The Longevity Movement Has a Data Problem
Bryan Johnson spends over $2 million a year measuring his body. Dr. Eric Topol, cardiologist and director of the Scripps Research Translational Institute, has spent two decades arguing that personalised, data-driven medicine is the only rational approach to human health. The quantified-self wave, once a fringe hobby of Silicon Valley engineers, has gone mainstream, with searches for "longevity test" and "biological age" growing year over year across Europe.
And yet, for all the cultural momentum behind the movement, most people who call themselves biohackers are doing it blind. They are taking NMN, optimising sleep scores, adjusting protein intake, and stacking supplements, without ever measuring the biomarkers that would tell them whether any of it is working, or whether it is even necessary.
The irony is sharp. The entire philosophy of the longevity movement is to test, measure, intervene and retest. It collapses the moment you skip the first step. You cannot optimise a system you have never measured. And measuring it properly requires knowing which markers actually correspond to healthspan, not just which ones your GP orders when something seems wrong.
This article maps the five clusters of biomarkers that a genuine longevity panel covers, explains the evidence behind each, and addresses the practical question European biohackers face: where do you actually get this done, at a credible standard, without flying to a US longevity clinic or paying $499 for a service that doesn't operate outside America?
What "Longevity Testing" Actually Means, and What It Doesn't
Biological Age vs. Chronological Age: The Right Frame
Chronological age is how long you have been alive. Biological age is how your body is actually performing relative to that number, and research consistently shows the two can diverge by a decade or more in either direction. A 2024 paper in Nature Medicine by Moqri et al. from Harvard and Stanford reviewed the current state of aging biomarker validation, finding that the most robust tools combine conventional blood markers with emerging approaches like DNA methylation clocks. The key insight: measurable blood biomarkers track meaningfully with biological aging trajectories, and many of the most predictive ones are available in a standard laboratory blood draw today.
An international expert consensus published in The Journals of Gerontology in 2025 identified hs-CRP, IGF-1, and GDF-15 among the biomarkers with the strongest consensus (70 to 98% agreement among panel members) for use in human aging intervention studies. These are not exotic markers. They are measurable, reproducible, and clinically validated. They are also, notably, absent from most standard blood panels. Our article on biological age testing explores this distinction in depth.
Why the Großes Blutbild and the Check-up 35 Don't Touch This Category
Germany's healthcare system is well-designed for what it was built to do: detect clinical disease in symptomatic patients. The Check-up 35 tests five values. Those are cholesterol, glucose, and a urine panel. The großes Blutbild adds differential white blood cell counts to a basic haematological picture. Neither touches metabolic risk, hormonal trajectory, inflammatory load, or cardiovascular particle counts. We mapped exactly what the großes Blutbild does and doesn't test in detail.
This is the structural gap that the longevity movement exists to fill. Not because the system is broken, since it is doing its intended job, but because "not clinically ill" and "biologically optimised" are entirely different standards, and the existing infrastructure only measures one of them.
The Markers That Actually Predict Healthspan
A genuine longevity panel covers five clusters. Each addresses a distinct biological pathway that research has linked to accelerated or decelerated aging. Taken together, they produce a functional baseline. It is a map of where your biology currently sits, and what deserves attention before symptoms arrive.
Cluster 1: The Inflammation Stack, hs-CRP and Homocysteine
Chronic low-grade inflammation is arguably the most important single concept in modern longevity medicine. The term inflammaging, coined to describe the persistent, low-level inflammatory state that accumulates with age, has become a cornerstone of biological aging research. It underlies cardiovascular disease, metabolic dysfunction, neurodegeneration, and multiple cancers. And it is entirely invisible without a blood test.
hs-CRP (high-sensitivity C-reactive protein) is the primary clinical tool for measuring it. Unlike standard CRP, which detects acute inflammation, hs-CRP is sensitive enough to capture chronic, subclinical inflammation. The thresholds that matter: under 1.0 mg/L indicates low risk; 1.0 to 3.0 mg/L is moderate; above 3.0 mg/L is elevated. Bryan Johnson has publicly described eliminating all measurable systemic inflammation as one of his primary protocol goals, with his hs-CRP falling below detectable levels. That represents one end of the optimisation spectrum. The starting point, for most people, is simply knowing where they are.
