Updated August 2026 to reflect the 2026 AHA/ACC dyslipidemia guideline and newer discussions from Peter Attia.

Outlive is a rich book. It introduces the concepts of healthspan vs lifespan, the “four horsemen” of chronic illness, and specific tactics when it comes to lab testing, nutrition, exercise, sleep, and emotional health.

At the end of reading it, you may feel a bit overwhelmed with all the information and left wondering: “So what do I do first?” Generally, Outlive’s approach to healthspan involves starting with a detailed set of biomarkers (mostly blood tests).

This “cheat sheet” outlines the specific lab tests recommended by Peter Attia in Outlive.

Since Outlive was published in 2022, guidance from medical societies—and the way Peter Attia talks about some tests—has continued to evolve. The notes and alternatives column below explains where the recommendations differ or where a newer test has become more useful.

The majority of biomarkers recommended by Peter Attia are lab tests, with some imaging and specialized testing like VO2 max.

Lab tests & biomarkers recommended in Outlive

Peter Attia’s recommended blood tests include ApoB, Lp(a), HbA1c, Vitamin D, and more. The table below outlines all of the lab tests recommended in Outlive:

Category	Biomarker	Notes or alternatives
Heart health	ApoB	More accurate than LDL
Heart health	Lp(a)	Important inherited risk factor for cardiovascular disease; the 2026 AHA/ACC guideline recommends measuring it at least once
Heart health	LDL
Heart health	HDL
Heart health	Triglycerides
Heart health	Triglycerides:HDL
Heart health	Non-HDL cholesterol
Heart health	Blood pressure	Measured with a cuff
Heart health	APOE genotype	Can inform Alzheimer’s risk, but does not diagnose disease; consider the clinical context before ordering
Metabolic health	HbA1c
Metabolic health	Vitamin D
Metabolic health	2-hour Glucose (OGTT)	Start with HbA1c (requires standard blood draw)
Metabolic health	Homocysteine	Associated with vitamin deficiency. Can measure B12, B9 (folate), B6 instead.
Metabolic health	Iron, ferritin
Liver	AST
Liver	ALT
Inflammation	ESR	hs-CRP is often more useful for cardiovascular-risk assessment, but an elevated result needs clinical context
Inflammation	CRP	Consider hs-CRP when the clinical question is cardiovascular risk; do not interpret it during an acute illness
Other	Uric Acid
Other	Testosterone (male)	Tread carefully: testosterone supplementation may increase heart disease risk.
Imaging / Other tests	VO2 max	VO2 max is measured in a lab, but Apple Watch and other wearables provide estimates
Imaging / Other tests	Colonoscopy
Imaging / Other tests	DEXA
Imaging / Other tests	CT Chest	For lung cancer. Guidelines recommend it for smokers, Attia also recommends for non-smokers.

Which labs in Outlive covered by health insurance?

A few of the labs in Outlive are standard and covered by insurance, such as a lipid panel. But many of the above—ApoB, Lp(a), inflammation, and so on—aren’t usually covered by insurance. Cash pay options do exist, however, for under $200.

Which biomarkers in Outlive are blood tests?

Most of the biomarkers recommended by Peter Attia are blood tests. For example, ApoB, Lp(a), cholesterol, triglycerides, AST, ALT, inflammation, and HbA1c can all be completed in a single blood draw. Some are specialized tests, such as VO2 max—VO2 max testing is often done in a lab while wearing a mask, but wearables like Apple Watch can estimate VO2 max. Some of these tests, like DEXA, are imaging.

Where to get affordable lab tests

You don’t need to spend thousands of dollars for labs. If you want an affordable comprehensive lab panel that also includes a detailed review with a doctor, Empirical Health’s advanced heart health program is a good place to start.

2026 update: what has changed since Outlive?

Since Outlive was published, medical guidelines have caught up. The 2026 AHA/ACC guidelines recommend that every adult measure Lp(a) and recommends ApoB in most cases. The guideline also recommends using the PREVENT-ASCVD equations to estimate primary-prevention risk and gives coronary artery calcium (CAC) scoring a larger role when treatment decisions remain uncertain. These tools do not replace a clinician’s judgment, but they make it easier to connect a lab result to an appropriate next step. PCSK9 inhibitors, long championed by Attia, have also advanced with a new PCSK9 inhibitor in pill form.

For most people, the practical starting point remains straightforward: measure the major cardiovascular and metabolic markers, understand your results in context, and use abnormal findings to decide whether follow-up testing or treatment is warranted.

Empirical Health is not affiliated with Peter Attia. Peter Attia does not own any stock in Empirical Health.