255. Lipoprotein A, DHEA sulfate, beta-2-microglobulin: the biomarkers most longevity protocols ignore and why they matter - withMike Lustgarten

Mike Lustgarten holds a PhD in physiology and spent years as a research scientist at the Tufts Human Nutrition Research Center on Aging, studying gut microbiome composition and blood metabolomics in older adults. In mid-2025 he left academia to go full-time with his platform, Conquer Aging or Die Trying. Since 2015 he's tested his blood 8 times per year, runs 25+ microbiome panels, 20+ epigenetic tests, and logs the weight of every food he eats to correlate diet changes directly against biomarker movement.

He asked for blood tests more than once a year. His doctor wrote "suffers from anxiety" in his medical record.

→ Lipoprotein A: doctors say "measure it once, it's genetic." He's run 50 tests since 2015 and moved his average from peaks of 145 nanomolar down to 88, with some tests approaching 70. The recipe matters. The data says so
→ HDL was 28mg/dL on a high-carb bodybuilding diet. Now consistently 50 to 69mg/dL for 18 tests in a row, inside his self-defined optimal range. Four dietary variables explain 81% of the variability. Identified entirely through his own correlations
→ Eating 200g of sardines per day may have raised his homocysteine from 8 to 12 micromolar in a single test period. The proposed mechanism: inorganic arsenic in sardines requires methylation to be excreted, depleting adenosylmethionine and disrupting homocysteine metabolism. He's now switched to salmon to test the hypothesis
→ On Brian Johnson, biohacking as a term, DHEA sulfate declining despite optimal testosterone, and why "analysis by paralysis" is the real risk of wearables: all covered, without pulling punches

If your GP told you your labs are fine and you still don't feel fine, this episode is the argument for why "within reference range" and "optimal" are not the same thing.