41+ Key Biohacking Tests for Health & Performance (Biometrics & Biomarkers)

Are your overall health and quality-of-life trending up or down? How do you know? Pay attention to the way you feel. But that only tells part of the story.

Establishing your self-quantification baselines enable diet, lifestyle, supplementation, and new habits comparison over time. Like steering a ship, you can make minor or major alterations based on the data you collect over time. Today we’ll cover some of the most useful health & wellness testing biomarkers you should track, and how to get started.

What Are Health Biomarkers & Why Are They Useful?

Health biomarkers are qualitative and quantitative measures of the functionality of different organs and biological systems. Biomarkers measure everything from physical speed to the composition of microbes in your gut, the aging process, stress levels, metabolic function, cardiovascular system, and other proxies of health.

Health markers can uncover problems long before they become serious.

Tracking biomarker changes gives a window into how lifestyle impacts health, wellness, and lifespan (here are my healthspan tips to make those quality years). Small lifestyle tweaks today can improve performance, overall quality of life, and prevent later disease. While scientific discoveries break on a daily basis, human biology still a black box.

I think of it like a forest. When lost, you could wander aimlessly, hoping to find a path out.

Or, you could climb a tree and gain a vantage point. The path from above is clear cut and obvious. Tracked biomarkers are one such tree.

Cardiovascular

Of great interest to biohackers, cardiovascular system health is indicative of the body (and brain) as a whole. After all, the heart has neurons and a direct connection to the brain.

Self-quantifiers start with the easily-measured, like:

• Maximum and minimum heart rate
• Average resting heart rate
• Heart rate variability
• Respiratory rate
• Blood pressure
• VO2 Max

You can glean lots of information from the basics.

Then, move to more advanced cardiovascular testing:

• Echocardiogram
• Calcium Arterial Calcification (CAC)
• Complete Blood Count (CBC)

Blood & Laboratory

Blood is one of the most powerful windows into your inner workings. A tiny blood sample can evaluate your nutrition, longevity measure, inflammation, hormones, immune health, metabolites, and much more.

The biggest downside is that it requires an in-person extraction.

Common blood tests and their purposes include:

• Fasting glucose & insulin: determine how your body responds to sugar.
• High-sensitivity-C-Reactive Protein (HS-CRP): measures overall inflammation throughout the body.
• Hemoglobin-A1C (HbA1c): average blood sugar over the last ~3 months.
• Vitamin D: vitamin D functions more like a hormone than a vitamin. Yet today many of us today are deficient.
• NMR LipoProtein panel: quantifies and distinguishes between problematic and healthy types of cholesterol and triglycerides.

With the above basics, some easy calculations give even more insight. For example, an accurate measure of insulin functionality is called HOMA-IR.

HOMA-IR = (glucose x insulin) / 405.

Lab testing gets expensive quickly. The next often recommended panels include:

• RBC Magnesium: nearly everyone is magnesium deficient. Unlike the standard magnesium test, the Red Blood Cell (RBC) version accurately measures bioavailable magnesium.
• DUTCH test: most hormone panels do not account for normal hormone fluctuations. DUTCH solves this by testing multiple samples throughout the day, providing higher-quality information.
• Omega 3:6 Index: compares anti-inflammatory omega-3 levels against pro-inflammatory omega-6. This can help explain if inflammation is coming from diet or elsewhere.

Sleep, Stress, Recovery

via GIPHY

Until recently few talked about recovery. The general public is now catching on to a secret of elite coaches. Most recovery takes place during sleep. Which in itself is problematic.

So far, the best all-encompassing biometric to quantify sleep & recovery is heart rate variability (HRV). HRV measures the balance between your fight-or-flight sympathetic nervous system and the rest-and-relax parasympathetic. Researchers have used HRV to predict everything from sleep quality to mood, age, and emotional state.

