This is a real Revi Longevity case study from a 29-year-old active woman in the UK. Her standard bloodwork looked mostly normal, but deeper longevity bloodwork highlighted two early optimisation opportunities: cholesterol-carrying particles and thyroid antibodies.
This is the point of Revi: Identifying your largest longevity opportunities, and the actions with the biggest impact — before small patterns become harder to move.
Summary
| 91.2 |
| Lipid & Heart 78.1 |
| Reduce cholesterol-carrying particles |
|
|
| 1. Inform GP - Confirm thyroid antibody pattern 2. Shift fat quality + increase soluble fibre 3. Develop a Zone 2 base |
| Omega-3 · soluble fibre · magnesium · B12 · folate · selenium (GP-gated) |
| Metabolism, liver, kidney, energy, body, lifestyle, most vitals — and Lp(a) optimal |
Data inputs
Summarised for the case study — we capture significantly more than this when you're onboarded to Revi.
| 29, female, 5'4", 61.8 kg · BMI 23.1 · waist-to-height 0.42 |
| Blood pressure 107/72 · resting pulse 77 |
| Trains 5 h/week · 2 units alcohol/week · 7 h sleep · non-smoker |
Her scores
Every system is scored against longevity-optimal — not just "in range." 100 = optimal; a lower score flags where there's the most to gain. Five of her eight systems are strong / optimal; one is the clear focus.
System | Score | Status |
|---|---|---|
| 78.1 | 🔴 Focus |
| 81.9 | 🟠 Opportunity |
| 84.9 | 🟠 Opportunity |
| 95.3 | 🟢 Strong |
| 95.4 | 🟢 Strong |
| 95.5 | 🟢 Strong |
| 99.0 | 🟢 Optimal |
| 99.5 | 🟢 Optimal |
What the engine connected
Rather than flag markers one by one, the engine groups related markers into patterns and ranks them by opportunity — how big and how real the gap is. Scored on the same 0–100 scale as the systems (higher = closer to optimal), so the lowest score is where the work is.
What the engine connected | Score | Strength | Flagged markers |
|---|---|---|---|
| 84.2 | 🔴 Biggest | LDL, ApoE, total cholesterol, ApoB |
| 86.5 | 🟠 Present* | hs-CRP, white cells |
| 88.8 | 🟠 Present | Anti-TPO antibody, FT4 |
| 92.7 | 🟠 Present | ApoA-I, HDL |
| 93.8 | 🟡 Emerging | Omega-3 index, AA:EPA ratio |
*Inflammation is training-confounded — hs-CRP can read higher when hard training has happened in the last 24–48 hours.
The two most significant findings
These are the markers behind the two findings that matter most, shown against their clinical reference range. 🔴 = outside reference · 🟠 = in range but short of optimal.
Finding 1 — Cholesterol-carrying particles (atherogenic lipid pattern)
Cholesterol itself is not the full story. What matters most is how many particles are carrying cholesterol through the blood, because those particles can enter artery walls over time.
In her case, LDL cholesterol, total cholesterol and ApoE were above range, while ApoB was still technically “in range” but higher than Revi’s optimal target. That means this was not an emergency — but it was a clear early cardiovascular optimisation opportunity.
The goal is simple: reduce the number of cholesterol-carrying particles over time through fat quality, soluble fibre, omega-3 intake and aerobic fitness.
Marker | Her result | Reference range | Status |
|---|---|---|---|
| 3.4 mmol/L | under 3.0 | 🔴 ↑ above reference |
| 5.63 mmol/L | under 5.0 | 🔴 ↑ above reference |
| 8.57 mg/dL | 2.2–7.3 | 🔴 ↑ above reference |
| 87 mg/dL | 53–182 | 🟠 within range, above optimal |
| 1.76 mmol/L | 1.55–2.5 | 🟠 within range, below optimal |
| 138 mg/dL | 95–176 | 🟠 within range, below optimal |
Finding 2 — Thyroid (early autoimmune signal)
Anti-TPO antibodies are immune proteins that can appear when the immune system is reacting against thyroid tissue.
