Biomarker Baseline Protocol
Peter Attia's Biomarker Baseline tests what actually predicts cardiovascular and metabolic disease early. It centers on ApoB and Lp(a) once, plus fasting insulin, an oral glucose tolerance test and HbA1c, since ApoB better predicts atherosclerosis than LDL-C alone and Lp(a) is genetic and can reshape your whole strategy. Attia targets optimal, not merely normal, ranges, acted on with a physician.
From Outlive and The Drive, Attia builds a baseline around the markers he weights most: ApoB and Lp(a) for cardiovascular risk, plus early metabolic markers (fasting insulin, an oral glucose tolerance test with insulin, and HbA1c) that move years before a standard glucose test flags anything. The core idea is optimal versus normal: lab reference ranges include many unhealthy people, so Attia targets tighter numbers and acts on them with a physician.
Why it worksâ–¼
Test Lp(a) one time
About 1 in 5 people carry elevated Lp(a); you cannot change it with lifestyle, but knowing it changes your strategy.
Track ApoB
Particle number, not just LDL-C, drives heart-disease risk.
Fasting insulin plus glucose (HOMA-IR)
Insulin resistance shows up years before HbA1c rises.
Oral glucose tolerance test with insulin
The most sensitive early window into metabolic dysfunction.
HbA1c
A longer-term average of blood glucose.
Wear a CGM for 2 to 4 weeks
Turns abstract numbers into behaviour you can change.
Round out the panel
Connects metabolic health to energy, cognition and body composition.
Test VO2 max and get a DEXA scan
VO2 max is a top mortality predictor; body composition and bone matter as much as bloodwork.
Re-test and adjust with a physician
Data only helps if you act on it and re-measure.
- Anyone who wants a real baseline instead of normal labs
- People with a family history of heart disease (Lp(a))
- Data-driven people who will act on the numbers
- Attia is diagnostics-first and sells no supplement line; the few supplements he personally uses (omega-3, vitamin D, magnesium) he sources from Momentous and AG1. The equipment and lab tests here are generic recommendations ordered through a physician or lab, not his products
- This is education based on Attia's published work, not medical advice or a prescription; interpret and act on results with a licensed physician
- ApoB targets and any lipid-lowering therapy (statins, ezetimibe, PCSK9 inhibitors) are physician decisions; no drug doses are given here and no medications are sold
- Some tests (OGTT, VO2 max, DEXA) are done at a clinic or lab
- Reference ranges vary by lab; optimal targets are stricter than standard cutoffs and should be discussed with your doctor
- July 3, 2026 Protocol published.
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Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol.ai is an independent platform. This protocol is based on the publicly available work of Peter Attia and is not created, reviewed, endorsed by, or affiliated with Peter Attia or Early Medical.