Your GP has been ordering the same cholesterol panel since the 1980s. Total, LDL, HDL, triglycerides. It is a decent starting point and it misses a lot. Monday's deep dive covered the first thing it misses. Today covers the other two, which is the shorter and more practical of the two conversations because you can add both to your next blood draw for the price of a takeaway lunch.
Three markers, one vial. Ask for them by the name written below, and if the tech looks blank hand them the printed page. Otherwise you leave with the same panel your GP ordered a decade ago.
The lipid panel your GP orders was designed forty years ago. Consider this the update.
The card lists Lp(a), ApoB, and hs-CRP with the target range and cadence for each.
1. Lp(a) - one, ever.
Monday's deep dive covered the full picture, so this is the one-paragraph version. Lp(a) is a cholesterol-carrying particle set close to birth, driven about 80 to 90 percent by the LPA gene, and roughly stable for the rest of your life. One in five adults carries a clinically elevated level (over 50 mg/dL) and does not know, because a standard panel does not measure it. The 2026 ACC/AHA guideline made testing Class I universal, meaning every adult, at least once, no exceptions. Florian Kronenberg's group at Innsbruck argued for that recommendation for a decade before the guideline caught up.
If your number comes back under 30 mg/dL you are done, never test it again. If it comes back over 50 mg/dL, the useful lever is not the Lp(a) itself, it is everything else you can move alongside it. Which brings us to the other two on today's list.
2. ApoB - once a year.
Apolipoprotein B is the count of every atherogenic particle currently circulating in your blood. LDL, VLDL, IDL, anything else with a cholesterol payload heading toward an artery wall. It predicts cardiovascular events better than LDL-C, and better than total cholesterol, which has been established in the literature for twenty years and has taken twenty years to reach a GP's ordering menu. Allan Sniderman at McGill, who has spent most of a career on this, wrote the 2022 JAHA consensus paper that reads as the best primer for a lay reader.
Target under 80 mg/dL for standard risk. Under 60 if your Lp(a) is elevated, you have a family history, or you have existing cardiovascular disease. This is the number statins, diet, and exercise actually move (they do not touch Lp(a), which was Monday's whole argument). Retest yearly, or twelve weeks after any intervention you want to measure.
3. hs-CRP - once a year.
High-sensitivity C-reactive protein is your inflammatory baseline. Two people with the same ApoB can have quite different heart-attack rates depending on where their hs-CRP sits. Paul Ridker's JUPITER trial in NEJM 2008 put the idea on the map. He randomised 17,802 adults with normal cholesterol but elevated hs-CRP to rosuvastatin or placebo, and the trial stopped early because the treatment arm was doing so much better than expected. Everything since has confirmed the frame.
Target under 1.0 mg/L for low risk. 1.0 to 3.0 is average. Above 3.0 is the inflammatory band that needs attention regardless of what your cholesterol looks like. Sleep, training load, visceral fat, gut health, and how much low-grade infection you are carrying all move this number around. Which means if yours is high, the fix is rarely a pill.
The question we keep getting this week
If my Lp(a) comes back high and I cannot lower it, what am I actually supposed to do?
Fair question, and the honest answer is not a supplement. It is a longer conversation, in this order.
First, if you have a primary care doctor you trust, bring the number to them.
ApoB and hs-CRP are on every commercial pathology form, so ordering is not the barrier. The barrier is whether the doctor will actually engage with the composite risk picture, or whether they will glance at a borderline number and default straight to a statin conversation. If yours does the interpretive work with you, that is the ideal setup. If yours is a ten-minute repeat-prescription visit that ends with 'come back in six months,' the direct-to-consumer labs we have been surfacing all week are the practical alternative. You do not need a doctor's permission to know your own numbers.
Second, consider adding a functional or naturopathic-trained clinician alongside your primary care. The functional side of the profession tends to think earlier and more thoroughly about lifestyle, diet, sleep, movement, and hormonal context, which are the exact levers you can pull when the genetic marker will not move. This is not a replacement for primary care. It is a broadening of it, and for a fixed-genetic marker like Lp(a) it is arguably the more useful of the two conversations.
Third, shift the target.
You cannot move Lp(a), so the goal becomes making every other cardiovascular number as clean as you can get it, because that is where every bit of remaining leverage now sits. ApoB under 80 mg/dL (or under 60 if you are high-risk), hs-CRP under 1.0 mg/L, blood pressure closer to 115/75 than 130/85, fasting glucose in the healthy band, waist circumference tight, sleep long enough most nights, alcohol occasional rather than daily, and enough weekly movement that your resting heart rate sits somewhere in the fifties. Each of those is genuinely moveable through diet, sleep, training, and stress work. Together they neutralise a real fraction of the elevated risk your Lp(a) is contributing on its own.
Your Weekend Action
Book the panel. In the US, Ulta Lab Tests sells all three markers standalone through Quest Diagnostics draw sites, no doctor's order needed, and each one runs somewhere in the $30 to $50 range.
If your budget allows, Function Health bundles the three plus about a hundred other markers into a $499 annual panel, which is more expensive and more complete. If you already know you want the full picture, Function is the cleaner choice. If you just want the three, Ulta is faster and cheaper.
In Australia, i-Screen bundles Lp(a) and ApoB into an advanced lipid panel for about $180, with hs-CRP as a separate add-on. MediTests runs the three standalone at around $69 each through Healius collection centres nationwide. Same blood draw either way.
Before Monday
If you have been reading Longevity Daily for a while now, you will have noticed that most things in longevity come back to four levers. Diet, movement, sleep, and purpose. Almost everything else you will be sold, whether that is a supplement, an elective test, a biohacking gadget, a longevity-branded protocol, or whatever the wellness internet is currently marketing, sits downstream of those four.
If someone is trying to sell you a longevity-branded product or protocol before the four levers are honestly in place, that is either the wrong buy for you, or the right one at the wrong time.
Until Then.
Longevity Daily · The Building Decades
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