Quantified Self for Longevity: The Ultimate Guide

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We’ve spent the last several months writing tons of in-depth articles on the importance of measuring your body—what’s called quantified self—for longevity.

This is because before you start taking those anti-aging pills, or sign up for experimental gene therapy, or embark on a complicated life extension regimen of saunas and broccoli sprout shakes, you need an in-depth understanding of your current health and the state of your body.

Not only must you know your baseline to see if your interventions are actually working, but to protect you from possibly harmful anti-aging interventions.

For instance, did you know taking an NAD+ booster like NMN or NR might actually be harmful, and not helpful for you if you have cancer?

While improving blood flow and increasing the body’s ability to create new blood vessels would normally be a good thing (and can protect against cancer if you don’t already have it), it’s a terrible thing to improve blood and nutrient flow to already-existing tumors and help them grow faster.

Just because a longevity therapy is good in general, does not mean that, at this exact point in time, it is good for you in particular.

And that’s where self-measurement and the quantified self for longevity come in.

A whole host of previously out-of-reach medical diagnostic techniques and technologies are now very much in the realm of affordability for the individual spanner/biohacker. A full genome sequencing that cost as much as $500 million in 2003 can now be had for under $300 today.

But between blood tests, biopsies, urine samples, medical “wearables” and continuous glucose monitors, genetic sequencing tests, and epigenetic age tests—to name but a few diagnostic options—how can you possibly decide what to do and, worse, how to interpret the results?

That’s where we’re hoping this self-measurement guide for life extension will help you.

We’ve taken all our research and lessons from the quantified self articles of the last few months and distilled them here into a single guide to give you the basics of self-measurement all at-a-glance, without having to wade through dozens of individual articles.

For each diagnostic tool we mention, we also give some detail on how and where to get it, how often and in what way to administer it, and how to interpret the results.

We’ve also added a brief outline of an example self-measurement regimen that we think will give you a pretty good idea of how to actually implement this self-tracking at a day-to-day and month-to-month level.

So, where to start?

1. Genetic testing

A genetic test is a foundational building-block for understanding your body because it is a test that reveals the actual building blocks of your body. The As, Ts, Gs, and Cs that make up the DNA of your genetic code determine a lot about your health; from your susceptibility to certain diseases, to your level of responsiveness to different health interventions and, maybe, even your ideal diet.

There are three key benefits of genetic testing for your self-measurement regimen. They are:

1. Disease prevention: Knowing you may have a higher risk for certain diseases, like specific cancers or heart disease, can not only help you decide what lifestyle interventions to prioritize, but can also inform your self-measurement strategy itself. For instance, if you learn you possess a BRCA1/BRCA2 gene variant that increases your risk of certain breast and pancreatic cancers you may decide to start regular mammogram or MRI screening earlier in life.
2. Better-tailored longevity interventions: Genetics impact the metabolism of drugs and other interventions differently in different people. If you have a rare genetic variant that causes aspirin to induce inflammation in your airways, then aspirin has gone from a possible longevity drug to a dangerous trigger for respiratory disease for you.
3. Identifying existing health issues: If you currently suffer from maladies you don’t yet know the cause of, a genetic test may help you find out the reason for your illness. Certain genetic variants can lead to vitamin deficiencies, hormone imbalances, and more.

There are two main types of genetic tests: genotyping tests, which look at the most well-known areas of the genome and cover about 0.01% of the total, and whole-genome sequencing tests, which cover the whole genome but cost a bit more and give you a lot of information we don’t yet know what to do with.

Both tests require a simple saliva sample from a mail-in kit and most are in the $100-$400 range. You only ever need to take a genetic test once in your lifetime.

Here are seven top DNA tests we’ve looked at for longevity:

1. Dante Labs (Best for depth)

• Coverage: 30x whole genome (with 130x of select areas in certain tests)
• Cost: $599-$1,490
• Speed: 2-8 weeks not counting shipping (though with possible large delays)
• Raw DNA data provided? Yes, as as gVCF and BAM files
• After-test support: Yes, with research referenced

2. Full Genomes

• Coverage: 15x-30x whole genome
• Cost: $645-$1,150
• Speed: 8-10 weeks
• Raw DNA data provided? Yes, as VCF, FASTQ, and BAM files
• After-test support: No

