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Blood biomarkers

One draw. A hundred answers.

Twelve body systems, read against your own history by a physician.

markers across twelve systems
100+markers across twelve systems
clinical risk scores calculated
4clinical risk scores calculated
in the chair, once
20 minin the chair, once
The panel

Twelve systems. Every marker named.

Not a summary of what we might run. This is the panel, listed in full, so you can check it against whatever you were offered elsewhere.

  1. Heart & lipids

    11 markers

    The particles and ratios that decide cardiovascular risk decades before symptoms.

    • Total Cholesterol
    • Triglycerides
    • HDL-C
    • LDL-C
    • Apolipoprotein B
    • Lipoprotein(a)
    • Chol / HDL ƒ
    • LDL / HDL ƒ
    • TG / HDL ƒ
    • Non-HDL Chol ƒ
    • Non-HDL / HDL ƒ

  2. Metabolic & blood sugar

    8 markers

    The earliest readable signs of metabolic drift - often years ahead of a diabetes diagnosis.

    • Fasting Glucose
    • HbA1c
    • Est. Avg Glucose ƒ
    • Fasting Insulin
    • Uric Acid
    • HOMA-IR ƒ
    • Glucose / Insulin ƒ
    • TyG ƒ

  3. Inflammation & immune

    25 markers

    A full blood count plus the ratios that turn it into a read on silent, ageing-accelerating inflammation.

    • White Blood Cells
    • Red Blood Cells
    • Haemoglobin
    • Haematocrit
    • MCV
    • MCH
    • MCHC
    • RDW
    • Neutrophils %/#
    • Lymphocytes %/#
    • Monocytes %/#
    • Eosinophils %/#
    • Basophils %/#
    • Platelets
    • MPV
    • NLR ƒ
    • PLR ƒ
    • LMR ƒ
    • SII ƒ
    • hs-CRP

  4. Liver

    10 markers

    Enzymes, proteins and a fibrosis index - the liver’s stress, often the first to register lifestyle load.

    • AST
    • ALT
    • ALP
    • Total Bilirubin
    • Total Protein
    • Albumin
    • Globulin
    • Albumin / Globulin ƒ
    • AST / ALT ƒ
    • FIB-4 Index ƒ

  5. Kidney

    7 markers

    Filtration measured two ways, because kidney decline is silent until late - a clean baseline is worth a lot.

    • Creatinine
    • Blood Urea Nitrogen
    • eGFR ƒ
    • Cystatin C
    • Albumin / Creatinine ƒ
    • BUN / Creatinine ƒ
    • Uric Acid / Creatinine ƒ

  6. Electrolytes & minerals

    6 markers

    The salts and minerals that keep nerves firing, muscles working and acid-base balance steady.

    • Sodium
    • Potassium
    • Chloride
    • Total CO₂
    • Anion Gap ƒ
    • Calcium

  7. Thyroid

    2 + add-ons

    The axis that sets your whole metabolic tempo - energy, weight and mood when nothing else explains them.

    • TSH
    • Free T4
    • Free T3 · add-on
    • Anti-TPO · add-on

  8. Hormones

    1 + add-ons

    Testosterone on every panel, with a deeper hormone work-up reflexed when your results or intake call for it.

    • Total Testosterone
    • SHBG · add-on
    • Free Testosterone · add-on
    • Bioavailable T · add-on
    • Estradiol · add-on
    • Progesterone · add-on
    • FSH · add-on
    • LH · add-on

  9. Vitamins & nutrients

    3 + reflex

    The deficiencies behind fatigue, low mood and poor recovery - common, cheap to fix, easy to miss.

    • Vitamin D (25-OH)
    • Vitamin B12
    • Ferritin
    • Serum Iron · reflex
    • TIBC · reflex
    • Transferrin Sat · reflex

  10. Urinalysis

    15 markers

    A non-invasive window on kidneys, hydration, blood sugar and silent urinary-tract issues.

