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 I do first”? Generally, Outlive’s approach to healthspan involves starting with a detailed set of lab tests (mostly blood tests).
This “cheat sheet” outlines the specific lab tests recommended by Peter Attia in Outlive.
Since Outlive was publihsed in 2022, there are some cases where guidance from medical socities has changed (for example, The American College of Cardiology now recommends inflammation testing for everyone, via hs-CRP) or where Peter has revised his own opinion (for example, on measuring cholesterol particles). The notes and alternative column has the details for each lab test/blood test/biomarker.
The majority of lab testing recommended by Peter Attia is through a blood draw, with some imaging and specialized testing like VO2Max
Lab tests recommended in Outlive
| Category | Test | Notes or alternatives |
|---|---|---|
| Heart health | ApoB | More accurate than LDL |
| Heart health | Lp(a) | Strongest hereditary risk factor for heart disesae |
| Heart health | LDL | |
| Heart health | HDL | |
| Heart health | Triglycerides | |
| Heart health | Triglyc:HDL | |
| Heart health | Non-HDL cholesterol | |
| Heart health | Blood pressure | Measured with a cuff |
| Heart health | ApoE-E4 Gene | Correlates with Alzheimer’s risk; consider first lowering ApoB since it has been shown to reduce risk of dimentia |
| 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 | Measure hs-CRP instead (2025) |
| Inflammation | CRP | Measure hs-CRP instead (2025) |
| Other | Uric Acid | |
| Other | Testosterone (male) | Tread carefully: testosterone supplementation may increase heart disease risk. |
| Imaging / Other tests | VO2 Max | VO2Max 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. |
Are the 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 of the lab tests in Outlive are blood tests?
Most of the labs 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 speciialized tests, such as VO2Max — VO2Max testing is often done in a lab while wearing a mask, but wearables like Apple Watch can estimate VO2Max. Some of these tests, like DEXA, are imaging. And some tests also involve
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.
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