Homocysteine is the second critical inflammatory marker, and the most consistently under-tested one. It is an amino acid produced during protein metabolism, and when it accumulates (typically because of B vitamin deficiency or genetic MTHFR variants), it damages the arterial lining and drives atherosclerosis. A meta-analysis of 23,623 subjects published in PMC found that elevated homocysteine was an independent predictor of cardiovascular mortality, with each 5 µmol/L increment in homocysteine associated with a 52% higher risk of coronary heart disease mortality. The optimal target is below 10 µmol/L; most lab reference ranges accept up to 15 µmol/L or higher, a gap that leaves considerable risk invisible.
The important nuance: homocysteine is largely correctable. Targeted B vitamin supplementation with methylfolate, methylcobalamin and P5P often normalises levels within weeks. But you cannot target what you have not measured.
If you have never had hs-CRP and homocysteine tested together, you do not know your inflammatory baseline. Aniva's panel tests both as standard, alongside 100+ other markers, for €199 per year. Get started with Aniva →
Cluster 2: Metabolic Health, the 5 to 15 Year Early Warning Window
The standard metabolic test, fasting glucose, is a late-stage signal. It catches diabetes that has largely already arrived. What it misses is the decade-long process that precedes it: insulin resistance, the state in which cells progressively lose their sensitivity to insulin's signal, forcing the pancreas to compensate with higher and higher output.
During this compensation phase, fasting glucose looks normal. HbA1c, the three-month blood sugar average, looks normal. But fasting insulin is already elevated, and with it comes a cascade of downstream effects: fat storage, particularly visceral and abdominal; chronic inflammation; hormonal disruption (elevated insulin suppresses SHBG, increasing androgen exposure); and progressive damage to endothelial cells.
Together, these three markers capture the full metabolic picture.
None of these appear on the German Check-up 35. HbA1c is sometimes ordered by GPs for patients with suspected diabetes risk; fasting insulin almost never. For anyone following a longevity protocol, whether tracking macros, experimenting with fasting windows or adjusting carbohydrate intake, running this cluster annually is the minimum viable metabolic feedback loop. Without it, you are adjusting variables in a system you cannot read.
Cluster 3: Hormonal Trajectory, Testosterone, DHEA-S, and IGF-1
Testosterone and Free Testosterone, the SHBG Problem
Total testosterone is what most labs report. Free testosterone, the small fraction that is not bound to proteins and therefore biologically available to cells, is what the body actually uses. The difference matters because SHBG (sex hormone-binding globulin) captures up to 98% of circulating testosterone, rendering it inert. A person with "normal" total testosterone and elevated SHBG can have the functional hormonal profile of someone who is genuinely deficient, with the full symptom picture of fatigue, reduced recovery, low libido and mood instability, while being told their results are fine.
What raises SHBG? Caloric restriction. Extended fasting. Liver stress. Chronic low-grade inflammation. In other words: many of the same interventions popular in the biohacking community can, paradoxically, reduce free hormone availability if baseline is not monitored. Our article on cortisol explores related hormonal interactions including the DHEA-cortisol axis.
DHEA-S, the Decline Curve Most Ignore
DHEA-S (the sulphated form of dehydroepiandrosterone) is the most abundant steroid hormone in circulation, and one of the most overlooked in standard medicine. Research published on PubMed tracking DHEA levels longitudinally in healthy men found that levels declined in 67% of subjects over a 13-year follow-up. More strikingly, adrenal DHEA production begins declining from approximately age 25, reaching levels roughly 80% lower than peak by age 75.
