCOS assessment	Day 2-4 preferred
SHBG	Essential	Carrier protein affecting free hormone levels	Day 2-4; note that oral contraceptives significantly raise SHBG
DHEA-S	Great to Have	Adrenal androgen precursor	Any day
Prolactin	Great to Have	Pituitary hormone	Any day; elevated prolactin causes cycle irregularity and infertility
TPO + Thyroglobulin Antibodies	Essential	Autoimmune thyroid markers (Hashimoto's)	Any day. Hashimoto's is far more common in women. Antibodies often appear years before TSH shifts. Under-tested.

The "Day 21" Myth: Everyone says progesterone should be tested on "day 21." That shorthand assumes a textbook 28-day cycle. The real rule is 7 days after ovulation. A woman with a 34-day cycle who tests on day 21 gets a low progesterone and a false conclusion about her fertility or luteal function. Track ovulation (with LH strips, basal body temp, or cycle tracking), then count 7 days. This single correction prevents an enormous number of misinterpretations.

On AMH: AMH predicts response to fertility stimulation reasonably well, but it is a poor predictor of natural fertility timing. It should not be sold to you as a countdown clock or a deadline. It is one data point in a larger picture.

Perimenopause and Postmenopause

Perimenopause is characterized by wildly fluctuating hormones. A single normal FSH or estradiol does not rule it out. Diagnosis is primarily clinical, based on symptoms and cycle changes, not on a lab value. Women are routinely told their labs are "normal" while clearly symptomatic, and that is a failure of interpretation.

Postmenopause: cycle timing becomes irrelevant. The panel shifts toward cardiometabolic and bone risk. Priorities become ApoB, Lp(a), HbA1c, insulin, thyroid, vitamin D, and DEXA for bone density, since fracture risk rises sharply after estrogen loss.

5. Level 2 ... Advanced and Specialized

This is where the money gets wasted if you are not careful. Some items here are genuinely valuable. Others are aggressively marketed to health enthusiasts with minimal evidence behind them. I am going to be direct about which is which.

Worth It

Omega-3 Index (EPA + DHA as % of red blood cell membranes)

Actionable: it tells you whether your fish oil dose is actually doing anything. Responds to intake. Target generally 8% or above. Nice-to-have, not foundational.

Cortisol (AM, serum)

Useful when there is real clinical suspicion (Cushing's, adrenal insufficiency). A morning snapshot, not a diurnal curve, but combined with DHEA-S it gives a rough read on adrenal output.

Celiac Panel (tTG-IgA + Total IgA)

Worth it with GI symptoms, unexplained iron deficiency, or family history. Critical: you must still be eating gluten when tested or the result is falsely negative. That single fact saves people a wasted test.

Methylmalonic Acid (MMA)

A more sensitive marker of functional B12 deficiency than serum B12 alone. Useful if B12 is borderline or symptoms are present despite a "normal" B12 level. Function includes this.

Redundant or Marginal

NMR LDL Particle Number

Largely redundant if you already have ApoB. ApoB is cheaper, better standardized, and guideline-endorsed. Do not pay for both. Function includes both, which is fine inside their panel, but do not add NMR on top of a standalone ApoB order.

Lp-PLA2

Adds little beyond ApoB, Lp(a), and hs-CRP for most people. Skip in a budget context.

Oxidized LDL

Assay standardization is poor. Rarely changes management. Skip.

Actively Oversold

4-Point Salivary Cortisol ("Adrenal Fatigue" Panel)

"Adrenal fatigue" is not a recognized medical diagnosis. Real cortisol pathology is diagnosed with dexamethasone suppression, 24-hour urine free cortisol, or ACTH stimulation ... not a saliva curve sold alongside a supplement protocol.

DUTCH Test (Dried Urine for Comprehensive Hormones)

Interesting research-grade information about hormone metabolism pathways. But it lacks outcome data, is expensive, and is heavily used to justify selling protocols. Not foundational for a baseline.

ANA (Antinuclear Antibodies) as a screening test in asymptomatic people

High false positive rate. A positive ANA without symptoms generates anxiety and unnecessary specialist referrals. Order only with real symptoms. (Function includes this and it is fine to have the data, but do not panic over a positive result without clinical context.)