3. Nebula Genomics (Best for privacy) (Best for cost)

• Coverage: 30x-100x whole genome
• Cost: $299-$999, plus $9.99-$19.99 per month for access to educational database (or lifetime access for $300)
• Speed: 8-10 weeks
• Raw DNA data provided? Yes, as FASTQ, BAM, and VCF files
• After-test support: Yes, with research referenced

4. Sequencing.com (Best for breadth of reports)

• Coverage: 30x whole genome
• Cost: $399
• Speed: 8-10 weeks
• Raw DNA data provided? Yes, as Paired FASTQ, BAM, VCF, and TXT files
• After-test support: Yes

5. 23andMe (Best for third-party analysis)

• Coverage: ~600,000 locations (~0.01% of genome)
• Cost: $99-$399
• Speed: 4-6 weeks
• Raw DNA data provided? Yes, as a tab-delimited TXT file
• After-test support: Yes, including 1-on-1 results walkthroughs with 23andMe employees

6. AncestryDNA

• Coverage: ~700,000 locations (~0.01% of genome)
• Cost: $119-$179
• Speed: 6-8 weeks
• Raw DNA data provided? Yes, as a TXT file
• After-test support: Yes, including access to a PWNHealth genetic counselor through direct messages

7. SelfDecode

• Coverage: ~700,000 locations (~0.01% of genome)
• Cost: $187-$387, requires annual subscription of $97
• Speed: 6-8 weeks
• Raw DNA data provided? Yes, as a TXT file
• After-test support: Yes

Additionally, you can use the raw genetic information you get from almost any of the above companies and upload it to further third-party DNA analysis websites to get some more insight into your health and disease risks.

Some of these third party genetic analysis tools include:

1. FoundMyFitness Genetic Reports
2. Genetic Genie
3. Promethease
4. Xcode Life
5. Nebula Genomics (yup, they also take third-party data uploads)
6. SelfDecode (yup, they also take third-party data uploads)
7. Sequencing.com (yup, they also also take third-party data uploads)

2. Blood testing

Blood tests are one of the most common ways to get an understanding of what is going on “under the hood” of your body. It’s why your doctor orders one (or more) every year for your annual physical, and it’s also often the first type of test that will be ordered to diagnose any illnesses or diseases you may be suspected of having. 

This is because blood goes all over the body and has tons of different cells, enzymes, proteins, and other cellular detritus floating around in there, so you can often see problems as they’re happening from many different parts of the body. Plus a simple needle prick is much safer and less painful than more invasive methods like biopsies, and cheaper than tests like whole-body MRIs.

But there are a bajillion different biomarkers you can get tested in your blood, and many of them may not have an impact on your longevity.

Below are the few tests that seem to get you the most bang-for-your-buck in terms of tracking longevity and aging biomarkers, and the specific biomarkers they test, plus how often to consider getting these tests.

Most of these tests can be ordered through your doctor or online through an affordable lab website like Walk-In-Lab, LetsGetChecked, EverlyWell, Personalabs, or Lab Me.

Complete blood count test (CBC) with differential (4-6 times a year)

The standard blood test you get at your annual doctor’s visit. This is important as well if you want to calculate your biological age using Morgan Levine’s phenotypic age calculator.

Key biomarkers tracked:

• Fasting glucose
• Serum albumin levels
• Serum creatinine
• Lymphocyte percent
• Mean red cell volume (MCV)
• Red cell distribution width (RDW) percentage
• Alkaline phosphatase (ALP)
• White blood cell count
• Vitamin D levels

Nuclear magnetic resonance (NMR) lipid profile test (4-6 times a year)

This will get all your standard lipid panel stuff, plus the more accurate advanced stuff like LDL-P.

Key biomarkers tracked:

• LDL-P
• Ratio of triglyceride to HDL cholesterol

High sensitivity C-reactive protein test (hs-CRP) (4-6 times a year)

For inflammation and to use in Morgan Levine’s phenotypic age calculator.

Key biomarkers tracked:

• C-reactive protein (CRP)

Comprehensive metabolic panel (CMP) with ALT and AST (4-6 times a year)

For liver function.

Key biomarkers tracked:

• Alanine aminotransferase (ALT)

Insulin-like growth factor (IGF-1) blood test (2-4 times a year)

For understanding dietary changes.

Key biomarkers tracked:

• Insulin-like growth factor (IGF-1)

DUTCH test (2-4 times a year)

This a urine test, not a blood test, but didn’t fit anywhere else. It’s the gold standard for measuring hormone levels.