Her thyroid hormone markers were not showing obvious thyroid disease, but Anti-TPO was above range. That does not mean she has a thyroid condition now. It means the pattern is worth knowing about, discussing with a GP, and monitoring early — before thyroid function changes.
This is exactly where early bloodwork is useful: not panic, but awareness.
Marker | Her result | Reference range | Status |
|---|---|---|---|
| 56.2 kU/L | under 34 | 🔴 ↑ above reference |
Her top 3 actions
═══════════════════════════════════════════════════════
Priority 1 — Discuss thyroid antibodies with your GP
GP Priority
Why: Anti-Thyroid Peroxidase Antibody is above its reference range, and while the elevation is modest, it sits alongside Free Thyroxine above its optimal zone — This does not diagnose thyroid disease, but it is a useful early signal to monitor — especially if it persists on repeat testing or is accompanied by changes in TSH, FT4, FT3, symptoms, or other antibodies.
Affects (Hormones): Anti-Thyroid Peroxidase Antibody · Free Thyroxine (FT4)
═══════════════════════════════════════════════════════
Priority 2 — Shift fat quality and add soluble fibre
Biggest multiplier
Why: Cholesterol-carrying particles — LDL, Total Cholesterol, and Apolipoprotein E — are all above their reference ranges, and HDL and Apolipoprotein A-I are both below their optimal zones, forming a coherent pattern where the highest-leverage first move is improving fat quality, increasing soluble fibre, and retesting the lipid response.
Affects (Lipid & Heart): LDL Cholesterol · Total Cholesterol · Apolipoprotein E · HDL Cholesterol · Apolipoprotein A-I
═══════════════════════════════════════════════════════
Priority 3 — Build a Zone 2 aerobic base
Cross-system driver
Why: Your resting pulse is above its optimal zone and both HDL Cholesterol and Apolipoprotein A-I are below their optimal zones — This may suggest that her aerobic base is less developed than her overall training volume implies — especially if most sessions are higher-intensity or strength-focused.
Affects (Lipid & Heart · Inflammation & Immune): HDL Cholesterol · Apolipoprotein A-I · Resting Pulse · C-Reactive Protein (hs-CRP)
Which supplements to add — and why
Each chosen for a specific gap in her bloodwork — framed for diet, tolerance and GP advice, not a blanket stack.
Supplement | Why — the gap it closes | Tier |
|---|---|---|
| Omega-3 index below optimal, EPA low, AA:EPA ratio high — her top supplement; supports the lipid and inflammation picture | Foundational |
| LDL & total cholesterol 13% above reference, ApoB above optimal — first-line soluble-fibre lever | Tier 1 |
| Magnesium 53% below optimal — a substantial gap, given her training volume and stress load | Tier 1 |
| Below optimal — part of the B12 / folate / magnesium nutrient pattern (energy, methylation) | Conditional |
| Below optimal — part of the same nutrient pattern (methylation, red-cell health) | Conditional |
| Selenium — Anti-TPO above reference — one of the better-studied nutritional options for thyroid antibody patterns, but only if appropriate and GP-aware | GP-gated |
Her plan — by priority area
Grouped by what the engine flagged. Each area carries everything that moves it — diet, training, supplement (type + dose), GP, retest — so each problem and its complete answer sit together.
1 · GP — Thyroid antibody
What fired: anti-TPO 56.2 (above 34), Free T4 above optimal.
Action | Exactly what to do |
|---|---|
See your GP (priority) | Book an appointment. Ask about: (1) whether a repeat anti-TPO is useful, (2) whether a full thyroid panel including Free T3 is warranted, (3) FT4 follow-up. Keep a brief log of symptoms (fatigue, temperature sensitivity, hair changes, mood). |
Selenium (GP-aware) | Discuss with your GP: selenomethionine 200 mcg/day (never exceed 400 mcg/day — narrow therapeutic window). Supports the antibody pattern; doesn't replace GP review. Food: brazil nuts, 1–2 a day is plenty. |
Support immune regulation | Consistent sleep and stress reduction. |
Monitor | Retest anti-TPO + TSH + Free T4 + Free T3, fasted before 09:00; repeat at 3–6 months, then annually. |
2 · Focus — Cholesterol-carrying particles (fat quality + fibre)
What fired: LDL 3.4, total cholesterol 5.63, ApoE 8.57 above reference; ApoB above optimal.
