Key Takeaways
- Standard Malaysian health screenings miss most longevity-relevant markers. You need to request specific tests.
- The essential longevity panel includes: hsCRP, HbA1c, fasting insulin, ApoB, homocysteine, vitamin D, DHEA-S, and more.
- "Normal" ranges ≠ "optimal" ranges. Lab reference ranges are based on the general population — including sick people. Optimal ranges for longevity are much tighter.
- Cost: RM 500–2,000 for a comprehensive panel depending on where you go.
- Test every 6–12 months. Track trends, not single snapshots.
Disclaimer: This guide is educational. Interpret blood results with a qualified healthcare professional.
Why Standard Health Screenings Fall Short
Every year, millions of Malaysians do their annual health screening at Pathlab, BP Lab, or their corporate wellness checkup. They get a sheet showing their cholesterol, blood sugar, liver and kidney function, and a thumbs up or thumbs down.
The problem: these screenings are designed to detect disease, not optimise health. By the time a standard screening flags an issue, you're often already in the disease range — not the "pre-disease" or "sub-optimal" range where early intervention is most powerful.
A longevity-focused blood panel goes deeper. It measures markers that predict disease 10–20 years before symptoms appear, and uses optimal ranges rather than "normal" (population average) ranges.
The Essential Longevity Blood Panel
Metabolic Markers
| Test | What It Measures | Normal Range | Optimal Range | Why It Matters |
|---|---|---|---|---|
| HbA1c | 3-month average blood sugar | < 5.7% | < 5.2% | Best marker for metabolic health & diabetes risk |
| Fasting Insulin | Insulin resistance | 2–25 mIU/L | 2–6 mIU/L | Elevated insulin drives aging, cancer, heart disease. Most important marker NOT on standard panels. |
| Fasting Glucose | Blood sugar | 3.9–6.1 mmol/L | 4.0–5.0 mmol/L | Basic but important. Combine with insulin for HOMA-IR calculation. |
| HOMA-IR | Insulin resistance score | < 2.5 | < 1.0 | Calculated: (fasting glucose × fasting insulin) / 22.5 |
Why fasting insulin is the most underrated test: Peter Attia calls fasting insulin "the most important blood test that nobody orders." You can have a "normal" fasting glucose while your insulin is sky-high — your pancreas is working overtime to keep glucose in range. By the time glucose rises, insulin resistance has been building for years. Catch it early with fasting insulin.
Cardiovascular & Inflammation Markers
| Test | What It Measures | Normal Range | Optimal Range | Why It Matters |
|---|---|---|---|---|
| ApoB | Atherogenic particle count | < 130 mg/dL | < 60 mg/dL | Better predictor of heart disease than LDL cholesterol. Peter Attia considers it the #1 modifiable cardiovascular risk factor. |
| hsCRP | Systemic inflammation | < 3.0 mg/L | < 0.5 mg/L | Chronic inflammation accelerates every aging pathway. Track this religiously. |
| Homocysteine | Methylation & cardiovascular risk | 5–15 µmol/L | < 8 µmol/L | Elevated homocysteine indicates poor methylation and increased stroke/heart disease risk. Often correctable with B vitamins. |
| Lp(a) | Genetic cardiovascular risk | Varies | < 30 nmol/L | Genetically determined. If high, indicates elevated CVD risk requiring aggressive ApoB lowering. |
| Lipid Panel | Total cholesterol, LDL, HDL, triglycerides | Various | TG < 1.0 mmol/L, HDL > 1.5 | Standard but important. Low triglycerides and high HDL indicate metabolic health. |
Hormonal Markers
| Test | What It Measures | Optimal Range | Why It Matters |
|---|---|---|---|
| DHEA-S | "Youth hormone" precursor | Age-dependent; aim for upper quartile | DHEA-S is the most abundant steroid hormone and declines steeply with age. Low levels correlate with frailty and cognitive decline. |