Key biomarkers tracked:

• Hormone levels of testosterone and estradiol

Of course, if you don’t want to do your own test scheduling and tracking there are several life-extension blood test companies that will do it for you, including:

1. InsideTracker

• Cost: $49-$589
• Number of aging biomarkers tracked: 7-43
• Sample/test type: Any Labcorp location, option for an at-home blood draw for an additional $96 

2. Jinfiniti

• Cost: $598
• Number of aging biomarkers tracked: 13
• Sample/test type: Home blood collection test kit

3. Lab Test Analyzer by SelfDecode

• Cost: $97 annually or $297 lifetime (plus the cost of any third-party blood tests)
• Number of aging biomarkers tracked: 800+
• Sample/test type: Any other third party test

4. Life Extension

• Cost: $35-$575
• Number of aging biomarkers tracked: 250+
• Sample/test type: Any Labcorp location

5. WellnessFX

• Cost: $78-$925
• Number of aging biomarkers tracked: 25-87 depending on package
• Sample/test type: Any Quest Diagnostics location

But of course, there are totally free ways to measure your own health as well.

3. Self-health testing

Beyond some obvious self-health checks like taking your own temperature, or using a scale to track your weight, or checking for (and reporting to your doctor) visible abnormalities like blood in your urine or stool, there are several tests you can do at home with zero or minimal equipment to track your health.

Five of these test for your general health and vitality and can be thought of as a proxy for cardiovascular fitness, flexibility, and bone and joint health. We’ve covered these in detail in a downloadable guide, but the basics are:

1. Resting heart rate (RHR): Find your radial artery on your wrist, just below the thumb, or your carotid artery in your neck, just below your jaw, and to the side of your windpipe. Place your index and middle fingers together over the artery (don’t use your thumb as it has its own artery that can screw up your count) so that you can feel your pulse. Start a stopwatch and count the number of beats you feel in a 15 second period and then multiply by four to get your RHR. 40-80 beats per minute seems in the ideal range, with lower being healthier.
2. Walking speed: Find a stretch of flat ground and time yourself walking as fast as you safely can for 10 meters. A gait speed faster than 1.0 m/s suggests better than average life expectancy and above 1.2 m/s suggests exceptional life expectancy.
3. Push-ups: Do as many good-form push-ups in one minute as you can. According to the study, “Participants able to complete more than 40 push-ups had a 96% reduction in incident [cardiovascular disease] events compared with those completing fewer than 10 push-ups.”
4. Sitting-Rising Test (SRT): Try to sit down and then rise again from the floor without using your hands, arms, or knees to assist you and without losing your balance (it looks like this). Starting with a score of 10, subtract one point for every support (hand, arm, knee, etc.) you needed to complete the test. The original study found, “Each unit increase in SRT score conferred a 21% improvement in survival.”
5. Handgrip strength: Get a normal analog bathroom scale and hold it with both hands. Squeeze each hand at a time as hard as you possibly can and record the weight achieved. For every 5kg reduction in grip strength, the risk of all-cause mortality increases by 16% according to a 2015 study.

In addition to those five general health and fitness tests, there are four self-exams specifically for detecting cancer that you can do right now at home. They are (with links included to more in-depth instructions):

1. Breast cancer self-test: Do both a visual and physical examination (with the pads of your fingers) of your breasts, looking for any abnormal lumps, changes in size, color, or changes in the nipples.
2. Skin cancer self-test: Do a visual examination of your skin (including your scalp and under your genitals) looking for any abnormal or changed moles, discolorations, or sores.
3. Testicular cancer self-test: Do a physical examination of your testicles using your thumbs and fingers looking for any abnormal lumps or nodules, or changes in size, texture, or shape.
4. Thyroid cancer self-test: Do a physical examination with your fingers of the sides of your neck near the thyroid to feel for abnormal swelling, lumps, or sore spots. Then swallow a sip of water and do a visual examination in the mirror looking for any abnormal lumps or nodules that protrude as you swallow.

4. Menstrual cycle tracking

If you have a period, your cycle is an essential part of your overall health. And that’s regardless of if you’re actively menstruating or not—there’s never a day that you’re not at some point on your cycle. Regardless of if you’re in the follicular or luteal phase, the menstrual cycle itself can affect your bodily needs. 