DHEA-S serves as a precursor for both testosterone and oestrogen, and low levels are associated with fatigue, reduced muscle mass, cognitive decline, and reduced resilience to stress. It is also one of the clearest single-number indicators of where a person sits on their hormonal aging trajectory. For anyone interested in understanding their biological age in hormonal terms, a single DHEA-S reading, and its trend over time, is more informative than almost any supplement stack.
IGF-1, the Double-Edged Sword of Cellular Repair
IGF-1 (insulin-like growth factor 1) is central to cellular growth and repair. The international biomarker consensus study cited above identified it as one of the highest-consensus aging markers, with 98% expert agreement on its relevance. In longevity medicine, optimal IGF-1 is typically considered to sit in the middle range, roughly 120 to 180 ng/mL, rather than maximised. The reason: IGF-1 drives cellular proliferation, which is useful for tissue repair but may, at high levels, promote growth of nascent tumour cells. The goal is not maximisation but calibration.
For biohackers experimenting with growth-promoting interventions such as resistance training periodisation, sleep optimisation and protein cycling, IGF-1 provides the direct biological readout of where the system is sitting.
Testosterone (total and free), SHBG, DHEA-S, and IGF-1 are all included in Aniva's standard panel. One blood draw. Every result in the app with its reference range and context. Apply for membership →
Cluster 4: Cardiovascular Risk, Beyond the Standard Lipid Panel
The standard lipid panel of total cholesterol, LDL-C, HDL-C and triglycerides has been the cornerstone of cardiovascular risk assessment for decades. It is also, by the standards of longevity medicine, woefully incomplete.
The issue with LDL-C is that it measures the weight of cholesterol in LDL particles, not the number of particles. Two people can have identical LDL-C readings with entirely different cardiovascular risk profiles, depending on whether their LDL particles are large and buoyant (lower risk) or small and dense (higher risk). The European Society of Cardiology's 2021 prevention guidelines elevated ApoB, which directly counts the number of atherogenic particles, as the preferred marker for lipid-related cardiovascular risk assessment.
The truck analogy is useful: LDL-C tells you the total weight of goods being transported; ApoB counts the number of trucks making trips through your arterial walls. Ten trucks with a light load each still make ten trips. It is the traffic, not just the cargo weight, that drives plaque formation. Our detailed article on ApoB, Lp(a), and the full cardiovascular marker picture covers this in depth.
Lp(a), lipoprotein(a), is the second critical marker that standard panels miss entirely. Roughly 20% of Europeans carry genetically elevated Lp(a), a particularly atherogenic lipoprotein that is largely unresponsive to lifestyle interventions. It is a fixed genetic risk, and most people who carry it have never been told. The only way to know is to test. A single lifetime measurement establishes whether Lp(a) needs to be factored into cardiovascular risk planning.
Together, ApoB and Lp(a) represent the part of cardiovascular risk that the standard lipid panel is structurally incapable of seeing. For the longevity-focused person whose standard cholesterol looks fine and who wonders why their actual risk might be higher, these two markers are where the answer often sits.
Cluster 5: Micronutrient Status, the Foundation Everything Else Rests On
Optimising performance on a depleted nutritional foundation is like tuning a car engine while running it on contaminated fuel. The results will be inconsistent and the feedback misleading. Four micronutrient markers are non-negotiable in a genuine longevity panel.
Vitamin D, technically a hormone, governs over 1,000 gene expression pathways including immune function, calcium metabolism, and thyroid signalling. The Robert Koch Institut's DEGS1 study found that 56% of adults in Germany have vitamin D levels below 50 nmol/L, a figure that rises sharply through winter months. Supplementing without testing is guesswork: the same 2,000 IU daily dose will land two individuals at entirely different serum levels depending on absorption, baseline status, and cofactor availability. Our article on vitamin D in Northern Europe covers the evidence on deficiency rates, optimal ranges, and the K2 cofactor question.
