You don't need to track everything. You need to track the metrics that actually predict long-term health outcomes—and know what your numbers mean beyond "normal range."
Biomarkers are measurable indicators of biological state or condition. They're how you turn subjective feelings ("I think I'm healthy") into objective data ("Here's what my body is actually doing").
For Black women, biomarker tracking isn't just about optimization—it's about advocacy. When you walk into a doctor's office with data, you change the conversation. You're no longer asking for permission to be taken seriously. You're presenting evidence.
This guide covers the essential biomarkers every woman should track, why they matter, how to measure them, and what to do when your doctor dismisses your concerns.
The Foundation: Cardiovascular Health
1. Blood Pressure
Why it matters: Cardiovascular disease is the leading cause of death for Black women. High blood pressure often has no symptoms until damage is done. Tracking this metric is non-negotiable.
Optimal Range
Less than 120/80 mmHg
How to Track
Home monitor, daily
Frequency
Daily if elevated; weekly if optimal
Track at the same time each day, ideally in the morning before eating or drinking caffeine. Sit for 5 minutes before measuring. Take 2-3 readings and average them.
2. Resting Heart Rate
Why it matters: A lower resting heart rate generally indicates better cardiovascular fitness and recovery capacity. It's also an early indicator of overtraining, illness, or chronic stress.
Optimal Range
60-100 bpm (lower is generally better for athletes)
How to Track
Wearable device or manual check
Frequency
Daily upon waking
Check before getting out of bed. A sudden increase of 5+ bpm may signal insufficient recovery, illness, or stress.
3. Heart Rate Variability (HRV)
Why it matters: HRV measures the variation in time between heartbeats. Higher HRV generally indicates better stress resilience and recovery. It's one of the most valuable metrics for understanding nervous system health.
Optimal Range
Highly individual; track trends, not absolutes
How to Track
Wearable (Oura, Whoop, Apple Watch)
Frequency
Daily upon waking
Your baseline is unique to you. A drop of 10-20% from your personal average may indicate you need more recovery. Rising HRV over weeks/months suggests improving resilience.
"Biomarkers don't lie. But they also don't tell the whole story without context, trends, and your lived experience."
Metabolic Health
4. Fasting Glucose
Why it matters: Blood sugar regulation is foundational to metabolic health. Black women have disproportionately high rates of type 2 diabetes. Catching dysregulation early is critical.
Optimal Range
70-85 mg/dL (fasting)
How to Track
Annual lab work or continuous glucose monitor
Frequency
Annually at minimum; quarterly if elevated
Standard "normal" range is 70-100 mg/dL, but optimal for longevity is tighter. Above 100 mg/dL is pre-diabetic territory. Track fasting glucose, HbA1c, and fasting insulin together for full picture.
5. HbA1c (Hemoglobin A1c)
Why it matters: Reflects average blood sugar over the past 2-3 months. More stable indicator than fasting glucose alone.
Optimal Range
Below 5.3%
How to Track
Annual lab work
Frequency
Annually at minimum
5.7-6.4% is pre-diabetic. 6.5% or higher indicates diabetes. If you're in the 5.3-5.6% range, pay attention—this is where intervention matters most.
6. Fasting Insulin
Why it matters: Often overlooked, but critical. High insulin levels occur years before glucose rises. This is your early warning system for metabolic dysfunction.
Optimal Range
Below 5 µIU/mL
How to Track
Lab work (must request specifically)
Frequency
Annually at minimum
Most doctors don't order this test routinely. You may need to ask for it directly. Elevated fasting insulin (above 10) signals insulin resistance, even if glucose is "normal."
Body Composition & Weight
7. Waist-to-Hip Ratio
Why it matters: Better predictor of cardiovascular risk than BMI. Visceral fat (around organs) is more metabolically harmful than subcutaneous fat.
Optimal Range
Below 0.85 for women
How to Track
Measuring tape
Frequency
Monthly
Measure waist at narrowest point (usually just above belly button). Measure hips at widest point. Divide waist by hips. Above 0.85 indicates increased cardiovascular risk.
BIOCULTURAL HEALTH PERSPECTIVE
Black women's bodies are often held to standards developed from research on white populations. Your "optimal" biomarkers may not match textbook ranges. Track your personal trends over time. If you feel great but your numbers are slightly outside the standard range, that context matters. Conversely, if you feel terrible but your numbers are "normal," advocate for deeper investigation. Your lived experience is data too.