    • Colour
    • Appearance
    • Specific Gravity
    • pH
    • Protein
    • Glucose
    • Ketones
    • Bilirubin
    • Urobilinogen
    • Nitrite
    • Leukocyte Esterase
    • Blood (occult)
    • RBC micro
    • WBC micro
    • Epithelial Cells

  11. Physical biomarkers

    10 markers

    Bloods tell you what’s happening inside. We also measure your body working - same visit, same record. Most labs never touch this.

    • Grip Strength (dominant)
    • Grip Strength (left)
    • Waist Circumference
    • BMI ƒ
    • Systolic BP
    • Diastolic BP
    • Resting Heart Rate
    • Body Temperature
    • Height
    • Weight

  12. Clinical risk scores

    4 scores

    Four validated scores computed from your results and intake - turning raw markers into 5-10 year risk, with no extra blood.

    • Cardiovascular risk
    • Metabolic syndrome
    • Liver fibrosis (FIB-4)
    • Insulin resistance (HOMA-IR / TyG)

ƒ marks a calculated value, derived from other markers rather than measured directly. add-on and reflex mark tests that run when your results or history call for them.

Reference ranges are benchmarked to optimal bands tied to healthy ageing, calibrated to your age, sex and Thai-appropriate data - and every result is read by your physician in the context of your full panel, history and goals. This guide is educational, not a diagnosis.

Two ranges rather than one

Your last blood test came back normal. That is a low bar.

A laboratory range is drawn wide enough to catch disease. The window where you actually feel and perform well sits inside it, and is much narrower. We read every marker against both.

A reference range is a statistical band. It describes the values expected in a typical community population, which is why a result inside one does not establish that you are well, and a result outside one does not by itself establish disease. A decision limit, tied to the risk of a specific outcome, is a different instrument. Your lab report mostly carries the first kind.[1]

So “normal” means common, in a population where being well is not the common case: 12% of American adults met every criterion for optimal metabolic health.[2] Ferritin shows how far that can go. A systematic review found laboratory lower limits sitting below the level that diagnoses iron deficiency, and often not rooted in strong evidence, so a result can be reported normal and be deficient.[3]

No bar carries a number. Ranges are set per person against your age, sex, history and previous panels, and your physician sets them with you, never a chart on a website.

  • Your own history

    Every panel is read against your previous ones. A number that has moved matters more than a number that is merely inside a band.

  • Your age and sex

    A single range built on everyone fits nobody. The window shifts across a life, and it is not the same window for both sexes.

  • What you are training for

    The window for someone in season is not the window for someone recovering from illness. The target follows the work.

How to read itIllustrative
  • Laboratory range
  • Optimal window
  • A reading

  • ApoB

    Heart Health

    Normal to a lab, outside optimal. Counts the atherogenic particles themselves, which a standard cholesterol panel does not.[4]

  • Fasting insulin

    Metabolism

    Inside the optimal window. Insulin sensitivity falls for years before fasting glucose moves, so it moves early.[5]

  • hs-CRP

    Blood & Immune

    Normal to a lab, outside optimal. Low-grade inflammation sits inside the normal band for years without ever being flagged.

  • Ferritin

    Vitamins & Minerals

    Normal to a lab, outside optimal. Laboratory lower limits often sit below the level that diagnoses iron deficiency.

Markers that change the plan

A longer list is only worth it if you can read it.

Six markers a standard annual rarely runs, and what each one actually tells you about the decade ahead.

  • Causal

    Apolipoprotein BApoB

    What it is
    One count of every cholesterol particle that can lodge in an artery wall - a single number for atherogenic risk.
    Why it matters
    A stronger predictor of cardiovascular events than standard LDL-C, and it moves 5-10 years before symptoms.
    What moves it
    Saturated fat, soluble fibre, body composition, exercise - and medication when the number warrants it.
  • Lifelong

    Lipoprotein(a)Lp(a)

    What it is
    A largely inherited lipoprotein you’re born with - tested once, for life.
    Why it matters
    An independent, often-missed driver of heart-disease risk that raises the urgency of every other number.
    What moves it
    Mostly fixed by genetics - so it changes how aggressively we manage the markers you can.
  • Early