For example, women have different macronutrient and energy requirements in different parts of their cycle. Women face reduced REM sleep and elevated sleeping heart rates during the mid-follicular phase. And the body’s basal temperature rises following ovulation. In other words, if you’re tracking your food intake, sleep, and daily temperature, menstrual cycle tracking is essential for context. 

Menstrual cycle tracking is also an essential barometer for female health and longevity. 

According to a study published in the Journal of Mid-Life Health, the mean age at natural menopause (ANM) is “an independent risk factor for long-term morbidity and mortality.” The authors add, “Menopause is not a central event but rather a result of primary ovarian failure secondary to apoptosis or programmed cell death.” In other words, the same biological processes that cause the molecular and cellular damage of aging and lead to Alzheimer’s, cancer, and cerebrovascular disease cause menopause itself. 

Women need to keep track of their cycle to know how it’s affecting their other systems. Other health issues can also be caught by period tracking, including ovarian cancer, PCOS, and pelvic inflammatory disease. Finally, women should track their periods to be apprised of signs of perimenopause, which can occur up to ten years before menopause itself, most often in the form of irregular or shortened periods. 

I (Rachel) tried and compared three different free period trackers (Clue vs Flo vs Glow) to help you with menstrual cycle tracking if needed. 

1. Clue

• iOS Rating: 4.8; 266,500 reviews
• Android Rating: 4.7; 1,036,702 reviews
• Paid version: $39.99 for 12 months
• Android | iOS

2. Glow Ovulation & Period Tracker

• iOS Rating: 4.7; 54700 reviews
• Android Rating: 4.6; 65,609 reviews
• Paid version: $47.99 for 12 months
• Android | iOS

3. Flo

• iOS Rating: 4.8; 678,100 reviews
• Android Rating: 4.8; 1,617,608 reviews 
• Paid version: $24.99 for 12 months
• Android | iOS

5. Fitness Wearables and Sleep Wearables

Long gone are the days when quantified self for longevity meant spreadsheets or a pen and paper, meticulously tracking weight, steps, resting heart rate, and sleep and wake times. Today, we have innumerable trackers that can automate and calculate so much more. The trackers that spanners are most interested in produce data that help the wearer into healthier lifestyle choices.

We looked at a number of wearables both for sleep and physical fitness. This is what we liked the most, arranged alphabetically. 

1. Apple Watch Series 6

• Recommended for: Lifestyle fitness, sleep with the SleepWatch app
• Battery life: Up to 18 hours
• Cost: Around $399

2. Dexcom G6

• Recommended for: Continuous Glucose Monitoring
• Battery life: Up to 90 days
• Cost: Around $370, according to GoodRx

3. Fitbit Versa 3

• Recommended for: Lifestyle fitness, sleep
• Battery life: Up to 3 days
• Cost: $229.95

4. Garmin vívosmart® 4

• Recommended for: Lifestyle fitness, sleep
• Battery life: Up to 7 days
• Cost: $129.99

5. Oura Ring

• Recommended for: Sleep
• Battery life: Up to 7 days
• Cost: $299

6. Polar H10

• Recommended for: Heart rate monitoring during exercise
• Battery life: Up to 400 hours
• Cost: $89.95

7. Polar Vantage V2

• Recommended for: Fitness for serious athletes
• Battery life: Up to 100 hours
• Cost: $499.95

8. WHOOP Strap 3.0

• Recommended for: Lifestyle fitness, sleep
• Battery life: Up to 5 days
• Cost: Starts at $30/month for the app subscription; the band itself is free

6. Strength Training and Sleep Apps

Strength training and sleep are two of the most important factors for longevity. 

Maintaining lean muscle mass is essential for living longer. The loss of skeletal muscle mass and function, known as sarcopenia, is often found in older adults, and it’s a major contributor to frailty. Strength training is an essential tool for preventing sarcopenia. For example, a study published in Preventative Medicine found that among adults older than 65, those who stuck to strength training guidelines had “46% lower odds of all-cause mortality.” 

Good sleep is also critical for human life extension. A 2017 article published in the Journal of the American Heart Association found that, regardless of the subject’s sex, sleeping outside of six to eight hours a night leads to “an increased risk of all-cause mortality and cardiovascular events.” People younger than 65 especially need to watch their sleep. Research published in the European Journal of Epidemiology shows: “The effect of short and long sleep duration on mortality was highest among young individuals and decreased with increasing age.”

Strength training and sleep are both critical for longevity, and there are a number of free strength training apps and free sleep apps that can help you quantify and track your progress. Our favorites are arranged alphabetically below. 