Magnesium is involved in over 300 enzymatic reactions including ATP production, DNA repair, and cortisol regulation. It is also the mineral most depleted by chronic stress, which means the biohacker population is, by definition, at elevated risk of functional deficiency. Standard serum magnesium captures only 1% of the body's total magnesium and is a poor proxy for cellular sufficiency; testing alongside clinical symptoms provides context that a number alone cannot.
Vitamin B12 is essential for neurological function, red blood cell formation, and homocysteine metabolism. Deficiency can be silent for years before manifesting as neurological symptoms. It is particularly relevant for anyone following a plant-based or reduced-animal-protein diet, and critical context for homocysteine interpretation, since B12 deficiency is one of the primary drivers of elevated homocysteine.
Ferritin, iron stores, is the most consistently under-tested marker in European fatigue. You can have near-optimal haemoglobin with critically depleted ferritin, and experience the full cognitive and physical consequences of iron deficiency (brain fog, reduced exercise capacity, hair loss) while being told your blood count is normal. A French RCT showed that iron supplementation reduced fatigue by nearly 50% in non-anaemic women with ferritin below 50 µg/L. Optimal is 50 to 100 µg/L; most lab reference ranges begin at 12 µg/L. Our article on iron and ferritin covers this in full.
The Function Health Comparison, and the European Reality
What Function Health Does Well
Function Health, the US-based comprehensive testing service co-founded with Dr. Mark Hyman, is the closest existing model to what the longevity movement has been asking for. At $499 per year, it offers 100+ biomarkers twice annually, an accessible digital dashboard, and written summaries for each result. For its US-based members, it represents a genuine leap beyond standard care. Reviews consistently note that it catches out-of-range values that standard physicals miss entirely, including ApoB, Lp(a), fasting insulin, and homocysteine.
What It Can't Do for Europeans
Function Health does not operate outside the United States. Its blood draws are routed through Quest Diagnostics and LabCorp, a network that has no European presence. The platform explicitly states it does not service international labs. For the growing number of European biohackers inspired by the longevity movement, Function Health exists as a reference point, not an accessible product. Signing up requires a US address. Getting tested requires travelling to the US or finding a workaround, neither of which represents a sustainable annual testing protocol.
There is also the currency of trust. A certified ISO 15189-accredited German laboratory operates under EU medical device regulation and GDPR data protection standards. Your health data stays in the EU. For many Europeans, this is not a minor consideration.
How Your Results Are Delivered and Explained
A list of numbers is not the same thing as an understanding of your health. Isolated values are easy enough to read on their own. Results that interact are harder: when ferritin is low and hs-CRP is elevated, when free testosterone is low but total testosterone is normal, or when homocysteine is borderline and B12 is also suboptimal. A bare PDF of values leaves all of that work to you.
Aniva delivers every result inside the app. Each marker appears with its reference range, a plain-language explanation of what it measures, and the context you need to see how it relates to the rest of your panel. From there you get a personalised action plan that sets out which markers deserve attention first and what practical steps are available to you. If anything is unclear, a personal health concierge is available in chat to answer questions about your panel and to help you prepare for a conversation with your own doctor.
Aniva's Panel: The Numbers
Aniva's annual membership tests 100+ biomarkers at an ISO 15189-certified German laboratory, covering all five clusters described in this article: inflammation (hs-CRP, homocysteine), metabolic health (fasting glucose, HbA1c, fasting insulin, HOMA-IR), hormonal trajectory (testosterone total and free, SHBG, DHEA-S, IGF-1, cortisol), cardiovascular risk (ApoB, Lp(a), full lipid panel, homocysteine), and micronutrient status (vitamin D, magnesium, B12, folate, ferritin, zinc). Results arrive in the app with reference ranges and context, together with a personalised action plan, and a personal health concierge is available in chat for your questions. The process is a single venous blood draw. There are no finger-prick limitations and no split-visit requirements. Cost: €199 per year.
The panel Bryan Johnson would track if he were based in Germany. One draw. 100+ markers. Every result explained in the app. €199 per year, less than a single private GP consultation.