    Fasting insulin + HOMA-IRƒ

    What it is
    How hard your pancreas works to keep blood sugar normal. HOMA-IR turns it into an insulin-resistance score.
    Why it matters
    Rises years before glucose does - the earliest readable sign of metabolic drift, and rarely tested elsewhere.
    What moves it
    Carbohydrate quality, body fat, zone-2 cardio and strength training.
  • Inflammation

    High-sensitivity CRPhs-CRP

    What it is
    A sensitive marker of systemic, low-grade inflammation.
    Why it matters
    Chronic inflammation is an upstream driver of ageing and cardiovascular risk - often completely silent.
    What moves it
    Sleep, body fat, recent infection, training load, and recovery.
  • Calculated

    FIB-4 fibrosis indexƒ

    What it is
    A score from age, ALT, AST and platelets that estimates liver scarring - no scan, no extra blood.
    Why it matters
    Fatty-liver disease is common and silent; FIB-4 is a first-line way to catch fibrosis risk early.
    What moves it
    Weight, alcohol, blood-sugar control - the same levers as metabolic health.
  • Core

    eGFR & Cystatin Cfiltration

    What it is
    How well your kidneys filter your blood - estimated from creatinine, then confirmed with Cystatin C.
    Why it matters
    Cystatin C is less affected by muscle mass, so it catches early decline that creatinine alone can miss.
    What moves it
    Hydration, blood-pressure control, and protein load.

About the tests.

Preparation, timing, and which ones you actually need.

References

  1. 1.Ozarda, Y., et al. (2018). Distinguishing reference intervals and clinical decision limits, a review by the IFCC Committee on Reference Intervals and Decision Limits. Critical Reviews in Clinical Laboratory Sciences. PMID:30047297
  2. 2.Araújo, J., Cai, J., & Stevens, J. (2019). Prevalence of optimal metabolic health in American adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders. PMID:30484738
  3. 3.Truong, J., et al. (2024). The origin of ferritin reference intervals: a systematic review. The Lancet Haematology. PMID:38937026
  4. 4.Borén, J., et al. (2020). Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal. PMID:32052833
  5. 5.Tabák, A. G., et al. (2009). Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. The Lancet. PMID:19515410
Performance medicine membership

Bangkok’s performance medicine membership.

Medicine, nutrition and training under one plan, on one record, with a doctor reading it every month, and a full re-measurement every quarter that the plan has to answer to.

  1. A physician review every month

    Not once a year, and not only when something looks wrong. Your results, your plan and what actually happened last month, reviewed by the doctor who wrote it.

  2. Nutrition and training, prescribed

    A coach and a nutritionist working from the same record as your physician. The plan is written, programmed and adjusted, rather than handed over as advice you have to implement alone.

  3. Re-measurement every quarter

    Over 100 biomarkers, body composition and the functional tests, re-run and compared against your own baseline. The plan answers to the evidence, or it changes.

Between the appointments

Ask Orba
The clinic's AI, grounded in your own record: every panel you have ever had, rather than the internet. Ask why a marker moved at eleven at night and get an answer that has read your history.
Your physician, between reviews
Message the doctor who wrote your plan, rather than whoever is on shift. Between reviews it runs over chat, with your coach on the same record. The monthly review is the floor.
Bloods where you are
Home or office, anywhere in Bangkok, or in clinic if you would rather. A quarterly re-test should not cost you a morning.
It runs while you travel
The plan, the coaching and the monitoring continue remotely when you are out of the country. The record does not pause because you did.

What a quarter looks like

Weekly
Coach check-in: what was prescribed, what happened, what got in the way.
Monthly
Physician review of your plan, your adherence and anything that has moved.
Quarterly
Full re-measurement, then a rewrite of the protocol against the new numbers.
Start with the baseline

The method only works from a measurement.

Everything above starts at the same place: one visit that maps where you actually are. What follows is decided by what that visit finds.

See the full protocol

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