| IGF-1 | Growth hormone activity | 115–300 ng/mL (age-dependent) | Complex — too high may accelerate cancer, too low indicates sarcopenia risk. Aim for midrange. |
| Thyroid (TSH, Free T3, Free T4) | Metabolic rate, energy | TSH 0.4–4.0 mIU/L | TSH 1.0–2.0; adequate Free T3 |
| Testosterone (men) | Male hormonal health | 8.4–28.7 nmol/L | Upper half of range for age |
| Estradiol (women) | Female hormonal health | Phase-dependent | Context-dependent |
Nutrient & Organ Function Markers
| Test | Optimal Range | Notes |
|---|---|---|
| Vitamin D (25-OH) | 40–60 ng/mL (100–150 nmol/L) | 40–70% of Malaysians are deficient despite tropical sun. Test and supplement accordingly. |
| Vitamin B12 | > 500 pg/mL | Important for methylation, nerve function. Vegetarians and older adults at higher risk of deficiency. |
| Ferritin | 40–100 ng/mL (men); 30–80 (women) | Iron storage. Too low = fatigue. Too high = oxidative damage and organ damage (hemochromatosis). |
| Liver panel (ALT, AST, GGT) | ALT < 20; GGT < 20 | Standard ranges go up to 40–55 — but optimal is much lower. Elevated GGT is an early marker of fatty liver and metabolic dysfunction. |
| Kidney (Creatinine, eGFR, Cystatin C) | eGFR > 90; Cystatin C normal for age | Cystatin C is a more accurate kidney function marker than creatinine, especially in muscular people. |
| CBC (Full Blood Count) | All within range | Screens for anaemia, infection, blood disorders. Essential baseline. |
The Complete Panel — Shopping List
Print this list or screenshot it. Bring it to your lab or doctor:
- Full Blood Count (CBC)
- Fasting Glucose
- HbA1c
- Fasting Insulin (often NOT included in standard panels — ask specifically)
- Lipid Panel (Total Cholesterol, LDL, HDL, Triglycerides)
- ApoB (may need to request separately)
- Lp(a) (one-time test — genetically determined, doesn't change much)
- hsCRP
- Homocysteine
- Liver Panel (ALT, AST, GGT, ALP, Bilirubin)
- Kidney Panel (Creatinine, eGFR, Urea)
- Cystatin C (if available)
- Thyroid Panel (TSH, Free T3, Free T4)
- Vitamin D (25-OH)
- Vitamin B12
- Ferritin
- DHEA-S
- IGF-1
- Uric Acid
- Testosterone (men) / Estradiol (women)
Where to Get Tested in Malaysia
Option 1: Pathlab / BP Healthcare Lab
Malaysia's largest private lab chains. Walk-in available, no doctor's referral needed for most tests.
- Pros: Convenient (hundreds of locations), affordable, quick results (1–3 days)
- Cons: Standard packages miss longevity markers. You'll need to request individual add-on tests, which increases cost.
- Cost for full longevity panel: RM 600–1,200 (depending on add-ons)
- Tip: Start with their "Executive" or "Comprehensive" package, then add fasting insulin, ApoB, homocysteine, DHEA-S, and IGF-1 individually.
Option 2: Hospital Labs (Private Hospitals)
Pantai, Gleneagles, Sunway Medical, Prince Court — all major private hospitals have in-house labs.
- Pros: Doctor consultation included, can test virtually anything, comprehensive reports
- Cons: Most expensive option; you're paying for the hospital markup and doctor's consultation fee
- Cost: RM 1,000–2,500 for comprehensive longevity panel + consultation
- Best for: People who want results interpreted by a doctor in the same visit
Option 3: Functional Medicine / Longevity Clinics
A growing number of functional medicine practitioners in KL offer longevity-focused blood panels. They already know which markers to test and how to interpret optimal (not just normal) ranges.
- Pros: They "get it" — no need to explain why you want fasting insulin or ApoB
- Cons: Premium pricing; limited availability
- Cost: RM 800–2,000 (panel + interpretation)
Option 4: Government Hospital Labs
The cheapest option, but limited test menu and long wait times. Most longevity-specific markers (DHEA-S, IGF-1, ApoB) are not routinely available in government labs.
- Cost: RM 50–200 for basic panel
- Best for: Budget-constrained screening. Get basics here, add specialized markers at Pathlab.