Heavy Metals (without exposure history)

Justified with real exposure: occupational, well water, old paint, high-mercury fish. Random screening produces confusion. Be especially wary of "provoked" urine testing (done after chelation), which is not validated and exists mainly to sell chelation therapy. Function tests lead and mercury, which is reasonable as a one-time check.

6. What Function Health Actually Tests and Why It Matters

I use Function Health. It costs $365/year (reduced from $499 in late 2025), tests 100+ biomarkers at your initial draw and re-tests roughly 60 at a mid-year follow-up, through Quest Diagnostics. Clinicians review every result. HSA/FSA eligible.

Here is what their panel covers, organized by body system, with honest notes on what each category tells you and what it misses.

My standard for anything I recommend. I only recommend what I personally use and what meets the highest standard I can find. The content is the content: a commercial relationship never changes my analysis, and it never removes the criticism. You will see that below... I name the two real gaps in Function's panel rather than talk around them. And the second the standard of anything I recommend changes, whether that is quality, price, ownership, privacy, or safety, I revise my position and tell you in that same moment. Not at the next newsletter. Immediately.

Heart and Lipids (15 markers)

Total cholesterol, LDL-C, HDL-C, triglycerides, ApoB, Lp(a), hs-CRP, non-HDL cholesterol, cholesterol/HDL ratio, plus the NMR particle breakdown (LDL particle number, LDL pattern, LDL peak size, large HDL particles, small and medium LDL particles). This is closer to what a preventive cardiologist would order than a standard physical. The NMR detail is a bonus on top of ApoB.

Metabolic (4 markers)

Glucose, HbA1c, leptin, uric acid. Notable absence: fasting insulin. Without it, you cannot calculate HOMA-IR for early insulin resistance detection. This is the biggest gap in Function's panel relative to what I would build from scratch. If you use Function, consider adding fasting insulin as an on-demand test or through a separate order.

Thyroid (5 markers)

TSH, free T3, free T4, thyroglobulin antibodies, and selenium. This is a complete thyroid picture, not just a TSH screen. Selenium is included because it is a cofactor for the enzymes that convert T4 to the active T3.

Female Hormones (9 markers)

AMH, SHBG, FSH, LH, prolactin, DHEA-S, free and total testosterone, estradiol. This matches what a reproductive endocrinologist would order.

Male-Specific (4 markers)

DHEA-S, FSH, free PSA, and total PSA. The core male hormone markers (testosterone, SHBG, estradiol) are tested for everyone. Note: Function does not appear to specify the sensitive estradiol assay (LC-MS/MS) for men. If you are a man tracking estradiol closely, confirm which assay is being run.

Vitamins, Minerals, and Nutrients (19 markers)

Vitamin D, the full iron panel (iron, ferritin, saturation, TIBC), magnesium, zinc, homocysteine, methylmalonic acid (a more sensitive B12 status marker), calcium, and an unusually detailed omega panel: total omega-3, EPA, DHA, DPA, omega-6 total, arachidonic acid, linoleic acid, omega-6/omega-3 ratio, and arachidonic acid/EPA ratio. This is closer to a standalone OmegaQuant test than what most lab panels offer.

Liver (8 markers), Kidney (9 markers), Pancreas (2), CBC (8), Electrolytes (6), Immune (7), Autoimmune (4), Urinalysis (20), Heavy Metals (2)

Standard organ function panels with good depth. The urinalysis is full (20 fields including microscopic findings), which contributes to the total biomarker count. Lead and mercury are included as heavy metals.

Honest assessment: Function is genuinely convenient, comprehensive, and good value for the breadth you get. The ordering, logistics, and longitudinal tracking are handled for you. But understand clearly what it is and what it is not. It is a testing and data service. It is not treatment, it is not prescriptions, and it is not a physician who knows your history. The most common complaint across every platform like this is the same: you get a wall of flagged results with templated recommendations, and no one helps you decide what actually matters for you specifically. That interpretation gap is precisely why this guide exists.

If you decide it fits, start at functionhealth.com. Read the two gaps above first, and plan on ordering a fasting insulin separately.

7. How to Draw Blood So Your Numbers Mean Something

This is the cheapest, most ignored part of the entire system. A trend is only readable if conditions stay constant. If you change the time of day, your training the day before, your hydration, or the lab itself, you have not measured a change in your health. You have measured a change in your circumstances.