Basic sleep, stress, and recovery biometrics you can track:

• Total sleep
• Sleep time and wake time
• HRV

More advanced wearables can also provide:

• Deep sleep: biohackers obsess over “deep” sleep — the most regenerating stage.
• REM sleep: the dreaming stage where the brain saves new information and combines it in novel ways. REM is key to lessening trauma and processing emotion.
• Number of wake ups: the more you wake up throughout the night, the worse sleep quality. Can also signify sleep apnea problems.
• Sleep latency: once your head hits the pillow, sleep latency describes how long it takes you to fall asleep. Certain evening routines impact sleep latency.
• Blood oxygen saturation (SPO2): even better for detecting sleep apnea, your blood oxygen changes in response to breathing.
• Respiratory rate: overtaxing the body causes you to breathe more. Long-term over-breathing is highly correlated with disease.

Now science has come around. Devices have sprouted up everywhere. Promising to predict everything from your energy levels to readiness to workout. These quantification devices are finally maturing and becoming more accurate.

Fitness

Physical shape and mental health are strongly related.

Luckily, many great measures of fitness require minimal (if any) equipment.

Anyone can track their body changes, and basic measures of mobility. Common fitness biomarkers include:

• Bench, squat, military press, and deadlift strength
• Grip strength
• Sprinting time
• Waist circumference
• Body mass index (BMI)
• Waist-to-hip ratio

For the latter, the healthy waist-to-hip ratio range is <1.0 for men and <0.8 for women.

Effective fitness biomarkers that require equipment include:

• Body fat percentage: an easy and cheap way to measure fitness progress. Either through DEXA scans, bioelectrical impedance, or old-school fat calipers.
• Respiratory rate: fit individuals breathe less. Measurable through certain wearables.
• Blood oxygen saturation (SPO2): better oxygen exchange is highly correlated with fitness.
• Bone density: increases with fitness. Declining bone density may indicate issues and potential cortisol dysregulation. Measurable via a DEXA scan or bioelectrical impedance scale.
• Glucose challenge: fit individuals respond well to glucose. Measurable via a continuous glucose monitor (CGM) or blood test.
• VO2 Max: a cardiovascular fitness metric that indicates the maximum amount of oxygen you can utilize during exercise. Measurable via certain wearables.

Longevity

Longevity markers are evolving.

Currently there’s a tradeoff between accuracy, affordability, and ease.

But are longevity tests worth the hassle?

Although some of the longest living people in the world break traditional health rules, they share common characteristics. Characteristics that everyone can work towards. Quantifiable longevity biomarkers like:

• Grip strength
• Ability to state your purpose
• Ability to walk up a slight incline at 4 mph for 15 minutes
• Ability to sit and stand without using hands 30 times
• Lean body

Granted, the advanced and expensive tests can add an extra layer of insight:

• Epigenetic methylation age
• Telomere length

They’re no panacea; state-of-the-art longevity tests have issues:

• Low-correlation with healthy outcomes
• Time of day when the sample was taken
• Which tissues were sampled

How Often to Measure Biomarkers

I just threw a lot of potential tests at you.

You can’t possibly measure each of these constantly, nor would you want to.

The best biomarker testing plan is the one that you’ll follow.

Wearables automate data collection saving you time and energy.

The Oura Ring has long been the biohacker’s favorite, but the WHOOP, Bio Strap, Ultrahuman AIR, and newer devices are competing for number one. Each of these devices automatically captures a plethora of insights.

WHOOP and Bio Strap are better fitness trackers than the Oura but require subscriptions for full data access.

Here’s a sample minimalist data collection schedule.

Daily wearable data:

• Sleep
• Recovery
• Activity
• HRV

Quarterly

• BMI
• Body fat
• Grip strength
• Waist to hip ratio

Yearly

• Lab blood work
• Microbiome (optional)
• Advanced longevity tests (optional)

Lifetime

• Genetic analysis (SelfDecode is the best DNA analytics software) Here is the frequently updated article on the new SelfDecode science, benefits, and usage guide.

Optimal Health & Wellness Biomarker Data

Establishing a baseline is the necessary first step to lasting health changes.

Overwhelmed by all the options?

Get thorough once-in-a-lifetime genetic testing.

Then passively collect health markers through a wearable device.

I recommend folks track three things on a daily basis:

1. Heart rate variability (HRV), which I recently wrote a post on.
2. Sleep cycles.
3. Daily step count (aim for 10,000+ steps per day).

These basics are the foundation of health. Assuming no serious issues, only then would I splurge on more advanced testing.

What wellness biometrics do you track and why?