Cost Breakdown (Estimated, 2026)
| Test | Pathlab (RM) | Private Hospital (RM) | Notes |
|---|---|---|---|
| CBC | 25–35 | 40–60 | Included in most packages |
| Fasting Glucose | 10–15 | 20–30 | Included in most packages |
| HbA1c | 35–50 | 50–80 | Often in diabetes packages |
| Fasting Insulin | 50–80 | 80–120 | ADD-ON — rarely in standard panels |
| Lipid Panel | 30–50 | 50–80 | Standard |
| ApoB | 60–100 | 100–150 | ADD-ON — request specifically |
| Lp(a) | 80–120 | 120–180 | One-time test |
| hsCRP | 30–50 | 50–80 | Specify HIGH-SENSITIVITY CRP, not regular CRP |
| Homocysteine | 60–100 | 100–150 | ADD-ON |
| Liver Panel | 30–50 | 50–80 | Standard |
| Kidney Panel | 25–40 | 40–70 | Standard |
| Thyroid (TSH, FT3, FT4) | 60–100 | 100–150 | Full panel recommended over TSH alone |
| Vitamin D | 60–90 | 80–120 | Essential for all Malaysians |
| Vitamin B12 | 50–80 | 70–100 | |
| Ferritin | 30–50 | 50–80 | |
| DHEA-S | 70–120 | 100–150 | ADD-ON — rarely in standard panels |
| IGF-1 | 80–130 | 120–180 | ADD-ON |
| Estimated Total | RM 700–1,200 | RM 1,200–2,000 |
Optimal vs "Normal": Why the Difference Matters
Lab reference ranges are derived from the general population — a population where 50% are overweight, 18% have diabetes, and many have undiagnosed metabolic dysfunction. Being "normal" means you're average. Average in Malaysia means metabolically unhealthy.
Let's look at a concrete example:
Fasting Glucose: "Normal" vs Optimal
- Lab "normal" range: 3.9–6.1 mmol/L (70–110 mg/dL)
- Longevity optimal: 4.0–5.0 mmol/L (72–90 mg/dL)
- A fasting glucose of 5.8 mmol/L is "normal" by lab standards but is actually pre-diabetic territory. A longevity-focused doctor would intervene here.
ALT (Liver Enzyme): "Normal" vs Optimal
- Lab "normal" range: Up to 40–55 U/L
- Longevity optimal: < 20 U/L
- An ALT of 35 U/L is "normal" but strongly suggests fatty liver — the most common liver disease in Malaysia affecting ~30% of adults.
This is why having a doctor or practitioner who understands optimal ranges (not just disease ranges) is invaluable.
How Often to Test
| Frequency | Tests |
|---|---|
| Every 6 months | Fasting insulin, glucose, HbA1c, lipid panel, hsCRP, liver panel |
| Annually | Full longevity panel (all markers) |
| Once (then as needed) | Lp(a), G6PD status |
| As needed | After starting new supplements/medications (3-month recheck) |
How to Use Your Results
- Track trends over time — a single snapshot tells you less than the direction of change. Create a spreadsheet or use an app to log results.
- Prioritize metabolic markers — fasting insulin, HbA1c, triglycerides. These predict the most disease risk and are the most modifiable.
- Address deficiencies first — low vitamin D, B12, or ferritin are easy wins with supplementation.
- Use results to guide supplementation — don't take anti-aging supplements blindly. Let your blood work tell you what you need.
- Combine with other assessments — biological age testing provides complementary data.
Pro Tips for Malaysian Blood Testing
- Fast for 12–14 hours before morning blood draw (water is fine). This ensures accurate fasting insulin and glucose.
- Morning draw (before 10am) — cortisol and some hormones are time-sensitive.
- Avoid intense exercise 24 hours before — heavy training transiently elevates liver enzymes and inflammatory markers.
- Specify "hsCRP" not "CRP" — regular CRP has a detection range for acute infection (0–200+ mg/L). High-sensitivity CRP measures the low-grade chronic inflammation relevant to aging (0–10 mg/L range with optimal < 0.5).
- Ask for actual numbers — some labs only report "normal/abnormal." You need the numerical values to track trends and compare against optimal ranges.
- Keep copies — request digital PDF results. Build your own longitudinal health database.
Bottom Line
Blood work is the foundation of any serious longevity protocol. You can't optimise what you can't measure. A comprehensive longevity panel costs RM 700–2,000 depending on where you go — a fraction of what most people spend on supplements or IV drips that they may not even need.
Get tested. Know your numbers. Optimise from data, not guesswork.
This article is for informational purposes only and does not constitute medical advice. Always discuss blood test results with a qualified healthcare professional.