1. adidas Training by Runtastic

Best for: Guided workouts 

Android | iOS

2. BodBot

Best for: Workout planning

Android | iOS

3. Fitness Point

Best for: Strength training journaling

Android | iOS

4. JEFIT

Best for: Community-focused exercisers 

Android | iOS

5. Nike Training Club

Best for: Class-focused workouts

Android | iOS

6. Pillow

Best for: Sleep tracking for people who snore

iOS only

7. Sleep Cycle

Best for: DIY variable tracking to correlate with sleep 

Android | iOS

8. SleepScore

Best for: Setting and reaching sleep goals

Android | iOS

7. Gut microbiome health testing

Can your gut microbiome help you age slower? There’s a good deal of new evidence about the microbiome and longevity, and the answer is a resounding “maybe,” with promising animal studies pointing toward a potential “yes.” 

For example, when researchers swapped the gut microbiome between young and middle-aged killifish, the middle-aged killifish lived 37% longer. Animal studies have also correlated microbiome differences to Alzheimer’s, certain cancers, and immune system degeneration. While scientists aren’t entirely clear on what the ideal microbiome is for humans, let alone how to manipulate a human microbiome in the long-term, it may hold a key to living much, much longer. 

There are two major gut microbiome testing companies that we selected for those looking to track their gut microbiome:

1. Psomagen

• Price: $129

2. Viome

• Price: $149

8. Cancer testing

Aside from the four (very easy and very important) cancer self-exams described above in section three, and genetic testing to check for your hereditary risk for certain cancers, there are many more advanced methods to test for cancer in your body, even if you don’t have symptoms.

Based on prevalence and death rates for different cancer types, the screening methods that may make sense to add to your regular regimen include:

1. Whole-body magnetic resonance imaging (MRI)
   1. Cancers it detects: Breast, lung, (possibly) pancreatic, colorectal, multiple myeloma
   2. Type of test: Magnetic resonance scan (no radiation)
2.  Low-dose computed tomography (CT) scan
   1. Cancers it detects: Lung and bronchus, colorectal, (possibly) pancreatic, multiple myeloma
   2. Type of test: X-ray
3. At-home colon cancer test kit
   1. Cancers it detects: Colorectal
   2. Type of test: Fecal immunochemical test (FIT)
4. Prostate-specific antigen (PSA) blood test
   1. Cancers it detects: Prostate
   2. Type of test: Blood test
5. Mammogram
   1. Cancers it detects: Breast
   2. Type of test: X-ray

For much more about each of these tests check out our full write-up on how to detect cancer early.

9. Epigenetic age clocks 

Life extension is about aging on the molecular level, so it’s up to spanners to figure out how to quantify their biological age. As you age, epigenetic changes accumulate in your body, creating markers, like rings on a tree, that inscribe your age onto your DNA. After analyzing hundreds of these markers, Dr. Steve Horvath published his first biological “clock” in 2011. If you’re 60 and his clock finds that you’re 65, you are aging quicker than other 60-year-olds. If your test says that you’re, instead, 55, other 60-year-olds are aging faster than you. 

There are now several commercial epigenetic age tests that are available for interested spanners. The below options are arranged alphabetically. 

1. Elysium Index

• Price: $499 

2. EpiAging USA

• Price: $169

3. Muhdo

• Price: $249.99

4. myDNAge

• Price: $299

5. TruDiagnostic TruAge

• Price: $399

6. TruMeTruAge Explorer

• Price: $99

An example testing schedule

With ALL the above tests and tracking methods, this quantified self thing can be pretty overwhelming (I know it is for us). So to try and make self-tracking as approachable as possible, we’ve created a simple calendar that plops all the important tests automatically into your schedule, including frequency. 

You can get the calendar here: https://calendar.google.com/calendar/u/0?cid=a2thNWUxcmJjN2xmNm1vZjB0aDhsbDBwNmtAZ3JvdXAuY2FsZW5kYXIuZ29vZ2xlLmNvbQ

Or view it here if you don’t have Gmail: https://calendar.google.com/calendar/embed?src=kka5e1rbc7lf6mof0th8ll0p6k%40group.calendar.google.com&ctz=America%2FCreston

Feel free to make a copy and adjust the dates to your specific needs (as not everyone gets their annual physical in January, for instance) and let us know if resources like this are helpful!