Action | Exactly what to do |
|---|---|
Improve fat quality | Extra-virgin olive oil 1–2 tbsp/day; oily fish (salmon, mackerel, sardines) 2×/week, 140 g portions; cut butter, processed meat and full-fat dairy from the same meals. |
Increase soluble fibre | Build to 30–40 g/day (≥10 g viscous): 40–60 g rolled oats at breakfast + 150 g cooked lentils or black beans at lunch + psyllium each evening. Build up over 2 weeks. |
Psyllium husk (supplement) | 1 tbsp (~5 g) in a large glass of water each evening, from week 1 → twice daily after 2 weeks if tolerated. Always with a full glass of water; space ≥2 h from any medications. |
Monitor | LDL, total cholesterol and ApoE trending down by 8–12 weeks. |
3 · Optimisation — Fatty acids (Omega-3)
What fired: Omega-3 Index, EPA below optimal, AA:EPA ratio above optimal.
Action | Exactly what to do |
|---|---|
Eat more oily fish | Salmon, mackerel or sardines 2×/week, 140 g — the primary lever; raises the Omega-3 Index and pulls the AA:EPA ratio down. |
Omega-3 supplement (food-first) | If the Omega-3 Index is still below optimal at the 12-week retest, add an EPA/DHA supplement. |
Monitor | Omega-3 Index & AA:EPA ratio begin shifting at 4–6 weeks. |
4 · Focus — Protective cholesterol (Zone 2)
What fired: HDL 1.76 & ApoA-I 138 below optimal; resting pulse above optimal.
Action | Exactly what to do |
|---|---|
Build a Zone 2 base | 3–4 sessions/week, 45–60 min, conversational pace (60–70% max HR) — cycling, incline walking or rowing. Track resting pulse weekly on waking. |
Optional VO2-max block | One session: 4 × 4 min at 90–95% max HR, 3 min easy recovery between, 10-min warm-up + 5-min cool-down. |
Monitor | Resting pulse falling by 4–6 weeks; HDL & ApoA-I by 8–12 weeks. |
5 · Re-test — Inflammation (confirm, don't chase)
What fired: hs-CRP 1.22 above Revi's low-inflammation target — may be training-related.
Action | Exactly what to do |
|---|---|
Balance training | Cap high-intensity at 1–2 sessions/week; make 2–3 moderate; leave ≥48 h between hard sessions. |
Retest hs-CRP | Fasted, before 09:00, ≥72 h after any hard training — checks whether the signal persists away from recent hard training. |
Monitor | Settles within 4–6 weeks if training-driven; hs-CRP signal clear at 6–8 weeks. |
6 · Optimisation — Nutrient pattern (magnesium, B12 & folate)
What fired: magnesium 53% below optimal; active B12 & folate below optimal.
Action | Exactly what to do |
|---|---|
Magnesium | Glycinate or threonate (avoid oxide), 200–400 mg elemental, evening ~30 min before bed, from day 1. Foods: 30 g pumpkin seeds, 100 g cooked spinach, 20 g dark chocolate (85%+), almonds, black beans. |
B12 + folate | Active B12 + methylfolate (methylated forms) — food-first; low-dose only if diet doesn't rebuild them. Folate foods: 90 g cooked spinach or 150 g lentils, 3–4×/week. |
Protein | 1.4–1.6 g/kg/day (~87–99 g) across 3–4 meals. |
Monitor | Magnesium, B12 and folate at 8–12 weeks. |
Revi — the Longevity Decision Engine. Most blood tests give you numbers. Revi tells you what matters most, why, and what to do first.
This case study is for educational purposes and is not medical advice. Findings are patterns to discuss with a qualified clinician, not diagnoses. Shared with the client's permission; some details summarised for privacy.
Cris Hesketh
Founder, Revi Longevity
revilongevity.com