Micronutrient Status
8. Vitamin D (25-Hydroxyvitamin D)
Why it matters: Critical for immune function, bone health, mood regulation, and cellular function. Black women are at higher risk for deficiency due to melanin reducing vitamin D synthesis from sunlight.
Optimal Range
40-60 ng/mL
How to Track
Lab work (25-hydroxyvitamin D test)
Frequency
Twice yearly (summer and winter)
Standard "sufficient" level is 30 ng/mL, but research suggests higher levels (40-60 ng/mL) are optimal for Black women. Most need supplementation, especially in winter.
9. Ferritin (Iron Storage)
Why it matters: Women lose iron through menstruation. Low ferritin causes fatigue, brain fog, and hair loss long before anemia shows up. High ferritin can indicate inflammation or iron overload.
Optimal Range
50-100 ng/mL
How to Track
Lab work
Frequency
Annually; more often if symptomatic
Many doctors only check hemoglobin, which can be normal even when ferritin is low. Request ferritin specifically if you have fatigue, heavy periods, or hair loss.
Inflammation & Immune Function
10. High-Sensitivity C-Reactive Protein (hs-CRP)
Why it matters: Measures systemic inflammation. Chronic low-grade inflammation accelerates aging and increases risk for most chronic diseases.
Optimal Range
Below 1.0 mg/L
How to Track
Lab work (high-sensitivity test)
Frequency
Annually
1.0-3.0 mg/L indicates moderate risk. Above 3.0 mg/L is high risk for cardiovascular disease. Can be elevated by recent illness, injury, or infection, so retest if high.
Sleep Quality
11. Sleep Efficiency & Deep Sleep Percentage
Why it matters: Sleep quality predicts longevity better than sleep duration. Deep sleep is when your body repairs tissues, consolidates memory, and clears metabolic waste from the brain.
Optimal Sleep Efficiency
85% or higher
Optimal Deep Sleep
15-25% of total sleep
How to Track
Wearable device (Oura, Whoop, etc.)
Sleep efficiency = (time asleep / time in bed) × 100. If you're in bed 8 hours but only sleep 6, your efficiency is 75%—indicating sleep quality issues.
How to Advocate When Your Doctor Dismisses Your Data
Black women's health concerns are routinely dismissed. When you bring biomarker data to your doctor and get pushback, here's how to respond:
1. Document everything. Keep a health journal. Note symptoms, when they occur, severity, and how they affect your life. Bring this to appointments.
2. Use specific language. Instead of "I'm tired," say "My ferritin is 22 ng/mL and I experience daily fatigue that interferes with work."
3. Request tests in writing. If your doctor refuses a test you want, ask them to document their refusal in your chart. This often changes the conversation.
4. Bring a list of questions. Write them down beforehand. Don't leave until they're answered.
5. Get a second opinion. If your doctor consistently dismisses your concerns, find a new provider. Your health is too important.
6. Know the difference between "normal" and "optimal." "Normal range" is based on population averages, not what's best for longevity. Advocate for optimal ranges.
"Your biomarkers are your baseline. Track them consistently, understand what they mean, and use them to advocate for the care you deserve."
Getting Started: Your First 90 Days
Month 1: Establish Baselines
- Get comprehensive lab work (metabolic panel, lipids, vitamin D, ferritin, thyroid, hs-CRP)
- Buy a home blood pressure monitor
- Measure waist-to-hip ratio
- Track resting heart rate manually or with wearable
Month 2: Build Tracking Habits
- Check blood pressure daily (same time each day)
- If using wearable, sync HRV and sleep data daily
- Note patterns: How do sleep, stress, and exercise affect your biomarkers?
Month 3: Optimize & Adjust
- Review your data. What's trending in the right direction? What needs attention?
- Make one targeted change based on your data
- Retest biomarkers that were out of range
Biomarker tracking isn't about obsession. It's about awareness. When you know your numbers, you can make informed decisions. When you track trends over time, you catch problems early. And when you walk into a doctor's office with data, you change the power dynamic.
Your biomarkers are your baseline. Use them wisely.
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