Start your membership →See the full biomarker list →
How to Actually Use a Longevity Panel
The panel is the beginning, not the end. Bryan Johnson runs blood draws every three to six months. That cadence is not necessary for most people, but the underlying discipline is: baseline, intervene, retest, iterate.
The practical protocol for someone starting out is straightforward. Establish a baseline, your first annual panel, before changing anything. This gives you a genuine reference point. Then make one or two targeted changes based on what the results show: address vitamin D if you are deficient; adjust dietary patterns if fasting insulin is elevated; investigate sleep quality or training load if hs-CRP is persistently raised. Retest the relevant markers in six to twelve months. Compare the trend, not just the number.
This is what separates longevity-oriented testing from standard medical testing. It is not about detecting disease. It is about measuring trajectory, tracking the direction of travel across the biomarkers that research links to healthspan, and adjusting course based on data rather than guesswork.
The supplement industry will always have something to sell you. The wearable industry will always have a new sensor to attach. The underlying question, whether any of it is moving the needle in your body, can only be answered by one thing. A test.
Conclusion
The longevity movement's central argument is correct: the standard medical system is designed to catch disease, not to optimise health. The gap between "not clinically ill" and "biologically well-positioned for the next decade" is measurable, and most people have never measured it.
A genuine longevity panel covers five distinct clusters: inflammation (hs-CRP and homocysteine), metabolic health (HbA1c, fasting insulin, HOMA-IR), hormonal trajectory (testosterone, DHEA-S, IGF-1), cardiovascular risk (ApoB and Lp(a) alongside the standard lipid panel), and micronutrient foundations (vitamin D, magnesium, B12, ferritin). Each has a distinct biological rationale. Each has markers that standard GP blood work almost never includes. And each is available in a single blood draw.
Function Health built the template in the US. Aniva is the European answer. It is ISO-certified, EU data-compliant, and available without a transatlantic flight or a US postal address. The protocol mindset Bryan Johnson popularised translates perfectly to the German context. The infrastructure now exists to support it.
Aniva tests 100+ longevity biomarkers at a certified German laboratory, with every result explained in the app and a personalised action plan, for €199/year. One blood draw. The complete picture.
Begin your membership →
Sources
[1] Peng H, Man C, Xu J, Fan Y. "Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies." Journal of Zhejiang University Science B. 2015. PMC4288948
[2] ScienceDirect review of DHEA longitudinal decline data. "Impact of dehydroepiandrosterone (DHEA) supplementation on testosterone concentrations and BMI in elderly women." 2020. ScienceDirect
[3] Visseren FLJ, et al. "2021 ESC Guidelines on cardiovascular disease prevention in clinical practice." European Heart Journal. 2021;42(34):3227-3337. Oxford Academic
[4] Moqri M, Herzog C, Poganik JR, et al. "Validation of biomarkers of aging." Nature Medicine. 2024;30(2):360-372. PMC11090477
[5] International Expert Consensus on Biomarkers of Aging. "Expert consensus statement on biomarkers of aging for use in intervention studies." The Journals of Gerontology: Series A. 2025. Oxford Academic
[6] Rabenberg M, et al. "Vitamin D status among adults in Germany, results of the German Health Interview and Examination Survey for Adults (DEGS1)." BMC Public Health. 2015;15:641.
[7] Nygård O, et al. "Plasma homocysteine levels and mortality in patients with coronary artery disease." New England Journal of Medicine. 1997;337:230-236. NEJM
[8] Function Health pricing and availability. functionhealth.com. Accessed March 2026.
[9] Harman SM, Metter EJ, Tobin JD, et al. "Longitudinal effects of aging on serum total and free testosterone levels in healthy men." Journal of Clinical Endocrinology and Metabolism. 2001;86:724-731.
This content is for informational purposes only and is not medical advice. Longevity biomarker ranges discussed in this article reflect research on optimisation goals and may differ from standard clinical reference ranges. Always discuss results and any interventions with a qualified healthcare professional before making changes to your health regime.