#	Rule	Why
1	Fast 10-12 hours, water only	Required for accurate triglycerides and fasting insulin/glucose. Non-fasting lipid panels are increasingly accepted, but fasting keeps your own series internally consistent.
2	Draw between 7-9 AM, consistently	Mandatory for testosterone (major diurnal variation) and cortisol. Good practice for everything else.
3	No alcohol for 48-72 hours	Affects GGT, liver enzymes, and triglycerides.
4	No hard training for 24-48 hours	Elevates CK, AST, ALT, hs-CRP, and creatinine. Elevated creatinine makes eGFR (kidney function) look worse than it is. A heavy deadlift session two days before a draw can manufacture a fake kidney problem and a fake inflammation problem in the same panel.
5	Hydrate normally	Dehydration concentrates everything: hemoglobin, hematocrit, albumin, BUN all read artificially high.
6	Stop biotin at least 72 hours out AND tell the lab	Biotin interferes with many immunoassays including thyroid and cardiac troponin. AACC guidance notes up to 72 hours may be needed. The FDA has stated there is not enough information to guarantee any specific hold time prevents bad results, so 72 hours is a sensible minimum, not a guarantee. Biotin is in most hair/skin/nail supplements and many multivitamins.
7	Hold non-essential supplements 24-72 hours	Biotin needs the longest hold. Never stop a prescribed medication for a test without asking the prescriber.
8	Women: record and control cycle day	Day 2-4 for FSH/LH/estradiol/AMH. 7 days post-ovulation for progesterone. Note contraceptive use.
9	Same lab, same assay, every time	Different platforms produce different absolute values, especially for free testosterone, estradiol, vitamin D, and ferritin. Switching labs mid-series creates a trend that does not exist.
10	Log your conditions with every draw	Date, time, fasting hours, last workout, alcohol, supplements held, illness, cycle day. This costs nothing and turns a pile of PDFs into actual comparable data.

8. Schedule A: Best Bang for Your Buck

This is for the person who wants a real health baseline done correctly without overspending or over-testing. Think of it as the minimum effective dose for knowing what is going on inside your body.

Year 1: Establish Baseline

Draw 1 (month 0): Full Level 0 panel including CBC, CMP, lipid panel, ApoB, HbA1c, fasting glucose, fasting insulin, TSH + free T4, vitamin D, hs-CRP, ferritin + iron panel. Add Lp(a) (once, never again). Add sex-specific Level 1 markers if budget allows.
Draw 2 (month 6): Core metabolic recheck: lipids, ApoB, HbA1c, fasting glucose, fasting insulin, hs-CRP. Add any Level 0 markers that flagged on Draw 1.

Estimated cost: Draw 1 is mostly covered by insurance at an annual physical. Out-of-pocket additions (ApoB, Lp(a), fasting insulin, free T3) typically run $75-150 through direct-to-consumer labs. Draw 2 can often be done for $100-200 cash through a panel provider.

Year 2+: Maintenance

Annual full draw: Complete Level 0 + sex-specific Level 1 once per year, aligned with your annual physical if possible.
6-month metabolic check: Lipids, ApoB, HbA1c, fasting glucose, fasting insulin, hs-CRP, vitamin D (especially if seasonally variable).
Ad hoc: Recheck anything you are actively trying to move, 90 days after starting the intervention. Do not retest HbA1c before 3 months.

Total annual cost: If your annual physical covers the core, expect $150-350/year in out-of-pocket additions. A platform like Function ($365/year) consolidates this and adds breadth.

9. Schedule B: The High-Performance Track

This is for the person who is actively optimizing ... training seriously, supplementing deliberately, managing hormones, or building a comprehensive longevity strategy. More data points, tighter intervals, and full hormone tracking.

Year 1: Deep Baseline

Draw 1 (month 0): Full Level 0 + full Level 1 sex-specific panel + omega-3 index + cortisol + DHEA-S + IGF-1. Add Lp(a) (once). Consider thyroid antibodies (TPO, TgAb) at baseline.
Draw 2 (month 3): Targeted recheck of anything you are actively intervening on. This is your first "did it move" check.
Draw 3 (month 6): Full metabolic + hormones + any markers of concern.
Draw 4 (month 9-12): Targeted recheck. By now you have 4 data points on your priority markers and real trend visibility.

