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Leonid Kim MD - 5 Critical Blood Tests EVERYONE Should Get (But Very Few Do)

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Author: Leonid Kim MD
Categories: Health
Tags: health
Views: 3 · Last viewed: 2026-10-16 15:01 UTC

Short Summary

Main recommendation: Ask about five blood tests that routine annual labs often miss, since they can catch early disease before symptoms or organ damage appear: Lipoprotein(a) (Lp(a)), Apolipoprotein B (ApoB), homocysteine (with MTHFR), uric acid, and cystatin C. The speaker also flags ALT, a liver enzyme test that is usually reported as normal but may already signal fatty liver disease. The video is educational only and not medical advice, so results should be reviewed with a doctor.

Key Points

  • The five promised tests are: 1) Lipoprotein(a) (Lp(a)), 2) Apolipoprotein B (ApoB), 3) Homocysteine (+/- MTHFR), 4) Uric acid, 5) Cystatin C.
  • Dr. Kim says Lp(a) is largely genetic, elevated in about one in five Americans, and roughly triples heart attack risk in people under 45; he recommends checking it once, especially with premature family heart disease.
  • Dr. Kim explains ApoB counts every atherogenic particle (LDL, IDL, VLDL), so in his view it predicts heart risk better than LDL-C, particularly with insulin resistance.
  • Dr. Kim treats uric acid and homocysteine as early markers of metabolic and cardiovascular risk, not just gout or vitamin status.
  • Dr. Kim notes that cystatin C gives a kidney function estimate less affected by muscle mass than creatinine.

Details Worth Noting

  • Concrete instructions: Ask your doctor to check Lp(a) once in your lifetime, especially if a family member had premature heart disease (before 55 in men, before 65 in women).
  • Concrete instructions: Request an ApoB test alongside a standard lipid panel; the speaker's longevity target is below about 60 mg/dL for most people.
  • Concrete instructions: For homocysteine, ask about B12, folate (B9), and B6 status; the speaker's target is below 10, possibly lower with added risk. If MTHFR variation is found, the speaker may suggest methylated B vitamins.
  • Concrete instructions: Check uric acid at least yearly, more often with insulin resistance, high blood pressure, heart disease, or fatty liver; the speaker aims for below 5.5 and advises looking at trends over several readings, since exercise can raise it temporarily.
  • Concrete instructions: Ask for cystatin C alongside creatinine for a fuller kidney assessment, since it can be affected by obesity, inflammation, or thyroid problems.
  • Concrete instructions: Ask whether ALT is interpreted against a healthier range; the speaker aims for ALT below 25 and suggests further workup above that, for fatty liver and insulin resistance.
  • The speaker notes that the ALT upper limit of 40 has drifted upward, and that the ACG guidelines consider healthy ALT roughly 29–33 in males and 19–25 in females.
  • The speaker says the 10-year ASCVD calculator is too short a window for plaque, which starts in early life.

Bottom Line

Routine labs may look normal while early risk is building, so ask your doctor about Lp(a), ApoB, homocysteine, uric acid, cystatin C, and a closer ALT review, and interpret them with professional guidance.