Comprehensive Biomarker Panel

Optimal. Not normal.

A reference range describes the middle of a population that includes people who are getting sick. It is a description of average, not a definition of healthy. We measure against optimal ranges instead — and we measure things a routine physical does not, starting with ApoB, the protein on every atherogenic lipid particle and a more accurate picture of cardiovascular risk than LDL alone.

Core Panel • one blood draw

Hormones • LC-MS/MS

Every Pane • MD-reviewed

Why We Measure It

A reference range is not a target.

Being inside the range means you resemble most of the people who had that test. It does not mean the number is where you want it.

Reference ranges are built by measuring a population and taking the middle of it. That population includes people with early insulin resistance, early kidney decline and untreated lipid risk, because most of them do not know yet. A number can sit comfortably inside the range and still be heading somewhere you would want to intervene.

The panel also matters as much as the ranges. Fasting insulin will show insulin resistance years before HbA1c moves — but a standard physical rarely measures it. Lp(a) is largely genetically determined and only needs measuring once in your life, which makes never measuring it a strange default. ApoB counts the particles that actually deposit cholesterol in an artery wall, where a standard lipid panel measures the cholesterol they are carrying.

That is the argument for a comprehensive panel: not more numbers for their own sake, but the specific numbers that move earliest.

The Panel

One draw. Four layers.

Layer 01

Core Panel

Included as standard with every comprehensive panel.

CBC with differential and platelets
Comprehensive metabolic panel (14)
Lipid panel
Apolipoprotein B
Lipoprotein (a)
C-reactive protein, cardiac
Homocysteine
Hemoglobin A1c
Fasting insulin
Uric acid

TSH and free T4
Vitamin D, 25-hydroxy
Vitamin B12 and folate
Iron and TIBC
Ferritin
Cortisol
Magnesium
Phosphorus
Lipase

Layer 02

Hormones

Included as standard. Panel differs by sex.

Male panel

Testosterone, free and total (LC-MS/MS)
Estradiol (LC-MS/MS)
FSH and LH
DHEA-sulfate
Sex hormone binding globulin
PSA total, reflex to free

Female panel

Hormones are measured by LC-MS/MS where available — the reference method. Many clinics use immunoassays, which can misrepresent testosterone and estradiol.

Layer 03

Advanced Add-Ons

Optional, on physician recommendation. Priced individually — from $8.

Layer 04

Advanced Longevity Testing

By physician consultation.

These go deeper into cancer risk and genetic predisposition, and are added on physician recommendation rather than offered off the shelf.

The Draw

One draw. Then we read it.

The whole core panel, including hormones, comes from a single blood draw in our Meridian office. It takes a few minutes.

How to prepare

Come in fasted. Water is fine; nothing else for the hours beforehand.

Turnaround

Results are back within [X] days. We contact you to review them.

Interpretation

Every panel is read by a physician.

A hundred values with no interpretation is not information. It is a spreadsheet.

Dr. Lyall reads every panel. What comes out of that is not a list of flagged values — it is a small number of decisions: which markers are trending in the wrong direction and how fast, which of them share a root cause, what to intervene on now, and what to watch at the next draw. A value inside the reference range still gets discussed if it is moving.

Results are read across the Peak Longevity Six rather than in isolation. Lipids and ApoB inform Cardiovascular. Fasting insulin and A1c inform Metabolic. The hormone panel informs Hormones. PSA and the advanced stool and genomic options inform Cancer Detection. Where two systems disagree, that is usually the most useful thing on the panel.

Cadence

Comprehensive panels are repeated twice a year, with follow-up labs in between where a result calls for it.

Pricing

Priced plainly.

Comprehensive biomarker panel

Pending

Comprehensive panel upgrade

$450

Add-ons, priced individually

from $8

The comprehensive panel is included in Peak Longevity and Peak Elite, twice a year, with follow-up labs where a result calls for them. Peak Foundations includes a targeted panel rather than the full one. Most patients use FSA or HSA funds.

Draws are done in our Meridian office, and patients come from across Boise, Meridian and Eagle. No referral is required.

Begin

You have probably been told your labs are normal. This is how you find out whether they are good.

The information on this page is for educational purposes and is not medical advice. Testing and treatment decisions are made by a physician in the context of your individual history.