Year 2+: Optimization Cadence

Quarterly draws: Core metabolic (lipids, ApoB, HbA1c, fasting glucose + insulin, hs-CRP) plus whatever you are actively managing.
Full panel every 6 months: Complete Level 0 + Level 1, including hormones.
Annually: CBC, CMP, full thyroid, vitamin D, omega-3 index, full iron panel.
90-day rule: Any time you start or change a supplement, medication, training program, or diet ... retest the relevant marker at 90 days. Not before.

Total annual cost: $600-1,200 depending on how much insurance covers. A Function membership ($365) plus 1-2 targeted add-on orders is an efficient structure. Heavy hormone tracking (TRT, HRT) may run higher through specialty labs.

The over-testing trap: Testing faster than a marker can biologically change produces noise, cost, and anxiety. The failure mode of enthusiasts is testing constantly and acting rarely. Four high-quality data points per year under identical conditions is better than twelve sloppy ones.

10. How to Test Whether Your Supplements Are Actually Working

Most people take supplements on faith. They heard something works, they bought it, they take it every day, and they have no idea whether it is doing anything measurable in their body. Here is how to actually find out.

Establish a clean baseline BEFORE starting

Test the relevant marker(s) before you begin the supplement. This is your control measurement. Without it, you have nothing to compare to.

Change only one variable at a time

If you start fish oil, vitamin D, and magnesium simultaneously and your omega-3 index improves, was it the fish oil or the magnesium? You cannot know. Start one supplement, hold everything else constant, and test. Then add the next.

Wait the correct interval before retesting

Every marker has a biological response time. Testing too early is wasted money.

Supplement	Marker to Track	Minimum Retest Interval
Vitamin D	25-OH Vitamin D	8-12 weeks
Fish oil / Omega-3	Omega-3 Index (EPA+DHA)	8-12 weeks (red cell membrane turnover)
Iron (ferrous bisglycinate, etc.)	Ferritin + iron panel	8-12 weeks
Magnesium	Serum magnesium (imperfect) + symptoms	4-8 weeks
B12 / Methylcobalamin	Serum B12 + methylmalonic acid	8-12 weeks
Creatine	No blood marker needed, performance + body comp	4-8 weeks
Berberine / Glucose-lowering	Fasting glucose, fasting insulin, HbA1c	HbA1c needs 12 weeks minimum; glucose/insulin 4-8 weeks
Red yeast rice / Bergamot / Citrus bergamot (lipid-targeted)	LDL-C, ApoB, triglycerides	8-12 weeks
Ashwagandha (cortisol-targeted)	AM cortisol + subjective tracking	8-12 weeks
Zinc	Serum zinc	8-12 weeks

Control your draw conditions identically

Same lab, same time of day, same fasting window, same supplement hold protocol, same training rest period. If your pre-supplement draw was at 8 AM fasting at Quest and your post-supplement draw was at 2 PM non-fasting at LabCorp, you have not tested the supplement. You have tested different circumstances.

Decide based on the data, not the marketing

If your omega-3 index was 4.2% before fish oil and 8.1% after 12 weeks, it worked. If your vitamin D went from 28 to 52, it worked. If you have been taking a supplement for 3 months and the relevant marker has not moved, either the dose is wrong, the product quality is poor, or the supplement does not do what it claims. Stop spending money on it.

Document everything

Keep a simple log: supplement name, dose, brand, start date, baseline lab date and value, retest date and value, other changes during the period. This is how you build an actual evidence base for your own body instead of relying on someone else's anecdote or a company's marketing claims.

11. Turning Results Into a Protocol

This is where almost everyone stalls. They test, they get a report, they feel briefly informed, and nothing changes. Here is the sequence that prevents that.

Step 1: Triage before you react

Sort every result into three buckets:

Urgent: needs a physician now (severely abnormal values, suspicion of serious disease)
Signal: a real pattern worth investigating and acting on
Noise: a single mild flag with no supporting context (remember the 5% rule)

Most flags are noise. Do not let red text drive decisions that should be driven by patterns.

Step 2: Look for patterns, not points

Elevated fasting insulin, triglycerides climbing, HDL falling, and a creeping HbA1c is not four separate problems. It is one problem ... insulin resistance ... showing up in four places. Treating it as four separate items is how people end up with four supplements and no improvement. Look for the underlying pattern.

