The Limits of Wearable Data External Focus: Wearables measure what’s happening outside—your movement, heart rate, skin temperature, sometimes blood pressure or oxygen. These data are useful for tracking activity and some cardiovascular trends, but they don’t reveal what’s happening in your blood, gut, hormones, or immune system (Estes, 2023). No Insight into Internal Biomarkers: You can’t detect vitamin deficiencies, hormone imbalances, cholesterol, blood sugar patterns (unless you use a specialised glucose monitor), liver/kidney function, microbiome balance, early inflammation, or disease signals—only laboratory testing can do that (Huhn et al., 2022) (Doherty et al., 2024). Early Disease Detection Gaps: Diabetes, anaemia, thyroid issues, cancers, autoimmune diseases develop silently and often won’t trigger wearable alerts until it's progressed (Metwally et al., 2025) Nutritional and Metabolic Blind Spots: Wearables can’t flag deficiencies, toxic exposures, or metabolic health—issues hidden deep within your biochemistry (Belabbaci et al., 2025). Why Wearables Can't Fill These Gaps Technological Constraints: Sensors can only pick up signals non-invasively through the skin. They can’t access circulating blood biomarkers or organ-specific processes (MDPI biosensor review, 2024) (ObvioHealth, 2025) Lack of Clinical Validation: Most consumer wearables aren’t validated in clinical settings. Only about 11 % of devices are validated for any biometric outcomes, and only ~3.5 % of outcomes are validated across all available devices (Doherty et al., 2024). Accuracy Challenges: Optical sensors (like PPG for heart rate) can be inaccurate during movement due to signal noise and light interference (Nature Digital Medicine, 2020) (Bent et al., 2020) Data Overload & Interpretation Issues: Even when accurate, the vast, fragmented data can confuse users and clinicians without context. Common issues include missing data, false readings, and interpretation errors (Johns Hopkins, 2023) (VanDerDonckt et al., 2024). False Sense of Security: Good wearable data doesn’t guarantee internal health. You could have hidden inflammation, cholesterol issues, or early disease despite “green” wearable metrics (Estes, 2023). What’s Missing: The Full Health Picture To understand your complete health story, you need both external tracking and internal biomarker testing. Wearables are excellent behaviour trackers - but blood, saliva, and stool tests reveal what’s really going on. What Wearables Can’t See: Blood Chemistry: Glucose, cholesterol, vitamins, hormones, inflammatory markers (e.g., CRP), liver/kidney health, tumour DNA (knowing cancer risk early via ctDNA testing) Gut Health: Microbiome composition, gut inflammation or permeability—only from stool or specialised laboratory analysis. Immune Profiling: White blood cell counts, antibodies, cytokine levels, signs of infection or autoimmune activity. Early Disease Risk: Many conditions show up in blood or saliva before impacting heart rate or sleep. For example, combining wearables with blood biomarkers helps predict insulin resistance with 80 %+ accuracy (Metwally et al., 2025). The Psychological and Social Dimensions Unmeasurable But Important: Emotional wellbeing, stress resilience, satisfaction, social support - all crucial to health but invisible to sensors (Crainiceanu & Simirnova, 2020) Environmental & Societal Context: Factors like living conditions, relationships, and social determinants profoundly affect health - most wearables ignore this bigger picture (RAND, 2022) (Belabbaci, Anaadumba and Alam, 2025). Wearables vs. Internal Health Testing What Wearables Track What Internal Tests Reveal Steps, heart rate, sleep Blood markers, hormones, nutrients Skin temperature, O₂, ECG Gut health, microbiome, inflammation Activity, calories, recovery Disease risk, organ function, immune profile Behaviour trends ctDNA, mental health, stress, social & environmental factors Your Combined Health Optimisation Strategy: Follow these three steps for a personalised, science-led health optimisation strategy by combining what wearables can track with what really matters under the surface: your biomarkers. Step 1: Match Wearable Data with Key Biomarkers Here’s how we link wearable insights with lab tests to get the full picture: Wearable Insight What It Suggests What You Should Test Low energy, poor sleep Hormonal dysregulation, nutrient deficiencies Cortisol, Melatonin, B12, Iron, Vitamin D, Thyroid Panel (TSH, T3, T4) High resting heart rate (HRV dips) Stress, inflammation, poor recovery CRP (inflammation), Cortisol, Omega-3/6 balance, HbA1c, Electrolytes Sleep disturbances Hormone imbalance, gut disruption Melatonin, Cortisol (diurnal), Gut Microbiome Profile, Magnesium, Oestrogen/Testosterone Plateau in fitness/performance Nutrient deficiencies, testosterone, anaemia Testosterone, Haemoglobin/Ferritin, Creatinine (kidney health), Vitamin D Weight gain or stubborn belly fat Blood sugar issues, insulin resistance, stress HbA1c, Fasting Insulin, Cortisol, Thyroid Panel, Oestrogen/Testosterone Frequent illness or low resilience Immune dysregulation, gut permeability WBC count, CRP, Immunoglobulins, Vitamin C & D, Zinc, Gut microbiome markers Step 2: Foundational Biomarker Testing (Recommended Every 6–12 Months) For a baseline that pairs beautifully with wearable insights, consider testing the following: Core Blood Health Full Blood Count (FBC): Infections, anaemia, immune status CRP (C-Reactive Protein): Inflammation marker Ferritin & Iron: Oxygen transport, energy Vitamin B12 & Folate: Cognitive, nerve & DNA function Metabolic & Hormonal Markers HbA1c & Glucose: Blood sugar control Thyroid Panel (TSH, Free T3, Free T4): Energy, metabolism, weight Testosterone, Estradiol, Cortisol: Performance, stress, libido, fat distribution Cardiovascular & Liver Cholesterol Profile: HDL, LDL, triglycerides Liver Function (ALT, AST, GGT): Detox pathways, inflammation Micronutrient Status Vitamin D: Immune, bone & mood Zinc & Magnesium: Recovery, stress, immune modulation Step 3: Create a Loop Between Wearables & Testing Think of it as a feedback loop: Wearables identify trends → Sleep decline? HRV dipping? Performance off? Lab tests validate or explain why → Is it hormonal? Inflammatory? Nutrient-related? You optimise with targeted changes → Supplementation, stress reduction, diet shift, etc. Track improvements with both tools → Re-test and monitor wearable trends to confirm impact. TL;DR: In Conclusion Wearables offer helpful real-time insights into your behaviour. But they only scratch the surface. For full health optimisation, pair them with routine internal testing - blood, saliva, stool. That’s when you get deep biological insight, early warning signs, and actionable data.