Step 3: Pick a maximum of three targets

Every marker you decide to move needs:

A specific intervention (what you are doing)
A specific mechanism (why it should work)
A specific retest date (when you will check)

If you cannot name all three, it is not a plan.

Step 4: Set the retest date the same day you get results

90 days out for anything metabolic. Put it on the calendar immediately, before motivation decays. The trend line is the actual product of this entire system, and it only exists if you maintain the rhythm.

Step 5: Keep one file

Every result, every draw condition, in one place you control. Not scattered across three patient portals and an email inbox. A spreadsheet works. A personal dashboard works. The tool matters far less than the discipline of putting every result in the same place under the same conditions.

Step 6: Know when to escalate

Some things are not self-managed. Severely abnormal results, suspected cancer, thyroid disease requiring medication, real hormone deficiency, kidney or liver dysfunction ... these need a physician. This system is for building an accurate baseline and having better informed conversations with your doctor. It is not a substitute for medical care.

12. Beyond Blood: The Tests That May Matter More

Here is the uncomfortable truth the blood testing industry will not lead with. Some of the highest-value health tests are not blood tests at all.

Coronary Artery Calcium (CAC) Score

A quick CT scan that measures actual plaque in your arteries. Not your risk of disease ... the disease itself. A score of zero is genuinely reassuring. A high score immediately changes treatment decisions. Typically $100-150, with a range of roughly $50-400 depending on location. Insurance usually does not cover it. Small radiation dose. For men over 40 and women over 50, or earlier with family history, this is the highest value item in all of advanced testing.

VO2max Testing

Cardiorespiratory fitness is one of the strongest known predictors of all-cause mortality, and unlike most risk factors, it is directly modifiable. A formal test gives you a number and a training target. Arguably deserves more attention than most Tier 3 blood markers.

DEXA Scan

Body composition (lean mass vs. fat mass) plus bone mineral density. The bone density component matters enormously for postmenopausal women, since fracture risk rises sharply after estrogen loss.

CIMT (Carotid Intima-Media Thickness)

Ultrasound of the carotid arteries. Reasonable alternative where CAC is unavailable. No radiation. Generally less predictive than CAC and more operator-dependent.

The reframe worth making: A $150 CAC scan and a VO2max test will usually change a healthy person's decisions more than $800 of exotic blood markers. Spend accordingly.

The Blood Work Protocol

Contents

1. Why Blood Work Is the Foundation of Any Health Strategy

2. What "Normal" Actually Means (And Why It Misleads You)

Two things follow from this, and both matter enormously:

3. Level 0 ... The Absolute Basics Everyone Needs

4. Level 1 ... Sex-Specific and Metabolic Deep Cuts

For Men

For Women

Perimenopause and Postmenopause

5. Level 2 ... Advanced and Specialized

Worth It

Redundant or Marginal

Actively Oversold

6. What Function Health Actually Tests and Why It Matters

Heart and Lipids (15 markers)

Metabolic (4 markers)

Thyroid (5 markers)

Female Hormones (9 markers)

Male-Specific (4 markers)

Vitamins, Minerals, and Nutrients (19 markers)

Liver (8 markers), Kidney (9 markers), Pancreas (2), CBC (8), Electrolytes (6), Immune (7), Autoimmune (4), Urinalysis (20), Heavy Metals (2)

7. How to Draw Blood So Your Numbers Mean Something

8. Schedule A: Best Bang for Your Buck

Year 1: Establish Baseline

Year 2+: Maintenance

9. Schedule B: The High-Performance Track

Year 1: Deep Baseline

Year 2+: Optimization Cadence

10. How to Test Whether Your Supplements Are Actually Working

Establish a clean baseline BEFORE starting

Change only one variable at a time

Wait the correct interval before retesting

Control your draw conditions identically

Decide based on the data, not the marketing

Document everything

11. Turning Results Into a Protocol

Step 1: Triage before you react

Step 2: Look for patterns, not points

Step 3: Pick a maximum of three targets

Step 4: Set the retest date the same day you get results

Step 5: Keep one file

Step 6: Know when to escalate

12. Beyond Blood: The Tests That May Matter More

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